KAISER HIV/AIDS REPORT

TUESDAY, MAY 29, 2001

POLITICS & POLICY

Concluding Africa Trip, Powell Restates U.S. Commitment, Pledges $50 Million to Expand Ugandan AIDS Program

Secretary of State Colin Powell concluded his four-country tour of Africa Sunday in Uganda, pledging $50 million over five years for the expansion of an HIV/AIDS prevention program that has successfully cut the country's rate of HIV infection among adults from 30% to 10%, Reuters reports.  The funds will be divided into two blocks -- $20 million to expand the prevention program to new areas of the country and $30 million to go toward programs for Uganda's 1.7
million AIDS orphans (Wright, Reuters, 5/27).  Powell praised Uganda's anti-AIDS efforts and told a group of health workers and volunteers in Kampala that "[t]here is no war on the face of the earth right now that is more serious, that is more grave than the war we see here in sub-Saharan Africa against HIV/AIDS," adding that they have "taken the battle to the enemy" (Strobel, Philadelphia Inquirer, 5/28).  Speaking Sunday in Nairobi, Kenya, at a meeting with
members of private humanitarian organizations, Powell told the relief workers that "the United States is in this battle with you.  We will do everything we can to help you win this battle.  And hopefully it's a battle we can win."  Powell said he was "deeply moved" by what he had seen during his tour and "promised to try and persuade President Bush and Congress" to dedicate more money to fighting HIV/AIDS in Africa (Raum, Associated Press, 5/27).  Speaking on
Saturday's CBS Evening News, Dr. Paul Zeitz, co-director of the Global AIDS Alliance, called the United States' $200 million donation to the proposed global AIDS fund "not much of a start" and added that he would like to see a contribution of $2.5 billion.  The White House has said it has "nothing to apologize for," calling the initial contribution "seed money" (Cowan, CBS Evening News-Saturday, 5/26).  Powell "suggested" that he agreed with the critics and said, "Activists would always want to see more, and I encourage them to keep pressing us.  We should try to do more" (Nichols, USA Today, 5/29).

Protests in South Africa

Powell finished his visit to South Africa on Friday with a speech before 3,000 at the University of Witwatersrand in Johannesburg that was met with applause, as well as "skeptical inquiries" and protests.  Powell, who said he was speaking on "behalf" of Bush, received a standing ovation after his speech, which called on Africans to "embrace free markets, democracy, the rule of law and foreign investment" (Strobel, Philadelphia Inquirer, 5/26).  He told the audience that the United States would be Africa's partner "every step of the way" as the continent turned toward democracy, development and free trade, but he stressed that the United States "cannot be the leading force to make peace" on the continent.  Powell did not set forth any "detailed goals," and many in Africa have criticized his visit as a "symbolic gesture" meant to "assure Africans that they will not be marginalized" under the current administration (Murphy, Baltimore Sun, 5/26).  Powell was met by protestors outs!
ide the university who blocked his motorcade for over a half-hour in a sometimes "tense" standoff with school officials (Philadelphia Inquirer,
5/26).  The protestors, members of Muslim and communist groups, passed out leaflets that likened Powell to an "Uncle Tom for both Bushes" and called him a "war criminal" for bombing Iraq.

A Better Reception in Soweto

The demonstration was in "sharp contrast" to the reception Powell received earlier in the day at the Village of Hope, a Soweto township AIDS clinic, where one patient called him a "role model to the men in Africa."  Florence Ngobeni, an HIV-positive South African woman, told Powell, "[E]ven though you have not brought anything, as the media said, your visit means a lot to us.  The government has always let us down, but you have promised and always delivered." When asked if the United States would help provide antiretroviral medications to Africans, Powell said he could not "specifically" answer that question and added that the United States will "do everything we can" to help ease the African AIDS epidemic.  "[T]hat was the message I wanted to leave here with," he added (Barber, Washington Times, 5/26).  Powell said HIV/AIDS is a "health care problem, but it is also a problem of poverty, adding that it is "an economic crisis, a social crisis, a crisis for democracy, a threat t!
o stability, a threat to the very future of Africa, because it is decimating the very people who build that more prosperous
democratic, peaceful future" (Lacey, New York Times, 5/26).

Judging Powell

Speaking to Newsday, Salih Booker, executive director of the Africa Policy Information Center, said that "[h]ow Powell handles the AIDS issue will ultimately determine how history
remembers him."  The AIDS crisis is "solvable, [and] history will judge him harshly if the United States fails to provide leadership and finance," Booker said, adding, "There are going to be more deaths than there were in the bubonic plague, the Black Death and the Spanish flu epidemic."  Critics, such as Moeletsi Mbeki, a researcher at the South African Institute of International Studies and brother of President Thabo Mbeki, said HIV/AIDS is "our problem
and we must solve it" (Mulugeta, Newsday, 5/26).  The trip made "clear" that Powell has a "mastery of issues" and an "ease in official settings," USA Today reports.  Powell "made a point" of criticizing what he labeled Africa's "big men" -- leaders like Zimbabwe's Robert Mugabe and Kenya's Daniel arap Moi -- who have "suppressed democracy."  He also publicly "challeng[ed]" Mbeki's public questioning of the link between HIV and AIDS.  "Let us be clear, our enemy is the HIV virus that causes AIDS.  Our enemy is not its victims," he told a group in Johannesburg (USA Today, 5/29).

Reflecting on the Trip

Reflecting on his African trip en route to Budapest for a NATO summit on the Balkans, Powell admitted his understanding of the continent's AIDS epidemic had previously been more "academi[c]," adding that the journey had given him a "full[er] appreciation" of the scope of the
epidemic (Lacey, New York Times, 5/29).  According to the Philadelphia Inquirer, Powell "strove to make it clear that his interest in the continent was not just personal, but reflected Bush's priorities."  Powell, speaking to reporters aboard his plane, said that the trip "made clear to Africa that it will be a priority for us" and acknowledged that there had been "some doubt about that" (Strobel, Philadelphia Inquirer, 5/29).  Barring the protests at Witwatersrand, the overall response to Powell was "magnetic," especially among foreign leaders, according to one official who attended most of the meetings on the trip.  Powell said that the good reaction was "principally because I'm the secretary of state of the United States of America, but underneath that there's a bit of pride that I'm an African American" and added that he was "pleased there is
that subtext."  Kenyan opposition leader Mwai Kibaki was among those impressed with Powell and the trip.  "I do not know what the Bush administration will do in the future, but this is a good start," he said (Wright, Reuters, 5/28).

Things Left Unsaid


Powell "repeatedly" spoke of the need for continued emphasis on prevention of HIV transmission, but never once said the word "condom" during his trip.  He also never addressed
the hiring practices at some U.S. embassies in Africa, which his agency oversees.  Some embassies have required potential local employees to take an HIV test and have denied
employment to those who tested positive, a practice that would be illegal in the United States. The U.S. embassy in Kenya has put an end to the testing there, and the State Department has conducted a review of the testing policies and the "insurance implications of hiring HIV-positive
workers" at other embassies (New York Times, 5/29).  A new policy, designed to serve as a "human rights model that will encourage other governments to end the stigmatization of HIV and AIDS patients," will be issued "soon," according to State Department officials.  Without addressing the embassy practices, Powell said Sunday at a Ugandan AIDS clinic, "[B]ecause someone has HIV does not make them any less valuable as a human being, does not make them any less valuable in our eyes or in the eyes of God."  The change is expected to increase yearly insurance premiums, which are based on national prevalence of the virus, for U.S. posts
in Kenya and South Africa alone by more than $1 million each.  The shift may also lead to "personnel shortages" as a result of increased absenteeism by those who are infected.
However, the State Department said the change in policy may be a "solid investment" because the agency can use the shift to "expand its role" in HIV and AIDS activities and  formally" incorporate prevention "best practices" into embassy programs by training employees to be peer educators.  U.S. Foreign Service officers and their families stationed abroad will continue to be tested before being dispatched and at "regular" two-to-three-year intervals.  Because the
government is responsible for diplomats' medical care, HIV-positive members of the Foreign Service are "restricted" as to where they can be posted as a result of "inadequate medical support" and the potential acceleration of HIV disease progression in tropical climates (Wright, Los Angeles Times, 5/29).

Reaction to Powell's Trip

Several editorials critiquing Powell's trip appeared in newspapers this weekend.  The following are excerpts of several:

*Baltimore Sun:  Powell's African trip "reflects his personal priorities, not his president's," a Baltimore Sun editorial states.  Powell has made it "clear he cares, is engaged and hopes to offer U.S. resources to help African efforts on behalf of health, democracy, peace, law and
order," the editorial continues, adding that "combatting diseases" is a "good and necessary" policy (Baltimore Sun, 5/26).

*Washington Times:  "The international community must be careful to invest wisely in Africa," a Washington Times editorial states.  "Aid dollars should go towards empowering Africans, fortifying democratic institutions and improving the foundations of basic services," the editorial
continues, adding that "[k]nee-jerk and often ineffectual attempts to treat AIDS and its related problems" should be "avoided."  Powell's "commitment" to Africa is "admirable and well-placed"; however, the AIDS epidemic is a "symptom of larger problems:  ignorance of how the disease is transmitted ...; official corruption, government lack of accountability, generally weak democratic institutions and therefore insufficient basic services for the population," the editorial states.  "While the AIDS epidemic is a colossal tragedy, the international community should be careful to target the real causes of the region's problems," the editorial concludes (Washington Times, 5/27).

*Atlanta Journal-Constitution:  The United States must commit medical assistance -- "not just drugs, and certainly not just payments to countries" -- in the fight against HIV/AIDS, an Atlanta Journal-Constitution editorial states.  The complex nature of HIV treatment makes monitoring
patients "necessary" and Africa has neither the "funding [n]or people for the job," the editorial continues.  The government must also "insist that Africa's leaders take the reins," the editorial says, stating that Mbeki's "reluctan[ce] to acknowledge the need for AIDS medications is inexcusable," especially "given [South Africa's] leadership role on the continent and the fact that
AIDS is rampant" in the country.  The Bush administration would be wise to follow a Nigerian proverb that states:  "One should keep one's eyes on one's destination, not on where one stumbled," the editorial concludes (Atlanta Journal-Constitution, 5/27).

*Wall Street Journal Europe:  Powell's "new approach" in addressing African leaders and African problems is "blunt and forceful," a Wall Street Journal Europe editorial states.  Powell "didn't mince words" during his tour, unlike other western leaders who have been held back by their "colonial pasts," civil rights records, "left-wing guilt" and "political correctness," the editorial continues.  "The surest sign of friendship is hard and honest talk, especially for those in Africa who need to hear it most," the editorial concludes, calling Powell's approach a "better way" (Wall Street Journal Europe, 5/28).

*San Jose Mercury News:  "Lip service and 'photo ops' won't overcome skepticism by some Africans who still view the White House's agenda with suspicion," a San Jose Mercury News editorial states.  The administration "noticeably falls down" with its "paltry" and "embarrassing" commitment of $200 million to the global AIDS fund, the editorial states, adding, "The world's richest nation must set an example by contributing considerably more money."  However, the
editorial continues that the administration's ability to handle trade and health issues on the continent give reasons for optimism, but concludes, "[W]e will reserve our applause until the administration lays out a more detailed vision that leads to significant, long-term diplomatic policies" (San Jose Mercury News, 5/28).

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