Does the large sums of money poured into African AIDS relief qualify as an accomplishment?
Absolutely. IIRC it's been estimated that something like 2 or 3 MILLION lives have already been saved. (Actually I think I saw that figure a few years ago.) It's probably been one of the most successful aid initiatives in human history, especially because of it's direct benefits wrt to human productivity, a key factor in the economic growth (or lack thereof) in developing economies.
On a closely related issue Bush deserves major kudos for achieving greater success in foreign aid reform -- e.g tying aid to good governance, channeling much of it through more accountable private agencies or public/private partnerships, requiring higher standards of accountability and transparency, using it in ways that establish infrastructure for follow on private investment instead of huge government projects, etc -- than any preceding President.