*EPF412 12/11/2003
U.S. Embarking on Largest Global Health Effort Ever, Official Says
(AIDS funding to target prevention, treatment, care, Tobias adds) (680)

By Kathryn McConnell
Washington File Staff Writer

Washington -- By contributing $15 billion in five years beginning in 2004 to fight HIV/AIDS, the United States is embarking on the largest commitment by a government to an international health initiative, says the Bush administration's new global AIDS coordinator.

In disbursing the funds, the administration will focus on helping countries teach people about prevention, treatment and care, said Randall Tobias, the U.S. government's first AIDS coordinator.

Speaking December 11 at the Woodrow Wilson Center in Washington, Tobias, who recently returned from visiting several countries in sub-Saharan Africa, said international discussions about how to deal with AIDS have shifted from those of "prevention versus treatment" to how to meet the challenge of eliminating the stigma of the disease so people can be diagnosed early and treated effectively.

Removing the stigma of getting tested for AIDS would encourage more people to take the diagnostic test, he said.

Tobias said 2004 will bring "hope of a new approach" for dealing with AIDS. A sign of that hope is the increasing number of world leaders who are admitting their countries are being affected by the disease, he said.

He challenged country leaders to publicly announce that they are getting tested to encourage others to do so.

The official commended the cooperation among governments and nongovernmental organizations (NGOs) that has produced "proven programs" to change behaviors. He thanked NGOs for helping governments become more focused on the issue of AIDS. He added that the private sector will also be important in future anti-AIDS efforts.

He said the United States' approach will be to look at evidence-based results of programs and at how to make programs sustainable. Initially, he said, the United States will focus its AIDS efforts on 14 countries in Africa and the Caribbean.

Tobias said the first phase of the United States' new global AIDS strategy will be concentrated in five areas. These are teaching prevention, especially to youth; rapidly expanding anti-retro viral treatment programs; helping governments improve their support services, such as maintaining a safe blood supply; teaching safe medical practices, such as administering clean injections; and caring and educating children left parentless by AIDS.

The United States also wants to work with recipient governments to help them learn how to effectively absorb donated funding to combat AIDS, he said.

Tobias said coordination among all organizations involved in addressing the disease is vital so all aspects of helping its victims can be addressed. Efforts include programs that provide adequate nutrition and safe drinking water to patients so they can most effectively respond to therapy, he said.

The battle in AIDS prevention, treatment and care "will be won or lost" in country after country at the community level, Tobias said. He recounted visiting an infected couple in a village where a community health worker had taught the husband how to take his medicines and monitor his wife's health to know when she would need to start taking doses.

Modern drug therapies, if continued regularly and as directed, can now allow a person to live a long life, Tobias said. The newer drugs are giving hope to people who feared getting tested and learning that they would soon die. Now people are realizing that if they are tested and learn they are infected, the drugs can help them live much longer than was previously possible.

Illustrating the scope of the global AIDS problem, Lee Hamilton, director of the Wilson Center, said that in some African countries, more than one-forth of the population is infected with HIV/AIDS, leading to economic decline and a rise in violence.

Further, Tobias said the daily death toll from the disease equals the number of passengers on twenty 747 jets. He said in some countries the rate of AIDS among women is significantly higher than among men.

Stressing the urgency of the problem, Tobias said that without increasing intervention at the international level, 85 million people could be infected by the disease by 2010.

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

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