PARIS, Dec 7 (AFP) - Africa comes under the spotlight next week at a key five-day conference where community work will be championed alongside cheap anti-retroviral drugs as a means of combatting the AIDS crisis ravaging the continent.
The annual conference on HIV and AIDS in Africa, opening ceremonially late Sunday in Ouagadougou, the capital of the western African state of Burkina Faso, gathers scientists, care workers and health ministers.
There will also be a cluster of western politicians, including Belgian Prime Minister Guy Verhofstadt, whose country is current president of the European Union (EU), according to the United Nations agency UNAIDS which is organising the conference.
Since AIDS was first discovered 20 years ago, 60 million people have become infected with the disease's precursor, the human immunodeficiency virus (HIV), 20 million of whom have already died, UNAIDS and the World Health Organisation (WHO) said last week in their annual report on the pandemic.
Of the 40 million people today living with AIDS or HIV, 28.1 million of them live in sub-Saharan Africa, the poorest and hardest-hit region of all.
"Without adequate and treatment and care," the agencies warned grimly, "most of them will not survive the next decade."
In Burkina Faso, Cameroon, Ivory Coast, Nigeria and Togo, at least five percent of the population aged 15-49 has HIV or acquired immune deficiency syndrome (AIDS).
In 16 other countries, the rate is at least one in 10. Worst of all is southern Africa, where in Botswana more than one in three of the nationwide adult population is infected.
The toll is so awful that the life expectancy in the worst-hit countries -- Botswana, Malawi, Mozambique and Swaziland -- is under 40, little more than half that of the West.
And the mounting economic and social stress, with the loss of skilled personnel, with babies infected while in the womb and children orphaned by AIDS, means some states could simply break up, the report warned.
Jean-Marc Foex, coordinator for a French-based AIDS charity which is deeply involved in Africa, the Association Francois-Xavier Bagnoud, said the picture was not uniformly gloomy, and it was vital to understand why.
Countries such as Uganda and Senegal "and more recently" Rwanda and Zambia were making inroads into the epidemic, he told AFP from Geneva.
They were gradually lowering the adult rates of infection, by thumping home a message of AIDS prevention using traditional leaders, churches, health workers and schools.
"The governments in these countries have an awarenesss of the problem that does not exist elsewhere," Foex said, adding that taboos about HIV were gradually being broken down by this honesty.
He contrasted this positive approach with the "doubt" which had been spread in South Africa by President Thabo Mbeki, who has questioned the clinical causes of HIV and resisted the introduction of drugs that can brake the spread of the virus.
The campaign to break down the cost of these anti-retroviral medications has made strides this year, after several pharmaceutical companies, acting in the face of mounting public criticism, agreed to slash their prices.
Momentum has been added by one of the episodes of the September 11 crisis: the anthrax scare.
The United States, which had loudly defended the right of Big Pharma to recoup the costs of expensive research by charging high prices, suddenly found itself on the receiving end when it looked at the bill for setting up a stockpile of anti-anthrax drugs.
Faced with fierce pressure from the US authorities and public, the German company Bayer agreed to nearly halve the price for its premium antibiotic, Cipro, to help build the drug reserves.
The price for a cocktail of anti-HIV drugs "has gone down from 3,000 dollars a year to, say, 350 dollars a year in the most favourable cases," said Foex.
"But who, among the poorest categories of people, can afford even that? No-one can," he complained.
"Eventually it will have to be free, but this will only happen if (African) governments are somewhat bolder on this issue and if Western doctors and decision-makers realise that the drugs can be administered properly in poor communities without building up the risk of resistance, as in the case of tuberculosis medicine."
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