Bill Clinton: Well, I think first of all, it is one of the central challenges of this time and presents an enormous threat to the growth and spread of democracy and freedom around the world, to the stability of life in Africa and the former Soviet Union and the Caribbean and, ultimately, the United States, because we have people from all those places in our country. I believe if we don’t do something to turn this epidemic around, the consequences would be horrendous, not only for all those who will die, but for all the rest of us who will live in a world that is profoundly scarred by having 100 million AIDS cases. I think we’ll lose in democracy. I think we’ll have more young people who don’t mind being mercenaries or terrorists. I think that we will have terrific economic and social dislocation. And we’ll also have a whole lot of little kids that will be orphans. But, you know, it doesn’t have to happen. And so, because I think there is, clearly, a path to prevent this from happening, I think it’s the sort of thing I ought to be doing. I don’t think that the United States fully appreciates yet how interdependent the world is, and how, if we want to live in a world that is globalized and reap the economic benefits of it without becoming more exposed to its violence and danger as we were on September the 11th, then we have to keep working on these terrible problems. We have to keep resolving the paradox of a world in which infant mortality is down and life expectancy is up, but we think AIDS will grow from 40 million to 100 million people. We have to keep resolving the paradoxes of a world where education is a great benefit, but 130 million kids aren’t in school, where the global economy has brought more prosperity than ever before, but half the world’s people live on $2 a day or less. We just have to keep working on those things. And the AIDS issue is one of the most pressing because it is life or death, and also because we can do something about it. When John Kennedy was assassinated, the Ambassador of Israel to the United Nations, Abba Edan, gave this unbelievable speech to the United Nations, and he started by saying, “Tragedy is the difference between what is and what might have been.” That’s why this AIDS thing is such a tragedy. It does not have to happen. It is preventable. It is treatable. You can stop the transmission from mother to child. We can do things here. And it does take a little money, but it’s a lot cheaper than dealing with the consequences. Well, I think, first of all, I think it is a national security argument. It will affect our national security if there are 100 million AIDS cases, and the fastest rates are in the former Soviet Union and in Russia. What are we going to do if there are millions of Russians with AIDS and the country is bankrupt and incapable of dealing with it? How do we know we won’t have more organized criminals in positions of influence? How do we know the temptations to sell some of their missile technology or their biological weapon stocks won’t be too great if we aggravate stability? But if you look at, the second fastest growing rates of AIDS are in the Caribbean. Now, we’ve been working in the Caribbean for more than a decade to try to stop the narco traffickers from gaining a big foothold there and sending all the drugs in the United States. What will they do in the Caribbean if the AIDS rates continue to grow? I passed this Caribbean trading issue right before I left office, and we’re buying more from the Caribbean, but they’ll be overwhelmed. The economic growth they have will be overwhelmed by the AIDS growth rate. And then, how will we keep the narco traffickers out? So it is a national-security issue for the United States.

George Strait: Congresswoman Pelosi, I was talking to Peter Piat a couple of weeks ago. And he says that his major focus is to turn AIDS into an issue for whom leaders around the country, politicians, they’re forced to take action because it will threaten, or at least be part of their political strategy, so that in his words, “Whether or not someone acts right on this, it will determine whether or not they get elected.” Do you think that his strategy’s right?

Nancy Pelosi: Well, I would hope that politicians and Americans throughout the world would act upon the AIDS issue because it is the right thing to do, because it is the humanitarian thing to do. Unfortunately, that has not happened. We have been talking from San Francisco about the mobilization against AIDS globally for over a dozen years. We knew early on that not only did we have to address the domestic challenge of AIDS, but if we were going to address it properly, we had to address it internationally. And not until recently, when people talked about it as a national-security issue, as an economic issue, has it received the kind of attention it has deserved as a humanitarian issue. I don’t know if it works politically, but I know it’s the right thing to do.

George Strait: Do you think that it really is an economic issue, that it really is a national-security issue, that is, is this strategy a good way to go?

Nancy Pelosi: I think that, if that’s what motivates people, I myself was very sad the day they had the U.N. conference on AIDS, declaring it a national security issue, and that’s why it deserved our attention. Because knowing that people had died and why, because it has become a national security issue, should it have been any more important than the lives of each of those people or the children orphaned by their deaths? So, if that’s the way we can get their attention, okay, we’ll take the attention and hopefully, the resources that match the concern, any way that we can get it. The truth is, is that it is a national security issue now. It didn’t have to be. We could have saved lives and prevented this. We didn’t. And so it is a national security issue, because where you have poverty and AIDS, you have an explosive combination, and you have a situation that is right for demagogues to send out a message of violence. So, is it a national-security issue? Yes. It does not promote peace, justice for most people, and this is a very unjust epidemic. It’s alarming to see the rate of new infections increasing in San Francisco. Here, we had a sophisticated population well aware of the risks involved in AIDS. But for many of us, at the onslaught of the AIDS epidemic, we were going to funerals every day, sometimes more than one in a day. The young people out there now do not have that experience. And also, they see that there are some regiments which sustain life and quality of life. They see their people that they know living with HIV and AIDS because there is medication, but that’s not a cure, and that’s not a guarantee that they’re going to sustain life until there is a cure. So, I think that the fact that they did not experience the tragedy of AIDS in such an overwhelming way the rest of us did, and that they see some hope in the medicines that are available now is unfortunate. It’s a hoax, really, and we have to do something to change our message about behavior and prevention.

George Strait: So, there’s almost an irony in the good news around drugs?

Nancy Pelosi: Exactly right.

George Strait: False hope?

Nancy Pelosi: The good news is, a long time ago, people wouldn’t get tested, because they didn’t want to know whether they were HIV positive or not, because what could they do about it, anyway? Now they can do something about it, but it does send a different kind of a message to the very young who never experienced the full tragedy of AIDS among their friends and see that there is an option, should one contract HIV.

George Strait: Overall, what’s the role of political leaders?

Bill Frist: In my travels around the world and throughout Africa as a physician, as a policymaker, I’ve come to the conclusion that the number-one issue is political leadership, doesn’t have to be just an elected politician in terms of a political leader, but somebody who moves people. It might be the head of the church. It might be a tribal leader. It might be a village leader, or it can be an elected official. We got to have leadership of the developed countries, the (MS?) countries as well as the developing and the undeveloped world. No matter how much money you spend, no matter how much you spend on this initiative, if you don’t have the political leadership, the leadership of that state or of that community or of that tribe involved, it’s highly unlikely that you’re going to be able to reverse this trend of increasing HIV/AIDS.

George Strait: Why is that?

Bill Frist: A lot of different reasons – what has happened, most effectively, and where it is the most useful to have that political leadership is to destigmatize HIV/AIDS. As we look at the history over the last 21 years, whether it’s domestically in this country or whether it is in Russia and India today or whether it is throughout Africa, there’s a stigma, and there has been a stigma attached to this little, cagey virus that is out there. Having a political leader come forward and address it head-on and begin every speech, as we saw in Uganda, addressing this issue, I think it’s going to be very difficult to muster the broad support that you’d need to combat this virus.

George Strait: Why should people care? Should we care for moral reasons, should we care for public-health reasons, should we care for national security? Why should people care?

Bill Frist: I represent the great state of Tennessee. About 6 million people in a state in the South here in the United States, and they ask me, “Why do you go to Africa? Why do you spend so much time on a committee on public health and a committee on foreign relations addressing HIV/AIDS?” First and foremost, I would say it is a moral conviction, a moral concern. History will judge us 20 years from now as how we, as a country, but, indeed, as a global community, addressed this virus. From an economic standpoint, people realize that the economies of countries, of growing countries, many of them early democracies, are being devastated, are being turned around with even negative growth not because of lack of democracy or a lack of freedom, but at the cost of this little, tiny virus. Thirdly, people realize today that when you knock out an entire generation of productive people, of the teachers, of the military, of the people who support the civil institutions of the elected officials, which is what’s happening in many countries around the world, you do create 10 million orphans in Africa, going to 40 million, orphans who don’t have mentors, who don’t have the structure of civil society or of discipline. As we address this issue of increasing terrorism over time, clearly, we have to be concerned when we have what could be a lawless society. The moral issue is a big one. The medical issue is a big one. The effect on the economies is a big one. The effect on the devastation of a military is a big one. Put that together, and we have what I believe is the greatest moral challenge of our time.