A Modest Proposal.(United States could help poorer countries fight disease)(Brief Article)(Statistical Data Included)

While America debates the disposition of $5 trillion in budget surpluses over the next decade, tens of millions of impoverished people in Africa will die needlessly of AIDS and other killer diseases because they lack the minimal income needed for lifesaving drugs and medical care. Their deaths will leave behind tens of millions of orphans, who will lose the chance for an education and an emotionally secure upbringing. Neither President George W. Bush nor his political adversaries have yet to mention the poorest of the world in their

debates over how to spend America's great bounty. So far, the United States and other rich countries have done almost nothing to help the poorest of the poor to fight AIDS, the greatest pandemic in modern history. The disease is hard to combat for several reasons. Most important, treatment is expensive. An annual drug regimen might cost about $500 per patient per year, but the poorest countries in Africa can afford only a few dollars per person per year in total health-care spending, an amount that in principle must cover not only AIDS, but other killers like malaria and tuberculosis that ravage the continent.

Without treatment, even prevention proves to be impossible. Effective prevention requires that individuals submit to testing for HIV, the virus that causes AIDS, and then to counseling and behavioral change if they are infected. But when treatment is not available, individuals shun testing. To be found HIV-positive is not a gateway to treatment, but a mark of certain death and therefore social and economic exclusion. It is estimated that perhaps only 5 percent of the 25 million or so in Africa who are currently HIV-positive even know that they are infected, and fewer than one in a thousand receive anti- retroviral treatment. Since the infection remains latent for many years--that is, without many clinical symptoms--infected individuals may infect many others before their AIDS becomes evident.

The rich countries have so far offered almost no funding for prevention or treatment of AIDS. It used to be said that the price for treatment was impossibly high, but now drug companies (both the major patent holders and the smaller generics producers) have signaled their readiness to supply the drugs ...