The noun pandemic, meaning an epidemic that affects a widespread area, dates from 1853. That year, the third cholera pandemic was sweeping through Europe. The first cholera pandemic had ravaged Asia in the early nineteenth century; the seventh cholera pandemic began in Indonesia in 1961. It reached Latin America thirty years later, causing 4000 deaths the year of its arrival, and it’s never left. Cholera can be treated with clean water and a mixture of sugar and salts that costs pennies. It still kills thousands every year. Combination retroviral therapy — the drug cocktails that have dramatically prolonged the lifespans of people with AIDS who have access to advanced Western medicine — can cost $12,000 a year. In Africa, AIDS kills thousands die every day.

(Today is World AIDS Day; this is a Link and Think post.)

The noun pandemic, meaning an epidemic that affects a widespread area, dates from 1853. That year, the third cholera pandemic was sweeping through Europe. The first cholera pandemic had ravaged Asia in the early nineteenth century; the seventh cholera pandemic began in Indonesia in 1961. It reached Latin America thirty years later, causing 4000 deaths the year of its arrival, and it’s never left. Cholera can be treated with clean water and a mixture of sugar and salts that costs pennies. It still kills thousands every year. Combination retroviral therapy — the drug cocktails that have dramatically prolonged the lifespans of people with AIDS who have access to advanced Western medicine — can cost $12,000 a year. In Africa, AIDS kills thousands die every day. Thabo Mbeki, the president of South Africa, has finally overcome his longstanding refusal to accept mainstream scientific opinion and began to move South Africa towards the Brazil model for fighting AIDS. South Africa is the most HIV-ridden country in the world, with five million HIV-positive people in a country of forty-five million. The Brazil model relies on cheap, generic retrovirals, produced locally or by Indian subcontractors, and for years, pharmaceutical companies fought it. The rules of the World Trade Organization’s intellectual property agreements allow for patents to be waived in the case of "public non-commercial use", however, and eventually, with much prodding from First World activists and Third World health officials (and Bill Clinton), they were able to reach an agreement. AIDS drugs in the countries that can least afford them will soon cost pennies a day.

This is wonderful news. All over the world, from Africa and East Asia to places less strongly associated with AIDS, such as China and India, there’s a crisis building. The Black Death of the fourteenth century swept through Europe and killed perhaps twenty-five million people (roughly a third of Europe’s population). In the great influenza pandemic of 1918, the Spanish flu killed forty million people. More than forty million people today are living with HIV. Millions more are infected every year. Three million died in 2002. The retrovirals make a difference in America, Canada, England; HIV is no longer a death sentence. But without the looming threat of a catastrophe, friends and neighbors and brothers and daughters and lovers wasting away before American eyes, will there be the same support for costly research and even costlier programs? Will Johannesburg and Guangzhou’s sufferers attract the same sympathy as Portland and Saint Paul’s?

Other diseases have been eradicated. Smallpox is extinct outside a few labs. Polio used to be a dreaded disease, striking down America’s children. Today, a cheap and effective vaccine has eliminated the disease in America. Worldwide, it lingers, however; tracking down and eradicating the last cases in India and elsewhere has fallen to the U.N., philanthropists like Ted Turner and Bill Gates, and, amazingly enough, the Rotary Club. AIDS is under control in America; I hope that doesn’t mean that it will be up to a few civic-minded Realtors and orthodontists to help the rest of the world.