The most unexpected and perhaps consequential words in President Bush's State of the Union address last week were also, depressingly but unsurprisingly, among the less remarked upon: "Seldom has history offered a greater opportunity to do so much for so many."
Bush was speaking of the AIDS pandemic on the African continent and of his proposal that the United States commit $15 billion ($10 billion in "new" money) over the next five years to fight it.
The scope of the AIDS plague in southern Africa is nearly beyond comprehension. As Bush ran through the terrible math, about 30 million people have the AIDS virus, including 3 million children younger than 15. There are whole countries in Africa where more than one-third of the adult population carries the infection. More than 4 million require immediate drug treatment. Yet across that continent, "only 50,000 AIDS victims -- only 50,000 -- are receiving the medicine they need."
Here are some other figures:
With only 10 percent of the world's population, Africa is home to 70 percent of adults and 80 percent of children infected with HIV in the world today. The rate of infection in Africa is 8.4 percent, compared with 1.2 percent worldwide. An estimated 19.3 million Africans have died of AIDS-related diseases since 1982. Nearly 2.3 million died in 2001. In that same year, there were 3.4 million new HIV infections in Africa; the year before there were 3.8 million. In 2002, the United Nations program UNAIDS projected that half or more of all 15-year-olds will die of AIDS in the worst-afflicted African nations: Botswana, Swaziland, Zambia, Zimbabwe and South Africa.
An estimated 600,000 African infants are infected through mother-to-child transmission each year. So far, more than 12 million children have lost one or both parents to AIDS; this number is projected to rise to 15 million by 2010.
In Botswana, 38.8 percent of all adults are infected. In a country of only 1.6 million people, approximately 75 people die of AIDS each day, and an estimated five new infections occur every hour. AIDS has cut life expectancy in Botswana from 71 years to 35 years and in Zimbabwe from 70 years to 36. By 2010, the Congressional Research Service reports, life expectancy at birth is expected to have fallen to 30 years throughout southern Africa. The CIA estimates that the hardest-hit countries will lose as much as a quarter of their populations.
Until now, the response by the United States to this holocaust has been scandalous. In 1999, after years of skyrocketing African AIDS deaths, with the annual total passing 2 million, and with the administration's own surgeon general comparing the situation in Africa to the 14th century's plague in Europe, President Clinton and Congress managed to cough up all of $225 million for global AIDS efforts. That same year, Vice President Gore led a determined administration effort, at the behest of the big-walleted American pharmaceutical companies, to stop African nations from doing the one most effective thing to slow the slaughter: producing or buying low-cost generic versions of the expensive drug treatments that had vastly reduced the number of U.S. AIDS deaths.
President Bush did not appear to promise much better than Clinton. His last previous global AIDS proposal was a modest $500 million program aimed solely at the politically safe goal of preventing mothers with AIDS from passing it on to their babies.
But then this: $15 billion, and not just for babies -- for vast programs of treatment with the cheap generic drugs, for wide-scale condom distribution. Billions in taxpayer money. For condoms in Africa. In a recession. In a time of record budget deficits. It is a rare and wonderful thing.
History will judge whether a world led by America stood by and let transpire one of the greatest destructions of human life of all time -- or performed one of the greatest rescues of human life of all time. President Bush has opened the door to the latter possibility. The drugs that are saving the lives of thousands upon thousands of Americans can do the same for millions upon millions of Africans.
The response to the president's proposal has been faint and largely uncaring. It must become deafening. It must become -- from Congress, from conservatives and Republicans, from liberals and Democrats, from the media, from our wealthy European friends, from all of us: Yes, do it. Do more. Up the ante. Make that $15 billion $30 billion. Do it now. Save 10 million lives.
We have a lot to do right now, but we can do this too. And what greater is there to do?