Fighting AIDS: Advocates call for dialogue, engagement

"More than anything else, we are the AIDS generation." Adam Frankel '03, co-founder of the University's chapter of the Global AIDS Campaign, pauses for a moment, brow furrowed, before he continues. "The first public announcement of AIDS was made in 1981, the year many seniors were born. In my opinion, this is the single most important cause of our generation."

With the announcement of President Bush's new Emergency Plan for AIDS Relief — a program set forth in Bush's State of the Union address that proposes to increase AIDS funding to 14 African and Caribbean nations — the AIDS pandemic has once again come to the forefront of national discussion.

Bush's plan promises a total of $15 billion over five years — nearly $10 million of which is new money — up from the $1.2 billion that the United States plans to spend this year. Implementation of the program will follow a "network model" that consists of central medical centers, corresponding satellite centers and mobile units that will administer uniform medical care in the participating countries.

The administration has yet to determine how to distribute the funds as well as how to transform the money into effective care, treatment and prevention, but already the means of distribution have become a central point of debate.

On one hand, the Bush administration appears to be leaning toward an approach in which the United States itself would distribute the money to recipient nations.

However, there is also pressure to distribute through the Global Fund to Fight AIDS, Tuberculosis and Malaria, a public-private partnership run through the United Nations that raises and distributes money for worldwide health spending.

"The new funding is a wonderful and huge first step, but Bush has not given money to the Global Fund which is very successful in distributing money effectively to countries severely afflicted with AIDS," said Nida Parks '03, co-founder of the University's Global AIDS Campaign chapter. "Wanting to control our own money is a very American thing, but since AIDS is a global problem, not just a U.S. problem, the fight against this disease should be an international effort."

Further U.S. participation in the Global Fund would also encourage matching grants from other countries as well as reduce the overlap of goals and funds that occur between bilateral programs, Frankel said.

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However, others argue against the efficacy of the Global Fund, claiming instead that bilateral distribution of the money is the easiest way to cut down on bureaucratic entanglements. In addition, bilateral distribution could also offer strategic benefits.

"I understand both sides, and I would like to see some of the money sent to the Global Fund," said Evan Lieberman, a professor in the politics department researching AIDS policy. "However, bilateral distribution also offers strategic advantages. We live in a world where the current situation suggests that it is nice to have friends and allies. It would be useful to give money and have the recipients realize that the money is coming from the U.S. rather than from the Global Fund."

Though the new initiative will make an important contribution to the fight against AIDS, it remains unclear whether the program will be able to do enough to make an impact in the near future.

"The Bush program will absolutely not do enough," Frankel said.

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Despite Bush's promise, the United States will not actually begin to increase its annual AIDS spending until 2006 at the earliest, he said.

Yet the United Nations has called for an immediate increase in AIDS spending around the world, saying the time to act is now.

"With AIDS, gradualism is death," Frankel said.

AIDS continues to be a devastating problem throughout the world with 42 million people currently infected, he said.

Sub-Saharan Africa, where much of the new U.S. aid will go, is the most severely affected area of the world, with 29.4 million people living with HIV or AIDS, according to the UNAIDS website. Several countries, including Botswana and Zimbabwe, have adult infection rates exceeding 30 percent.

Despite the severity of the AIDS crisis and the efforts of campus groups such as the Global AIDS Campaign to increase student awareness, much of the University community remains relatively distanced from the issue.

"A lot of student complacency is due to a feeling of defeatism," Frankel said. "The epidemic becomes daunting when you look at the numbers. But AIDS doesn't just affect populations — it affects individuals and families, and when we start to look at the individual stories the fight against AIDS becomes inspiring, not depressing. We know how to fight AIDS. Now the issue is raising awareness and putting the resources behind successful responses to the disease."

Nevertheless, campus activism is not dead. The Global AIDS Campaign has remained active in balancing campaigns to raise AIDS awareness on campus with efforts to promote advocacy within the larger community.

In December, the group organized a series of lectures, movie viewings and other events during AIDS week, including the planting of 2,000 red flags in the 1879 courtyard to demonstrate what proportion of Princeton students would be infected with HIV if the University were in Botswana.

The group is also currently lobbying for a needle exchange program in New Jersey, which would remove syringes from the drug paraphernalia list, helping to reduce AIDS transmission among drug users who share needles.

"We stay in touch with the larger national campaign, but it is also important to do things where you can see tangible results," Parks said. "As Princeton students we have a certain degree of leverage with legislators and community leaders that puts us in a unique position. Sen. Frist has expressed interest in getting Princeton students involved with strategies and ways to address the problem of AIDS, so overall Princeton is becoming more committed to the cause."

In addition to student efforts to raise awareness, Lieberman has begun to investigate the possibility of developing an academic and intellectual forum for promoting AIDS awareness.

"Right now there is a strong community interest in the AIDS issue, but there is no institutional base for exchanging information," Lieberman said. "Though things are still in the early stages, we hope to develop a forum for sharing this knowledge perhaps through increased course offerings, lectures and other events."

As the fight against AIDS continues both on campus and around the world, the most effective means of combating the threat is still individual involvement, activism and commitment, Parks said.

"Grassroots mobilization is extremely important in fighting this disease," she said. "People on campus don't think that AIDS is going to affect them, but we are moving closer to being a fully global community and everything will eventually cycle back and affect us as well. We have to acknowledge the problem now."