Magazine article Ms

Unholy Alliance

Magazine article Ms

Unholy Alliance

Article excerpt

Empowering women at the heart of the pandemic is vital to ending HIV/AIDS


HIV and AIDS were sweeping the globe, with near-pandemic conditions in sub-Saharan Africa, where 70 percent of new HIV infections were occurring. One of the fastest-growing HIV-positive populations was in South Africa, where the disease was threatening to derail the new democratic government and the nation's recovery from apartheid. By 2000, HIV and AIDS had orphaned more than 10 million African children. And while AIDS in the United States was quickly changing from a certain death sentence to a chronic disease, thanks to widespread availability of antiretroviral (ARV) drugs, the outlook was far different overseas: Less than 1 percent of AIDS drugs were sold in African nations south of the Sahara Desert.

The need for action, particularly by the United States, was clear. And three remarkable people came together around that kitchen table in Washington, D.C., to create a U.S. response-U.S. Rep. Ron Dellums; Barbara Lee, Dellurns' former chief of staff and now his successor; and Dr. Allen Herman, founding dean of South Africa's National School of Public Health.

Together they developed the idea for an "AIDS Marshall Plan for Africa" that would be partially funded by a trust set up at the World Bank. This eventually transformed into the Global Fund to Fight AIDS, Tuberculosis and Malaria, which led in 2003 to the creation of the President's Emergency Plan for AIDS Relief (PEPFAR) and its reauthorization in 2008. In addition their work led to legislation enacted in 2005 to provide assistance to orphans and vulnerable children in developing countries affected by HIV/AIDS.

The trio's combination of knowledge, strategy and commitment was remarkable. In Congress for 27 years, Rep. Dellums propelled many initiatives, including the fight for sanctions against South Africa's apartheid regime, as well as working to rescue Africa from HIV/AIDS. Rep. Lee came to Congress from a distinguished career fighting for civil rights, women's rights and health care, and as founding cochair of the Congressional HIV/AIDS Caucus she doggedly and strategically pursued other members of Congress to take up the cause of eradicating AIDS worldwide.

Finally, Dr. Herman, who worked with South African anti-apartheid leader Stephen Biko and is married to women's health-care expert Dr. Deborah Smith of Washington, D.C.'s famed Whitman-Walker Health Center, had unparalleled understanding of U.S. and South African health-care delivery systems, as well as how government funding is distributed.

Their brainstorming session around the kitchen table has had great results worldwide: As of June 2013, 1 million babies have been born HlV-free thanks to PEPFAR, and PEPFAR direcdy supports more than 5.1 million people with lifesaving antiviral treatment-up from 1.7 million in 2008. From 2001 to 2011, PEPFAR also supported more than 1 million voluntary medical male circumcisions (which lower the chances of contracting and spreading HIV), and the program provided HIV testing and counseling for more than 46 million people. In sub-Saharan Africa from 2005 to 2011, AIDS-related deaths decreased 32 percent, and new HIV infections fell 33 percent between 2001 and 2011.

Researchers from Stanford estimate that PEPFAR saved 630,000 lives because of its efforts to reduce HIV/AIDS in nine of its targeted countries (including South Africa) between 2004 and 2008. Moreover, the study found a spillover health effect that reduced mortality by another 110,000 lives in those years.

But along with these good outcomes from PEPFAR, the magnitude of HIV/AIDS in Africa is still staggering.

Nineteen African countries lead the world with more than 24.5 million in reported infections-more than 60 percent of the global HIVinfected population. South Africa has the largest number of people living with HIV-some 5.7 million-with a 17.8 percent prevalence rate among adults (ages 15 to 49). …

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