Acting now to make a difference.

• Position: Michael Merson, executive director WHO Global Program on AIDS - Fight AIDS Worldwide - Cover Story - Interview

With an estimated 5,000 people infected each day with HIV, urgency is a feeling Dr. Michael Merson knows well. The devoted Executive Director of WHO's Global Programme on AIDS (GPA) speaks movingly to groups and individuals around the world about the need to act now to fight the deadly virus that leads to AIDS.

"In Africa, south of the Sahara, some communities have been hit so hard that there are funerals every day or two. Soon this will be happening in parts of Asia and Latin America as well", he said on World AIDS Day--1 December 1993--in New York. "For a family already living at the poverty line or below, the loss of their breadwinner and caretaker is catastrophic for those left behind--the children and the elderly."

Encouraging people to talk frankly about a sexually transmitted disease (STD) that's often shrouded in fear and mystery, dealing with Government and public denial about the gravity of the AIDS epidemic, and confronting insufficient resources to care for victims of the disease--these are daily challenges for Dr. Merson, who has been head of WHO's global efforts to fight AIDS since May 1990. Originally from New York, he joined WHO as a medical officer in 1978 and became Director of the Diarrhoeal Disease Control Programme in 1984, where he served until joining the GPA.

"One of my most vivid personal memories is being surrounded by hundreds of people with AIDS in a clinic in Uganda", he recalled recently. "They were just clamouring for medicines to treat their throat infections, so they could at least swallow their food. Can you think of a more basic necessity of life?"

Despite the tragic numbers of AIDS-related deaths, this compelling advocate takes heart in the fact that attitudes are changing and Governments are showing greater commitment to combatting the epidemic.

In an interview with the UN Chronicle, Dr. Merson shared his reflections on the daunting task ahead in preventing the continued spread of AIDS.

How effective has the GPA been? How has it changed?

If you look at the early stages of the epidemic, most of the initial work was in advocacy and focusing on prevention. That remains a large amount of what we do. The other part of what we do, which I added when I became Director, was the treatment of sexually transmitted diseases. People who have an STD, such as chlamydia or gonorrhea, are at greater risk of getting and transmitting HIV.

I think this Programme has done a great deal to raise awareness. I can't think of any...