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Clinton on AIDS: 'It bothers me to see people die'
Former President Clinton


AIDS (Disease)
Bill Clinton

NEW YORK (CNN) -- Former President Clinton says the world must make a "real commitment" in fighting the AIDS epidemic by getting medication to the most urgent areas and by promoting health care, awareness and prevention of the disease.

Clinton and his Clinton Global Initiative teamed up with "CNN Presents" to explore how to defeat this catastrophic disease. Here are Clinton's comments to CNN host, Dr. Sanjay Gupta:

GUPTA: As a former president, you could do just about anything you want to do, yet you chose AIDS. Why?

CLINTON: Because it's still a massive epidemic. Nobody has to die. ... It's 100 percent preventable, and yet we have five million new infections a year. Most children who get it in the developing world die because hardly any of them get any medicine. And the health systems that exist around the world are, so far, incapable of getting the proper messages on both prevention and treatment to people.

... And even though more and more money has been appropriated, we're still not having the impact we ought to have. ...

And it just bothers me to see people die. ...

GUPTA: What have you seen in terms of the single most important thing to actually beating this?

CLINTON: If there is a single most important thing, it is a combination of national commitment and confidence on the part of the countries that have high infection rates or that have the potential to have an exploding infection rate.

Lesotho, a small country in Africa, has the third highest infection rate in the world. And they now have a very aggressive program of offering the test to everybody 12 and over. ...

Where there's no health network in rural areas, then you have to have a real commitment to go out there, not only to get the medicine, but to get the awareness, the prevention and then the network that can provide care...

GUPTA: When you're meeting with someone like Hank McKinnell, the CEO of a large pharmaceutical company (Pfizer), ... what are you asking him for?

CLINTON: ... A lot of people are dying today ... because we don't have the health care infrastructure to distribute medicine. That's what Dr. (Paul) Farmer has done in Haiti and what he's now in the process of doing in partnership with us and the government of Rwanda. ... Mr. McKinnell ... has been very active in Uganda, trying to help build health care infrastructure.

Secondly, a lot of big pharmaceutical companies have licensed specific drugs to generic producers. Bristol-Myers Squibb has a licensing agreement with our South African partner. Merck just signed a licensing agreement with one of our Indian partners. And what we try to do is to use these producers to get very low-cost medicine out there.

Now, we can provide the first-line drugs at $136 a person a year. That's the lowest price in the world. And when I started, the generic price was $500, and now the average price of generics, because we led the market, is now under $200. ...

GUPTA: We talked about medications, we talk about prevention, but can you legislate behavior the way people think?

CLINTON: You can't legislate it, but you can change it. ... The Chinese government asked me to come in and ... work there. They actually asked me to go out into rural China and have dinner with people with HIV on national television, sit on the floor and play with kids to help overcome the stigma. ...

I went to a prevention and support program in Zanzibar, the island off the coast that's almost 100 percent Muslim. And after it, the women who were HIV positive walked down the street to Stone Town, the capital, with "I am HIV positive" T-shirts. ...

GUPTA: If you were president today, with all that you now know about AIDS, what would you do? What would you do differently?

CLINTON: First of all, ... I commend President Bush and the Congress for appropriating far more money than we could ever get back in my second term. We did triple overseas assistance to AIDS, but I commend them for that.

The first thing I'd do is fix this American problem that I just mentioned, so we can get working people with HIV to stay in the workforce and keep getting care.

Then, globally what I would do is to try to get our pharmaceutical companies to do more partnerships, like the ones I mentioned with Merck and Bristol-Myers, with the generic producers. ...

And then, I would design all my programs by letting each country's culture define what we do in the area of prevention. ...

Finally, 90 percent of the people who are HIV positive don't know they have the virus. That means we have to test more people

You wonder how come we're getting 5 million more people a year. You just assume that everybody that's HIV positive is irresponsible, that they won't behave in a responsible fashion. That is not true. Ninety percent of the people who have this infection do not know it. ...

I don't think we should go to mandatory testing. But we should go to opt-out testing. We should go to people and tell them what the facts are and promise to fight stigma and promise to help keep them alive. And then let them opt out if they want. I don't think many people would opt out under those circumstances. And we'd save a lot more lives. ...

GUPTA: We're talking about ending AIDS. How are we going to do that?

CLINTON: If we're going to end AIDS, I agree that we have to keep working on the vaccine, the microbicides, cure and other prevention strategies. There's a sweeping new study that has not yet been validated, but it's encouraging, saying that if a lot of these countries adopted male circumcision, they could reduce communication of the virus by more than 50 percent. ...

But meanwhile, to get there and be a humane society, we have to help people live as long and as well as we can. And most of the money has gone to give the medicine to young adults and not very young children. ... You have these kids dying like flies because they get no medicine.

Last year in the whole developing world, young children that needed pediatric AIDS medicine, there were 25,000 kids getting it. And a half million died.... If everybody decided that no little kid was going to die, we could close that gap in no time, and we could provide half a million children the medicine.

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