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World AIDS Day: A Look at the Fight Against the Global Pandemic

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The 18th annual World AIDS Day was observed yesterday around the theme “Stop AIDS, Keep the Promise.” The World Health Organization estimates that 3.1 million people worldwide will die of AIDS this year including 500,000 children and a recent UN AIDS report showed that the number of people living with HIV has topped 40 million for the first time. We speak with the Center for Health and Gender Equity. [includes rush transcript]

The 18th annual World AIDS Day was observed yesterday around the theme “Stop AIDS, Keep the Promise.” AIDS organizations across the globe are urging governments and the international community to remain committed to fighting the HIV/AIDS pandemic. The groups are focusing on holding political leaders accountable for previous commitments to HIV/AIDS prevention. They are especially interested in enforcing pledges world leaders made at this year’s G8 Summit to ensure universal access to AIDS treatment by 2010.

The World Health Organization estimates that 3.1 million people worldwide will die of AIDS this year including 500,000 children. Earlier this month, a UN AIDS report was released showing that the number of people living with HIV has topped 40 million for the first time. Sub-Saharan Africa remains home to more than half of those with HIV, but infection rates have spiked all over the world.

In India, at least 4.5 million people live with HIV. This is the most in any country outside of South Africa. Latin America saw a record number of new infections. And the U.S., Canada and Europe also witnessed an increase in infections. One million people in the U.S now live with HIV with at least 35,000 infections occurring this year.

Governments across the world announced initiatives and programs to address the crisis. The African state of Lesotho, which has one of the highest infection rates in the world, launched the world’s first door-to-door HIV testing service. India’s Prime Minister Manmohan Singh called for people to shed inhibitions and start discussing sex in an effort to increase AIDS awareness. President George Bush stressed the US ”ABC” policy in a press conference Thursday. This stands for abstinence, being faithful and using a condom. He also touted U.S efforts to combat HIV abroad.

  • President Bush, Washington DC, December 1, 2005.

For more on World AIDS Day we speak with the Center for Health and Gender Equity

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This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: This is the President speaking on World AIDS Day.

PRESIDENT GEORGE W. BUSH: Our concern about HIV/AIDS does not stop at our borders. Other nations face greater challenges, yet they are moving forward with courage and determination that inspires our respect and deserves our support. Nations like Uganda and Kenya have demonstrated that leadership and honesty can overcome stigma and reduce rates of infection. Nations like Botswana and Namibia have shown that anti-retroviral treatments can be widely delivered and highly successful. These countries and many others are fighting for the lives of their citizens, and America is now their strongest partner in that fight. And we’re proud to be so.

We’re supporting our partners through the Global Fund, which is helping nations purchase medicines and treat tuberculosis, the deadly infection that often accompanies AIDS. We’re also supporting our partners through the Emergency Plan for AIDS Relief, the largest initiative in history to combat a specific disease. This effort is designed to support and strengthen the AIDS-fighting strategies of many nations, including 15 heavily afflicted nations in Africa, Asia and the Carribean. In May 2003, we committed $15 billion over five years to meet specific goals, to support treatment for two million people, support prevention for seven million people, support care for ten million people.

AMY GOODMAN: President Bush speaking yesterday in Washington. We’re joined in our D.C. studio by Jodi Jacobson, Executive Director of the Center for Health and Gender Equity, known as CHANGE. Welcome to Democracy Now!


AMY GOODMAN: Your response to President Bush’s picture of the world today when it comes to AIDS and HIV?

JODI JACOBSON: Well, generally speaking, I think the President is right when he says that we have initiated — the United States has initiated a far-reaching plan to combat HIV/AIDS, and certainly, we have put more money in under this administration than in any previous administration, and rightly so, because this is an epidemic of unprecedented proportions. It’s connected to other epidemics of malaria, tuberculosis and reproductive and sexual health. However, I think we have to think not just about how much money we are spending, but how we are spending it, and the politics that our money has brought with it on the ground, particularly in the area of prevention.

AMY GOODMAN: Can you explain? What’s the problem?

JODI JACOBSON: Yeah. Well, the President talks about A.B.C., for example, which is the much-touted framework for abstinence, be faithful, and use condoms. The problem is that under a comprehensive approach to HIV prevention or prevention of any sexually transmitted infection or unintended pregnancy, a comprehensive approach affords the individual and a population information on all aspects of prevention. You want to delay sexual debut in adolescence as long as you can. You want to encourage people to be monogamous. You want to encourage people to use any available prevention technology, which today we have male and female condoms.

Unfortunately, what the U.S. policy does is breaks those up into pieces, and yet calls them a comprehensive approach. And what I mean by that is, for example, we are supporting throughout Sub-Saharan Africa a great deal of funding going to abstinence-only-until-marriage programs and “be faithful” programs that segregate out information on and access to male and female condoms to people even whom are already sexually active. And our policy, generally speaking, is allowing condom distribution only to so-called “high risk” populations, like sex workers and truck drivers, despite the fact that in populations in Botswana, in Nigeria, in Uganda, any one of the priority countries of U.S. global AIDS relief.

This is a generalized epidemic, and in fact, infection rates are rising most rapidly among those ages 15 to 24 and among married women in their twenties and thirties. So, a focus on abstinence only does not do much for those populations, and hence, I think our prevention focus is not only going to be proved ineffective, but may, in fact, lead to unnecessary numbers of new infections.

JUAN GONZALEZ: And to what degree is the Bush A.B.C. policy effecting how other governments in Africa and other parts of the world develop their own policies to battle AIDS?

JODI JACOBSON: Well, very strongly so. Actually, yesterday the Pan-African Treatment Access Movement put out a statement protesting the Bush administration focus on abstinence only, because they see in the many countries in which they work in Sub-Saharan Africa a driving tendency toward shifting away from more comprehensive strategies toward an abstinence-only approach for the general population or an abstinence and faithfulness approach for the general population, and the disappearance of condom procurement and distribution.

In Uganda, for example, we’ve seen over the past year a condom crisis of unprecedented proportions. Condoms literally disappeared from the marketplaces in Uganda and from the government health system, due both to actions by the Ugandan government, as well as the sort of setting of the United States’ policy in Uganda. In Nigeria, a colleague recently told me that condom social marketing and distribution programs once funded by the United States have been totally cut, and now in ten states of Nigeria, where once you had an effective public campaign for people who were sexually active to use condoms, that has disappeared. Similarly, we’re hearing these stories in Botswana, in Zambia, and elsewhere.

So I think what’s happening is that we have a lot of money, we have a lot of clout, we have a lot of political power. We come into a country, and we start to say, 'If you want our money' — and people need it, because this is, again, an unprecedented epidemic, then we carry a lot of power with how we force people to shape their programs if they want to get funding to address HIV.

AMY GOODMAN: And, finally, Jodi, the issue of corporations and drugs and availability and patents around the world.

JODI JACOBSON: Well, I think, you know, what we’re seeing on the treatment side is that there are some very hopeful signs with an increasing number of people with access to treatment. We also, though, see that there’s a promise by the G8, as you noted earlier, to get by 2010 up to between 10 and 12 million people on treatment. We’ve got roughly just over a million people on treatment today. We’ve got some 40 million people infected with HIV worldwide, and a large share of those are in need of fairly immediate treatment, so in order to scale up and make sure that we get somewhere close even to the 10 to 12 million people that we need on treatment by 2010, we need everybody’s help. We need to make sure that affordable generic drugs are made accessible as quickly as possible. We need to make sure that we do enlist the corporate world.

I think earlier on, the Bush administration policy was rightly criticized for favoring brand-name drugs over generics. I think that has been changing, as the F.D.A. has moved through the process of approving generic drugs, although my understanding is that we still don’t have a three-in-one or triple combination single pill. So, we’re on the way to improving access, but I think one of the really critical things we can’t forget here and something the President mentioned yesterday is that our tendency under this policy has been to favor so-called faith-based groups, both in prevention and treatment.

And what we’re concerned about on the treatment side is that there really is a — we’re talking about health systems in Africa, particularly, that are literally crippled, and unless we build those health systems, the public health systems, from the bottom up, we will not have the ability either to reach the goal of 10 to 12 million people by 2010, nor leave behind a sustainable system of ensuring that people have access to drugs over the long term, because my fear is that as the epidemic continues to grow, we’ll see some donor fatigue. And I hope that doesn’t happen, but history shows us that over time, people get tired of funding something that doesn’t go away. This is why we need the most effective prevention programs that we can have to stem the spread and also to increase the capacity of health systems on the ground in Africa to continue to provide treatment, even after donor funding may decline.

AMY GOODMAN: Jodi Jacobson, thank you for joining us, founder and Executive Director of the Center for Health and Gender Equity, CHANGE, in Washington, D.C.

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