Yet, none of these would be possible but for one equally extraordinary gift from no other than nature herself; of all the species and phenomena that inhabit the earth, our race was blessed with the faculty of reason. With this most exceptional distinction, we are able to care for ourselves and our kind in a manner denied all other species. With this faculty we have devised the most efficacious shelters from the elements. With this faculty we have invented the most efficient means of mobility. With this gift we have defied gravity and created vacuums against the dictates and natural laws of physics. But perhaps most significantly for the survival of our race, with this faculty we have discovered and devised, steadily and methodically, the most extraordinary means to fight and even eradicate disease and all those vulnerabilities that otherwise leave us prey to the ravages of natural processes and our predatory neighbors. The gifts of observation, articulation, and reasoning have made it possible for us to devise and compile this marvelous branch of knowledge called medicine, without which our species would long have fallen to the assault of time. I address you today as custodians of this most indispensable profession to which the human race owes its survival and perpetuation.

I realize that among us this morning there are individuals from numerous other walks of life, yet who are, one way or another, connected with or interested in the study or general practice of human well-being. There can be no better or more appropriate audience for the issue that I have chosen to address today. For, although it was my initial interest to explore with you the general theme of art and health in our world today, I have nevertheless decided instead to focus on a rather unique situation that I consider most teething. This situation concerns art, no doubt, because it concerns life, and life and art are inextricably interwoven, inasmuch as art enhances the quality of life and life is necessary in order to produce art. The great American author, James Baldwin, once wrote that life is more important than art and that is what makes art important. This situation therefore concerns the very possibility—and indeed essence—of art. It also concerns our moment in history, and the rapid changes that define that moment; the fact, for instance, that whereas in the past health and life, whether physical or spiritual, occupied a primary place in our cares and considerations as individuals and as a civilization, today those considerations and many others come second to economic convenience and profit. I've chosen to call your attention to the fact that, today, Africa faces one of the greatest catastrophes in human history, namely, the AIDS plague.

In the West this admittedly universal problem is battled constantly by the entirety of the relevant sections of the scientific community and the health-care sector, including healthcare providers and the medical and pharmaceutical industries. It is also addressed with the full power of the State. But as you know, the very opposite is the case in Africa. Today statistics reveal that perhaps more than two-thirds of the global number of HIV-positive patients are in sub-Saharan Africa, although the continent only accounts for less than a tenth of the world's total population. Those statistics may well be familiar to most of you, but for the benefit of those who have only a vague idea of the enormity of this human crisis, it is perhaps no undue imposition to repeat them. As we speak, experts estimate that 13 million people in sub-Saharan Africa have already died of AIDS. That is more than the entire populations of whole countries put together. Another 10 million are expected to die over the next five years. In a country like Botswana, of every three citizens, one is infected by the HIV virus or already has AIDS. In Swaziland and Zimbabwe every one in four people is infected. In Lesotho and South Africa every one in five people. By the year 2010, the average life-expectancy for the sub-region would have fallen to 30, and the greatest number of orphaned children in all of human history would have been created in Africa by AIDS. On the average no family would be spared a death, no community let untouched, and no culture could claim to be whole again. It is no consolation to know that by the middle of this century, if this crisis is unchecked, sub-Saharan Africa would have lost more human beings and resources to the AIDS plague than it did in all of four centuries of slave trade, internal wars, and colonial domination. We are speaking, then, of an epic holocaust the like of which has not been seen before. We are looking at the valley of the dry bones.

These are men and women, children and adults, homosexuals and heterosexuals, puritans and prostitutes alike. And the greater tragedy is that there is no respite. In its halting match towards self-reliance over the past forty years, Africa has nevertheless failed to rally the strength and will to provide its people with the barest minimum protection against the most common challenges to good health and well-being. In the face of this cataclysm, it has even less hope to find the resources to cope. A prominent German philosopher once wrote that after the Nazi holocaust, it is impossible to write lyric poetry, by which he meant that beauty and art are inconceivable in the aftermath of such gruesome experience. One looks at the African predicament and wonders; how can we speak of art in the face of such calamity? How does one think of art in the face of survival itself? How does one make art among the dead and the dying?

We are here today to investigate the role of art in human health and well-being. But in a predicament where entire populations are under threat of annihilation, and with them the heritage and cultural memory of centuries, perhaps the imperative is not to find the role of art in health, but to look instead into the role of health in the survival of a people and its culture. Art is for the living, and in a land of the dead, how can there be art? This may well appear as a far too simplistic way to couch this matter, and of course no experience or predicament is quite as simple and straightforward. Yet the situation remains that we are faced with a phenomenon of such great magnitude against which that continent and its people have no defenses at present, which means that millions are confronted with the stark realities of life and death.

Of course art has its role even in such a desperate situation, albeit only in the realm of education and awareness since art as therapy is only relevant to those who already have access to medical therapy, which is not the case with the majority of sufferers in Africa. Certainly, part of the problem with the AIDS plague in Africa is a cultural one, with populations that are largely unfamiliar and often non-receptive to safe sex or other proven protective practices against infection. In this sense art and artists have a major role to play whether through visual art, theatre, or other means of getting rigidly disposed populations and cultures to adapt to the new realities of this epidemic. However, the greater challenges of the African AIDS crisis are political and medical, and it is for this reason that I have chosen to call your attention to it today.

AIDS has spread so exponentially in Africa and claimed so many lives because the continent and its leaders lack the will to confront it or put in place the infrastructures necessary to combat it. Also, and this is very important and very relevant to this audience, the international medical and pharmaceutical community has exhibited less than genuine dedication to the crisis in Africa, and this is not a case of blaming the outsider for one's problems. Although scientists have regularly engaged in research in Africa, exposing even non-infected Africans to some of the most dangerous medical experiments that often end up in infecting healthy individuals with the disease, the benefits of these experiments are rarely extended to dealing with the ongoing disaster on that continent. Drug manufacturers have shown reluctance to save lives because they place profit before African survival. Foreign governments with the infrastructures and facilities have shown reluctance because in their thinking, the crisis in Africa is an African problem. On these fronts art has little to offer but to raise the alarm, to let the world know that we need the Africans, too, and that all those who have the know-how and wherewithal to help have a moral obligation to do so.

For what does it benefit us if we should accumulate all the knowledge and all the profit and lose a huge portion of humanity? What does it benefit medicine and science that we make discoveries and develop drugs and therapies, but fail to make them available to a race in distress? What does it benefit us that we speak about art and health and harmony when entire cultures are on the edge of obliteration? I address you today not as politicians or policy-makers necessarily, but as professionals, as men and women whose calling dictates that you save lives, that you dedicate yourselves to the survival of our species. I come before you not as an artist or a philosopher, but as a man whose race is on the brink of a great calamity. Should the scientific and health providing community sit back and watch this calamity unfold unchecked, soon it will be redundant to speak about art because there will be almost no one on that continent to produce art. Perhaps those who visit in the aftermath of it all would only be able to utter those chilling words from Dante's Inferno which ominously reappear in T. S. Eliot's The Wasteland: 'I could not believe that death had undone so many.'

There is an unarguable moral obligation facing this community in Africa. If that tragic continent has been failed time and again by its own leaders, it provides no exoneration for the rest of humanity should we also fail it. This is my appeal on this session on art and health, that the international medical and health-providing community collectively rededicate itself to combating this awful plague because cultures and civilizations that do not survive, do not produce art.

Thank you.