Remarks for Conference on "AIDS in Africa: A Perspective from African Mothers"

Thank you very much for that kind introduction.

I would like to thank Dr. DeGioia for his warm welcome to the campus and for Georgetown's commitment to health research. I also want to acknowledge the State Department's Office of International Visitors, which arranged this event and the exchange program that brought these mothers to the U.S. to share their story.

It’s a pleasure to welcome our guests from South Africa to Washington. They were welcomed in style by the First Lady at the White House this morning. Perhaps I should tell them now that that is not something we do for everyone who visits our country – but you are special!

The impetus for this visit was the First Lady’s visit to one of the Mothers to Mothers sites in South Africa last July. I was able to join Mrs. Bush there, and her visit is a powerful memory for me. To me, seeing our First Lady connecting with these women was really a vivid image of the strong and growing partnership between the people of the United States and the people of Africa.

Let me take a few moments to offer an overview of the global HIV/AIDS pandemic today, and of our nation’s response to it. Let me begin by asking you to imagine a scenario.

Imagine waking up one morning, turning on the radio, and hearing that twenty 747s around the world, each fully loaded with 400 passengers, had crashed, killing everyone aboard. Imagine what a devastating shock such a tragedy would be.

Then imagine waking up the next morning and hearing that the exact same tragedy had happened again. And waking up the morning after that, and the morning after that – every day, in fact, and hearing that 20 jet airliners had crashed, leaving no survivors.

Believe it or not, that is the toll AIDS takes every day around the world. 8000 people are dying every day due to this killer, and each one is an individual, with a name, a family, a story. The worldwide HIV/AIDS pandemic is, first and foremost, a human tragedy.

At the same time, we must acknowledge the grave consequences it brings for social development, and for global security. Young adults embody human potential – the skills, experiences, and knowledge that lift societies out of poverty. But young adults in Africa and Asia and the Americas are the ones most likely to die of AIDS, and when they do, their children are unlikely to stay in school. How can children reach their potential if they’re locked in a desperate struggle for their very survival?

So HIV/AIDS is not just a disease that is killing individual, families, and communities today, it’s a destroyer of hope for the future. We have often been reminded in recent years that our world is smaller than many once thought. It’s not a good assumption today, if it ever was, that hopelessness in faraway places will not touch us here at home. Without hope, people can be driven to extremes.

In much of the world today, bringing hope simply must include aggressively confronting HIV/AIDS. This is a challenge for the whole world, and at this point, it is not one that we can leave developing nations to face on their own. In President Bush’s view – and my own – the U.S. has a unique ability to lead the world in rising to this challenge – and we are doing just that.

The President’s Emergency Plan for AIDS Relief, or PEPFAR, has now been up and running for over two years, and it is an extraordinary venture.

Under the five-year strategy we’ve put in place, America is now fighting HIV/AIDS with programs in over 120 countries around the world, with a strategic focus on 15 of those countries that together account for over one-half of the world’s 40 million HIV infections. Approximately 26 million of the world’s 40 million HIV-positive people live in sub-Saharan Africa.

In my view, how we go about this work is crucial. We work in partnership with hard-hit nations and their citizens, supporting their leadership and strategies. Why is that so important?

The reality is that the fight against HIV/AIDS will take decades. Every nation must take ownership of its own fight. That’s the only way to achieve results today and to sustain their responses for the long term. That’s why we’re so committed to working in support of national strategies, rather than imposing solutions of our own that may not take root.

PEPFAR reflects these goals through its values of accountability for results, and sustainable partnerships with nations. The title of our recent Report to Congress on the results achieved this past year is “Action Today, A Foundation for Tomorrow.” To me, that phrase captures the fact that these objectives go hand in hand.

What we have been able to achieve, together, in the first two years of PEPFAR is simply remarkable. It all starts with prevention, because if we are not able to reduce the number of people who become infected, we will simply never be able to provide treatment and care to everyone who needs it.

We are pursuing an incredibly diverse portfolio of prevention interventions. These include the balanced, evidence-based ABC approach pioneered in Africa – Abstain, Be faithful, and correct and consistent use of Condoms. Encouraging new evidence from a growing number of countries in Africa and elsewhere is confirming the ability of ABC behavior change to reduce HIV rates, and we are seeking to support this development.

Antiretroviral treatment is another urgent focus. There were only 50,000 people in all of sub-Saharan Africa on treatment when the President launched the Emergency Plan. Through 2005, the number of people on PEPFAR-supported treatment worldwide has risen to approximately 471,000, of whom over 400,000 are in sub-Saharan Africa. That’s the beginning of a transformation – from despair to hope.

By the way, it’s worth noting that about 60 percent of those on treatment are women. Many were concerned that women would have difficulty accessing services, but that percentage is one of many reflections of our nation’s commitment to ensure that women’s needs are fully addressed.

Another aspect of PEPFAR is support for families, communities, and nations in meeting the needs of children orphaned by AIDS, and those made vulnerable by the illness or death of loved ones. Last year, U.S. partnerships with host nations reached over 1.2 million such children, allowing them to go to school, to get the food they need – in short, to be children.

Now that life-extending treatment is becoming more widely available, the decision to get tested for HIV can open the door to a better future. We’re working with nations to spread the word, and to date, U.S.-supported programs have reached over 9.4 million people with counseling and testing. Making sure that pregnant mothers have access to testing when they seek antenatal care is one example of how we’re reaching out.

So those are some of the highlights of our “action today.” But I’m even more excited about the “foundation for tomorrow” that we’re laying. For example, sustainable responses depend on having local people with the skills needed by their society. So PEPFAR and our partners are training people -- over half a million in 2005 – to serve their communities in combating HIV/AIDS. In these countries, the effects of this training will ripple out for decades.

Normally, when I talk about all these things to audiences here in the U.S., I think it’s difficult for people to picture what it all means. But this audience has a tremendous advantage: you’ll get to meet some of the people our partners support and hear from them directly what this effort means.

It’s a pleasure to honor Mothers to Mothers for helping families face the awesome challenge of living positively with HIV/AIDS. In paying tribute to these women, we also honor the people of thousands of other partner organizations of the President’s Emergency Plan around the world. Mothers to Mothers is one of many PEPFAR partners with deep roots in the communities they serve, making them uniquely qualified to meet the needs of their people.

Preventing the tragedy of mother-to-child transmission of HIV is one of the highest priorities of PEPFAR. Mother-to-child transmission is now an exceedingly rare event in the United States. We are working toward the day when that can be said of South Africa and other developing nations.

In just the first two years of the President’s Emergency Plan, we supported our partners in South Africa and other countries in reaching over 3.2 million pregnant women with services to prevent mother-to-child transmission. We estimate that these interventions have prevented at least 47 thousand infant infections to date. What’s more, every visit to one of these programs includes the routine offer of HIV counseling and testing, which can be the gateway to treatment and care for mothers themselves.

It’s really a tremendous achievement, and the credit belongs to the brave people like our guests today, and to our dedicated U.S. Government personnel in the field who are assisting them.

Now, until we reach the point at which pediatric HIV transmission is eliminated, it will remain crucial to make antiretroviral treatment available to every child who is infected. This past year, we estimate that at least 7 percent of those who received treatment at PEPFAR-supported sites were children. That’s likely an underestimate, but what’s clear is that there are many more children we need to reach.

There are so many challenges involved in responding to global HIV/AIDS, and pediatric treatment is certainly among the most difficult. Bringing leaders on pediatric treatment together to work through the issues, especially the scientific challenges, is a necessity.

This morning the First Lady announced a new public-private partnership, in which the U.S. Government will work with both innovator and generic pharmaceutical companies, as well as international organizations such as UNAIDS and UNICEF, to find solutions to these scientific challenges. It will take of us, working together, to meet the range of daunting challenges HIV/AIDS poses for families around the world.

The HIV/AIDS emergency continues to exact a horrific toll on our world. We must never lose sight of that fact – but equally, we must take note of the growing number of positive developments around the world today. The mothers who have joined us today represent a growing reality, of leadership against this disease at the grassroots level. Often, I have noticed, this leadership comes from women. That’s a development that our nation is proud to support.

My message to our guests today is that the American people are proud to be your partners, and that we will continue to stand by you in the days ahead.

With that, let me introduce Dr. Anthony Fauci, a man who is an inspiring leader in the world’s fight against HIV/AIDS and many of the other diseases of our time. For over 20 years, Dr. Fauci has been the Director of the National Institute of Allergy and Infectious Diseases, where he oversees research to prevent, diagnose, and treat infectious diseases – both HIV/AIDS and many others. Dr. Fauci serves as one of the key advisors to the White House and Department of Health and Human Services on global AIDS issues, and he has been an invaluable partner during the early years of implementation of the President’s Emergency Plan.