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Whatever Happened to AIDS?

Complacency Replaces Crisis As Epidemic Rages On

International Threat

A quick look beyond U.S. borders offers a totally different picture. Every hour, 350 people die of AIDS. Another 42 million people have HIV infection; nearly all will die. Fee, just back from a visit to Tanzania in the shadow of Mount Kilimanjaro, calls it "a dreadful situation." Markel says the same thing.

"If you travel to Africa, it is remarkable how many people are HIV-positive and not being treated. They are not nearly as blasé," Markel says. "Just a few weeks ago the CIA came out with a report that HIV is the greatest international security threat. By 2020, 65 million more people will die. So it is something we should be alarmed about. We need to be inspired to do something about this worldwide epidemic."

A start has been made. The United Nations has organized a global fund to fight malaria, tuberculosis, and AIDS. Early funds will be spent to treat people in nations where there is an existing health infrastructure, and to create such infrastructure in nations where it does not exist. The U.S. is the largest funder of AIDS programs in the world, Schwartlander says. To a large extent, future efforts will depend on ever greater funding from the U.S. and other wealthy nations.

"Public health is not a local or state or national concern -- it is global," Markel says. "We have to get used to the idea that the health of people in Zimbabwe affects the health of people in Ann Arbor and New York and Los Angeles. We have to fund the health of the world because it does impact all of us. And there are also issues of clean air and clean water. Until we get use to that we are going to be in trouble. The good news is it doesn't cost that much. If all rich countries put in $10 per person per year, we could treat everyone with HIV. It seems to me that is a pretty good investment, especially compared to what a war costs."

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