Influenza (Avian and other zoonotic)
Pioneer Of America's Global HIV/AIDS Program Recalls Hope After Years Of Despair
Through his office window at what was then one of Africa's few modern clinics dealing with HIV and AIDS, the man who now oversees the United States' threatened global AIDS effort used to hear the sound of taxis pulling up throughout the day.
If he turned his head to look out the window, Dr. John Nkengasong said, he knew what he would see: another desperate family carrying a dying loved one — a man or woman already lapsing into a coma, a stick-thin child — and hoping to find help.
It was before the Bush administration started the U.S. President's Emergency Relief Plan for AIDS Relief, known as PEPFAR, in 2004. There was almost no affordable effective treatment anywhere between South Africa and the Sahara, no rapid HIV tests or high-quality government labs, and few beds for AIDS patients.
HIV/AIDS CAN BE ELIMINATED BY 2030 IF COUNTRIES TAKE THE CORRECT STEPS, ACCORDING TO UN
Nkengasong has spent decades working in Africa on HIV and AIDS, a career intertwined with the U.S. Program that since its introduction 20 years ago has transformed care in some of the hardest-hit countries and saved an estimated 25 million lives. He spoke to The Associated Press during a battle over funding in Congress that imperils the AIDS program's future.
Ambassador-at-Large John Nkengasong, new head of the Bureau of Global Health Security and Diplomacy at the State Department, speaks during the 2023 Concordia Annual Summit on Sept. 19, 2023, in New York City. Nkengasong has spent decades working in Africa on HIV and AIDS. (Riccardo Savi/Getty Images for Concordia Summit)
Opponents say the HIV/AIDS funding could be indirectly supporting abortion abroad, although the Biden administration and PEPFAR's defenders say there is no evidence that it does. After a handful of conservative lawmakers threatened for months to block the funding unless restrictions were attached, a compromise was struck in late March that extends the funding for a year.
But advocates of the program warn that without the full five-year renewal, its future remains in doubt as the political debate over abortion and reproductive rights only becomes more combative.
Before PEPFAR, in most cases, Nkengasong's infectious disease clinic in Abidjan, in the Ivory Coast, could offer the families no care. In their loved ones' last hours, the families who came there often were left to crouch outside, in the parking lot.
They would surround "a skeleton of a human being, with a tinge of flesh over their bodies," Nkengasong recalled. "They held their loved ones, giving them the best comfort they could."
Soon enough, the sound of wailing would rise through his windows. The cries signaled another death to HIV/AIDS, one of millions in Africa by the mid-2000s.
The scene would be repeated "nearly hour by hour," Nkengasong said. Sometimes he would get up and close the curtains, blocking out the misery of an epidemic he could not then stem.
Two decades later, Nkengasong says, his trips to the region from his offices in Washington bring joyous meetings with men, women and children whose lives were saved through PEPFAR, credited as the biggest government effort ever against a single disease.
In all, the U.S. Program has spent more than $110 billion on HIV care and treatment, local medical systems and social programs aimed at stemming infection. The U.S. Says it has saved 25 million lives in sub-Saharan Africa and other vulnerable regions, including those of 5.5 million children.
'A THRIVING INDUSTRY OF COFFINS'Nkengasong, who was born in Cameroon and did his graduate studies in Belgium, worked in Africa in the 1990s, when the AIDS epidemic was raging all but unchecked.
It made for a "thriving industry of coffins," he said. Visiting cities in Uganda, Rwanda, Kenya and elsewhere for his work on infectious diseases, he would travel streets lined by handmade coffins of all sizes.
Beds of infectious-disease clinics were full of "adults lying there looking like babies, because of what HIV had done. That ugly face," Nkengasong recalled.
With early retroviral medication averaging $10,000 per patient per year, only 50,000 HIV-infected people in sub-Saharan Africa were estimated to be receiving effective treatment in the mid-to-late 1990s. That was out of what the World Health Organization said was 10 million people there living with HIV and AIDS.
THE 'AHA' MOMENTOne day in spring 2002, as he was in his lab conducting tests, a large American delegation suddenly arrived at the clinic in Abidjan.
Health Secretary Tommy Thompson and other leading U.S. Health officials crowded into the facility, along with representatives of businesses and members of faith-based organizations.
"I remember opening the door and the first person who walked through was Dr. Fauci," Nkengasong recounted. Anthony Fauci, a leading HIV researcher, was then a top official at the U.S. National Institutes of Health and a leader in Nkengasong's field of HIV and AIDS work. "And he said, 'John, good to see you again.' And I was so excited."
Unbeknownst to Nkengasong and his colleagues, national security adviser Condoleeza Rice and other officials privately had been making the case to President George W. Bush that the global HIV epidemic was where the U.S. Could make a huge difference.
For the Bush administration, the epidemic presented an opportunity to do good at a time when the U.S. Was waging war in Afghanistan and later Iraq as well after the Sept. 11, 2001 attacks.
Nine months after the Americans showed up in his lab, "we're watching news on CNN, it was the State of the Union address," Nkengason recalled. "And President Bush announced the start of PEPFAR."
That night, the president pledged an initial $15 billion over the next five years to tackle the AIDS epidemic around the world.
Nkengason called it the "aha moment" for himself and others fighting AIDS in the most vulnerable region of the world.
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Two decades later, AIDS deaths globally have fallen nearly 70% from their peak in 2004. Sub-Saharan Africa is still the most vulnerable region and home to two-thirds of the people living with HIV. But the PEPFAR program and others have strengthened health care systems to deal with infectious diseases, made treatment available to millions, and expanded support for the most at-risk populations, including women.
On a trip back to Abidjan, Nkengasong met a healthy 17-year-old girl, one of millions spared from infection at birth thanks to medical treatment that prevented HIV transmission from their infected mothers.
This past summer, he visited a clinic in Namibia where HIV-infected mothers had delivered "super healthy" babies thanks to treatment that saved them from infection.
"I grabbed some of the babies and looked at them," he said. Holding them, he wondered what would have happened to them without proper care.
"And they just give you that smile," he said.
Debbie Allen Says Whoopi Goldberg's 'A Different World' Episode Saved Lives During HIV/AIDS Epidemic
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Debbie Allen Recalls How Whoopi Goldberg Became The 'Secret Weapon' On "A Different World" Amid AIDS Epidemic
"... It made it possible to save millions of lives, that you said yes [to the show], Whoopi Goldberg," Allen told her on 'The View'
Allen Berezovsky/Getty; Jamie McCarthy/Getty
Debbie Allen (left); Whoopi GoldbergDebbie Allen says they were able to make a difference in spreading the message of the HIV/AIDS epidemic in the early 90s — and it was all thanks to Whoopi Goldberg.
The Fame actress, 74, who appeared with her A Different World cast members on The View, recalled the obstacles she and the show writers went through to air their infamous episode spotlighting the HIV/AIDS epidemic.
"I remember especially the degree of difficulty of doing a show about AIDS, and Whoopi Goldberg was our secret weapon," Allen shared. "She was someone that I knew; we were friends. We all knew that she was gonna win that Oscar that year."
Allen explained that the show had been the "first network television show" to address the epidemic after Magic Johnson first announced that he was HIV positive. She said that she and the show's lead writer and producer Susan Fales-Hill "put their heads together" on how to introduce the topic into the show for general audiences.
Related: 'A Different World' Star Dawnn Lewis on the 'Ceiling' for Black Actresses: 'What Does a Person Have to Do?'
"I said we gotta get a big gun to make this happen," she shared. "And Whoopi, I called her, and the actress said, 'Yeah, I'll do it.' She was down. And it made it possible to save millions of lives, that you said yes..."
"That's the truth because the advertisers were pulling out," she added, to which Goldberg responded, "I remember that."
Allen noted that they "had never had to show a script to an advertiser" before that episode, but that it ended up becoming their "highest-rated episode that year."
Whoopi Goldberg (top left), Dawnn Lewis, Darryl Bell, Cree Summer, Sara Haines, Debbie Allen (bottom left), Kadeem Hardinson, Jasmine Guy and Sunny Hostin
Related: A Different World Cast to Reunite for 10-City HBCU Tour, Over 35 Years Since the Show's Premiere (Exclusive)
The View host went on to discuss the importance of the sitcom — which ran from 1987-1993 and also starred Lisa Bonet, Jasmine Guy, Jada Pinkett-Smith, Kadeem Hardison, Darryl M. Bell and Tisha Campbell. The show had been a spin-off of The Cosby Show and followed Bonet's character as she entered Hillman College in Virginia.
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"I want to point out something because the thing that no one has said yet that I want to make sure that I point out is that yeah folks needed a job, but this was also a unique opportunity… because you only saw one show full of characters who were brown about a school, a college, someplace you didn't see us on television," Goldberg said.
She jokingly added, "And anytime Debbie asked me to do something, I just say, 'Yes.' "
The View airs weekdays at 11 a.M. ET on ABC. A Different World is streaming on Max.
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