Todd Post/Bread for the World
At an AMPATH (Academic Model
for Providing Access to Healthcare)
workshop in Eldoret, Kenya, a woman
on antiretroviral medication is now well
enough to learn new livelihood skills.
years has been the struggle to prevent and treat global HIV/AIDS. As with
polio, HIV anywhere poses a threat to people everywhere. Infections that were
later determined to be the result of HIV were first noted in 1981 in the United
States. By 1985, there were people on remote Pacific islands who were HIVpositive.
Gradual improvements in treatment meant that many HIV-positive Americans were living far longer and in better health than at
the beginning of the pandemic. In Africa, however, the
outlook had not improved. Many HIV-positive people
were unaware of their status, so the virus spread rapidly,
and very few people could afford the new antiretroviral
(ARV) medications. Several nations saw dramatic drops
in life expectancy. Millions of orphaned children strained
the ability of grandparents and extended family to care
for them. There was a new phenomenon, “child-headed
households,” where eldest siblings as young as 11 struggled to grow food and care for younger children.
Early in 2003, President George W. Bush announced
the President’s Emergency Plan for AIDS Relief (PEPFAR), with initial funding of $15 billion for HIV prevention, treatment, and care in 15 of the hardest-hit
countries. Bush declared, “We have a chance to achieve a
more compassionate world for every citizen. America believes deeply that everybody has worth, everybody matters….” He said that helping people with AIDS is part of a legacy of American
compassion, just as the Marshall Plan was.
Today, 40 times as many Africans receive ARV treatment as before PEPFAR
began. By the hundreds of thousands, people in their twenties, thirties, and
forties have gotten well enough to return to work and parenting. Far fewer
newborns contract HIV from their mothers. The AIDS pandemic is not over,
but there is hope that the tide is turning.
PEPFAR’s priority now is to support countries in strengthening their health
care systems to provide HIV treatment on their own. PEPFAR is part of the
U.S. Global Health Initiative established by President Barack Obama; the initiative’s other components share this emphasis on building health care systems
able to provide the medical services needed for a healthy population.
Making Progress That Will Last
Norman Borlaug, an American scientist, has been called “the father of the
Green Revolution,” an enormously successful effort in the 1960s to increase
the yields of staple crops. In many Asian and Latin American countries, new
high-yield seeds and techniques brought a tripling of production. The proportion of people in Asia who were malnourished fell from 51 percent in 1960 to
16 percent in 2000.
Success may have brought complacency, however. In the years that followed, the United States and other developed countries cut back sharply on
investments in global agriculture. Many developing countries followed suit as
12 Essay 2
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Bread for the World Institute