Harry Truman once said, "I trust the people because—when they know the facts—they do the right thing." The facts about AIDS in the poorest countries—especially Africa—are now clearly in focus. They show not just an unprecedented humanitarian tragedy, but a clear and present danger to the United States.

In Africa today, 9500 people will contract HIV and 6500 will lose their lives to AIDS, dying for want of medicines that we take for granted. When they die, they take with them their earning power, their human capital—and they leave behind their children. Unless we, as an international community, go to war against this killer, there will be at least 25 million AIDS orphans in Africa by the end of this decade. It's hard not to be evangelical about the facts.

When President Bush delivers his State of the Union address tomorrow, he will focus on the military threats to national security: Iraq, North Korea, terrorism. But I hope that for a few minutes the president will talk about the global AIDS crisis—and define a historic American response.

A plague of biblical proportions is spreading on what historians and America's critics will note is America's watch. A "Lord of the Flies" syndrome is emerging: children bringing up children. It's hard for the heart not to be moved by the immense loss of lives. It's hard for the head not to see the security implications of the destruction of the African family, African economies, African hopes.
One of the marvelous things about living in the D.C. area is the ready availability of the Smithsonian museums—treasure houses on subjects as varied as space, natural history and art—and all available year-round for free.

Though the 9/11 hijackers were mostly wealthy Saudis, they took refuge in the failed state of Afghanistan. There may be 10 potential Afghanistans in Africa. Secretary of State Colin Powell has warned that AIDS, as much as any rogue nation, is a grave threat to America's security and the world's stability.

It does not have to be this way. Medicines can halve the chance of a mother giving HIV to her child. Anti-retroviral drugs produce something called the "Lazarus effect": A patient can go from death's door back to work within three months. That's quite a return on a dollar-a-day investment, which is what those drugs now cost us. Soon they will cost even less.

When I met with President Bush last year, he promised that despite the deficit, if we could show him effective programs, these efforts would not go without funding. We can. Prudent investments through targeted bilateral aid and the Global Fund to fight AIDS, Tuberculosis, and Malaria are saving and transforming lives based on what works: prevention, treatment, and care. See Uganda, Senegal, Zambia. Failure to invest now will leave us with a moral deficit and our children with the consequences of a global security deficit.

I recently traveled America's Midwest talking about AIDS. In the heart of America we felt the decency and generosity that springs from the soil. We saw the values that set the moral compass for the rest of this country. And we heard the rumblings of a movement. At a truck stop in Iowa, teamsters told us they would transport medicines to South Africa, where 50 percent of truckers are HIV-positive. In churches in Iowa, Illinois and Nebraska, I was asked to preach from the pulpit, but actually it was the congregations that led the call, not me.

The facts are transforming mainstream America, just as Truman said they would. In thousands of letters and calls to the White House and Congress, the American people are saying AIDS is an emergency. Bipartisan health experts agree that, from the United States, at least $2.5 billion is required this year to kick-start the war against HIV and AIDS and to show the poorest, most vulnerable people in the world that America is a true partner for health, global security, and prosperity. I'm from Europe, where the response has not yet matched the scale of the crisis—we will have to follow America's lead in this war.

It's a chance to show what America is for, not just what America is against. Two-and-a-half billion dollars is a lot of money. But too much to help save the lives of 3 million black people a year, care for Africa's 13 million AIDS orphans, and prevent 30 million people from contracting HIV? I don't think so. More important, I don't think most Americans think so.

In crude financial terms, this is an extraordinary return on investment. America's leadership would force other nations to step up and do their fair share. The longer we take, the greater the cost—measured in millions of lives and many tens of billions of dollars. Every State of the Union address is historic and every budget momentous. But with facts like these before us, this is when American leadership—global leadership—really matters.

I'm in the business of making music; I know about screaming crowds. President Bush is in the business of making history. I'm convinced that if he stands before Congress tomorrow night and declares that Africa's AIDS epidemic is an emergency, people watching in America and around the world will stand up, cheer and volunteer to help. And if he backs his commitment in his budget, he will show the world the kind of leadership that only America can provide. As the Midwesterners I met told me, this is not simply a matter of conscience. It's a test of America's greatness.

Copyright © 2003 The Washington Post