- The Washington Times - Sunday, December 14, 2003

TORORO, Uganda.

Travel 10 miles north of the provincial hospital here on a rutted dirt track and you come to a village called Chegen. There’s no electricity, and the nearest water comes from a well a mile away.

In tiny round mud huts with thatched roofs and floors paved in dried cow dung, dozens of people are living with HIV/AIDS. Most of them would be dead if they didn’t get weekly deliveries of anti-retroviral (ARV) drugs, delivered by health workers on Suzuki motorbikes.

Outside one of those huts, a beautiful 33-year-old woman with the saddest eyes I have ever seen is kneeling on the ground, telling her story to a half-dozen of us, including William Haseltine, the CEO of Human Genome Sciences, and Louis Sullivan, the former health and human services secretary. The woman’s husband died of AIDS, and, by tradition, her in-laws banished her and took her house away. Destitute, she was given a small space by a church. She now lives there with her two daughters.

Debilitated by AIDS, she says she struggles to find the money to pay their school fees and must beg for food. “She is very grateful,” translated Sam Okwaare, Uganda’s energetic commissioner of health, who grew up in a village nearby and was educated in the United States. Mr. Okwaare’s resourceful system of home-based AIDS care, provided by the motorbike angels, is one of many programs here that is funded by the U.S. Department of Health and Human Services, whose charismatic secretary, Tommy Thompson, has taken AIDS in Africa as his special cause.

Welcome to ground zero of the global AIDS epidemic. Spend a week here, and it will tear your heart out. The United Nations recently reported that two-thirds of the 40 million people living with HIV/AIDS are in Africa. Last year, about 2.3 million Africans died of the disease, compared with 18,000 Americans and Western Europeans.

Overall, about 1 in 12 people in sub-Saharan Africa have the HIV virus. In Swaziland, the proportion has grown from 4 percent a decade ago to 39 percent. In Zimbabwe, one-fourth of adults have HIV. But Uganda, where infection rates are about 8 percent (still more than 10 times U.S. levels), is a success story. A high-level delegation, led by Mr. Thompson, and including the directors of the Centers for Disease Control, the National Institutes of Health and the World Health Organization, came here to see why.

Following the motorbikers was a “life-altering experience” for those in the delegation, said Randall Tobias, the U.S. Global AIDS Coordinator, who is directing dispersal of the $15 billion that President Bush, in an unprecedented measure, has promised to fight the disease in 14 nations, including Uganda.

The problem in Africa, at least for now, is not the drugs. As Mr. Thompson said several times during the trip, “It’s the infrastructure.” As soon as a solid distribution and monitoring system is developed, as here in Tororo, the drugs, which in some cases cost as little as a dollar a day, can be distributed.

But there is deep concern, voiced by many experts on this trip, that today’s ARVs — especially if they are administered without the proper safeguards — will lose their effectiveness in a short time, and, if that happens, will drug companies, under severe attack from political activists (but not from afflicted Africans here on the ground), continue to devote huge sums to research for the next generation of ARVs? One source in a position to know said that two of the six key research drug companies that make ARVs have decided not to continue in the field.

What is clear is that watching the suffering of Africans with AIDS, and the orphans the disease has produced, had a powerful impact on members of the delegation — notably Mr. Thompson himself. With tears welling in his eyes, he told a crowd assembled at the hospital after the visits: “I am absolutely moved and transformed. … If you really want to change the world, do it through bringing health and clean water to people who need it. Nothing is more powerful than a foreign policy based on health and clean water.”

James K. Glassman, a resident fellow at the American Enterprise Institute and host of TechCentralStation.com, traveled with the Thompson delegation, which toured Cameroon, Zambia, Rwanda, Kenya and Uganda.

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