America's Gift: Fighting HIV/AIDS in Uganda

As president, George W. Bush did something momentous that few of you may know about - something so momentous that it is saving millions of lives and generating good will for America around the world.

Millions of Africans who had been dying of AIDS are now living with AIDS, thanks to President Bush's program. The U.S. is providing pills to more than two million people with HIV/AIDS, people who could never afford them and who were condemned to die. The medicine not only saves their lives, it permits them to live full lives.

"60 Minutes" and correspondent Bob Simon went to Uganda, where AIDS has ravaged the country, killing more than a million people and where Dr. Peter Mugyenyi, a pioneer against AIDS, told us how grateful he is to Americans for saving his fellow Ugandans.

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"We thank, sincerely, the American people. They are the people who are saving lives. They are the people who can be proud that lives are being saved on this continent," Dr. Mugyenyi said.

Bush created the program in 2004 with the bi-partisan backing of Congress; last year, Congress raised the funding to about $7 billion a year for the next five years.

Dr. Mugyenyi has called this the greatest aid effort in modern times. "There has never been a rescue mission, a mission of mercy of this magnitude that has produced such magnanimous results," he explained.

He told us Africans now see America differently.

"The impression that people in Africa have of America is that America is no longer the world's policeman. It is now Africa's friend. What an image," he said.

"60 Minutes" met some exuberant looking children - every one of them has HIV or AIDS. They would all be dead or dying if it weren't for America. Now they're alive and thriving.

Viola is 13. Her mother died of AIDS and she was dying from it too until she began taking those drugs provided by the United States. We met Viola at her home where she lives with her aunt.

She has to take a lot of pills every day. Asked if she never forgets taking her medication, Viola said, "I can't forget."

"I think I can die," she said, after being asked what the consequence of forgetting might be.

Viola will be fine, but Dr. Sabrina Kitaka, a pediatrician, remembers all the children who died before America came to the rescue six years ago. She had 2,000 children who needed life-saving drugs, but only enough pills to treat 30 of them. So she sent home more than 1,900 children with only vitamins and hope, a false hope because all but the 30 chosen children died.

"You were, in fact, playing God," Simon remarked.

"But we had no choice," Dr. Kitaka explained.

No choice because she had no pills. Ed Bradley saw that when he came to Uganda ten years ago and talked to Mugyenyi when the situation looked hopeless.

"In bed after bed, Mugyenyi showed us patient after patient who couldn't afford drugs either to fight the virus or the diseases it brings. This man had arrived at the hospital two weeks earlier," Bradley said in his report.

Mugyenyi told Bradley it would cost $600 a month to treat this man and patients with the drugs they need.

But the doctor explained that the man made maybe $5 or $10 a month.

"Even after pooling their resources, his family didn't have the money for treatments. They decided to take him home to die," Bradley reported.

But today generic drugs have made AIDS pills much cheaper: treating one patient for a year used to cost more than $7,000; now, it's less than $300. As HIV destroys a person's immune system leading to AIDS, patients need powerful pills, antiretrovirals they're called, or miracle pills.

To stop the virus, most patients have to take two to six pills a day. Now, with the U.S. paying for the pills, AIDS patients are no longer doomed. Mugyenyi can give them all the drugs they need and send them home smiling.

"Absolute miracle, because this kind of situation, Lazarus syndrome, people being resurrected from the dead was inconceivable only five years ago," he said.

But even with American aid, the battle is far from over.

Several sexual customs in Uganda make AIDS hard to contain: polygamy is accepted in much of the country and infidelity is so widespread that the main chain of transmission is someone having sex outside of marriage and then transmitting it on to their spouse.

And then there are the sugar daddies: that's what Ugandans call rich old men with young mistresses, passing it on to a new generation. It is such a problem that there are even billboards discouraging it.

For example, one billboard reads, "Would you let this man be with your teenage daughter? So why are you with his? "

Prostitutes still find plenty of customers in Kampala, even though half of the women are infected. All the AIDS and all the infidelity make AIDS tests essential. Two million Ugandans are getting aids tests this year, paid for by America.

They stand in long lines scrunched up against each other, thousands in one day. Charles Byamukuma and his ebullient wife Sarah came to get tested together after three years of marriage.

Asked if she was nervous about it, Mrs. Byamukuma said, "I am curious to know the results."

But her husband, smiling, said, "I am not worried."

Remarkably, they welcomed "60 Minutes" to watch as a counselor handed them their results, and asked them to read them to each other.

Both tested positive for HIV, and were stunned and deflated. At least now, that's not a death sentence.

Mary Kibwakali was expecting her second child in a month. Her husband, Henry, told us, "We have a girl and we're hoping for an heir."

As for their AIDS test, luck was not with Mary.

She tested HIV positive, while Henry tested negative.

When Henry heard that his wife tested positive we could see him pull away from her. He did not comfort her when she cried. Mary doesn't speak English and Henry made it pretty clear their marriage was over.

"I fear I will not be very comfortable to sleep with her," he said.

At least finding out now that Mary is positive gives doctors time to minimize the chances that she will pass HIV on to her baby; 100,000 children alive in Uganda today got HIV/AIDS from their mothers either at birth or from breast milk.

And thousands of adults are still dying of AIDS, because, like Dan Engobi, they didn't get treatment in time. Engobi is 35 and probably won't see 36. He is wracked by waves of pain and just sits or sleeps in his hut, waiting to die.

"Some people come when it's too late, and even with antiretroviral drugs, you may not rescue them," Dr. Kitaka explained.

Just then, a natty young gentleman caught our eye. According to Kitaka, his name is Michael and he does have AIDS.

"But the American program will save his life?" Simon asked.

"Yes and that, as a pediatrician, is my joy to see every single child grow up to full capacity and be a responsible citizen of this nation," Kitaka replied.

"This little fellow could be an old man one day. And he'll have to change his suit, but other than that, he'll be just the same," Simon remarked.

"Exactly, yeah," Kitaka replied.

A Ugandan singer named "Supercharger" wrote a song thanking America because he has AIDS and pills supplied by America are keeping him alive. He's paid, partly with American AIDS money, to teach children how to avoid AIDS while he entertains them.

Uganda's campaign to stop the spread of AIDS is called "ABC."

A for abstinence, B for be faithful to your partner and C for condoms. But lately the government has stressed abstinence and fidelity with condoms running a distant third.

"It's a fall-back position," Uganda's President Yoweri Museveni said.

A "fall-back" is how the president refers to condoms.

"It's better than being sick," the president said.

Asked if he thinks condoms are a last resort, the president told Simon, "Certainly, they're a last resort in our culture. But in case you can't abstain, you can't be faithful, then, go for the fall-back position."

In a country which is 80 percent Christian, the priests and the president sing the same song: abstinence for singles; fidelity for married couples; and condoms for those who can't measure up.

"When HIV/AIDS comes, we can defeat it with a magic bullet called abstinence and faithfulness in marriage," Pastor Martin Ssempa said.

A Ugandan evangelical, Pastor Ssempa tries to sell abstinence to tough customers: students on the campus of Makere University.

The U.S is spending $17 million a year in Uganda for abstinence programs, but it's not working.

The AIDS rate is inching back up, above six percent, because now that AIDS is no longer a death sentence people are getting more careless about spreading it. Sadly, the solution has become part of the problem.

"If people are becoming complacent about AIDS, how do you as a preacher put the fear of God into them?" Simon asked.

"I think it's the fear of AIDS in them," Ssempa said.

Asked if everyone doesn't know the risk of AIDS, the pastor said, "No. Every year, there is a new group of young people that come into sexual maturity. There's a group of adolescents that enter into sexual experimentation. They have never heard that AIDS spreads. They have never seen someone die from HIV/AIDS."

And disaster is looming: in Africa, a million more people a year will come down with HIV/AIDS.

The U.S. says it simply can't afford caring for any more new patients so, unless other wealthy countries step up, millions are doomed. For now, the U.S. says it will keep treating people already in the program.

"Thank heaven" says pediatrician Sabrina Kitaka.

"Are you convinced or optimistic that the Americans will go on doing this?" Simon asked.

"Sometimes I worry that, supposing they stop, then what?" she replied.

"The answer is simple. They would die, wouldn't they?" Simon asked.

"That's the truth," the doctor replied. "And what would all our efforts have come to? To zero. It's like blackmailing the American people, but we hope and pray that they will continue to support this program."

Produced by Robert Anderson