AIDS, TB top WHO’s priorities

Dr. Jong-Wook Lee, new head of the World Health Organization, spoke to Washington Times special correspondent John Zarocostas in Geneva recently. Dr. Lee, 58, a South Korean, earned his medical degree at Seoul National University and a master’s degree in public health from the University of Hawaii. Before taking over as director general two weeks ago, he worked 19 years for the WHO in technical, managerial and policy positions, and made his mark spearheading the fight against tuberculosis and vaccine-preventable diseases of children.

Question: Dr. Lee, you were put in charge of the World Health Organization at a critical time, soon after the outbreak of SARS [severe acute respiratory syndrome] pushed the agency to the forefront of international public-health policy. What are your priorities?

Answer: Well, I said on a number of occasions that HIV/AIDS, tuberculosis and malaria will be among top priorities, especially HIV/AIDS. We are committed to putting 3 million HIV-infected people on anti-retroviral medicines by the end of 2005. This is a very big commitment. It has to be followed up. Another very big practical priority is polio eradication, which has been going on now for 15 years. And our target year is 2005. Last year, 1,918 polio cases were reported in seven countries.

Now we have to concentrate our efforts in these countries and complete the job. The other priority is the Millennium Development poverty-reduction goals agreed to in New York in 2000, which is a commitment by the heads of state of the world, and there are six health-related goals. So we again have to be part of that.

Q: President Bush promised to spend $15 billion in the worldwide fight against AIDS in his State of the Union message, and Secretary of State Colin L. Powell says AIDS is one his biggest foreign policy priorities. Where does the WHO fit in?

A: We are not starting from scratch or in a vacuum. There’s the global fund, UNAIDS, and before that started there was a WHO global program on AIDS. So we have long experience in dealing with AIDS.

Right now, what is different from the past is that we have the real possibility of providing medicines at affordable prices to the people who are in need. Previously in America and Europe, typically the cost of medicine for treating one person per year was about $10,000, which has now been reduced to about $300 using generic drugs.

But $300 per person per year is still too high. So the issue we have to work on is to reduce this or purchase the drugs and offer them free of charge to the people in need. The treatment is one thing, but the counseling, the prevention, condom use — these are all part of it.

We spent a lot of time [considering] whether it should be prevention or treatment, but now the view is we have to do all these things at the same time. We have to tell people how to prevent AIDS infection, and also at the same time we have to provide the counseling, the testing and also put people on treatment. We cannot talk of counseling and prevention when we can’t do anything if the person is [HIV] positive.

So all should go hand in hand. No more [of] this philosophical discussion, but some practical action. And then to take action also we need some kind of practical action plan, country by country, province by province. And we should also check what the global fund is doing.

You mentioned the $15 billion Bush-Powell initiative. This is a very important part of the whole activity. As you know, we brought in Jack Chow, who … was the representative in the State Department on this issue. [Dr. Jack C. Chow, previously ambassador and special representative of the U.S. secretary of state for HIV/AIDS, is now assistant director general of the WHO for HIV/AIDS, tuberculosis and malaria.] So if anybody understands or knows this Bush initiative, I doubt whether anybody understands it better than Jack Chow. So we are in a good position.

Q: The SARS outbreak moved markets, and suddenly governments started to look at health issues as a national-security priority. It changed the way health is perceived in Cabinets around the world. What are the lessons learned, and what is foreseen down the road?

A: Number one, it’s a public-health disease outbreak, not just some mundane health problem. Because it can cause great havoc to national economies, it’s become a security issue, and affected the hotel airline industry, and clearly it clicked it could be a national-security-economy issue. That’s one thing.

The other lesson we learned is that we have to shorten the lead time from the outbreak to the case detention. So every country now has to invest in their public health system. And also for us in the WHO, it was a wake-up call.

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