WORLD VIEW/Paul Cullen: What ever happened to AIDS? It's only six months since the United Nations General Assembly held a morale-boosting special summit devoted to the epidemic, and world leaders set up a Global Health Fund to tackle the crisis. Yet today, the issue threatens to disappear from the radar screen.
September 11th and the "war on terror" has consumed all the attentions of the US and its allies, and older scourges have been sidelined or forgotten.
The UN Secretary General, Mr Kofi Annan, called last year for funds of $10 billion a year to tackle HIV/AIDS, yet only $2 billion has been raised so far.
In the three months after September 11th, only $2,000 came in. As former president, Mr Bill Clinton, has pointed out, the US has spent the $2 billion it was expected to contribute on two months' war in Afghanistan.
Yet it hasn't gone away, you know. In the 20 years since it emerged, the disease has infected 65 million people.
It is the world's fourth biggest killer. Some 40 million people are living with the disease, two-thirds of them in sub-Saharan Africa.
As Dr Peter Piot, director of UNAIDS, which is leading the international against the epidemic, said in Dublin last week, AIDS - along with conflict - remains the greatest threat to development in the world. You might as well throw money away as invest in the Third World without grappling with the threat posed by the disease.
There are worse diseases than AIDS, in terms of casualties, but few are as insidious. Because it is largely spread by the sexually active, the disease most harshly affects the engines of society - teachers, managers, doctors, truckdrivers, mothers and so on.
Adults of working and parenting age are being wiped out, leaving a population that is disproportionately very old and very young.
Older people in many parts of the developing world find they have no-one to care for them in their last years. Meanwhile, there has been an explosion in AIDS orphans, many of them vulnerable to the threats of street crime and prostitution.
Dr Piot cited the example of Zambia, where the number of teachers killed by the disease each year outnumbers the annual output from teacher training colleges.
It is evident therefore that there is little point in investing in that country's education system unless steps are taken to ensure there are teachers available to fill the classrooms.
The availability of drug treatments that retard the progress of the disease has proved a life-saver for many Westerners suffering from the disease.
It has also taken the issue off the top of the political agenda. For many Western governments, satisfied with their efforts at containment, AIDS is as pressing an issue as, say, malaria.
Yet AIDS is spreading to the most populated countries. Russia says its rate of growth of HIV is worse than many African countries. In India and China, the disease is taking firm hold.
Ireland's tally of 290 new cases of HIV in 2000, while small, is the highest since reporting began. Meanwhile, resistance to drugs is increasing. Dr Piot's message in Dublin was that treatment of the disease is now as important as prevention.
Poverty explains the disparity in access to drugs; only 50,000 out of 25 million sufferers in Africa can avail of treatment, but in Europe there is virtually 100 per cent availability.
"In the past year, the price of treatment has come down from about $10,000 to under $1,000, but this is still too high for the poorest countries," he says.
"Wider access will only come about through a major increase in funding internationally." Money, not surprisingly, was on Dr Piot's mind when he came to Dublin.
Like so many UN leaders, he spends much of his time rattling the collection-box when he would rather be concentrating on the job in hand.
Happily, in Ireland UNAIDS is pushing an open door. A growing aid budget means that money is available for the global fund, but Ireland also distinguishes itself by having a thought-out strategy to support HIV/AIDS programmes in badly affected countries.
As well as developing expertise internally, Ireland Aid was one of the first donors to ensure that HIV/AIDS issues are integrated into all aspects of its programme. The Government has also tried to act as an international advocate on the issue. The Taoiseach has visited the worst affected countries in Africa and was one of only two political leaders to travel to New York for the UN special summit last June.
According to the Department of Foreign Affairs, up to $30 million of the increased aid budget will be targeted on the fight against AIDS.
There is good news in this dark tale. Countries like Uganda and Cambodia have turned the epidemic around, and Zambia and Tanzania may soon do so.
Drug prices continue to fall. One developing country, Brazil, where the number of AIDS deaths has fallen dramatically in the past four years, has succeeded in providing free antiretroviral treatment for people with AIDS.
Researchers are showing greater optimism about finding a cure and 80 possible vaccines are being tested. The global fund is ready to begin dispersing its funds.
Yet we are still on target for 100 million cases by the year 2005.
According to the former US president, Mr Clinton, the result may be a bigger threat to peace and security than global terrorism.
"If that happens, it probably will be enough to crumble fledgling democracies. If probably will be enough to spread violence among young people who fear that they only have a year or so to live and therefore can't understand why they shouldn't be involved in whatever conflict is handy," he warned in a speech last December. All of this points to the need for the Government to keep making the case for action on AIDS internationally.
Yet it may take the end of the war in Afghanistan for the US to address its responsibilities elsewhere in the world.
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