Don't Expect a Thank You, Kansas

In a few days some 25,000 people from all over the world will amass in Washington for the International AIDS Conference, the first gathering of the HIV/AIDS community inside the United States since 1990.
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In a few days (July 22) some 25,000 people from all over the world will amass in Washington for the International AIDS Conference, the first gathering of the HIV/AIDS community inside the United States since 1990. In anticipation of the momentous meeting I have had the same dream, over and over, for months. With the Olympics opening in London later this month, I've visited in my mind's eye the opening parade of athletes, entering the stadium by country, proudly holding their nation's flag and sporting their country's colors. In my recurrent dream the International AIDS Conference opens with a similar parade, featuring clusters of people waving their national flag along with signs that read, "I am alive today because of your dollars -- thanks, America." It won't happen, of course. The massive "March on Washington -- Keep the Promise" planned for July 22 is far more likely to have a tone of rage, or of demand, than of gratitude. But folks in Kansas City, Memphis, Selma, El Paso and all across America need to know that you are, indeed, keeping nearly 6 million men, women and children alive with your tax dollars. Actually, the total is much larger than that, America, because 6 million is just the number of people that are every single day taking anti-HIV medicines that they receive through programs that you fund. Most of them are parents, so your keeping them alive means that they are around to care for their children -- more lives you are saving. And your dollars pay for HIV prevention campaigns in countries all over the world -- millions more lives are saved, thanks to your generosity, because they never get infected with the awful virus in the first place. Oh, it gets better: Your tax dollars paid for the scientists that invented some of the medicines they are swallowing, and the diagnostic tests and much more. Take pride in this, Detroit. Embrace the wonder of this achievement, Chatanooga. When you see coverage of the International AIDS Conference on your computer or TV look at those faces and remind yourself: Alive, thanks to one or two of my annual tax dollars. (That's all it is for most Americans -- a couple of bucks a year.) A few years ago at a medical conference in Madrid I met a German physician and her husband, and we chatted over plates of tapas. She told me that she had learned her excellent English by reading tiny scraps of paper. I did not understand, of course, so she explained that after World War II ended she found herself, at the age of 10, trapped in the part of Berlin controlled by the Soviet Army, surrounded by bomb devastation and unable to find her parents. Starving, alone, she scrambled through rubble in search of food and items she could sell on the black market. Then the United States Air Force began dropping CARE packages, small parcels loaded with food and hygiene products, and the ten-year-old girl learned to spot the planes and race past the Soviet tanks to snap up boxes packed with food she could eat, and supplies she could sell. By the mid-1950s, as the Cold War divided Germany, school children all across America made small CARE packages, inserting a candy bar, pencil, ruler, protracter, toothbrush, bar of soap and other items. And before closing up the box each American youngster was encouraged to write a little note to an imaginary German child. As my new German physician friend described these notes, explaining that she saved and memorized every single one, I felt a chill, recalling the many CARE boxes I had filled and notes I had written. Hunched over my third grade desk, fat pencil in hand, trying to neatly write in block letters, "Dear Friend, I hope that you are well. My name is Laurie and I live in Los Angeles. It is sunny here. I hope it is sunny in Berlin. Enjoy the chocolate kisses, they are my favorites." "I remember those notes, and the Hershey's chocolate bars," the now-adult woman told me. "They kept me alive." More than half a million CARE packages were dropped over Berlin between 1946-60, keeping thousands of people like this 10-year-old orphan alive. Today's CARE packages are stuffed with bottles of antiretroviral pills, condoms, HIV test kits, medicine for tuberculosis, bednets to guard babies against malaria-carrying mosquitoes -- but no hand-scrawled notes from childish American well-wishers. Perhaps today young people in Boise or Cleveland need to stretch their imaginations a bit more to feel the connection they share with the faces that will march through Washington on July 22nd. But make no mistake about it: The connection is there. Though other countries and private donors contribute to the prevention and treatment of AIDS, none can match the sheer scale of what America is doing. Combined, U.S. government and private American donors supply more than 60 percent of the global HIV budget, including indirect support, channeled through the Global Fund to Fight AIDS, Tuberculosis and Malaria. In 58 countries babies are born free of HIV, thanks to U.S.-supported treatment of their pregnant mothers. In those countries this year the President's Emergency Plan for AIDS Relief, or PEPFAR, will use your tax dollar to prevent 12 million new HIV infections -- imagine that! A mere $6.6 billion this fiscal year -- out of a total U.S. budget of $3.8 trillion -- is the cost of our modern day, life-giving packages. That's 0.16 percent of the federal budget, to save millions of lives. What a bargain. Among the thousands of Americans that filled CARE packages in 1946 was President Harry S. Truman. In 1962 President John F. Kennedy looked back on the CARE program, saying it represented 60 percent of all the aid that made it into Soviet occupied Berlin. "Every CARE Package is a personal contribution to the world peace our nation seeks," Kennedy said. "It expresses America's concern and friendship in a language all peoples understand." No, my dream won't come true, giving me that HIV parade of nations with "Thanks America!" signs. But Truman didn't stuff bandages into a CARE box, expecting a thank you note in return. And I never imagined as a school girl that five decades later I would meet my German counterpart in a Madrid tapas bar, and hear her tearfully say, "They kept me alive."

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