A War We Can Win

As a State Department doctor in Africa in the mid-1980s, I saw diseases like AIDS take root. Before long, it became clear to me that African countries, like other developing nations, faced two possible futures: heartbreak or hope. In one future, disease would condemn struggling nations to a cruel fate of crushing poverty, a crumbling workforce and catastrophic death. In the other, the United States and other nations would fight a common enemy, uniting every nation and every culture against health scourges everywhere.

The humanitarian implications are profound, but so are the economic ones. We can spend years arguing over which tax or trade policies will best help poor countries economically, but fighting diseases that kill millions and cripple countries' workforces will help most of all.

Avian flu is a new threat, but AIDS, tuberculosis and malaria are not; they take more than 6 million lives annually. Fortunately, we already have the tools to fight global disease. We know, for example, that five simple interventions (among them vaccines, antibiotics and Vitamin A) can significantly increase child survival at minimal cost. We know that more expensive interventions to provide AIDS treatment and education have shown promising results in Uganda, Botswana, Mozambique and elsewhere. We know that the major diseases exacerbate one another--and that if we can keep you from getting AIDS, you're less likely to die of malaria, and if we can cure your TB, you're less likely to die from AIDS. And we know that the key is providing enough doctors and nurses, effective and affordable medications and preventive care worldwide.

Basic policy changes will help us win this war. First, we need more resources. President Bush made headlines in 2003 when he promised $15 billion over five years to fight HIV, TB and malaria. It's a start, but billions more are needed. Meanwhile, we can spend our money better. Current law sets aside a third of all AIDS-prevention spending for abstinence education, which is less effective than other prevention tools. If we increase our contributions to international groups like the Global Fund, which has programs in 128 countries worldwide, we can leverage the resources and good will of other developed nations.

We have to broaden our targets and methods, too. Most AIDS-fighting funds provided through our current program go to just fifteen countries and address only about half of all AIDS cases worldwide. We need to reach the rest. And in this war, we can't ignore disease-fighting "treatments" that doctors cannot deliver: clean water, nutrition, improved access to education and rights for young women. These are as essential as medicine.

In the three minutes it has taken to read this article, fifteen people have died from AIDS, tuberculosis or malaria. The world cannot afford to wait another three minutes to act.

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