Miami Herald - November 29, 2002

Some 42 million people, including 3.2 million children under age 15, live with HIV/AIDS today. That figure could explode to 90 million by 2010, according to the report. The only way to stop the social and economic ravages of this pandemic is for industrialized countries, led by the United States, to fund sharp increases in global prevention efforts. Pharmaceutical firms, too, must step up to facilitate low-cost AIDS drugs.

By far the world's most afflicted region is sub-Saharan Africa, where 29.4 million people have HIV/AIDS. There, 58 percent of the infected adults are women. Worse, the infection rate among young women ages 15 to 24 -- who are physically and culturally more vulnerable to infection -- is twice that of males that age.

The dreadful consequences include fueling a deadly famine. And damages multiply with the growing numbers of infected women. Not only are women with AIDS less able to work, the traditional caretakers also are less able to care for stricken relatives and children. More infected women means more children born with the virus. Entire generations, ages 20 to 45 in Africa in particular, are being decimated.

Like other sexually transmitted diseases, AIDS isn't stopped by borders -- certainly not in this age of global migrations. Like the canary in the mine, AIDS trends in Africa alert us to future dangers elsewhere.

Some solutions are basic, some extremely difficult. Education and prevention work. The U.N. report describes some successes in such efforts, particularly those targeted at young people. But generating fundamental behavior changes are far harder to achieve in deep-rooted cultures that actually make women more vulnerable and today promote the spread of HIV.

Education can increase condom use and reduce casual sex and infection rates. Mother-to-child infection can be curtailed by drug treatment. Anti-retroviral drug therapy can give those with HIV an extended, productive life. For women in societies that consider them subordinate, however, little short of economic independence may free them from vulnerability to rape and infection.

Governments and donors have pledged more than $2.1 billion to the new Global Fund to Fight AIDS, Tuberculosis and Malaria. But it projects that these monies will run out by 2004 and has called for another $7 billion. Developed nations must increase their contributions. Cleaning up the catastrophe 20 years from now will be far more expensive than funding a package of prevention, education and development programs now.

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