TIME, March 4, 2001
A New Dawn for Africa?
Catching his fellow leaders by surprise, Libya's Muammar Ghaddafi has set in motion a plan for a continent-wide African Union. TIME's Cairo bureau chief, Scott MacLeod, talked with Libya's Ali Treki, one of the chief architects of the proposal
BY SCOTT MACLEOD
Libya has pulled off something of a diplomatic coup. Catching more powerful rivals like Nigeria and Egypt by surprise, Colonel Muammar Ghaddafi's regime has quickly marshaled many of the nations of the continent behind a plan to establish an African Union. The proposed political and economic bloc, which is set to replace the 38-year-old Organization of African Unity, is designed to more effectively manage the continent's affairs as well as its relations with the rest of the world. If all goes to plan, the Union's executive council, parliament, court of justice, peacekeeping force and financial institutions will foster greater cooperation, end wars, promote prosperity and evolve into a single political body to rival NAFTA and the European Union. As Africa's leaders gathered in Libya this week to discuss the Union, Dr. Ali Treki, the Libyan secretary for African unity, spoke to TIME Cairo bureau chief Scott MacLeod about the future of the continent.
TIME: What is behind Libya's efforts?
Ali Treki: The idea is not a new one. In 1963, the great leaders of Africa met in Accra to discuss uniting Africa. Some of them believed this unity should be achieved quickly, but others, like the late Julius Nyerere of Tanzania, thought it should be achieved gradually. Nyerere later told us he regretted that position, saying "We lost a lot of time."
This is the era of globalization. The United States has entered NAFTA with Canada and Mexico. The Europeans have achieved their unity, and every few years they have a new member of the European Union.
China is a big country with more than 1 billion people. Africa, on the other hand, is divided into small pieces, due to colonialism.
This has really created a problem. We can't achieve any progress in economic development. To give you an example, in north Africa, we have a steel factory in Libya, another in Egypt, another one in Algeria, but they are all losing money. Why not have one that will be successful? Colonel Ghaddafi started thinking, "Why not try again to achieve African unity?" The reaction of the African heads of state was quite amazing.
What is the hurry?
The division of the continent is very bad. We have almost 15 countries subject to civil war, or regional war, like in Congo. The national countries are not in a position to continue like this. Some countries cannot even pay the salaries of their armies. We are losing 1.5 million people from malaria, and 2 million from AIDS. We have to get together.
How will the African Union made a difference in a conflict like the Congo?
Right now, Africans are not capable of helping the Congo survive. There is a great risk that the Congo will split. We have no means to supply troops or send materials. We are waiting for the big powers, or the U.N. Security Council, to send troops. Some African countries have the means, like South Africa, Egypt, Nigeria, Algeria, Libya, but they are not together. If they came together in the Union, they would help the others. We are doing a lot in mediation, but it is not very effective. You need quick action. Look what the Europeans did in Kosovo. They intervened quickly and saved the situation. We cannot do that in
Africa. For the last 30 years, there is a civil war in Angola, and the world is silent about it. No one can stop this war. United, we could do a lot.
Why couldn't this be done by the existing OAU?
The OAU charter is very mild. It was created at a time when Africa was under domination. The main objective was the liberation of the continent. The OAU did a lot for that. But the OAU had no army, no
intervention forces, no money. The Union will deal with politics, economy, communications. The chairman of the OAU is just a figurehead. The president of the Union will have more power to intervene.
What are the economic benefits?
Take into consideration globalization. American and European corporations are getting together. Small banks are dying and are joining each other, even across national borders. You have car production between countries. Africa has to think and look to the market as a whole. We are buying wheat from the United States and Europe. I think the price is less if you buy wheat for 200 million people instead of just 1 million. Globalization is not a threat. It is a fact that we have to live with.
What are the top priorities of the Union?
First, the security of the continent. To end the conflicts. Then to fight poverty and disease.
What are the obstacles ahead?
Self-interest is a big obstacle. These states have their own heads, armies, flags. It is not easy for them to sacrifice all that for the sake of the continent as a whole. I can't say tomorrow that we will have effective unity. It takes time. But we have to start.
BBC, 3 March, 2001, 10:39 GMT
An African refugee's story
Many civilians have fled fighting in Sierra Leone
By Mark Doyle
When I first set eyes on four-year-old Fatoumata Seesay, a small girl carried in her mother's arms, I looked away, unable to cope.
I was in a camp for Sierra Leonian refugees in Liberia, and the sun had reached its midday zenith.
As usual when a journalist visits refugees in Africa, I was surrounded by a heaving throng of people desperate to tell stories of injustice and inhumanity.
The body heat from the crowd, and the smell of stale sweat, was mingling with the heat haze from the sandy ground. Then Fatoumata Seesay's mother pushed through the crowd and pulled a dirty cloth off her daughter's body to reveal her horribly swollen head.
"This is my daughter," the refugee mother said. "I need help".
Human instinct
I looked away because I had never seen such a dreadful deformity before. Fatoumata's head - her face, her skull - was swollen at least three times larger than it should be. Her hair, which should have been dark African curls, was wispy and weak.
The girl laid her heavy head on her mother's shoulders and her mother, Maimuna, could hardly cope with the weight.
I suppose I looked away because this vision was just too shocking to take in, even for someone who has seen a fair bit of suffering caused by African wars. Not only was this child in a refugee camp, born of a penniless mother, but she was also desperately sick, and, let me be honest, ugly as well.
My instinct was to walk away. Nothing can be done. Freak show stuff. Sad, but hopeless.
However, I was working with some African journalists who were made of sterner stuff. They said, quite correctly, "Let's get her story, if her mother wants to tell it".
Maimuna wept as she told her story, obviously beside herself with grief and guilt and motherly love.
50/50
Fatoumata was born normal, if it can be said to be normal to be born a refugee. But then her head began swelling. She was diagnosed as having hydrocephalus, a disease where excess fluid on the brain cannot be released and causes swelling.
A doctor in the refugee camp, an obviously respected young Liberian woman, said she treated Fatoumata as best she could.
But this doctor was working in a dirty wooden shack with no floorboards, her only apparent resources being a stethoscope around her neck and a comforting smile.
We asked the doctor if Fatoumata could be treated.
"Maybe," she said, "But not in this place".
She said even with proper treatment the girl had only a 50/50 chance of survival.
Then we spoke to an official of the United Nations Refugee agency that runs the camp. It turned out that Fatoumata had also seen a medical specialist but that, ultimately, the financial resources were not available to treat her.
There was a slim chance, the UN official said, that the girl might get further help, but, he added, one should not hold out too much hope.
Mother's wish
You might ask why I am telling this story. After all this is just one girl. Just one displaced person among millions scattered by the three-way war being fought between Liberia, Sierra Leone and Guinea.
It is a war fought through proxy rebel groups. It is a conflict for control of diamond mines and other financial resources.
This is, indeed, just one case, and a fairly hopeless one at that. But the African journalists I was working with thought it was quite obvious why we should tell Fatoumata's story.
"Someone, somewhere," they said, with a clarity which cut through the fog of emotions, "might pay for her and her mother to go to a hospital, where they belong."
Fatoumata's plight probably won't change, and if it does, it won't change the world. It certainly won't change the situation of hundreds of thousands of other war refugees in west Africa whose desperate, daily grind passes virtually unnoticed.
Fatoumata's mother, Maimuna, was just one of the heaving throng that crowded around us in the refugee camp, rich visitors from another world. As we left, some of them, as usual, and understandably, asked for money. But Maimuna did not ask for a penny.
"I just want you to tell my daughter's story," she said.
Philadelphia Daily News and Inquirer March 4, 2001
Where AIDS is rampant and help scarce
By Andrew Maykuth
CAPE TOWN, South Africa - Zackie Achmat barely concealed his excitement when he arrived at Cape Town International Airport from Bangkok last October and strolled past the customs agents with his suitcase full of illegal drugs.
Buried beneath his folded clothes, Achmat carried 3,000 tablets of fluconazole, the only drug known to treat a potentially fatal brain inflammation that afflicts AIDS patients.
The version of the drug made in Thailand is illegal in South Africa because it is the chemical equivalent of a drug sold under patent here by the American pharmaceutical company Pfizer Inc.
Achmat, 38, an HIV-positive gay-rights activist, smuggled the generic drug into South Africa to make a point: Most AIDS sufferers here can't afford treatment. For the $12 cost of a single tablet of the Pfizer drug Diflucan at a South African pharmacy, Achmat could buy 28 generic tablets in Thailand.
"Profiteering, at the expense of life, even when protected by law, is not a right," Achmat said when he announced his smuggling feat. "The right to life and access to health care are nonnegotiable."
This skirmish is part of a global war that Western drug companies face over their patents and their prices. It's a fight that could affect not only impoverished AIDS sufferers here, but prescription-drug users in the United States and around the world.
The major drug companies, several of which are based in the Philadelphia region, fear that cheap generic drugs could flood the West, undermining the industry's entire pricing structure and its ability to fund new drug research.
Tomorrow, a trial opens in Cape Town in which 40 of the world's drug companies are challenging a 1997 law that allows the government to dismiss patent protection for drugs in the interest of public health.
The law permits the government to import drugs from other countries where the same manufacturer may sell them cheaper than in South Africa. And it permits the health minister to authorize the generic manufacture of patented drugs.
That would allow South Africa to produce AIDS drugs that cost a patient $10,000 a year in the United States for less than a tenth the price. (The exact cost is uncertain, but generic manufacturer Cipla Ltd. of India has said it would sell the AIDS drugs to Doctors Without Borders for $350 per patient per year.)
Activists say the big pharmaceutical companies are insensitive to the scale of the AIDS epidemic in sub-Saharan Africa, where 70 percent of the world's 36.1 million carriers of the AIDS virus live. In South Africa, nearly 10 percent of the population is now believed to be HIV-positive. That's 4.2 million people, more than in any other nation, more than all the HIV-positive people in North America, South America and Western Europe combined.
AIDS advocates say the lack of access to expensive Western drugs is causing millions of Africans to suffer and is condemning to death thousands of children who could be prevented from contracting the virus from their infected mothers with a few doses of drugs.
"We had to stop accepting patients referred to us for Diflucan because we did not have enough for our current patients," said Sue Roberts, the head nurse in the infectious-diseases ward at Johannesburg's Helen Joseph Hospital, where more than 70 new patients are diagnosed each week with HIV/AIDS. "Those who can't afford to buy the drugs at a private pharmacy - they just sit at home and die."
Nation allows a patent violation
After Achmat smuggled in the generic AIDS drugs, the South African government denounced his stunt. But less than two months later, the nation's Medicines Control Council - the South African equivalent of the Food and Drug Administration - authorized him and other activists at Treatment Action Campaign to import limited amounts of Biozole (the generic fluconazole), even though it violates Pfizer's patent.
In January, Treatment Action Campaign brought in its first legal shipment, about 2,000 tablets.
AIDS activists in South Africa see this as a pivotal victory in a worldwide revolution to lower the cost of prescription medications, especially those that treat HIV/AIDS.
The lawsuit against the government by the Pharmaceutical Manufacturers Association of South Africa, which includes a number of American firms, goes to trial tomorrow. The drugmakers say a 1997 law allowing generics violates the nation's commitment to world-trade treaties because it allows the health minister to act unilaterally without first having to prove a drug manufacturer abused its patent. The law also makes no provision for compensating the patent-holder.
While manufacturers are concerned the law might erode their business in South Africa, their underlying fear is its potential effect on markets in the U.S. and Europe, the source of most pharmaceutical profits.
"Clearly, intellectual-property rights are the lifeblood of our industry," said John Kearney, the chief executive of the South African subsidiary of GlaxoSmithKline, which sells AZT, an AIDS antiretroviral drug. GlaxoSmithKline's U.S. headquarters is in Philadelphia.
The drug companies say they must charge high prices to those who can afford them to finance drug research. If pirate manufacturers can copy their new inventions, researchers have less incentive to develop drugs that relieve AIDS suffering.
Opponents contend that discounting drugs in the Third World would hardly impair earnings.
"It's not a question of tapping into Pfizer's profits," said Dr. Neal David, a partner in a Cape Town clinic that is providing generic fluconazole to patients. "They make plenty of money."
Pharmaceutical producers say that if less-developed nations want low-cost medicines from the drug companies, they must first manage their drug-supply systems closely. Suppliers say South Africa is notorious as a source of black-market drugs; half the medicine in government warehouses is stolen.
"There's a concern here about security of supply," said Mirryena Deeb, chief executive of the Pharmaceutical Manufacturers Association, whose members include most of the world's major suppliers. "At the end of the day, we have a business and we have to keep an eye on our important markets."
As much as the dispute in South Africa is about health care, it is chiefly a titanic ideological struggle between the apostles of globalization, represented by the drug companies, and the advocates of equal access to health care. The two ideologies collide when international trade rules hamper efforts to create cheap medicines.
The drug companies say that controlling AIDS is far more complicated than just improving access to drugs. Many African political leaders deny the severity of AIDS or barely acknowledge it, so the efforts to educate the public about AIDS prevention are weak. Most African nations lack the infrastructure to detect and treat AIDS, as well as the medical personnel trained to administer complicated antiretroviral cocktails used by AIDS sufferers in the West.
Under such circumstances, drug companies argue that even if African governments were given an unlimited supply of free drugs, most AIDS sufferers would go untreated. It might actually worsen the epidemic, they contend, if powerful antiretrovirals were administered improperly, leading to the development of more resistant forms of the virus.
Even the price of drugs from pirate manufacturers in Thailand, India or Brazil is still too high for many African nations, most of which are unhindered by international patent laws because they have not signed world trade agreements, as South Africa has. In sub-Saharan Africa, per-capita income is $520 a year, making even cheap drugs too expensive.
"It's clear that patent rights themselves are not an obstacle to access," Glaxo's Kearney said.
Fighting skepticism in South Africa
The public debate on AIDS has taken especially bizarre twists in South Africa, which has Africa's most advanced medical system for patients who have private insurance, while its public health-care system is that of a developing nation.
Nelson Mandela never uttered the word AIDS in public while he was president. Thabo Mbeki, elected to succeed Mandela in 1999, first confounded AIDS activists by championing government research into a bogus AIDS cure called Virodene. Then he expressed doubt that HIV caused AIDS, setting back AIDS-prevention efforts.
"Some patients dropped out of our program because the president was saying HIV doesn't cause AIDS and they thought his opinion should be worth something," said Roberts, the public-health nurse in Johannesburg.
Since Mandela and the nation's first black-led government came to power in 1994, the relationship between drug companies and the government has been characterized by distrust and antagonism.
South Africa's new leaders, many of them socialists trained in former communist states and admirers of Cuba's model of health care, were deeply skeptical of the white-led medical establishment that had administered the two-tiered racially segregated system of the apartheid state.
Mandela's government channeled public funds away from hospitals and into primary health care, such as rural clinics. That improved the government's ability to treat outbreaks of basic ailments, but it eroded a system that would later be needed when the number of AIDS patients began to multiply unexpectedly.
For the new health officials, the most obscene embodiment of the old elitist system were multinational drug manufacturers that they believed made outrageous profits though their drugs were only available to a minority of patients.
The course was set for a collision.
Mandela's government drafted a new Medicines Control Act, allowing the health minister to abrogate a patent to benefit public health. The industry complained the law doesn't spell out a procedure for abolishing patents or compensating patent-holders, as required by international treaties.
A spokesman for the Department of Trade and Industry explained the government's need to override patent rights by decree:
"The judicial system sometimes does not work with the urgency that policy makers require," said Tshediso Matona, South Africa's chief trade negotiator.
The pharmaceutical manufacturers complained that the government never attempted to negotiate discounts, nor did it seek bids for bulk purchases of drugs that might have let it gauge the best available price.
Ayanda Ntsaluba, director general of health ministry, said the government declined to negotiate for discounts because even cheaper prices were beyond the health ministry's budget. Instead, the government pursued the adversarial law.
"We wanted to send a very strong signal," said Ntsaluba. "We don't want our intentions confused."
The government stood firm behind its new law despite warnings from the United States and European Union that the legislation sent an antibusiness signal to prospective foreign investors far beyond the pharmaceutical industry.
Drug companies try for damage control
Meanwhile, the AIDS epidemic grew into a massive crisis. The South African government at first blamed its inability to treat patients on the cost of drugs, sparking protests in America by activist organizations such as ACTUP. Pressured by the left in an election year, the Clinton administration eased its objections to South Africa's stance on generic drugs.
With a public-relations disaster looming over prices, drug manufacturers began to make public offers for steep discounts.
Glaxo-Wellcome, predecessor to GlaxoSmithKline, offered to knock 70 percent off its price of AZT. (Last month, Glaxo said it would make AIDS drugs available in poor countries at 90 percent off its U.S. price.) The antiretroviral, used with other drugs, suppresses the advance of AIDS and helps prevent mother-to-child HIV transmission.
While several African nations signed up for the discounted drugs, the South African government was skeptical, saying the offers were ploys to expand market share. Even at the discounted prices, they said, the government would go bankrupt if it attempted to treat everyone with AIDS.
Pressure mounted on the South African government to at least treat HIV-positive pregnant women to reduce chances their babies would inherit the virus; a three-dose treatment of Nevirapine - two for the mother and one for the baby - costs $4, and studies have shown it can reduce the number of babies born with the disease by about one-third.
But Mbeki and the health minister balked, questioning Nevirapine's toxicity. (In January, the government relaxed its stance slightly and agreed to allow a Nevirapine pilot project at 18 hospitals.)
"The South African government has shown no indication in wanting to treat HIV/AIDS," Deeb said. "They started out saying the problem was cost. Then we offered to discount the drugs and they said they were toxic. Then they questioned the link between HIV and AIDS."
Pfizer was a favorite target of activists for keeping its price high for fluconazole, which not only was the only treatment for cryptococcal meningitis but also a preferred way to treat thrush, a painful fungal inflammation of the throat and mouth that commonly afflicts those with compromised immune systems.
At the Sparrow's Nest hospice in a Johannesburg suburb, Jane Molefe, 24, does not know Diflucan by name. The AIDS patient, whose 4-year-old son is also dying of the disease, says she only recognizes fluconazole as the green-and-white capsule the nurse gives her to relieve the intense heartburn that comes with thrush.
"When it burns here, I have no appetite," she said, weakly pointing her bony fingers to her chest. "When I take the green-and-white pill, the pain goes away."
But Sparrow's Nest has so little access to fluconazole that most patients go without, said the Rev. Corine McClintock, a nurse who heads the hospice. Last month, four children came down with thrush. Ms. McClintock obtained four Diflucan capsules and carefully divided the medication among the children over three days; it wasn't enough, so one of the children did not recover well.
"We have to beg, borrow and steal for Diflucan," said Ms. McClintock, who has developed a network of sources at hospitals and pharmacies who provide her with the drug. "Right now we don't have any because we can't afford it."
Last April, amid calls to lower the price of fluconazole, Pfizer stunned the AIDS community by offering to donate Diflucan to South Africa for two years.
There were several conditions to Pfizer's offer. The drugs would treat patients only at public hospitals, not at hospices such as Sparrow's Nest.
The activists regarded Pfizer's offer as a clever business move. Pfizer got much positive publicity and a $50 million tax deduction. And it still did not plan to discount the drug sold through private pharmacies.
But 11 months after the offer was extended, Pfizer has yet to distribute one free tablet of Diflucan.
The delay in distributing the drug was caused by Pfizer's insistence on controls to ensure the drug does not get sold on the black market. One of Pfizer's concerns is its home market: Diflucan sells for about $17 a pill in North America, where its main users are not AIDS patients, but middle-class women who buy a one-dose treatment for yeast infections, or vaginal thrush.
Pfizer offered to donate Diflucan in tablet form, to distinguish the donated drugs from the capsule form that is sold commercially in South Africa.
Pfizer filed an application for the new Diflucan formulation in July, expecting quick approval. But regulators did not approve the application until mid-February.
Now, Pfizer says, it will begin distributing the drug free to patients within weeks.
Each month is valuable for Pfizer; the patent for Diflucan expires next year, and it will then become fair game worldwide for any generics manufacturer.
"The AIDS issue has become so big," said Matona, the South African trade negotiator. "We've lost time. We were envisioning a partnership. Now we're reacting to AIDS. It's not an ideal environment."
Andrew Maykuth's e-mail address is foreign@phillynews.com
2000 Philadelphia Newspapers Inc.
Reuters March 2
'United States of Africa'-Another Gaddafi Vision?
By Lamine Ghanmi
SIRTE, Libya (Reuters) - African leaders pledged on Friday to speed up continental union and create a `United States of Africa,'' but diplomats warned the lofty project sponsored by Libyan leader Muammar Gaddafi (news - web sites) may remain just a vision.
Ending a two-day summit of the Organization of African Unity (OAU) in Gaddafi's hometown, they agreed to set up a continental confederation loosely modeled on the European Union (news - web sites).
The African Union would be headed by a Council of Heads of State, have a pan-African parliament, a central bank, Court of Justice and a single currency.
Whether it will become reality is another matter.
Gaddafi, swapping his traditional Libyan dress for a pink African robe and flashing a victory sign, said: ``Africa now represents the largest force on the world map. Now is the time for Africa after the European era of colonialism.''
Others were skeptical.
``If you want to be really serious, what Africa wants is stability and democracy first, not another African unification engine,'' a delegate from a sub-Saharan nation said.
Ambitious Goal For Africa
With the world's poorest continent wracked by wars, ethnic and religious divisions, talk of an economic and political grouping similar to the EU may seem inappropriate.
``All these urgent issues need urgent answers. I hope that our leaders will not be distracted
by this attempt to build the union,'' another delegate said.
In 40 of the 53 OAU member states the average person lives with less than $100 per year. Out of the 36 million people infected with the AIDS (news - web sites) virus worldwide, 25 million live in sub-Saharan Africa.
``This summit will not solve all of Africa's problems,'' said former U.N. Secretary General Boutros Boutros-Ghali, in Sirte as an observer. ``It's a positive step, to be encouraged, but only the first one.''
Diplomats said Gaddafi's active sponsorship of the African Union reflected his wish to present himself as a respected pan-African leader after taking a peacemaking role in recent months in the Democratic Republic of Congo (news - web sites), Sierra Leone and Sudan -- with mixed results.
``The projected union puts Libya on the African stage at par with the continent's main players,'' a delegate said. ``Gaddafi has the support of many small, poor nations. This gives him diplomatic leverage.''
Gaddafi, in power since 1969, burst on to the world scene in the 1970s with his alleged support of guerrilla groups in the
Middle East and elsewhere and his use of Libyan oil wealth to promote the cause of ``freedom fighters'' around the world.
Long a political pariah in the West and defiant until his recent rapprochement, he then tried to unite his fellow Arab ''brothers,'' in vain. Now he has turned to Africa.
``The new world order,'' he said in his speech on Friday, ``is not based on weapons of mass destruction but on the people's will. Africa does not have these weapons. However, weapons rust whereas the will of the people does not wear out.''
Long Process Ahead
According to the final communique, 52 of the 53 OAU members -- only suspended Comoros was absent -- signed the founding act of the union.
The new entity will come into force once its creation is ratified by the parliaments of two-thirds of OAU members, a process diplomats said may take months if not years.
The next OAU summit, to be held in Lusaka, Zambia in July, will adopt the necessary measures to formally transform the OAU into the African Union, the text said.
The union reaffirms the inviolability of Africa's post-colonial borders