MICHEL MARTIN, host:
I'm Michel Martin, and this is Tell Me More from NPR News. Just ahead, a prominent evangelical leader challenges Senator Barack Obama's biblical knowledge, we'll talk about it, and your comments and e-mails. But first, the White House Office of Faith-Based and Community Initiatives is now holding its Innovation and Effective Compassion National Conference. It's an event that explores ways that religious communities can address pressing social problems. One of the top issues on the conference agenda is HIV/AIDS. Ambassador Mark Dybul has been a major force in building relationships between the Bush administration and the AIDS advocacy community since he became the U.S. Global Aids coordinator in 2006. And he joins us now to talk about faith based approaches to the issue. Welcome, thank you so much for speaking with us.
Mr. MARK DYBUL (U.S. Global AIDS Coordinator Ambassador): Great to be with you.
MARTIN: What's the mission of your office?
Mr. DYBUL: Well, no less than to turn the tide against HIV/AIDS globally, and the American people have gotten on their way to do that with a strong bipartisan support and the president's leadership. So we have the largest international initiative in history of 18 billion dollars over five years and doing nothing short of expanding, globally, prevention care and treatment services.
MARTIN: Some people continue to be surprised by the scope of this administration's commitment to HIV/AIDS. What do you think it counts for? Is it a matter of faith? Is it a matter of the president's personal interest? What do you think accounts for that commitment?
Mr. DYBUL: All of the above. I believe it began with the president's personal commitment and Mrs. Bush's personal commitment. It comes from his heart. He always says to whom much is given, much is required when he talks about this initiative. It comes from a faith and belief in the American people and the compassion and generosity of the American people. As long as their money gets something, as long as their hard earned tax dollars get something and save lives, very compassionate and generous. And also an understanding that HIV/AIDS, because it kills mostly 15 to 50 years old, is wiping out a generation of parents, teachers, peacekeepers, and the people who will secure the future. So it' a combination of all of those things depending on who you're talking to, but it comes deeply from the commitment to care for our brothers and sisters and serve.
MARTIN: You've been working obviously in various countries and along with the leadership of various countries according to the programs that they have already in place, and some of those are faith based and some of those are not. Do you see a profound difference in the way faith based groups and secular groups approach this issue?
Mr. DYBUL: Well, I think faith-based groups tend to be in communities where there aren't other organizations. You could go to many places and not find a government structure or a traditional NGO, but you'll find a faith community, and that's particularly true in Africa where we do so much work. So they tend to be where people are. They tend to meet people where they are. Several of the programs also have pretty holistic approaches, so it involves orphan care, food, education, it's just a full spectrum of services. Whereas public health institutions don't tend to have that full spectrum of services, and we found at least in Africa where 30 to 70 percent of healthcare is provided by faith based institutions that they tend to be among the strongest and best equipped but...
MARTIN: Can I just stop you for a second? What you're saying is, if - for whatever reason the faith-based groups are just more holistic in their treating like the whole person or family as opposed to the disease? Is that what you're saying?
Mr. DYBUL: Yes. For example in public health institutions, I can use HIV treatment as an example, you'll get the basic medical care, but it's not attached to social services, it's not attached to orphan care and education and food for the family. Whereas in many of the faith based sites, all those pieces get wrapped around the health structure itself, so it really is a communal approach and a whole aspect of the family and person approach.
MARTIN: But you know, another thing that has been true in this country is that many people who've become infected with HIV/AIDS have not felt welcome in their communities because of the stigma of the disease, and some say that religious institutions and the way they approach people with the disease are part of that, of maintaining that stigma in some ways. How do you think - first of all, do you think that you've seen any progress on that point, and how do you think religious organizations or faith based groups can be more helpful in this area?
Mr. DYBUL: I think there has been a lot of progress. I think here there isn't much division between secular and faith based, because, as many of us who were involved in this 20 years ago in the United States remember, we were suing doctors, and nurses, and others to touch HIV positive patients. So it takes a while to get over the stigma of a new disease no matter where you're coming from, but there has been, among some groups in Africa, and I'm talking specifically about Africa because that's where we do most of our work, there have been some groups who years ago in both secular and faith communities that had high levels of stigma.
Much of that has been overcome and actually there have been tremendous strides in some organizations. There's the church in Zimbabwe that used to teach polygamy and now it teaches monogamy because of HIV/AIDS. There's been a real shift. We have some real leaders out there in the faith community working with their pastors, priests, and imams to make sure that people understand that HIV/AIDS is a medical disease and needs to be treated as such.
MARTIN: Is there something that you've seen in international faith based efforts to fight HIV/AIDS that you'd like to see more of here in the U.S.? I think we often think as the U.S. as kind of the standard bearer for medical care that we then export elsewhere, but is there something you've seen overseas that we think we could use more of here?
Mr. DYBUL: Well, I think there are a couple things. One is the family centered approach and whole person approach. We're actually seeing much better adherence rates to HIV therapy in Africa for example, at least for now, than we saw in the United States because when someone leaves the health center, there's a social net for them in their community, buddy assistants and other things to help people take their medication. So, on adherence, we're actually doing a little bit better there than here.
MARTIN: You sound really kind of upbeat and excited, as you always do whenever I hear you speak, but there are some people who would say gee, you know, we're two decades into this epidemic. And some people thought that we'd be farther along in curbing the rate of new infections, in coming up with a vaccine, in coming up with a cure even. When you think of where we are relative to where we've been, do you - I don't know. Do you feel optimistic, pessimistic?
Mr. DYBUL: Absolutely. Very optimistic, especially if you look at the last five years, and, you know, I come from the science background, so I know that a cure for this disease is going to be very difficult. We've never truly cured a viral disease. We've had vaccines for them, but this is a very unique type of virus for a vaccination. And so it's going to be much more difficult and complicated so maybe I'm upbeat because I know enough about the virus, but you have to be tempered in it. But if you look at the gains over the last five years, five years ago people said you couldn't do treatment in resource-poor settings. Now millions of people are receiving treatment, and what I see, and the reason I'm optimistic is I get that hope from people as I see them in Africa. People whose lives have come back, their personal lives, their community, people feel that they can take control of their communities and their lives. It's one of the most remarkable things the American people are doing, creating hope. So we should be optimistic because we're the ones creating the hope out there and it's a really exciting thing to see.
MARTIN: Is there anything that's still making you crazy? You say well, I'm an ambassador, I should be able to fix this.
Mr. DYBUL: Not fast enough. There's nothing we're doing we can't improve. I'll worry when we think there are things we can't improve. We constantly need to push. Lives are at stake, human beings are out there suffering, and so we need to push at every step, but if you look at the progress it's breathtaking. It's nothing short of breathtaking. And that's why we all have to be hopeful, but use that hope, to commit ourselves again to recommit ourselves to doing even more.
MARTIN: Ambassador Mark Dybul is the U.S. Global AIDS coordinator. He's participating in this week's White House Faith Based and Community Initiatives Conference being held in Washington, D.C. He joined us from his office in Washington. Ambassador, thank you so much for speaking with us.
Mr. DYBUL: Thanks very much.
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