- The Washington Times - Sunday, July 4, 2004

KAMPALA, Uganda.

When someone asks me about what HIV/AIDSis doing to Uganda and Africa, I think of empty spaces at my family’s table.

I had eight siblings — four sisters and four brothers. They are now three and two. And what is true for me is true for most in Uganda and much of Africa.

If one surveyed the schoolchildren of Uganda, one would find that more than 70 percent know someone who has died. In many families, children are now the heads of households, with almost 2.5 million — a tenth of the nation’s population — now orphaned.

This is the legacy of HIV/AIDS we now face, and it threatens to only become worse.

Many in the West ask what they can do to help.

One thing developed nations can do is to stop debating quick-fix solutions for problems in Africa.

This has happened in the debate over the use of brand-name drugs from pharmaceutical companies in the United States and Europe and generic brands, which come mainly from India.

RecentlytheWorld Health Organization de-listed two generic drugs being supplied to Africans because they weren’t bioequivalent to the brand-name drugs they replaced. But with most clinics more than 10 miles from people’s homes, many Africans won’t know they should stop taking those drugs and return them for better alternatives. Africans with HIV/AIDS will need a steady supply of new drugs that are safe and effective.

New AIDS drugs will be needed in the coming years to overcome resistance to the old. Many are already on the second line of drugs — so researchers have to keep abreast if the hopes of nations and the people living with HIV/AIDS are to be sustained. There is fear that very soon people will be at the top of the ladder and the situation will be tense, since they will have no treatment to turn to. The doctors will be faced with a situation they are not equipped to handle.

Researching and developing therapies from traditional medicines could be a great option — since there is little resistance developed to most of them. But who will invest in researching and developing them if everyone wants and gets existing drugs at the lowest price?

And without them and the promise of effective treatment, what will encourage people who may develop HIV/AIDS to overcome their fears of stigmatization and bear the costs of being tested — when the tests can cost more than the drugs themselves?

The focus of the West and the media on drug prices distracts from the real challenges in Uganda and Africa — an inadequate health-care systemandpoverty. Africans need more clinics, more health workers and more education for the caregivers if they are to improve the lives of patients living with HIV/AIDS.

No doubt, we greatly appreciate President Bush’s commitment of $15 billion to fight HIV/AIDS in Africa. In addition to this unprecedented generosity, what Africa also needs from the West is not merely charity but the freedom to trade.

If the United States and Europe would open their agricultural markets to African exports, Africans could then better afford the kind of health-care system needed to combat not only HIV/AIDS but other health scourges in a sustainable manner.

Westerngovernments might also consider financial commitments to help educate and train our orphans, who then will be able to establish sustainable money-generating ventures in Africa.

My family’s table has three empty spaces. The developed world needs to open a place at their economic table for African nations if our own is not to become emptier still.

Edreda Bampata is a field coordinator for the Uganda Youth Forum.

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