The terrible reality is that with the best prevention programmes

The terrible reality is that with the best prevention programmes in the world - and many of them are truly inspired at community level - we're still facing several million new infections all over the planet, not just Africa, every year. And an equal reality, which must be faced, is that it's going to take generations to change male sexual behaviour, if ever. And as everyone surely by now understands, treatment itself will prolong life, but it's not a cure. So so much of what we're doing in response to the pandemic, while monumentally vital, will not, ultimately, subdue it. The question then that must be asked is why such limited focus, in speeches and advocacy, is given to the matter of a vaccine? I'm going to try to deal with that in speeches over the next number of weeks and months, but for the moment allow me merely to say the chillingly obvious: only a vaccine will write an end to the pandemic. Until that day comes, we will forever count the bodies.

Stephen Lewis, the UN's Special Envoy for HIV/AIDS in Africa. Photo by Brenda Barton, WFP

Just yesterday, in New York, I visited the offices of IAVI, the International AIDS Vaccine Initiative, headed by its creator, a remarkably intelligent and charismatic CEO, Seth Berkley by name. IAVI is actually an NGO - non-governmental organization - which in only five years has managed to put together the largest number of
public/private vaccine trials on the ground in developing countries.

Only the pharmaceutical company Merck, rivals IAVI in the energy with which a vaccine is currently being pursued. Seth Berkley points out that in the 23 years of the pandemic, only one potential vaccine has gone to
phase three, human trials (unsuccessful by the way), a situation which he describes as crazy. And when you begin to probe the reasons, it's not simply because of the huge scientific complexity - although that is
undoubtedly a major factor - but like so much else with AIDS, it's also a matter of resources and priorities and political will, although it must be said in this forum that Canada to its credit is one of the largest contributors to the Vaccine Initiative (which is not to say that the contribution is sufficient).

As things now stand, even with the best possible results of the various trials underway, we're still several years away from a vaccine. And every year the infections mount and the lives are lost in the millions. It seems to me a matter of the most elemental logic that the political and scientific establishments, in developed and developing countries alike, should be maniacally obsessed with the quest for a vaccine.
Despite the magnificent efforts of IAVI, the issue still lacks the profile it must have. Something, somewhere, is deeply, profoundly, out of whack.

And that brings me to the conclusion of these remarks, with special reference to Rotary. The current issue of the New Yorker magazine carries an article titled "The End of Polio; a disease on the edge of extinction". The article, in fascinating exposition, describes how, over fifteen years, millions of lives have been rescued from death and paralysis by the unremitting campaign of immunization, led by WHO and UNICEF, to wipe polio from the face of the earth. It will be achieved by 2005. But the article also faithfully points out that Rotary has contributed well over half a billion dollars to the campaign, earning the kudos and recognition which accompanies a magnificent contribution to human well-being.