According to delegates at the 14th annual International AIDS Conference in Barcelona last week, $10 billion is needed to control the AIDS epidemic. But can the money be raised? And if so, what is the most effective way to spend it? The fate of millions of people hang on the answers to those questions.
AIDS funding often goes to increase education about risks and prevention, to find a cure or vaccine or to improve the affordability and accessibility of drugs. But health officials can't afford to focus on just one type of aid; they need to employ a combination of all these strategies.
Educating people about the risks of unprotected sex, distributing condoms and offering free needle exchanges can make an impact on certain populations.
Unfortunately, many people in the world who are most at risk for infection and targeted by these efforts -- homosexual men, prostitutes, intravenous drug users and young people -- appear to remain uneducated about prevention tactics. Governments must work with them. They must admit the severity of the epidemic and reject the stigma of the disease. They must reject idealistic approaches that uphold abstinence as the only form of prevention and treat AIDS as the public health problem it is.
Even if education were universal, funding would still go toward the development of a cure or vaccine. Researchers are making gains, such as a recently discovered drug, T-20, that reduces high levels of HIV in the blood.
Conference delegates heard some harrowing statistics: Some 13 million children worldwide have been orphaned by AIDS, and it is projected that 20 million children will be orphaned by 2010. Effective drugs such as T-20 could make the difference in prolonging the lives of AIDS-afflicted parents and improving the lives of their children.
But if people do not have enough money to buy medicine or know where to get it, or are not properly supervised to ensure that the dosages are regularly taken, the opportunity offered by these drugs will be wasted. Money must go to decreasing costs and increasing accessibility of drugs in order for people to take full advantage of their possibilities.
But can the money be raised? Perhaps, but it will require a political will that hitherto has been lacking. According to protesters from Act Up, who shouted "shame, shame!" at U.S. Health and Human Services Secretary Tommy G. Thompson at the conference last Wednesday, the Bush administration should make a greater monetary contribution.
Stripped of their potentially alienating agitprop theater, the activists have at least half a point. The United States donates less than 1 percent of its gross national product to foreign aid overall and ranks lowest among industrialized countries in percentage terms. On AIDS, the administration's strategies focus on preventing the spread of AIDS from mothers to children instead of on education and medicine. As one of the world's wealthiest nations, the United States has a moral responsibility to help attack the AIDS scourge -- and should do more.
Even so, emptying money into AIDS inflicted African countries -- which are ground zero for the epidemic -- is not necessarily the answer, as many are riddled with corruption. This is a world problem and each nation needs to take responsibility in its own way. Money can buy medicine but it can't buy good governance and enlightenment. For all these reasons, the alarming news from the AIDS conference was not tempered by optimism.
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