Global AIDS Epidemic: Getting Things Done.

We cannot wait for governments to find the political will to deal with AIDS just through their own bureaucratic processes. The initiative must come from people in all areas of life -- including government, industry, the professions, and the general public. The world has more than enough resources to deal with HIV/AIDS (and also tuberculosis, malaria, and other infectious diseases); and there are millions of people who care and can help. The big shortage is of attractive, workable opportunities for channeling this concern into effective action.

For example, we heard from one U.S. HIV physician that he wanted to donate his vacations for several years to go to Africa or wherever he was needed, to train doctors in diagnosing and treating HIV disease. But he could find no program that had set up arrangements for doing so. (Some U.S. HIV doctors and researchers already work in Africa, but usually full time; we also need opportunities for doctors who want to maintain their current practice but could donate vacations, or work during other special occasions.)

For a different example, consider the great change in the worldwide discussion of treatment access and prices of medicines. Three years ago, almost everyone took antiretroviral prices of about $10,000 per patient per year, even in the poorest countries, for granted -- along with the death without treatment of almost everyone with HIV in Africa and other poor regions. The change could not have happened without the work of a fairly small number of activists around the world -- in ACT UP in the U.S. and France, Treatment Action Committee in South Africa, the Health GAP Coalition in the U.S., and other organizations. How did workable opportunities for involvement in this activism come into being? We do not know.

As key issues now move toward infrastructure, there will be more need than ever for both volunteer and professional involvement. Not everyone need work abroad. For example, if HIV doctors cannot find suitable programs through which to volunteer vacation time, then activists could find out why. Perhaps some organization already has such a program but is not well known. Or maybe someone needs to bring together funders with organizations like Doctors Without Borders, which already do this kind of work. Perhaps some medical organization already sends physicians abroad but has never worked in HIV before, and might be willing to start now. Volunteers need to research such possibilities and start bringing people together.

And of course almost all countries need lots of work in generating public pressure so that governments will have the political will for serious commitment in AIDS and other infectious diseases, and will develop the large-scale programs that require governments involvement.

We greatly need the work of determined activists, volunteer or professional, with "people" skills or organizing skills, as well as those with medical or other technical training and experience. But this need does not automatically translate into workable roles that people can choose for themselves. Clearly we already have the need, the resources, and the people willing to help with AIDS and other infectious diseases. The big challenge is how to develop the human structures so that the resources get used and the work gets done.

[Note: This writer has a personal Web site, http://www.communicationpractices.org, to explore the development of self-education practices for improving human relationships. We believe this work can contribute to the conscious development of social roles, helping to improve institutions as well.]