Journal of the American Medical Association (09.26.01) -
"The 20th anniversary of the first diagnosis of HIV infection
has come and gone. ... Headlines made when UN Secretary-
General Kofi Annan appealed for the world to act on the global
emergency AIDS represents have been superseded by other
events. It's back to business as usual. Or is it?
"It must not be. The AIDS crisis is as real now as a few
months ago, and it will continue to grow unless the world is
constantly reminded of it and plans to stem the epidemic are
turned into action. ... The effects of globalization mean that
there no longer is such a thing as a localized health problem.
The HIV/AIDS epidemic is a global emergency and it calls for
global commitment and action. ... Frighteningly, it has taken
22 million deaths and 13 million orphaned children to act as a
global alarm clock. ... The onus is on us -the health care
professionals -to make sure the momentum is kept up. We must
intensify our efforts by working together, agreeing on best
practices, reaching more people, and measuring our results. A
broad range of organizations are now helping governments and
societies to intensify their response. ...
"Prevention is and will be our central focus. While finding
the best care for the millions living with HIV is a moral
imperative, it is even more important to prevent hundreds of
millions more from becoming infected. We must enable the most
vulnerable groups, including young people and women, to
prevent being infected with HIV and to access treatment for
other sexually transmitted diseases. This calls for frank
discussion about the causes and prevention of these diseases.
We must not shy away from promoting condom use, the most
effective method of prevention known. ...
"Many say that in bringing needed medicines to the poorest
countries, price is only one factor, and they are right. But
many also say that bringing complicated HIV/AIDS treatment
regimens to poor settings is impossible. These people are
wrong. ... WHO is focusing our efforts on developing care
regimens that are workable and safe in low-resource settings.
We are helping those who provide care to select and use cost-
effective regimens that reflect local circumstances as well as
individual needs. Much work is needed if we are going to give
quality care to a substantially larger number of people living
with HIV. Essential action also includes fostering research
and development of diagnostics, microbicides, and vaccines;
monitoring and surveillance of HIV incidence; and ensuring
"There are several hopeful signs. Investments in research -to
develop vaccines, diagnostics, and effective medicines, often
in conjunction with WHO and the UN Joint Programme on HIV/AIDS
-have increased dramatically. At the G8 Summit in Okinawa in
2000, the G8 nations made plans to increase support for
investment in confronting HIV/AIDS and promoting health in the
world's poorest communities; they strengthened their
commitment this year in Geneva. The G8 proposals have been
bolstered by the UN Secretary-General's call in April for a
Global Health and AIDS Fund. Since then, governments, private
entities, foundations, and individuals have committed almost
$1.5 billion to the fund. ...
"As health care professionals, we may sometimes feel
overwhelmed by the massive gaps between what is needed and
what is available to help communities fight HIV. We know,
however, that we have no choice but to respond to the millions
of individuals whose lives are destroyed or severely
compromised each year by this virus, and the tens of millions
more whose standards of living are put in danger."
The author is the Director-General of the World Health