Voices of the Invisible People

During the past 20 years, more than 65 million people across the globe have become infected with HIV. Around the world, 25 million have died – more than all of the battle deaths in the 20th century combined. By decade's end there will be an estimated 25 million AIDS orphans. If trends continue, by 2025, 250 million global HIV-AIDS cases are a distinct possibility.

According to Greg Behrman, author of "The Invisible People: How The U.S. Has Slept Through The Global Aids Pandemic, The Greatest Humanitarian Catastrophe Of Our Time," the pandemic is reshaping the social, economic, and geopolitical dimensions of our world. Decimating national economies, creating an entire generation of orphans, the disease is generating pressures that will lead to instability and possibly even state failure and collapse in sub-Saharan Africa. Poised to explode in India, China, Eastern Europe and Russia, AIDS will have devastating and destabilizing effects that will reverberate throughout the global economy and the international political order.

Despite all this, Behrman points out the United States has consistently failed to act decisively.

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Terrence McNally: A few years ago you were working at Goldman Sachs in Manhattan. What led you to focus your attention on the global AIDS crisis and the US response?

Greg Behrman: I was studying at Oxford and was very interested in the idea of new security threats. People were starting to talk about enormous health crises in terms of national security. I came across stories on the global AIDS pandemic and I was absolutely shocked. I had no idea of the magnitude, had no idea what it was doing to Africa, and it seemed so underappreciated. The question began to emerge – "What have we done about it?" and evolved into "What has the US done about it?" What has the world's wealthiest, mightiest, most advantaged country done to address one of the greatest threats now known to mankind?

I was supposed to go back to Goldman Sachs, but I told them that I had to stay with this, to answer this question, to tell this story.

As someone who was neither a published writer nor an AIDS expert, where did you go from there?

In the preface of 'The Best and the Brightest,' David Halberstam wrote that when he was a young writer, he went up to a major author at a cocktail party, and asked him "What makes for a best-selling and important book?" The writer told young Halberstam, it's a book that you feel has to be written.

For me, that was the case with this. I have come to think that this issue is the defining moral challenge of our time. Maybe once a generation or once every 50 years, a crisis comes along that is so enormous, that you can take the measure of our humanity by how we respond.

I had a burning passion to tell the story. There was a time when I thought that publishing this would mean going to the local Kinko's and cranking out 20 copies and giving it to family and friends. I had the good fortune to find a great agent and a great publisher who really got behind it, and I'm now able to share the book with a lot of people.

Bush mentioned global AIDS in his state of the union. What has been the Bush administration response so far?

In January '03 President Bush announced a $15 billion emergency plan for AIDS relief – a huge step up over past US policy. We're in the first year of that five-year plan, and the administration has so far released about $2.4 billion.

Now $15 billion over five years implies $3 billion per year. In fairness to them, they never said $3 billion a year. They're saying they need time to ramp up, and that the funding commitment will be a bit back-ended. They're short of the $3 billion this year, so it has to be watched carefully. Perhaps because I have an historical perspective, I'm inclined to give them the benefit of the doubt.