AIDS Relief: Saving Millions to Save Ourselves
by Swanee Hunt, Scripps Howard News Service, June 18, 2003

President Bush’s AIDS bill has brought staggering statistics back onto the front page. The pandemic has killed an estimated 23 million of more than 60 million people infected. Nearly three-quarters of this global total are in sub-Saharan Africa, where young women account for nearly 60% of HIV infections, and are twice as likely to contract the disease as males the same age. AIDS has orphaned over 11 million children in the region.

Behind these numbers are victims without health care or medicine, families unable to care for dying relatives, teenagers and adults uneducated about the basics of safe sex. The tragedy was brought home to me with a letter from a South African friend watching her sister die from the disease she contracted from her husband.

“I shared the fear of, and nearness of, death, trying to lessen her pain while struggling with mine. Being close to the ravages of AIDS has made me realize once again that only when there is a face and name can we begin to understand the trauma behind the AIDS statistics in South Africa.

“We are blessed that my sister has a family that loves and supports her…as her body tries to fight the destruction caused by this awful disease. However, many AIDS sufferers in South Africa have been abandoned by their families and ostracized by their communities. They face the trauma of this terrible disease and of isolation at a time they need support the most. Theirs will be a lonely death.

“Some of my family members, my mother included, started talking about my sister in the past tense. … [My sister] told me that more than the pain from her illness, what is most difficult to deal with is the humiliation; having to be washed and fed, to be supported to walk…. She is a very independent person who has been the doer, instead of the done-for. She is an elegant, beautiful woman. To watch her disappear before my eyes into a shadow of herself has been one of the most painful experiences in my life.”

To prevent such senseless deaths, the U.S. recently passed the global AIDS relief bill spearheaded by the administration. The law triples what the federal government may spend on AIDS and other infectious diseases in Africa and the Caribbean, up to $15 billion incrementally over the next five years. It sounds impressive, but the bill may be an empty promise. The administration has only appropriated about one and a half billion dollars for next year.

Here’s the kicker. For patently domestic political reasons, the bill requires that one-third of AIDS prevention money go to programs that exclusively promote sexual abstinence. But people are not going to stop having sex, no matter what puritanical notion we write into our laws. It’s no surprise that public health experts report that abstinence programs are far less effective than the promotion of condoms and safe sex practices.

In Uganda, an AIDS awareness campaign has dramatically increased condom use: the number of men using condoms more than doubled in five years. That aggressive campaign has reduced the incidence of AIDS from an estimated 18 percent to 5 percent.

In South Africa, a condom campaign has proven extremely successful. But international donations pay for only about three condoms per year for every man in sub-Saharan Africa. Two billion additional condoms are needed annually, according to the Global HIV Prevention Working Group.

What else can we do? The most effective HIV prevention strategies tackle the problem from every possible angle, like promoting protected sex; improving treatment of sexually-transmitted diseases; promoting voluntary testing; preventing mother-to-child transmission; and improving blood safety. Even that’s not enough. The more difficult, but equally important, policy reforms include basic education to increase the economic, political and social power of young women and girls. That education can empower them to take charge of their fates. Millions of women who culturally can’t say “No” are paying the price with their lives.

Two-thirds of the 45 million new infections projected before 2010 could be averted if existing measures were exponentially increased, according to the Prevention Working Group. But until we commit additional funds, persuade the global community to chip in, and aggressively launch prevention and awareness campaigns, this pandemic will continue to rage.

We are all part of the world community and we should bear the burden collectively. As Martin Luther King Jr. preached, “What affects one directly, affects all indirectly.” It’s too late to save my friend’s sister. But it’s not too late to save millions more, and—however indirectly—save ourselves.