Wednesday, September 26, 2007
Global initiatives
Last year, when doing some investigations on the incidence of HIV/AIDS around the world, I heard a fact that stuck with me. I was moderating a discussion with former President Bill Clinton and Pfizer CEO Hank McKinnell. I had asked the CEO why Pfizer and other pharmaceutical companies didn't offer life-prolonging AIDS medications to certain countries at a lower cost. He told me even if the cure for AIDS came free in the form of a glass of clean water, we still wouldn't rid the world of AIDS. I thought about that for a while and it made sense. The point was that the pharmaceutical companies certainly needed to do their part, but that people on the ground also needed to systematically guarantee access and the funding needed to be available to make it all happen. Lots of moving parts.

As I have covered the Clinton Global Initiative for the past three years, I have come to better understand the value of putting people in the same room who control these various parts. There are plenty of famous faces including Desmond Tutu, Al Gore, Angelina Jolie, Lance Armstrong and Ted Turner to name a few. But there are also people like Paul Farmer. A physician from Boston, Paul lived with his family in a modified school bus for a chunk of his childhood. Now, he is a Harvard M.D. who has made it his life's work to provide access to health care in some of the most remote and dangerous places on earth. Haiti, Rwanda, and many other places.

Paul is the kind of guy that will sit in the room with the CEO of large pharmaceutical companies, Clinton and lots of concerned citizens. He will lay out exactly what he has seen around the world and what will be needed to provide the crucial access that has proven a stumbling block for so long. If history is a good measure, CGI will raise billions of dollars again this year as it has in years past, but with the help of the more than 1,000 leaders from around the world, including Paul Farmer, it will make strides toward getting that "free clean glass of water" to those who need it most.

The Clinton Global Initiative, along with other forums such as Davos, Switzerland, are typically a yearly gathering of people who define global problems and potential solutions. Do you think these sort of non-governmental organizations make a difference? Would you get involved?
"He told me even if the cure for AIDS came free in the form of a glass of clean water, we still wouldn't rid the world of AIDS."

Oh the irony of this statement is striking and chilling. Unfortunately it’s sad, but true. The "powers that be" have their own agendas and ideas of what should take place, where, and for how much. The people actually vulnerable to infection have little control. There have been studies showing that simply cleaning yourself properly after a certain amount of time following sex can decrease your risk of HIV infection substantially. It's also been shown that many people in HIV-epidemic countries are washing in ways that actually increases their risk of HIV three- to four-fold. Creating programs to teach people in 3rd world countries improved post-coital hygiene has been estimated to be able to decrease HIV risk by as much as 60%. But what do the powers that be (i.e., Western researchers) decide to push for in HIV-ravaged countries?

Increasing rates of circumcision.

Yes, that's right. I haven't seen a single article on the hygiene studies in any major news outlet. Westerners would rather focus their efforts on recommending that millions of dollars be spent getting 100% of African men circumcised (at the expense of taking funding from other serious conditions such as TB and malaria) instead of teaching people how to clean themselves properly, which is virtually free and actually more effective than circumcision. Circumcision is an unnecessary, culturally-offensive, and relatively expensive surgery that can increase someone's risk of HIV when it's performed in these targeted impoverished areas with unsterile medical supplies. However, teaching someone to wash just isn't technological enough for Westerners for it to be promoted on any significant scale. It doesn'’t require shiny supplies and medical training, which gets us excited and makes us feel like we're really doing something. It doesn’t make a good headline or press release from the WHO. I mean, how can it be that clean, proper use of water has been an effective answer all this time? Can it be that European countries with very low circumcision rates keep their HIV rates low by having good hygiene and access to clean water? Certainly not. There must be a procedure involved in ending the AIDS epidemics in 3rd world countries. A drug. A microbiotic. A surgery. A lab coat. It should require latex gloves and a doctorate, dammit!

Free soap and water?! Surely, I'm joking.
I would be happy to get involved if the real problem was considered and that is lack of population control. Almost all of the problems of the world stem from over population until we do something about that we will be unable to solve the other problems.
Yes Dr. Gupta, President Clinton's Foundation is making a great impact in bringing to light the great issues of our time especially in public health. The HIV crusade is just one of his many examples. The main issue is even though we have great ARV drugs that do extend lives, we need more healthcare workers on he ground to ensure that the treatments are distributed properly and that patients are followed up. That is where medical students and other young professions can get involved by volunteering.
Dr. Gupta's parting comment, "Do the non-governmental organizations make a difference?" Yes, they do, as talking about global problems and potential solutions simply are getting the information out on the table. For anything to start from nothing, someone has to quit sweeping it under the carpet and discuss it. It may take years to enable our third world countries with clean water, soap and education. If you can't talk about what the problems are, ways to address those problems and possible solutions one might as well establish the human race as extinct; going out in a last over-populated, uncircumcised, under medically funded gasp.
In the Sept. 17 issue of TIME, Prof. Jeffrey Sachs recognized a handful of NGOs that are truly making a difference in the world. In what he termed a Global Coalition of Good, Sachs pointed out that NGOs such as Physicians for Peace have become ambassadors of goodwill defining America's reputation in the world.

Yes, NGOs make a difference. Without them and the passion with which they do their jobs, the world would be much worse.
Get a behind-the-scenes look at the latest stories from CNN's chief medical correspondent, Dr. Sanjay Gupta, and the CNN Medical Unit producers. They'll share news and views on health and medical trends -- info that will help you take better care of yourself and the people you love.
CNN Comment Policy: CNN encourages you to add a comment to this discussion. You may not post any unlawful, threatening, libelous, defamatory, obscene, pornographic or other material that would violate the law. Please note that CNN makes reasonable efforts to review all comments prior to posting and CNN may edit comments for clarity or to keep out questionable or off-topic material. All comments should be relevant to the post and remain respectful of other authors and commenters. By submitting your comment, you hereby give CNN the right, but not the obligation, to post, air, edit, exhibit, telecast, cablecast, webcast, re-use, publish, reproduce, use, license, print, distribute or otherwise use your comment(s) and accompanying personal identifying information via all forms of media now known or hereafter devised, worldwide, in perpetuity. CNN Privacy Statement.