HIV in Africa

....Today, the change for the better is astonishing: Idoko now treats nearly 6,000 HIV-positive patients. He has expanded his clinic three times in five years, and his waiting room once again is too crowded. ``Now, we are eyeing an abandoned building nearby," he said last week, chuckling.

The major reason for Idoko's success is the Bush administration's AIDS program, which in the last three years has sent billions of dollars to Africa and helped save the lives of hundreds of thousands of people. When I moved to Africa three years ago, the President's Emergency Plan for AIDS Relief, or PEPFAR, was just getting off the ground. As I return to Washington this month, the $15 billion program is just hitting its stride, and many Africans believe it has become the single most effective initiative in fighting the deadly scourge.

``The greatest impact in HIV prevention and treatment in Africa is PEPFAR-there's nothing that compares," Idoko said.

Only you wouldn't know it in America-or Canada, or Europe, for that matter-given the tenor of the AIDS debate in Washington and the nature of the international media coverage.

That debate was on full view last week at the International AIDS Conference in Toronto, which ended Thursday. While the AIDS epidemic in Africa is as urgent a crisis as it ever was-an estimated 24 million are infected on the continent and as many as 2 million died last year from AIDS-related illnesses-there are now at least some hopeful signs, though few activists in Toronto wanted to give the United States any of the credit. Indeed, the politically polarized bickering, according to those in Washington AIDS policy circles, could have effects far beyond the Beltway, threatening to impede national and international funding for AIDS programs.

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One telling moment in Toronto came last Sunday when Bill Gates, whose foundation has spent billions on global health in recent years, praised PEPFAR, prompting a chorus of boos from the audience.....

The reason? Because it insists on trainng in abstinance and working with churches, both which are acceptable in African culture but unaccepatable in the US and European circles, where hatred of religion and anger at anyone hinting their promiscuity spread HIV is the dirty little secret no one wants to discuss.