Excellent op-ed in the Times today, “Putting a Plague in Perspective,” by Daniel Halperin (a senior research scientist at the Harvard School of Public Health and the 2005-06 HIV prevention adviser in southern Africa for USAID) — Halperin marshals an argument that by focusing on funding AIDS projects in Africa, rather than wider public health concerns to address problems such as inadequate access to safe water. He writes:

“Many millions of African children and adults die of malnutrition, pneumonia, motor vehicle accidents and other largely preventable, if not headline-grabbing, conditions. One-fifth of all global deaths from diarrhea occur in just three African countries — Congo, Ethiopia and Nigeria — that have relatively low H.I.V. prevalence. Yet this condition, which is not particularly difficult to cure or prevent, gets scant attention from the donors that invest nearly $1 billion annually on AIDS programs in those countries.

I was struck by this discrepancy between Western donors’ priorities and the real needs of Africans last month, during my most recent trip to Africa. In Senegal, H.I.V. rates remain under 1 percent in adults, partly due to that country’s early adoption of enlightened policies toward prostitution and other risky practices, in addition to universal male circumcision, which limits the heterosexual spread of H.I.V. Rates of tuberculosis, now another favored disease of international donors, are also relatively low in Senegal, and I learned that even malaria, the donors’ third major concern, is not quite as rampant as was assumed, with new testing finding that many fevers aren’t actually caused by the disease.”

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