Africa Embraces Anti-retroviral Therapy

Whenever the issue of using drug therapies to treat AIDS in Africa came up in the last decade, many people argued that it couldn't be done there.

The mantra was that "Africa doesn't have the infrastructure to be able to distribute (anti-retroviral) drugs because they wouldn't be kept on the proper time-frame and protocols wouldn't be established, says President George W Bush's special advisor, Jendayi Frazer, who is also senior director for Africa at the National Security Council (NSC).

That argument, though faulty, she says, is what prompted the president's announcement in his state of the union address of an emergency plan for AIDS relief, a five-year, US $15,000 million initiative that will build up Africa's health infrastructure.

It is aimed to give the most afflicted countries in Africa and the Caribbean the weapons to fight and win war against HIV/ AIDS, in part by introducing widespread use of anti-retroviral (ARV) drugs.

Speaking to a packed conference at the Mayflower Hotel in Washington on March 7 commemorating International Women's Day, Frazer said the president's emergency AIDS plan "is very much focused on trying to build the health infrastructure so that anti-retrovirals (ARV's) can be widely distributed in Africa; it's very much focused on the treatment side."

The event, featuring a discussion on "Women and Orphans : The Face of AIDS in Africa," was hosted by the United Nations Information Centre, which was created through a $1,000 million from cable television impresario Ted Turner.

The priority of this emergency plan, Frazer continued, is specifically to prevent seven million new infections and provide ARVs for at least two million HIV/AIDS-infected people.

While the plan's initial focus is in Botswana, Cote d'Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, South Africa, Tanzania, Uganda, Nigeria, Rwanda, and Zambia, Frazer adds: "What we expect is that President Bush will scale that up again 'include other countries' as we see these programmes have effect on the ground."

However, she added: "Our approach is not simply focused on treatment," and she mentioned a recent conference on palliative care-- to moderate the intensity and reduce the violence of AIDS-- recently conducted by Joseph O'Neil, director of the White House office of AIDS policy.

Putting money into the global fund to fight AIDS, tuberculosis and malaria, is a further effort "to leverage funding and we have a commitment to try to mobilise international resources," Frazer said.

President Bush has said "we need a second round of pledges."

She added that the United States is "deeply committed to the global fund; we have put (secretary of health and human services 'Tommy' Thompson as chairman of the board of that fund to demonstrate our commitment."

The United States has made "three pledges: The first one was $200 million, then up to $500 million and then to $1,500 million," Frazer said.

Adding that before the United States makes another pledge, other countries - "Canada, France, Japan, and the Netherlands, Russia, and Britain, who have made first round pledges that are about to expire must renew pledging. So we do see the global fund as leveraging and acting on all fronts.

"Clearly, we all know how important prevention is, to stop the disease by particularly focusing on education and working with African leaders to make this a high priority," Frazer said.

"President Bush, when meeting with African heads of states, always asks what is the state of HIV/ AIDS in their country; what the prevalence rates and what are they working on; what their strategies are to help prevent it and to treat those infected. So it is in fact a comprehensive approach."

Asked why it is taking so long to implement the new emergency funds for African AIDS, Frazer said. "The pledge is $2,500 million, but only one million has been dispersed on the ground (in Africa).

"The administration is not going to commit more money until we actually see programmes on the ground operating. It is a very phased approach. It's not enough to just commit more money."

She reaffirmed that "the president's commitment is unquestionable. As we see the programmes operating, more money will flow. But it makes no sense to commit more money over the $1,500 million before we even set up the programmes to (use) that money."

A participant from the embassy of Malawi said she was "one of the Africans who was very, happy to hear about the $15,000 million the current administration has pledged towards fighting HIV/ AIDS."

However, she said, she was dismayed to learn that "there were some countries that were excluded," and asked if they would be included at some point.

Frazer answered: "Yes. What happened with the emergency plan is that it was focused on the 14 countries that were part of the mother- child transmission initiative. The 12 in Africa serve as 'focus' countries."

Other US- funded programmes are also helping in the prevention and treatment of AIDS, she said, including regular bilateral assistance programmes, whether run by the centres for Disease Control (CDC) or the US Agency for International Development (USAID) or another body.

"And so other countries are receiving US funding in HIV/AIDS," Fazer said. "In the implementation of this programme, we would certainly look to work particularly in Africa, with strong regional organisations like the Southern Africa Development Community (SADAC) to try to get that treatment and health infrastructure built across countries.

"And so while I can't say at this moment that we will add this particular country or that particular country, there is a commitment to try to continue (funding) the Global Fund, and, perhaps in the implementation of the Emergency Plan, make sure that anti-retrovirals go beyond those 14 focus countries and the Caribbean community countries."

The ambassadors of Cyprus, Zambia and Mozambique were in attendance as well as a prize- winning national public radio reporter (Brenda Wilson received a Kaiser Foundation award to study AIDS in South Africa) and others who are working to prevent and treat HIV/AIDS throughout Africa.