AIDS awareness: Raising the red flag

Yesterday was World AIDS Day, and this week the Princeton chapter of Student Global AIDS Campaign (www.fightglobalaids.org) is cosponsoring World AIDS Week. We have planted 2,000 red flags in 1879 courtyard today to signify the approximate number of people at Princeton University who would be infected with HIV if Princeton had infection rates equal to those in Botswana.

AIDS is the most important issue in the world. It is also one of the complicated issues in the world — and that is reason enough for many people to give up. They say: AIDS infects 40 million people around the world and affects tens of millions of others, and AIDS infects young people more than anyone else, and it affects the developing world, which is the least able to combat it, and it feeds on human behavior, and it feeds on gender inequalities and indigenous cultural practices, and governments have other priorities (such as malaria and tuberculosis, poverty, famine, and education), and governments are negligent, and leaders are incompetent, and there are scarce resources in money and people, and promiscuity and drug use are sinful and inevitable, and western governments will never do enough, and drug companies are just in it for the profit. Though true, these are often mere excuses for inaction.

Over the past two summers, I have traveled to Africa, Eurasia and South and Southeast Asia to study the private and public responses to HIV/AIDS. And I can say without exception that my travels inspired me. They inspired me because everywhere I went, I met grassroots activists who had dedicated their lives to this issue. Even in places like China and Zimbabwe, where the central governments have been shamefully remiss in their AIDS efforts, there was vital community work bubbling beneath the surface. And in my meetings with senior United Nations officials, nongovernmental organizations (NGOs), grassroots organizations and HIV-positive activists, I made several observations that may clear up some of the confusion surrounding the discourse on AIDS.

The first misconception I would like to dispel is that no one knows how to stop the AIDS epidemic. This is false. There are dozens of best practices books, published by the United Nations and others, promoting the most effective methods of countering the spread of HIV. For example, one of the best ways of combating HIV/AIDS is peer education, whether it is among young people, prostitutes, drug users or the so-called "floating population" of migrant workers. In Saigon, I spoke with a former drug user named Vy, a 26-year-old girl kicked out of her home by her father when he learned she was HIV-positive. Vy told me that she wanted to be a peer educator because it would help her regain her self-esteem, reenter society and teach others about the dangers of HIV/AIDS. Peer education helps both the peer being educated and the peer doing the educating. And there are many other effective methods of reducing the HIV prevalence rate, such as harm reduction programs like needle exchange and condom distribution.

"Okay," you might say. "If it is so easy to combat AIDS, why aren't more governments doing so?" And you would be right in asking that question. The reason is that too often, there is an abysmally low level of political will on the HIV/AIDS issue around the world. The most important factor in combating AIDS is high-level political commitment. When that commitment is there, progress can be made no matter how culturally sensitive the issue of AIDS and no matter how seemingly impractical the cost — just look at Brazil, Uganda and Thailand for relative success stories in the fight against AIDS.

So why isn't the political will there? In Russia, one reason is that the leadership believes that if HIV stays concentrated among drug users and prostitutes (where it is currently concentrated), it will kill them off, which wouldn't be so bad a thing for Russia. In China, one reason is that if China acknowledged the extent of its epidemic, it would have to acknowledge the scale of illegality because the primary methods of transmission in China — drug use, prostitution and illicit blood banks — are illegal, and because many government leaders are ignorant. In Zimbabwe, the main reason is that President Mugabe is a tyrant who cares nothing for the wellbeing of his people. Often, government leaders hide behind issues of scarcity and political sensitivity so that they do not need to address the issue. They do this because they themselves discriminate against those who are HIV-positive or they are unwilling to make the sacrifices that will be necessary to combat the disease.

But governments are increasingly realizing how important the issue is. AIDS is much more than a health issue. AIDS is an economic issue because sick people are less productive and save less. AIDS is a political issue because those who are denied AIDS treatment have already begun to demand it from their governments. AIDS is a military issue because AIDS is spreading rapidly among the armed forces, and because high prevalence rates in different areas may affect decisions about troop deployment. And failure to act on AIDS will inevitably set back progress on a host of other fronts, because action delayed costs far more than action now. AIDS demands immediate action. We can make a difference because we are making a difference — I know because I have seen the difference being made around the world. This is the task of our generation. History will judge us for how we acted on this issue. So let it be said by posterity that it was this generation — our generation — that saw the challenge, faced it squarely and with dedication and vision, turned the tide. Adam Frankel is a Wilson School major from New York, N.Y. He can be reached at afrankel@princeton.edu