World AIDS Day is December 1: an opportunity to come together in a spirit of remembrance for those who have been lost to this disease, compassion for those who are suffering today, and commitment to help others remain free from infection. Despite the continuing tragedy of HIV/AIDS, there is a growing basis for hope. The successes the United States has achieved, working in partnership with some of the most severely affected nations, demonstrate the difference that action can make – and challenge the world community to greater action.

The theme of this year’s World AIDS Day is “Keep the Promise,” and the United States is doing just this. In 2003, President George W. Bush led the world into action when he announced the President’s Emergency Plan for AIDS Relief – a five-year, $15 billion, multifaceted approach to combating the disease in 123 countries around the world. This is the largest international health initiative directed at a single disease that any nation has ever undertaken. With the strong support of Congress and the American people, the United States now leads the world’s donor nations in its level of financial commitment to the fight.

The Emergency Plan supports diverse prevention, care and treatment strategies, with an intense focus on making the money work. The heart of this strategy is partnership with host nations to build a locally-driven response to the pandemic. HIV/AIDS will be a fact of life for many years to come in these nations, and the fight against HIV/AIDS will only succeed today, and be sustainable tomorrow, if the local population owns it.

Here’s how President Bush recently put it: “This effort is succeeding because America is providing resources and Africans are providing leadership. Local health officials set the strategy and we're supporting them.” The Emergency Plan is working in support of host nations’ HIV/AIDS strategies, helping them to build comprehensive and effective national responses that can be sustained for the long term.

HIV/AIDS is an incredibly complex disease, and the Emergency Plan supports a correspondingly varied range of locally-designed interventions. To help people protect themselves, U.S. partnerships support the “ABC” strategies developed in Africa (abstain, be faithful, and correct and consistent use of condoms). Other key prevention efforts focus on increasing HIV counseling and testing, preventing mother-to-child transmission of HIV, ensuring safe blood and safe medical injections, helping injecting drug users, and meeting the special challenges of women and girls.

Another prevention focus is meeting the many challenges of women and girls in the nations hardest-hit by HIV/AIDS. In Kenya, the U.S. supports outreach with Maasai communities that has led to changes in traditional practices, eliminating high-risk sexual behavior while preserving cultural heritage. For example, new cohorts of warriors are renouncing the practice of being honored by young women with sexual favors.

Treatment is another key element. When the initiative was announced, there were only 50,000 people receiving lifesaving antiretroviral treatment in sub-Saharan Africa. The United States initiative has supported locally-owned, multisectoral programs in Africa that have vastly increased this figure -- and the number continues to grow rapidly.

The United States is supporting care for people living with HIV/AIDS and for orphans and vulnerable children on a massive scale. Care programs range from helping people living with HIV/AIDS in a village in Thailand learn income-generating skills to helping child heads of households in Rwanda care for their younger siblings

Accountability, which has not always been a focus of international development initiatives, is central to the Emergency Plan. The United States is working to help host nations improve their ability to monitor programs and evaluate what works. All donors must ensure that only programs that show results continue to be funded, and that the lessons we learn are applied to make our programs more successful.

As success grows, how can other nations that do not have large-scale bilateral programs like the United States increase their commitment to fighting global HIV/AIDS? The Global Fund to Fight AIDS, Tuberculosis, and Malaria is a key multilateral initiative. While the U.S. remains by far the Fund’s largest donor for now, the Fund provides a vehicle for other governments to intensify their efforts.

In partnership with many nations, the locally-owned successes the U.S. has supported to make the money work on the ground today and build sustainable responses provide a strong foundation for the future. In this spirit of partnership, may the world community rededicate itself to creating hope for a future free of HIV/AIDS.

To learn more about the World AIDS Campaign and how people around the world are renewing their commitment to the fight on World AIDS Day, visit http://www.worldaidscampaign.org/.

More information also is available on the World Aids Day 2005 Web site of the Joint United Nations Programme on HIV’AIDS to highlight December 1 (World Aids Day 2005) activities.

More information on the AIDS Alliance for Children, Youth & Families is available on the group’s Web site.

For the latest developments, see HIV/AIDS.

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