*EPF305 11/27/2002
Leadership, Commitment Are Key to Confronting HIV/AIDS
(State Dept. HIV/AIDS Representative discusses new data on disease) (990)

By Charlene Porter
Washington File Staff Writer

Washington ���� As a new global census reveals that the HIV/AIDS epidemic stalks the world at an unrelenting pace, U.S. Deputy Assistant Secretary for Health and Science Jack Chow says HIV/AIDS "continues to outpace the world's ability to confront the virus and mitigate its impact."

In a Washington File interview, Chow said, "The United States is committed through its bilateral programs and a new platform of pursuing diplomacy as a means of mobilizing societies and galvanizing leaderships to take constructive action against the pandemic."

Chow also serves as the Special Representative of the Secretary of State for HIV/AIDS and has traveled to 11 nations in 2002 urging stronger action against the pandemic.

The Joint United Nations Program on HIV/AIDS (UNAIDS) released its annual survey on the pandemic November 27, finding that the number of people infected with HIV and living with AIDS worldwide has climbed to 42 million.

While sub-Saharan Africa remains the region of the world with the greatest number of cases, the aggressive progress of the virus in other regions is a finding that stands out for Chow, both diplomat and physician. The UNAIDS report, "AIDS Epidemic Update 2002,"said that Eastern Europe and Central Asia have the "unfortunate distinction" of having the world's fastest growing epidemic with an estimated 250,000 new cases over the last year, roughly a 25 percent increase in a single year.

Chow said of that finding, "It confirms that the virus will infiltrate, permeate and devastate every society that is ill-equipped or under prepared to forcefully undertake public health efforts."

The UNAIDS study estimates more than 3 million deaths from the virus in 2002, and 5 million persons newly infected with HIV. Even with that terrible toll, Chow's travels this year give cause for optimism because of the new commitment he observed among national and social leaders to launch initiatives to attack the disease and prevent its further spread.

Recalling his trip through five African nations in November, Chow said, "I was very heartened at the personal commitment and courage of individual health workers toiling in hospitals and clinics in the most desolate, remote parts of these countries."

Beyond the important day-to-day work that they do in coping with the human ravages of the epidemic, Chow said these health workers also understand the strategic global plan advocated by the United States and the United Nations on how best to contain the disease. "Even in the most isolated parts of Africa, people understand that governments, civil society and the health sector have to knit together coalitions, partnerships and alliances to help those most in need, not only the infected but the affected as well."

The UNAIDS theme selected for the December 1 recognition of World AIDS Day is "Live and Let Live," an effort to reduce the stigmatization and prejudice that surrounds the disease. These negative social reactions to people living with HIV/AIDS do much more damage than a case of hurt feelings, according to all the evidence.

In communities where the possibility for stigmatization is great, individuals are less likely to be tested for the virus. Without testing and knowledge of their HIV status, they are then more likely to pass the virus to others. A person who is unaware of his or her HIV status does not seek out health care services, and is thus likely to suffer more adverse health consequences as the virus begins to take its toll. In many regions, those services include a network of HIV-infected people who can provide much needed emotional support.

Chow said leadership is the key to overcoming social stigma and prejudice about the disease. He praised leaders in Uganda and Thailand for setting the proper tone to minimize the shame associated with the disease.

Uganda and Thailand are "prime examples where leaders through assessment of potential devastation that HIV/AIDS could wreak on their societies made a conscious decision to not only speak out as national leaders, but to make accountable the coterie of ministers . . . to have their entire governments speak out," Chow said. "This allowed leaders in other sectors of the society ���� such as the religious community and the business community ���� to do likewise."

Because of those actions, combined with public health and prevention campaigns, Uganda and Thailand have achieved what are widely regarded as some of the world's best records for containing and reversing the progress of the disease.

Though Chow celebrates these examples of progress against the epidemic on World AIDS Day 2002, he cautions that HIV/AIDS remains one of the greatest threats to international security looming in today's world. While this recognition has been an element of U.S. policy for about two years, Chow said the ever-higher toll of the disease in some nations is raising new concerns about other social threats "intersecting with HIV/AIDS" and worsening the level of crisis.

According to the UNAIDS report and other international relief agencies, this trend is unfolding in southern Africa where the epidemic is recognized as a factor in deepening the effects of drought and famine. The agriculture workforce has been diminished by the disease, causing further reduction in agriculture productivity, resulting in food shortages.

Chow cited poverty, illiteracy, under education, conflict and other diseases as examples of social problems that intersect with HIV/AIDS and accelerate the spread of the epidemic. And when that happens, the disease works to exacerbate the existing problems, Chow said.

A recent report from the National Intelligence Council predicted the next wave of HIV/AIDS will occur in five populous nations -- Nigeria, Ethiopia, Russia, India and China ���� where large populations will give momentum to the spread of the virus. The report suggests that those countries must take more aggressive action to preserve any hope of containing the disease.

"We can make a substantial difference," Chow said, citing again those examples of nations where aggressive leadership and partnership have worked to create successful public health and prevention efforts to contain the disease. "We should adapt and replicate those successes in all countries of the world."

(The Washington File is a product of the Office of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)

Return to Public File Main Page

Return to Public Table of Contents