Talking It Over

Twenty years ago, no one had ever heard of the human immunodeficiency virus. Yet, today, it is the fourth leading cause of death worldwide. In sub-Saharan Africa, AIDS is the leading cause of death, killing 5,500 people and infecting 11,000 new victims each day. In our own country, we learned just last week that the rate of HIV infections is no longer declining. Despite these grim statistics, though, there is cause for optimism.

Last year, on World AIDS Day, my husband spoke about the growing tragedy of children orphaned by AIDS, and directed his Office of National AIDS Policy to lead a fact-finding mission to Africa. What they found is a human, economic, political and social catastrophe that touches each and every one of us. If we don't take steps to stop it today, what we are witnessing in Africa will most likely be repeated in India, Southeast Asia and the Newly Independent States of the former Soviet Union.

Although AIDS kills indiscriminately, the disease is stalking women and young people in Africa disproportionately. More than half of all new HIV infections are among women, shattering families and placing extraordinary burdens on the villages that have been the backbone of the child-rearing tradition.

In addition to isolation and stigma, the destruction of families threatens child welfare in unprecedented ways. In many places, one-quarter of the children are living with an HIV-positive parent, and are destined to be orphaned by the end of this year. Over the course of the next decade, more than 40 million children will lose one or both parents to AIDS.

An entire generation of Africa's children is in jeopardy.

AIDS is not only causing unfathomable human suffering, it is also wiping out decades of progress on a host of development objectives. Life expectancy in Zimbabwe has dropped by an unbelievable 25 years. In the coming decade, child mortality will triple. In the Ivory Coast, one teacher per day dies of HIV/AIDS. And despite steady advances in access to education, a rapidly increasing number of children, particularly girls, is dropping out of school to work or care for dying parents. Far too few are finding their way back.

In Zambia, 100,000 children, most orphaned by AIDS, are living on the streets of Lusaka. In an effort to survive, many are forced into crime, sex and drug operations, and we can only assume that HIV is spreading rapidly among them.

Not surprisingly, this extraordinary level of human devastation is jeopardizing economic growth and threatening political stability.

Over the course of the next 20 years, it is predicted that AIDS will reduce the economies of sub-Saharan Africa by as much as 25 percent.

AIDS is not just an African problem. It is a worldwide problem, and it is time to act.

Our efforts in this area must be part of our overall development policy. Leadership, combined with sustained investment, has made, and can continue to make, an extraordinary difference. Uganda's President Yoweri Museveni demonstrated bold leadership early in the epidemic by developing a plan to reduce the stigma and transmission as well as to support those who became sick. As a result, infection rates in urban Uganda have been cut in half.

Over the past decade, the United States has invested with the Ugandan government, other donors and non-governmental organizations to provide HIV prevention, care and support. When I was in Uganda, I saw the results at the AIDS Information Center I visited and on billboards exhorting Ugandans to protect themselves against the disease. Now, momentum is building, and other African leaders are speaking out as well.

In July, the Vice President, calling AIDS in Africa the "worst infectious disease catastrophe in the history of modern medicine," announced that the administration would seek the largest-ever budget increase in the global battle against AIDS, an increase that would allow us to more than double our efforts in sub-Saharan Africa. In addition, several new initiatives, including a UN Conference on Children Orphaned by AIDS and a G-7 debt-relief agreement that will allow countries to target new resources for combating the disease, will encourage public and private groups around the world to become involved.

As part of this initiative, this week at the White House, I convened a meeting of senior government officials, corporate CEOs, representatives of the World Bank, the United Nations, international foundations and community groups to discuss how best to enhance and coordinate our AIDS efforts in Africa and around the world.

The global battle against AIDS has just begun, and we know the worst is yet to come. But the faces of the world's children beckon us — especially members of Congress — to act now. It is time to develop the capacity and partnerships we lack, not only to seek a vaccine, but also to care for those who are suffering from this dreadful disease today. To find out more about Hillary Rodham Clinton and read her past columns, visit the Creators Syndicate web page at www.creators.com.

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