- The Washington Times - Friday, April 12, 2002

The call of Sen. Jesse Helms, North Carolina Republican, for $500 million to be spent protecting young children and their mothers is right on the mark: a downpayment on a world that respects the dignity of every life, regardless of income or the accidents of geography.

All children and mothers at risk of death in poor countries including those in the path of the AIDS virus should benefit from this important investment.

For a few dollars each, drugs (Nevirapine and others) could greatly reduce the spread of the AIDS virus from mother to child. But these lives cannot be saved in a vacuum. The world is polarizing: while the rest of us look forward to brighter and healthier futures, one-fifth of the children born around the globe last year (mostly in Africa) actually had a shorter life expectancy than their sisters and brothers born 10 years earlier. AIDS did not create the vast inequities in health, but it has certainly thrived in the world's dark corners of poverty and disease. And it has highlighted and worsened disparities and despair.

Yet, even without AIDS, 10 million young children will die needlessly in poor countries this year (more than 10 times the number infected with HIV), almost all from diseases easily prevented or readily treated. Pennies worth of antibiotics could save 3 million children who will die of pneumonia.

Proven vaccines against measles, tetanus and whooping cough could save another 2 million. A cheap and simple cocktail of salts that even the youngest can take by mouth could save another 2 million who will die of diarrhea. Basic medications and treated bed-nets to keep mosquitoes away from sleeping children could save 1 million from malaria. And decent basic care at the time of delivery could save the lives of half a million mothers and several million newborns.

None of these actions require dramatic new discoveries or enormous new investments. Most don't even require doctors. Yet, for years, U.S. support for international assistance directed at protecting the lives of young children and their mothers has languished, even as our response to AIDS has quickened. With his bold call, Mr. Helms has now changed the terms of the debate, rightfully framing the issue as one of basic morality rather than simply self-interest.

AIDS does not do its work in isolation. It acts not only as a killer itself, but also as an amplifier of these age-old killers of children, and it has shone a spotlight on an array of health conditions that should simply not exist in our modern world. Children with AIDS die at even faster rates from pneumonia, diarrhea, measles and malaria. Mothers with AIDS are even less likely to be able to give their children the care and nurturing they need. As practitioners and public health professionals who have worked on these issues around the world for decades, we recognize that the only way to fight a disease as pervasive and insidious as AIDS is to encircle it, hitting it from multiple directions. Our focus must remain on the human beings at risk, not the disease.

So we call for Mr. Helms' worthy proposal to incorporate the realities of not just the AIDS virus but of the health conditions that enable it to spread so viciously. To vigorously fight mother-to-child transmission of HIV, we call on Congress and the administration to make the health care of children and mothers in the world's poorest countries a U.S. priority. To find HIV-infected mothers and treat them in a timely fashion will require that all mothers-to-be have access to good pregnancy and delivery care; this will in turn save far more lives than just those infected. To care for the newborns and young children who are at risk of infection will require basic health services available to all children in the communities where these children live, not just in hospitals used by a small percentage of the poor.

And we must assure that we not only prevent infection of newborns but also help the survival of their already-infected mothers.

To define our desired outcome as healthy children and intact families, not just children free from the AIDS virus, will require a focus on the delivery of a package of essential preventive services and care that will multiply the impact of this proposal many times over. With one bold stroke, this proposed $500 million would double the funding the U.S. provides each year to programs directed toward bettering the health of the world's children and mothers.

A flowering of human potential: we commend Mr. Helms for his vision and compassion.

Louis Sullivan, M.D., former U.S. secretary of health and human services, is president of Atlanta's Morehouse School of Medicine and co-chairman of the President's Advisory Council on HIV and AIDS. Nils Daulaire, M.D., is president and chief executive officer of the Global Health Council.

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