Editor's Notebook: Get Serious About Fighting AIDS

At the beginning of the last decade, the world had a chance to halt the spread of AIDS in Africa. At the time, 4 million Africans were HIV-positive. The World Health Organization's Global Programme on AIDS, headed by the visionary Jonathan Mann, worked with governments across Africa to plan national prevention programs. The pilot program was launched in Uganda, the epicenter of the crisis. Health workers entered training for a continent-wide mobilization to stop the epidemic.

And then, for reasons that ultimately come down to the world's lack of resolve, the program fell apart. Funding disappeared, and plans were scaled back. Ten years later, 25 million Africans are infected; 18 million have died; and 13 million orphans struggle to cope without their parents. The toll is set to exceed that of the Black Death. One of the only success stories on the continent is that of Uganda, where those trained to work on the pilot program stayed on and, with support from Uganda's president and international donors, cut the rate of new infections by more than half. If the program had continued, it is possible that the rest of sub-Saharan Africa could look like Uganda.

The situation today is both bleaker and brighter than that in 1991. The AIDS pandemic is cutting through lives and communities like a scythe, threatening to swallow a whole generation. But international policy is coalescing like never before: in a historic summit, more than 30 African heads of state gathered in Nigeria last month for an AIDS conference. African leadership must be the core of any strategy to combat the epidemic. Now, after tragic years lost, it seems that such leadership is beginning to emerge. At that meeting, U.N. Secretary General Kofi Annan called on the leaders to multiply their health budgets and take serious action, and he called on the developed world to donate $7 to 10 billion a year to support their efforts. That kind of money can help stop the new infections (almost 4 million last year in Africa), treat the sick (at $350 per person per year, AIDS drugs are now cheap enough that we can finance them but still too expensive for poor countries to buy for themselves), and help communities support the swelling ranks of AIDS orphans. As did the Global Programme before it, Annan's Global AIDS Trust Fund has the potential to start turning the tide.

We are at a crossroads. We can seize the opportunity to fight AIDS, or we can do what we did last time-let our plans fade away and avert our eyes as thousands perish day by day. President Bill Clinton, along for the ride in Nigeria, suggested that the U.S. donate a quarter of the needed money. That's the first path. The Bush administration took a hesitant step down the second path last week by announcing its first contribution to the fund: $200 million. As Oxfam has said, the administration left off a zero. If the richest country in world history won't spare a few billion as it cuts taxes by more than a trillion dollars, it will do little to galvanize financial support from other countries and foundations. If students and other concerned citizens do not wish to be complicit in a monstrous crime of omission, they must step forward and ask Bush and Congress to take the first path and allocate $2.5 billion to the AIDS trust fund.

In hospitals in Jos, a city in Nigeria (where more than 2 million adults are HIV-positive), word has begun to spread that help might be on its way. Families that had until recently thought the deaths of mothers and fathers were inescapable are now scrambling to find enough money to buy drugs that can keep the sick alive. Most families in this situation will run out of money after a month, or perhaps two. America can play a role in sustaining their chance at life, and in sustaining the chance for life of a continent. With an amount of money that means almost nothing to our government, we can change the future for countries of millions of people. We can take the first path, and try to make up for the opportunity we missed in 1991. We can offer hope to Africans. Or we can let them die. Make your choice, President Bush.