This World Aids Day marks the beginning of a fourth decade living with a global killer. I understand that many of you have just picked up your morning paper and may not want to think about disease, death, and devastation. I understand that you may think Aids is too complicated and too persistent for us to solve. I understand that you likely have a dozen other issues clamouring for your attention – global warming, poverty, world peace, just to name a few – and the day has only just begun.
But I would make the case that Aids is still worthy of our attention, resources, and effort – now, more than ever before. Not because of my personal connection to a disease that has taken so many friends and colleagues over the years. It's not the troubling fact that Aids continues to attack young adults as they make their way into the world and start their own families. Nor is it the way Aids devastates household incomes and national economies, propelling the perpetual cycle of poverty.
In fact, I am compelled not by despair but by hope. I'm heartened by the recent statistics from UNAIDS that tell a promising story – 5 million people on treatment and a 25 per cent drop in new infections across the worst-affected countries since 2001. I'm motivated by the progress that Aids has quite unintentionally moved forward, rather than the destruction it has left in its wake.
Because despite the chaos Aids has wrought, it has also resulted in remarkable human compassion and ingenuity. When it struck the gay community with such ferocity, Aids galvanised gay men not only to demand medical treatment as patients, but also equal treatment as human beings. When religious leaders and moral crusaders declared it to be "God's judgment", brave and unlikely champions such as Princess Diana and Ryan White emerged to challenge the prejudices and taboos that lived in the hearts of millions. And when epidemics claimed the lives of millions of nurses, teachers, miners, and soldiers, an army of ordinary people proved to be much stronger, building networks, raising funds, and opening their hearts to the sick and their homes to the orphaned.
In 2001, the Global Fund – the most ambitious response to a global catastrophe since the Marshall Plan – was established to fight Aids, TB, and malaria. And in 2003, George W Bush launched the President's Emergency Plan for Aids Relief – PEPFAR – the largest international health initiative ever directed at a single disease. What has this incredible and unprecedented convergence of love, compassion, money, political will, and science given us?
For one thing, it it has shattered the belief that poor countries are unable to manage complicated medical treatment. When PEPFAR was announced, only 500,000 Africans had access to HIV treatment, now 5.2 million people are on life-saving medicines. In Botswana, where 39 per cent of the population was infected with HIV in 2002 and life expectancy was under 40 years, President Mogae has claimed the Aids treatment that now reaches 80 per cent of patients saved his country from the brink of extinction.
For another, the innovation and ingenuity that has enabled millions to live longer lives has benefited so many more. The Global Fund has increased resources for more than just Aids: 35 per cent of its funding strengthens health systems that reach all patients, not just those with HIV. Since the Global Fund there is a real goal to eradicate malaria and usher in the first new TB drugs since the 1970s. The Aids epidemic has created an architecture to improve global health. It has given new impetus to improving primary education for a generation of Aids orphans. It has sharpened focus on gender equality and reinvigorated efforts to end maternal mortality. It has challenged stigmas and double standards that persisted long before the disease appeared.
I am proud that the Elton John Aids Foundation has contributed to this progress for nearly 20 years. Through the Foundation I have witnessed the ingenuity, the compassion, and the human love that has made a difference, not just in the fight against Aids, but in all aspects of the complex, globalised world in which we live.
Before I sound too much like a musician with his head in the clouds, let me be clear. I agree with President Clinton, who writes today, about how much work remains to be done. I understand the challenges of getting 10 million patients the treatment they still need and filling a funding shortfall of $10 billion in the midst of a widespread economic crisis. I recognise the need for business expertise and leadership, good government policies, and engaging affected communities. I know the barriers that exist to building up the capacity of health care systems, training enough health care workers, and eradicating dangerous stigmas that keep many people from knowing their status and obtaining the medicines that could save their lives.
Yet, on this World Aids Day, I hope to share how a disease that once made us feel helpless can make us feel hopeful – and even proud. I hope these stories restore your faith in compassion. But most of all, I hope to leave you with a renewed sense that not only is this battle worth fighting, it is one we can win. And in many ways, it's the very thing that could save us all.