All the dying people: HIV/AIDS is causing dramatic losses in Africa, cutting the average life expectancy in South Africa from 70 years down to 30, closing almost half the schools in the Central African Republic, and wreaking havoc on economic development. (African - AIDS).

AIDS is thought to have originated in Africa and nowhere else has it had such a devastating effect. Of the world's 36 million AIDS sufferers, 25 million are in Africa. Already, 17 million Africans have died of AIDS-related illnesses. However, the potential for a horrible catastrophe is much greater, as in some places 90% of the population has HIV, the precursor of AIDS.

Worldwide, AIDS kills someone every second, and every six seconds it infects someone new - almost 15,000 people a day. In 2000, 4.7 million adults were infected and 600,000 children were. So far, about 58 million people have been infected and experts think that's only about half the final tally. That's the prediction if something is done about the epidemic: unchecked, the number of people infected would be in the hundreds of millions.

While industrial countries have kept the HIV infection rate among adults to less than 1%, in many African countries it is more than 10%. In South Africa, it is 20%. In Zimbabwe and Swaziland, it is 25%. And in Botswana, which has the highest infection rate, 36% of adults are HIV positive.

According to one report, this epidemic, now producing thousands of orphans each day, has produced 30 million orphans in sub-Saharan Africa in the last 20 years. One bleak estimate suggests there could be 100 million orphans in Africa by the end of this decade.

The International Partnership Against AIDS in Africa says that "By threatening a generation of youthful, productive people, the disease is mortgaging the continent's future."

The impact on those who are left is immense. More than 900,000 African school children have lost teachers to AIDS, and one in every seven farmworkers in sub-Saharan Africa has died, which inevitably affects the food supply. According to Mark Schneider of the International Crisis Group, a multinational non-governmental organization funded by Canada, the U.S., and Europe, "AIDS has wiped away the development progress of the last two generations. We've established that when a country reaches the point of having 10% of its population infected by HIV, the growth in GDP (Gross Domestic Product) is cut by a third."

A report released in June 2001 by the UN Development Program suggests that if the epidemic remains untreated, the worst-affected countries could see their economies shrink by as much as 40% over the next two decades.

The disease is spreading to other regions of the developing world as well, particularly in the former Soviet states, the Caribbean, and parts of East and South Asia. By 2005, an estimated 100 million people will be infected.

A 2001 study warned that controlling the world epidemic of HIV-AIDS would need another $26 billion (U.S.) by 2005, when the annual cost would run to $9.2 billion. The researchers said two-thirds of the money should be spent in Africa and almost one-third in Asia. They said only $1.8 billion is being spent annually on HIV-AIDS in the developing world, where more than 90% of the infected live. The U.S. spends about $20 billion domestically every year, with fewer than one million sufferers.

People infected with AIDS in many parts of Africa get no medical assistance atall - less than one-tenth of one percent of the 25 million infected Africans have access to the life extending drugs that are available to people in Western countries; in others, help is available but it's way too expensive. Some drug companies have cut the cost of their medications to 10% of their North American price; it would be nice to report that this was out of a genuine desire to help, but it's more likely a reaction to the dreadful press the pharmaceutical companies have been getting. But even with such huge discounts the cost of treatment is far more than many can afford. Part of the answer to treatment is cheaper generic drugs.

In April 2001, heads of state and officials from 43 African countries met in Abuja, Nigeria, to declare a state of emergency over AIDS and demand changes to laws and trade rules to make drugs affordable to fight the disease.

A month earlier lawyers representing 39 of the world's largest pharmaceutical companies assembled in a courtroom in Pretoria, South Africa. They were there with a legal suit to stop South Africa from acting on a 1997 law allowing it to import low-cost generic drugs. But, the suit was withdrawn in April. An Oxfam spokesman described the case as a public relations disaster for the drug makers: "The public cost to the companies of continuing the case has been driven through the roof by public campaigning," said Kevin Watkins. "[Also,] they didn't have a case. A lot of people in the industry felt un comfortable with it right from the start."

However, the drug companies still argued that the problem is more than one of cost of treatment: they say if the drugs were given away for free, there still is the problem of getting them where they're needed because many countries in Africa have no medical infrastructure to deliver them. They also say there are too few doctors and not enough clinics, drug-monitoring labs, or storage facilities. Add to these problems poor public education and political instability or corruption in some cases and the solution becomes far more complex than drug costs. To those who say pharmaceutical companies are interested only in making profit, the industry says it's those profits that are reinvested in high-cost research and development. (Critics would add that a hefty sum goes to marketing and lobbying too.)

Acknowledging that the crisis isn't entirely the responsibility of drug companies, the World Health Organization in Geneva thinks Western countries, foundations, and private donors should pump money into the battle against AIDS. And, from the industry, it wants a differential pricing system allowing poor countries to pay less for drugs in return for controls to prevent the drugs being re-exported to richer countries. Activists couldn't agree more. They reason that in a health emergency such as the HIV-AIDS crisis, compromises on patent protection should be made. That won't solve all the continent's problems, but it's an important part of the solution along with a lot more foreign assistance in building a better medical infrastructure to deliver the drugs to the people who need them.

SUGGESTED ACTIVES:

1. Only 13 of the 1,223 new drugs patented between 1975 and 1997 were for infectious diseases, although 6.1 million people died in 1998 of TB, malaria, and respiratory illness. Clearly the Western world is indifferent to the health problems of developing nations. Discuss this viewpoint.

2. A recent article in Current History magazine quotes Belgian professor Dr. Peter Piot of the UN AIDS program as saying: "If [the AIDS pandemic] would have happened ... with white people, the reaction would have been different." The article goes on to say that the AIDS crisis in Africa reflects "the racial double standard that has marginalized African lives for the past 500 years. This double standard divides the world between rich and poor, white and black. The past five centuries have brought not only progress, but also considerable suffering - and Africa has suffered disproportionately, and still does ..." Discuss what you think would have been done if the Western world had been hit with HIV-AIDS to the same extent as Africa has, and what you think should be done to help Africa.

3. Neville Hodgkinson, former science correspondent of The Sunday Times (London), challenges the idea that HIV originated in Africa. He says that the tests used to detect HIV are not accurate in poor countries because false-positive results can occur in the presence of TB and malaria, which affect millions in Africa. He adds that numerous chronic infectious diseases prevalent in Africa cause immunosuppression, as well as signs for AIDS. In the mid-1980s millions of dollars in foreign aid became available to fight the disease and Mr. Hodgkinson says it was in the interest of some of the most desperately poor African countries, such as Uganda and Tanzania, to report high rates of AIDS. In an article in New African in September 2001, Mr. Hodgkinson quotes Dr. Christian Fiala, an Austrian doctor who has spent years researching the development of AIDS, including a fact-finding mission to Uganda and Tanzania. Dr. Fiala concluded "that the horror stories of an epidemic of a new infectious disease in Africa `exist exclusively in the heads of the statisticians who ... use untenable and escalating multiplications to arrive at their alarming conclusions.' "They're saying the whole African-AIDS theory is an illusion and that devoting more and more domestic funds to AIDS activities is taking resources away from welfare, education, rural development, and other health purposes in Africa; it's diverting funds away from the continent's real problems, most of which relate to poverty. Mr. Hodgkinson's book on the controvercy, "AIDS: The Failure of Contemporary Science," was published in 1996 by Fourth Estate. Research this idea of illusion, find out how many followers it has, and try to determine if those involved have anything to gain. On the other hand, is there anything to be gained by inflating the incidence of AIDS in Africa?

FACT FILE

AIDS is the leading cause of death in sub-Saharan Africa, killing 10 times as many people as the continent's wars.

FACT FILE

By July 2000, the AIDS epidemic was taking more than 6,000 lives a day in Africa - the equivalent of 15 fully loaded jumbo jets crashing with no survivors and the number is expected to be double that during this decade.

FACT FILE

The World Health Organization estimates that at least five million HIV-AIDS patients in the developing world could benefit from drug cocktails, which have only been in use for about four years but have already cut the death rate by 70% in the West.

FACT FILE

Close to half of Zimbabwe's health care budget is used to treat AIDS patients; in some hospitals in Burundi and South Africa, AIDS patients occupy 60% of the beds.

Websites

United Nations AIDS Program - http://www. unaids.org/

Positive Action - http:// www.positive-action.org/

Canadian HIV/AIDS Legal Network - http://www. aidslaw.ca/home.htm

RELATED ARTICLE: Desperate for funds.

The Abuja (Nigeria) Declaration urged African nations to spend 15% of their budgets on the health crisis, and asked rich countries to donate 0.7% of their gross national product. It also supports U.N. Secretary-General Kofi Annan in his call for a new multi-billion dollar global AIDS fund. As recently as July 2001, none of the mighty G8 countries had met the promised donor target of 0.7% of GNP, although small economies such as Denmark, the Netherlands, Norway, and Sweden routinely surpass it.

RELATED ARTICLE: Some good news.

Sub-Saharan Africa, a region of 600 million people, is moving into uncharted territory. This isn't the first large-scale epidemic: smallpox decimated New World Indian populations in the 16th century, and the bubonic plague hit Europe in the 14th century, but nothing has ever caused such a concentrated loss of adults.

The good news is that some countries are halting the spread of the HIV/AIDS virus. The key, according to some observers, is strong leadership from the top. In Uganda, where the epidemic first took root, the active personal leadership of President Yoweri Museveni over the last twelve years is credited with reducing the share of adults infected with the virus from a peak of 14% to 8%. Uganda's President saw education as the best way to combat the spread of the disease. Through a relentless public awareness campaign, religious and cultural taboos had to be broken to talk openly about sex. The result has been that the number of new infections has dropped well below the number of deaths from AIDS.

Some consider the Brazilian program to fight AIDS the best in the world: in 1996, 9,600 Brazilians had the disease but by 2000, the number of deaths fell to 1,200. The government provides about 100,000 people with a cocktail of drugs and training in how to take it effectively. One of the keys to the program's success is that government laboratories produce most of the 12 drugs in the cocktail - only two are imported at prices that absorb 36% of the country's annual AIDS-prevention budget. Zambia, and parts of India, have also developed similar campaigns. By taking easy action against the threat of the disease, Senegal prevented the epidemic from gaining momentum and held the infection rate to two percent of its adults, a number only slightly higher than that of the industrial countries.