The U.N.'s Role in the AIDS Fight

The United Nations and international aid groups have made progress fighting AIDS in the developing world, but much is left to be done. Stephen Lewis, the U.N. Secretary-General's special envoy for HIV/AIDS in Africa, talks with Farai Chideya about the epidemic. He is the author of Race Against Time.

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ED GORDON, host:

Clearly, progress is being made in Kenya and throughout the developing world. But could it come faster? NPR's Farai Chideya spoke to Stephen Lewis. He's the UN Secretary General's special envoy for HIV/AIDS in Africa and the author of Race Against Time. He says Kenya's minister of health is doing what she can to help places like the Suba district, but she's run into a few surprising roadblocks.

Mr. STEPHEN LEWIS (United Nations Special Envoy for HIV/AIDS in Africa; Author, Race Against Time): You've had a situation in Kenya where they have 4,000 retired nurses whom Charity Ngilu has desperately been trying to employ as minister of health, but she hasn't been able to employ them until recently because the International Monetary Fund said she would breach the macroeconomic framework, and was, therefore, not permitted to do so.

One has to understand that one of the frustrations for many of these countries is that the international financial institutions - the IMF and the World Bank -are not always helpful. In fact, they impose conditions and strictures which are profoundly damaging.

In this case, the IMF relented and Charity Ngilu is now hiring her own nurses, improving their training and getting them available around the country to handle the treatment.

FARAI CHIDEYA reporting:

I want to move on to talking about AIDS education for children, as well as just regular education to insure that girls, as well as boys, have a future and are able to support themselves.

Mr. LEWIS: The huge problem of the pandemic is gender inequality. I mean, that's what's driving the pandemic. I hope the world wakes up to that one day. The situation of women and girls is so desperately vulnerable, and the need to change male sexual behavior is such an imperative.

And all of that can come about over time if education improves, whether it's primary school or secondary school where young boys learn to respect young girls, where efforts at prevention, abstinence and fidelity to be sure, but primarily, the use of a condom if you're a sexually active young person. All of that has to be taking place in schools.

The truth is that nine, ten, eleven-year-old kids - they're so sophisticated about matters sexual these days in the presence of the pandemic that it's crazy not to discuss these things with them.

CHIDEYA: How can the U.N. help foster this approach to really dealing with the gender inequalities, gender repression, that you say are driving the pandemic?

Mr. LEWIS: I think that's one of the great challenges for the U.N. and I think that it's one of the areas of greatest failure of the U.N., if I may be so bold.

The United Nations desperately needs an international agency for women. It doesn't have one. More than half the world's population is largely unrepresented in the work of the United Nations. There simply are not any powerful agencies, with the possible exception of the U.N. Population Fund, which deals more narrowly with sexual and reproductive health.

But on everything from sexual violence to economic empowerment, to political representation, to HIV/AIDS, the whole gamut through maternal mortality, all of these things do not have, within the U.N., the kind of force which they must have to overcome the gender inequality.

It's so desperately important that we realize that at the center of the pandemic - suffering, carnage, almost beyond the capacity of words to describe - are women and girls. And unless the U.N. rallies to that truth, we'll never break the back of the pandemic.

CHIDEYA: Mr. Stephen Lewis, thank you.

Mr. LEWIS: Not at all.

GORDON: That was NPR's Farai Chideya speaking with Stephen Lewis, special envoy for HIV/AIDS in Africa for the United Nations. He's also the author of Race Against Time.

To hear an extended version of Farai's interview or see photos of the women and children of the Suba district, visit our Web site at npr.org.

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GORDON: Coming up, a Texas Congressman says Katrina evacuees have overstayed their welcome and he wants them out. And a federal court rules that prisoners aren't entitled to minimum wage. We'll discuss these topics and others on our Roundtable.

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