The toll from the HIV/AIDS epidemic is becoming more evident each day. Last year close to 2 million people worldwide died from the disease. The number of AIDS orphans is horrifying: 8.3 million children, according to UNICEF.
Less well reported is the growing economic impact. In Zimbabwe, companies report training seven workers for each job, as the death roll is so great. In Zambia, colleges graduated 300 new teachers last year; but AIDS took the lives of 600. In South Africa, analysts predict that the epidemic could kill up to 10 percent of the mining work force each year. AIDS will drive up the payroll costs of this critical industry in South Africa by 45 percent, an industry already racked by falling world prices.
While the impact today is greatest in Africa, the rate of spreading infection in South Asia is one of the most rapid in the world, threatening havoc in that already volatile region within a decade.
Faced with this devastating epidemic, African countries have become increasingly frustrated with the gap between the industrialized countries' ability to treat AIDS patients, and thus lower death rates, and their own lack of the resources to do so. This has led to attacks on the patent rights of pharmaceutical companies, by South Africa in particular, and challenges to these rights by others in the World Health Organization.
Led by Zimbabwe, countries are arguing that health should take priority over trade or intellectual property protection. The South African challenge is technically not aimed at AIDS medicines per se. But the confrontational attitude behind these challenges has its origins in the AIDS crisis.
Most African countries would be unable to administer the complex use of AIDS "cocktails" even if the price were within reach. But a new development has offered the prospect of a partnership between the international community, pharmaceutical companies and African and other nations under siege. This is the discovery of a relatively simple means of interrupting the transmission of HIV from an infected mother to the unborn child. At least this much could be addressed now.
Such a partnership would involve major donors, such as the United States, to cover the administrative costs, UNICEF to ensure proper ministration of the medicine, the pharmaceutical companies to make this relatively low-cost medicine available free or at least at cost, and the governments of Asia and Africa to launch and oversee the program.
This is still a small step toward controlling this disease. Some day, a much greater partnership will be needed to administer a vaccine, once it is developed. For now, however, pharmaceutical companies, which have been notoriously insensitive to the underlying crisis when vigorously defending their patent rights (Bristol-Myers being a welcome exception), can demonstrate concern in a tangible way.
For Vice President Al Gore, dogged by protesters over his alleged defense of the pharmaceutical industries' claims against South Africa, this would be a most appropriate initiative to lead. It would have far more impact than the extra $100 million request for HIV/AIDS he recently announced with Archbishop Desmond Tutu, as welcome as that is.
The HIV/AIDS epidemic is perhaps the most serious source of future social and economic upheaval in large parts of the world today. It demands initiatives far greater than anything done so far. A public-private partnership as described here could be the forerunner of the kind that eventually will be needed.
The writer, a former U.S. ambassador to South Africa, is a visiting fellow at the Overseas Development Council.