OUAGADOUGOU, Dec 12 (AFP) - The time is approaching, maybe sometime next year, when Jean-Baptiste Kiwallo will feel like he is playing God.
A doctor at a Red Cross Outpatients Centre for AIDS victims, Kiwallo, 31, may have to join his colleagues in determining who, among their poorest patients, can get the free wonder drugs that will sustain them in life and who must be denied them.
Those who make the list have the chance of living a normal life, of holding down a job, of watching their children grow happily into adulthood.
Those who are fail are condemned to a slow, mortal decline, their children plunged into the nightmare of AIDS orphans.
The well-equipped, spotlessly clean clinic opened just 15 months ago in Ouagadougou, the capital of Burkina Faso, offering HIV and AIDS patients counselling, testing and anti-retroviral drugs for a token fee or for free.
The centre was instantly overwhelmed. Within a few months it had to close down to be expanded, more than doubling from 170 square metres (1,800 sq. feet) to 400 sq. metres (4,100 sq. ft).
It reopened again last November 20 and less than a month later is already running at maximum capacity, treating around a thousand people as outpatients.
On average, several dozen people walk through its doors every day for treatment.
On some days, it's a hundred, and the two doctors -- soon to be three -- and four nurses then work late into the night.
Word has spread across much of western Africa about the dazzlingly whitewashed little hospital and its rumoured elixir of life.
"We have had cases of people who are brought in on a stretcher and don't have the strength to get up. After a few months (on anti-retrovirals), they put on 20 or 30 kilos (44 or 66 pounds) and are full of life again. They always greet me in the street, and come by the clinic once in a while to say thank you," says Kiwallo.
"People now come from Bobo-Dioulassou (a town in the far southwest of Burkina Faso), from Guinea, from Benin, from Niger, looking for help," he adds.
Those who can afford it pay a contribution towards the anti-retrovirals -- drugs that suppress the virus, but not eliminate it -- equal to a small percentage, usually between five and 15 percent, of their income.
People who are destitute, many of them AIDS widows or orphans, get the precious drugs for free for life, thanks to a benefactor in Paris, Jacqueline Beytout, whose foundation co-runs the facility with the French Red Cross, the Burkinabe state and the Pan African AIDS Organisation (OPALS).
The trouble is that the centre only has enough resources to pay for 300 of these lifetime free courses of treatment, and demand is so enormous that already more than 175 slots have been filled.
At some point, Kiwallo and his colleagues may have to decide some mightily unanswerable questions.
Is a young man with advanced AIDS worth more than old one in an early stage of infection? Is a widow with children aged 16, 12 and eight more deserving than a single mother with two children aged three and one?
"The decision is tough, but we have to do it," says Kiwallo, explaining that a candidate's case would come before three panels that would separately examine the medical, psychological and social aspects.
So far this year, the price of a monthly individual course of anti-retroviral drugs, negotiated by the Burkinabe ministry of health and the big pharmaceutical companies, has fallen from 300,000 CFA francs (450 dollars) per month to less than 100,000 francs (150 US). Kiwallo is hoping for additional declines, donations and subsidies that could push it down to as low as 15,000 francs.
With every price fall, the bar above 300 creeps higher.
And the list of survivors grows longer.
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