Editor's Note: Todd Schafer is Chief Executive Officer of the Global AIDS Interfaith Alliance. Michael O’Hanlon is Director of Research and Senior Fellow of Foreign Policy at the Brookings Institution. They were Peace Corps Volunteers in Zaire (now the Democratic Republic of Congo), 1982-1984.
By Todd Schafer and Michael O’Hanlon – Special to CNN
In July 1982, we arrived at the birthplace of AIDS – Congo – before the disease had a name. Before the year was out, rumors were spreading in the countryside of a lethal sexually-transmitted disease, and by April the cover of Newsweek magazine (our only regular connection to the outside world) screamed “EPIDEMIC: The Mysterious and Deadly Disease Called AIDS may be the Public Health Threat of the Century” and included the “African Genesis” theory tracing AIDS’ roots to equatorial Africa.
By the time we completed our service, our Peace Corps Director was dead of SIDA (the French acronym for AIDS), a fellow volunteer was infected, and dozens of our dear Zairian friends and colleagues were heading towards a painful and premature death.
Over the ensuing quarter century, the AIDS epidemic claimed nearly 30 million lives, 70% of them in Africa. Still, on this World AIDS Day, there is much to celebrate.
Today, due to tremendous medical breakthroughs – especially antiretroviral therapy and strict adherence to an ever-improving regimen – an AIDS diagnosis in much of the world is no longer a death sentence. In fact, in North America (and similarly in Europe, and Australia), annual AIDS deaths have been declining since the late 1990s, with more than one million people living with HIV today.
The news in the countries of sub-Saharan Africa, where more than two-thirds of all people living with HIV reside, stands in stark contrast. More than one million adults and children are still dying of AIDS annually, with nearly two million persons newly infected each year. The scale of the epidemic continues to boggle the mind: With more than 5 million HIV+ people, the nation of South Africa has five times the U.S. caseload with one-sixth the population… tiny Malawi has three times the United States’ AIDS-related deaths annually with just one-fifteenth the population… and even tinier Swaziland has the highest HIV prevalence in the world at more than one-quarter of its adults.
And yet, these grim statistics hide signs of real progress. Due to both international and national efforts to stem the AIDS tidal wave, the HIV incidence rate in 22 countries of sub-Saharan Africa declined by more than 25% between 2001 and 2009, and, because of treatment scale-up, AIDS deaths have fallen by 20% since just 2004. Today, nearly 40% of medically eligible adults and children in sub-Saharan Africa are receiving antiretroviral therapy, compared to just 2% in 2002.
Understandably, many in the media and donor community have grown tired in this fight. Worldwide funding for AIDS (especially in Africa) has increased significantly since the 1990s, led by the Global Fund, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the Gates Foundation, and others.
These efforts, and the thousands of grassroots programs they support and complement, have played a direct role in the curbing of the African continent’s AIDS mortality and morbidity trends. Yet, in 2010 global funding for AIDS programs fell by nearly 10% from a year earlier. This is no time to take our foot off the gas.
We call for this sustained effort fully aware that all parts of the U.S. federal budget, and especially the so-called “discretionary budget” that includes foreign assistance, are under severe pressure right now. Cutbacks of 10 to 20 percent are likely in some accounts. But while there may be parts of the foreign aid budget that deserve scrutiny and warrant reductions, we need to remember that “foreign aid” with all its politically negative connotations includes lifesaving programs like this one.
Private and individual contributions can only do so much to compensate for cuts in government money, and while we hope they increase, their capacity for growth is limited. HIV/AIDS, though a thirty-year old problem, is more like a Haiti earthquake in slow motion—with even greater numbers of victims around the world—than a classic foreign aid project.
When it is a matter of life and death, and when a few dollars per victim per year can be decisive, our sense of decency and values as Americans really offer us no choice.
U.S. Secretary of State Hillary Clinton agrees. Last month, she stood before the gathered scientists and public health experts of the National Institutes of Health and laudably staked out the goal of an “AIDS-free generation,” beginning with recommitting to prevention and treatment efforts in the world’s hardest hit countries. “This goal would have been unimaginable just a few years ago,” she said. “While the finish line is not yet in sight, we know we can get there because now we know the route we need to take.” With 60% of medically eligible sub-Saharan adults and children not receiving antiretroviral therapy, it is hard to argue.
The views expressed in this article are solely those of Todd Schafer and Michael O'Hanlon.