PRETORIA -- In his bid to forge a new partnership to improve the way African nations are governed, Prime Minister Jean Chrétien is avoiding many of the thorny issues that cause some of the strongest Western criticism of the nations he visits.

Yesterday, Mr. Chrétien refused to comment on South Africa's slow distribution of an anti-AIDS drug to pregnant women, which even former South African president Nelson Mandela has criticized.

Last week, the Prime Minister refused to publicly denounce the imposition of Islamic law in northern Nigeria, which allows for the stoning of women convicted of adultery. Mr. Chrétien said Canada's policy on the practice was well known.

Mr. Chrétien is working on a plan to improve democracy, human rights and good governance in Africa, but critics say he is trying too hard to please his hosts.

Keith Martin, Canadian Alliance critic for Africa and Latin America, said that if Mr. Chrétien is not part of the solution, he's part of the problem.

"I think Prime Minister Chrétien has done a grave injustice to the people of Africa and tragically to those who have AIDS," he said. "He's basically given tacit approval to Thabo Mbeki's lethal disregard for the HIV pandemic."

"Few things are as gut-wrenching as seeing a roomful of bassinets and every third child is dying of AIDS," said Dr. Martin, who has worked in Africa as a doctor. "These invisible children must be backed by voices in the West."

Ralph Jurgens, executive director of the Canadian HIV-AIDS Legal Network said Mr. Chrétien's silence is disappointing.

"It's crucial that the Prime Minister speak out about HIV and what Africa needs to do to tackle it."

Dr. Martin said Mr. Chrétien should have denounced the law in northern Nigeria that allows the stoning of women.

"If Prime Minister Chrétien is to have an ounce of credibility with dealing with human rights, he must stand up for the basic norms of human decency."

Mr. Chrétien has been a hit with his African counterparts, who have greeted him at their palaces in Morocco, Algeria, Nigeria and South Africa, or have travelled from neighbouring countries to meet him.

In South Africa, Mr. Chrétien met Mr. Mbeki, who is under pressure to allow widespread use of nevirapine, a drug that reduces the transmission rate of HIV from an infected woman to her infant.

For now, the drug is only administered as part of pilot projects in 18 hospitals in the country.

Mr. Mbeki's controversial views on HIV (he has questioned whether it is actually linked to AIDS) have only reinforced attacks from critics who say he is foot-dragging on the epidemic.

In a briefing note, the Canadian government said that some of the money earmarked for HIV and AIDS is not used by the South African government and rolled over from year to year.

South Africa is fighting the biggest battle against the disease in the world, with an estimated 4.7-million citizens infected, or about a quarter of the adult population.

So many children are losing their parents that a new family structure is appearing in the country: child-headed households.

Pieter Koorts treats HIV-infected mothers and children at the Kalafong Hospital, where premature babies struggle to survive, even though many of them are likely to die young from the disease they carry. Next door is Mohaus Children Home, where dozens of orphans play under the care of volunteer nurses.

Having worked on a pilot project with the drug, Dr. Koorts said that nevirapine has shown its effectiveness in reducing the transmission rate of the virus.

It is an inexpensive product, given once to the mother during labour and shortly afterward to the newborn.

"Any drug that can reduce the transmission of HIV would obviously be very important," he said.

The South African government, however, has been fighting a long court battle against activists who want to expand the use of nevirapine across the country.

Mr. Chrétien refused to comment on the issue yesterday.

Calgary -- It is good that Prime Minister Jean Chrétien did not criticize South African President Thabo Mbeki over his refusal to provide AIDS drugs to pregnant women (PM Avoids Criticizing Africans' Records -- April 8). Mr. Mbeki is probably right.

An application to use the drug in question (nevirapine) on pregnant women in the United States was recently withdrawn by the manufacturer (Boehringer Ingelheim). It cited irregularities in the definition of adverse events in a clinical trial in Uganda.

There were lots of adverse events: Almost 6 per cent of the babies whose mothers had taken this drug died. And without a placebo in the trial it is impossible to say if the rate of death and illness was higher or lower than it would have been without the drug.

Nevirapine was compared only with another AIDS drug (AZT) that is known to be highly toxic, known to cross the placenta and believed to be a carcinogen and mutagen.

President, Alberta Reappraising AIDS Society

Confronted with one of the great human tragedies of the modern age, what did Prime Minister Jean Chrétien do and say? He shrugged and he mouthed platitudes.

How African countries fight the terrifying AIDS epidemic is up to them, Mr. Chrétien told reporters Sunday in Pretoria. This from a prime minister who does not shy away from telling countries when, in his view, their foreign policies are wrong, their trade practices are wrong or even -- sometimes -- when their abuse of human rights is wrong.

Nodding approvingly as Mr. Chrétien sloughed off the AIDS issue was the President of South Africa, Thabo Mbeki, whose wrong-headed policies are condemning hundreds of South Africans every day to excruciating deaths from AIDS.

The leader of a country in which 4.7 million citizens are infected with the AIDS virus (more than any other nation in the world), Mr. Mbeki persists in the crackpot belief that the deadly disease is not caused by HIV. As a result, powerful, anti-retroviral cocktail drugs that have dramatically cut AIDS death rates elsewhere are barely available in South Africa. According to Mr. Mbeki, they are as toxic as the disease itself.

Worse, Mr. Mbeki has applied his theories to his nation's infants. The anti-retroviral drug nevirapine, administered to AIDS-infected, mothers-to-be just as they begin labour, has reduced HIV-transmission to infants by 50 per cent in trial after trial. Access to nevirapine would prevent more than 1,000 AIDS infections of South Afarican newborns every week.

But when the drug's German manufacturers offered it free of charge to all HIV-positive mothers-to-be in South Africa, Mr. Mbeki's government spurned the offer. If it were a white South African politician denying his country's black majority access to anti-AIDS drugs that could save or greatly prolong their lives he would be universally condemned in the world of public opinion.

Mr. Chrétien's toleration of the South African president's head-in-the-sand attitude toward AIDS seems to say that Canada cares nothing about the needless deaths of so many people. It is a shameful response to a life-and-death issue that towers in importance over all the feel-good issues the prime minister is trying to trumpet during his African tour. As one critic remarked, what good is spending money on schools if all desks are empty because of AIDS?

New study shows AIDS drugs equally effective as poverty and malnutrition.
Summary: Median time from seroconversion to AIDS and death in poor, starving rural Africans (without access to health care, purified water or electricity) living in the Masaka District of Uganda (where malaria, dysentery and measles are endemic) is no different than that observed in Europeans, North Americans, or Australians who have full access to proper nutrition, health-care, "life-prolonging" antiretrovirals, and prophylaxis against opportunistic infections (OI)!
Conclusion: These observations are consistent with the hypothesis that antiretrovirals are killing people just as fast as poverty and malnutrition.

Drug firm withdraws nevirapine
Business Day (South Africa) March 23, 2002
Problems which US officials said were "potentially quite serious" prompted the withdrawal of an application for approval to allow pregnant women and newborn babies to take an existing AIDS drug.

Jimmy Carter angers ANC
Business Day (South Africa) March 10, 2002
The African National Congress has reacted angrily to former United States president Jimmy Carter's statements on how President Thabo Mbeki should respond to the HIV and Aids pandemic. "We find it alarming that president Carter is willing to treat our people as guinea pigs, in the interest of pharmaceutical companies, which he would not do in his own country," the ANC said in media statement in Johannesburg.

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