Fighting AIDS In Africa

Some good news in the fight against AIDS on the African continent, courtesy of the Boston Globe.

FIVE YEARS AGO, in Jos, Nigeria, a city on the country's central plateau, Dr. John Idoko regularly made rounds in a hospital packed with people dying from AIDS because they couldn't pay for the antiretroviral drugs necessary to keep them alive. Three years ago, as the price of the drugs plummeted, the Nigerian doctor was able to deliver the life-extending medication to 700 patients-until his government's supply ran out for several months.

Today, the change for the better is astonishing: Idoko now treats nearly 6,000 HIV-positive patients. He has expanded his clinic three times in five years, and his waiting room once again is too crowded. "Now, we are eyeing an abandoned building nearby," he said last week, chuckling.

The major reason for Idoko's success is the Bush administration's AIDS program, which in the last three years has sent billions of dollars to Africa and helped save the lives of hundreds of thousands of people. When I moved to Africa three years ago, the President's Emergency Plan for AIDS Relief, or PEPFAR, was just getting off the ground. As I return to Washington this month, the $15 billion program is just hitting its stride, and many Africans believe it has become the single most effective initiative in fighting the deadly scourge.

"The greatest impact in HIV prevention and treatment in Africa is PEPFAR-there's nothing that compares," Idoko said.

And unlike many government programs, this one is flexible enough to adjust needs and approaches.

Some US AIDS coordinators in Africa grumble about the spending requirement on abstinence programs. In Washington, US officials have given waivers to some countries to spend less money on abstinence programs, allowing the continuation of effective existing efforts to distribute condoms to truck drivers and reaching out to men to try to change sexual behavior.

In Nigeria, Idoko said that more money should be spent in all areas of prevention, especially in the education of young people.

"It's not that people in Africa are having more sex than anywhere else, it's just that sex in the West is a lot safer because of the information they have and because of the technology that is available," Idoko said. "For many Africans, buying a pack of condoms is a huge problem. Many don't have enough money."

The program's approach to combatting the spread of AIDS is as simple as ABC: abstinence until marriage, being faithful and condoms. In Africa, approximately 1 of every 16 people ages 15-49 are HIV-positive. The continent holds 10 percent of the world's population -- but 60 percent of AIDS cases.

A friend of mine spends volunteer time working in HIV prevention and treatment in Africa. She tells me the majority of the cases she sees comes from male-to-female or female-to-male infection -- and the majority of those involve prostitution. It's in this area that the ABC program will work best.

As in the United States, a good portion of Europe and almost all of Latin America and Asia, gay people who live in Africa, however, are denied the right to "A." But there's nothing stopping them from B and C.

While there is much still to be done, it is good to see that American dollars are being put to good use abroad -- particularly in a region known for its corruption and thievery. Now about that $2 billion a year we give to Egypt ...