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    $5 Per American Each Year Could Control AIDS


    Why would the U.S. agree to such a plan? Sachs argues that the national security depends upon it. He says that the uncontrolled AIDS epidemic in Africa poses two very distinct threats.

    "First there are the effects of disease on the breakdown of societies abroad," Sachs tells WebMD. "Therefore, the U.S. will be pulled into conflicts or mass migrations we don't want to get into -- or later, we'll be paying the price of aiding collapsed societies. And then there is the public health implication. By having a seething cauldron of disease in Africa --without helping rebuild their ruined public-health system -- we are leaving ourselves exposed to public health risks. It is a reckless gamble on our part."

    Even if the plan makes good sense, is it politically possible? Sachs argues that the time is ripe.

    "I really think this is going to happen, and that the current administration will make it happen with demand from citizens and support from pharmaceutical companies," he says. "It is the kind of policy initiative that fits well with U.S. needs, and it's something the President likes -- a public/private effort. President Bush should get involved and get involved fast. I urge pharmaceutical companies to go to him and demand that he act."

    The $5 billion plan would allot $3 billion to renewed AIDS prevention efforts and $2 billion to providing AIDS drugs. It calls for effectively rebuilding Africa's demolished public-health system in a methodical, country-by-country effort guided every step of the way by World-Bank-funded scientific research.

    Kevin DeCock, MD, is head of CDC activities in Kenya and strongly seconds Sachs' plans.

    "We are responding to the African disaster in a remarkably half-hearted way," DeCock says. "You can't have credible prevention without care, and you can't have credible care without prevention. We have to stop people from getting exposed to HIV. If they are exposed we have to stop them from getting sick. And if they are getting sick we have to stop them from dying. It is untenable that most of the deaths are in the southern hemisphere and most of the drugs are available in the north."

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