Newsday - July 9, 2000
Laurie Garrett, Staff Correspondent

For at least thirty years military forces have served as mobile vectors for the deadly virus. Today, HIV has found unwitting allies in the war raging in the Democratic Republic of Congo.

Surprisingly, the war in Congo has indirectly affected computer information at Los Alamos Laboratory in faraway New Mexico. In the enormous computers there are stored the genetic details of every analyzed strain of HIV viruses, with the earliest sample dating from 1959. Dr. Bette Korber and her colleagues have noticed that, "something strange is going on in Congo. It's as if all the African HIV clades [subtypes] are mixing there, forming strange recombinants. We're seeing variants never seen before."

At least seven different countries are fighting against one another in battles meant to decide the fate of Congo, formerly known as Zaire, and its valuable oil, mineral and gem resources.

The Congo War, which began as a civil war in 1996 overthrowing former dictator Mobutu Sese Seko, originally placed rebel leader Laurent Kabila in power. Guerrillas, representing various Congolese ethnic groups, are fighting Kabila and one faction or another is backed by military forces from Uganda, Rwanda, Zambia, Namibia, Zimbabwe and Angola. Congolese rebels also have been moving freely in Tanzania, Burundi, Sudan and the Central African Republic. South Africa has attempted to broker a peace, but all sides are tugging at the influential nation, hoping to drag it, too, into the fray.

This spring, hostilities took turns for the worse as Rwandan and Ugandan troops-supposedly fighting as allies-opened fire on one another. In May, Kenyan President Daniel arap Moi and Tanzanian President Benjamin Mbaka brokered a peace deal but fighting has continued. In northern Tanzania, government officials said they fear the war will soon spill over into their Kagera District.

Until recently, one of the "remarkable features about HIV" was the geographic restrictions seen of various subtypes, or clades, of the virus. In the Lake Victoria region (Uganda, Kenya, Tanzania and Rwanda), nearly all HIV was of either the D or A clades. In southern Africa, where the epidemic is comparatively newer, C clade has dominated. The C clade has also been the major form of HIV in Ethiopia and the Horn of Africa. West Africa, in contrast, has been dealing mostly with A, G and D clade viruses.

But now, Korber said, "recombination is happening so fast that we see the clade distinctions beginning to blur," and viruses are emerging that have genetic bits of, for example, Ugandan D clade HIV, C clade pieces that look Zambian and A clade material that appears Congolese.

It is not possible to predict whether this Congo HIV mlange will lead to greater dangers.

Maj. Ruranga Rubaramira of the Uganda Defense Forces acknowledges that AIDS is taking a serious toll. In a May speech at an AIDS event in Kampala, Uganda's vice president, Dr. Speciosa Wandira Kazibwe, declared the epidemic "a security issue," implying that her country's advances in rolling back HIV incidence could be threatened by viruses brought home by returning soldiers.

It wouldn't be the first time soldiers brought HIV home to their Ugandan wives and girlfriends.

In 1962, Uganda gained its independence from the British Empire, bringing Milton Obote and his military right-hand man, Maj. Gen. Idi Amin, into power. Amin then overthrew Obote in a coup in 1971, commencing what is commonly called "the Ugandan Reign of Terror." He bled the national economy dry, expelled the nation's Asian population and ordered the torture and execution of an estimated 500,000 Ugandans, about 3 percent of the population, during his eight- year reign.

Amin directed much of his brutality against the Baganda people of Uganda's Rakai District. For three years Amin's soldiers, many of them mere boys, occupied the district, exacting "tributes" in the form of sex with village women.

On Oct. 30, 1978, Amin's army, bolstered by arms supplied by Libya, launched an invasion of neighboring Tanzania. The troops massed in Rakai District and rolled unopposed across the border, seizing the Kagera District of Tanzania. Six months later, the Tanzanian Army reclaimed Kagera with a force of 45,000 and, upon seeing the destruction, rape and brutality Amin's soldiers had exacted upon their fellow countrymen, descended upon hapless Rakai with a vengeance.

"They stayed here a very long time," Serapio Semanda, age 75, recalls in Kibumba village in Rakai. "They were just brutal, taking the women, roaming like vagabonds."

Amin retreated to Kampala, recalls attorney Sophia Mukasa-Monico, who was then a student at Makarere University. Even then, according to Mukasa-Monico, Amin said, "There is a very, very bad disease that is passed by sex and it is from Tanzania. It is venereal and it is incurable."

"And that was 1978," said Mukasa-Monico, who heads Uganda's private group, The AIDS Support Organization. "Even at the University we were saying some of the boys had this new disease-be careful. And during Idi Amin's time something fell in the morals. And sex was the release."

But the disease wasn't from Tanzania-though by then infected Tanzanian soldiers were spreading it. Thanks to the Amin brutality and the movement of soldiers in the area, AIDS soon exploded in the Kagera District of Tanzania.

Since the global AIDS pandemic first exploded out of warfare between Uganda and Tanzania, military activities-both conventional and guerrilla-have played a key role in spreading HIV around the continent. In April, when President Bill Clinton declared the AIDS epidemic a U.S. national security threat, the rising infection rates among African militaries were crucial to his move.

In Uganda, military affairs were also what originally awoke President Yoweri Museveni to his country's AIDS crisis shortly after he overthrew the government in a military action in 1986.

"Because in 1986, after the president came to power, they had a guerrilla force," recalled Dr. David Kihumuro Apuuli, head of the Uganda AIDS Commission. "They wanted to transform it to a conventional army. So they sent 50 generals to Cuba for training. And 18 turned out to be HIV-positive, and Castro called Museveni and said, 'You have a problem.' And Museveni felt so sorry, so upset, because these were comrades who had fought with him in the bush."

Maj. Rubaramira, who fought alongside Museveni and became infected with HIV in 1985, said that Museveni "talked about HIV even when we were in the jungle. He wrote a message to all officers to be careful of the new disease."

Following Castro's startling phone call, Museveni decided to tell the whole nation, starting Uganda's large-scale and candid AIDS education campaign.

A similar chain of events befell the Zimbabwe Armed Forces, as related by Brigadier General David Chiweza-but with a markedly different outcome. Chiweza fought alongside Robert Mugabe in the Rhodesian Civil War of the 1970s, and once Mugabe became president of the renamed nation, Chiweza rose through the ranks of Zimbabwe's professional military.

"This is where I come in," Chiweza explained. "I got a vision 10 years ago. I was in China as Zimbabwe's defense attach."

China had a mandatory HIV testing law for all foreigners. The men under Chiweza's command were screened, "and the Chinese called me in and said, 'Look, we can't accept them in the country.' And I saw a lot of my guys were HIV-positive. It was 1990 and 13 out of 60 were HIV-positive, and 30 out of 60 had" sexually transmitted diseases. "So that was a shocker for me. As a military man I never thought about HIV. For at least a week I was not myself. I went mad because I couldn't believe I would be well when so many of my countrymen were not."

Chiweza retired from the military in 1995. Today, he notes, HIV rates are soaring among Zimbabwe's military personnel. And unlike Museveni, Mugabe has remained nearly silent on the subject of AIDS throughout his 20-year rule of Zimbabwe.

HIV rates in African militaries all over the continent have reached frightening proportions, with the highest seen in South Africa. This spring a malaria survey was conducted of the South African National Defense Forces stationed in the state of KwaZulu- Natal. It was decided as an afterthought to screen the blood samples for HIV-90 percent turned up positive for infection. Soldiers in a base near the Mozambican border tested 70 percent positive, prompting newspapers across South Africa to declare that three-quarters of the nation's soldiers were infected.

Seventy-five percent is the current infection rate of the Malawi Army. And Zimbabwe's Army, in a recently disclosed survey that had been meant to remain secret, turned up 80 percent positive.

Earlier this year the U.S. Central Intelligence Agency released its estimates of African military infection rates, indicating that up to 60 percent of Congo's and Angola's armed forces, 20 percent of the Nigerian military, and 30 percent of Tanzania's army are now infected.

"Amazing, no?" asks Apuuli. "So definitely war is going to perpetuate HIV/AIDS on this continent."

Marked features of contemporary African warfare are famines, massive refugee movements, widespread rape of village women and elevated levels of prostitution in urban areas by women desperate to find means to feed their children. All of these outcomes may promote sexual behaviors that spread HIV.

"So, soldiers die of HIV in Congo-is anybody surprised by that," indignantly asks Dr. John Rwomushana of Uganda's AIDS Commission. "They shouldn't be. This whole region is a refugee setting. These issues must be addressed. A success story of Uganda [AIDS control] is nothing in a sea of HIV/AIDS. The war is demonstrating this. For HIV there are no boundaries. Leaders have to put down their arms and fight a different war-against HIV."

Zimbabwe, where one of four adults is HIV-positive, is taking an opposite course, however, spending roughly twice as much Zimbabwean money on the war in Congo-a nation with which it shares no borders- as on health.

"I have to defend Defense," Minister of Health Dr. Tim Stamps insisted. "It's a very unstable continent...We are reluctantly in the DRC [Congo]. None of us want our people to be killed on foreign land."

Chiweza, the retired general, was stunned.

"I think it's always better to serve the highest, rather than the immediate goal. In the end you will be confronting graves."

In Uganda, Major Rubaramira was more adamant, and angry. "This is war," he shouted, pounding his fist on the table. "If there is any strategy to fight AIDS it should be used. And if someone prevents that, that person is an enemy for humanity...the spread of HIV is the fault of the leaders.

"And I think if they are not going to listen we should find a mechanism of infecting them."

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