I’m a big believer in setting highly ambitious targets in order to galvanize communities and countries to take action on serious issues. When I was at the World Health Organization in 2003, we set a target called “3 x 5” – committing to treat 3 million people with HIV/AIDS in the developing world by 2005.
At the time, just a few hundred thousand people in the developing world had access to the life-saving treatment. When we announced the target, the global health community was still arguing about whether HIV treatment in poor countries was possible. Some called it an impossible dream that would give people false hope.
I responded that no one ever said treating 3 million people would be easy. But we needed a measurable and time-limited target to change fundamentally the way we thought about the challenges of HIV in developing countries. The target helped change the way we worked – we had fewer arguments about if we should do it, and focused on how to get it done.
Jim Yong Kim knows something about prejudice. When he was growing up Asian American in Iowa, kids would make “kung fu” gestures and hurl racial slurs at him. In an op-ed published in the Washington Post, the World Bank Group president writes that his experiences are “trifling indignities” compared to what gay and lesbian citizens of Uganda and Nigeria are now experiencing, in the wake of new laws making homosexuality a crime punishable by up to life in prison.
Institutionalized discrimination goes far beyond those countries, he notes; 81 other countries also criminalize homosexuality. It also goes beyond sexual orientation to encompass laws that discriminate against women and members of minority groups. And aside from being wrong, Kim writes, “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.”
He points out the irony that AIDS activists, many of them gay, fought to ensure access to life-saving drugs for people with AIDS, most of them African. Kim concludes, “Eliminating discrimination is not only the right thing to do; it’s also critical to ensure that we have sustained, balanced, and inclusive economic growth in all societies.”
Read the full op-ed here.
Building social movements. I often hear about the need to create social movements to tackle a number of entrenched global challenges such as ending extreme poverty, promoting greater income equality, and combatting climate change.
History is full of social movements that have succeeded and failed. The lessons from one ongoing movement that I know well – the fight against AIDS – should be examined closely by those looking to build movements today.
Lesson No. 1 from the AIDS movement is to believe only in the possibility -- not the inevitability -- of success. Opponents will fight and appear immovable. As those of us who lived through the early days of the AIDS fight, it was always far from certain that we would reach our goals.
Although I have committed much of my career to the global fight against HIV and AIDS, this year's World AIDS Day is a special one for me in two ways. First, there's the remarkable news from UNAIDS that more than 8 million people globally are now on treatment, and 25 countries have achieved more than a 50 percent decline in HIV prevalence. With this progress, I am more optimistic than ever about our ability to end AIDS.
As the US government’s new blueprint for an AIDS-free generation demonstrates, today we have the science, the knowledge, the experience, and the tools to fight the epidemic. I was particularly happy to see that the blueprint included multi-year, sustainability strategies and that it stressed the need to support country leadership. With that leadership, and with a long-term plan owned by countries, these efforts can succeed.
The Bank said today it is mobilizing over $7 billion for health and education to help poor countries battle threats to their social services during the crisis. The new health and education numbers follow an announcement earlier this week that its investments in social protection programs, including social safety nets, are expected to rise dramatically for 2009-2010 to $12 billion.
As part of this announcement, the Bank released a report titled, Averting a Human Crisis During the Global Downturn, which examines how previous financial downturns affected countries’ social protection programs.
Crisis Can Affect Social Services Programs
Evidence from previous crises in Argentina, Indonesia, Thailand, and Russia shows that governments were forced to cut health services as a result of shrinking budgets and that returning health spending to pre-crisis levels took up to 10-15 years to achieve, according to the report.
"We cannot afford a 'lost' generation of people as a result of this crisis," said Joy Phumaphi, the World Bank's Vice President for Human Development and former Health Minister for Botswana. "It is essential that developing countries and aid donors act now to protect and expand their spending on health, education and other basic social services and target these efforts to make sure they reach the poorest and most vulnerable groups."
AIDS Treatment Programs in Jeopardy
The report also warns that according to preliminary findings from 69 countries, which offer treatment to 3.4 million people on antiretroviral treatment (ART), suggests that 8 countries now face shortages of antiretroviral drugs or other disruptions to AIDS treatment. Twenty-two countries, home to more than 60 percent of people worldwide on AIDS treatment , expect to face disruptions over the course of the year.
"We cannot afford a 'lost' generation of people as a result of this crisis," Phumaphi said. "It is essential that developing countries and aid donors act now to protect and expand their spending on health, education and other basic social services and target these efforts to make sure they reach the poorest and most vulnerable groups."