When leaders lead

Ugandan President Yoweri Museveni, for example, rarely delivers a speech in which he does not mention AIDS, and the trickling down of that rhetoric is at least partly responsible for the levelling off of infection rates in urban areas of Uganda. Some surveys in antenatal clinics there have found that between 1990-1993 and 1994-1995, HIV prevalence among women aged 15-24 declined by 35 per cent. 

In South Africa, President Nelson Mandela has called for a national struggle to vanquish AIDS on a scale similar to that mobilized to bring down apartheid. Zimbabwe responded to high HIV prevalence rates with a mandatory weekly lesson in life skills for all students aged 9 to 19. The course, begun in 1993, addresses HIV/AIDS in the context of coping with emotions and expectations, gender roles and plans for the future, and students role-play to develop strategies for responding to peer pressure. 
 

Educating people about how AIDS is transmitted is essential in combating the disease. A girl participating in an AIDS awareness workshop in Bujumbura (Burundi) holds a T-shirt that says, "We are taught and we teach AIDS  awareness" in the Kirundi language.

Similar bright spots of leadership are occurring in Asia. Only a few years ago, Thailand was viewed by complacent neighbours as the only country in the region likely to have a significant problem with AIDS. The virus had gained a foothold in 1988, and the availability of commercial sex in the country of 59 million people allowed it to flourish. As a result, about 45,000 Thais died from HIV infection in 1995. 

But Anand Panyarachun, who was Prime Minister in 1991 and 1992, instituted a far-reaching AIDS education programme that has put Thailand in much better shape than some of its neighbours. Mr. Anand required every government minister to include a budget line for AIDS. The centrepiece of a public education programme was a series of explicit AIDS prevention messages aired on radio stations at least once every hour. Condoms were widely distributed to brothels. Sex businesses that refused to require condom use were shut down. Calls for abstinence from casual sex were partnered with the condom campaign, promoted tirelessly by the Prime Minister's dynamic AIDS adviser, Mechai Viravaidya. 

As a result, there was an 80 per cent increase in sexually transmitted diseases in Thailand from 1989 to 1994. The number of new HIV infections in Thailand each year has more than halved since 1990. Success stories like these should be the most powerful argument against complacency. 

These successes demonstrate that if we focus our efforts on those most vulnerable, if we expand use of the communication tools that work and commit ourselves to developing a vaccine and affordable drugs, we can stop this plague. We already proved we can muster global will and resources with the campaign that raised vaccination rates worldwide from 40 per cent to 80 per cent in just five years. 

The worst that can happen for our prospects of wiping this virus from the earth is to allow complacency and divisiveness between the haves and have-nots to prevent us from developing responses that work in the countries where they are most needed. We can defeat HIV/AIDS—if we all acknowledge our ownership of it. 

President Mandela said it best: “As the freedom of each nation is interdependent with that of others, so too is the health and well-being of their peoples. Nowhere is this more true than in the case of AIDS. The challenge of AIDS can be overcome if we work together as a global community."