I am tired of AIDS and HIV, of talking about it, hearing about it, reading about it, and thinking about it. I would rather think about my Enron holdings, or the fact that I believe the young couple kissing on the sidewalk in front of my home when I drove by unexpectedly one evening a few months ago included my daughter. (You are busted!) In the U.S. AIDS deaths have been cut in half in the last ten years, new cases are down to 40,000-plus annually, and besides, the disease can be avoided by anyone with a condom and half a brain, right? Let’s move on to something important, like jailing corporate CEO’s, for example.

Good company abounds when it comes to my AIDS ennui. President George W. Bush seems tired of it too, which is probably why he did not even talk about HIV / AIDS in his State of the Union address this past January. He spoke at length of the terrorism which killed almost 5,000 Americans in 2001, but said nothing of AIDS, which killed more than 17,000 Americans that year. U.S. funding for the international “war” against AIDS continues to dwindle in comparison to the number of cases worldwide. Some gay men seem tired of the topic; a recent study of gay and bisexual American men newly diagnosed with the HIV virus found that 65 percent were unaware they were infected, and most thought they were at low risk of becoming infected. Those men were evidently living in the same la la land as President Bush when he appointed former U.S. Rep. Tom Coburn to co-chair the Presidential Advisory Council on HIV and AIDS. Coburn’s principle qualifications were his conservative politics and the fact that he has been a strong advocate of abstinence-only HIV prevention programs. That approach to fighting the world’s deadliest sexually transmitted disease is akin to searching for land mines by plugging your ears, closing your eyes, and stamping about with your outstretched foot while singing “Mama Said They’ll Be Days Like This.”

The national American nap in the AIDS war, however, is contributing to the nightmare that is AIDS around the world, and increases the risk that the nightmare will come home to haunt us too. Around the world at least 45 million people are infected, and more than 60 million will be infected by the year 2010. More than 25 million AIDS victims have died and 4 million more are dying each year (about 8,000 a day). In South Africa a quarter of the adult population is infected. Worldwide, 14 million children have lost at least one parent, and in Zimbabwe one child in five has lost both parents. Social development will be impossible in such countries unless the epidemic is brought under control. The plague is just taking off in China, where already 1 million are infected and 800,000 babies a year are infected with the HIV virus at birth, a tragedy that is entirely preventable with treatment.

We really should not be sleeping here either. More than 300,000 American are infected with HIV and the AIDS has killed more than 450,000. The rate of new infections is creeping up, and one third of new cases are among heterosexuals. We are all but a bad night in the fast lane away from contracting the disease.

These brutal realities of AIDS here and around the world stand in sharp contrast to this country’s failure to do much of anything to fight AIDS abroad. The U.S has pledged only $500 million over the next three years to the international AIDS fight, less than 15 percent of what international AIDS experts believe the U.S must contribute. It is estimated that a mere $10 billion a year for AIDS prevention programs could cut the rate of new AIDS cases in the world by half, an amount that is pennies on the dollar of what those AIDS cases, which could have been prevented, will ultimately cost. The lack of funding continues despite growing evidence that the only magic bullet against AIDS is money to prevent infections (a vaccine is years off).

Also shameful is the continued resistance of American pharmaceutical companies to allowing the production of generic versions of their AIDS-fighting drugs in those countries being decimated by AIDS. None of those countries can afford the drugs unless they can produce the generics. That resistance is supported by the U.S government, a support that means the protection of pharmaceutical company profits at the expense of Third World lives because less than 1 percent of AIDS patients worldwide can afford the full cost of non-generic AIDS drugs.

The story is long and appalling, but boils down to this; Americans need to wake up from their AIDS nap and tell our leaders that snoozing in the AIDS war is not a leadership act. We need to pay our share of the costs of international AIDS prevention, support the availability of generic drugs in countries dying for them, and chase the AIDS epidemic at least as hard as we are chasing Osama bin Laden. Until we do we will be confined to the kindergarten of nations, no matter how rich and well armed we are, and millions will die waiting for us to grow up.

Erik Steele, D.O. is a physician in Bangor, an administrator at Eastern Maine Medical Center, and is on the staff of several hospital emergency rooms in the region.