President George W. Bush's new AIDS initiative has heightened expectations of a more robust global effort to combat the devastating threat of the AIDS pandemic. Yet there is still woefully little progress on the most fundamental element of any AIDS prevention strategy: education.
If the United States and its partners in the Group of Eight industrialized countries, whose leaders meet in France next week, are serious about a true preventative strategy on AIDS, they could start by showing at the meeting that they are committed to a bold global crusade to get all young children particularly girls to complete a basic and, hopefully, a secondary education.
Schools are essential to AIDS prevention because they provide the best way to reach the next generation of Africans with the information and motivation to change behavior. Even though half of all new HIV infections are among 15- to 24 year-olds, prevalence rates are lowest among those in the 5-14 age group. This generation provides the greatest window of hope for preventing the spread of the AIDS virus.
School-based AIDS prevention programs can give children the information they desperately need to go from a simple awareness to an actual understanding of the disease. In Cameroon, for example, more than 90 percent of teenagers have heard of AIDS, but not even 30 percent know how to avoid contracting the AIDS virus.
Beyond basic knowledge, recent research has found that to be most effective at getting kids to actually change their behavior ideally to choose abstinence, but when that choice is rejected, to use condoms and be faithful to a single partner interventions need to teach specific skills that enable children to make safe choices in difficult, real-world situations. One such program in Uganda managed to reduce the percentage of sexually active students in their last year of primary school from 43 percent to 11 percent in just two years.
Yet while programs like these offer great hope, it would be a mistake to think that the connection between AIDS and education went no deeper than directing money to support prevention efforts in existing schools.
Even the most effective school-based prevention program cannot work where children do not attend school. More than half of African girls aged 6 to 11 are not in school, as few as 10 percent of girls finish even a primary education in many parts of rural Africa, and teenage girls are five times more likely than teenage boys to contract the AIDS virus in Africa. Getting girls into the classroom may be the most cost-effective first step to AIDS prevention available.
One should not underestimate the importance to AIDS prevention of increasing the commitment to universal primary and secondary education. A recent study in Uganda found that over the course of the 1990s, people who finished secondary education were seven times less likely to contract HIV and those who finished primary education half as likely as those who received little or no schooling.
The Group of Eight needs to forge a true global compact to support poor nations that come forward with rigorous, accountable plans to achieve at least universal basic education including integrated strategies for AIDS prevention. To jump-start such a compact, the Group of Eight should announce a multibillion-dollar commitment of contingent funding.
Currently the United States spends only $250 million on supporting universal education about what a single U.S. city spends to build 14 high schools. The United States should commit $2 billion to $3 billion in contingent funds and ask other developed countries to do their share too.
This amount represents only a fraction of the cost of rebuilding Iraq, and considering the benefits in fighting AIDS, reducing poverty, encouraging healthier families and increasing women's empowerment, there could be no wiser or more cost-effective investment.
The writer, formerly national economic adviser to President Bill Clinton, directs the Center for Universal Education at the Council on Foreign Relations.