We need a little uplift, a reminder that although world leaders today from Washington to London to Beijing may be dishonest vandals, it doesn't have to be that way.

Even flawed presidents and prime ministers can act in noble ways, and we saw that in the 2000s when George W. Bush, Tony Blair and others made a heroic effort to tackle AIDS and malaria and save children's lives around the world. European and American leaders backed the Global Fund to Fight AIDS, tuberculosis and malaria, which since 2002 has saved 32 million lives. That's not a misprint. And some 17 million of those lives are from PEPFAR, an AIDS program that Bush founded.

Gavi, the Vaccine Alliance, has saved 13 million lives. Credit:Peter Braig

Then there's Gavi, the Vaccine Alliance, created in 2000 with public and private backing: it has saved 13 million lives. We live in an age of miracles when a group of public health nerds, backed by world leaders and front-line health workers, can save lives by the million. These may be the greatest successes in the history of human governance. Only half as many children now die worldwide as did in 2000. That's 5 million children's lives saved each year.

Yet today, the kind of global leadership we saw in the early 2000s is gone. Bravo to French President Emmanuel Macron for remaining a supporter of multilateral aid, but he's the exception. President Donald Trump has tried to slash aid, although in Congress, Republicans and Democrats alike have resisted, and Trump used his speech last month to the United Nations to preach nationalism.