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Notes -
The PEPFAR numbers get complicated, even under their own assumptions, if you look at them remotely critically. USAID as a whole have numbers some more plausible backing, but that's damning with faint praise, and they're still not that plausible.
Part of this is the difficulty of getting any serious numbers at scale: you can't get a good measure of how many people are dying of what cause in Somalia for the same reasons people are (presumably) dying in Somalia.
More of it's because they had easy metrics that showed they were Doing Something, and a lot of reasons to conflate Doing Something with actual productive impact, and very few people with the ability to investigate those numbers had or have the ability to promote their findings. So you get a lot of statistics where the underlying measure is partly or mostly money spent, sometimes added through many other statistics that are partly money spent.
The political impact is messy, and virtually unprovable and undisprovable. The steelman arguments are less a clear fund labeled 'make sure Lula gets reelected', and pretty much any spending could also have a side effect of an army dedicated to promoting a specific political viewpoint or blamming the political opposition, but it's not clear what proof would look like, and even less clear what would be needed to show it didn't happen.
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