SPEECH BY WILLIAM JEFFERSON CLINTON
CHAIR, INTERNATIONAL AIDS TRUST
 
 KAISER FAMILY FOUNDATION
AND
COLUMBIA UNIVERSITY GRADUATE SCHOOL OF JOURNALISM
GLOBAL AIDS CONFERENCE

 
MAY 4, 2002

Thank you Drew for your warm and generous welcome – and for all that the Kaiser Family Foundation is doing to fight AIDS – here at home and around the world.  And thank you Columbia for hosting this important conference.  Together you have gathered an impressive array of opinion leaders charged with the responsibility to tell the story and to shape our reality. 
 
Today, we need to work harder than ever to remain focused on AIDS, because the horrific terrorist attacks of September 11 – which killed people from 80 nations, thousands from America – will weaken us if it succeeds in turning our attention away from the global war on AIDS.
 
This is a very real danger. In the ten weeks before September 11, the world had raised $1.5 billion for the Global Fund for AIDS and Health. In the ten weeks after September 11, we raised $2,000. We can not afford a truce in the war on AIDS.  We can not call a ceasefire when the killing continues.
 
To regain our momentum on the war on AIDS, we need to keep some things in mind: First, terror has a very long history. In spite of this long history, no terrorist campaign standing on its own has ever succeeded and it usually backfires. The purpose of terror, after all, is not to achieve military victory, but to change our behaviour. Terror can’t win unless we give it permission to win – and we are not about to give it permission.
 
So we are determined to defeat the Taliban and Al Qaeda. That is essential. But defeating these terrorists, by itself, cannot bring us the world we want, and so it cannot be our only goal. Building the world we want for our children in the 21st century will require a much larger and more sustained effort.
 
If I asked you what you believe to be the single most dominant force of the early 21st century world you may have said “economics, information technology or advances in the biological sciences”.
 
On the other hand, if you dedicate a lot of your time to fighting poverty, war and disease, you may have quite a different perspective. You might have said the single most dominant force of the early 21st century world is global poverty – because half the world’s people live on less than $2 a day.
 
Or you might have said, “Before global poverty ruins us, environmental crises will consume us”. Or you might have said, “Before global warming gets us, global health crises will”.
 
The central irony of our time is that with all of our progress we’re still bedevilled by the oldest problem of human society, the demonization of people who are different.
 
None of these things define the 21st century – they all reflect what defines it: and that is the most breathtaking increase in global interdependence in all of history. You used to have to be a visionary to see it. Today, you have to be blind not to see it. It is an everyday reality no ordinary citizen can escape.
 
Our interdependence has brought us great benefits and great vulnerability. As Kofi Annan has said, “the spread of AIDS is partly a tragic by-product of globalization. At least we now see the beginnings of a global response”.
 
If we don’t want to put the walls back up, and we shouldn’t, and probably couldn’t even if we tried, we must do everything we can to strengthen the positive forces of interdependence and to diminish the negative ones. That means using the new capabilities of our global world to defeat the new dangers.
 
If you accept that our global interdependence is the defining feature of our future, it does not minimize the importance of defeating AIDS; it multiplies it. Because just as we are all interdependent, the issues that affect us are all intertwined. It is hard to see how we can lose the war on AIDS, and win our battles to enhance global health, reduce poverty, promote stability, advance democracy and increase the peace and prosperity of the world.
 
Today, there are more than 40 million men, women and children living with HIV and AIDS. Fifteen thousand more are infected every day. More than 25 million people have died from AIDS. 8,200 more are dying every day. One child dies of AIDS every minute. There may be nothing worse than a parent burying a child, unless it is to bury your parent while still a child – 13 million children have been orphaned from this disease. If we do not change these trends, 40 million children will lose one or more parents to AIDS in the next ten years, and there will be a hundred million AIDS cases by 2005.
 
Those who are willing to do little or nothing to defeat AIDS share the same false belief. It’s somebody else’s problem. Many still believe AIDS is an African problem. It is not. True the devastation is worse today in Africa than elsewhere but other nations are today where Africa was ten years ago, and are making many of the same mistakes.
 
The nation with the greatest number of AIDS cases today may well be India, where estimates are that three quarters of the population get no AIDS education at all.   
 
China recently had its first national conference on AIDS in Beijing, where the Chinese Health Minister estimated there are 600,000 people in China with AIDS.  And UNAIDS has projected that the number could reach 10 million by the decade’s end.  But here’s the really frightening fact: it is ignorance that speeds the spread of AIDS, and experts have judged that only four percent of the adults in China know how AIDS is contracted.
 
In Russia, infection rates are increasing at triple the rate of a few years ago. Dr Alex Gromyko, who is an HIV advisor to the World Health Organization, says within two or three years several million Russians will be infected. “When the deaths will be counted in the millions” he says, “then we will start to understand the tragedy”.
 
But the numbers don’t come close to telling the whole story. Eighty percent of those dying from AIDS are between the ages of 20 and 50. In some nations, teachers are dying faster than they can be trained; that hurts education. Doctors and nurses are dying from the disease; and that hurts health care. Farmers and farm labourers are dying, and that hurts food production. Factory workers are dying, and that hurts productivity. Members of the police and military are dying, and that undercuts the forces that keep order. Mothers and fathers are dying, and that shatters lives and families.
 
The spread of AIDS is not a misfortune; it is a tragedy in the Shakespearean sense, which means - a horrible event that didn't have to happen. Forty million orphans in ten years does not have to happen. One hundred million AIDS cases in 5 years does not have to happen. But to stop it, we're going to have to decide collectively as nations and individuals, as businesses and non-profits that we're going to do whatever it takes to defeat it.
 
It will take at least two things:  it will take a clearer understanding of the threat and of our own interdependence.  And it will take greater confidence that we have the means and the courage to turn the tide. 
 
Every nation has customs and traditions that can make AIDS difficult to discuss. But around the world, people are taking risks to defy old taboos, push bold plans, and make dramatic improvements in the health of their nations. Of course, it's common for leaders not to want to speak out. As one journalist has explained: "what politician wants to be associated with a national calamity?" Fair question. I would answer: if you're unwilling to be associated with it, you are partly to blame for it.
 
We have seen first-hand the difference strong leadership can make in ending the stigma and reversing the disease. When faced with an AIDS crisis in Uganda, leaders didn't look for ways to muffle speech; they looked for megaphones to amplify it. They called it the "Big Noise." Every government official was instructed to talk about AIDS in every public speech they gave. And it moved the debate beyond stigma and started a dialogue that ultimately led to greater prevention and infections rates cut nearly in half.  Similar successes are being found in Zambia and Cambodia. 
 
Brazil has offered triple therapy free of charge to people with AIDS – even those in the most remote villages of the rain forests. During difficult economic times, there has been great pressure on President Cardoso to end the AIDS program, but he has refused.  
 
In just three years - with a combination of medicine and an aggressive program of education and prevention - they cut the AIDS death rate by more than half, saving the government hundreds of millions of dollars and keeping the number of new infections to less than half of what was projected.
 
When I visited Nigeria in my last year in office, President Obasanjo and I attended an event on AIDS, where a young man talked about how he fell in love with a woman who was HIV positive, and they got married.  And then his wife became pregnant.  He had already lost his job because he was HIV positive and he was desperate to find the money to get the medicine for his wife so that their child could be born without the virus.  And finally, he got the money, his wife took the medicine, and the baby was born HIV negative.  When the man finished his story President Obasanjo brought his wife up on stage and embraced her in front of hundreds of people, and it was all over the press in Nigeria the next day.  It helped teach a nation that we need to fight AIDS, not people with AIDS.
 
So these efforts of public leaders are essential and reduce stigma and make possible the public discussion necessary for prevention.  But one of the best ways to reduce stigma, is to help people live longer.  That’s why I am troubled by the argument that in the fight against AIDS we must choose between prevention and treatment.  This must not be an either/or proposition.  Prevention and treatment are not separate approaches; they are interrelated and reinforcing.  We can and we must do both.
 
Unless there is a treatment, there is little incentive for people to learn their status.  It is through voluntary counselling and testing that some of the most effective behaviour change occurs.  And as people actually live with AIDS - their presence in the home, the workplace, and the community reduces stigma and begins to bring AIDS out of the shadows.
 
Our battle against AIDS will take an all out effort of all sectors of all societies to make this happen.  We all have a role to play.
 
Secretary General Kofi Annan has called for $7-10 billion to wage an effective campaign against global AIDS.  The US share would be something in the order of $2 billion - or 2 months of military presence in Afghanistan. 
 
These are serious numbers.  They are not calculated on the basis of some slight percentage increase above what we gave last year.  They are calculated based on what it will take to win.  For the United States, it amounts to about one tenth of one percent of the federal budget.  There is no reason not to do this.  Given the scale of this threat, the success we have seen, and the relatively small share of our resources it demands - there is no valid argument against it.  It will only fail if we fail to make a loud argument for it.
 
Businesses, obviously, have much to offer, both in direct economic activity, but also in direct programs relating to AIDS. They can contribute drugs, test kits, computers. They can offer workplace programs that start with workers and expand to communities. They can offer expertise in distribution systems (after all, they can ensure that anywhere in the world you are no more that 1 minute from a cold coke). And they are experts in marketing skills that can get people to do just about anything - including changing their behavior.
 
Non-governmental organizations, unions, churches, synagogues, mosques, students, private citizens, people living with AIDS, and all of us are critical to this effort. And schools must be involved - that is where we have to take the steps to save the next generation.
 
But while our efforts to fight AIDS will be largely funded by governments, foundations and corporations, if they’re going to succeed, they will be largely run and guided by people. In the US, and in many places in the developing world, it has been individuals, families, and communities infected and affected by AIDS that have sounded the alarm about AIDS and joined together to care for their own. With limited resources, they have developed the solutions that have laid the groundwork for the global response. We need this kind of mobilization in the global battle against AIDS. That’s why I’m proud to chair the board of the International AIDS Trust along with my co-chair President Nelson Mandela.  We are working with partners around the world to mobilize the will, funding, and strategies needed to effectively fight AIDS worldwide. 
 
At the outset of my remarks, I recited some grim statistics about AIDS. But what I really meant was - haven’t we had enough? How many deaths will it take to shake the world into doing what it takes to stop AIDS?
 
We should have passed that point. The heartless march of the AIDS pandemic reminds us that for all the progress we have made in the world, we still have much work to do. We all have to change. We have to develop a global level of consciousness about what our responsibilities to each other ought to be.
If AIDS were raging in Europe and America the way it is in Africa, we would be well on the way to winning this war. This is not surprising. When we try to make the world better, we start with our neighbours. But in this global age, your chances of living or dying should not depend on what neighborhood you live in. Globalization has made everyone our neighbor and has given us both the means, and the motive, to treat them as neighbors.
 
You – our friends in the press corps – can help make this real.  You can bring home to us all both the challenge of AIDS and the opportunity to make a difference.  You can enable us to feel both the horror and the hope.  And you can remind us in a thousand different ways – and from a thousand different angles – that this fight is every leader’s fight, it is every parent’s fight, and it is every person’s fight.  
 
You can help ensure that we finally stop telling ourselves that 40 million of our neighbors with AIDS are someone else’s problem. We can’t keep putting our hands over our ears so we don’t hear their cries for help. We can’t keep pretending that we can forever claim for ourselves what we deny to others. We live in a world without walls. We have to make it a home for all our children.
 
Thank you very much.