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Lions Roar : March 2006
"The pandemic is preying on women relentlessly," he says, "threatening them in a way that the world has never before witnessed. The virus threatens the very existence of women in some countries." nity or extended family, and now they are having kids of their own and they haven't got a clue what to do." He says only five to eight percent of pregnant women in sub- Saharan Africa have access to PMTCT (Prevention of Mother- to-Child Transmission) programs. "This is a terrible deficiency. There is no excuse for this state of affairs" -except the parsi- mony of the wealthy world and the empty pledges of its leaders. "Because of the low access rates, thousands upon thou- sands of babies are born HIV-positive who need not be in- fected. Most of them die-helplessly, pathetically-before the age of two. But for those HIV-positive women who have access to PMTCT, the program is a godsend. One tablet of the drug nevirapine during the birthing process, and the liquid equiva- lent within 72 hours of birth, and the infection rate is cut by 53 percent." During a launch of antiretroviral treatment guidelines, Lewis meets with women from the community of Mafeteng in Lesotho, South Africa. He says no pediatric treatment formulation existed-25 years into the pandemic-until the Clinton Foundation went to India in 2005 and negotiated a price for a low-cost generic drug. "We lose half a million children a year. But up until now, you've had to break the adult tablets, take out the powder, speculate about weight and age of the child and how much powder you needed, and the same with the syrup. Why wasn't this done before? "It's all just so bad. It's so awful. How do you get people to understand? How do you get things mobilized? It's so crazy. 68 SHAMBHALA SUN MARCH 2006 It's as though the world has regressed to the Middle Ages in places. Then you hear the apocalyptic language that is used in Africa by Africans. You sit down with the president of Zam- bia and he starts talking about the Holocaust in his country, and he doesn't even have prevalence rates of infection that are close to Zimbabwe's, Lesotho's, Swaziland's, Namibia's, or South Africa's. He's at 15 or 16 percent; they're all way over 20 percent. So it just tears you to see what's going on." LEWIS WRITES in the opening sentence of his recently pub- lished book on the pandemic, Race Against Time (House of Anansi Press, Toronto): "I have spent the last four years watch- ing people die." Nothing, he writes, prepared him for the carnage of AIDS. For two years prior to his appointment as UN AIDS envoy, he sat on a commission of inquiry into the genocide in Rwan- da. It was a descent into depravity, in his words: visiting sites reminiscent of Auschwitz, meeting mutilated survivors, inter- viewing women raped over and over and over again. But at least the Rwandan genocide had an end. Not the pandemic. Not AIDS. "I had no idea," he admits. "I don't know how naive I could have been. I just didn't understand what I was walking into. And it is all so preventable." Preventability is the second theme Stephen Lewis dwells on, after the pandemic's horrific assault on women. The pandem- ic, he says, can be stopped by money, leadership, and the right policies-and without those three ingredients in the quanti- ties required, there is nothing but the awful toll of death and social destruction. Late last summer he all but called the U.S. government recklessly negligent for bowing to the Christian right and ty- ing AIDS assistance money to Uganda to a condition that the country's public health authorities stress abstinence and de- emphasize condoms in their AIDS education programs (the country's infection rate, having been in decline, is starting to creep upwards again). When U.S. officials denied his accusations, he stopped a hair's breadth short of calling them liars-something UN offi- cials just don't do. There were persistent, well-sourced reports out of Washington and New York that the U.S. State Depart- ment wanted him removed from his post. He has excoriated the World Bank and the IMF for impos- ing structural adjustment programs-dictating how much Af- rican governments can allocate to social programs in exchange '"d ::r: o """Ì o 0:; >-< z e """Ì 0:; ...... z C/J