Los Angeles Times - Wednesday, August 1, 2001
Maggie Farley, Los Angeles Times

Starting Sept. 1, a total of 10,000 adults and 5,000 children will receive a government-subsidized cocktail of anti-retroviral drugs designed to combat the symptoms of AIDS, Stephen Lewis, the U.N.'s special envoy for HIV/AIDS in Africa, said.

"It's a quite extraordinary intervention, a measure of the president's determination that they maintain the level of the pandemic where it is and try to turn it back," Lewis told reporters at U.N. headquarters on Monday. "They recognize that if Nigeria fails, then much of Africa will fail."

The experimental program involves just a fraction of Nigeria's estimated 2. 6 million people with HIV, the virus that causes AIDS. But Lewis said it underlined the country's commitment to tackle the disease that has infected 26. 5 million people across Africa, the world's hardest-hit continent.

Until this year, many African leaders maintained that AIDS was not a problem in their nations, and on Monday, South African Catholic bishops condemned the use of condoms as an "immoral and misguided weapon" in the fight against AIDS.

But Nigerian President Olusegun Obasanjo has been a leader in Africa's struggle against the pandemic. At the first U.N. Conference on AIDS held in June, he warned of "the extinction of an entire population of a continent," and argued for cancellation of Africa's debts so it could marshal its resources against the disease.

The government also took independent steps, including hosting a Harvard School of Public Health study of health systems in three Nigerian states. The research is funded by a $25 million grant from the Bill and Melinda Gates Foundation.

Earlier this year, Nigeria sent its health minister to India to negotiate a special deal with Indian pharmaceutical company Cipla Ltd. to supply an inexpensive, generic version of a three-drug cocktail. Cipla had originally offered the treatment to developing countries' governments for $600 per person annually, and to nonprofit organizations for $350 each, but the Nigerian health minister secured the lower price for the country in April, Obasanjo said.

The treatments will be administered by Nigeria's teaching hospitals, and patients will have to pay between $7 and $8 a month to receive the drugs. Part of the program is a comparison between two treatment regimens, with 60 percent of the patients receiving a six-drug cocktail, and 40 percent taking a two- drug combination, Lewis said.

"We've all heard of the alleged crippling constraints -- from the tatters of the health infrastructure, to the absence of human resources, to bureaucracy that doesn't work," he said. But after meeting with leaders and grass-roots organizations in Kenya, Rwanda and Nigeria during a recent visit, he said he was confident that "there is tremendous progress to be made in the face of the obstacles."

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