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Published: Saturday, 8/11/2001

AIDS not only pestilence

It is not surprising that U.N. Secretary General Kofi Annan made a stirring speech recently on HIV and AIDs, the scourge that has left 17 million Africans dead and 25 million infected with HIV, to say nothing of its impact in other parts of the globe. Mr. Annan pointed out that the world should refrain from passing moral judgments on AIDS victims “and making out that it is all their fault.”

Prompted by the horrendous death tolls, the United Nations has little choice but to recognize the need for action. This death-dealing, economy-wrecking disease, with 36 million victims worldwide in the past two decades, could well surpass in another 20 years the estimated cost of 60 million lives lost during World War II, the calamity that led to the founding of the U.N.

Still there is a nagging concern on the part of many public officials that once again a campaign against a single disease may divert public attention from other killers of mankind. One remembers Richard Nixon's war against cancer, the victorious end of which is certainly nowhere in sight.

Six infectious diseases claim millions of lives a year. Tuberculosis and malaria, both of which seemed at times to be on the brink of extinction, rank along with AIDS among the three top global killers in this category. Heart disease and cancer ravage populations in both the developed and less developed nations. Tuberculosis kills up to 2 million people a year, and measles up to a million children a year in poor nations. Diarrheal disease claims 600,000 annually.

Doctors and public health officials sometimes throw up their hands in despair at the number of needless deaths that could be prevented by vaccination or other low-cost prevention measures.

Malaria is one of the most persistent and least publicized killers, claiming a million victims a year, because the most common drug, chloroquinine, is becoming less effective for the same reason that antibiotics are - the rise of drug-resistant strains of infectious disease. A bed net treated with insecticide (cost $10) would do much to reduce the threat of malaria, called by some authorities the greatest killer in the history of mankind.

It is a form of triage, to be sure, but some experts are heard to say that it would be better for public health campaigns to “focus on the things we do know how to fix.” It is argued that costly treatment of AIDs victims in poor nations will come only at the expense of vaccinations and diversion of resources from other worthy causes.

A multi-disease strategy would serve more people more effectively than another single-shot effort such as the anti-AIDS campaign. In light of the way this disease has ravaged sub-Saharan Africa, few critics would attack such a campaign very openly.

Clearly, though, a multibillion dollar, multi-faceted attack on the conditions that lead to high death rates from preventable diseases would make more sense. Unfortunately, it is far from clear that the United Nations will be able to marshal the resources needed for a humanitarian venture of this scope.

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