Dear Presidents Bush and Mbeki:
I AM WRITING to you because you lead, respectively, the country spending the most on combating HIV/AIDS and the country with the highest burden of HIV/AIDS disease. Each of you is in the final years of your term in office, and it is time to ensure your legacy.
Your predecessors, President Clinton and President Mandela, both expressed the same regret now that they are out of office: They wish they had done more to marshal the power of their presidencies to combat the HIV/AIDS epidemic.
Let me encourage you not to look back with the same regret when you could instead make your vigorous and energetic efforts against HIV a hallmark of your tenures, when you could instead look with pride at the lives you saved.
Mr. Bush, you can be proud of the President's Emergency Plan for AIDS Relief. I have seen firsthand the wonderful results of your commitment of $15 billion over five years. When I first started working in South Africa five years ago, no physicians wanted to treat people with HIV. Now, I have personally visited clinics in South Africa funded by your relief plan, and the hope and optimism are palpable, the way it was in 1996 in the United States, when lifesaving antiretroviral therapy became available.
Mr. Mbeki, five years ago there were Armageddon-like predictions that the economy of South Africa was going to collapse under the weight of HIV. But instead the economy is thriving. You are working hard to deliver on promises of free healthcare for mothers and infants, clean water, electrification and universal education. Your belief is right on the mark that eradicating poverty and the conditions that fuel HIV will help to ameliorate the effects of the disease.
But both of you have the opportunity to do more to counteract what is the world's most lethal epidemic in centuries.
Here is a plan of action:
1) Make young women a particular focus of your efforts. In South Africa, as in many other sub-Saharan African countries, 25% to 30% of young women will have HIV by the time they are 25. They are getting it by having unprotected sex with older men, in some cases because of sexual violence. Gender equality must be your policy in dealing with AIDS, and you must establish specific programs to protect young women.
2) Create specific HIV/AIDS treatment and prevention services for the poor. Those with the fewest resources must be provided with special access to programs.
