Death and denial

As the 13th International AIDS Conference continues in South Africa, alarming statistics and projections continue to emerge. Alarming, however, may not be the right word to describe a catastrophe so long foreseen and neglected.

Sub-Saharan Africa is being ravaged by the disease. As many as one in five people there are infected with HIV. It is home to two-thirds of the world’s 34 million infected, not counting the 17 million already dead. The next phase of this calamity, experts say, will be for the world’s poorest region to become the world’s largest orphanage.

It has, coincidentally, been 13 years since a CIA intelligence officer charged with tracking political upheaval in the world identified HIV/AIDS as the single greatest threat to the stability of developing nations. That report was shelved, the victim of indifference, social taboo, racism and the false belief within wealthy nations that they had escaped the worst.

The worst is proving to be a relentless hunter. In 1990, is was estimated that an effective education and prevention for Africa would cost $3 billion. A model developed in Uganda that sent the rate of new infections into decline was willfully ignored. The unspoken sentiment among devloped nations was “demand management” — the concern that providing modest financial assistance would only lead to larger requests. Today, the cost of providing effective treatment to those millions of African patients is pegged at $60 billion.

In the sub-Sahara, only South Africa has an economy that can even begin to bear such costs. In a disaster so driven by denial, it figures then that South African President Thabo Mbeki would open the conference with a speech clinging to the scientifically debunked belief that poverty and malnutrition — not HIV — causes AIDS. In contrast, the government of Zimbabwe recognizes the true situation but would have to spend almost three-fourths of its gross national product to deal with it.

In one sense, President Mbeki is correct — AIDS is not just another infectious disease. It flourishes in poverty and oppression, it preys particularly upon those women and children forced into prostitution. It is, though, utterly incorrect to assert that AIDS cannot be controlled until poverty is eliminated.

Scrambled priorities also afflict those best positioned to help. The drugs — AZT and 3CT — that can prevent infection in newborn babies and drive AIDS into remission cost about $11,000 per year per patient. Pharmaceutical companies have long promised low-cost medications to Africa, but insist they must withhold delivery until local governments become more efficient and less corrupt.

Meanwhile, the death toll from AIDS is on track to exceed both world wars. There is as yet no cure, no vaccine, but there are proven preventions, underused and underfunded. The dire statistics and projections coming out of the South Africa AIDS conference are alarming. The question is whether the world will awaken.