Thirty years after the first cases of AIDS were identified, rock star and activist Bono sat down with TIME managing editor Rick Stengel to look back and look ahead.
Where are we in the fight against AIDS now?
It's mathematics. A pandemic is on the decline at the moment when fewer people are infected than are being treated. Right now, for every person treated with antiretroviral drug therapy, two people get infected. That has been the case for four years. This year, with some breakthroughs in science and a little more practical help, there's a chance to turn that around. Those breakthroughs are that they've discovered that antiretroviral drugs, if administered early, have a preventative power. Male circumcision has now come out as being a really powerful tool to fight the disease. And if the mother-to-child transmission is controlled, those three things together have the effect of lowering between 40% to 60% [the rate] of infections. That's the number. If everyone recommits, that's what this moment will be.
What does recommitting entail?
What we've asked for is a commitment to move the 4 million people who are treated today by the U.S. for AIDS on PEPFAR [the President's Emergency Plan for AIDS Relief] to 6 million by 2013. We think President Obama is going to commit to that, and if he does, I will punch the air because it literally is the beginning of the end of AIDS. And as I say it to you, I can hardly believe the sound of it as it comes out of my mouth. If Congress disagrees, if the American people disagree, with this harsh recession biting at everyone's heels, then we could actually blow it. So this is the worst time to stop.
How did we get to this point?
American leadership. I mean, you Americans are so good at beating yourself up. It is remarkable. There's this sense of shrinking influence on the world. It's not true. Nearly 5 million lives have been saved around the world because of American leadership. In polling about countries that most admire the U.S., eight of the top 10 are in Africa.
Is there someone who was most crucial in this fight?
In his 2003 State of the Union speech, President Bush offered $15 billion over five years to fight this disease, the largest ever response to a health pandemic. In 2002 there were about 300,000 people in the developing world on antiretroviral drugs. There's now 6.6 million. President Clinton's creative intelligence and negotiating skills got the price of the drugs down. And it's important to point out that the Evangelical Christian community who had been judgmental about AIDS actually repented, and they really, as you say in America, got busy. And you've got to go back to John Kerry and Bill Frist. They had a bill--the Frist-Kerry AIDS bill--years before in the Senate which put the U.S. in the lead on this issue. But in the end, President Bush had to make that call, and I think he was being very smart. Africa is to him what China was to Nixon, and I think that's very clever because by 2050, Africa's population will be 2 billion. China's population, which is around 1.3 billion, will either have steadied or declined. There are 15 additional African economies about to become middle income over the next decade. The demand for American goods, for American technological know-how, technology, engineering, is vast.