World AIDS Day

A Decade of Progress on AIDS

By BONO

I’LL tell you the worst part about it, for me.

It was the look in their eyes when the nurses gave them the diagnosis — H.I.V.-positive — then said there was no treatment. I saw no anger in their expression. No protest. If anything, just a sort of acquiescence.

The anger came from the nurses, who knew there really was a treatment — just not for poor people in poor countries. They saw the absurdity in the fact that an accident of geography would deny their patients the two little pills a day that could save their lives.

This was less than a decade ago. And all of us who witnessed these dedicated African workers issuing death sentence after death sentence still feel fury and shame. AIDS set off an almost existential crisis in the West. It forced us to ask ourselves the big, uncomfortable questions, like whether capitalism, which invented the global village and kept it well stocked with stuff, could also create global solutions. Whether we were interested in charity... or justice.

The wanton loss of so many lives in Africa offended the very idea of America: the idea that everyone is created equal and that your destiny is your own to make. By the late 1990s, AIDS campaigners in the United States and around the world teamed up with scientists and doctors to insist that someone — anyone — put the fire out. The odds against this were as extreme as the numbers: in 2002, two million people were dying of AIDS and more than three million were newly infected with H.I.V. Around 50,000 people in the sub-Saharan region had access to treatment.

Yet today, here we are, talking seriously about the “end” of this global epidemic. There are now 6.6 million people on life-saving AIDS medicine. But still too many are being infected. New research proves that early antiretroviral treatment, especially for pregnant women, in combination with male circumcision, will slash the rate of new H.I.V. cases by up to 60 percent. This is the tipping point we have been campaigning for. We’re nearly there.

How did we get here? America led. I mean really led.

The United States performed the greatest act of heroism since it jumped into World War II. When the history books are written, they will show that millions of people owe their lives to the Yankee tax dollar, to just a fraction of an aid budget that is itself less than 1 percent of the federal budget.

For me, a fan and a pest of America, it’s a tale of strange bedfellows: the gay community, evangelicals and scruffy student activists in a weird sort of harmony; military men calling AIDS in Africa a national security issue; the likes of Nancy Pelosi, Barbara Lee and John Kerry in lock step with Bill Frist and Rick Santorum; Jesse Helms, teary-eyed, arriving by walker to pledge support from the right; the big man, Patrick Leahy, offering to punch out a cranky Congressional appropriator; Jeffrey Sachs, George Soros and Bill Gates, backing the Global Fund to Fight AIDS, Tuberculosis and Malaria; Rupert Murdoch (yes, him) offering the covers of the News Corporation.

Also: a conservative president, George W. Bush, leading the largest ever response to the pandemic; the same Mr. Bush banging his desk when I complained that the drugs weren’t getting there fast enough, me apologizing to Mr. Bush when they did; Bill Clinton, arm-twisting drug companies to drop their prices; Hillary Rodham Clinton, making it policy to eradicate the transmission of H.I.V. from mother to child; President Obama, who is expected to make a game changing announcement this World AIDS Day to finish what his predecessors started — the beginning of the end of AIDS.

And then there were the everyday, every-stripe Americans. Like a tattooed trucker I met off I-80 in Iowa who, when he heard how many African truck drivers were infected with H.I.V., told me he’d go and drive the pills there himself.

Thanks to them, America led. Really led.

This was smart power. Genius, really. In 2007, 8 out of the 10 countries in the world that viewed the United States most fondly were African. And it can’t be a bad thing for America to have friends on a continent that is close to half Muslim and that, by 2025, will surpass China in population.

Activists are a funny lot. When the world suddenly starts marching in step with us, we just point out with (self-)righteous indignation all that remains to be done. But on this World AIDS Day I would like you to stop and consider what America has achieved in this war to defend lives lived far away and sacred principles held closer to home.

The moonshot, I know, is a tired metaphor; I’ve exhausted it myself. But America’s boldest leap of faith is worth recalling. And the thing is, as I see it, the Eagle hasn’t landed yet. Budget cuts ... partisan divisions ... these put the outcome in jeopardy just as the science falls into place. To get this far and not plant your flag would be one of the greatest accidental evils of this recession.

Bono is the lead singer of the band U2 and a founder of the advocacy group ONE and the (Product)RED campaign.