“Poverty and inequity are the world’s greatest killers,” Michel Kazatchkine, U.N. special envoy for HIV/AIDS in Eastern Europe and Central Asia, writes in an opinion piece in The Age, noting, “The developing world bears an extraordinarily inequitable burden of infectious disease, 90 percent of it, and yet these countries represent just 12 percent of all health spending.” He continues, “AIDS is a classic example. Of the 30 million AIDS deaths since the virus that causes the disease was identified 30 years ago this week, 90 percent have occurred in Africa.” However, “against such odds, the face of AIDS has changed from one of desolation to one of hope,” Kazatchkine states, adding, “The global effort to defeat AIDS over the past three decades has demonstrated a long-suspected truth: health should no more be seen as a consequence of economic growth.”

“AIDS is perhaps the pre-eminent example of successful investment in health,” Kazatchkine writes, highlighting the history of the disease and the progress made in prevention, treatment and care. “Several factors have been key to this remarkable progress” in reducing HIV/AIDS mortality, he states, including “activism and social mobilization,” a “global political commitment to funding health,” and “‘innovation’ in the way in which aid is provided through new global mechanisms and partnerships, and in the way it is accounted for — increasingly, based on performance of programs.” However, “[t]he question today is whether this remarkable progress can be sustained and amplified … in a global context that has changed significantly from what it was 10 years ago,” he writes, noting that “while inequities between countries have decreased, and the overall proportion of people in extreme poverty has decreased, the inequities within countries are now increasing everywhere, particularly in middle-income countries and emerging economies.” Kazatchkine continues, “But there is a way forward, as AIDS has shown” (5/22).