In Uganda, A Leader Creates Hope

It is easy to get discouraged by what's happening in Africa, but there is also good news. Ed Bradley reports. In Uganda, the democratically elected president, Yoweri Museveni, had the foresight 14 years ago to confront the AIDS epidemic.

Although Uganda is one of the poorest countries in the world, since 1993 the rate of new HIV infections here has declined by 50 percent, even while the infection rate continues to soar in other, wealthier countries.

Museveni has applied a no-nonsense approach to governing his country, ending much of the chaos that formerly reigned. He has applied the same method to the HIV, which surfaced in Uganda in the 1980s.

The president first realized the problem when he sent some soldiers to Cuba for training. Fidel Castro took him aside and told him that out of 60 soldiers, 18 had AIDS.

At that point, he knew that Uganda had a big problem, Museveni recalls.

He decided to attack it in what he calls "the traditional African way."

"When a lion comes to the village, you make an alarm, you make the loudest alarm, and everyone hears that there is a danger in the village and everyone wakes up," he says. "So that's what I did. When I go to a public rally, I don't only talk about the politics, I talk about AIDS also."

"I knew that a lot of our people would die if I did not shout loudest," Museveni says.

"Changing sexual practices is extraordinarily difficult for people," says Richard Holbrooke, the U.S. ambassador to the United Nations. "People don't like to talk about it. Museveni in Uganda has been an exception."

Museveni openly advocates the use of condoms, which offended some in Uganda, home to a large Catholic population. "Some priests and those bishops tried to say something about that but we ignored them because they had no solution," he says.

The condom message is everywhere. And judging by the steep decline in new HIV infections here, the message seems to be working. Still Uganda has nearly a million citizens - one-tenth of the country's population - living with and dying from HIV/AIDS.

And many Ugandans who get the disease have a difficult time paying for treatment, which is expensive. The government doesn't have the money to help people pay for medicine.

Dr. Peter Mugyeni is a national leader in the war against AIDS. Drugs that extend life indefinitely in the West are out of reach in Africa, he says. "All the modern drugs are here, but patients have to pay for them."

At one hospital, Dr. Mugyeni pointed out patients who were not able to afford drugs to fight HIV or AIDS.

The average cost of treatment, he says, is $600 in U.S. dollars a month. Many Ugandans, though, make only $5 or $10 a month. "We have here drugs; they work wonders; they are highly effective, but we can't access them because of cost," he says.

Mugyeni says that without the drugs, patients' long-term prospects are not good. Three months ago, the Ugandan government sent Dr. Mugyeni to Geneva thelp the United Nations pressure drug companies to make prices affordable for the 23 million Africans infected with HIV.

"It is immoral," Mugyeni says. "It is unethical to have drugs that are effective and sit by while millions are dying."

Ambassador Holbrooke says the drug companies are not doing their part to solve the African AIDS crisis. "It's an absolutely appalling situation," he says. "They only develop vaccines for baldness or whatever. And...it's been said that they'd rather treat a bald American than a dying African."

"Anybody who goes through the crisis on AIDS in Africa and South Asia and elsewhere today and doesn't do something about it who could have will look back on his or her career later, and they will be ashamed of themselves," Holbrooke says.

As to those who argue that corporations must think about shareholders and profits, Holbrooke says that large pharmaceutical companies are wealthy enough that offering cheap drugs will not bankrupt them.

Anyet, he says, cheap drugs by themselves won't solve the problem.

"Even if the pharmaceutical companies gave away the drugs, you'd still have an education problem," he says. "You'd still have a testing problem, and you'd still have a delivery problem."

There are many places in Africa where there are no doctors and no clinics. In those places, it would be difficult - perhaps impossible - to get sophisticated drug treatments to those suffering from AIDS.

60 Minutes II requested interviews with five major manufacturers of AIDS drugs: Pfizer, Glaxo-Wellcome, Merck, Bristol-Myers Squibb, Boehringer Ingelheim and Hoffman-La Roche - as well as their Washington-based lobby, Pharma. None of the six groups agreed to be interviewed.

Pharma did send a letter, which reads in part: "Health systems can only operate if there are adequate infrastructures and adequate resources devoted to health care."

In many parts of Africa those resources exist right now. There are clinics, hospitals and health workers ready now to relieve suffering and extend hundreds of thousands of lives, if only they could afford the drugs.

In Africa, where 23 million people are infected with HIV, less than .01 percent of them are getting these drugs.

One Uganda, 11-year-old Molly, is one of the few. A few months ago, Molly, suffering from advanced AIDS and abandoned by her family, had almost died. Then a British couple met her at an AIDS clinic and offered to pay for the life-extending medicine.

Molly, who is now relatively healthy, says that she is happy. "I get something to eat," she says. "I get medicine. That's what makes me happy."

Her best friend is Natasha. But Natasha can't afford the drugs that keep Molly alive. A few months ago, she was hospitalized with complications from AIDS - and doctors say that her prognosis is bleak.

What 60 Minutes II found in Africa is more than a tragedy. It is a warning. If the epidemic continues on its current path, 10 ears from now 100 million people around the world will have been infected with HIV. No country, no region, no city can be quarantined from this virus.

Where governments failed to confront the AIDS epidemic decisively, the burden of fighting it has often fallen on those who have the virus - people like Mercy Makhalamele and Frank Guni, who try as they might, are no match for the virus. But now finally they may be getting some powerful help.

Five pharmaceutical companies are currently negotiating with the United Nations and with some African countries to drop the prices on HIV drugs there. If these negotiations succeed, then children like Natasha may be able to grow up. And women like Mercy Makhalamele may be able to grow old.

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