• Some highlights from this interview
• Discussing Scripture with Jesse Helms
• His meetings with President George W. Bush
• Is he concerned about aligning himself with the Christian right?
• What motivates him?

• Related features
• More on global financing for HIV/AIDS

This is a very depressing subject. Why do you spend so much time talking about it?

Anyone that's involved in development has discovered that all the good work that's been done in development has been undone by the AIDS emergency.

The first thing I decided to do was never say the word "AIDS" without putting the word "emergency" following it. ... Six and a half thousand Africans dying every day of a preventable, treatable disease is not a cause; it's an emergency. ...

Do you find it a difficult subject to deal with?

What I find difficult dealing with is wanting to talk to anyone about some of the sights that we have seen. Seeing people queuing up to die three to a bed, two on top and one underneath, of a preventable, treatable disease more than pisses me off. It makes me ashamed, and more importantly, it makes me put my anger to use.

I think in the history books, in 50 years' time and 100 years' time, this age of AIDS will have a very large chapter, and the way in which our civilization did or did not respond to it will be very telling of us and damning, and certainly for the last 20 years of the 20th century. Hopefully the story of the beginning of the 21st century will bring some light, and our activism will kick in in the next years, and perhaps there will be a vaccine, because one day, the age of AIDS will be over. I want that, and others who work on this want that, of course, sooner -- in the next 10 years if at all possible. ...

Why did you decide actually to focus on this particular issue, and then what did you do once you made the decision?

Well, we founded an organization called DATA -- Debt AIDS Trade Africa, so the acronym worked. We believe these are the three biggest issues facing Africa. The acronym worked both ways -- Democracy Accountability Transparency Africa as well.

But there is no doubt that we couldn't prevail in any way on debt and trade without dealing with AIDS. You can't run businesses if 10 percent of them are dying. It was an extraordinary statistic, actually, to discover when I was in South Africa the giant corporations, where they had 10 percent, 12 percent of their work force with a death sentence on their head. I mean, it's very hard to do business in that environment.

So those of us that believe in the future of the continent of Africa and see Africans as very noble, royal, entrepreneurial people, we have to make ourselves available there to get them through this phase so that their fate can be the same as South Asia and other countries that were emaciated by poverty but are now thriving.

Africa will thrive. There's aspects to the AIDS problem in Africa, as I'm sure you've discovered, that make the particular strain or clades, as they are called, in some areas of Africa, much more virulent. That's why through heterosexual sex you have this kind of evil flowering, this sort of almost exponential metastasizing of the disease, and through Southeast Africa in particular.

You reached out to the American evangelical community pretty actively. Why did you do that?

I was offended to discover that the religiosity of this country, which is one of the reasons why we are getting places in some ways on debt cancellation -- the churches got behind that -- was not available to the AIDS emergency. ...

I think [that] of evangelicals polled in 2000, only 6 percent felt it incumbent upon them to respond to the AIDS emergency. I was deeply offended by that, so I asked to meet with as many church leaders as I could, and used examples from the Scriptures. Isn't this the leprosy of the age?, I argued. Isn't this what the Christ spent his time with? Yet the church now is walking across the road and looking the other way, and does that not contradict the very central tenets of the Scriptures that you believe are literally true?

I was amazed at the response, because a lot of people changed their mind, which was amazing. In fact, I would argue now that the evangelical community, particularly the young ones, especially in the Christian music scene, are some of the most active activists we have. So it's kind of thrown me for one, actually. I used to love giving hell about them, and I can't anymore.

There was, of course, an amazing incident [with] [former Sen.] Jesse Helms [R-N.C.], the great old cold warrior himself. After going through this with him and explaining that there was 2,103 verses of Scriptures pertaining to poverty, and that second to redemption, this is the second most important theme, and that sexual behavior, even misbehavior, doesn't seem to be there that much -- it's mentioned a couple of times in the Old Testament -- he was amazing, actually, because he not only was moved by this; he was moved to do something. And he had a press conference where he publicly repented for the way he thought about the AIDS virus. That really helped us with the evangelicals. ...

[Do you get nervous talking to politicians in Washington?]

I'm never nervous. ... They should be nervous because I'm representing people who they hold the power of life and death over, not me. I wouldn't want to be sitting there. I wouldn't want to be a lawmaker turning down an offer to increase foreign appropriations to deal with the biggest health crisis in 600 years, realizing that there are people who will die as a result of that. I wouldn't want to be that.

So no, I'm not nervous. They should be nervous. I represent young people who can't be in the room, and I try to do it with some grace. I try not to club my way through the argument. I try to speak it quietly and seriously and as delicately as I can, but I rely on the weight of the argument more than my own celebrity or my own, you know, even indignation to do the work.

Jesse Helms is a tough guy; that's well known. But he's also rigorous from his point of view, and our argument is rational and considered, even on the scriptural front, even with considerable backup. You know, Christ only speaks of judgment once, and oddly enough, it's in regard to the poor. I think it's Matthew 23. It's the famous lines: "I was naked and you clothed me. I was a prisoner and you visited me." And then they say to Christ: "What are you talking about? You weren't. I was sick, and you came to me." And he says: "No, I wasn't. But as much as you do this to the least of these, you do it unto me." And the implication is also in the reverse, if you don't do it.

So that's a very powerful piece of Scripture, and he was very moved. Even emotionally, he kind of welled up. As I was leaving the room, he said -- this big, tall, Southern old boy, this amazing character -- he just said, "I want to give you a blessing." He put his arms around me, and then he gave me his blessing. And I take blessings pretty seriously. I would have liked one from Frank Sinatra. I think I got one, actually, now that you mention it. But an older person who's been through so much in their life, coming indeed as he did from a completely different political point of view to myself, it was a very powerful moment for me.

I went out and of course told the assembled press what had happened, and they couldn't believe it. But if that was it, that wouldn't have been enough. He followed through. ...

Does your own faith motivate you in this?

I think the thing that really motivates me -- of course, it comes from an assembly of worldview, the way you see the world. It's shaped by lots of things, and yes, the Scriptures have certainly made an influence on me. I put Catholic guilt to work pretty good for a rich rock star.

But the thing in the end that really does motivate me is the stupidity of it, in a way. I think stupidity annoys me almost more than anything. I suppose that's it -- it's the missed opportunity.

Here you have -- particularly in Africa, which is 60 percent of the disease -- here you have 40 percent of the continent is Muslim. They are relatively friendly, but as my friend Terry George, the great writer and director of Hotel Rwanda, said, what if Nelson Mandela had turned into Osama bin Laden?

Maybe it's smart to just help people with these crushing problems. These drugs are great advertisements for us in the West, for our ingenuity, our technology, our innovation, particularly in the United States.

I said that to President Bush. I said, "Paint them red, white and blue if you want, but these drugs are the best advertisement you are going to get right now, and that might be important right now."

So above the moral imperatives comes the political imperative to some people. So fine, whatever brings you to the party.

[How do you feel about aligning yourself so closely with some of the rhetoric of the Christian right?]

I have learned to interface -- what I think would be the contemporary term -- with various different lexicons, and people speak very different languages. I've learned to speak in a lot of tongues, and I can live with the bellicose language of some fervent, fire-breathing Christians, sure. ...

It's not my language, but actually, I don't mind how people come to this, to the front line on this. People have different motivations. I surprise myself [about] how much I've learned from conservatives, not coming from that vein, even conservative Christians whose beliefs I don't share.

But convictions in the end, they can be dangerous, but a world without them is just kind of an awful kind of gray, amorphous mass. They are idealists, some of these people -- now, from my point of view, perhaps narrow-minded; from your point of view, perhaps narrow-minded idealists. But just widen that aperture, and there is a lot of potential there as opposed to the alternative, which is apathy. I think apathy offends me way more than the kind of fervent religiosity.

Talk about your meetings with President Bush in March 2002. ... Going into the Oval Office, what case did you make to him? We've got footage of you coming out, saying he called AIDS a genocide.

The first time I met President Bush was really to thank him for this $10 billion Millennium Challenge, new approach to AIDS, by rewarding countries that tackle corruption and have poverty-reduction programs in place. A very smart idea -- underfunded still, I might add. It doesn't have the impetus that it should have, but a very good idea. I was there to thank him for that.

But while I was thanking him, I wanted to impress upon him how important the AIDS emergency was in affecting the outcome of development. And he was very well informed about it. I was surprised that he knew as much as he did, because I wasn't there to talk about that. I mean, that wasn't on the schedule.

But he was very interested, and then he described it himself as a genocide. Now, I love the word "genocide," because as ugly a word as it is, it implies complicity, right? Genocide happens because of other people. It's not an accident. I think others in the White House were nervous that he used that word, but I of course used the word, and I'm still using it. I told him later, I said, "Thank you for that word." And he said, "Well, I just meant it in terms of scale, you know." I said, "Well, I like to use it, because it's a very emotive term." So he was helpful there.

To be fair to President Bush, after a series of meetings and after the conservative Christians got busy, … and after a lot of people right across the NGO [non-governmental organization] community also got busy, he really responded, and he responded in a way that no one could ever have imagined.

People laughed out loud in my face when I said a conservative administration is going to pay for antiretroviral drugs for Africans. They just said, "You are out of your mind." In fact, the head of USAID [United States Agency for International Development], Andrew Natsios, had made a comment about: "Listen, it's ridiculous. Africans don't have wristwatches." He's since taken back that comment. I shouldn't bring it up, but I always do. It shows the mind-set. …

So when President Bush in 2003 at the State of the Union announced a $15 billion commitment over five years to fight the AIDS emergency, a lot of people were very surprised and shocked. But I was not, because we had worked very closely on it with him, and I was very proud of our part in it as a small organization. But it didn't stop there, because you had to get the money spent, and it wasn't being spent fast enough.

So I had another meeting with President Bush where I had to complain to him about the speed, and I had said, "Look, in the State of the Union you had talked about getting the drugs on bicycles and motorcycles, and where are they?" It got quite heated, and he was like, "Hey, hold on, let me speak here." I was kind of ranting. Being an Irish rock star, you do rant. Afterwards people were saying, "Well, was that a row?" And it was a row, but it was a good old row. I mean, I was kind of impressed he had the passion to make the case.

What was the case? What did he say?

He was saying this is very difficult, and you do not want to do this wrong. He said: "We are doing this right. We are going to do this right, but I'm telling you we are going to do it." And I was going, "Well, let's see it then." …

So a year from that day, this last year, there are 400,000 Africans on antiretroviral drugs paid for by the United States across the Global Health Fund, PEPFAR [the President's Emergency Plan for AIDS Relief], which is the United States' bilateral program. Last year there was none. That is an amazing achievement.

It was very nice for me to be able to go back to him this time and say: "Look, no ranting. You really delivered. We really appreciate it. Now we would like some more funding for the Global Health Fund, but congratulations." I think that's probably the best news he had that week.

Did you make the case that more money from PEPFAR should be or should have gone to the Global Fund [To Fight AIDS, Tuberculosis and Malaria]?

Oh, yeah. But in a way, we have been doing that all the time. He had it up to here with the Global Health Fund, because every person he talked to was hitting him with the Global Health Fund. [Republican Pennsylvania Sen.] Rick Santorum was hitting him on the Global Health Fund. But he delivered on the bilateral program, to be fair. …

You talked to him about the administration's position on protection, particularly abstinence?

There is a rumor around that the administration is against condom use, and it's actually not true. The abstinence, be faithful, condoms -- the ABC program -- is basically what the administration's position is.

But there are certain groups, be they Catholic groups or other groups, who will not, of course, be apart of C. Again, you can't expect Catholic missionaries to be selling condoms. We would like them to, but they are not going to, and you've got to respect that.

Because of this language, … there are people out there who feel that if they are anti-condom, they will get more cash to spend. It's simply not true, and I had to look at this very hard before my last meeting with the president. It turns out the largest purchaser of condoms on the planet Earth is the United States government. I'm not even sure the president knew that, and I'm not sure he would want to trumpet it out there, but it's actually the hard facts.

You've got to watch the politics of AIDS. The politics of AIDS can work both for and against the victims of AIDS. …

You mention treatment. With these treatment programs, there's a moral commitment. When you put somebody on treatment, you're essentially making a promise to them.

That's right.

Can you describe what you see, whether we as a society are aware of the commitment we're making with programs like PEPFAR? Will the money be there and the drugs be there down the line?

Yeah, I think it's an obscenity, the idea of taking people off drugs once you put them on them. I think if that happens, I think all the good that President Bush's historic AIDS initiative did will be completely undone. I told him that, and we have told the same to all these politicians in all the various countries. And it's true of the Global Health Fund. ...

I hope these leaders understand that when they make a commitment to a family, a man, woman, child with AIDS, that it's a long-term commitment, because if budget cuts bite too hard, you will have the most preposterous sight of people being taken off antiretroviral drugs. If that happens, it will blow up. It will set fire to any good any of us have been working towards, ... because of course, people will die. It's obvious. You can't take people off these medications. ...

How do you respond to people who say treatment programs are great, but both the Global Fund and PEPFAR place too much emphasis on treatment [as opposed to prevention]? ... The political message is on treatment, and therefore you're not taking all the steps that need to be taken to stop the pandemic.

Any medic will tell you that prevention and treatment are the equal parts of any approach to health.

It is extraordinary that in India and China, you have these sleeping monsters. You would think more time would be spent on making sure that the disease doesn't wake up in those two huge populaces, because 1 percent of a billion people, that's an awful lot of people. And 10 percent, the world has never seen the likes of it. So there has to be a change of behavior, and education has to be apart of it. There is just no way around this.

But I think in a funny way, the thing about the drugs is that just once you have them, you have to hand them out. I think it was [U.N. Millennium Project Director] Jeffrey Sachs, my good friend and mentor in so many ways on so many things, who wrote a piece for the Times about the bubonic plague in Europe in the Middle Ages, where a third of Europe was lost to the black death, as it was called then. He was trying to imagine the scenario where -- he just made it up -- where if China had a treatment for the bubonic plague but hadn't got it to Europe because it was expensive or difficult, how would China be treated in the history books?

That's us, or that was us. We may be just turning the corner now into a place of responsibility for having developed these drugs. And being able to make them in a very cost-efficient way, we have to get them to people.

As I said to you earlier, they won't just transform the lives and communities of the people who receive the drugs; they will also change the way those lives and communities see us, and that might be important. That might just be important at this time.

There is a lot of suspicion in the world about we in the West, our value system. In fact, do we have any values? To be sitting on these technologies and not getting them out to the wider world in this emergency, that would confirm their worst suspicions, I would have thought.

So how we respond to HIV/AIDS tells a lot about [us].

How we respond to the AIDS emergency will describe us for posterity is the truth. You see all the stuff about the Irish peace process. You see it on the nightly news, and it's great -- there's a lot of American Irish people -- but it's a postage stamp in history. This is a whole chapter, the age of AIDS, and we will be defined and described by how we do or don't respond to it.