By Lee Cullum, KERA 90.1 commentator
Dallas, TX – President Bush found a sea of troubles plus a few islands of hope during his trip to Africa, but nothing is more disturbing over the long haul than the AIDS pandemic. One of those islands of hope that he visited is Botswana. Though the highest in the world, or always near it, in the spread of HIV/AIDS, with 38.8% of adults infected, this country has a government noted, as many are not, for its enlightened approach to the problem.
What that government did was form a partnership with the Bill and Melinda Gates Foundation and the Merck Foundation, both of which put up $50 million each over the next five years to combat the plague of HIV/AIDS. Merck also agreed to contribute free medications.
They quickly understood, explained Linda Distlerath, vice president of the pharmaceutical company, that a nationwide approach offered the only chance of success. This is because people in Botswana, a small country of 1.7 million, move around a lot. They live in several places: their home village, their work (which may be in the mines) and at their cattle posts, little plots where many like to keep a few cows or steers. Hence, a way had to be found to track people all over the place, making sure they take their medication which is simpler than it used to be but unforgiving of those who miss a dose. Then HIV quickly can become drug-resistant and more virulent than ever, often moving into the unborn children of pregnant women.
Women fare especially badly in Botswana. While as adults, they make up half the infected population, as young girls they are two-to-one more likely to have HIV/AIDS than young boys. That's due to rape by their fathers and uncles.
Merck and the Gates people have attacked the situation from every conceivable angle, bringing in doctors from Britain, the Netherlands and the University of Pennsylvania to train medical staff; building 20 prefabricated clinics all over the country; recruiting local organizations to help educate everybody about the crisis; installing more than 10,000 condom dispensers. They've also taught interested groups to write proposals that then circle back to Merck and Gates for funding. Thus far, 217 proposals have been reviewed and 64 of them approved.
Botswana is one of the countries that will receive help from the $15 billion acquired from Congress by the Bush administration to fight AIDS. It already has made an impressive beginning. As Linda Distlerath points out, today 8,000 people are enrolled in her program. Eighteen months ago it was zero. But there is much more to be done since over 260,000 adults are infected. As a result, the current lifespan of 67 years is expected to drop to 47 by 2010. By then the number of children orphaned by AIDS likely will rise from 65,000 today to as high as 214,000. One official observed that this will change drastically the whole social order of Botswana. The country will become one huge orphanage.
There is bloodshed in Congo and a mess in Liberia, with Sierra Leone not far behind. But no catastrophe on the continent equals HIV/AIDS in its deadly implications. The president did a good thing when he went to Africa to see the situation for himself. Now more private interests must follow the lead of Gates and Merck and join the counteroffensive.
Lee Cullum is a frequent contributor to KERA and to the Dallas Morning News.