The New York Times - October 24, 2004
Michael Wines

In a national address on Saturday, on the eve of the 40th anniversary of Zambian independence, President Levy Mwanawasa said a growing population and recent economic problems had "reduced the capacity for the government to maintain quality health services" even as AIDS-related sicknesses were on the rise.

"The impact on the health care delivery system is enormous, with 50 percent of hospital beds occupied by patients with H.I.V.- and AIDS-related illnesses," he said. "There is not enough money to spend on social services such as health."

He nevertheless said that the goal of reaching 100,000 Zambians with free or subsidized antiretroviral drugs, first announced in September, would be met.

More than one million of Zambia's 10 million citizens carry the virus that causes AIDS, including one in six adults. About 200,000 are in an advanced stage of AIDS-related ailments and would benefit from antiretroviral treatment.

The government once hoped to have 70,000 of its citizens on antiretrovirals by the end of this year, but the rollout of the lifesaving anti-AIDS drugs has proceeded markedly slower than expected. The first major donations of money from the Global Fund to Fights AIDS, Tuberculosis and Malaria came this year, as well as the beginnings of a White House program, the President's Emergency Plan for AIDS Relief, which has expanded drug treatment in the capital, Lusaka.

Japan announced early this month that it was increasing its donation to Zambia for AIDS relief. In September, Zambia's Commerce Ministry declared the AIDS pandemic to be a national emergency, an act required under international agreements to permit the cheaper domestic production of patented antiretroviral drugs.

But the government is in a race against the pandemic, with long-latent H.I.V. infections developing into AIDS at an ever-quicker pace and AIDS deaths exacting an ever-greater toll on the economy.

In an appeal last week for $404 million in international donations to forestall famine in southern Africa, the World Food Program warned that AIDS was dramatically worsening hunger in the region by killing farm workers and laborers who bring food to market.

Hundreds of thousands of people in Mozambique and Zambia face hunger, despite above-average harvests in the region, because they are unable to gain access to harvested food, the agency stated.

The government has said that it expects to spend $500 million through 2010 on AIDS treatment programs. But with Zambia's economy increasingly on the skids, it is not clear where much of that money will be found. Mr. Mwanawasa said in his Saturday address that his government would continue a stringent economic program on which the International Monetary Fund has conditioned a promise to write off $3.8 billion of the nation's $7 billion foreign debt next year.
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