The World Bank pioneered global HIV and AIDS financing early in the emergency and remains committed to achieving Millennium Development Goal 6, to halt by 2015 and begin to reverse the spread of HIV and AIDS, through prevention, care, treatment, and mitigation services for those affected by HIV and AIDS.
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If the Ebola epidemic devastating the countries of Guinea, Liberia and Sierra Leone had instead struck Washington, New York or Boston, there is no doubt that the health systems in place could contain ... Show More +and then eliminate the disease.Hospitals would isolate suspected cases. Health workers would be outfitted with proper protective clothing and equipment. Doctors and nurses would administer effective supportive care, including comprehensive management of dehydration, impaired kidney and liver function, bleeding disorders and electrolyte disturbance. Labs would dispose of hazardous materials properly. And a public health command center would both direct the response and communicate clearly to the public about the outbreak.Ebola is spread by direct physical contact with infected bodily fluids, making it less transmissible than an airborne disease such as tuberculosis. A functioning health system can stop Ebola transmission and, we believe, save the lives of a majority of those who are afflicted.So why isn’t this happening in West Africa, where more than 1,500 people have already died?As international groups pull staff from the three countries, airlines suspend commercial flights and neighboring countries close their borders, some have argued that it will be next to impossible to contain the outbreak — that public health systems are too weak, the cost of providing effective care too high and health workers too scarce.But Ebola has been stopped in every other outbreak to date, and it can be stopped in West Africa, too. The crisis we are watching unfold derives less from the virus itself and more from deadly and misinformed biases that have led to a disastrously inadequate response to the outbreak.These biases, tragically, live on, despite evidence that disproves them again and again.Just 15 years ago, Western experts said confidently that there was little that rich countries could do to stop the global AIDS crisis, which was killing millions of people in Africa and elsewhere.Today, thanks to leadership and advocacy from President George W. Bush, a bipartisan coalition of members in Congress, courageous faith-based organizations and U.S. government researchers such as Tony Fauci and Mark Dybul, more than 10 million Africans are getting life-saving treatment.The take-no-action argument has been used over the years as an excuse not to mount an effort to control drug-resistant tuberculosis, malaria and many other diseases that afflict primarily the poor.But the reality is this: The Ebola crisis today is a reflection of long-standing and growing inequalities of access to basic health care. Guinea, Liberia and Sierra Leone do not have the staff, stuff and systems required to halt the outbreak on their own. According to its ministry of health, before the outbreak Liberia had just 50 doctors working in public health facilities serving a population of 4.3 million.To halt this epidemic, we need an emergency response that is equal to the challenge. We need international organizations and wealthy countries that possess the required resources and knowledge to step forward and partner with West African governments to mount a serious, coordinated response as laid out in the World Health Organization’s Ebola response roadmap.Many are dying needlessly. Historically, in the absence of effective care, common acute infections have been characterized by high mortality rates. What’s happening with Ebola in Africa has been no different.A 1967 outbreak in Germany and Yugoslavia of Marburg hemorrhagic fever — a disease similar to Ebola — had a 23 percent fatality rate. Compare that with an 86 percent rate for cases across sub-Saharan Africa in the years since. The difference is that Germany and Yugoslavia had functioning health systems and the resources to treat patients effectively. The West African countries coping with Ebola today have neither.With a strong public health response led by the United Nations, the World Health Organization, the United States, Britain, France and other wealthy nations, the virus could be contained and the fatality rate — which, based on the most conservative estimates, exceeds 50 percent in the present outbreak — would drop dramatically, perhaps to below 20 percent.We are at a dangerous moment in these three West African countries, all fragile states that have had strong economic growth in recent years after decades of wars and poor governance. It would be scandalous to let this crisis escalate further when we have the knowledge, tools and resources to stop it. Tens of thousands of lives, the future of the region and hard-won economic and health gains for millions hang in the balance.Originally published in the Washington Post Show Less -
Growing up in Iowa, I was often judged solely on appearance. In stores, strangers would make karate-chop gestures at me, inspired by the popular TV series “Kung Fu.” When I played quarterback for my h... Show More +igh school team, opponents were not above slamming me to the dirt and then piling on racial slurs.These incidents embarrassed me and made me self-conscious. But they are trifling indignities compared with the discrimination that many people around the world face based solely on their sex, age, race or sexual orientation.I raise this in light of the law Uganda enacted this week, which could imprison for life those convicted of homosexuality, and the increased violence against gays in Nigeria after an anti-gay law took effect there this year.These countries are in the news now, but our focus should be much broader: 81 other countries — in the Americas, Asia, Africa and the Middle East — have passed laws that make homosexuality illegal. In the United States, although Arizona’s governor vetoed a bill this week that would have allowed businesses to deny service to gay people, nine states have laws that limit how public school teachers can talk about homosexuality. More than 100 countries discriminate against women. And an even greater number of countries still have laws that discriminate against minority groups.Institutionalized discrimination is bad for people and for societies. Widespread discrimination is also bad for economies. There is clear evidence that when societies enact laws that prevent productive people from fully participating in the workforce, economies suffer.Discrimination against women is a case in point. A World Bank study last year of 143 economies found that 128 countries still have at least one legal difference in how men and women are treated, which constrains women’s economic opportunities. These barriers include laws that make it impossible for a woman to independently obtain an ID card, own or use property, access credit or get a job.In 15 economies, husbands can prevent their wives from working, although in the past two years Ivory Coast, Mali and Togo have reformed such restrictions. Show Less -