Newsday - Tuesday, July 9, 2002
Laurie Garrett, Staff Correspondent

A U.S. delegation led by Health and Human Services Secretary Tommy Thompson is making an effort to display America's support -- and funding -- in a gathering that has grown despairing and hostile.

"Last night at dinner, at the next table over, a bunch of activists were talking about everything that is wrong with America," Thompson said in an interview last night. "I thought, if it was not for America, the Global Fund [for AIDS, malaria and tuberculosis] would be nothing. If it was not for America, mother-to-child transmission programs would not get off the ground. If it was not for America you would not have the opportunity to build infrastructures in countries so they can use these drugs properly."

This afternoon Thompson will address the gathering, and protesters are expected.

The forum has become bewildering territory for Americans and Europeans, as the agenda has spread beyond traditional issues of health, science and foreign aid. Thompson shook his head in response to an Indian delegate's speech assailing U.S. farm subsidies. "To stress their points, they can make accusations that aren't even connected to HIV or the epidemic," he lamented.

The appearance of issues such as agricultural trade policies are being aired by those who insist the AIDS pandemic is not only threatening the stability of national economies and governments, but is even exacerbated by such policies. Addressing a session yesterday, Dr. Bernhard Schwartlander, director of AIDS programs for the World Health Organization, described AIDS' impact on economies.

"For some time now, macroeconomic data have hinted at the potential impact -- an estimated 2.6 percent reduction in GDP [gross domestic product] in countries with over 20 percent prevalence, and a drop in national economic growth from 2 percent to 4 percent across Africa as a whole," he said.

One study that showed particular devastation examined the Lake Victoria region of Africa. Between 1990 and 1995, Dr. Basia Zaba of the London School of Hygiene and Tropical Medicine said, 47 percent of all deaths in Masaka, Uganda, were due to AIDS. In a neighboring district, the rate reached 74 percent. Among the survivors, orphans are more than three times as likely to die before their fifth birthdays, compared with non-orphans. Among the key causes of death was starvation.

South Africa's Medical Research Council president Dr. M.W. Makgoba said that each AIDS death in southern Africa translates into a household loss of income of 34 percent.

Such snapshots of catastrophe have churned the desperation and anger of AIDS-afflicted nations. In an interview, Jack Chow, deputy assistant secretary of state for health and science, said the AIDS pandemic "is a growing part of the State Department agenda."

Thompson said, "I think America is doing a lot of things right. Can we do more? Yes. But we want to make sure that what we are doing is not wasting efforts, that it works."

At Sunday night's opening ceremony, Thompson's counterpart from Spain, Celia Villalobos, angrily left the stage after her speech was nearly drowned out by angry Spanish delegates who accuse their government of acting as poor hosts. Many African, Asian and Latin American delegates and journalists had visa difficulties due to requirements that those from poor nations provide copies of personal bank account statements and proof of health insurance.

Those from North America, Japan and Europe entered the country without such requirements.

The Spanish government insists there were no improprieties, but conference organizer Shaun Mellors, of South Africa, conceded any AIDS meetings held in Europe would likely experience similar visa difficulties. The reason: what he called "Fortress Europe" -- the fear that some conferees from poor countries would choose to stay illegally in the wealthy world.

A decade ago the International AIDS Conference was scheduled to take place in Boston but had to move to Amsterdam when Congress passed the Helms Amendment, requiring HIV testing for those seeking extended visas and denying admission to HIV-positive would-be visitors to the United States.

The International AIDS Societies, which organizes the biennial meeting, officially voted never to convene in a nation that discriminates against travelers based on their HIV status, so the United States is not eligible.

The 2004 gathering will be in Bangkok, and the 2006 gathering is scheduled for Toronto. The Canadian government recently approved mandatory HIV testing for immigration. Thomp.son, who said he was unaware of the history of U.S. restrictions on travel for HIV-positive individuals, said he would like to see the United States host the gathering again some day.
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