Chicago Tribune - August 22, 2003
Laurie Goering, Tribune foreign correspondent

Alec Erwin, the country's minister of trade and industry, told the surprised U.S. group that he does not believe the international studies that show AIDS is reducing life expectancy and slowing economic growth in South Africa, said Sen. Bill Frist (R-Tenn.), Senate majority leader and head of the six-senator delegation.

South Africa has the world's largest number of people infected with HIV, the virus that causes AIDS.

The government's apparent denial of the scope of the crisis may jeopardize South Africa's chances of winning a hefty share of the $15 billion in anti-AIDS funding for Africa that President Bush has promised over the next five years. The senators, in Southern Africa to study AIDS prevention and treatment programs, will play a key role in determining whether the funds are appropriated on schedule and where they go.

"If the U.S. is going to be investing taxpayers' money . . . we need to make sure it's invested with full cooperation and support of governments," Frist said Thursday while touring AIDS care facilities near Johannesburg.

"If there's not a recognized problem among leading figures here, it makes it more difficult" to address the epidemic, he said.

He stopped short of saying South Africa might lose its chance at a share of the U.S. AIDS funding. But he said he was disappointed that President Thabo Mbeki was not in the country at the time of the visit, that Health Minister Manto Tshabalala-Msimang had not scheduled a meeting with the group and that the trade minister appeared to be downplaying the effects of the crisis.

"Obviously, it disturbs me," Frist said. "The complexity of the problem demands political leadership."

Free medicine announced

South Africa's government, long reluctant to accept the scope of the AIDS epidemic or launch effective treatment programs, earlier this month announced that it would begin providing free life-extending anti-retroviral drugs to some of the estimated 4.7 million people infected with HIV in the country.

Until now, only a small number of South Africans have received such treatment, usually because they work for private companies committed to providing it or because they have volunteered for drug studies. Most South Africans cannot afford effective therapy, which costs at least $90 a month, about the same as a monthly disability pension.

The new government move, which the president's Cabinet termed a matter of "national urgency," was hailed as a dramatic turnaround. AIDS researchers, treatment advocates and corporate treatment providers Thursday told the visiting senators they believed that the government would stick to its new course on treatment.

"They opened the door a week or so ago, so they can't close it now," said Dr. Donnie McGrath, a researcher and anti-retroviral therapy advocate in South Africa's KwaZulu-Natal province, where nearly one in three adults carries HIV.

But Senate delegates said they were disturbed by the government's seeming reluctance to admit the scale of the problem, even as neighboring countries such as Botswana have embraced AIDS treatment.

Studies show HIV-AIDS is now the top killer of South Africans, accounting for about 30 percent of deaths. Life expectancy has plunged by a decade in the past nine years. Calculating economic losses from the disease is more difficult, but some researchers think the country's 3 percent annual growth rate has been nearly halved by AIDS, which has led to absenteeism, rapid workforce turnover and other problems for industry.

Sen. Lamar Alexander (R-Tenn.), chairman of the Senate's African Affairs Subcommittee and another of the visitors to South Africa, said he believed all $15 billion of Bush's announced Emergency Plan for AIDS Relief eventually would be allocated and that South Africa would get its share.

Response changing

"The South African government has not as enthusiastically reacted to this [AIDS] challenge as I would have expected them to, but that is changing," he said.

Bush's AIDS initiative is designed to prevent 7 million new HIV infections in Africa and the Caribbean during the next five years, treat 2 million AIDS patients and provide care for 10 million HIV-positive Africans and AIDS orphans.

In the next week, the visiting senators also are to travel to Botswana, Mozambique and Namibia before returning to Washington for appropriations hearings.

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