TCS Daily

Terrorism, AIDS and Partnerships

By James K. Glassman - December 3, 2003 12:00 AM

NAIROBI, Kenya, Dec. 3 -- CNN went bonkers over a travel alert yesterday aimed at Americans venturing here, and the front page of today's East African Standard screamed, "Nairobi on High Terror Alert." But, at least for now, Al Qaeda is nowhere in evidence. So, undeterred, a high-level delegation, headed by Health and Human Services Secretary Tommy Thompson and President Bush's AIDS czar, Randall Tobias, met with Kenyan President Mwai Kibaki and other officials on the most pressing problem facing Africa today -- the devastating AIDS epidemic.

The visit to Nairobi, which included a reception at the residence of Ambassador William Mark Bellamy, was remarkably upbeat. At last, the AIDS epidemic, which afflicts 40 million people worldwide -- about two-thirds of them in Africa -- is being taken seriously.

"We are here to find ways we can enhance our support for the people of Kenya," said Thompson at a conclave at the Kenyatta conference center in downtown Nairobi. "The continent of Africa has been ravaged for far too long," said Tobias.

Thompson's group -- an unprecedented collection of 105 government officials, corporate executives and leaders of non-governmental organizations -- received a rousing welcome here. "I sincerely want to thank President Bush for his emergency plan for AIDS relief," said Kenya's engaging Health Minister, Charity Ngiliu. She added, "We strongly support public-private partnerships."

Such partnerships were the main focus today, thanks to a joint announcement by the Global Business Coalition on HIV/AIDS and the Global Fund on AIDS, Tuberculosis and Malaria that nine corporations had pledged to use their facilities and employees to expand workplace HIV/AIDS prevention and treatment programs into the communities where they operate.

For example, Pfizer, Inc., the giant pharmaceutical company, will send 20 health fellows -- some of the best and brightest executives at the company -- into the field to improve community outreach programs to fight AIDS in Africa. As Hank McKinnell, chairman and CEO of Pfizer, put it: The drugs exist to combat the disease, but, "what is not available in adequate supply is resources and infrastructure."

Among the other companies that have developed programs in what is being called the "co-investment partnership" are Bristol-Myers Squibb -- which, as CEO Peter Dolan pointed out, has already dispersed $96 million in 150 grants in the effort and is now replicating a primary-prevention center in Botswana in another African country to be announced -- and LaFarge, a building material producer with operations in Cameroon, which has trained health workers to provide HIV treatment to employees and their families and is now expanding that assistance to non-employees in the area.

Richard Holbrooke, the former top State Department official who heads the Global Business Coalition, praised the companies that were participating in the "first [such] partnerships in this war." But he lamented, "Most companies still don't see it's their responsibility."

Still, optimism reigns. The BBC reported this week that the Merck Co.'s health foundation is training 435 Kenyan volunteers to conduct clinical trials of an AIDS vaccine. There is evidence that antenatal programs -- to reduce the chance of AIDS for a baby born to an HIV-positive woman -- are working.

And the money is beginning to flow, led by the Bush Administration's commitment of $15 billion over five years, primarily to Africa -- a commitment given critical and heroic support by two members of Congress on this trip, Sen. Don Nickles (R-OK) and Rep. David Weldon (R-FL).

There is optimism that the "three-by-five" goal, announced Monday by the World Health Organization -- three million HIV-infected patients treated by 2005 -- will actually be met.

Meanwhile, the health-care officials in the delegation, including such luminaries as Anthony Fauci, who directs the National Institute for Allergy and Infectious Diseases at the National Institutes of Health, and Jack Chow, the top AIDS executive at the WHO in Geneva, were talking about easier-to-administer anti-retrovirals (three drugs in one pill). And costs have fallen sharply. As Ngilu pointed out, Only two years ago, a full course of anti-retrovirals cost about $12,000 annually in Kenya. Now it's $150 a year.

But it seems to me that the ease of use and the low cost of generics -- made possible in part by the TRIPS agreement cemented in Cancun in September -- raises a troubling question: What happens as the virus mutates and new drugs are needed to take the place of the ones that work currently?

Will the research pharmaceuticals companies, which have often been cast by activists as villains in the AIDS drama, want to spend the billions necessary to develop new drugs if they are continually under attack, despite their good works, and if their prospects of profit are diminished?

That's a story that will develop later in our travels, I'm sure.

Editor's note: James K. Glassman and Eric Bovim of TechCentralStation are traveling with the Thompson delegation in Cameroon, Zambia, Rwanda, Kenya and Uganda.


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