Extended Interview: U.S. Global AIDS Coordinator Mark Dybul

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• SUSAN DENTZER:

  Ambassador Dybul, thanks very much for talking with us. When the Global AIDS Initiative was announced by the president, there was a lot of skepticism in many circles. People said the pandemic is out of control, the expense of putting so many people on treatment will be very costly, Africans don't have watches, they cannot adhere to treatment regimens. There was really a sense in many corridors that the effort was futile. How far have we come?

• MARK DYBUL:

  We've come a long, long way, and I actually think you've put your finger on something very important because it's not just about AIDS. The history of development is fundamentally a disbelief that countries, continents can actually change and develop, and PEPFAR is part of a much broader vision that President Bush has for development. And that's the first time a country has pretty much stood up and said, "We can actually do this. We can tackle this epidemic. And the reason we can do it is not because of Americans, it's because of the talent, commitment, and abilities of people in country."

  So I think that's a very important point, and because of that, because what PEPFAR is doing is partnering with others. It's non-Americans going and doing. It starts that way, but the goal is to turn it over to people in the country as rapidly as possible.

  The reason PEPFAR has succeeded is because of the power of partnerships. And so we have actually exceeded or met where we thought we would be in terms of prevention, care, and treatment. Prevention is a little tough to monitor, but in terms of care and treatment.

  We will meet the goals the President set for prevention, care, and treatment probably ahead of schedule. And again, the reason for that is the power of partnership.

  So when President Bush started this, when he announced this, 50,000 people — 50,000 people in all of sub-Saharan Africa were receiving antiretroviral therapy. Through last September we supported treatment for 1.1 million people. That's people in country moving within communities, nations, and in fact the continent to expand treatment.

  Care — we're spreading care for 4.5 million people, including 2 million orphans and vulnerable children. This is in three years.

  So I think what it shows is that power partnership, the power of the American people standing with the people of Africa to support their efforts to expand their programs and tackle their problems. And that is actually teaching us that development is not this hopeless thing. And that, I think, is the greatest thing about PEPFAR, its hope. It's creating hope where there was no hope, it's telling people, and letting people see that they can tackle a fundamental problem, that they can succeed, and it's spilling over into so many other areas.

  So I think you've put your finger on what I believe is the most important thing of PEPFAR — changing despair, changing a disbelief in the ability of a continent to change, to hope, and to support their efforts to turn their epidemic around.