The UN Security Council yesterday discussed a health issue for the first time in its history, with the United States leading an initiative to focus on the AIDS [crisis, saying that] governments must consider the epidemic a threat to peace and security on the continent. (Chris McGreal, London Guardian, 11 Jan).

"We must understand that the old concept of global security-with focus almost solely on armies, ideologies and geopolitics-has to be enlarged, "[Vice President Albert] Gore said (Bob Davis, Wall Street Journal, 11 Jan). "When 10 people in sub-Saharan Africa are infected every minute, when I I million children have already become orphans ... when a single disease threatens everything from economic strength to peacekeeping--we clearly face a security threat of the greatest magnitude," he said (Betsy Pisik, Washing- ton Times, 11 Jan). The "heartbreaking" implications of the epidemic, he said, threaten every person in the world (Zuckrnan/Lauria, Boston Globe, 11 Jan), and by discussing the issue, the Security Council set a precedent for governments "to see security through a new and wider prism (Linda Fasulo, MSNBC.com, 10 Jan).

Speaking on behalf of the United States, Gore announced that the Clinton administration will seek an additional $100 million in aid for anti-AIDS efforts in Africa. The additional funding, he explained, would. go toward:

· Reducing the stigma associated with the disease;

· Strengthening "health infrastructures" to treat and prevent the spread of HIV/AIDS;

· Reducing mother-to-child transmission of the virus;

· Supporting home- and communitybased care for AIDS patients; and

· Providing care for children orphaned by the disease (CNN Interactive, 10 Jan).

. . . Gore said the administration will also seek another $50 million for vaccine development and distribution and will develop a new partnership with African businesses to promote AIDS awareness in the workplace (CNN Interactive). The proposals' prospects in the US Congress are uncertain, however. The current Republican Congress has been "highly suspicious" of foreign aid in general, and aid to Africa has "Plummeted" since the end of the Cold War (Fasulo, MSNBC.com, 10 Jan).

Currently, the United States is the largest single contributor to the worldwide fight against AIDS. If passed, the administration's proposal would bring total US international AIDS funding to $325 million. In his remarks, Gore also urged other wealthy nations to join the United States in the fight against the disease, saying it is time to "knit together" disparate international efforts (Michael Littlejohns, Financial Times, I I Jan).

UN Secretary-General Kofi Annan also addressed the council saying " . . . Last year, AIDS killed about 10 times more people in Africa than armed conflict. " (UN Newservice, 10 Jan). The disease has threatened political stability by creating millions of orphans and killing teachers, health workers and public servants, Annan said. "In already unstable societies, this cocktail of disasters is a sure recipe for more conflict," he said. "And conflict in turn provides fertile ground for further infections" (Nicole Winfield, Associated Press/Nando.net, 10 Jan).

Peter Piot, the executive director of UNAIDS told the council that his program would need $1 billion to $3 billion per year in order to fight the disease in sub-Saharan Africa alone (Barbara Crossette, New York Times, I I Jan). World Bank President James Wolfensohn also appeared before the council and noted that prevention is much cheaper than treatment. "We estimate the cost of prevention is between $1.50 and $3.50 per capita per year, compared to over $7 per capita per year needed for basic treatment, Wolfensohn said (Robert Holloway, Johannesburg Mail & Guardian, I I Jan). Walfensohn called for a"War on AIDS," saying the epidemic threatens economic development and anti-poverty efforts in Africa. "I have told all my offices in Africa that we will provide governments with the maximum available funding to create and implement programs he said, "We can make a very big difference, but we cannot do the job alone" (World Bank release, 10 Jan).

Mark Malloch Brown, administrator of the UN Development Program (UNDP), said anti- AIDS efforts must focus on altering social norms and traditions. "Change must begin by confronting the regions troubled inheritance," including extensive migrant labor and social norms that "make it hard for women and girls to deny men sex." HIV rates among girls, he said, are three to four times higher than those among boys (Crossette, New York Times). Maoch Brown said the epidemic has the potential to reduce the region's gross domestic product by one-third (UNDP release, 10 Jan).

MIXED REACTIONS To US, UN PROMISES

... Timothy Stamps, Zimbabwe's health minister, said pressure should be applied to pharmaceutical companies to make AIDS drugs more affordable. Dumisani Kumalo, South Africa's UN ambassador, said the pandemic can only be stopped by alleviating poverty and improving education. Many diplomats expressed the hope that the Security Council's attention to the issue will set off a new global campaign to combat the disease BBC Online, I I Jan.).

Some Security Council members opposed the discussion of the AIDS epidemic. Russia refused to speak at the meeting, saying UN bodies such as the World Health Organization and the UN Economic and Social Council (ECOSOC) were more appropriate forums for the debate. China also voiced reservations about the discussion (CNN Interactive).

In the United States, many observers saw Gore's involvement as a political ploy designed to improve his standing with interest groups important to his presidential campaign. But US Ambassador to the UN Richard Holbrooke, who has been mentioned as a potential secretary of state in a Gore administration, dismissed the accusations. "None of what he is doing here today has any impact" on the presidential campaign, he said. And ACT UP, a US-based AIDS activist group, said the funds that would be provided by Gore's proposal were inadequate anyway. "We can spend $1 billion on war in a day, but we won't spend $1 billion a year to keep people alive," complained Eric Sawyer of ACT UPs New York chapter (Gerstenzang/Farley, Los Angeles Times, 11 Jan). Gore became entangled with AIDS activists last when he was accused of helping pharmaceutical companies back global trade rules that restrict the supply of low-cost AIDS drugs to South Africa (Pisik, Washington Times).

An editorial in the New York Times welcomed the administrations initiative, but said more funding is needed. "AIDS is not just a humanitarian problem," the Times argues. "The sheer scale of Africa's AIDS epidemic defies comprehension." While the $325 million sought by the Clinton administration is of surely welcome, it is "woefully inadequate when measured against the scale of the problem." The United States, in contrast, spends $7 billion a year on domestic AIDS prevention, treatment and research.

Nevertheless, the Times states, "by giving this crisis the prominent platform it deserves, the United States is finally providing the leadership needed to overcome what the vice president properly decried as the ignorance and indifference that lead to infection " (11 Jan).

According to the Johannesburg Mail & Guardian, the HIV/AIDS epidemic will cause average life expectancy in Africa to fall to 40 by 2008, increase health care costs by up to 60%, and result in the resurgence of other diseases such as tuberculosis, malaria and cholera (Aaron Nicodemus, 11 Jan).

AFRICA HOPES FOR VACCINE; RESEARCH FOCUSES ON WEST

Several southern and central African countries are "eagerly collaborating" with foreign AIDS researchers and contributing modest amounts of their own funding to create and test vaccines, a strategy which "appeals to government officials who are bitter about the high cost of foreign drugs and the global imbalances in AIDS-related research," the Boston Globe reports ...

"The only practical, affordable means to control our AIDS epidemic over the long term is by mass vaccination," said Walter Prozesky, head of the South African AIDS Vaccine Initiative.

South Africa's goal is to have a locally produced vaccine available by 2005. Yet searching for a vaccine raises "false expectations that a cure will be available soon and [provides] African governments with an excuse for not implementing proven measures to reduce HIV infections or break down the stigmas and taboos surrounding AIDS and sexual behavior," the Globe notes.

"A vaccine initiative is about more than the vaccine," said Janet Frohlich, community liaison officer. "Part of the process involves educating people about expectations. They have to understand that they may be looking at a 10-year program" (Kurt Shillinger, Boston Globe, 7 Jan).