Throughout the rise of the AIDS pandemic, the United States has been the world's largest donor and its most vocal mouthpiece in the fight against the disease. No other country had experienced AIDS the way the United States had. More than any other wealthy nation, it bore the visceral scars of its very own AIDS epidemic. The experience placed it in a position to lead.
During the same period, the United States grew into a position of military, economic, and cultural power unrivaled in modern history. In 2003, the U.S. military budget would come to exceed military spending by the rest of the world combined. Its economy was by far the world's largest, comparable to the entire European Union. The breadth and influence of American culture and values, its "soft" power, was unmistakable. The combination placed the United States in a unique position of leadership.
America's peerless global reach meant that it would be particularly vulnerable to the economic and geopolitical instability the pandemic was poised to beget. It also meant that the U.S. response to the pandemic would have a profound bearing on the global response at large.
The "global community" is generally only as strong as the commitments of its nation-state members. Despite flourishes of leadership from others -- such as the Scandinavian countries, too small to recalibrate the global response by themselves -- U.S. policy consistently set the bar for the rest of the world. By and large, as went the U.S. response to global AIDS, so went the global response.
AIDS is a global catastrophe that requires an international response. It is critical to examine the national leadership of the most affected countries and the global community at large. They are part of the story, and indeed, they are part of this story. However, the primary focus here is the U.S. response: How has the mightiest, wealthiest, most advantaged country in the world responded to the defining humanitarian catastrophe of our time?
In a speech at the Kennedy Center in Washington, D.C., on June 11, 2003, Secretary of State Colin Powell shared the results of a recent analysis his staff had prepared. One could add up all the deaths in the twentieth century from weapons of mass destruction, Powell said, multiply that number by ten, and it still wouldn't equal the number of people that would die of AIDS in the next twelve months. Months earlier, a Washington Post editorial suggested that the pandemic was probably "the most underestimated enemy of all time."
Throughout the pandemic's twenty-year flight, the United States has shrunk from its strategic imperative and its moral obligation, failing at almost every turn to lead a comprehensive global response to the pandemic. The account herein tells an inglorious chapter in our glorious national history. Yet, the exploration that follows has been spurred by a profound faith in the singularly American capacity to harness its unique sense of mission to achieve a transcendent aim. It has been driven by a hope that history might evince the mistakes of the past, so they need not be the mistakes of the future.
The U.S. response is a very human story, and it is told here as such.
This is the story of The Invisible People. It is the tragedy within the tragedy. It is about our refusal to see them.
Sauntering through the halls of yet another international health conference on a soft summer day in June 1983 in Arlington, Virginia, Dr. Joe McCormick wasn't entirely in his element. Forty years old, McCormick had already become the head of the Special Pathogens Division at the Centers for Disease Control, or CDC, the world's technical center of excellence for the surveillance of disease. McCormick's job was to hunt down emerging and reemerging infectious diseases. That meant frequent trips to formidably intemperate far-flung corners of the globe. McCormick would identify the disease, take stock of the scale of infection, and, when possible, take the steps to control the outbreak.
It was a life of science and adventure that, growing up on a farm in Indiana, was well beyond McCormick's wildest boyhood dreams. With his slight country accent, intense eyes, and mischievous scowl, McCormick appeared every bit the part. In a division of "virus hunters," McCormick had earned himself special distinction -- colleagues knew him as a "disease cowboy," the public health equivalent of a Delta Force captain.
Despite his preference for fieldwork, McCormick's presence at the conference was crucial. Over the past several years he had become one of the world's leading experts on hemorrhagic fever, the topic at hand. Following one of the sessions, McCormick struck up a conversation with Dr. Jan Desmyter, a clinician from Belgium with whom McCormick had a casual acquaintance.
A few minutes into a cordial side-conversation, Desmyter remarked, almost in passing, "You know, we've been treating a good number of people who have come in from Zaire seeking treatment for what seems like that same disease that they've spotted in New York and Los Angeles." Still largely mysterious, the disease had only recently, just ten months earlier, been dubbed Acquired Immune Deficiency Syndrome, or AIDS.
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