Newsday - February 29, 2000
Laurie Garrett, Staff Writer

The sessions mark a striking shift in global political views of the disease, from virtual silence last year to an actual "Declaration of War on AIDS" issued by the UN Security Council on Jan. 10.

Yesterday, in keeping with this change in priorities, the U.S. State Department issued a memorandum to all its missions and embassies, declaring "a proclamation of war against this disease." And UN Ambassador Richard Holbrooke said yesterday, "Clearly and flatly the U.S. will not support any peacekeeping mission anywhere...that does not support action on this issue."

Holbrooke has repeatedly argued that sending soldiers into such areas as Rwanda or Congo, without strong education about HIV risks, imperils both the lives of those military personnel and the safety of their missions.

In some countries-notably those of the former Yugoslavia-local political leaders have claimed that UN peacekeepers are spreading HIV through sexual activity with local men and women.

Since the Jan. 10 Security Council Session on AIDS in Africa-organized by Holbrooke and Vice President Al Gore-a growing global political concern about HIV has emerged. Dr. Peter Piot, director of UNAIDS, the global AIDS program, said yesterday, "Finally, finally we are seeing changing gears in the international community..."

Piot, a Belgian scientist, noted a change in Washington, where a seemingly newfound concern about the African AIDS crisis has in recent days opened doors at the White House and created what he termed "a time of great opportunity."

"Let's agree that here, today, we put aside all the doom and gloom talk of AIDS in Africa," Piot told a small gathering of luncheon guests yesterday at Holbrooke's offices. "Today we've got to go beyond that. We must spread a message of hope ...People see now that this [epidemic] is part of globalization. Fifty-million people who became infected over the last 20 years ...are all connected. This is a global problem requiring global responses."

In recent weeks, World Bank Director James Wolfenson has called for an "AIDS war chest" to be used for accelerated HIV prevention campaigns. Gore has promised $100 million in U.S. funds to feed that war chest. Wolfenson says Africa alone needs $2.3 billion in HIV prevention funds this year.

South African first lady Zanele Mbeki said yesterday that the only way to slow the spread of HIV in her country is through economic programs aimed at giving women control over their own lives. Mbeki made no mention of treatment for the estimated 2 million South Africans currently infected with HIV.

Treatment has become the most devisive issue since the UN Security Council issued its Jan. 10 declaration. Emphasis at the UN, and at the top levels of many governments, has been on prevention rather than treatment. But activists, both in the wealthy and poor worlds, charge that a war on AIDS that ignores the needs of people already infected means, as the ACT UP-Paris organization puts it, "that millions of people with HIV in Africa are only good for the role of bugbears of the world contagion."

In the United States, individual care amounts to about $20,000 a year in medical tests and drugs-an astronomical and unobtainable cost for Africans.

"We shouldn't continue to dance around the issue," Piot said, warning that drug companies and financial donors will eventually have to face up to the global inequities currently inherent in HIV care.

ILLUSTRATION/PHOTO: AP Photo - UN Ambassador Richard Holbrooke

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