It’s kind of a cliche to say disease knows no borders, but sometimes you have to state the obvious.
El Salvador is just a short flight away from the U.S. As if to emphasize just how globalized things are, Salvadorans now use American dollars as official currency (though the colón remains legal tender).
AIDS and tuberculosis are serious problems in this tiny, densely populated Central American nation (7 million people in a nation that’s about one-tenth the size of Washington state).
And if these infectious diseases cannot be contained in El Salvador, they can be exchanged across borders almost as easily as the dollar.
There was a time when AIDS was viewed as only a problem of the gay community. Today, there’s a tendency to view it now as largely a problem for Africa — which is where AIDS emerged, perhaps 50 years or more before it spread worldwide and was recognized as a threat to anyone.
As for TB, few of us seem to give it much thought even though one out of every three people on the planet is estimated to carry the infection. Drug-resistant TB is on the increase worldwide. But drug-resistant TB generally only gets our attention whenever it arrives on our shores carried by some hapless air traveler.
I visited El Salvador last April, on a media tour sponsored by the Global Fund to Fight AIDS, Tuberculosis and Malaria. Not much malaria there. But HIV/AIDS is still on the increase and tuberculosis appears to be a significant problem that, so far as I could tell, is only incompletely recognized and under control.
Starting today, government officials, public health experts and others will meet in New York City at the United Nations to discuss “replenishment” of the Global Fund (why do these organizations always pick such ostentatious language?).
I’ll try to cover the discussion, as best I can some 2500 miles away, and draw on some of the people I met in El Salvador — some who might not be on treatment or even alive today if not for the Global Fund — to illustrate what’s at stake.