Ten years after

Published: Wednesday, December 1, 2004 at 6:01 a.m.
Last Modified: Tuesday, November 30, 2004 at 10:12 p.m.
Ten years ago, delegates from nearly 180 nations came together in Cairo, Egypt for the International Conference on Population and Development. Out of that conference arose the first truly global effort to come to grips with an HIV/AIDS epidemic that was leaving no corner of the world untouched.
Ten years later, midway through the Cairo Conference's 20-year global action plan, there has been some progress, but not nearly enough, in regard to combatting HIV/AIDS.
On the plus side, most nations have adopted education, prevention and treatment strategies intended to stem the spread of the sexually-transmitted disease. On the negative side, nearly 40 million people have been infected in the last two decades, and 20 million have died. In some sub-Saharan African nations, 25 percent of the workforce is HIV positive.
Worldwide, less than 20 percent of the people at high risk of infection _ mostly the young, and particularly women _ do not yet have access to preventative or intervention services. And the great majority of those who do have the virus cannot obtain life-sustaining, high-cost antiretroviral therapy.
The dilemma facing the world 10 years after Cairo is that the HIV/AIDS epidemic cannot be treated in isolation, as though it were a public health problem that can be "cured" with the proper medication or vaccine.
It fact, the spread of the virus cannot be confronted without also confronting a host of related issues; like access to family planning services, contraceptive use, and reproductive rights.
As a "State of the World Population" report this year from the United Nations Population Fund puts it, "HIV/AIDS interventions must be linked more effectively to other components of reproductive health."
"Since most HIV transmission is through sexual contact, reproductive and sexual health information and services provide a critical entry point to prevention...," the report states. "Linking prevention efforts and voluntary HIV testing and counseling with existing reproductive health services can improve outreach, reduce stigma and save money."
Recently, 75 world leaders signed a document reaffirming their nations' commitment to the Cairo Conference's 1994 action plan. Among those signing were leaders from Great Britain, Canada, France, China, Japan and many of the world's other major industrial powers.
One leader who declined to sign the reaffirmation was President George W. Bush, whose administration has also withheld U.S. financial support for the United Nations Population Fund for the last three years.
Notes a recent article from the World Population News Service, "The Bush Administration....has challenged the Cairo document at virtually every opportunity." Pressured by domestic religious activist groups that equate the phrase "family planning" with "abortion," Bush has withheld $34 million this year alone from the Population Fund.
The President has spoken eloquently about the need to mount a crusade against the HIV/AIDS epidemic. And he has even pledged billions of dollars toward the effort. But a crusade that does not take into account the role that education, access to family planning services and contraception must necessarily play in prevention is doomed to failure at the outset.
Today is World AIDS Day. In the United States alone, nearly 1 million people are living with the virus. Especially alarming is the rapid spread of the virus among women and girls; worldwide, nearly half of those living with the virus are female.
Ten years after the Cairo Conference, there is a critical need to step up international efforts to control the devastating spread of this deadly virus. The United States ought to be a world leader in that effort, but ideological blinders keep the Bush Administration from exerting any meaningful leadership.

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