Today, the world will celebrate the 13th annual World AIDS Day. OK, maybe celebrate isn’t the right word. The world will observe this recognition of the AIDS epidemic, with a focus on sub-Saharan Africa. Current figures from UNAID, the United Nation’s AIDS organization, show that the world has added more than 5 million new AIDS cases this year. UNAID estimates that 36.1 million adults and children worldwide are currently living with HIV and AIDS. Of those infected, 25.3 million are in sub-Saharan Africa, 5.8 million are in South and Southeast Asia, and 1.4 million are in Latin America. This truly a worldwide problem, and the world needs to spend more time and energy on prevention, education and research for a cure.
In 1981, the disease now known as AIDS was identified in the United States. That year, the Centers for Disease control spent only $1 million on research, while spending millions more on lesser threats, such as Legionnaire’s Disease. Thanks largely to Rep. Henry Waxman, D-Calif., Congress began more aggressive funding, despite President Reagan’s staunch opposition. In 1985, there were nearly 13,000 cases of AIDS in the United States.
Presidents Reagan and Bush fought for 12 years against Congress’ efforts to increase funding for AIDS research, education and care. If their intent was to make the epidemic worse, they succeeded. Today, there are more than 400,000 people living with AIDS or HIV, and more than 425,000 have died from the disease since 1981. Government assistance has grown along with infections: The Kaiser Family Foundation estimates the federal government spent $9.7 billion in 1999 on a wide variety of HIV/AIDS programs.
So what will a new president bring to the AIDS fight? The picture is unclear. If Texas Gov. George W. Bush is elected, many executive AIDS programs may be derailed. If Vice President Al Gore is elected, new AIDS funding will face a fight from the Congress. AIDS funding has barely been keeping up with the increasing costs of administering health care and doing research, and the situation isn’t likely to dramatically change.
Additional funding for domestic research and prevention isn’t going to solve the problem, however. Attitudes in wealthier Western countries about the disease need to change. Intravenous drug users continue to get infected, and the fastest-growing demographic of new HIV infections is heterosexual women. But AIDS still carries the stigma of its early association with gay men. Even among that demographic, infection rates are rising after a decade of decline. Recent studies have found that younger gay men in America seem to think that AIDS isn’t that large a threat. Perhaps this is because of the advanced drug “cocktail” therapies that allow the infected to live better, longer lives. But people with AIDS still die prematurely. There is no cure. Western countries need to realize this and redouble their efforts on research and prevention.
Eastern Europe and the former Soviet Union have an AIDS attitude problem as well. Much like China a few years ago, the public perception is that no AIDS problem exists. The threat isn’t discussed, and as a result infections in the area have doubled in the last year, adding more than 500,000 new AIDS cases, according to the UNAID report. Most of these are among IV drug users and sex workers.
In developing nations, the situation is substantially worse. In Africa, the rate of new infections is finally dropping — but this isn’t a good thing. Reuters reports that so much of the sexually active population is already infected, there aren’t many more people to become infected. Nearly one in 10 African adults is infected with the disease. And in Africa, treatment and infection are issues of race, class and gender. Medication is often only available to the wealthy or the white in larger cities. Small villages often don’t have the medical infrastructure to distribute medication, even if they could afford it. Discussing AIDS is seen as a threat to masculinity in many African countries, and women are not often empowered to control their own sexual destiny.
To add to the difficulty in Africa, the 13th International AIDS conference in Durban, South Africa, this summer ended up not focusing on finding ways to get more international assistance, but instead became an argument about whether HIV causes AIDS and whether sick people diagnosed as having AIDS in Africa actually have AIDS, or whether they simply have other opportunistic infections. These are certainly big questions that the scientific community needs to investigate. But the harsh reality is that Africans need help now.
The world currently has 36 million people infected with AIDS. That may not seem like much compared to the world population. But then, 13,000 infections in the United States in 1985 didn’t seem like much. The international community needs to use World AIDS Day to re-energize and refocus worldwide efforts to stop this epidemic. The United States needs to do its part as well. If we don’t, those 36 million will only be the tip of the iceberg, and in 15 years we’ll all be asking why we didn’t do more
earlier.