- The Washington Times - Friday, May 25, 2001

PRETORIA, South Africa — Secretary of State Colin L. Powell arrived in the heart of the worldwide AIDS epidemic yesterday, where one person in five is infected and millions will die without prompt delivery of lifesaving drugs.
Mr. Powell said South Africas leader is "fully seized" with the AIDS problem, but senior U.S. officials said President Thabo Mbekis failure to act promptly has allowed the epidemic to spin out of control.
"Its not just South Africa where leaders have ducked the issue," said a State Department official aboard Mr. Powells plane yesterday as he flew from Mali on the second leg of an Africa trip.
African leaders initially refused to accept that sexual activity spreads AIDS, and then failed to openly advise people to use condoms, limit their sexual partners or abstain from unprotected sex, said U.S. officials and AIDS specialists.
U.S. officials took pains not to openly criticize Mr. Mbeki as he dealt with the worlds biggest AIDS caseload, affecting almost 10 million people and climbing by about 15 percent a year.
Mr. Mbeki questioned last year whether AIDS was caused by the HIV virus and refused to give anti-viral drugs to pregnant women with AIDS to protect their children. He also has refused to pay for AIDS-fighting drugs that companies now freely allow to be copied.
"President Mbeki has unorthodox views on this subject," said Andrew Natsios, new administrator of the U.S. Agency for International Development, which is giving $8.4 million to fight AIDS in South Africa this year.
He said Mr. Mbeki is now "cooperative" but implied that the initial failure to publicly explain that sexual intercourse spreads AIDS has allowed the infection rate to get out of control.
"When the infection rate gets past 4 percent, there are geometric increases in the spread of the disease," said Mr. Natsios, speaking to reporters aboard the Powell plane yesterday.
AIDS is still spreading rapidly, and next year is expected to have infected 25 percent of South African adults. The average lifespan of South Africans is falling from 60 years to 40 because of the disease, which attacks many of the educated, middle-class people needed to run the country.
Asked by reporters whether Mr. Mbeki has acted properly in fighting the disease, Mr. Powell said after a 45-minute meeting with the South African leader: "The president is fully seized with the need to fight AIDS… . The leaders of the region are well aware of it."
U.S. foreign aid to fight HIV/AIDS has tripled in the past three years to $300 million — about half of all international aid provided by all donor nations to fight the disease, U.S. officials said yesterday.
However, U.N. Secretary-General Kofi Annan has said that from $7 billion to $10 billion is needed to stanch the epidemic, which has killed 22 million people worldwide since it began in the late 1970s.
Thirty-nine pharmaceutical companies have abandoned legal attempts to block South Africa from importing or manufacturing versions of the costly anti-AIDS medications, but Mr. Mbeki has angered some health care advocates in South Africa by refusing to commit government funds to purchase and distribute the cheaper drugs.
Dr. Nils Daulaire, head of the Global Health Council and former senior public health official at U.S. AID, warned that without a reliable system of health care workers to administer the complex series of pills each day, many Africans will take incorrect or insufficient doses and spawn drug-resistant mutations of the disease.
Mr. Mbeki and Mr. Powell also discussed the Middle East and African conflicts.
Mr. Mbeki called Mr. Powell "an old friend of our people" and praised President Bush, whom he planned to meet in Washington next month. Mr. Powell said Mr. Bush "encouraged this trip" and showed interest in meeting with the leaders of 35 African countries selected to participate in a U.S. trade accord.

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