Really, after that video, what more do you need? Incredibly powerful work—John, I commend you. Diane, Anna—thank you for welcoming me to New York and involving me right from the get-go in one of the most important causes of our time.
Now, this is a tremendous cause. At the heart of it, is an acronym that is seriously problematic: PMTCT. But you didn’t have to hear that once, right? Because designers are involved, marketers are involved, people who understand branding and convincing people of things are involved. The “prevention-of-mother-to-child-transmission”: for years we went around saying “PMTCT.” It doesn’t roll off the tongue [Laughter]. And in it, I think it offers you some insight into some of the challenges we face at the UN as we roll around in acronyms and alphabet soup. And “Born Free” is the antidote to that.
We’ve heard of the 1966 movie, and we’ve listened to the Kid Rock song—some of us. But this concept of Born Free has nothing to do with lion cubs or motorcycles. It is humanizing, and it humanizes one of the most vital causes of our time. It is a slogan, as you’ve heard, that captures the need for children—babies—to begin life with a fair chance at living life. It’s the urgency of making sure that the baton passed by one generation to the next is not tainted by the poison of HIV/AIDS.
John is right to call it “the tip of the spear,” a simple intervention that can reduce sharply the global harm caused by AIDS. And the facts are overwhelming. Medically, the transmission of the disease can be prevented with this one pill, about 97 percent of the time, through the timely application of this antiretroviral therapy. Our challenge—and this is, this is a fresh challenge—is not if or how, but how much money can we raise; how much of an increase in awareness we can create; and how many pregnant women can we reach? These are all measurable, achievable goals. And it’s—there’s a simple formula here, a simple equation: the more we reach, the more we save. And it’s very rare, when it comes to foreign policy or public health or development that it is that linear.
AIDS used to overwhelm us, and I don’t have to tell all of you who’ve been active in combating this disease for several generations now. When we first encountered the disease, in this country, or internationally, we lacked everything: the knowhow, the tools, the network that now exists, and the necessary moral imagination to take it on.
In the late 1990s, one of my remarkable predecessors in this job, Madeleine Albright, visited a shelter for mothers with HIV/AIDS in Africa. She had just become secretary of state, and she later described her encounter. She said, quote: “There I was, with all the power of America behind me, and yet the mother beside me was dying, and the baby in my arms had been born with a death sentence. I found myself whispering: ‘It’s gonna be okay,’ but I felt utterly helpless and there was nothing okay about it,” end quote.
In those dark days, we were losing, losing the struggle. The life expectancy in whole countries was being driven down by a decade or more. The hard-won economic gains were being obliterated, and AIDS orphans had become a separate demographic category. In most of the world most of the time, an HIV positive diagnosis meant certain death.
But things slowly changed. And in 2001, the UN created a Global Fund. Two years later, thanks to pressure from many of you and a strong bipartisan coalition in Congress, President Bush announced the US Plan for Emergency AIDS relief, which was adopted, and generated $37 billion in American contributions over the past decade. And worldwide, of course, governmental action has been enhanced and fortified by private donors and public health groups who have come together.
In the process, new medical treatments have been developed. The cost of these lifesaving medicines has come way down. And we’ve begun to focus special attention on this issue—on halting transmissions from mother to child.
Over the past seven years, the number of at-risk women receiving ARV therapy has increased from virtually zero to more than one and half million annually. And in that time, the number of children born with AIDS has been cut in half. This reduction shows that a world where all children are born free from the virus is within our grasp, and it is, as you heard, a very, very possible dream.
But Born Free and efforts like it remain critical because, in recent years, government funding for AIDS has been flattened. Progress in fighting the virus has come largely through more efficient techniques, such as bringing treatments closer to where people live, combining several medicines into the single pill, and caring for AIDS and TB patients under the same roof.
But nothing could be more cost-efficient than this: than preventing the spread of HIV/AIDS in the first place. And, of course, nothing could be more humane. The average life expectancy in sub-Saharan Africa is now about 60. The average for an HIV-positive baby who receives treatment is 14—just 14. Without treatment, most children die before they are 2. This is unbearable. Imagine being a mother–or a father–who lives with that double agony: the agony of seeing your innocent child suffer such pain, and also feeling the agony that you are in some way responsible. It is hard to conceive of a greater sorrow than that.
Since AIDS cases began to proliferate in the early 1980s, the virus, as all of you know, has taken the lives of more than 25 million people, and it has been the nightmare from which we are still trying to recover, a nightmare that has confronted us with a medical challenge but also the social one you know well, because our reaction to the disease has been marked by bigotry, discrimination, and in some countries, officially sanctioned denial.
And yet, amid the horror, there has also been the uplifting spectacle—captured in this film, captured in the efforts of all of you—of people mobilizing across every boundary of race, nation, culture and orientation to join in a common cause.
I, like John, will never forget my encounters in sub-Saharan Africa with HIV activists, with people like Zackie Achmat, who many of you know, and others in the Treatment Action Campaign in Khayelitsha, South Africa. HIV positive and HIV negative people alike wearing proudly their “HIV Positive” t-shirts. There can be immense power in a single truth-telling voice, but when millions of such voices come together speak as one, they—we—can end an epidemic.
And that’s why fresh initiatives such as this one are vital and timely. Increasingly, as you know, we’ve heard people talk of donor fatigue. But I don’t sense a lot of fatigue here in this room. This is more of the, kind of, impatience variety—no fatigue here. There is determination in this room. There is determination in all of the actors who are coming together in the private sector, in government, in the non-governmental world, and the communities: the people; that mother who said, “I am the face of AIDS.” That’s a determination.
And we will plug away, day by day, patient by patient, country by country until the tragedy of AIDS is consigned to history. Zero is a solemn commitment to eliminating AIDS, a solemn commitment to zero untreated infections, zero transmissions from mother to child, zero AIDS-related deaths. A solemn commitment that every child will be born free.
We now have the knowledge, we have the tools, we have the network, and we most certainly have the moral imagination. All that is left for us do to is to go forth and deploy them, and to get others to do the same.
Thank you so much.
This site is managed by U.S. Mission to the United Nations in New York City and the Bureau of Public Affairs in Washington, DC. External links to other Internet sites should not be construed as an endorsement of the views or privacy policies contained therein.