Thank you for your warm and generous welcome. I appreciate your gracious reception. I am very honoured indeed to be the guest of the National AIDS Trust, and to deliver the second annual lecture in honour and memory of your patron Diana, Princess of Wales, whom myself and Hillary still miss, four years after her death.
When Lady Diana Spencer became the Princess of Wales, there was nothing in her new duties that obliged her to lead the world toward greater compassion and understanding. It was just the natural expression of her personality. She understood the power of her example and she used it to stunning effect. In 1987, when so many still believed that AIDS could be contracted through casual contact, Princess Diana sat on the sickbed of a man with AIDS and held his hand.
If the Princess of Wales could hold the hand of a man with AIDS, who could claim to be above it? She showed the world that people with AIDS deserved not isolation, but compassion. It helped change world opinion, helped give hope to people with AIDS, and helped save lives of people at risk.
The mission of replacing ignorance with understanding and indifference with caring is the key to ending so much human suffering. I want to thank all of you today at the National AIDS Trust for carrying on Princess Dianas mission to prevent the spread of AIDS, and improve the quality of life for those living with it. You are paying her the greatest possible tribute.
The world misses Princess Diana today for so many reasons. We especially suffer from the loss of her ability to focus public attention on a global challenge. We need to work harder than ever today to keep our attention focused on the war on AIDS, because the horrific terrorist attacks of September 11 which killed people from 80 nations, thousands from America, and 300 from the United Kingdom, can weaken us if it succeeds in turning our attention away from the war on AIDS. About two and a half times as many people die every day from AIDS as died on September 11 from the terrorist attacks.
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 afford no truce in the war on AIDS. You cant call a ceasefire when your enemy wont stop killing.
To regain our momentum on the war on AIDS, we need to keep some things in mind: First, terror, the killing of non-combatants for political, religious or economic reasons, 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 behavior. Terror cant 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 advances in the biological sciences. The results of the sequencing of the human genome and other research will rival the significance of Einsteins discoveries. Were developing microscopic testing mechanisms with nano-technology to identify cancers just a few cells in size. Were researching the possibility of digital chips to replicate sophisticated spinal nerve movements, raising the prospect that people in wheelchairs will get up and walk. We will be seeing your mothers bring their newborns home from the hospital with a little gene card mapping out their future, telling what the problems are, what the strengths are, what to do. And those babies will have life expectancies greater than 90 years.
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 worlds people live on less than $2 a day.
Or you might have said, Before global poverty ruins us, environmental crisis will consume us. Or you might have said, Before the global warming gets us, global health crises will. We see public health systems breaking down across the globe, and epidemics rising. Of all the people who will die this year, one in four will die of AIDS, TB, and malaria or infections related to diarrhea, most of them little kids that never got a clean glass of water.
The central irony of our time is that with all of our progress were still bedeviled by the oldest problem of human society, the demonisation 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. Philosophers and theologians have talked for millennia about humanitys interdependence. Politicians have taken it seriously at least since the end of World War II, the dropping of the bomb, and the establishment of the United Nations. You used to have to be 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, who received the Nobel Peace Prize in Oslo this week, said in his inaugural lecture here in 1999, the spread of AIDS is partly a tragic by-product of globalisation. At least we now see the beginnings of a global response.
If we dont want to put the walls back up, and we shouldnt, and probably couldnt 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 minimise 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 a hundred million people will become HIV infected by 2005.
Those who are willing to do little or nothing to defeat AIDS share the same false belief. Its somebody elses 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.
China recently had its first national conference on AIDS in Beijing, where the Chinese Health Minister estimated there are 600,000 people in China infected with HIV/AIDS and the number of HIV infections reported in the first half of this year has jumped 67 percent over last year. But heres 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 Organisation, 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.
The numbers dont 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 our own interdependence. And it will take greater confidence that we have the means and the courage and the knowledge to turn back this disease.
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.
Brazil is the only developing nation in the world to offer triple-combination-therapy free of charge to people with AIDS. During difficult economic times, there has been great pressure on President Cardoso to end the AIDS program, but he has refused. And Brazil delivered life-saving drugs to the most remote villages of the rain forests, proved to the world that these people could take them correctly at virtually the same rate as patients in the United States, and in three years - with a combination of medicine and an aggressive program of education and prevention - they cut the AIDS death rate in half. In 1994, the World Bank estimated that by the year 2000 Brazil would have 1.2 million people who are HIV positive; because of their effort, they had fewer than half that number.
When I visited Nigeria in my last year as President, 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 they could have chance that their child would be born without the virus. And finally, he got the money, his wife took the medicine, and the baby was born without the virus. 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. Thats 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 changes occur. 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 established the Global Fund for AIDS and Health. Finally, thanks to his leadership, we have a vehicle for measuring our financial commitments against the scale of this crisis. He had said it will tale $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. For the UK, it would be about half a billion (USD). 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 Unites 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.
Of course, we need to keep fighting on other fronts as well. AIDS is not just a health issue; its a development issue as well. We have to work to reduce global poverty and increase economic empowerment. We had a great effort last year and to reduce the debt of the 24 poorest countries. It was one of the happiest accomplishments in my time as President, and people of all political persuasions were behind it. The poor countries get the debt relief only if they put all their savings into health, education, or economic development. The results have been stunning. We should do a lot more of it.
The same argument applies to education. There are a hundred million kids that are not in school today. We ought to get them in school. Every additional year of schooling in a poor country adds 10 to 20 percent to a childs income. Brazil has 97 percent of its children in school. Why? Because they paid their mothers in the poorest 30 percent of the families a monthly fee if they send their kids to school 85 percent of the time. So they have almost everybody in school. In my last year as President, we got $300 million to provide a meal to children in poor counties, but only if theyd come to school to get it. Do you know what $300 million will buy? A meal for more than six million children everyday of the school year. We ought to fund programs like this and get these kids in school.
Broad-based efforts to lift the economies of the poorest nations will make a dramatic difference in the efforts to fight AIDS. 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 organisations, unions, churches, synagogues, mosques, foundations, 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.
Our efforts to fight AIDS will be largely funded by governments, but if theyre going to succeed, they will be largely run and guided by people. In the US, the UK 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 mobilisation in the global battle against AIDS. Thats why Im proud to chair the board of the International AIDS Trust. We will be working partners in the UK and around the world to tap AIDS-fighting genius wherever we find it, and then spread it around the world.
At the outset of my remarks, I recited the grim statistics of HIV/AIDS. Forty million infected with HIV/AIDS. 15,000 more infected each day. Twenty-five million have died. 8,200 more die each day. A child dies every minute. If you have been involved in this issue for a long time, and I know you all have, you become used to hearing this horrible litany over and over again. But as we recite these numbers, we are not just announcing statistics. What we are really saying is - havent we had enough? What is the point we will not tolerate?
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 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. All living beings on this earth have to adapt to their environments. If they cannot adapt, they cannot survive. We have to adapt by abandoning our old habit of the human mind that either demonizes, or at best is indifferent to, people we see as different. 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 neighbourhood you live in. Globalisation has made everyone our neighbour and has given us both the means, and the motive, to treat them as neighbours.
We cant keep telling ourselves that 40 million of our neighbours with AIDS is someone elses problem. We cant keep putting our hands over our ears so we dont hear their cries for help. We cant 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.