Epilogue. Of scientists and crusaders
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Of scientists and crusaders 127  Epilogue Of scientists and crusaders What one needs in life are the pessimism of intelligence and the optimism of will. — André de Staercke, former Belgian ambassador to NATO Twenty years into the AIDS epidemic, little had been accomplished to thwart the disease in developing countries. With the exception of some minor milestones in the field of bloodscreening and educational efforts, HIV continued to spread like wildfire around the world. The situation was particularly disastrous in sub-Saharan Africa. The tepid international commitment in the 1980’s and 90’s was partly duetothefactthatonlyveryineffectivedrugswereavailable.Theproblems were compounded by the absence of political will, denial by leaders in the most affected countries and lack of funding. In the United Nations family very few multilateral organisations had been monitoring the crisis. Six of themfinallydecidedtocoordinatetheiractionsinthefieldofHIV/AIDSand created UN–AIDS in 1995. Belgian scientist, Peter Piot, became the head of the coordinating agency, he raised awareness slowly but surely.1 The tipping point occurred in January 2000 when U.S. ambassador to the UN, Richard Holbrooke, persuaded his colleagues to convene a meeting of the Security Council concentrating on Africa. The meeting woke people up. The epidemic in Africa, ground zero of HIV/AIDS constituted a new type of security challenge. More than 11 million AIDS orphans could easily become weaponized as child soldiers. The diminishing demographics and drastic reduction in life expectancies were upsetting the political and economic stability of almost all affected countries. The formal reason for putting “AIDS in Africa” on the agenda of the Security Council was the danger that peacekeeping operations posed in spreading the virus.2 The Council adopted a resolution in that regard, but the meeting had a much larger outcome. From then on, HIV/AIDS would 128 Cold War Triangle be dealt with at the highest level of government. It spawned a series of regional initiatives, most notably the summit on AIDS in Africa convened by the Organization of the African Union. As Peter Piot recounts in his book: One head of state after the other broke the silence on AIDS in their country, collectively the continent acknowledged at last, that it had an AIDS problem. Sensing the support from the international community, the heads of state were now committed to tackling the epidemic. Shortly before the summit, UNAIDS and WHO had negotiated major price reductions for antiretrovirals with the pharmaceutical industry, and the first Indian generic antiretrovirals arrived on the African market.3 Funding,however,wasstillamajorproblem.TheUNcalledfortheestablish­ ment of a special fund for AIDS in 2001, which became the “Global Fund to fight AIDS, Tuberculosis and Malaria” a year later. Donors, led by the United States felt the UN was too slow and inefficient to manage an emergency fund and insisted the Global Fund would be established as a public-private partnership . The United States became its first supporter with a contribution of $200 million and pledged that it would match every other contribution. The Global Fund has become a major game changer and so has the groundbreaking President’s Emergency Plan for AIDS Relief (PEPFAR). President George Bush Jr. took everybody by surprise in his State of the Union address on January 29, 2003: Today on the continent of Africa nearly 30 million people have the AIDS virus , including three million children under the age of 15. There are whole countries in Africa where more than one-third of the population carries the infection. More than four million require immediate drug treatment. Yet, across that continent only 50,000 AIDS victims are receiving the medicine they need. But the cost of antretroviral drugs has dropped drastically which places a tremendous possibility within our grasp. Seldom has history offered a greater opportunity to do so much for so many. His speech was the parting shot for America’s involvement not seen since the Marshall Plan. At stake was nothing less but the saving of a generation in Africa.4TheU.S.SecretaryofHealthandHumanServices,TommyThompson, Of scientists and crusaders 129  was one of those charismatic leaders who mobilized both public officials and private business to work on PEPFAR. He took them along on his missions to Africa and showed them how their contributions could make the difference. He impressed on them with dramatic effect that: “It’s like a war, only this war is taking 3 million lives a year!”. It was on one of those trips, in the company of Tommy Thompson, that John Martin became alerted to AIDS in Africa. It touched him...