A Former President's Plea to Curb AIDS in Africa

By Jimmy Carter

International Herald Tribune

Like most Americans, I am deeply distressed by the growing AIDS crisis in Africa. More than 25 million Africans are infected with the HIV virus, and more than half that number have already died. In fact, AIDS now exceeds malaria as the single leading cause of death on the continent, turning back the clock on hard-won gains in life expectancy achieved by many countries in recent decades.

This accelerating crisis will take millions of more lives, and threatens to destroy national economies and even obliterate some cultures unless the governments and citizens of African countries, with support from the world community, understand that this epidemic can be conquered only by preventing new infections. There has been some progress, such as the strong leadership demonstrated in slowing the spread of HIV in Senegal and Uganda, and some promise in the recently announced effort by the government of Botswana, the Bill & Melinda Gates Foundation and Merck & Company, to provide resources to improve the state of AIDS care in that country.

The World Bank, the U.S. government, and the pharmaceutical industry also are considering ways to make costly drugs more widely available for impoverished victims. But much more than the treatment of those already infected can and must be done to avoid an unprecedented disaster.

I offer the following suggestions: First, heads of state and government must lead. They must publicly acknowledge and articulate the gravity of the threat posed by the AIDS epidemic, despite the stigma, taboos and deeply personal aspects associated with the disease. Leaders need to address their people on television and radio, support extensive advertising campaigns and personally and publicly review the progress of national programs to prevent HIV infections and combat the disease. International help should focus on those nations where government leaders enthusiastically make such efforts. Second, African governments and their international partners must concentrate on preventing new infections. It is, of course, essential to make affordable medical care available to HIV-infected persons and to provide counseling services to those who are already infected. Discrimination against those with HIV cannot be tolerated, both from a human rights standpoint and because such actions discourage the openness and testing necessary to slow transmissions.

But it is necessary to avoid the natural tendency to focus most or all of our resources and attention on caring for the sick.

As with other infectious diseases, it is essential that governments give highest priority to preventing the spread of the virus to new victims and mobilizing their entire society to that end. Ministries of health should determine the current status of such indicators as knowledge and attitudes about the disease; sexual practices, including levels of condom use; and the prevalence of the infection in young adults and pregnant women. Based on their findings, they must develop and implement aggressive programs to slow, and eventually stop, the spread of AIDS.

All levels and sectors of government and society must understand how they can contribute to this national struggle, and receive help to do so. This will mean widespread education with peer involvement and massive promotion of effective use of condoms and available testing for infections. Those infected must receive care that is at least dignified if not high-tech, and those at risk must not be shunned. Research is imperative, but we all must use what we have to fight this war as best we can now and use new developments as they appear. Third, there is need for broad partnerships. This problem is bigger than any one country, agency, group or individual. The Carter Center is working in successful partnership with national governments, volunteer health workers in villages, international and bilateral assistance agencies, foundations, other nongovernmental organizations and private corporations. Africa will need even more creativity and allies in its fight against this deadly new enemy.

The writer, a former president of the United States, contributed this comment to the International Herald Tribune. (Not to be reproduced without the permission of the author.)