AIDS battle burnishes Bush's legacy in Africa

Hundreds of centers in Rwanda
Desperately poor Rwanda, where Ruxin runs a health care project, now has more than 100 centers where people can receive AIDS testing, counseling and treatment, up from just two in 2002.

"I am heartbroken overall by the Bush administration," Ruxin said in a telephone interview. "But from my perch here in Rwanda, it is impossible to deny the results and achievements of PEPFAR. Many Rwandans were made Republicans because this was the first administration that has taken an interest and done something here."

Ruxin hopes Obama will learn lessons from PEPFAR's first five years — in particular to end the emphasis on abstinence and start funding groups who work with prostitutes and carry out abortions.

PEPFAR's biggest single success story is the fortyfold increase in the number of Africans receiving life-prolonging medication in the past five years.

Populous countries like Nigeria and Ethiopia are still struggling to increase access to medication. But in Rwanda, 71 percent of those in need of AIDS drugs received them in 2007, up from 1 percent in 2003, and in Namibia the rate shot up to 88 percent, from 1 percent.

AIDS is no longer a death sentence for people like Ndaxu Mungunda, a Namibian diagnosed as HIV positive after the birth of her child. She, her husband and child were given AIDS drugs provided at all major Namibian hospitals, thanks in part to PEPFAR funding which has increased tenfold in the past five years to $109 million.

Four years later, at age 40, she and her husband look forward to something that is by no means a certainty in Africa's AIDS era — a ripe old age.

Hope restored to families
Jones Mubita, a Zambian policeman, had given up hope for his young daughter, a "mere skeleton" covered in boils when she was hospitalized. With the help of AIDS drugs provided by the U.S. government the child is now back at school, he says, beaming.

At a 22-bed clinic run by Living Hope, a church-based charity near Cape Town, 85 percent of patients now survive and only 15 percent die. A few years ago, it was the opposite, says Pat Ball, a retired teacher from North Carolina, and a volunteer at Living Hope.

Denis Farrell / AP An unidentified patient sits near a memorial tree in the hospice at the Tapalogo project in Phokeng, Rustenburg, South Africa, Dec. 19, 2008.

The acclaimed mothers2mothers organization has expanded from about 40 locations around Cape Town to nearly 500 in seven African countries thanks to PEPFAR cash. Its network of more than 1,000 HIV positive women are trained as "mentor mothers" and paid to counsel the newly infected and ensure they and their babies stay healthy. Thanks to the growing provision of AIDS drugs to pregnant women, few babies in the m2m network are now born with AIDS, says co-founder Gene Falk.

In big South African government clinics, there is palpable optimism that AIDS infected newborns could become history.

Children are especially vulnerable as they are harder to diagnose and quickly pass the point beyond which medication can help.

In a sunny room furnished with toys and a play kitchen at the Soweto Hospice in Johannesburg, dying children are given a chance to enjoy what remains of their life.

"We want to give them their childhood back," said Louisa Ferreira, director of the nine-bed pediatrics unit funded by PEPFAR. "The hospice is not about death. It's about life."

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