Washington File - March 10, 2000
Charles W. Corey - Washington File Staff Writer

"I dare say, Mr. Chairman, that this combination has never been seen before in the Congress," he said, referring to the witness panel in which he appeared along with Sandra Thurman, the director of the U.S. Office of National AIDS Policy, and Under Secretary of the U.S. Treasury Timothy F. Geithner.

"Wars have to be fought on every front," he told the lawmakers, African ambassadors, diplomats, and public health officials who had packed into a Capitol Hill hearing room -- and one of the fronts where that war must be fought, he said, is the international financial institutions such as the World Bank.

Holbrooke cited the World Bank because he was called to appear before the committee to discuss the drafting of legislation that would help create a World Bank trust fund to combat the HIV/AIDS pandemic.

While combating the spread of the deadly disease sometimes seems to be overwhelming, Holbrooke told the lawmakers, "there are practical ways to cut into it" and an HIV/AIDS trust fund administered by the World Bank can be one such way, "directly applying needed resources to fight the problem."

"AIDS is a growing concern in places like Russia and South Asia," he told his audience, adding, however, that while no region or issue is immune, "nowhere is the disease's impact more evident than in sub-Saharan Africa. "AIDS threatens a broad swath of African states, endangering millions of lives," he stressed. "Although the crescent of states from Kenya to South Africa has only 10 percent of the world's population, it has over two-thirds of the world's HIV-positive people and nearly 85 percent of all AIDS deaths. The disease kills 10 times more people in sub-Saharan Africa annually -- more than 2.6 million last year alone -- than all of the continent's armed conflicts combined." Americans should be proud that the United States is the largest donor of international development assistance for HIV/AIDS, he said, while calling on the U.S. government to do even more. Holbrooke reminded the lawmakers that while addressing the U. N. Security Council last January during Africa Month, Vice President Gore announced that the administration would ask Congress for another $100 million to fight the epidemic, bringing the U.S. total this year to $342 million. Following his comments, Holbrooke responded to questions from the lawmakers. Asked if there is any one institution that can run or coordinate the worldwide HIV/AIDS fight, Holbrooke said, "The U.N. can and should do more, and UNICEF [United Nations Children's Fund] has a role." But, being frank, he said, "There is no single international institutional answer, any more than there is a single U.S. government answer, any more than there is a single African government answer." Holbrooke went on to praise U.N. Secretary-General Kofi Annan for his commitment to the worldwide war against HIV/AIDS, calling Annan the "best U.N. secretary-general ... since Dag Hammarskjold." He also credited Annan for being bold and creating UNAIDS, the Joint United Nations Program on HIV/AIDS, based in Geneva, which coordinates all of the United Nations' multifaceted HIV/AIDS programs. Annan created UNAIDS, he said, "precisely because he did not think the existing bureaucracies were adequate." Speaking frankly again, Holbrooke told the lawmakers about the disease in sub-Saharan Africa, where, he said, "the highest male spreaders" of the disease are the police and the military. "The pattern of infection is the reverse of what people think it is," he explained, "because the higher the rank, the more likely they are to be infected because they have money, which gives them access to prostitutes."

Holbrooke said he is "profoundly worried that the governmental structures in many countries in Africa are very reluctant to pursue or encourage testing -- voluntary testing" for the disease. He also said HIV/AIDS victims still wrongly suffer from stigmatization. "If people test positive, they are going to be ostracized," he noted. Victims of the disease must be destigmatized, he insisted -- which means, "If you test positive you don't lose your job. Your family does not throw you out on the streets. Leadership is essential" to correct the stigmatization problem, he said. Summing up, Holbrooke said, "Our bottom line [main point] here today is that resources in conjunction with the right leadership in Africa will make a difference." But he cautioned that "this is not a bottomless pit" that requires endless amounts of money to solve it. Holbrooke said he and his colleagues were appearing before Congress to help "raise the alarm" about the impact of the disease, which causes about 5,500 deaths across Africa each year. Certain practices, he said, can easily help stop the spread of the deadly disease. As an example, he cited the transmission of the disease from an infected mother to her infant. "If women who are HIV-positive don't breast feed, you will immediately cut the rate in that transmission belt by over 50 percent." While Holbrooke noted that many people worldwide think the situation is hopeless, he said that that is not the case. "Uganda, Thailand, and Senegal show the contrary.... You have in this room ambassadors from Africa -- Swaziland, Uganda, and others -- who are here to tell you it is not hopeless. Triage [of anti-HIV/AIDS assistance] by continents is obviously immoral, it won't work. It's not economic, strategic " and it "fails on every level." "In the end," he stressed, "the solution must rest with the leadership of each individual country affected. "There is a reason Uganda has reduced its rate from 30 percent to 9 percent while its neighbors went from 9 percent to 30 percent. The reason was the leadership [of] President [Yoweri] Museveni that destigmatized the issue, that spoke frankly and bluntly in terms that are not always culturally appreciated in this country as well as in Africa about how the disease is caused and spread." (The Washington File is a product of the Office of International Information Programs, U.S. Department of State. Web site: usinfo.state.gov)

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