Glimmers of hope, but miles to go on AIDS

World AIDS Day - a good time for stocktaking - came and went last week and the news is both good and bad.

It's good because apathy about combating AIDS in many countries has suddenly been overtaken by concern and action. More money is flowing from donor nations who want to help. The cost of drugs to treat the disease medically is coming down.

But the bad news is that this problem, once described by US Secretary of State Colin Powell as "bigger than the war on terrorism," remains immense. Somewhere around 40 million people worldwide are infected. While three-quarters of them are in Africa and the challenge there is most acute, the disease is spreading to countries like India and China. AIDS, once thought to be most prevalent among homosexuals and intravenous drug users, now is rampant broadly among the poverty-stricken of some of the most backward nations in the world. Tragically, some of the most seriously afflicted are the innocent children of parents who have died from the disease. There are already millions of orphans in Africa diagnosed with the AIDS virus.Some officials estimate the numbers might top 30 million in several years.

The enormity of the challenge is prompting new initiatives. In South Africa, more than 5 million citizens are HIV-positive, more than in any other country, but the government has, until now, been notoriously lax in reacting. India has the second-largest number, about 4.6 million. A few days ago, both countries announced ambitious new programs to treat their respective AIDS patients with anti-retroviral drugs. Microsoft billionaire Bill Gates has pledged a $200 million grant for AIDS prevention programs in India.

China is another country that has been in denial about the challenge of 1 million citizens infected with HIV. But last week, China's Prime Minister Wen Jiabao pledged support to a new AIDS public-awareness program. He promised free AIDS drugs to all who need them, and an education program that will include condoms and safe-sex advice.

Meanwhile, although the cost of AIDS drugs has been sharply declining, a critical problem has been the shortage of medical personnel to administer them. One US doctor I know, who has been involved with the program in Africa, says there just is not the infrastructure in place to treat patients. Last week, in something of an assault on this problem, the World Health Organization, a United Nations agency, announced a program to train 100,000 healthcare workers who, it is hoped, would be in place to deliver the drugs by late 2005.

The US is bringing new focus to bear on the AIDS problem with an 80-member delegation that last week began a tour of sub-Saharan Africa. Headed by Health and Human Services Secretary Tommy Thompson, its function is to both raise awareness and study what more needs to be done. In Zambia, Mr. Thompson delivered a $6.3 million grant to help fight AIDS. In Rwanda, he promised help and laid a wreath at a memorial to victims of 1994 genocide. In that massacre, thousands of women were raped and infected with HIV.

President Bush has been personally concerned with the world's AIDS crisis. In his State of the Union message this year he pledged to increase US spending on AIDS prevention by $3 billion a year for the next five years. To ensure that the new money is not diluted by corruption or misspending in the countries it was intended for, the president required that the receiving nations give proof of good government. Congress appears ready to support the Bush initiative with a hefty increase in foreign aid next year, most of the increase being for HIV/AIDS, and most of that going to Africa.

While such efforts are welcome in cranking up the war against AIDS, a new UN report last week said that the world's financial response has been "woefully inadequate." Without additional money, claims the report, it is unlikely the goal of halting and reversing the epidemic by 2015 will be met. The report sees a gap of $1.6 billion this year between projected spending and what AIDS programs need.

The report was based on data from 103 of the 189 countries signing a UN Declaration of Commitment on HIV/AIDS in 2001.

But there were glimmers of hope, said UN official Paul De Lay. Of the 189 signatories, 93 percent have developed a required national AIDS strategy.

Clearly, in the war against AIDS, much has been done, but much more needs to be done.

• John Hughes, editor and chief operating officer of the Deseret Morning News, is a former editor of the Monitor.