World AIDS Day, observed on December 1, marks 20-years since the first cases of the Human Immunodeficiency Virus were identified. The United Nations believes that, 20-years later, HIV-AIDS remains one of the greatest health threats the world has seen.
Last June, the U.N. General Assembly held a special session on HIV-AIDS in an effort to dramatize the problem on a global stage. World leaders spoke of the need to mount an aggressive fight against the disease.
Secretary of State Colin Powell, a former Army General, told the Assembly that he knew of "no enemy in war more insidious and vicious than AIDS."
The three-day session ended with adoption of a resolution committing all nations to specific goals in both the prevention and treatment of HIV-AIDS. The sincerity may be there but, according to Dr. Desmond Johns of the U.N.AIDS organization, the results have yet to be seen.
"The world continues to face a worsening AIDS epidemic, a truly global epidemic," he explains. " We are estimating there have been three-million deaths in the past year, five-million new infections, and perhaps a total of 40-million people living with HIV-AIDS."
AIDS is a great human tragedy with mothers and fathers dying, leaving untold numbers of orphans and many young people who are just beginning to take their places in society are becoming sick and dying. But U.N. officials point out that, beyond the human dimensions, HIV-AIDS also has severe economic effects, especially in poor and developing nations.
Earlier this year, the United Nations established a Global Fund to finance treatment and prevention programs. So far, $1.6 billion has been pledged, a substantial sum but way below the $7 billion that U.N. Secretary-General Kofi Annan has said the fund requires.
Dr. Peter Piot, the Director of UN-AIDS, says the recent global attention to the issue of terrorism has had the unfortunate effect of reducing the attention paid to HIV-AIDS.
"It is undoubtedly true that the September 11 events were a major blow to the global agenda of AIDS where we really had an unprecedented momentum, not only in western countries but internationally," he says. "That momentum has not come to a stand still, but is has been affected in terms of things like pledges to the Global Fund. It has also been more difficult for us to include AIDS in the political dialogue."
U.N. officials involved with the AIDS issue say fighting terrorism is a global priority, but that AIDS is also a priority and the two should not compete against each other.
People often associate HIV-AIDS with sub-Saharan Africa and its is the most severely affected region with about 70 percent of the cases. But the United Nations recently reported the disease is now spreading the fastest in eastern Europe and especially in Russia where the number of reported cases has jumped almost 13 fold in less than three years.
UN-AIDS says the battle against the disease must include both education, to prevent new cases, as well as treatment that can prolong the productive lives of those already infected. Treatment is contingent on making sure that poor nations have access to expensive HIV drugs and that health care systems in those countries can effectively administer the drugs.
But Dr. Piot says there is one other element that is often critically important in the fight against AIDS.
"Leadership at the top is really crucial to move a whole nation, to make sure that the money is there, that every sector of government is going to contribute to the effort and it [leadership] creates an environment in which all kinds of groups can work on the issue," the doctor says.
UN-AIDS officials point out that, even in relatively poor nations, strong national leadership on HIV-AIDS issues can make a very positive difference.
One of the biggest problems in confronting HIV-AIDS has been the stigma and the silence it engenders. The stigma has not vanished, but UN-AIDS says it is lessening. Perhaps, on World AIDS Day 2001, that alone can be reason to hope that the lofty pledges of world leaders last June can start to become realities.