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The Washington Quarterly 24.1 (2000) 191-196



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Joining Forces to Fight HIV and AIDS

Sandra L. Thurman


Nearly two years ago, at the request of President Bill Clinton, I traveled to sub-Saharan Africa to bear witness to the growing AIDS pandemic and to explore effective ways of enhancing the U.S. government's response. Since then I have made eight trips to 11 African countries. The visits have afforded me, cabinet officials, members of Congress, corporate and religious leaders, and others the remarkable opportunity to witness the global AIDS emergency where it lives--in homes; in marketplaces and villages; and in the faces of the countless children, women, and men caught in the crossfire of this relentless disease.

We are at a critical juncture in our battle against AIDS. After almost two decades of slow and steady progress in this country, far too many are anxious to believe that the worst is behind us. On the contrary, with 40,000 new infections every year in the United States, and 6 million new infections around the world, what we are seeing now is only the beginning. By 2005, it is projected that more than 100 million people worldwide will have become HIV-infected. The sobering truth is that this pandemic is far from over--in fact, it has just begun to unfold.

We Know What's Coming

Here at home, the public and policymakers are beginning to realize that the AIDS epidemic in the United States is only a small part of the pandemic that is sweeping the globe. Although much of the devastation is occurring beyond our shores, it is raging on a level beyond comparison to the bubonic plague of the fourteenth century.

Nowhere is this devastation more evident than in Africa. Last year alone, [End Page 191] AIDS killed ten times more Africans than all of the armed conflicts on the African continent combined and has now become the leading cause of death among people of all ages. Most alarming is that the progression of this pandemic has outpaced all projections. In 1991, the World Health Organization predicted that, by 1999, 9 million would be infected and nearly 5 million would die in Africa because of AIDS. The resulting numbers are two to three times greater, with nearly 24 million infected and 14 million deaths.

Every day Africa buries nearly 6,000 men, women, and children as a result of AIDS, and that count will more than double in the next few years. Every eight seconds, another African becomes infected--11,000 daily.

Sadly, an entire generation of children in Africa is in jeopardy. In several sub-Saharan countries, between one-fifth and one-third of all children have already been orphaned by AIDS. The worst is yet to come. Within the next decade, more than 40 million children will have lost one or both parents to AIDS. This is about the same number as all children in the United States living east of the Mississippi River. If left unchecked, this tragedy will continue to escalate for at least another 30 years.

It is increasingly clear that AIDS is not just a health issue; it is a fundamental development issue, an economic issue, a trade issue, and a key security and stability issue. In just a few short years, AIDS has wiped out decades of hard work and steady progress in improving the lives and health of families throughout the developing world. In some southern African countries, infant mortality is doubling, child mortality is tripling, and life expectancy is plummeting by 20 years or more due to HIV/AIDS.

Economic growth and development in the most seriously affected countries are considerably threatened. AIDS is already having an effect on the economic future of Africa. That impact will grow as AIDS continues to strike down skilled workers in their prime and force companies to hire and train multiple employees for every one job, assuming that up to one-third will die of AIDS. According to the Economist, recent studies have found that AIDS is seriously eroding the economies...

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