Bush Continues Africa Trip With Stop in Botswana; Calls AIDS ‘Deadliest Enemy Africa Has Ever Faced’
President Bush today continued his trip through Africa with a stop in Botswana -- which has the highest HIV prevalence in the world -- saying that HIV/AIDS is the "deadliest enemy Africa has ever faced'' and pledging the United States' support in the fight against the disease, the AP/New York Times reports (AP/New York Times, 7/10). Currently, 36% of Botswana's 1.6 million people are HIV-positive, London's Independent reports. By 2010, more than 50% of the country's children will be AIDS orphans and the average life expectancy will have fallen from 47 years to 27 years. As a result of the grim statistics, drug companies and not-for-profit organizations are donating funds to the country's comprehensive prevention and treatment efforts (Frith, Independent, 7/10). Botswana has received grants for its universal access antiretroviral drug program totaling more than $100 million over five years from the Bill & Melinda Gates Foundation and drug maker Merck. In addition, the Harvard AIDS Institute has built a $4.5 million AIDS research laboratory and is training health care workers to address the epidemic (Kaiser Daily HIV/AIDS Report, 7/9).
Stigma Still a Problem
First lady Laura Bush and Botswanan first lady Barbara Mogae today visited a hospital funded by the Gates Foundation and Bristol-Myers Squibb's Secure the Future initiative (Independent, 7/10). The Children's Clinical Centre of Excellence project is a partnership among BMS, Houston-based Baylor College of Medicine's International Pediatrics AIDS Initiative and the Republic of Botswana. The center houses a large outpatient clinic, pharmacy, laboratory, medical library, conference center and offices and provides nutritional, psychological, social and child life services along with comprehensive primary and specialty care for infants and children who are HIV-positive or who have been orphaned by the epidemic (Kaiser Daily HIV/AIDS Report, 6/23). The building, which has state-of-the-art testing facilities and air-conditioned treatment rooms, cost $2 million to build, but some local AIDS advocates say that the stigma attached to the virus has caused many parents to not take their children for tests there because it will "mark them out," according to the Independent. A doctor in the capital Gaborone said, "I think the companies wanted something that looked good. I sometimes wonder how much good it will do when we can't even persuade parents to get their children tested." Ernest Darkoh, operations director of a large-scale treatment program in Botswana, said, "There has been denial on a massive scale in this country." Abe Whendero of the country's National AIDS Coordinating Agency said, "Botswana is faced with extinction because of AIDS," adding, "Without help, our country will disintegrate. What is so frightening is that the epidemic doesn't seem to be flattening out, as it has in Uganda" (Independent, 7/10). During a luncheon with President Festus Mogae, President Bush said, "The people of this nation have the courage and resolve to defeat this disease and you will have a partner in the United States of America" (AP/New York Times, 7/10).
Bush yesterday met with South African President Thabo Mbeki, "press[ing]" him to "deal with the epidemic more effectively," the New York Times reports (Stevenson, New York Times, 7/10). Mbeki's administration has faced criticism from people inside and outside of South Africa for its lack of action in the fight against HIV/AIDS. Although Mbeki has rescinded previous comments he made stating that HIV does not cause AIDS, advocates continue to question his position on the disease (Kaiser Daily HIV/AIDS Report, 7/8). Administration officials said that they were "optimistic" about the country's efforts to combat the disease. "What we believe is that the South African government, under the leadership of President Mbeki, clearly understands the needs for [antiretroviral treatments]," a senior administration official traveling with Bush said (New York Times, 7/10). Bush said, "South Africa has recently increased its budget to fight the disease, and we noticed and we appreciated that" (McQuillan, USA Today, 7/10).
Creating a 'Common-Sense Strategy'
Officials offered to include South Africa in the first round of the five-year, $15 billion global AIDS initiative as a way to push Mbeki "to move faster to bring all available weapons [against HIV/AIDS] to bear," according to the Times (New York Times, 7/10). The Bush administration has not called for any preconditions for South Africa to participate in the initiative, which the government sees as a vote of confidence in Mbeki's leadership, South Africa's Business Day reports. Health Minister Manto Tshabalala-Msimang is expected to prepare a proposal based on what the United States is willing to provide, according to Business Day (Business Day, 7/10). Bush said, "We need a common-sense strategy to make sure that the money is well spent. And the definition of well spent means lives are saved, which means good treatment programs, good prevention programs, good programs to develop health infrastructures in remote parts of different countries so that we can actually get antiretroviral drugs to those who need help." However, some AIDS advocates said that Bush "missed an opportunity" to make a "more direct public statement" about Mbeki's approach to the epidemic, the Times reports. Mark Heywood, national secretary of the Treatment Action Campaign, said, "There's no evidence that President Bush's visit advanced the South African government's thinking. We're still stuck with a government policy that is at odds with medical thinking universally" (New York Times, 7/10).
During his visit to South Africa, Bush "affirmed the United States' commitment" to an international trade agreement that would allow developing countries to produce generic versions of antiretroviral drugs, Long Island Newsday reports. But an administration official said that the president's statement did not "signal a change" in the country's position on a 2001 World Trade Organization proposal on the issue (Mulugeta, Long Island Newsday, 7/10). WTO talks over generic drug access have been stalled since members missed a Dec. 31, 2002, deadline to reach an agreement. U.S. negotiators in February refused to sign a deal under the Doha declaration to allow developing nations to override patent protections to produce or import generic versions of drugs to combat public health epidemics, including HIV/AIDS, unless wording was included to specify which diseases constitute a public health epidemic. The United States said that without such a list, developing nations could use patent overrides to produce generic versions of any patented drug, including drugs that are not used to fight public health epidemics. However, the United States last month made a concession by dropping its demand that the agreement apply only to a specified list of diseases (Kaiser Daily HIV/AIDS Report, 7/2). The official said, "The WTO agreement includes other drugs that are not AIDS drugs, such as aspirin and other commercial drugs. That's why we oppose it" (Long Island Newsday, 7/10). Bush said, "The United States supported a moratorium on the enforcement of patent laws concerning those drugs related to diseases that were causing pandemics. We will continue to work with South Africa, as well as other countries, to see if we can't reach a common-sense policy that, on the one hand, protects intellectual property rights, and on the other hand, makes life-saving drugs ... more widely available at reasonable costs" (Agence-France Presse, 7/9). Heywood said, "Whatever Bush said ... the U.S. is still blocking the production of these drugs" (Long Island Newsday, 7/10).
Bush on Friday is scheduled to visit Uganda, which has "launch[ed] a credible battle against AIDS," Reuters reports (Busharizi, Reuters, 7/10). Uganda has had success in lowering its HIV prevalence by employing the "ABC" HIV prevention model -- abstinence, be faithful, use condoms. Bush has cited Uganda's program as a model for his global HIV initiative. The program has led to a drop in the country's HIV prevalence from 30% of the population to 5% in a little more than 10 years (Kaiser Daily HIV/AIDS Report, 7/9). In addition, condom use in the country has increased from 5% in 1990 to 54% today, according to Agence-France Presse. Sam Okware, a Ugandan health official and former head of the country's National AIDS Control Council, said that the country's "tendency to face up to the reality of HIV/AIDS ... has allowed Uganda to do so much in mitigating the AIDS catastrophe over the last decade," according to Agence-France Presse. Okware added that Bush's visit will be "good [because] it adds political commitment at all levels. ... He is not coming empty handed," referring to the global AIDS initiative (Morland, Agence-France Presse, 7/10). Bush is scheduled to travel to Nigeria on Saturday (USA Today, 7/10).
The following broadcast programs reported on Bush's trip to Africa:
- CBS' "Evening News": The program reports on Bush's proposed AIDS funding and the effects of the epidemic in South Africa (Plante, "Evening News," CBS, 7/9). The segment is available online in RealPlayer.
- NBC's "Nightly News": The program reports on AIDS in South Africa and Bush's challenge of receiving congressional approval to fund the global AIDS initiative (Brown, "Nightly News", NBC, 7/9). The segment is available online in WindowsMedia.
- NPR's "Morning Edition": In the first of two segments on Bush's trip to Africa, journalist Joe Davidson provides a commentary in which he raises questions about how much funding Congress will appropriate for African assistance (Davidson, "Morning Edition," NPR, 7/10). The segment is available online in RealPlayer. Also on "Morning Edition," Don Gonyea reports that Bush will focus on AIDS during his stop in Botswana (Edwards, "Morning Edition," NPR, 7/10). The segment is available online in RealPlayer.
- NPR's "Talk of the Nation": The program provides an overview of Botswana and how the country is responding to the AIDS epidemic. The segment includes comments by Heinz Klug, associate professor of law at the University of Wisconsin (Neary, "Talk of the Nation," NPR, 7/9). The segment is available online in RealPlayer.
- PRI's "The World": In the first of two segments on AIDS in Africa, the program provides an overview of the global AIDS initiative and the role of abstinence. The segment includes comments by Bush, Rep. Mike Pence (R-Ind.) and Colin Jones, administrator of AIDS assistance for the Anglican Church (Costello, "The World," PRI, 7/9). The segment is available online in WindowsMedia. The second segment focuses on AIDS in Botswana and includes comments by Emeldah Mathe, a business and development consultant in Gaborone (Mullins, "The World," PRI, 7/9). The segment is available online in WindowsMedia.