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Subject: <toc> NYTimes.com Article: Whistling Past the Global Graveyard
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The New York Times
http://www.nytimes.com/2002/07/14/weekinreview/14FREN.html?ex=1027616484&ei=
1&en=35b11b55dd4a05af
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Whistling Past the Global Graveyard
July 14, 2002 By HOWARD W. FRENCH
TOKYO
THE details may change each year, but when the 14th International AIDS
Conference got underway last week in Barcelona, the flood of alarming
statistics about the progression of the disease around the world was
entirely familiar.
Soon, average life expectancy will dip below 40 years in 10 African
countries. Twenty-five million children will be orphaned worldwide by the
disease by the end of the decade. In Russia, H.I.V. infection has increased
15-fold in three years. In China, 17 percent of the population has yet to
hear of AIDS, even as the disease takes off there in earnest.
Sometime soon, AIDS will have killed more people than all the wars of the
20th century. Yet, in a paradoxical way, the most pessimistic data coming
out of the conference may come from the few bright spots, including the
United States and a few other rich countries.
People in the United States and Western Europe, where annual treatments may
average $35,000 per patient, have begun to think of AIDS as a survivable
condition. Each year, moreover, new data seem to feed a growing conviction
in the wealthiest countries that the epidemic has been blunted in their own
backyards.
In Japan, the world's second-largest economy and a lavish spender on
scientific research, there has never been an AIDS epidemic. Search as one
might, it was nearly impossible last week to find more than a brief mention
of the Barcelona conference in newspapers.
AIDS has always created a chasm between rich and poor. More than ever
before, though, the pandemic is carving up the world into islands of
affluence, medical prowess and good governance, and vast regions of poverty,
imploding institutions and despair.
Perhaps the most glaring symbol of this divide is the tepid Western response
to the United Nations' plea for $10 billion a year to fight AIDS. Many
experts call this the minimum amount needed to blunt the epidemic and care
for the sick and dying. But the world's rich nations, lacking the same sense
of urgency that drove them to action in response to Al Qaeda, or in the gulf
war, are now offering less than one-third of this sum.
Strong moral objections have long been raised to the West's seeming
indifference to the plight of many African societies. And yet the growing
magnitude of the AIDS crisis has tested the illusion of invulnerability,
prompting a search for more pragmatic solutions.
"The world stood by when AIDS was spreading in Africa," said Peter Piot,
executive director of the United Nations AIDS program. "We can't do the same
thing now that it is spreading in Eastern Europe, at the doorsteps of the
E.U."
Beyond the universe of AIDS experts, however, many people involved in
international affairs say appeals to realism like this do not go far enough.
For them, the central lesson of the Sept. 11 terrorist attacks is that in
today's globalized world there is no such thing as lasting insulation from
other people's crises. When entire societies are allowed to collapse and
human miseries are permitted to fester, sooner or later those who had the
means to help do something about it but didn't will have a steep bill to
pay.
TODAY, some people will say, `Why should we care?' " said Joseph S. Nye Jr.,
dean of the Kennedy School at Harvard University and author of "The Paradox
of American Power" (Oxford University, 2002). "Well, in the mid-1990's, many
people said pretty much the same thing about Afghanistan: `It is in terrible
shape, but what does it matter to us?' On Sept. 11 we found out what it
matters to us."
If the challenge from AIDS was limited primarily to Africa, a continent
perennially shunted to the periphery of the world's concerns, some might
still maintain that wealthy nations need do little more than apply the kinds
of Band-Aids and moral salves that are being employed there now. According
to yet another statistic issued in Barcelona, although 28.5 million of the
world's 40 million people infected with H.I.V. live in Africa, only about
30,000 Africans are receiving treatment with anti-retroviral drugs.
Year by year, however, it is becoming clearer that Africa is hardly alone.
In Russia, the rate of infection is growing as fast as anywhere. China and
India each acknowledge millions of recent cases, and yet both are thought to
be vastly underreporting the crisis. In Indonesia, the disease has been
spreading like wildfire.
In the future, the main hotspots highlighted in any new atlas of this
epidemic will be major countries (albeit not Western ones) that are the
anchors of entire regions. The doomsday scenarios that full-blown AIDS
epidemics in all these places imply are almost too extreme to contemplate.
For self-interested Westerners, it is easy to conjure images of the
devastation that could visit the more affluent parts of Europe if the former
Soviet empire were to be sucked into the AIDS vortex: refugees streaming
into Europe, economic collapse, even the outbreak of violence on such a
scale that the rich nations might be forced to intervene. But the West is
less accustomed to contemplating more distant catastrophes.
In thinking about India and China, Africa may once again serve as the best
cautionary model of how a disease can change the course of human history.
Africa, with all its problems, had made great strides in terms of life
expectancy, and in some countries, economic development as well. Like a
century suddenly torn off a calendar, those gains are now being wiped out,
and with one-third or more of adults infected with H.I.V., few institutions
can remain intact.
In living memory the world has seen mass death in places like China, with
its great famine, and the damage has stayed contained. This is a vastly
different era, though, one of huge trade and investment linking all parts of
the world, not to mention the proliferation of nuclear weapons. And the
wholesale collapse of institutions, like China's army - the world's largest
- is something mankind has never seen.
Yet these are precisely the kinds of threats that the international
conference-goers have been warning of.
Given such realities, it would seem the world is rapidly approaching a
critical fork in the road. One way, perhaps, lies death on a scale unseen
since the worst plagues of the past. The other way lies a Herculean common
struggle against AIDS, of uncertain outcome. Either way, experts from a
multitude of disciplines say everyone - rich and poor - will be involved.
"The message of Sept. 11 is that there are no more quarantines," said Ramesh
Thakur, a political scientist and vice rector of the United Nations
University in Tokyo, "and isolation is an illusion."
http://www.nytimes.com/2002/07/14/weekinreview/14FREN.html?ex=1027616484&ei=
1&en=35b11b55dd4a05af
Copyright 2002 The New York Times Company
