Little Hope, Less Help

Strong leadership from public officials may help, but most African governments have been slow even in admitting they have a problem. It is only in the past 18 months that President Daniel arap Moi of Kenya and President Robert Mugabe of Zimbabwe have used the word disaster in relation to AIDS.

Yet amid the despair, at least two countries have managed to address these problems. Led by President Yoweri Museveni, Uganda started a public AIDS-education program in 1990 that has driven the rate of new infections down dramatically in some places. And Senegal, with its own awareness program, has also cut taxes on condoms and got religious leaders to participate in AIDS education. As a result, Senegal's infection rate is a mere 1 in 50 adults, one of the lowest in Africa.

The notion that developed countries could do more to subsidize the cost of drugs was given impetus by a study reported in Durban last week. Such aid has been dismissed in part on the grounds that patients on these medicines need more monitoring than local health officials can possibly provide. But pilot projects in Ivory Coast, Senegal and Uganda have proved that even poor patients can stick reasonably well to a regimen without constant supervision.

If that's true, then drug companies and Western governments have lost a major excuse for inaction. When the G-8 economic summit convenes this week in Okinawa, AIDS will be a major item on the agenda. And while the African crisis may worsen, it's at least possible that last week's consciousness-raising meeting in Durban could mark a change in attitude--and perhaps even a tiny glimmer of hope.

--Reported by Peter Hawthorne/Cape Town and Simon Robinson/Nairobi