Each week, nearly 25,000 adults and 3,600 children die from AIDS globally.  This includes nearly 18,000 adults and 3,400 children in sub-Saharan Africa alone.  While co-infection with tuberculosis is often the proximate cause of death, the unfortunate cause in far too many cases is stigma.  Stigma kills.  It’s that simple.  While we have made great strides in overcoming stigma through access to HIV prevention, care, and treatment services, work remains to be done.  Fear of disclosure still keeps people from seeking help; it delays access to life-saving treatments and it contributes to poor adherence.  We are seeing the effects of stigma today in West Africa -- and here at home -- with the Ebola epidemic.  We have been seeing it for decades with HIV/AIDS.  On World AIDS Day 2014, nearly 35 years into the global AIDS epidemic and more than 10 years after launching the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), it is important to reflect on how far we have come in our partnership with the governments and people of Africa and on how much still needs to be done.

 

Today, the Bureau of African Affairs and our embassies across Africa are working with the U.S. Global AIDS Coordinator, Ambassador Deborah L. Birx, M.D., to do, as she puts it, “The Right Things, in the Right Places, at the Right Time.” By that she means, working with our partners to target resources most effectively.  Through PEPFAR, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and a strong commitment from countries themselves, tremendous progress has been made over the past decade.  Together we have saved millions of lives.  But with millions of people undiagnosed and untreated and rates of new infections stubbornly high in too many countries, we have to examine the barriers that still exist to treatment and prevention.  One of those, even after all these years, is stigma, the reluctance to acknowledge the disease; the shunning and shaming of those who are infected; the failures of some leaders to speak out openly about the disease; and the countless barriers to personal or public disclosure.

 

That’s why I am proud that today, as part of World AIDS Day, many of our posts are tackling the deadly issue of stigma head-on, through innovative approaches and frank dialogue.  The Kingdom of Swaziland, for example, has the highest HIV prevalence rate in the world.  More than one out of every four adults is infected.  With support from PEPFAR and its lead prevention partner, Population Services International, the Ministry of Health in Swaziland is leading a ground-breaking testimonial campaign featuring ordinary HIV positive citizens who have openly declared their status.  The images and stories challenge stereotypes and dispel myths in Swaziland about what it means to live with HIV.  To underscore the message that anybody can be at risk for HIV/AIDS, the U.S. Embassy in Mbabane is hosting screenings at local schools of “The Announcement,” a documentary which tells the story of professional basketball player Magic Johnson and specifically addresses the issue of stigma related to HIV/AIDS.

 

In neighboring Mozambique, they are tackling stigma through the Embassy’s “Ser O Positivo” (Be the Positive One) campaign and through the efforts of their “AIDS Ambassadors,” individuals who have chosen to make their status public and are helping to break down the wall of silence -- starting with the Embassy community itself.  In Namibia and the Democratic Republic of Congo, the Embassies are collaborating with local journalists on documentaries about HIV/AIDS.   Both programs will feature interviews with people living with HIV/AIDS and talk about how stigma and social exclusion has impacted their lives, as they have learned their status, dealt with a diagnosis, and shared that diagnosis with family and friends.  These are just a few examples. At U.S. Embassies across Africa, we will commemorate World AIDS Day using two of the most powerful tools in the fight -- information and dialogue.

 

Today, as the world confronts the Ebola epidemic in West Africa, we draw lessons and hope from our battle against another one.  In Africa, 7.6 million people are alive today because they are on treatment for HIV/AIDS, thanks to PEPFAR.    Just a decade ago, nearly all would have faced a certain death sentence.  Both epidemics have demonstrated the importance of robust public health systems, the imperative of a strong international response, and the indispensability of local leadership.  They also demonstrate the perils of stigma.  That is a lesson for us here at home, just as much as in any country in Africa.  Nothing spreads faster than fear and intolerance -- they can be as deadly as any virus.  Our weapons against them are courage, compassion, information, and opportunities for treatment.  So, on World AIDS Day 2014, take a moment to remember the millions lost, celebrate the millions saved, and salute the courage of all those fighting HIV/AIDS and other diseases. 

 

To learn more about the U.S. government contribution to the HIV/AIDS response, please visit www.pepfar.gov.