International AIDS Conference

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(Host) Last week, as all eyes were on Boston and the Democratic National Convention, commentator Nils Dauliare was in Bangkok for a very different kind of meeting.

(Daulaire) Every two years, the global community gathers for an international conference on AIDS. This year, just a few weeks ago, it was in Bangkok, Thailand. The 20,000 people there represented nearly every country on earth, but two groups stood out for me.

The first was people living with AIDS. Starting at the AIDS conference in Durban, South Africa four years ago, those whose lives are on the line brought home to us their urgent desire to be seen not just as victims but as central actors in fighting the spread of this deadly virus. We heard them, and the world began a remarkable shift – from simply writing off the millions already infected, to relying on them to help shape a meaningful response.

At Bangkok, they again took center stage, holding up a mirror to political leaders and health bureaucrats to show the human price of business as usual. And they loudly challenged those who look to differentiate the good AIDS victims – mothers and infants whose personal decisions could not be blamed for their infections – from the others – those whose own actions led them to be exposed to the AIDS virus. This is a particularly insidious distinction, since the virus itself couldn’t care less which human meat it is consuming. In fact, those at high risk because of personal actions are crucial targets for prevention and care efforts, since these are precisely the individuals most likely to bring AIDS into a community, and to spread it widely.

The science is clear. We can be morally judgmental or we can fight AIDS. Take your pick. Politicians take notice.

The second group was those practitioners on the front lines of AIDS care and prevention. At the AIDS conference in Barcelona two years ago, they startled much of the world by saying that even the poorest of the poor could be effectively treated with anti-AIDS drugs. That prompted a U.S. initiative promising $30 billion over five years for treatment, care and prevention – the largest global health investment in history.

This year, the practitioners were back, with growing evidence that anti-retroviral drugs – now costing just a fraction of their original price – can and do work in the most challenging environments. Now our greatest obstacles are inadequate health care systems with which to deliver these services. It’s not doctors that are most needed, but nurses and paramedics, trainers and managers, educators and community mobilizers who can make good the world’s promises of help and care.

As we move into this political season, that’s something I hope that both President Bush and Senator Kerry will remember. Both candidates have said they are committed to dealing with the global AIDS crisis. Both are talking about mobilizing serious resources. But each must resist some of their core constituencies’ ideologically driven, simplistic and simply wrong strategies. Abstinence only. All we need is generic drugs. Just add money. Just send doctors.

In this global struggle, one size does not fit all. In the next 12 months, three million people will die of AIDS and another 5 million will be newly infected. Above all, AIDS calls for a thoughtful, thorough, honest and non-political response.

This is Nils Daulaire.

Dr. Nils Daulaire is president of the Global Health Council, headquartered in White River Junction. He spoke from our studio in Norwich.

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