Washington, DC — The 'war' on HIV/AIDS has become heated in the last few days as participants attend the 2004 international AIDS conference in Bangkok, Thailand. Unfortunately, the war that has broken out between the United States and France, and, various delegates of different ideological prisms and business orientation/persuasions have done nothing to save even one life of the millions now dying of AIDS or prevent even one young African from contracting the HIV disease. As the war of words continue regarding the best way to fight HIV/AIDS, especially in Africa, more than 8,000 people will die today of AIDS and nearly 15,000 will become infected with HIV, an almost death sentence in many impoverished nations of the world.
Why should we be concerned about a war of words over HIV/AIDS? We are concerned because this is a disease that is responsible for more than 20 million deaths, according to the UNAIDS. This is also a disease that currently afflicts 38 million people worldwide. This disease infected 5 million people in 2003 and killed 3 million in the same year. Despite its devastating consequences, only 7 percent of 6 million infected people that urgently need life saving anti-retroviral therapy are getting these medicines, although these drugs are available in the stockpiles of pharmaceutical companies in western countries.
We are talking about an epidemic that currently infects 25 million Africans, and killed 2.2 million Africans in 2003, according to the UNAIDS. This epidemic is responsible for the situation whereby a child born in Zambia in 2002 will live for only 32.7 years. This is an epidemic that infects 39 percent of all adults in Swaziland and at least 37 percent of all adults in Botswana. We are talking about an epidemic that has plunged the life expectancy of Zimbabwe from 56.6 years in 1990 to 33.9 years in 2002.
Organized efforts to fight HIV/AIDS in developing regions, especially Africa, face a grave danger of degenerating into a war of soaring oratory, media blitz and national strategic posturing. Today, we are not aware of any organized effort either on the part of the United States, France, any Western nation or any African government, any bilateral or multilateral agency that will provide immediate relief to an indigent mother of three young children newly diagnosed with HIV either in South Africa, Zambia, Kenya or Nigeria. We are also unaware of any organized international remedial effort that can bring immediate relief to an indigent family in Malawi, Namibia, Tanzania or Democratic Republic of Congo struggling with the painful death throes of a hitherto male breadwinner who is slowly dying of AIDS. We are yet to know the real reason why generic and pharmaceutical companies cannot work together to make lifesaving drugs available to clinically qualified individuals living with HIV/AIDS, especially when a global buyer like the Global Fund to fight AIDS, TB and Malaria is available.
Finally, we are completely unaware of how the war of words in a conference attended by more than 10,000 people will change the status of families infected or affected by HIV/AIDS. The divisive debate over abstinence or condom use is diversionary if at risk individuals do not even have the chance of participating in customized and culturally appropriate information, education and communication campaigns (IEC). Most IECs in heavily affected countries are deeply influenced by donor country priorities, have poorly perceived local messengers, and are rarely customized to meet local exigencies. Struggles over more money to the Global Fund to fight AIDS, TB and Malaria (which we strongly support) should not obscure the fact that most approved monies from the Fund is yet to be disbursed to recipient countries for various reasons beyond the scope of this article. The strident struggle over access to available antiretroviral drugs glosses over the fact that most heavily affected nations are yet to invoke relevant World Trade Organization DOHA declarations on emergency health situations.
The real war on AIDS has come a long way. It appears that in critical junctures of organized remedial efforts to fight AIDS, war of words break out when the business at hand demands urgency and accelerated action. In 2001, when the war of words was over whether millions of Africans should be left to die or not of AIDS, we cautioned against letting people die because of the color of their skin, geographical location or station in life in the thought-provoking article titled 'HIV/AIDS in Africa: It is Time to Stop the Killing Fields' published in the United States based Foreign Policy in Focus Journal (http://www.fpif.org/briefs/vol6/v6n15hivafrica).
We believe that we cannot afford another period of rhetorical posturing when the international war on AIDS is at its decisive stages. Today, the war on universal access to lifesaving drugs is essentially over both within the legal system and the court of public opinion in the West and heavily affected countries. Virtually every heavily affected country has acknowledged its HIV/AIDS problems and is taking steps to fight back. Every Western country is increasing its financial and technical commitment to fight AIDS. Every multilateral agency is ramping up its anti-AIDS activities. Every major foundation is either engaged or seeking ways to become involved in AIDS remedial efforts.
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We believe that this is the time to end the war of words and flowery rhetoric on AIDS remedial efforts and face up to the looming, ultimate battle against HIV/AIDS: how to prevent new infections at the individual level, and how to provide clinical/supportive care for each person living with HIV/AIDS. All of the stakeholders in the fight against HIV/AIDS must focus on this ultimate battle. We in the Constituency for Africa, will be happy to join a battle of words and ideas over how best to meet the needs of individuals at risk of HIV transmission, infected with HIV or affected by HIV/AIDS no matter their geographical location on our earth, or their station in life.
Dr. Chinua Akukwe is a member of the Board of Directors of the Constituency for Africa (CFA), Washington, DC and a former Vice Chairman of the National Council for International Health (NCIH) now known as Global Health Council, Washington, DC. Melvin P. Foote is the Chief Executive Officer of the Constituency for Africa (CFA) in Washington, DC.
