Diplomatic and health issues rarely intersect, but this is becoming increasingly less true on the international front, as the fight against AIDS has forced two Bush administration cabinet members to work together as an instrument of American foreign policy.
Speaking at World AIDS Day ceremonies earlier this week, Secretary of State Colin Powell expressed the blunt truth about the disease: "Every nation is vulnerable. No nation is protected by geography or political boundaries or social boundaries or religious boundaries. AIDS will attack us all and is attacking us all."
Powell's cabinet colleague, Health and Human Services Secretary Tommy Thompson joined in the ceremony. "It is estimated that 45 million people worldwide will be infected with HIV in the coming decade," said Thompson. "And some 44 million children will lose one or both parents to AIDS in those same ten years."
Powell then cited more statistics, staggering and mind-numbing in their size and significance - to lay out the picture of AIDS as it now stands worldwide. "Forty-two million people now live with HIV/AIDS," said Powell. "An estimated 8,500 people die every day. That's six people every minute."
When the HHS secretary speaks about AIDS you might be right to think the impact would be limited to medical and personal family issues. But when the Secretary of State addressed the topic, he invited 164 representatives of Washington's diplomatic corps to the event.
Diplomats from 86 embassies showed up to hear the two senior American officials shine a bureaucratic spotlight on the problem that affects all of them and for many, the very governments they serve. Exact numbers are unclear but an overwhelming number of those who suffer from HIV/AIDS live in the developing world and have little or no access to the latest (and most expensive) medical treatments.
Several examples of leaders in the developing world were cited by Powell as proof that the battle against HIV/AIDS can be fought with some success.
In Uganda, the government led by President Museveni has seen the infection rate fall by 50 percent since 1992; in Cambodia, the country in Asia with the highest percentage of adults with HIV, the government has stabilized the rate of infection; and in Brazil, the number of HIV-infected is only one-half of what had been projected.
Overall, HHS says U.S. government spending on HIV/AIDS is now about $16 billion a year. That includes a $500 million contribution (over two years) to the U.N.'s Global Fund to Fight AIDS, Tuberculosis and Malaria. The Bush administration has requested $1.3 billion for the 2003 fiscal year for international spending to combat HIV/AIDS.
Powell has called on U.S. diplomats around the world to pay attention to what he calls the HIV/AIDS "pandemic" and the reason for his appeal becomes clearer the more the disease spreads.
"HIV doesn't just destroy immune systems; it also undermines the social, economic and political systems that underpin entire nations and regions," Powell explains. "The disease spreads fastest in places under stress, weakening already fragile support systems beyond the breaking point, causing whole societies to begin to shudder and reach the edge of collapse."
All of this is true, so far as it goes. What Powell is not saying directly, but only implying, is that if the AIDS "pandemic" is not stopped, many governments in the Third World will collapse because people will not only not have health services to care for them, they will also not have functioning government services across the board.
People with HIV/AIDS do not report for work, if they have jobs at all; they cannot adequately care for their children, who will become orphans and will need to be taken care of. Economies collapse, governments fall, chaos reigns.
Yes, there is a genuine, humane response to the problem but something else is also quite clear: no administration in Washington wants to have to deal with chaos throughout the developing world.
If that scenario is allowed to play out, the cost in both human and economic terms will be not only too high to pay, but also too high to even contemplate.
By Charles M. Wolfson