'War on AIDS:Free From Poverty, Free From AIDS' by
James D. Wolfensohn
President
The World Bank Group United Nations Security Council meeting on HIV/AIDS in Africa, January 10, 2000 View the Video Clip
of the Speech Mr. President of the Security Council, Mr. Secretary-General, Ambassador Holbrooke, Distinguished Permanent Representatives,
Let me first congratulate you, Vice-President Gore, most warmly for putting the subject of AIDS in Africa on the agenda of the Security Council, and let me thank you for the invitation to speak at this meeting - the first time ever for a president of the World Bank.
I appreciate very much your unyielding support for our institution and the cause of development. It is also a further example of the growing cooperation between the Bank and the United Nations - and I pay tribute to the leadership of the Secretary-General, Kofi Annan - now brought to a new level by a link between the World Bank and the Security Council.
For me this is not surprising. I do not know very much about the workings of the Council or how agendas are set. I have an image of midnight meetings, of responses to urgent crises, of conflict resolution at the highest and most sophisticated level of diplomacy and power politics. Like many, I am in awe of your efforts.
And yet, Mr. President, in a very real sense I believe that what my colleagues and I do every day is to address the issue of global peace and security. We do it by addressing the source of the most fundamental and pervasive causes of conflict, namely the issue of poverty and development.
One does not have to be a social scientist or a diplomat to know that people who live in orderly, well-governed, representative societies where there is economic opportunity, social justice, human rights, and declining poverty are less likely to be fighting, less likely to be angry, less likely to be frustrated than those who live in chaotic or poorly managed societies, where opportunity is denied, where poverty is pervasive, and where there is little hope of good or effective government.
We believe that combating poverty, giving opportunity to citizens, and providing effective development programs are the true key to security and peace. If this belief is justified we should be in closer touch with this august body.
Mr. President, as we meet here today, much is at stake. We will be judged by our actions on three broad counts:
First, we will be judged on whether we are serious about Africa's development and inclusion. Whether we are serious about working with Africans to give their continent a chance in the 21st century. Whether Africa, that suffered so badly so long under oppression and racism, can at last free itself of poverty and integrate with the modern open global economy. Africans must lead, but we must partner with the strong new generations in Africa to build the institutions, the structures, the rule of law, the human rights, the governance that are needed for people to take hold of their future. Only if we beat back AIDS can Africa take that step.
Second, we will be judged on whether we globally understand the nature of human security and sustainable development. Security develops from within societies. If we want to prevent violent conflict, we need a comprehensive, equitable and inclusive approach to development. A culture of prevention needs to permeate our work. Security, empowerment and opportunity must be recognized as key to freedom from poverty - just as freedom from poverty is key to security. Communities that are riven apart by disease are weak communities. Weak communities are subject to strife. Beating back AIDS in Africa will support a culture of peace.
Third, we will be judged on whether the international community can face up to global challenges. AIDS is a global issue. It forces us to bring all our understanding together - of security, health, economics, social and cultural change. It forces us to bring all actors together - from developed and developing countries, communities and governments, business and NGOs, science, faith and civil society.
Across the world, there is a wave of concern about whether we can come together and deal with the pace of globalization. How we beat back AIDS will show whether we are truly able to lead jointly to face global challenges.
Mr. President, I come here today because AIDS in Africa is not only claiming lives, it is changing the very nature of development. As one farmer in southern Africa put it: "Today, we are spending more time turning the bodies of the sick than we are turning the soil."
More than 13 million Africans have already died of AIDS, 23 million are now living with HIV/AIDS, and 10 million African children have been orphaned by AIDS. The 21 countries with the highest rates of HIV are all in Africa. The arithmetic of risk is chilling. A child born in Zambia or Zimbabwe today is more likely than not to die of AIDS.
Many of us used to think of AIDS as a health issue. We were wrong. AIDS can no longer be confined to the health or social sector portfolios. Across Africa, AIDS is turning back the clock on development.
Over the last four decades in Africa we have seen life expectancy increase by 24 years, and education and health programs extended to improve literacy and give greater opportunity. We have seen the growth of a new generation of African leaders, greater voice for the people, and more democratic regimes. But today Africa is in crisis of a type never seen before. Nothing will put Africa back more quickly, reverse the gains, and throw countries into turmoil than the current AIDS epidemic.
In too many countries the gains of life expectancy won are being wiped out. In too many countries more teachers are dying each week than can be trained. Judges, government officials, military personnel, women and girls, and the young are being ravaged with enormous economic reversal of development gains.
Nothing we have seen is a greater challenge to the peace and stability of African societies than the epidemic of AIDS. African leadership must recognize it, they must fight it, they must overcome social mores and admit that the countries are at war. We must support them. The Security Council must take note. Together we must act.
Mr. President, in AIDS we face a war more debilitating than war itself because in so many countries it is seldom spoken of, because it does not catch the headlines, because the voices of its victims do not reach the corridors of power.
We face a major development crisis, and more than that, a security crisis. For without economic and social hope we will not have peace, and AIDS surely undermines both.
We need to break that vicious circle of AIDS, poverty, conflict, AIDS. For the truth is that not only does AIDS threaten stability, but when peace breaks down it fuels AIDS. Of the countries in Africa with the highest prevalence of AIDS, half are engaged in conflict of one kind or another.
AIDS spreads through the military. It spreads even when conflict ends and when populations move. It spreads rapidly among refugees - 75 percent of whom are women and children making them especially vulnerable. There are too many refugees in Africa. Too many refugees and too many conflicts and AIDS is their handmaiden.
Mr. President, it is a grim picture. But that is the reality of AIDS.
To beat it, we must be convinced of two things:
One, we can win. We can stop its spread. We can prevent new infections. We can treat those who suffer better. In time we can hope to find a cure. I propose to confidently hold up the prospect of a world free of AIDS.
For that, we know, we need a world free of poverty.
Two, we must build on the dignity of the human individual and the capacity of her community. For far too long, all over the world, and in too many places still, AIDS is faced with silence, shame and denial. If we fail, that will be the reason.
Care, not fear. Dignity, not denial. This is where winning starts, in families, communities, governments, nations.
And we in the international community must work together with only one purpose in mind, winning. Each institution bringing its best strengths, aligning with others, adding value as we concert our efforts.
We have come a long way. UNAIDS, in which the World Bank was a partner from the outset, was a major innovative step. The Partnership Against HIV/AIDS in Africa launched here at the UN last month brings us even further. And we are partnering with many African governments in new ways.
We pledge to walk together with Africa on this journey - knowing it will be long.
Mr. President, each step of that journey demands that we do things differently.
When we think about security we must think beyond battalions or borders. We must think about human security, about winning a different war, the fight against poverty. The World Bank is ready and anxious to work with the Security Council now and in the future on a broad range of issues affecting human security.
We must shine a spotlight on the AIDS issue, put it front and center. Break the silence; destigmatize it. And build coalitions with governments, the private sector and civil society to fight it.
We must find innovative ways to make care and treatment available, including affordable drugs. The science is difficult and the market incentives are weak, but we must create new win-win strategies with the private sector in order to address this critical market failure.
We must speak openly about sex and gender inequalities, and about rape.
We must raise more resources - recognizing that it makes no sense to give aid with one hand if we do nothing to stem AIDS with the other.
We must put prevention at the center. We estimate that the cost of prevention is between $1.5 and $3.5 per capita per year - compared to over $7 per capita per year needed for basic treatment - and, of course, the cost of treatment per patient is astronomically higher.
Africans must lead. I say it again because it is so crucial. We know it can be done and done successfully. We have the examples of Uganda and Senegal, important strides in Malawi and elsewhere, and further afield we know of the ground-breaking work in Thailand.
And we must acknowledge that without peace and stability in Africa the chances of staunching this epidemic will be much slimmer.
Three months ago in Lusaka, the World Bank launched a new strategy for HIV/AIDS in Africa. I bring it to this table.
This strategy declares AIDS as a top priority for the Bank in Africa and commits us to an unprecedented effort, in partnership with UNAIDS, to support countries and communities in this struggle.
We will mainstream AIDS in all our work in Africa, recognizing that AIDS and development are inextricably tied together; we will back this commitment with increased funding and with a long-term partnership.
We must recognize that if we provide the resources and the enabling environment, solutions will come from communities. No community wants to dash the dreams of its children. AIDS will do nothing to change that bedrock bond between generations.
But communities need financial support; and their programs need to be scaled up - we estimate that the total sum needed for prevention in Africa is in the order of $1 billion to $2.3 billion and yet at present Africa is receiving only $160 million in official assistance for HIV/AIDS. Every war needs a war chest, but that provided by the international community is woefully empty.
I have told all my offices in Africa that we will provide governments with the maximum available funding to create and implement programs. We can make a very big difference but we cannot do the job alone.
We will discuss AIDS at the meeting of the Development Committee in April, and I hope that there too we can see action on the issue of resources.
We must build a coalition for change. As surely as if we mobilized for peace, we must now mobilize for war. A war against AIDS. A war for Africa's future and for our own.
Let me leave you with the voice of a young African woman whose village has been all but destroyed by AIDS. "We do not think,"she said, "that life will become any better for our children and even for generations to come."
Mr President, I believe that with a concerted international effort we can prove her wrong. Let us align our strengths to one day see a world free of AIDS.
Together, we can extend local information programs, educate for safer behavior, distribute condoms. Together with the private sector we can expand low cost treatments.
We know it can be done. But we do not have much time. The cost of inaction will be great. The cost of action is relatively small, but the rewards are priceless. A better chance of peace and stability and hope for millions who now live with none. That is surely the true meaning of security.
Thank you. |
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