The United States and the International Control of AIDS

Before the end of 1988, 300,000 cases of acquired immune deficiency syndrome (AIDS) are expected to have been reported worldwide since 1981. Three epidemiological patterns have emerged. One, in the Americas and Europe, is where transmission is primarily among homosexual men and intravenous drug users. In Africa, the virus primarily is spread heterosexually. A third pattern, in Asia, the Middle East, and Eastern Europe, is manifested by low prevalence but transmission through homosexual and heterosexual contact and contaminated needles. AIDS cases will increase in number dramatically over the next three years, with devastating social and economic consequences. Health-care systems and economic resources in large cities in the United States will be severely strained. African countries will lose many educated and economic leaders. Many Third World countries will have lower productivity and economic output. A global strategy is emerging to understand and control the spread of AIDS. To provide the commitment and leadership necessary to control AIDS in the rest of the world, the United States must first demonstrate a stronger moral conviction and societal will to control the disease in this country.