Op-Ed on World AIDS Day

World AIDS Day is commemorated on December 1st each year to highlight successes and remaining challenges in the fight against HIV/AIDS. This year, the international community has many successes to acknowledge. We now have proven methods for combating HIV/AIDS, including effective prevention and behavior-change strategies, fighting stigma and discrimination, and partnering government with civil society. We know that leadership is essential, that early and effective action can contain and even roll back epidemics and reduce the burdens of disease on families, communities, and nations. Where there used to be a “prevention versus treatment” debate, today few dispute that where lives can be saved, they must be saved. The international community has taken action against the crisis of HIV/AIDS, with vital contributions from the Global Fund to Fight AIDS, Tuberculosis, and Malaria and other multilateral institutions.

The United States has stepped up to the challenge of global HIV/AIDS with President Bush’s Emergency Plan for AIDS Relief. As President Bush has stated, “in the face of preventable death and suffering, we have a moral duty to act, and we are acting.” The $15 billion, five-year initiative is targeted to preventing 7 million new HIV infections, providing treatment medicines to 2 million HIV-positive individuals, and caring for 10 million people living with HIV/AIDS and children orphaned by the disease. The Plan increases by $1 billion our contribution to the Global Fund, bringing total U.S. contributions to $1.6 billion -- almost half of all pledges to the fund to date. It continues our bilateral assistance to some 75 countries combating HIV/AIDS, and offers $9 billion in funding to 14 target countries representing 50% of the world’s population of people living with HIV/AIDS. The initiative represents the largest commitment in history by a single nation for an international health initiative.

And yet enormous challenges remain. Five million people have been infected with HIV in the year since last World AIDS Day. Three million more have died, leaving behind anguished loved ones, abandoned children, ravaged communities. Increasingly, AIDS has a woman’s face: women now account for more than half of infections worldwide -- and that proportion is growing. In claiming the lives of societies’ most productive populations -- adults ages 15-45 -- HIV/AIDS threatens a basic principle of development -- that each generation do better than the one before it. HIV/AIDS has deepened poverty, reduced life expectancy, diverted state resources and left a generation to grow up without the love, guidance and support of parents and teachers. And in a time when we celebrate the proliferation of democracy, AIDS threatens to wipe out the institutional memory of nascent nations, as civil servants fall prey to AIDS.

There is no doubt that HIV/AIDS represents one of the greatest challenges of our time. Its defeat will require constant and concerted commitment from all of us. In order to maximize the impact of our efforts, the United States is committed to working with governments, civil society groups, and multilateral organizations to achieve the goals of President Bush’s plan. The United States cannot achieve these goals on its own, nor should the goals -- 7 million infections prevented, 2 million on treatment, 10 million receiving care — represent the limits of what is possible. Working together, these goals should be mere stepping stones to a world in which AIDS is no longer a stranglehold on our future.

Working together requires leaders from every sector -- government, community, faith-based, and private -- to contribute to the fight against HIV/AIDS. As donors and partners, the U.S., other countries, and multilateral institutions are willing to do their part. But donors cannot educate all of your children; build, staff and sustain critical health infrastructure; transform the hearts and minds of your fellow citizens; or provide care to every employee or neighbor. We can support your efforts, but the initiative must come from you. Your leaders must be willing, in word and in action, to confront this disease. And therefore you must be willing, in word and in action, to demand it. HIV/AIDS knows no boundaries, it discriminates against no ethnicity, no gender, no age, no religion. It will not ignore you, although you may try to ignore it.

Without intervention, researchers predict that over 75 million people will be infected worldwide by 2010, with a loss of human life to AIDS totaling 100 million by 2020. Let us not make this our world. Let us look back and say that they underestimated our compassion, our resolve, our power to act. Let us mark this World AIDS Day as the turning point against the disease.