josh

Josh Ruxin is a Columbia University expert on public health who has spent the last couple of years living in Rwanda. Heís an unusual mix of academic expert and mud-between-the-toes aid worker.

This week, while President Bush travels to Ghana, Liberia, Tanzania, Benin and Rwanda - the nations on his African itinerary - he will be visiting more than a few AIDS treatment centers. This makes sense: a big reason for the presidentís visit is to see firsthand the progress made by the life-saving initiatives he set in motion through his administrationís programs.

More than $19 billion has been invested in programs to fight AIDS, malaria and other killers. More than one million Africans with AIDS have been put on AIDS drugs, and new programs are aggressively treating and preventing malaria, the biggest killer of children under five on the continent. Though more needs to be done going forward, the Bush years have been a time when a foundation was laid for meaningful global public health interventions, and itís right for the president to see the real impact of the United States dollars on African lives.

While the medicine and care provided by the Bush Administration is indeed important, it is only part of a larger equation. Providing health care support will treat disease, but it canít eliminate its roots in poverty. Business development can. The more prosperous people are ó whether in the United States or sub-Saharan Africa ó the less likely they are to contract AIDS.

Rwanda has taken an approach that includes massive health care improvements alongside extraordinary efforts to build the private sector. This approach makes sense: a recent BBC report showed that economic growth does not necessarily improve health. President Kagame ó when not pushing health issues ó has recently visited far[-]flung places like the Consumer Electronics Show to drum up investors in Rwanda.

Several months ago, I wrote in these pages about the need for technology businesses to invest in countries like Rwanda. Among the comments Iíd read in response were a few that wondered why in the world we should be worried about that kind of development when providing food and medicine was an infinitely more immediate issue.

The fact is, between providing aid and encouraging business development, you canít do either exclusively: you must do both. If you only provide medications and food, you may treat disease, but youíll have to do it over and over again. Adequate AIDS treatment alone might get us to where we were 25 years ago - but on its own does nothing to cultivate economic productivity. AIDS treatment alone fails to address the root causes of disease. In the community of Mayange, Rwanda, a Columbia University project recently rolled out voluntary counseling and testing for AIDS. While the community quickly took advantage of the new service, it was not exactly the talk of the town. Several weeks later, the basket weaving cooperative in Mayange received a purchase order for $2,000 of coasters and placemats. The community has been talking about that ever since.

Encouraging local business, urging international development, teaching micro-finance and building cooperatives does something health care canít accomplish, something that can lift people out of the cycle of disease and despondency. More than ďfighting poverty,Ē which has always seemed to me to be a goal thatís not ambitious enough, these types of programs can create prosperity. Prosperity is the engine that can pull a whole nation up, and could bring AIDS down to levels youíd find in Europe or the U.S.

So, while President Bush will be looking at AIDS centers, he should also take a close look at the business environment, what his programs have helped bring about, and what more can be done to create more opportunities. If it seems counterintuitive to stress business and prosperity, just think how much easier it would be to get ahead of killers like AIDS if the number of new cases goes from a flood to a trickle.