For years now, the topic of HIV/AIDS has dotted front pages of mainstream media and has finally been placed squarely in the public eye. It is not uncommon to read about the latest AIDS stories in Esquire, or to see international activists mingle with movie stars in large and publicized events to raise awareness and money. Everyone seems to know that the HIV/AIDS epidemic is a problem, but today on World AIDS Day, we must stop merely contemplating the epidemic’s impact and engage our government and our campus in a new dialogue based on action and change.
We constantly hear about the number of people living with AIDS (42 million) and the number of people infected each day (14,000), and the statistics desensitize us, leading us to shrug our shoulders and agree that it is bad and say nothing more. This is a mistake. Morality and altruism alone do not drive American foreign policy or campus awareness and are insufficient in motivating action. We must acknowledge the multifaceted impact of the illness, and we must understand that it does not simply end lives, but it threatens U.S. security, economic development, and the stability of governments around the world. Only when this fact is made clear may we rally our government around a new foreign policy and engage our campus in debate that has, so far, been slight.
Take South Africa. The virus in South Africa has driven up infant mortality by 44 percent, a change often associated with state failure. In Sub-Saharan Africa, it has orphaned 13 million children, and in 1999 alone, killed 860,000 teachers; teachers and healthcare workers are dying there faster than they can be trained. Even more worrisome are the millions of displaced and uneducated children whose parents died of AIDS and who compose a new generation of young people susceptible to recruitment and influence by regional warlords and extremists. As early as February 2001, George Tenet, director of the Central Intelligence Agency, said before the Senate Committee on Intelligence that “AIDS in Africa basically takes generations out play. And then you have refugee flows. And then you have economic disasters. And then you have civil wars that require exfiltration and some kind of involvement whether you choose to or not.” No country is immune, and degenerating societies in one region of the world can damage the economies and compromise the safety of nations thousands of miles away by increasing the cost of doing business abroad, and by being susceptible to exported terrorism.
In spite of the long-awaited Bush AIDS Plan, the coffers of the key funding source to fight the epidemic, The Global Fund, remain grossly empty. Meanwhile, the problem only escalates. In Kenya, 75 percent of police deaths were caused by AIDS: the virus does not simply attack individuals, but the very institutions that constitute the framework of daily life and continuously protect citizens’ safety and freedom. While the moral argument for increased foreign aid has great value in itself, the international security threat of the epidemic must also be acknowledged if we are to effectively combat this problem.
This summer, while in the Kayelitsha township of South Africa, I saw the devastation first-hand: what shocked me most, however, was the crime. HIV/AIDS had robbed Kayelitsha of any sound functioning economy; desperation easily led to violence, and the struggle to survive led to hostility and murder. The “Doctors Without Borders Clinic” I visited had to be locked down and I was forewarned by officials that if I ventured into the depths of the shanties, I would not come back. Kayelitsha presented a strange scenario in which the politics of health access valued political pride over human lives, regardless of the cost of drugs that could combat the spreading epidemic. With leaders denying the need for treatment programs, the entire population had been put at risk, leaving the potential for economic disaster on the heels of human tragedy. Tackling this issue as a student is possible: we underestimate our ability to write, to travel, to influence, and to coordinate in order to influence policy-makers and those on the ground.
Indeed, South Africa, like many others nations, should not fade into the imagination as an intangible problem better left alone. The public health crises cannot be solved with the quarantine of a continent, and the United States must not only focus its foreign policy on public health and development in a moral context — which has proven insufficient in the past in implementing foreign aid programs — but in light of the very safety of its people and the stability of the international system it helped to build. We must write letters, meet with our representatives, and travel to the places hit hardest.
On World AIDS Day, let us stop contemplating the devastation, and instead, let us join the fight.
David Steinberg is Co-Founder of Yale AIDS Watch, and Co-Founder and Editor-In-Chief of PH: The Yale Journal of Public Health.