Two important studies released prior to World AIDS Day reveal three striking truths about the pandemic that has claimed over 20 million lives. The color of AIDS is Black, hard work to fight HIV can pay off, and urgent action is needed to halt and reverse the pandemic at home and abroad.
This year the theme of World AIDS Day is "leadership". It will be the leadership, or lack there of, of this nation and its citizens that will determine if we will conquer AIDS as we defeated the "Black Death" centuries ago or if this new Black plague will continue to claim millions of lives. One of the first tests will be if the President's Emergency Plan For AIDS Relief (PEPFAR) is reauthorized with at least $50 billion over the next five years dedicated to end global AIDS.
Disproportionate Impact on People of African Descent
The 2007 UNAIDS Update reveals that the epicenter of the global crisis is in Africa and the District of Columbia HIV/AIDS Annual Report shows that our nation's capitol has the worst AIDS rate in the country. There is no mistake that this global health crisis impacts Black people more than any other group in the U.S. and internationally. Of the global total of 33.2 million people living with AIDS in 2007, 22.5 million are in sub-Saharan Africa. More than three quarters of all AIDS-related deaths in 2007 were in Africa. In the U.S., the city of Washington rivals the country of Rwanda in HIV prevalence. Black residents account for 86% of people living with AIDS. Nine out of 10 women who tested positive are African American.
There was some good news in the UNAIDS report. The total number of people living with HIV/AIDS was revised downward. The overall number of people with AIDS continues to increase, but global HIV prevalence has been leveling off. The HIV/AIDS virus might have started to follow the trend of other epidemics and hit a plateau. Stabilizing infection rates can be attributed, at least in part, to the effective efforts of the education, health and human rights workers on the front lines of the pandemic that have implemented evidence-based prevention methods and advocates that have increased access to antiretroviral treatment. HIV/AIDS does not have to be a death sentence, but less than 30% of Africans living with AIDS have access to life-saving treatment.
This good news must be tempered by the reality that "leveling off" in countries like Botswana still means prevalence rates over 15%. The HIV virus already adapts to resist treatment in some hosts. Even if the current HIV virus has leveled off, there is a very real threat that if we don't invest in the fight now, the virus could mutate significantly, spreading more easily or becoming increasingly drug resistant, triggering a second wave of the pandemic.
Our counterparts on the continent, including the leading umbrella for AIDS organizations, PATAM, tell us that ideological approaches to prevention have undercut the effort to stop the spread of HIV/AIDS and treatment programs are desperately under funded. Lingering illegitimate debts of dictators from decades past have crippled health and education sectors and allowed vital infrastructure to crumble. The investment to end HIV/AIDS must come hand-in-hand with debt cancellation and efforts to reconstruct the health and education sectors, building capacity to absorb the level of resources needed to reverse the pandemic.
Comprehensive Approach Needed Urgently
This brings us to the final truth--the U.S. must act now--in our nation's capitol, across this country, and as global leaders to invest in a comprehensive approach to stop and ultimately reverse the greatest health crisis of our times. Domestically, policy-makers need to adopt and fully fund a strategic plan to address the crisis, with an emphasis on reaching people of color. Internationally, the U.S. must work to fulfill the Group of Eight (G8) wealthy nations pledge of universal access to treatment. When the U.S. leads at the G8, contributing its fair share, the world follows.
Looking beyond statistics, let's remember the people affected by the pandemic. 191 children under the age 13 were living with AIDS in Washington, DC in 2006. On the continent of Africa, when their parents die, the oldest girl-child is the first to leave school, often turning to prostitution as the only way to generate income to feed her family. The world has the resources to end AIDS, what is missing is the political will to do so. Every delay escalates the cost, financially and in terms of lives lost. If the color of AIDS was white, would we hesitate to fully fund the fight?
As we enter the holiday season and prepare for a new year, let us resolve to cultivate compassion and commit to push policy-makers to re-authorize PEPFAR with a minimum commitment of $50 billion and no ideological constraints and then elect leaders that will prioritize the pandemic.
Gerald LeMelle is the newly appointed Executive Director of Africa Action. Prior to this post he served as the Deputy Executive Director for Advocacy of Amnesty International.
