Fighting AIDS in Africa

If you want to change the world, start with AIDS in Africa. If you want to save lives, fight AIDS in Africa. If you want to work on the most serious crisis facing humanity today, fight AIDS in Africa. The peoples of a continent are being decimated, their future is being destroyed--and we have the power to help stop it.

In Botswana, a 15-year-old boy has a two-thirds chance of contracting and dying from AIDS. In the worst-affected countries, upwards of one in five adults is already infected. With nearly 4 million new infections last year, these numbers are only increasing. For Africa's 25 million infected, AIDS is effectively a death sentence; if nothing is done, these millions and more will die, leaving behind 40 million orphans by the year 2010. To put that in perspective, there are about 40 million children in American public schools.

The World Bank says that "AIDS has an unprecedented impact on economy and society--because it kills so many adults in the prime of their working and parenting lives, it decimates the workforce, impoverishes families and shreds communities." In Zimbabwe, agricultural output dropped nearly 20 percent in 1999 because of AIDS; left unchecked, the disease will shatter economies throughout Africa.

Beyond economics, AIDS threatens stability and security. Secretary of State Colin Powell and the Central Intelligence Agency have noted the security threats that necessarily arise from rapidly declining life expectancies and diminishing life prospects. How can a nation plan for long-term growth when its people are unlikely to live past 40? If AIDS continues its reign of devastation, the highest levels of government and civil society in many African countries will collapse. With them will go the prospects for peace.

AIDS in Africa requires a global response. A serious, well-funded, three-pronged approach of prevention, treatment and community support is needed. These elements go hand in hand.

The need for prevention is obvious: the continued spread of the disease will multiply the damage already done. While the commitment of many African governments to fighting AIDS has been tragically scarce, more and more leaders are seriously engaging the issue. They hope to replicate the successes of Uganda, which went from being the world epicenter of the AIDS crisis to one of the least-affected countries after its president made AIDS a top priority. The international community must work in partnership with these governments to build effective, large-scale prevention programs.

However, it will be extremely difficult to make headway with prevention measures unless treatment is available. Would you allow yourself to be tested in a country with no available AIDS drugs, where stigmas against the infected could lead to the loss of your job and your family? In areas where drugs to prevent mother-to-child AIDS transmission are made available, people are willing to be tested and take part in prevention. Where these drugs are scarce, there is little incentive to be tested.

Prevention is one argument for treatment. Community stability is another. Half of the infected in sub-Saharan Africa are women, and AIDS will leave millions of children parentless. Even if the drugs that are available can only preserve life by 10-15 years, those years are critical if communities are to survive. And beyond either of these arguments is a basic humanitarian obligation. With effective life-extending AIDS drugs available at prices below $1,000 a year, allowing millions to perish would be a monstrous sin of omission.

Community support must also be a feature of a global commitment to fighting AIDS. The 10 million children already left parentless by AIDS are stretching Africa past its limits. 30 million more orphans would be overwhelming. While treatment is critical to save the families of millions of these children, resources must be dedicated to looking after those without guardians. Unattended, few of these children will attend school or become literate; they will have few life prospects and little reason to hope. They must be helped.

Peter Piot, Director of UNAIDS, has said that, "the great moral test of our time is how the rich countries respond to the AIDS crisis." As America decides how to spend a $5.4-trillion projected surplus, it must bear in mind that enormous good can be done for less than $10 billion. Last year, the United States contributed about $350 million to fighting global AIDS; this year, it should multiply that amount several times. Stone Professor of International Trade Jeffrey D. Sachs '76 and others have estimated that dramatic gains in fighting AIDS in Africa can be had for only a few billion dollars a year. The U.S., working with other developed countries, must secure funds to pay for AIDS prevention, treatment and community support.

Certain members of the new administration and legislators on both sides of the aisle have pledged their support for a serious U.S. commitment to fight AIDS in Africa. In order for them to succeed in boosting U.S. involvement, however, their voices must be amplified by the voice of the public. We must swamp Washington in letters, phone calls, news pieces and other indications that America cares about AIDS in Africa. Simultaneously, pressure must be brought to bear on drug companies to lower the price of AIDS drugs to developing countries to the cost of production. Students must answer the calls of a global conscience and act now to end the global AIDS crisis. Each day that passes brings 8,000 new deaths. There is no time to wait.

Benjamin M. Wikler '03 is a social studies concentrator in Cabot House. He is president of the Harvard AIDS Coalition.