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 You are in: Bureaus/Offices Reporting Directly to the Secretary > Policy Planning Staff > Secretary's Open Forum > Proceedings > 2001 - 2002

The Role of Public-Private Partnerships in the Global Fight Against HIV/AIDS

Colin L. Powell, Secretary of State
Donald Evans, Secretary of Commerce; Scott Evertz, Director, White House Office on National AIDS Policy; and a Distinguished Panel of Experts
Remarks to the Open Forum
Washington, DC
June 24, 2002

Alan Lang: Secretary Powell, Secretary Evans, Under Secretary Dobriansky, Mr. Evertz, distinguished visitors, colleagues and friends, good morning. I'm Alan Lang, Chairman of the Secretary's Open Forum, and I'm delighted to welcome you to todayís conference on the role of Public-Private Partnerships in the Global Fight against HIV/AIDS.

As I think about the vital roles of business, government, labor, philanthropic organizations, the NGO community and individuals in meeting one of the most critical challenges in history, Iím reminded of something Jonas Salk said, "The greatest reward for doing, he noted, is the opportunity to do more."

Today, we hope that more and more people across our nation and around the world will follow examples set by many organizations represented here at this conference. We hope that all of you will seize opportunities to do more in this global fight against AIDS.

The impact of this pandemic has been felt on every continent and every field of endeavor, and there is a growing sense that in order to meet this global challenge more must be done to develop and strengthen public-private partnerships. And so today, we encourage you not only to share what you are doing, but also to help us all find ways to do more.

And now, it is my privilege to present the moderator of this segment of our program, the Under Secretary of State for Global Affairs, Paula Dobriansky. Please join me in welcoming her with a warm round of applause.

Under Secretary of State Paula Dobriansky: Thank you Alan, for that introduction. Your hard work and also the efforts of your colleagues in putting together this event are greatly appreciated. The idea for todayís meeting came from Dr. Drew Altman, the President and CEO of the Kaiser Family Foundation. Drew called me last year to say that he thought an event of this kind would be a unique and helpful way of promoting public-private partnerships in the fight against HIV/AIDS. I shared this idea with Secretary Powell who readily agreed to sponsor a meeting. This morningís open forum is the fruition of that idea.

What unites all of us is a common goal to end the threat of HIV/AIDS. In the audience and participating in todayís discussions, are representatives from a very broad range of sectors -- government, business, labor, foundations and the non-governmental communities. To win the battle against AIDS, we must forge together the most effective partnerships possible. Government is a critical partner in this cause. Representing the leadership of this administration, it is my great pleasure to introduce our first three distinguished speakers.

First, we will hear from Secretary of State Colin Powell. As Co-Chair of the Presidentís Task Force on HIV/AIDS, Secretary Powell has been a leader and a role model in the international fight against this pandemic. His commitment to this issue has been truly steadfast.

A discussion about public-private partnerships and the role of the private sector, in particular the business community, would of course be incomplete without the Secretary of Commerce, Donald Evans. We are delighted Secretary Evans could also join us here as well this morning.

And representing the White House is Scott Evertz, Director of the White House Office of National AIDS Policy, who has played an important role domestically and internationally on this issue. My thanks to all of your for participating in our open forum and Mr. Secretary, let me welcome you and turn the podium over to you. Thank you.

Secretary of State Colin Powell: Well, thank you very much, Paula, and let me take this opportunity in front of this audience to thank you for the leadership role that you have playing within the department and within the interagency process and throughout the international community in highlighting the problems associated with HIV/AIDS.

And Alan, let me thank you for the leadership that you have been giving to the Open Forum over these years. This is a remarkable forum that we hold on a regular basis in order to bring in people into the department to help educate us and to share with each other ideas, especially new ideas on the various issues of the day. And no issue of the day could be more important than the one that we are dealing with today.

And Drew, please do take full credit for having come up with the idea some time ago, and weíre pleased, now, that it is come to fruition today. I also want to thank my colleague, Don Evans, for being here, as well as Scott for also being in attendance. I regret that the Secretary of Health and Human Services, Tommy Thompson, and Secretary of Labor, Elaine Chao, who are also actively involved as leaders within the Administration in dealing with this problem are unable to be with us this morning, but express their regrets as well as their greetings.

And a special thanks to all of you who would take time from your schedules, your various activities to be with us today and to work together to share ideas and see what we can do to put public-private partnerships together in a more effective way, so that we can go after this enemy. We can do a better job of leading this global fight against HIV/AIDS.

At the beginning of this century, you may recall, just 18 months ago when we were going through the excitement of a new millennium and we saw all kinds of promise in this new millennium, we saw a possibility of a spread of political and economic freedom. We saw that democracy with each passing day was seen in more and more parts of the world as the way forward. But even though there was trouble in the world and we see that trouble on our television sets today, nonetheless, at the beginning of the new century, we saw opportunities for piece. We saw opportunities for freedom and those opportunities are still there.

We saw breakthroughs in technology, which perhaps might even allow us to envision a day in this century when most of humanity would be free from tyranny and poverty. So, it is century of promise. Even with all of the problems that we face on a day-to-day basis, there are great opportunities out here. Yet, all of these opportunities, these promising trends, which America has done so much to advance, these trends for a better century can be reversed because of this one thing, this one problem, this one crisis on the face of the earth, HIV/AIDS.

AIDS is not just a compelling moral issue. It is not just a humanitarian issue. It is far more than just a health issue. It is a security issue. It is a destroyer of nations. It is a destroyer of societies. It has the potential to destabilize regions, perhaps even entire continents. It can tear social fabric apart within any nation. It can rob young democracies of the citizens they need to build freer, better futures for themselves and for their children.

HIV/AIDS is an economic issue, leaving nations without the human resources to grow and develop, ultimately sapping global well being. This audience is sophisticated with respect to this crisis. You know the numbers, but they bear repeating nonetheless, that five million people are infected each year. Thatís 14,000 new infections a day and nearly 50 percent of the infected are women, the backbone of families in so many developing nations of the world. And in turn, they are the backbone of economy, developing economies in so many developing nations in the world.

Life expectancy has dropped below 40 in some sub-Saharan countries. Less than 40 years of age life expectancy in the 21st Century at a time when just a few years ago these same countries might have been looking at 50 or 55 years, going the other way because of this one -- one disease, this one pandemic. People are dying in what should be the prime of their lives, their most productive years. It is not a disease that goes after the old, it can infect the young, but it devastates those who are in the prime of their years, the prime of their lives.

Markets, literally, are dying off. Surely, AIDS has dealt blows to business and investment in so many developing countries and business and investment are crucial to lifting nations out of poverty, to lifting people out of poverty and destitution and to putting those nations on the path of sustainable development.

AIDS is destroying workforces, productivity declines and absenteeism that increase when workers need to take time off for their own medical needs or to take care of family members who are ill, who have no one else to take care of them. The people are not in the workplace. They are either consumed with the disease or taking care of those who are. We hear terrible stories about companies in some parts of sub-Saharan Africa, and weíll focus on sub-Saharan Africa, but itís a problem in the Caribbean. Itís a problem in other parts of the world. There is no nation that is immune from this pandemic, this crisis.

And we hear stories from sub-Saharan Africa, however, that some companies have to train three workers to be sure that at least one of them will remain healthy and have some longevity in that company, in that workplace. There are 12 million AIDS orphans in the world and 30 million projected by the year 2010; lost children, children without caregivers. Children without -- what hope for the future? No hope for the future. Children who will not be educated, who will not acquire skills that will make them contributing members of society. And even if they stay healthy, they are losing their teachers. In the Central African Republic in Cote d'Ivoire, 70 percent of the deaths that occur among teachers linked to AIDS. Teachers in the prime of their life when they should be educating youngsters and passing on enthusiasm and energy and education and a belief in the future, that teachers, themselves, are dying.

In the decades ahead with this kind of loss, where will the skilled workers come from? Where will the educated people come from to run those countries, to run those societies? This is why President Bush focused on this particular subject last week when he announced that over the next five years the United States will double to $200 million our funding for education and teacher training in Africa. As the President said, "Education is the foundation of development and democracy in every culture on every continent."

I visited Africa last year with my wife, Alma, and we traveled through a number of countries where weíve seen the impact. They have seen the impact of this disease and there was nothing sadder than to see it up close and personal, and to see families where the active generation, the working generation has been devastated. You have grandparents and you have the grandchildren, but the parents, themselves, are being devastated by the disease, and so you have grandparents who have little or no income trying to raise and take care of the children. And the grandparents will not be there when the children that do survive slowly come up in age and are looking even more for the kind of support they will need from the families. Families being ripped apart by this disease.

We must do all we can, now, to ensure rising generations in developing countries have the skills and the good health to provide for themselves and their families and to contribute to the future prosperity of their countries. In every way imaginable, then, the AIDS pandemic threatens lives and livelihoods, governments and businesses, hard-won achievements of the past and cherished hopes of the future. The worldís response to this crisis must be no less comprehensive and no less relentless than the AIDS pandemic itself.

President Bush has made stemming AIDS a top priority for his Administration. So, the Presidentís Task Force on HIV/AIDS, Commerce Secretary Evans, Health and Human Services Tommy Thompson, Labor Secretary Chao, and I and our other colleagues in the Cabinet are working closely to coordinate efforts for the domestic and international fronts of this global war. And the American people, I believe, can be proud that the United States was the first nation to pledge support to the Public-Private Global Fund to Fight AIDS, Tuberculosis and Malaria.

We continue to be the largest single donor to the fund and our $500 million pledge has attracted $1.4 billion more from other nations to date, including key contributions from private organizations, corporations, and foundations and the like. Itís just the beginning. We really do have to grow that Fund, double and triple it, and the United States who has committed to do everything that we can not only in the form of our own contribution, but in the form of encouraging others in both the public and the private sectors to make additional contributions.

The United States is also the largest contributor to bilateral programs against AIDS worldwide. And just last week, President Bush announced a new $500 million initiative to stem the transmission of HIV from mother to child, something that we know how to do, something that is not that difficult. Something that it will literally be criminal if we didnít invest in and help those nations with the willingness to do so. And with the leadership to make it happen, to make this happen in order to break that link in the chain from mother to child. This effort will be aimed at prevention and treatment programs in Africa, the Caribbean, areas in the world where infection rates are the highest.

The challenge of this global magnitude, however, requires leadership and partnership that extends beyond governments. It also requires leadership and partnership between the public and private sectors, between institutions and individuals, between business and labor. We all must work together. An so, todayís open forum affords an opportunity, an important opportunity, for all communities represented here to exchange experiences, insights and ideas about what can be done, individually and collectively. Organizations are here such as the Global Business Coalition on AIDS, the Corporate Council of Africa, and the International Organization of Employers on the World Economic Forum. All of them are already helping companies share Best Practices.

And shortly, you will hear from Don Evans and from business leaders about wonderful efforts that individual companies are making, companies which truly are on the front lines of the AIDS war. If you havenít done so already, I strongly encourage the CEOs that are here today to develop AIDSí policies for the countries in which your companies operate. Iíd also ask you to encourage your counterparts in other companies to do the same. Through your different business associations make sure that you take this AIDS message back, not only to your company, but to all the companies within your sector, within your business association because we need to leverage meetings like this and touch many more people than just those who are present today.

Business leaders can also act as force multipliers, as they like to say in the military, by reaching out to opinion leaders in government and throughout the country, the societies in which you are working in which you have a business presence. Working together and that way you can break the silence and remove the stigma from those who are infected. The workplace is an ideal delivery point for HIV/AIDS prevention and care. Businesses can lend their infrastructure, their public relations network, and their distribution systems to help raise AIDS awareness and to distribute vital information.

Companies can provide AIDS prevention education in the workplace. Why not make it a mandatory part of your education program for employees in those countries? Many companies routinely do strategic planning, scenario planning. Maybe you should consider sharing some of your assessments, what youíve learned about dealing with this disease in the workplace, and what youĎve learned about educating your employees in these places. Why donít you share that information with governments, especially our own government here, so that we can all do a better job of understanding the impact of AIDS around the world. And hopefully, thatís one of the outcomes that will come out of this conference.

Corporate leaders can see to it that their managers implement fair employment practices to ensure there is no discrimination related to a personís HIV status. No stigmatization, they are just like anyone else. This is one of those lessons we have to get to all employers and nations around the world that they must not stigmatize people who are ill. They need our help. They need our compassion. They need to be given the opportunity to be contributing members of society. And we would expect businesses to institute care and support programs for their employees and for their families.

There is also much that American labor can do at home and through its extensive ties to workers in other countries. Many American unions are already involved, such as the American Federation of Teachers. Labor, too, has useful structures -- union halls, union organizations, locals. All of these organizations and structures can be used as part of this great crusade. Peer counseling has proven effective as a means of reaching people and changing their behaviors. This peer counseling can take place in a labor hall. It can take place in a factory. It can take place in an office.

Collective bargaining doesnít work against an epidemic. What does is working collectively with management, government and other key elements of society. This is a crusade that must be won. This is a challenge that must be faced. This is something that each and every one of us must get involved in, in our own way and in a business way, not only in our own lives, not only in talking to others about it. But if we are in government, it makes no difference what Cabinet department you might be in, you have a role to play. If you are a business leader making a profit in a country, itís important for you to give back to that country by helping in this crusade, which might destroy that country, but more importantly, your business opportunity in that country.

Foundations have a particularly unique role to play, because foundations contribute more than just money. They are contributing their long experience in evaluating proposals and working with grantees. They also bring expertise in the health field. We all know of the work of the Bill and Melinda Gates Foundation, of any other foundations represented here. This particular one is showing us whole new ways of working, including through partnerships with pharmaceutical companies and governments to provide anti-retroviral medicines.

Another fine example is the Kaiser Foundation, whose HIV/AIDS work focuses on South Africa. As I speak, eight foundations are working together on a pilot program to reduce mother-to-child transmission of the AIDS virus. For decades, American government, business and labor have pooled strengths to extend economic and political freedom around the globe. Together, we have helped to open unprecedented opportunities for prosperity, democracy and peace. And now we have to do it again, to deal with another enemy, a new enemy, an enemy that is as deadly as any enemy the world has seen, frankly, in all of recorded history.

I want to say to this group here today that you can be sure that under President Bushís leadership this government will commit all of its resources, all of its energy, all of its leadership ability to playing its part. But it goes beyond just what the government can do. It goes into what labor can do, what business can do, the foundation world can do, what each and every one of us can do in our own lives at home knowing others who have suffered from this disease, but who are part of our community or our family, certainly part of our human family. We all have a role to play.

And I thank you so much for giving us this opportunity to gather you together and talk about the roles that each and every one of you and your organizations can play. Thank you very much. Itís now my great pleasure to introduce my buddy, my wingman, Secretary of Commerce Don Evans.

Secretary of Commerce Don Evans: Thank you, Colin. Thank you Secretary, so much. I am -- I canít tell you how thrilled I am to be here. As somebody that has spent 26 years of his life in the private sector and now in the public sector, I see both sides of this issue. I see the power of public-private partnerships. Iíve seen it for both sides now.

But you know one thing Iíve really learned since Iíve arrived in Washington, D.C., people say youíre now in public service. Youíre a public servant. I say, well, maybe so, but when I was in the private sector, I was a public servant. I was there to serve the people. Thatís why weíre all here, is to be public servants no matter if youíre in government or in private sector. While weíre here our highest calling in life is to serve other people.

So I canít tell you how pleased, Colin, I am to be here and to participate in this and be your wingman and be on your team to fight this battle. I want to thank Alan for your hard work, and Paula, thank you very much. Scott, good to have you here. I want to thank the Secretary for hosting this forum. But more than that I want to thank him for what all of us know being an extraordinary leader in this world at this moment in time. I want to thank him for his passion to work with this crisis that weíre discussing. I want to thank him for his compassion of the people that it touches. I want to thank him for a heart thatís as big as all outdoors and touches every continent on the planet. And thank you, Mr. Secretary, very much for your leadership here.

As I travel the world, it is clear to me that many of the challenges that we face to improve the quality of life for all of our fellowman can be met, can be -- and explored and improved by the public-private partnerships youíre talking about here today. Certainly, the AIDS challenge calls for just those kinds of public-private partnerships, as well as the foundations and other community involvement. But as President Bush has said, "The extension and the extent of devastation wrought by AIDS shocks the conscience." Weíve all heard the grim statistics. You know all too well the terrible loss of life on this planet. And each loss of life has a far-reaching impact on all of us as neighbors as we continue to unite this world, continue to connect this world, continue to integrate this world.

It kills potential. It wipes out dreams. It silences ideas. It robs energy from our cultures, our societies, and our global economy, and yes, it leads to hopelessness. AIDS attacks the most productive adults across the globe tilting the scales against economic progress in the countries hardest hit by this disease. According to our Census Bureau, in the next eight years -- in the next eight years, by the year 2010, the average life expectancy will be cut by 40 years in Zimbabwe. In South Africa, by 30 years. Thatís in the next eight years.

This terrible disease is robbing us all, denying all humanity the higher quality that is so -- higher quality of life that is so universally desired and deserved. Thatís not right and thatís not good, and we have the power, the power right in this room to do something about it and responsibility to do something about it. We need action. We need results. President Bush, as the Secretary has already said, has made it a focal point of this Administration. Last week, the President announced the new $500 million initiative for Africa and the Caribbean. The funds are to help prevent the transmission of HIV virus from mothers to child, and they are in addition -- those funds are in addition to the about $1 billion that has been committed to the Global AIDS program and projects.

The government, however, canít solve this crisis on their own. This is a battle. It must be joined by all. That includes the private sector, and we are seeing private companies, U.S. companies, step up to the plate all across America and around the world. One way American companies step up to the plate, is through constant innovation from dozen of new AIDS treatments now in the pipeline to new technologies to address world hunger. The American engine of innovation can and must be a major contributor.

Another way that U.S. private sector can help is through direct engagement in the communities they touch. Later this year, Iím planning to take a trade mission to South Africa. Weíll spend a week or so down there and there are 900 -- 900 now, U.S. companies already doing business in South Africa. And South Africa also is a country where one in eight citizens is said to be HIV positive. Everywhere I go around the world, I highlight U.S. companies that invest abroad and understand the importance of giving back to society, understand that our calling in life is to serve other people.

These virtues of corporate citizenship do enrich communities and improve the quality of life in the host countries where theyíre located. In South Africa, the Ford Motor Company has set up what could be a model AIDS program. And remember, when youíre talking about Ford Motor Company, youíre not talking about a single entity. Youíre talking about hundreds of thousands of employees that are committed to this program. Youíre talking about hundreds of thousands of shareholders that own the company. Itís their money that is committed to this program. A key factor in Fordís AIDS awareness program is that senior management is committed to it. The people of the company, as I said, are committed to it.

Thereís an HIV/AIDS program manager at an engine plant in Port Elizabeth and at the assembly plant in Pretoria. They are trained peer counselors, AIDS prevention and education programs for their employees is a part of their mission. Voluntary testing is part of the program. Company sponsored community events with HIV/AIDS awareness themes, part of their program. Fordís outreach also includes care for the youngest victims of this disease and AIDS orphans. Ford is not alone, though, in the effort to fight and prevent this disease.

Daimler Chrysler recently recognized by the Global Business Coalition on HIV/AIDS in the International AIDS Trust for its AIDS program in South Africa. Bristol Meyer Squibb has a Secure the Future program to help orphans, women, and children with HIV/AIDS in sub-Saharan Africa. And a number of pharmaceutical companies have announced that they will make AIDS drugs available at or just below cost or at no profit. There are many other companies and foundations in this battle exploring ways to fight this disease.

Again, we have the power in this room to make a difference. We have the responsibility in this room to make a difference. For all the brave work that the private sector has already done, there is more to do. We each have to have a responsibility to tackle this crisis. We each ought to take on the challenge to go against -- go have a war against this crisis and against AIDS.

So, I say to all of you, get involved. If youíre already involved, ask yourself what more you can do, how you can redouble your efforts. Challenge your peers to join the war on AIDS. I assure you that at the Department of Commerce we stand ready to work with all American companies and all of you. We must do this so we can save individuals, we can preserve families, we can build businesses, we can grow economies, realize a dream of peace and prosperity all around this world that we all share and fulfill our highest calling in life, which is to serve other people.

Thank you very much and God bless you.

Scott, come up. Scottís from the White House. Weíre delighted to have you here. Youíve been serving on this task force for the last 15 -- 14 months now. Thank you very much, Scott.

Mr. Scott Evertz: Thank you, Mr. Secretary. A special thanks to Alan for organizing this, Under Secretary Dobriansky, and of course, Secretary Powell. Mr. Secretary, your leadership and your outspokenness on this issue make the work that all of us do that much easier and we appreciate it and I applaud it on more occasions than you might know.

How appropriate that we gather today in the presence of our Secretary of State and Secretary of Commerce to talk about how public-private partnerships can and must be developed to stem the tide of HIV/AIDS. Itís a uniquely American concept and one that the Administration applauds and one that President Bush is excited by. And we really can do no less than to gather as corporate citizens, foundations, and the public sector to address the rising tide of HIV/AIDS across the world.

The two secretaries did a fabulous job laying out the statistics. The statistics are mind boggling. But I would point out that Secretary Powell also talked about his personal experience in Africa. And I can tell you having recently returned from Africa, there is nothing like witnessing the devastation personally to cause you to say, "I can and will do everything in my power to address this pandemic." Itís also an experience that Iím sure the Secretary will attest to. It can be uplifting, because in the midst of the horrifying statistics and in the midst of the devastation that you witness in every country that you visit in sub-Saharan Africa, and the Caribbean I might add, you also see examples of incredible hope.

Secretary Evans referred to the Ford Motor Company and their program in South Africa and it is truly exciting to see this program. I had the pleasure and the opportunity to visit the Ford Motor Company with Secretary Thompson and these employees -- thereís no other word to describe the peer educators than psyched. They are psyched in their work. They are excited to be bringing the message to their peers that HIV is something that should be something of the past. And so while you balance that excitement with the vision of the orphans that you see, you find yourself having this internal struggle. And something I tell you that I cannot explain, but something that is causing me to recommit myself on a daily basis to doing the best job I can in this Administration to address AIDS both domestically and internationally.

And today, you have my promise and my pledge that I will continue to do that. Although, as I shared with Secretary Evans, those of us that are in these positions are aging at a much more rapid rate than our calendar years. I think itís about ten to one. So, by the time Iím finished Iíll be about 70 years old, but hopefully, I will have done the right thing and contributed a little bit to what is an absolute unfathomable pandemic.

I have had the opportunity, as I said, to travel to Africa, Mexico, and the Caribbean, and again, witness incredible hope amidst incredible despair. Now, something that weíve always had a hard time dealing with is poverty, and we recognize that one thing that we will have to do is to integrate our HIV/AIDS programs with our other domes -- international assistance and we intend to that. The President, as you may know, has initiated the New Millennium Challenge Account, which is our pledge to increase bilateral assistance in the developing world. Because we recognize we will not get a handle on HIV/AIDS unless we get a handle on the poverty that wreaks havoc across the world.

I had the pleasure of working closely with Secretary Thompson when he was Governor of Wisconsin in developing what we proudly say is a pretty good service delivery system. And the reason the service delivery system for people living with HIV/AIDS in Wisconsin is so good is the involvement of the various sectors represented in this room. You will find in the State of Wisconsin corporate contributions to AIDS service organizations unlike those in practically any other state, and thatís important and thatís vital. You also find in Wisconsin a commitment to the civil rights protections of people living with HIV/AIDS because of my good friend, Tommy Thompson, and his commitment to ensuring that people are not stigmatized as Secretary Powell has challenged us.

And so, I challenge all of you in the room today to join us because government does not have all of the answers and far too often that old joke about weíre here from the government and weíre here to help is true. We canít do it all and sometimes we arenít helpful, but you represented in this room are and can be. Our friends from the Kaiser Foundation and the Bill and Melinda Gates Foundation have been enormously helpful in this pandemic and I know that they will continue to be.

And Drew, thank you, I didnít know it was your brainchild, but thank you for your insight and your ideas. Helene Gayle is here from the Bill and Melinda Gates Foundation. Weíll look forward to dialogue with her during the roundtable. She was quite a leader at the Centers for Disease Control and sheís gone on to do that at the Bill and Melinda Gates Foundation.

And Iím not going to go around the room and recognize everyone in here whose a friend, but how exciting it is to be able to look on both sides of this room and through the middle and see people that I consider to be friends. And they are friends because they are joined together as stewards of limited resources, but as Christians, Jews, and Muslims who because of our faith or with no faith at all, recognize that we need to reach out to the human family that is suffering and address this epidemic.

A lot of people talk about when history is written, what will they say about our response to the HIV/AIDS pandemic. And I have to tell you, a lot of my activist friends in the NGO community predict that history will not look favorably upon our response to HIV/AIDS, but we are at a point where we can make sure that history does not read that way. And my vision of that history is a history that says unlike anytime in the history of the world, people of different nations, of different faiths, people from business, religious, many cultural backgrounds got together because they said, we donít care who is being infected with this disease, we must respond and we will respond. So letís all work together to make sure that those who follow us read that history, that history that says they did respond.

I encourage you to join us and I encourage you to work harder than ever because itís gonna require very, very hard work and Iím very encouraged by the presence of so many in the room today. I bring greetings from the President. He is excited by whatís happening in this country, because it really is an example of the good that America can do when we choose to respond.

Thank you so very much. I look forward to the participation in the roundtable. Thank you.

Under Secretary Dobriansky: Let me thank Secretary Powell, Secretary Evans, and Scott Evertz for opening up our first panel this morning. I have to say that truly your commitment, the three of you, your passion and also the very strong support that you have rendered on behalf of public-private partnerships, and particularly in this area, is very, very much appreciated. If you could all join me in thanking our opening panel and our distinguished members again.

I now will turn the proceedings back over to Alan Lang. Alan?

Mr. Lang: Thank you very much, Secretary Dobriansky. As our first panel departs, thank you all for remaining at your seats. At this time, weíll move down to the lower level of the auditorium for the roundtable discussion.

Dr. Jack Chow: Hello, welcome to the roundtable discussion portion of our morning today on the role of Public-Private Partnerships in the Global Fight Against HIV/AIDS. My name is Jack Chow. Iím the Deputy Assistant Secretary of State for Health.

As Secretary Powell and Secretary Evans and Scott has said that the global spread of HIV/AIDS is infiltrating, permeating, and devastating scores of societies leaving no sectors unthreatened. To attain success in reversing the pandemic, our response must be equally effective, compelling, and comprehensive. Public-private partnerships and global health are growing rapidly as a means of assembling resources, know-how, and willpower.

Just to mention a few, the new -- brand new Global Fund to Fight AIDS, Tuberculosis, and Malaria has just been established, The Global Alliance for Vaccine and Immunizations, the International AIDS Vaccine Initiative, Medicines for Malaria Venture, Global Alliance for Tuberculosis Drugs, the Gates Merck Botswana Partnerships, and many others. By leveraging and mutually reinforcing the assets and advantages among governments, non-governmental organizations (NGOs), organizations, and private citizens, we can find new ways to innovate and create new pathways for more public and private investment.

Our aim today, at the roundtable, is to identify the opportunities to be developed and the obstacles to be overcome in creating partnerships against AIDS. This morning we have invited a diverse, dynamic, and committed group of individuals representing organizations with experience and commitment to partnerships.

And at this time Iíd like to introduce our panel. You all know Scott Evertz, Under Secretary Dobriansky, and Alan Lang. Iíd like to begin with Dr. Drew Altman, the President and CEO of the Henry J. Kaiser Family Foundation. Mr. Morton Bahr, the President of the Communications Workers of American. Dr. Thomas Coates, from the University of California San Francisco. Dr. Richard Feachem, also from the University of California at San Francisco and the incoming Executive Director of the Global Fund. Dr. Helene Gayle, AIDS expert at the Bill and Melinda Gates Foundation. Mr. Stephen Hayes, the President of the Corporate Council on Africa. Dr. Vincent Kerr, Chief Medical Officer for the Ford Motor Company. Mr. Chris Kirubi, a prominent Kenyan industrialist who serves on his countryís AIDS Advisory Council, is the first African to serve on the Global Business Council Advisory Board here in New York, Dr. Lynn Marks, the Vice President at Glaxo Smith Kline in infectious diseases. My colleagues Dr. Anne Peterson, the head of the Global Health Bureau at the Agency for International Development, and Dr. Eve Slater, the Assistant Secretary for Health at the Department of Health and Human Services.

With that, I would like to invite Dr. Slater to speak a few words on behalf of Secretary Thompson, who told me personally he want -- how much he wanted to be here for the entire morning, but could not, and thank you for coming on behalf of the Secretary.

Dr. Eve Slater: Jack, thank you very, very much. Under Secretary Dobriansky, Jack, thank you, Dr. Evertz, Chairman Lang. A pleasure to speak on behalf of Secretary Thompson who, indeed, would have very much have preferred, I think, to be here this morning. But itís my pleasure to deliver some comments on behalf of HHS.

We certainly appreciate the huge global challenge as has been summarized by the speakers at the first panel and that surrounds our day-to-day activities. We are very much encouraged by the successes of biomedical and behavioral research supported by Health and Human Services to prevent, treat and control HIV infection and its clinical manifestations. Together, these interventions have had significant impact on controlling the HIV/AIDS epidemic in the United States and worldwide.

The Presidentís budget plan for fiscal year 2003 includes a total of $12.9 billion within Health and Human Services to fight HIV/AIDS and the federal budget proposed is in the order of $16.1 billion. Our most important research involves developing vaccines to prevent the disease, an area in which we are making progress. This year the NIH will spend more than $2.8 billion total on HIV/AIDS research, and that includes approximately $220 million to support international HIV/AIDS research and infrastructure building.

We are encouraged by our success and prevention, a proven strategy that is cost effective. We have developed sophisticated medical and public health systems to implement and monitor and evaluate HIV control activities, including in particular, voluntary counseling and testing. We know what our priorities need to be in arresting the spread of HIV around the world. First, dramatically reducing HIV transmission from mothers to infants. Second, delaying sexual initiation and encouraging abstinence and healthy lifestyle choices among young people. Third, protecting the blood supply. Fourth, reducing the incidents of sexually transmitted diseases. And five, diverting individuals from injection drug use into drug treatment programs.

We have found that working with community based organizations who often have relationships with local business communities is an effective way to lessen the impact of the epidemic on individuals, families and communities. And through our Health Resources and Services Administration, we have developed a clinical network that provides a continuum of care for persons living with HIV in the United States. We know anti-retroviral drugs can reduce the level of the virus in the body and prolong lives; however, treatment is far more than just antiretrovirals.

For more of those infected individuals, they need community support as well as basic primary care, and the special care for opportunistic infections, such as TB and for prevention, the care and treatment of sexually transmitted diseases and opportunistic infections of all sorts. To bring the benefits of this range of treatment to more people, we should help upgrade the basic systems to provide the needed medications for symptomatic care. We should also begin building the more complex systems needed to provide more sophisticated medicines to safely and effectively avoid creating resistant strains, a lesson that has been learned all too hardly from the efforts to control TB.

Youíve heard about the Mother-to-Child HIV Prevention Initiative. I wonít dwell on that initiative, but simply applaud it. This past spring, Secretary Thompson led a delegation of government, religious, and other nonprofit organizations and private industry to Mozambique, South Africa, Botswana, and the Cote díIvoire, in order to see firsthand the challenges that their healthcare systems face especially in light of the spread of HIV/AIDS across the region.

There he visited with government officials and made several site visits to witness the progress and achievements of several public-private partnerships. Discussions took place to work together to prevent transmission, to address the growing number of AIDS orphans. Secretary Powell said estimated to exceed 40 million by the year 2010, and to expand programs and services to support those most at risk. Our Centers for Disease Control and Prevention at HHS has provided expertise and support with the Ministries and local NGOs in those countries to develop voluntary counseling and testing facilities.

While in South Africa, Secretary Thompson signed a cooperative agreement between the Department of Health and Human Services and the American Center for International Labor Solidarity, which will be investing almost $1 million to strengthen the capacity of South African trade unions to develop and implement effective HIV/AIDS prevention.

Additionally, he visited the Ford Motor Company in Southern Africa and was awarded Secretary of Stateís Corporate Excellence Award for its -- which was awarded to the Secretary of Stateís Corporate Excellence Award for its exemplary HIV/AIDS program that it created with the assistance of our department. The Africa trip succeeded in proving that public-private partnerships like the Global Fund to Fight AIDS, Tuberculosis and Malaria, are essential. Commitment at all levels is required.

So, Iím therefore very pleased that this topic of discussion has arisen. I look forward to being part of the further discussions today. Thank you, Jack.

Dr. Chow: Thank you, Dr. Slater. We also invited a very special guest to join us today and that special guest was Ambassador Richard Holbrooke, who now serves as the President of the Global Business Council on AIDS. Unfortunately, his schedule could not -- did not work out and as many of you -- Ambassador Holbrooke spurred the United Nations to hold its first Security Council Meeting devoted to HIV/AIDS. And we at the State Department appreciate and are proud of his tenacious efforts to raise HIV/AIDS as a compelling foreign policy challenge for the United States. We asked him if he could tape a message to the forum and he graciously said that he would. So, if we may go to the tape to hear our message from the Ambassador.

Mr. Richard Holbrooke: I want to congratulate the open forum for holding this important meeting today on AIDS and to express my deep regret that I am unable to join you because of a prior commitment. I especially want to congratulate Secretary Powell whose leadership on the HIV/AIDS issue since he became Secretary of State has been exemplary and in the highest traditions of expanding the definition of what the State Department should do. And all of you today whoíve come to this meeting because it matters.

In my view, and Iím speaking now as a man who joined the foreign service as an FS-O8, we had FS-O8s in those days -- in 1962, 40 years ago -- I donít think thereís been an issue in our time, not even the great issues of war and peace and terrorism, which is anymore important than HIV/AIDS. It is not only the worst health crisis in 700 years and it is that. Itís also a social and economic crisis that will destabilize countries politically and create security problems not only in that southern tier of Africa, but in other parts of the world if itís not addressed frontally.

The United States must take the lead in this. Iím glad that the Bush Administration has increased the amount of money for this issue and is also paying attention to related problems such as malaria and tuberculosis. I was recently in South Africa and Botswana looking at this problem in my capacity as President and Chief Executive Office of the Global Business Alliance against HIV/AIDS, and what I saw there only reinforced my view that this issue must be addressed very rapidly.

All of you know what awesome infection rates there are, but I want to stress two points. One, the death rate in the highly affected countries is only now beginning to rise because most people are still HIV positive and they donít have full-blown AIDS. So, what weíve seen is just the proverbial tip of a terribly large and awesomely dangerous iceberg. Secondly, of all the statistics that Iíve heard about HIV/AIDS and the ones youíre hearing today, the single one that I think is most dangerous is that 95 percent of the people in the world who are HIV positive do not know it and they are wittingly or otherwise spreading it.

The fight cannot be restricted just to governments and NGOs. It must include the corporate sector. And so, when I left the United Nations post last year at the suggestion of Kofi Annan and with strong support from my friend, Colin Powell, I agreed to become the head of the international effort focused on corporations. Now, we now have increased the size of this organization, the Global Business Council on HIV/AIDS, from about 15, six months ago to over 55 today, including some of the great firms in the United States and around the world. Coca- Cola, American Express, AOL Time Warner, AIG, Unilever, Heinekenís, Daimler Chrysler, and even mining companies like Anglo American, which employs 90,000 people in South Africa have all joined. We have relationships now, partnership relationships with the Confederation of Indian Industries in New Delhi and with the Business AIDS Councils in Botswana and South Africa and weíre spreading.

But I need to say frankly to all of you that businesses have done only a fraction of what they should be doing, only a fraction. Companies with important overseas efforts, with employees overseas, need to clean up their own workplace and extend testing, counseling, and I believe treatment, although thatís expensive and controversial, to their workers. They must create islands of non-AIDS invasiveness in the terrible epidemic that is raging.

And those companies that donít work heavily in the highly affected areas, and again I stress itís not just Africa, although Africa is the epicenter. It is also India. Itís also China, Russia, Ukraine, and the Caribbean, and many other parts of the world. Companies which do not work in those areas, but share the corporate social responsibility, which should be part of every major corporation, can participate by supporting the Global Business Council, by working with the State Department, by urging foreign governments and other people to take the appropriate actions.

Again, Iím very sorry I canít be with Secretary Powell and his Cabinet colleagues today, but the fact that several of them have joined him today attests fully to the enormous importance of this issue. Even after September 11, even as we fight the war on terrorism, whose success is in my mind absolutely assured given our strength and our strong leadership, it is all the more important to recognize that HIV/AIDS is not going to go away. It will require sustained effort, which in a sense, is another kind of war in and of itself. I hope the Foreign Service, the State Department, under Secretary Powellís leadership, will make this one of its top priorities. Thank you.

Dr. Chow: A good round of applause for Ambassador Holbrooke. Thanks you. Well, weíll delve right into the discussion. Iíll put a variety of questions to our panelists that will cover a variety of topics. Please let me know if youíd like to speak.

First, I would like to start with the Global Fund as the most recent partnership to be created and weíre delighted to have Dr. Feachem. And I would like to put the question to him is, what is your vision for how the private sector, including the foundations and companies, how can they best contribute to the work and the mission of the Global Fund? Dr. Feachem.

Dr. Richard Feachem: Well, good morning. Good morning, ladies and gentleman, and a great pleasure and honor to be here. And thank you, Ambassador Chow, and Iíd like to recognize also your leadership in mobilizing the international response to HIV/AIDS and the other great killers of poverty.

Iíd like to just say a very few words about the Global Fund and then come to your question, specifically, around public-private partnerships and the role of the private sector. Echoing whatís already been said this morning, Iíd like to emphasize that HIV/AIDS is the worst health tragedy in recorded human history. It is already worse than the Black Death in Europe and Asia Minor in the 14th Century. And I emphasize already worse, because if we continue as we are at the moment this pandemic will not peak before 2050 or 2060. So, these are early days in the unfolding disaster of unparalleled magnitude and the magnitude is already unparalleled.

As Ambassador Holbrooke emphasized, the vast majority of people who are going to die are going to die in the future. And our response to this unfolding tragedy, as other speakers have emphasized, has been woefully inadequate and history will judge us poorly. There has been far too little done and still in many parts of the world we have denial or semi-denial around the existence of the problem, the nature of the problem, or the magnitude and devastation that this one virus will cause.

And the Global Fund has been created to transform this situation, alongside other initiatives and working in partnerships with many other organizations, its mission is, I think, no less than to turn this situation around and create a transformation. The Global Fund, as you all know, will also invest into other great killers of poor people everywhere in the world, tuberculosis and malaria.

In the case of tuberculosis, a disease that is getting worse everywhere. A disease thatís riding on the back of HIV in a very successful and lethal way, but a disease where there is much that we can do and much that we know how to do.

And malaria, the disease within tropical Africa is responsible for one-quarter of all under five-year-old deaths. The disease that African mothers fear most. Visit any African village and talk to mothers about what really scares them and youíll hear malaria rather than HIV or TB. The fever that can so quickly lead to death in a young child. And again, there are many things that we know how to do and that we can do to significantly reduce quickly the devastating toll of malaria particularly among children.

Coming now to the participation of the private sector in the work of the Global Fund and in the bigger enterprise that weíre all engaged in. To me, it is absolutely vital and can be described in three ways and Iíll do that very briefly. The first role might come under the heading of Corporate Good Citizenship, Corporate Good Global Citizenship. Small companies and large companies, national companies and multi-national companies can do far more with their own workers, with the families of their workforces and in the communities in which they work and in which they have a substantial presence.

They can do far more to build islands of good practice with relation -- in relation to HIV prevention and therapy, islands of good practice in TB diagnosis and treatment and islands in good practice of malaria prevention and malaria treatment. And we see some early exciting examples of this, but there is a lot further to go.

Iíve just noticed that this bottle of water that Iíve been kindly given by the State Department is actually made by Coca-Cola. So, they can deliver water to the State Department. They can also deliver HIV prevention throughout Africa and letís work with them to make sure that actually happens.

A second category of private sector engagement is the pharmaceutical and biotechnology industries. For the three diseases that I have mentioned -- HIV, TB and malaria -- we desperately need better drugs and we need them fast. We desperately need better diagnostics and we need them fast. And for all three diseases we need vaccines that work and we donít have them at the moment.

And those are tasks of the pharmaceutical industry and the biotechnology industry. Those are tasks that the pharmaceutical industry and the biotechnology industry are already engaged in, but that engagement needs to grow. And part of the growth of that engagement will come from the incentive structure that says to those companies, there is a market. There is someone to buy these new products, if you invest in the R&D and bring them to the marketplace and the Global Fund is part of that changing market environment. It provides new purchasing power to bring those products to poorer people to poorer countries, people who, in some cases, cannot afford to purchase those products themselves.

And the third category of private sector engagement, which I sometimes feel is the least spoken about but perhaps the most important, is service delivery on the front line. For each of the three diseases, malaria, TB, and HIV, and for any country that you could choose to analyze or visit, there is no plausible case that you can make that the government infrastructure alone can deliver what needs to be delivered to turn these diseases around. There is no country where the public infrastructure is capable of delivering all the preventive and curative responses that are required to significantly impact these three diseases.

And so the role of the non-government actors is absolutely essential. And those non-government actors are many. They include NGOs, both local NGOs and international NGOs. They include faith-based organizations, such as the great chains of Christian -- either Catholic or Protestant -- hospitals throughout Africa. In many African companies, roughly half of all hospital capacity is in the hands of Christian organizations collaborating with government.

And thirdly, it includes private sector, sometimes for-profit delivery channels that can effectively bring needed goods and services to people in remote areas. A very good example of that is bed nets in Tanzania. If you want to buy a bed net in Tanzania, go to your local small trader. Donít wait for the government to provide it to you, because youíll wait a long, long time. Itís your local small shopkeeper who will provide you with that bed net at a very reasonable price and the government can always step into subsidize it if you are too poor to meet the $2.50 or $3 cost of that bed net. And soon, as a result of investments from the Global Fund, those same small traders should be able to supply impregnated bed nets, which are so much more effective than bed nets themselves.

So, absolutely crucial and vital roles for the private sector and Iíve mentioned some dimensions of those roles. In conclusion, Dr. Chow, let me just mention that the commitment of the Global Fund is to bring hope, to make a difference, to get money and in some cases significant sums of money to those on the front line who are doing good work, and to do this in a way that involves low transaction costs and produces measurable and demonstrable impact on the three great diseases that we are tackling.

We will need to do this with continued strong support of the United States Government and the continued strong support and partnership of the many organizations represented in this room today. I thank you very much.

Dr. Chow: Thank you, Dr. Feachem. Any comments? Mr. Bahr.

Dr. Morton Bahr: For about the -- well first, let me say that there -- in every one of the countries that weíre speaking about, thereís a -- thereís a labor movement on the ground. Africa, the Caribbean, and everywhere else. For the past two years or so, I have been using every forum within the international labor community to stress the importance of the international labor movement to develop partnerships, both with private industry and government. Little has been done.

Iíve also spoke in connection with the spread of HIV/AIDS, and as Secretary Powell spoke this morning, the need for education. That if we had a much narrower digital divide, for example, between the United States and Africa, the ability to disseminate education would be a lot easier. For example, according to World Bank figures, the date that the 100th millionth American had access to the Internet, there were only 600,000 in the whole continent of Africa who had access.

Thatís a problem weíre dealing with and probably because weíre in the communication industry, weíre more conversant with it. But as a result of repeated conversations and speeches Iíve made, a month ago I was invited to meet with World Bank CEO, Mr. Wolfensohn, where we had the opportunity to discuss both the role of international labor in the HIV/AIDS crisis, as well as tying in the need to deploy technology throughout Africa for the purpose not only of disseminating information regarding HIV/AIDS, but to deal with illiteracy, to deal with skills training, to deal with lifelong learning, to deal with telemedicine, a whole variety of things.

The meeting with Mr. Wolfensohn resulted in a second meeting two weeks with the folks at the bank who have the direct responsibility for the AIDS program and they shared a good deal of information country by country. But whatís critically important to me and I think to what the previous speaker spoke about, is that there will be a meeting in October in Washington of the World Bank and some 60 global labor leaders where this issue will be on the table. It will be on the agenda for direct involvement of the international labor community in partnership with industry and government around the world. So, I think thatís a strong step in the right direction. A long way to go, but progress comes slowly.

Dr. Chow: Thank you, Morty. I turn the floor to Drew.

Mr. Drew Altman: I want to thank Paula Dobriansky for giving me credit for this idea. I assume the usual rules apply, which are that it will be viewed as the Secretaryís forum if it is judged to be successful, otherwise it will be viewed as Drew Altmanís idea.

Speaking of the digital divide, I also want to mention one of the contributions I hope weíre making to this meeting, one of those cameras is from Kaisernetwork.org. We are webcasting this session through our free health information service worldwide. We cover about 300 important health related events a year. So, if any of you anyplace -- any of you here have an important event that you would like to bring to a broader audience, please just let us know that. Thatís what weíre there to do.

I know Iím here as a representative of the foundation community along with Helene, so one thing I want to say very clearly is, that Iím not here to preach to the others. While there has been some real foundation leadership, itís also true -- especially Gates -- it is also true that there are only a handful of the major foundations that are involved in global HIV and so foundations really do need to do more.

I thought about what I would emphasize today and I decided that my main theme today would be the importance of youth and young people as global HIV is increasingly becoming a youth-driven epidemic. One-half of all new infections are young people at 7,000 infections a day. In South Africa where we have worked for 15 years, there are 12 million kids, 6 million of them will die as a result of HIV if things donít change. In Barcelona, we will be releasing new projections about young people and HIV, which are very frightening to me.

And it was for this reason that we played a role in organizing and in funding, along with the Gates Foundation, the loveLife program in South Africa, which is the worldís largest HIV prevention program for young people. And in a nutshell, it is a powerful combination of media messages nationwide and a broad range of services nationwide. All of them underscoring an upbeat message about positive lifestyles and responsible decision making, which is already starting to show results in terms of significant numbers of kids abstaining from sex, delaying having sex, reducing numbers of partners, practicing safer sex, and just moving their lives in a more positive direction, because itís a program that goes far beyond HIV with computers and sports and so forth.

But there are two lessons from our experience in South Africa, which I think are germane to Jackís charge and to this forum. One of them is that big public-private partnerships in big countries really can happen. Itís not just soft, warm and fuzzy words, public-private partnerships. So that, for example, loveLife is a partnership between U.S. foundations, leading South African NGOs, it is itself an NGO, the South African government, which has been a partner from the start and a major funder, and South Africaís largest media companies. And most recently, the Mandela Childrenís Foundation has joined with a $3 million commitment and a major commitment has just been made richer by the Global Fund, which is just critical, indispensable to the future of this program.

So, itís an important model for this discussion, because if you think about it, itís South Africaís HIV prevention program for youth, but itís not a government program. Itís a public-private partnership. And the other point that I want to make about it is that, as Iíve been around and worked on this issue and if you think about the many roles that companies can play and the private sector can play, the companies who I think are uniquely positioned, especially when it comes to reaching youth, are media companies and you see that also in loveLife. The SABC and the independent newspaper group have made unprecedented commitments, $13 million a year in real commitments, 5-year commitments or multi-year commitments.

And the same is true of our biggest media companies and the worldís biggest media companies. We have operated partnerships for years with MTV, BET, Nickelodeon, Univision focus on HIV. These work. Theyíre powerful. A million kids in a short period of time calling a hotline and weíre looking forward to announcing a new partnership of global reach with MTV International in Barcelona. So, I think media companies are especially positioned to play a very, very broad role.

And one idea that Iíd like to push, which I think could take a push from a President or a Secretary or a Secretary General, is that every year each of the major media companies announces their pro-social campaign and priority and they all do different things, but they do a lot. I would love to see the leaders of all of the largest media companies stand up together and announce that next year that in their own ways they would all make HIV their number one priority. I think that would be unprecedented but also profoundly important, and perhaps, achievable. Viacom in particularly deserves credit for already taking significant steps in this direction.

Finally, Scottís remarks were very powerful to me and there is no substitute for seeing not just the problem, but the solutions that are out there firsthand. We recently took a group of very prominent U.S. journalists to different parts of Southern Africa, so I extended an offer, which is that if there is interest in a follow-on effort, bringing a group coming from this forum to Southern Africa to see all kind of programs firsthand, weíd be delighted to help organize it and play a significant role in it.

Dr. Chow: Thanks, Drew. Does anyone have a build-on comment to what Drew had to say? Lynn.

Dr. Lynn Marks: Thank you, Dr. Chow. I especially appreciate the opportunity to participate in this open forum. I think thereís been a myriad of themes that are very positive that weíve heard from the introductory statements and then the ones weíve heard already. Those center around partnership, which again I think in terms of my company and/or other large pharmaceutical companies, the number of government and non-government initiatives and foundations in which weíre involved is increasing. I think we can do a lot more but we have a starting point.

I think we also agree totally with the ideas of the importance of education and the multitudes of ways in which we can move forward and across the world such as Dr. Altman mentioned. And then we have the focus on mother-to-child transmission, which for our company has been a long-term commitment in terms of recognizing that importance. And itís impressive to see the magnitude of the commitment to that initiative and the importance that that can play in world health.

And then there was talk of the future and the importance of innovation, and I think Dr. Feachem speaking along the lines of not only this epidemic, the HIV/AIDS epidemic, but also the importance of malaria and tuberculosis. And our company is committed to finding research and development into vaccines and medicines for HIV/AIDS, malaria, and tuberculosis and we will continue to do so. So, I think thereís a lot of common ground, a lot interest in doing more, the recognition that we can work together, bring our pieces of the puzzle to the table to make a better picture for the future. So, I appreciate that opportunity.

Dr. Chow: Iíll recognize Anne and then Helene to speak.

Dr. Anne Peterson: Thank you and thank you so much for the opportunity to be here this morning, Jack. Iíd like to play off of what a number of others have said and start with not only what Scott said earlier, but Drew. We need to remember that this is not only a daunting time in looking at HIV/AIDS, but a very exciting time. Weíre beginning to see our first successes at national levels and we certainly are seeing successful small programs across the world. One of the things that USAID as an agency tries to do is gather those success stories, hear whatís really working and get it back out.

You have in front of you the Workplace AIDS program. Thatís an USAID funded thing. What Iím getting now and many of us we heard about big companies and what they can do in partnerships, this is a time where we can really do some big partnerships. Iím hearing from the big companies, "Weíre doing the workplace wellness for our staff. Now, where do we go?" And thereís been some very innovative thinking about how do I reach out now to communities around, to media training. Weíre trying to promote some of those things that again, Best Practices.

I will say that one of the biggest challenges facing me within both supporting the Global Fund and our bilateral programs is the scaling up of the small successes that we have, places where we donít have a big partnership that can reach out very broadly, but within the orphan care issue is a great example. How do we take some wonderfully successful small projects and make them bigger, broad enough or multiple factors of them enough to take care of the scope of the problem?

And I heard several people talk about other networks. Dr. Feachem mentioned the NGOs and the faith-based organizations. I think we need to remember that small businesses, faith-based organizations, private sector, the small marketplace shops that are selling the malaria net, those are places also that we have to reach out to a broad network of little groups to scale up our response to the problem. So, I think itís the combination, and maybe the media will be key to that as well as our networks that go out very far or the big companies like Coca cola that reach out very far, to draw in many new partners.

So, I would encourage us to think about how do we gather the success stories? How do we bring the success stories back out to the big partnerships, the corporations? But then, how do we also mobilize the main networks of much smaller groups who are often on the ground in communities and really transforming? And as much as USAID can help, we are willing, excited and really looking forward to that.

I certainly work in my own life on both ends of this, both private sector, government sector, on the ground, in Africa, care deeply and would love to find new ways of working with the private sector to move this forward. Thank you.

Dr. Chow: Let me recognize Helene.

Dr. Helene Gayle: Yeah, thank you and Iím very pleased to be able to be part of this and want to thank you, Jack, and Scott and Paula, all of you for your leadership in these efforts. Because I think it really does make a big difference to those of us who are all in this together.

I just would like to talk a little bit about the public-private partnerships, but perhaps from a slightly different perspective, why itís so important for HIV/AIDS particularly. I think, you know, we talk about public-private partnerships. We all know theyíre good things. We talk about it as motherhood and apple pie and, you know, I think sometimes we forget why they are so important and particularly why they are so important for this disease. And I was listening to Drew talk about the loveLife program, it kind of brings to mind a lot of the reasons why it is particularly important for us to remember the relative roles that all the different partners can play, particularly for HIV when weíre dealing with a disease that is primarily affecting -- primarily transmitted through sexual transmitted -- transmission and use of drugs as well as mother to child transmission. But by definition is linked to very sensitive issues, linked to issues that are oftentimes very controversial, and often affects the populations that are already most vulnerable in our society, oftentimes more stigmatized in our societies.

And I think itís for that reason as well as all the reasons that we already know, that these public-private partnerships are so critical to make a different in this disease, where the ability to reach out to communities at greatest risk can oftentimes not be done by public sector and governmental organizations, oftentimes needs to be reached non-governmental organizations, faith communities that have such a large role in shaping community norms and society norms.

And I think, we need to think a little bit more sometimes and get past the simplistic notion that these things are good, but really why is it particularly important for HIV, and how can we make sure that weíre all doing our relative roles. The role of the government sector has to be very different than the role of the private sector and the business community. I think we need to think a little bit more about how we make sure that weíre doing strategizing and coordinating our roles relative to this issue, perhaps better than we have.

And I think in HIV, because of the necessity, because of the urgency of it, we are seeing different sectors come to the table like never before and coordinating like never before. But I think weíve got to think about how do we do this in even a more coordinated way. No matter how much our resources continue to grow, weíre still being outpaced by this disease. And so, our ability to really think and be a little bit smarter, a little bit more strategic about how we play off of each other as complementary, I think, is gonna be particularly important as we face the challenges that everybody has thrown out.

That we are just at the beginning of this epidemic, we have not yet faced what all the real challenges are going to be. And as we continue to have a disease that peopleís social vulnerabilities are as much at the root of this as the virus, weíve got to think about being smarter in the way we work together.

Dr. Chow: Thanks, Helene, and Iíll just note that the Gates Foundation has a seat on the Global Fund Board and you have been a focal point for the other foundations to think through and coordinate your thoughts on how foundations contribute to the Global Fund for an -- as an example.

Dr. Gayle: And I just, since you brought up Global Fund, I just do want to say I think this is another area where we are not yet where we need to be. But I think weíre gonna get there because we recognize how important having that be a different kind of mechanism than weíve had before. One where we can kind of come together around the table, pool our different interests, and again, be complementary in the way we act. I think itís going to make a big, big difference in the way we move with the Global Fund. So, weíre all excited about Richard joining soon.

Dr. Chow: Stephen Hayes from Corporate Council on Africa.

Mr. Stephen Hayes: Thank you, Jack. Thereís -- listing in here, thereís so many things that I want to say or respond to, but I also on Heleneís statement, congratulations to you for putting this together because I think the role of government is to bring people together. And itís one of the few instruments I think where a lot of disparate parties who normally clearly donít sit down together will, and so, I would encourage you to continue that.

Two things Iíd like to outline. One is the Corporate Council. For those of you who arenít familiar with the Corporate Council on Africa, itís a 185 corporations who are members. All are doing business in Africa. They range from the Fortune 500 companies to small businesses. Collectively, our members represent about 85 percent of all U.S. private investment in Africa. We had a task force on HIV/AIDS in Africa. We are now in the process of -- that report has been out some time. We are now in the process of hiring, interviewing staff to work with corporations.

Out of our 185 members, perhaps -- as I was sitting here thinking -- perhaps as many as 50 but probably no more, have an HIV/AIDS policy in Africa. So one of the -- clearly, one of our goals is that every member has an HIV/AIDS policy working in Africa, particularly for the workplace, and particularly our recommendations are also to include the families of workers. I think that someone had mentioned itís economically not feasible to do that. I would disagree. I think that good studies coming out of, I think, Boston University is showing that, in fact, it is economically feasible and in the best interest of companies to expand the service on HIV/AIDS.

But clearly not enough is being done and clearly there is some -- there are some signs still that tough times are ahead. U.S. investment in Africa is actually at its lowest level in 25 years and in the first quarter of this year shows that that investment is running one-third below last year. I think an integrated approach to AIDS has to take place and the trouble with about talking about islands of success, I think that there are really no islands of success as long as the disease overwhelms everything else.

I think we have to come to an integrated approach so that thereís -- it canít -- success canít be isolated just like the disease, itself, canít be isolated so easily. We have -- we have to go beyond and expand our vision of that. Itís not enough for islands of success. They will simply be islands in the sea of poverty and disparity otherwise. I donít think, I donít think that unless -- unless we are ready to address the economic problems in Africa that weíre gonna be able to find what cures the -- what cures HIV/AIDS or TB or malaria.

And if we have to address investment, to address the issues of poverty and in that way I think I agree with President Mbeki (?) that the issues also involve poverty. So, we have to take a much more integrated approach, especially at the government level. How do we increase investment in Africa? How do we increase the business linkages? And how do we especially address the issues of infrastructure? Yes, some of our corporations are showing great programs. Coca-Cola is, in fact, looking at using their network, which is probably the most successful distribution network in Africa, using that network to distribute information and education on AIDS. But until thereís a -- until thereís adequate infrastructure in Africa, youíre not going to be able to deliver. Coca-Cola can only do so much. So, there needs to be an economic vision of how we increase economic opportunity, how we increase infrastructure in Africa, and how we invest the corporate community in planning.

The corporate community and labor market is coming together in some areas. Daimler Chryslerís program is an outstanding example of that. And in fact, it was so awarded in part because of labor and management working together. But so few corporations are involved, and I would say so few labor organizations as well, are involved in national planning -- planning forces in Africa, partly because national commissions have not been established in many companies in Africa to address HIV/AIDS. So until those commissions are working, thereís going to be a tough time.

This is where government, U.S. Government, can play a role in working with other governments to form national planning forces on AIDS and making sure that the corporate sector, the labor sector, and the nonprofit sector is involved in those national planning forces. Clearly, theyíre not. We have a long way to go. So, my argument of placement would be that we need an integrated approach. There does have to be some leadership from government as well and we have to be working together.

Dr. Chow: Thank you, Steve. Next Iíd like to -- since he spoke on infrastructure, I turn to Tom Coates as we get into more specific ideas on ways to improve public health infrastructure. Part of the Presidentís plan last week includes the proposal to create a hospital twinning projects, that is to say pairing American hospitals and medical centers with their counterparts in Africa for the purposes of training and conveyance of skills. And Dr. Coates at UCSF has been a pioneer in talking with his colleagues in Africa. And Iíd -- I would like to yield the floor to you and ask you to share our ideas on this idea.

Dr. Thomas Coates: Thank you, Jack, and thank you everyone for hosting this panel today. Itís really an unprecedented opportunity. It seems that a common theme of the morning is how will history judge us. Will it judge us well, or will it judge us poorly? And the answer is yes, probably both ways.

Dr. Slater mentioned the NIH budget for HIV/AIDS, 2.8 billion, unprecedented in the world. The contribution of this government to the scientific understanding of HIV/AIDS is truly remarkable. Two hundred million, over $200 million of the NIHís budget is going into international research and capacity building.

We at University of California, as well as all the other major academic medical centers around the country, are participating in that kind of work and have experience what can happened with research capacity building through the NIH programs, particularly through the Fogarty International Center. Weíve trained over 160 individuals at UCSF. Weíre not alone. Weíre not unusual. Some of whom have gone on to get advanced degrees at the University of California Berkeley, others of whom have gone home, then, to assume important positions. For example, one of our graduates is the head of the National AIDS Control program in Brazil and other places like that.

The concept is a very simple one. Letís take that same concept and apply it to clinical care. We know that how long people live in clinical care is a function of whether they have access to life saving medications, but also whoís prescribing those lifesaving mediations. And we in the U.S. and in Europe and in other places have built up a large repertoire of experience. So, the notion is a very simple one, to pair U.S. institutions with developing country institutions for the purpose of allowing exchanges. Residents, house staff, medical students, faculty traveling there, living there for three, four, six, twelve months. The same thing in return. It not only will help us to build capacity in the area of care, but also to really develop another set of advocates for this -- for this initiative.

But thereís also another kind of twinning that Iíd like to put on the table, and that is the twinning that can occur when we in the HIV/AIDS arena look at other causes. And probably one of the most important turning points in at least recent history was in 1989, when the South African government abandoned Apartheid. And one of the reasons that that came about was because of the role that many American corporations played, particularly in the adoption of the Sullivan Principles. And the Sullivan Principles were relatively simple, 184 companies signed on and it called for non-segregated work places, fair employment and pay, improved schools, housing and training. And it seems to me that we need to derive a set of Sullivan Principles that will apply to the HIV/AIDS issue.

If one looks at that sector of the population, I guess the second -- so the second point I want to make besides history judging us poorly and also judging us well, is that HIV/AIDS is so compelling to us because it feeds on social inequity. And at the same time that weíre trying to solve the medical and public health problems, weíre also grappling with this issue of how do we deal with social inequity, economic inequity.

But particularly -- a particularly insidious kind of inequity is gender inequity. Sixty-five percent of people living with HIV in sub-Saharan Africa are women. And women, if one follows a cohort of young women from the age of 12 to 25, by the time theyíre 25, 30 to 40 percent of them will be HIV infected. Women are disproportionately affected. So, perhaps we could derive a set of principles that -- you know, thereís so much talk about what can workplace do and this and that and the other thing.

One thing, one simple activity would be to learn from the Sullivan Principles and say, "Well, letís apply principles of gender equity." Equal economic opportunity for women, equal pay, equal job security, micro finance credit schemes, preferential support for women-owned businesses, industry sponsored education for employees, daycare, reproductive health.

Now, itís interesting that the Global AIDS Fund is organized along the lines of infectious diseases -- AIDS, TB and malaria -- but thereís another dimension, reproductive health -- access to reproductive healthcare, access to medications, pre- and post-natal family leave time -- and Iíd like to see that as a single initiative that goes forward. So, I think there are multiple twinnings that can take place that could make -- that could be concrete, and things that we could do within the next year that would absolutely make a difference. Thank you.

Dr. Chow: Next, I turn to Chris Kirubi. You and I have had conversations about poverty reduction in the fight against AIDS and weíd love to hear the viewpoint from you as an African representative here today.

Mr. Chris Kirubi: Dr. Chow, my first is to say many thanks to the American government through the Secretary Powell, (inaudible) and everybody else involved in this for organizing this forum today. I wish this forum happened 20 years ago. We have AIDS 20 years to date. Chris Kirubi, who am I? I was awarded twice in two years in Aruba at Price Waterhouse investigations as a leading businessman in East Africa.

And because of that I found myself thrown into the arena of taking on the responsibility of highlighting the issues on AIDS infections, what it does to the business. I realized my business and those of others was in jeopardy, and we will have no business to talk about if we did not address the issues we are talking about today. We canít talk much more than what Secretary Powell said today about the issues of what AIDS is all about, and I do believe, again, it is the worst enemy the world has ever seen.

My appeal to all of you is to ask you, can we take the issues of these epidemic with the same vigor, with the same determination that we took September 11 when the terrorist attacked New York and Washington. We in Kenya, where I come from, but really I come from Africa were also a victims of a terrorist attack. We lost a lot of people in Kenya. Tanzania did the same and, therefore, we do feel and we share with you the grief that happened on that day. But it was very, very admirable the way the community here reacted to that incident.

AIDS is killing more people every day than those killed with that incident in New York and Washington. And therefore, I feel very strongly that we can do more and really galvanize on how to deal with these silent, very dangerous enemy of the world population. I also must thank the NGOs, the USA, and other organizations that have quietly through very difficult times have tried to grapple with this issue of the AIDS epidemic.

But I also must make it aware that we have focused too much on access to drugs. Access to drugs is the end tail of failed policies, because the drugs do not cure, they only prolong your life. Why canít we focus on preventing people from getting AIDS?

Our children from the ages of 11, 10 years even, are all victims to AIDS. Their teachers are dead. We can hardly train enough teachers to replace those who die. I would also like to say AIDS has no discrimination and I would like to caution that can we make sure when resources are available, let us not discriminate the countries to receive those support.

Women donít like the governments, but the poor people have nothing to do with those governments. Weíve talked a lot here about South Africa, but what about Zimbabwe, Rwanda, Burundi and all those other countries? I think we need to look at what is available and equitably share it throughout the region with each of us tainted with AIDS. I must thank those donors like Bill and Melinda Gates Foundation. We have (inaudible), they are visiting us in Kenya. Itís very easy to visit South Africa and to think youíve been in Africa.

I would also like to say that the goals to the new chief objective of that Global Fund reaches must be enhanced and supported even more. But I would also like to ask Richard to do the business of departmental funds. He not different so much for the World Bank and I (inaudible) way of doing things; fast, faster, faster, because each day people are dying.

When we say we will talk about next disbursement two years or six months from today, you just count how many people have died between the first disbursement and the next disbursement. I think what we should have done once this disbursement was done, we should be saying, can people bring more money to the table? How much more can we do to the next country, which missed the first round, because in the meantime lives are being lost?

I really would like also to appeal for a general support to the companies who are engaged in research, so that when they discover and come up with a cure to the treatment of HIV and AIDS, we do not put them under pressure to give these things for free. We will tell them you are partners. We are your partners, for which you have the drugs available at reasonable prices to the poor and afflicted.

I work -- I network with our National AIDS Council and I know how much private sector partnership with the government can have an impact. I can see very clearly the Kenya National AIDS Council is something that the government, itself, can copy what this countryís doing. Iím also a member of the Business Global Coalition, and I do appeal for companies out here to support that Global Fund, because we need them to support the poor little companies in Africa who are not able to survive, leave alone bring up effective programs within their companies.

I happen to be the Chairman of the Private Sector Business Council on AIDS and HIV in my country. And we have to support most of the companies because they have nothing themselves. So, the small companies we put together, they employ too many people and they need support. We cannot ignore them, so, we must come up with projects that work for those little companies rather than to look at Ford and Coca-Cola and we thank you for your support. And I do hope that everybody will have an equal opportunity to protect their workers. Thank you very much.

Dr. Chow: Thank you, Chris. Beautiful, beautiful expression of your heartfelt assessment of the challenges in Africa on AIDS. Next, I turn to Dr. Kerr from Ford.

Dr. Vincent Kerr: I would like to heartily endorse what Mr. Kirubi has said. We talked a little bit before the forum. I think one of the reflections Iíd like to offer this group is HIV/AIDS we think of as a human disease with a human host. But the real host is fear, ignorance, apathy, and the silence that existed for perhaps, 20 years, which allowed this epidemic to be an economic inequity. Those are the true hosts.

And so when I look at what Ford Motor Company in South Africa has been able to do, it addressed those issues primarily. I feel that while that effort has been recognized by the Secretary of State and weíre proud of that, it is as if Ford has brought a cup of sand to this island of success.

And so, the reason I endorse heavily the comments made is that we touched 3,000 workers in South Africa and if you expand that to families, to some friends, to immediate associates, it is still but a drop. More people are employed by small businesses, and to echo Colin Powellís words, Secretary Powellís words, we need to find a force multiplier and it is the small businesses. Because all this turns on, I think, the micro-interactions of people to people being able to influence what happens, not the macro.

And that would be my offering to this group. I think what we bring is the ability to share materials, to share policies, to share how we train our peer-to-peer interactors, counselors, but magnify it through the multiple of small businesses that exist in these countries.

Dr. Chow: Thank you, Vince. Steve.

Mr. Hayes: I just want to reiterate, or echo the small business concern as well. There are different models to work with on AIDS, particularly in Africa. There are certainly the models for what the large corporations can do, but half our members are small businesses, and those are the companies that particularly lack a policy on AIDS. But also, I think there -- unless there is investment, particularly from the small business sector, which is one of the United States greatest strength. Eight-five percent of our workforce comes from the small business sector. If we can bring the small business sector together with that and help develop that in Africa, where I think without this with the development of the small business sector and the entrepreneurial success, Africa will not develop to the extent that it needs to. That unless we can bring those together, then Dr. Kerr is exactly right, we still have the small islands of success, while a sea of problems just simply overwhelms us.

So, I think the development of the small business sector, and particularly as it relates to the AIDS policy, could do a lot more for Africa than any one element. Of course, itís only one part and we have to work -- again, actually in the comprehensive approach, I was very impressed with Dr. Coatesís idea. And then that could be something also that could be very, very helpful for all, assuming we can find the comprehensive model that takes in the small as well as the large. Thank you.

Dr. Chow: I opened the floor. Morty, quick question about the notion of twinning. Weíve heard it in a context of hospitals. Iím curious to know your assessment on the applicability of this idea to American labor and working with their counterparts.

Mr. Bahr: As I said, itís been late in coming, but through the effort of President Sweeney of the AFLCIO and now through the International Confederation of Free Trade Unions, I think we do have, in fact, in Kenya and Nigeria, we have the first two places where the National Trade Union Centers are deeply involved in the fight. Actually, have received grants from the World Bank but itís still a drop in the bucket.

So -- but I might just add that weíve been involved with the Pediatric AIDS Foundation almost since its inception. I met Elizabeth Glaser back in 1990 and this was a time when no research whatsoever was being done in Pediatric AIDS. None of the treatments or medications or drugs was applicable to children. And I invited her to address our convention in 1990, not knowing what the reaction would be because there was still -- people were still in the closet, as was Elizabeth back then. The -- she spoke to 2,000 delegates. Her message was just tremendously accepted and as a result the delegates voted to make Pediatric AIDS Foundation our charity of choice.

And since then, with the exception of the Melinda and Bill Gates Foundation, which is pretty good company to be with, weíre the single largest contributors. But -- and we did the pioneering work with the mother-to-child transmission vaccine.

But to put it in perspective, when we first announced that breakthrough, it was at a board meeting at Childrenís Hospital several years ago in Boston and the Chairman of the Pediatrics section -- I think it bears out to what Mr. Kirubi has said that -- let me put this in perspective. What we are now able to do is perhaps give newborn children 10 or 11 more years of life before the disease catches up with them. And so it drives home further that while that -- this is not a single problem, that while we are very happy and are working hard to educate women around the world, thank the Pediatric AIDS Foundation now, and together with the Bush new initiative, it plays right into this. But the Pediatric AIDS foundation is now in 14 countries with active programs at 140 cites. But thereís such a long way to go that we want to expand this through the labor movement.

One last comment. I was in South Africa in 1997, when the three unions at the South African telecom, the black, colored, and Indian dissolved. It was the end of Apartheid at the company and formed the Communication Workers Union of South Africa. I met with the new officers, young, vibrant and enthusiastic and learned that 27 percent of the workforce was illiterate, functionally illiterate.

Mr. Hayes was talking about building infrastructure. Itís practically impossible, if not impossible to build an economy, a 21st Century economy without a first rate telecommunications system in the country. And I suggest that with 27 percent illiteracy, which at the time President Mandela was the one who let these people just flow through the system because of high unemployment, and then let the high school graduates fall behind. But to their credit, the union leaders were not happy to let that happen.

And since SPC, one of our bigger and best employers here in the United States -- I just got a 30 percent interest in the company -- we were able to bring the local leaders to the United States and coming back again this fall, where we put together a distance learning program, which now is being worked with the auto industry through the Council on Adult and Exponential Learning as the deliverer of the service.

So thereís, I think a need for both the trade union movement and corporate America to fully understand that poverty, illiteracy, the lack of education goes hand in hand with the ability to do an effective job in combating the disease. And this is the area that weíre trying to work.

Dr. Chow: Thank you, Morty. Weíll have time for one more comment from Helene and then weíll have to wrap.

Dr. Gayle: Yes, I was just gonna make a follow-on comment to a couple of comments that people have made. Iím very appreciative of all the credit that people have given the Bill and Melinda Gates Foundation. You know, it is a large foundation. Global health is one of its highest priorities and within global health, HIV/AIDS and halting the transmission of HIV, is the highest global health priority.

But I just want to stress, even a foundation as large as the Gates Foundation canít do it alone, and all of the efforts that we do are very much in partnership, very much in collaboration with a range of partners. And people have mentioned some of the efforts weíve been involved in like the Global Fund, like the International AIDS Vaccine Initiative -- IAVI -- loveLife, and I could go through a lot of them.

I guess I just stressed that to say that I think the important part of what weíre talking about is the fact that no one organization, no one type of institution can do it alone. Not only because nobody has all the resources, and part of this is very much a resource issue, but also because in a disease like HIV if we donít all take responsibility for something that really has such a global impact, weíre not going to solve it. And so, it really does take everybody feeling like they are very much a part of this, ultimately, to make a difference, and all sectors of society seeing themselves in this epidemic if we are going to make a difference. And so, you know, we continue to really want to work in partnership broadly.

And I was -- just an unpaid advertisement -- we did recently a working paper on global health alliances. Itís called Developing Successful Global Health Alliances and itís on our Web site and we really encourage people to take a look at it, because it really kind of encapsulates some of the things we have talked about today, the types of partnerships that are appropriate for different global health priorities.

Dr. Chow: Thank you, Helene. Weíll click away this afternoon. Unfortunately, weíve come to the end of our allotted time. I want to thank all of the participants. There are many outstanding ideas that weíd like to pursue. And now, Iíd like to turn the floor over to Under Secretary Dobriansky for any closing remarks she would like to make on behalf of the Secretaryís Open Forum.

Under Secretary Dobriansky: Thank you. First, Iíd like to just go back to where we began in the sense of first thanking Alan Lang and the open forum for all of your support. Iíd also like to recognize Dr. Jack Chow for your leadership and also the tremendous support of your team in putting this entire program together today and in particular, Nancy Carter-Foster. Iíd also like to thank all of you, our participants around the table as well as our entire participants in this entire auditorium.

I just wanted to say a few brief words. First, I was very struck by the discussion that took place here and if there was one single theme, overarching theme, that I think ties all of this together, and that is the strong commitment to public-private partnerships, that to move ahead and we all hope, successfully, thatís what we want, that it is critical, crucial to have strong public-private partnerships.

I was very struck by a number of the comments today, whether itís the Corporate Good Citizenship, the engagement of the pharmaceutical and biotechnical companies and that kind of staunch engagement must continue to grow, that services delivery on the front lines is important and crucial. I thought is was especially important, Dr. Feachem, hearing this from you because in terms of the Global Fund, in terms of the grants that are coming forward, thatís critical and crucial.

And I think, Helene, if I may say, Iím only picking out a few comments here when you said communities is the greatest risk and best be reached by the private sector. That sums it up in this case because you can have supportive governments, but if you donít have also that engagement of the private sector on the ground, that support may not really bring a viable project to fruition and it may not be successful. So that partnership is vibrant.

I have to also mention that Iím very struck by that the fact that this forum really has underscored, I think, very vigorously the role that labor must play in this, that the role of not only businesses, but small businesses in this regard. Weíre not only talking about corporations but also small businesses. The importance of youth, the importance of media, that our emphasis must be placed on the next generation.

And in thinking about the next generation, itís not only the future but itís also about innovation in here, that we have to not lose site about innovation. And no less a core and critical underpinning of all of this is the dealing with the inequities, the inequities that we are confronted in many situations across the globe, and thinking of those creative strategies as to how to combat those inequities.

In conclusion, Iíd just say this. I think we mentioned this at the outset but itís worth noting that our entire proceedings, in fact, have been broadcast to our posts abroad. So everything that has been discussed here today is shared at our posts and, in fact, I know will also be reused when they invite many guests in across -- across the globe.

And I thought about it that really when -- whatís the -- whatís I guess the cornerstone on which this whole meeting has been brought together, is that you have to say that no government, no business, no foundation, certainly no labor union and no NGO can really turn us back on this issue. That we are in this all together and we have to pull together through vibrant public-private partnerships. We have a challenge ahead of us.

This meeting is, as we see it, part of a process, a process that we will come together not only collectively, but I know we have individually with many of you. But we see this as an ongoing process and one in which we want to continue to work very hard and very diligently with you towards our ultimate goal of eradication.

And really, thank you again, all of you for coming here today. And Iíd like to say I think we also should thank you, Jack, and your team, again, for pulling this all together. So, if youíll join me in applause.

Dr. Chow: Thank you, Paula, and thank you all.



Released on July 3, 2002

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