TURNING THE TIDE AGAINST HIV/AIDS
By James D. Wolfensohn
James D. Wolfensohn is president of the World Bank. Here he comments
on the worldwide HIV/AIDS epidemic, as the U.N. Special Session on HIV/AIDS
opens in New York June 24-27.
WASHINGTON -- Last year alone, AIDS killed almost
3 million people around the world. More than 5 million became newly infected
with HIV, nearly 4 million of them in Africa. The HIV/AIDS epidemic is
spreading at alarming rates in other regions as well. In Eastern Europe,
and South and Southeast Asia, there is evidence that the disease is taking
deadly hold of people and their communities. In the Caribbean, AIDS has
become the major cause of death among men under the age of 45.
As heads of state, policymakers, U.N. agencies, health experts, civil-society
groups and others converge on New York for the U.N. Special Session on
HIV/AIDS, these facts should command the world's attention. Under the
leadership of U.N. Secretary General Kofi Annan, this high-level global
meeting will underscore that HIV/AIDS is no longer just a health problem,
but a global development problem, threatening to reverse many of the gains
made over the last half-century. More than that, it is an international
security problem, and, as such, it needs a war chest and a rigorous strategy.
A growing consensus has emerged among U.N. agencies, donors and stakeholders
that a global trust fund offering grants for the prevention and treatment
of HIV/AIDS and other communicable diseases is the only way to surmount
the very large financing gap threatening to defeat the fight against AIDS.
But as such, we want to ensure that the proposed fund provided financing
over and above existing foreign aid. To reallocate those funds would simply
be a shell game.
I hope and trust that governments, charitable foundations, the private
sector, civil-society and other groups attending this special session
will respond generously to the challenge of checking the spread of HIV/AIDS
and contribute significantly to the war chest that will be needed.
While money alone will not solve the problem, it is a vital part of the
solution, and funds earmarked for confronting the epidemic are currently
much too low. Total global support for HIV/AIDS in developing countries
last year was probably under $1 billion, less than a third of the estimated
need in Africa alone.
Dramatic reductions in prices of anti-retroviral drugs are key to treatment.
But even they do not provide the magic bullet. At $400-$500 a year, down
from $10,000, they are more affordable, but still well out of reach for
the vast majority of infected people in developing countries where per
capita income is less than $500 per year, and where governments spend
less than $5 per person on health care.
Prevention is key. But prevention is costly as well. What is needed is
at least $9 billion per year.
The World Bank, in partnership with African governments, has launched
the Multi-Country HIV/AIDS Program (MAP) for Africa, which over the past
year has provided $500 million in new money to help 10 African countries
scale up effective prevention, care and treatment. The MAP makes significant
resources available to civil-society organizations and communities, which
have developed some of the world's most innovative HIV/AIDS interventions.
Next year, we plan to finance another $500 million to reach 15 more African
Moreover, the bank has unveiled a new $150 million fund to fight HIV/AIDS
in the Caribbean, and $40 million in recent lending has also gone to support
HIV/AIDS prevention and care in Bangladesh.
These reflect a solemn pledge I made last year that there will be no limit
to the amount of funding we are willing to provide, and that no national
HIV/AIDS program will be stopped because of lack of funding. I reaffirm
that commitment. But not one on its own -- not the bank, donor agencies,
national governments, NGOs (non-governmental organizations) or the private
sector -- will be able to provide the scale of money and support needed
to engage HIV/AIDS at the global and country level and ultimately prevail.
For this reason, the bank strongly supports the establishment of the global
fund within the context of meeting the International Development Goals.
These call for a halving of the proportion of people living in extreme
poverty by 2015 and also urge greater strides in reducing infant, child
and maternal mortality.
Treatment, prevention, implementation -- all these are needed. But there
is one more essential element in our strategy. Leadership. In too many
countries, AIDS, sex, rape and condoms are subjects rarely mentioned.
In too many communities, men believe that sex with a virgin will cure
them. The human tragedy surrounding that belief is staggering -- in South
Africa today, 95,000 children under the age of 15 are HIV positive, most
of them girls. More and more leaders are beginning to break the silence.
We need others to follow suit. Rich countries must set an example by putting
up funds and offering help to those who speak out.
Collectively we have the resources, and we surely have the need. All we
lack is the political will. Let us join with the G-7 and the U.N. system
to commit to a global fund. Let us also invite civil society into this
global campaign against HIV/AIDS. Its contribution could be enormous.
Civil society has played a pivotal role in all countries that have had
success against HIV/AIDS. At the global level, representatives of civil
society should be involved at all stages in the design, decision making
and implementation of HIV/AIDS-related activities. At the country level,
civil society should have a direct role in AIDS governing bodies, and
those bodies should channel a significant share of HIV/AIDS resources
directly to the local level and to community organizations.
So, let us all join arms and show that we are not powerless against this
epidemic. Let us mobilize the money, the political will and the battle
plans to turn the tide of this global threat. Let us then make this U.N.
Special Session on HIV/AIDS a pivotal moment in the fight.
(c) 2001, Global Viewpoint.
Distributed by Los Angeles Times Syndicate International, a division of
Tribune Media Services. Distributed 6/20/01