Greg Behrman, Author, The Invisible People
Trevor Neilson, Executive Director, The Global Business Coalition on HIV AIDS

Opening Remarks from Nicholas Platt, President of the Asia Society.

In a program discussing the new book “The Invisible People: How the U.S. Has Slept Through the Global AIDS Pandemic, the Greatest Humanitarian Catastrophe of Our Time,” author Greg Behrman offered the audience a presentation of the current global AIDS conflict. Following his remarks, Trevor Nielson, Executive Director of the Global Business Coalition on HIV/AIDS, moderated a discussion about the global AIDS pandemic, The Invisible People, and what must be done, with particular regard to those countries most adversely affected by the epidemic in Asia.

In his remarks, Greg Behrman advanced the theory that AIDS should be considered and responded to as a new security threat, offering the audience an account of what the world knows about AIDS today: in the past 20 years, 65 million people have become infected with HIV; 20 million people have already died from AIDS; 8,000 people die of AIDS every day. With these figures, Greg argued that it is feasible to believe the ominous predictions of some world leaders’ that AIDS is leading to the extinction of their people. Particularly unsettling is the observation that AIDS could orphan 25 million children by 2010. Despite these pessimistic figures, Greg argued that AIDS is preventable and treatable when prevention measures are carried out correctly. This is evidenced by the success of prevention efforts n Uganda, Thailand, Brazil and several other nations.

Greg identified the AIDS pandemic as the ‘defining global challenge of our time.’ There has never been a more critical juncture in which to question the United States’ and the world’s failed response to the AIDS pandemic, as the disease threatens to explode in the next wave of countries in Eurasia, in particular, India, China, and Russia.

Greg argued that there are four lessons to be learned from our past failures to address the emerging AIDS crisis in Eurasia. First, he called on leaders to break the historical cycle of leadership abdication, underscoring leadership as one of the two most crucial elements in a successful AIDS policy, the second being resource mobilization. Around the world, leaders have feigned ignorance or indifference when approaching the AIDS issue. The stigma attached to the disease and an unwillingness to mobilize the resources necessary for fighting the disease characterize many of the world leaders’ failure to create an effective AIDS policy.

Greg illustrated the importance of leadership with examples from India and China. In India, the political leadership failed to address AIDS destruction because of factors like bureaucratic malaise and racial or cultural elitism. China’s leadership, until recently, also denied the extent of AIDS impact, despite the fact that trends such as great economic change, increasing migration and movement, and social dislocation provide an ideal environment for AIDS’ explosion. Yet of the three countries now most vulnerable to an AIDS explosion (China, India and Russia), China’s government offers the most hope, as testing and treatment have become more readily available. However, the government’s ambivalence towards effective policy reform on AIDS is demonstrated by the fact that Chinese leaders still continue to detain AIDS activists. In contrast, Russia’s response to AIDS has been the worst of the three countries, with little discussion about the AIDS issue at the presidential and cabinet level and funds towards AIDS prevention totaling a mere one million dollars over the next five years.

Greg argued that there is much the United States can do by assuming a leadership role in the international community, such as helping to ensure that the resources necessary for treatment and prevention are readily available where needed.

Greg suggested that a second lesson learned from the last twenty years of United States AIDS policy is that the pandemic must be seen and understood in all of its magnitude. According to Greg, the disease has become more than a simply moral or humanitarian crisis, which is how the AIDS issue was traditionally viewed. The spread of AIDS produces adverse effects on world economies, which in turn could affect individual nation’s security policies. All three of the most critically affected Eurasian countries, India, China, and Russia are strong, nuclear powers in a critical juncture in their transition to democracy. AIDS could significantly undermine these countries’ power and success at attaining democracy.

A third lesson offered by Greg is that while it cannot solve the issue alone, the U.S. must lead the international community in addressing the AIDS crisis. ‘International policy reveals that the U.S. is the indispensable power in the AIDS issue’. In order to counter the fragmentation, bureaucracy and duplication inherent in an uncoordinated, multilateral AIDS policy, the U.S., with its unparalleled commitment to fighting AIDS, must lead the rest of the world.

Finally, Greg advocated ‘getting ahead of the curve’ in terms of the world’s response to the conflict. The world has witnessed many missed opportunities to fight the disease. The current Bush administration emergency plan (PEPFAR) to treat 2 million people serves as such an example. As it now stands, PEPFAR is not the viable long-term global strategy the world needs.

What the world needs is a more global strategy. A true response should include the emergency plan as well as five other stipulations: it must be global; it must build sustainable health infrastructure in the developing world and in countries most acutely affected by the disease; more resources and legislative incentives towards finding an AIDS vaccine must be committed; global AIDS must command a much higher level of presidential and cabinet-level diplomatic priority; and a wider base of popular support and pressure is needed.

During the question and answer period, the participants and audience members discussed issues such as the role of leadership in the domestic and international arenas, highlighting in particular the current Bush administration’s seemingly bilateral approach to the AIDS issue and its decision to include Vietnam in its emergency AIDS relief plan. Discussion also included the links between socio-economic disarray provoked by AIDS and fundamentalism, the roles of the American people and the UN in fighting the AIDS pandemic, the United States’ leadership role in the AIDS pandemic, and how to address political backlash from countries resistant to U.S. leadership in the AIDS crisis.