Working Globally to Mobilize Families To Confront AIDS

[Guest guest]

Working

Globally to Mobilize Families To Confront AIDS

Keynote Address as

prepared by

Dr. S. Zeitz, Executive

Director, Global AIDS Alliance

July 22, 2004, Atlanta, Georgia

NIMH Annual

International Research Conference on the Role

of Families in Preventing

and Adapting to HIV/AIDS

Thank you Dr. DiClemente for your very kind introduction. I

am profoundly grateful for the opportunity to be here today to share some

perspectives on the global AIDS pandemic and the mounting crisis of orphans and

vulnerable children.

I also want to thank my dear friend and mentor,

Thurman for asking me to fill in for her. As we all know, no one can fill in

for Sandy. Her dynamism and commitment to

the AIDS battle here in Atlanta

and her Herculean efforts to mobilize the U.S. government when she served as President

Clinton’s AIDS Czar are unmatched. I first met Sandy in Zambia where I was living and working—in the center

of the AIDS holocaust---in the late 1990s. At a point when I was personally despairing

at our collective failure, Sandy gave me hope that we, as people on the planet, can

do better than we are doing now to respond to these crises. I am so thankful to

Sandy each day for all that she does!

She asked me to send her love to all of you this morning.

The global AIDS pandemic is, from my vantage point, the

central global justice issue of our time. The current global AIDS situation is

a direct manifestation of:

economic injustice—as poor, impoverished

people are disproportionately affected;

racial injustice—as people of color make

up the vast majority of those affected here in the USA and around the world;

gender injustice----as women now make up the

majority of HIV/AIDS in Africa;

age injustice—as the majority of the

15,000 new infections per day are occurring in 15-24 year olds; and

finally,

sexuality injustice—as people who choose non-heterosexual

practices are systematically stigmatized around the world.

The paradox and the opportunity of this pandemic is

that we have to fix—at least partially---these injustices in order to solve

this crisis. My vision is that together we will mobilize ourselves to take

collective action to fix these injustices. And by doing so, we will, at the

same time be renewing ourselves and our families. By working together to fix these

global injustices, so many atrophying souls can be stirred into faster action and

towards more effective solutions---and with due haste.

At the recent International AIDS conference in Bangkok, UNAIDS announced that approximately

40 million are infected and over 20 million have already died. With 8,000

deaths each day---families, communities, and entire societies are being

decimated each and every day. While the HIV/AIDS pandemic reeks havoc throughout

Africa, and picks up speed, the virus is also

now spreading exponentially in Russia, India, and China. Additionally, we are also bearing witness to a

massive secondary pandemic, that of orphans and vulnerable children.

The most recent estimates reported at Bangkok in the latest

edition of the UN’s “Children on the Brink” report estimates

that there were 143 million orphans and vulnerable children worldwide in 2003,

with AIDS directly causing the greatest increases. The report also projects

that if nothing serious is done, we will see the number of AIDS orphans continue

to rise for at least the next 10 years. Currently, AIDS creates a new orphan

every 14 seconds.

The crisis is so severe that we are now seeing a full

generation of kids raising their siblings in what are now called child-headed

households or sibling families. There is a new lexicon now emerging as the “Lord

of the Flies” is becoming a reality in more and more devastated

communities. There is a growing generation of kids trying literally to survive

each day as they are saddled with hunger, disease, and largely untreated

post-traumatic stress disorders. As a father of five sons, I can tell you that

I wouldn’t want my relatively healthy boys running the roost without consistent

loving adult guidance.

With the loss of so many parents, we are seeing unexpected

consequences. For example, southern Africa has been suffering from a minor drought over the

past two years. Normally, this would have been a transient event in which time-proven

local adaptation efforts would have sufficed. In the era of AIDS, however,

communities have not been able to cope. A recent UN investigation revealed

that huge number of AIDS-related deaths prevented the normal inter-generational

transmission of cultivation and agricultural skills, leaving those behind

without the know-how to respond.

In Zambia,

it was recently reported that over 2000 primary school teachers died last year,

many from AIDS, yet the training programs for new teachers only produces about

1000 new teachers per year. As you can imagine, this is destroying the

infrastructure of an already weak system.

Though we must fully witness this unfolding devastation, we are

also in the unique position of being able to create the needed change. It is

within our ability to ensure that children aren’t abandoned and that this

generation of children aren’t discarded.

For the first time in human history, we have the technology,

the wealth, and a new global consciousness to respond and I believe that we will.

We have practical and cost-effective solutions. We know how to support local

communities in their efforts to deliver programs to support these children

with strengthened social support structures, basic education, primary health

care, HIV treatment when necessary, psychosocial support, life skills training,

microfinance programs, and food security and nutrition. There is no magic

bullet, no panacea, and no vaccine to solve these problems. We need a

full-thronged investment in a comprehensive and multi-sectoral response to this

crisis. Biomedical solutions alone will not nearly suffice. Our funding and

our policies must evolve quickly to reflect these realities.

As stakeholders around the World, we are now actively

struggling in the transition from the failed incremental “pilot” response

of the past to an expanded and comprehensive response to AIDS pandemic and the

crisis of orphans. The key question is how fast will we move to make change

happen??

In response to these challenges, I am proposing an agenda

for action, which, if implemented, would dramatically accelerate action to

hasten the end of the AIDS pandemic and expand global action for children:

First, we must mobilize the resources necessary to have an

impact. Money is the oxygen for action and for life.

UNAIDS estimates that we need $12 billion in 2005 to

scale-up a minimum package of prevention, care and support, and lifesaving ARV

treatments. By 2007 the annual global estimated need will be $20 billion for

AIDS programs. In addition to these needs, UNICEF is in the process of

finalizing a global costing estimate for responding to the crisis of orphans

and vulnerable children. It is my understanding that their estimates to

provide comprehensive community-based support, revitalize child survival

programs, and achieve universal primary education, will be at least $10 billion

per year. Adding up these numbers, we will need approximately $30 billion per

year from all sources.

As the United States controls one-third of the global economy. we are

calling on the US government to mobilize its’

one-third fair share of the global need. The $10 billion dollars needed

annually from the US government to fight AIDS and

support the world’s children. This amounts to just $36 per American per

year. What an amazing return on investment America could have. Wouldn’t it be great if America once again showed her “big

heart” instead of just her military might?

As we contemplate the role of our government is responding

to this global situation, I’ve come to understand that all of us have the

opportunity to become citizen advocates. Grassroots pressure from constituents

is the key to mobilizing our political leaders to take action and through such

efforts we can demonstrate that our democracy is working.

To accelerate these efforts, a new coalition of coalition of

humanitarian groups, religious organizations, and students and other people of

conscience are mobilizing around a new campaign called “Global Action for Children”. I’ve been witness to

so many examples of simple actions that Americans are taking to mobilize themselves

and their families all over this country. This mobilization is already having a

direct impact on the political feasibility of this agenda. But obviously, we

all need to do more.

Some people call these levels of funding unrealistic and too

radical. After living and working in southern Africa for 6 years, I’ve come to believe that these

goals are realistic and rational. When faced with the stupefying psychotic

complacency of Capital Hill, I’ve learned to sustain my relentless

efforts by reflecting on Gandhi’s guidance when he said, " First they ignore you. Then

they laugh at you. Then they fight you. Then you win. "

Our second priority is to remove the external debt burden

that shackles African governments. Each year, for example, African governments

are paying approximately $12 billion in debt serving payments to wealthy

creditor governments, the IMF, and the World Bank. This is a systematic extraction

of resources from the impoverished global South to the wealthy global North---which

I believe is an ongoing legacy of the colonial era.

The Heavily Indebted Poor Countries or HIPC Initiative that

was launched in the late 1990s has proven itself to be too slow and too

limited. Even the World Bank itself reports that the Initiative is failing. The

22 countries participating in this Initiative are still spending more repaying

debts than they currently spend on health care.

Evidence also shows that when the budgetary savings from

debt relief are allowed to stay in the debtor countries, two-thirds of those

resources are being spent on health and education, with most of the remainder

being used for HIV/AIDS programs, improved water supply, better roads and improved

democratic governance.

We should all work to ensure an immediate transfer of these

annual debt service payments towards funding of poverty reduction, an AIDS

response, and allow countries to establish comprehensive social safety systems for

orphans and vulnerable children. It’s high time to let these

impoverished countries help themselves with their own resources. When this reform

eventually happens, we will all know that real change has arrived.

Another top priority we have is the need to dramatically and

rapidly expand access to lifesaving antiretroviral AIDS medicines in order to

keep economically productive parents alive. This is primary orphans’ prevention.

Also, we must develop new drug regimens and pediatric formulations to ensure

that all HIV-infected children are also being treated with lifesaving AIDS

medicines.

We strongly support WHO’s goal of reaching 3 million

medically eligible people by the end of 2005—the so-called 3-by-5 initiative.

Please note that this goal is only a 50% coverage target, as there are 6

million people in urgent need of treatment. Over 3 million children under the

age of 15 are currently living with HIV/AIDS.

So many people ask me, if this goal is realistic. After so

many of us have been duped by the relentless flow of lofty goals and

declarations, we all should have a healthy skepticism. In the case of WHO’s

3-by-5 initiative, after studying the issues, I do believe that there is

practical evidence from affected countries that this goal could be achieved in the

next 17 months….if only we could generate the political will and

resources necessary.

Another key priority the Global Action for Children campaign is for the rapid and

immediate elimination of all government-imposed school fees which act as a key

barrier to primary education for children, particularly for orphans and young

girls. The UN reports, that of the 34 countries unlikely to meet the goal of achieving

gender equity for primary schooling, 26 of those still charge school fees.

The per capital income in Congo is $70, but schools fees range from $50 to $175 per year

per child. After school fees were eliminated in Uganda enrollment soared from 2.5 million

in 1997, to 6.5 million in 2000. Enrollment of girls went from 63% to 83%, and

by 2000 there was virtually no gender disparity. More recently, the Government

of Kenya eliminated school fees which brought 1.5 million more orphaned and

vulnerable children into the system. These bold political initiatives by

African leaders galvanized widespread institutional reform which has been

dormant for way too long.

As the parent of an adopted Zambian son, I’ve learned

firsthand, as I’m sure you all know, these orphaned children are all

yearning to find a stable family. In Africa, the extended family network is the first avenue for

support. As those systems become stretched and overburdened, community support

systems must be reinforced and strengthened. Despite being a response of last

resort, institutional care is becoming more and more common as the indigenous

systems I described are collapsing. In addition, I do believe that renewed efforts

are needed to allow orphaned children to be adopted by relatives, even if they

are living in another country. Currently, country-to-country adoption

restrictions that exist are extremely prohibitive.

Finally, the United States must join the community of nations by becoming a co-signatory

to the UN Convention on the Rights of Children. Our government has far too long

evaded its responsibility as the world’s most delinquent mega-power and

renew our efforts to give the dream of life and liberty to all of the children

of this World.

In closing, I would like to ask each of you to consider new

ways in which you can mobilize yourself, your family, your neighborhood, your

faith community, your kids school, your workplace, wherever, to take renewed action

on behalf of the World’s children.

As people living in this time and in this place, we must

take mover forward together to succeed this in this profound human endeavor.

As Archbishop Desmond Tutu says, " We are one world and these children

are our children. Their fate is our fate, each of us can make a

difference. Everyone can help to save lives. "

Thank you again for this opportunity to share my ideas.

FOR MORE INFORMATION:

websites:

www.globalaidsalliance.org;

www.globalactionforchildren.org

email: pzeitz@...