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On the eve of World AIDS Day, panelists ARCO Forum.detailed the complexity of the AIDS epidemic in Africa.
The directors of AIDS initiatives from the World Health Organization (WHO), World Bank and several smaller non-governmental organizations discussed last night the roles their groups play in combating AIDS and the difficulties they have encountered.
Stone Professor of International Trade Jeffrey D. Sachs, director of Harvard's Center for International Development, began the discussion with a summary of economic concerns that have plagued AIDS-afflicted developing countries.
"This is a pandemic that rivals any dread disease in history," Sachs said. "There are tens of millions marked for death, and unless we act, all of these infected will die in a few years."
In a brief presentation, Naomi Nhiwatiwa of the WHO echoed Sachs' concerns by depicting the plight of AIDS-afflicted African societies.
She portrayed a culture completely ravaged by the disease, where children are forced to leave school to care for orphaned siblings, damaging the job market.
Health care infrastructure is also in crisis, she said, as doctors and nurses are also dying from the disease.
"Up to 70 percent of hospital beds are occupied by HIV victims," Nhiwatiwa said.
Keith Hanson of the World Bank AIDS Campaign Team for Africa said his organization had finally realized the seriousness of the epidemic and was beginning to increase the attention devoted to it.
"Life expectancy has fallen by 10 years in Africa, and may fall to 30 years. [This rate] has not been seen for about 1,000 years in Europe," Hanson said.
Sachs urged a comprehensive response to the crisis in Africa, calling on wealthy nations to contribute to a program that integrates prevention, treatment, research and organization into a coherent whole.
Calling on industrialized countries to provide greater assistance, Sachs said, "Nothing's been done in scale. Perhaps $70 million was spent last year in Sub-Saharan Africa, or approximately $3 per person afflicted."
Sachs said that using generic drug products could result in significantly lower costs than those projected by many opponents of increased assistance.
"It would cost $365 to save an adult African for one year....The orphans [would then] keep their parents, which is a damn good buy," Sachs said.
He called for billions of dollars in place of the $70 million currently contributed by the U.S., blaming the current paucity of funds on the greed of wealthy nations.
"The poor and rich are living together, with the poor dying and the rich with more wealth than they know what to do with," Sachs said, referring to current U.S. budget surplus.
"We could give $2.7 billion if we each just give up a movie and popcorn a year," he said.
Ochoro Otunnu, president of the Africa AIDS Initiative, echoed Sachs' concerns by calling for wealthier nations to forgive the debts of developing nations afflicted with AIDS, as well as to help them boost public health initiatives by reducing military expenditures.
Hanson said that the World Bank responded late to the crisis, and had not devoted all the funds needed to stop the crisis.
Dr. Jim Yong Kim, the director of the Program in Infectious Disease and Social Change at Harvard Medical School and executive director of Partners in Health, said his personal experiences demonstrated the degree to which the World Bank's unwillingness to contribute had hindered AIDS relief.
Kim's efforts to bring relief to the HIV-infected, who often suffer from multi-drug-resistant (MDR) tuberculosis, were initially met with skepticism from officials at the WHO, who he said were under pressure by the World Bank to limit costs.
Though the WHO claimed that MDR tuberculosis infection was untreatable and that the costs would be forbiddingly high, Kim silenced opposition with an 85 percent cure rate in a shantytown in Lima, Peru, using less expensive generic drugs.
"Four directors of the WHO Global TB Program had pronounced a death sentence without knowing that generic drugs were available," Kim said.
Since then, he has received more cooperation from the WHO. He said he sees progress but added that the situation might improve further if governments compelled pharmaceutical companies to provide drugs at "reasonable cost."
Courtney A. Roberts '03 said she found the presentation educational.
"This was really interesting because it showed all the types of people involved," said Courtney A. Roberts '03. "It's not just a medical issue--it really is a world issue."
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