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For pittance, global AIDS can be fought

Trudy Rubin Philadelphia Inquirer

At a time when no one can predict the course of the war on terror, let alone the Iraq war, Irish rock star Bono came to Philadelphia to talk about a war that can be won.

U2’s lead singer wants to rally Americans ONE by ONE to fight global AIDS and extreme poverty. So there he was in front of Independence Hall on Sunday, with Dikembe Mutombo of the New York Knicks and Grammy winning Christian musician Michael W. Smith pushing — meaning make ONE call on your member of Congress to do more.

Wednesday, he was down in Washington, testifying to Congress on the need for the Bush administration to fund fully its commitments to the war on AIDS.

OK, you say, but that war is even harder to fight than the anti-terror war. Still, the energetic and extremely likable Bono makes the impossible seem possible.

And he brought someone with him to Philadelphia who serves as a terrific reminder that real changes are happening in the anti-AIDS war.

Bono’s secret weapon is Agnes Nyamayarwo, a tall, shy Ugandan nurse who lost her husband and 6-year-old son to AIDS. She, too, is HIV-positive. Her 17-year-old son was so ashamed of his family that he ran away and was never seen again. A prime source of Africa’s AIDS dilemma is the social stigma that prevents people from getting tested or seeking help.

Agnes Nyamayarwo broke the taboo. She joined a group of HIV-positive women who took drums and went around to Ugandan villages urging the sick to seek treatment. “Agnes is one of the heroes of the hour, spreading the message,” says Bono.

But prior to 2002, none of these grass-roots drummers had access to antiretroviral medicines. “Of the 26 in our group, we lost five or more a year,” says Nyamayarwo. Here is where the hopeful part of the story kicks in.

Uganda has shown the key combination of factors that, in a few countries, has driven infection rates down. From the top came crucial political leadership: President Yoweri Museveni broke taboos by promoting safe sex on television. From the grass roots came small organizations such as Agnes’ group TASO and — of critical importance — a broad push by churches and mosques to reinforce the safe-sex message.

But this successful formula deals with prevention. It still doesn’t provide the money for treatment, to keep the members of TASO alive.

President Bush, to his credit, has increased U.S. spending on HIV/AIDS programs, promising that America will spend a total of $15 billion over five years. But the need is urgent. As many as 46 million people live with HIV/AIDS today, and an estimated 20 million have already died of the disease.

More than 28.5 million of those infected live in sub-Saharan Africa, where only about 70,000 are getting antiretroviral drugs. So it is essential that Congress provide as much of the money up front as possible. But the President requested only $2.1 billion last year (Congress raised it to $2.4 billion) and $2.8 billion this year.

Not so significant, you say. Then listen to Agnes Nyamayarwo. She managed to get drugs through a private donor, until the day U.S. funds started paying for her treatment. But others are dying from lack of medication. “People won’t even come to be tested if there are no drugs for treatment,” she told me.

So time is short, even as the chances to combine prevention and treatment improve. This is a cause that should appeal to all Americans. Bono has rallied businessmen, along with liberal and conservative church groups. He pays tribute to Pennsylvania’s conservative Sen. Rick Santorum for help with congressional funding.

Agnes is living proof that some African countries can deliver HIV/AIDS treatment. More countries could develop the necessary infrastructure with additional funding.

The cost of waging this war is a pittance compared with that of fighting terrorism.

But victory could save as many as 100 million lives.

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