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Death By Denial: AIDS in Africa

To many Americans, the worst of the AIDS crisis is in the past. Fewer Americans are dying from it, more are living with it, and there are new drug treatments for those who can afford them.

But halfway around the world, it's a different story. Every minute, 11 people in the world are infected with HIV. Eight of those people live in sub-Saharan Africa.

Right now, AIDS has infected 23 million Africans - and it shows no signs of stopping there. New strains of HIV and diseases brought on by HIV are showing up in Asia, Europe and America.

For the past five months, Ed Bradley and 60 Minutes II followed the story of AIDS in Africa, and traveled into some of the far reaches of that continent, where the disease has cut the deepest scars.

Under President Thabo Mbeki, South Africa has one of the most progressive governments on the African continent. But instead of confronting AIDS in his country, President Mbeki has astounded even many of his own supporters by refusing to accept the fact that HIV causes AIDS - a debate that the rest of the world settled years ago. In South Africa, 1,600 people are infected with HIV every day. Ed Bradley reports.

Mbeki's position has frustrated and outraged AIDS experts around the world. The head of South Africa's premiere medical research institute, Dr. William Makgoba, says the president is wasting precious time on a foolish exercise. Makgoba says he has made his views clear to President Mbeki.

While the government in South Africa rehashes old scientific arguments, HIV rates here are increasing as fast as in any country on earth. One in five South African adults is going to die of AIDS. Most of them don't even know they have they have the disease; the ones who do are afraid to talk about it.

Mercy Makhalamayle is not.

"I'm from a very strict family. I was married young, and my husband was the first person I ever was with," Makhalamayle says. "I was pregnant with my second child, and I went to the hospital, and I was asked for an HIV test. I felt well, there's nothing wrong with me but I might as well do it because I'm pregnant. And the results came out positive."

She prayed every day that her daughter would be born without HIV. In South Africa, one out of three mothers with HIV passes the disease on to her baby. Each week there, 290 babies one-year-old or younger die of AIDS. Many of them are buried alone, unclaimed by parents who don't want the stigma of AIDS on their families.

Makhalamayla kept her own HIV status a secret while she was pregnant, but the morning she had her baby, the nurses read it on her chart. After she gave birth, they left her by herself because they were afraid to touch her.

One in five South Africans is infected with HIV (in America that would amount to 40 million people). Yet almost no one in South Africa talks about it. Many of them don't dare to, for fear of being cast out of their families, fired from their jobs or worse.

Nearly everyone here nows the story of Gugu Dlameenee. In 1998, she admitted publicly she was HIV positive. Three weeks later, she was stoned to death by a group of young men who said she'd brought shame to her community.

For Makhalamayle, it was eight months before she could work up the courage to tell her husband Sam that she was HIV positive.

Sam Makhalamayle, who thought he did not have HIV, beat her up and pushed her into a hot stove, burning her arm. The next day he went to her job and told her to move out of their home. Her co-workers then found out her HIV status and told her boss. She was fired that same day.

Sam Makhalamayle did have HIV; that's how his wife became infected. Sam Makhalamayle died of AIDS in 1994.

"I'm so angry, and I don't know where to take this anger to," she says. "But I think I'm angry with the fact that all these things happened to me and to probably 80 percent of the people that are HIV positive in this country. And really, nothing is changing."

For man South Africans, 1994 was a thrilling year. Apartheid was dismantled. Nelson Mandela triumphed. And Africans from other countries began to pour across the nation's borders - for work, trade or just for the glittering promise of living in Mandela's South Africa.

But South Africa opened up just when the most deadly plague in history was making its way through the African continent. For years, the AIDS virus had wound its way along trade and trucking routes and spread through the nation's mining camps.

Even now men from all over Africa come to work in these camps, where many of them have sex with prostitutes several times a week, and few of them use condoms. And when these men return home, they often infect their wives and girlfriends with HIV.

Now, more people in South Africa are infected with HIV than in any other country in the world. And by all accounts, the government's efforts to stop the epidemic have been too little, too late.

"There's definitely a prevention campaign, but it's a total failure," says Dr. Eric Gomaere, a Belgian physician who works for the Nobel Prize-winning group Doctors Without Borders.

Gomaere says the clearest sign that South Africa's AIDS policy has failed is that so few people there are even willing to find out their HIV status. Only one out of 100 HIV positive South Africans knows it.

"There's no reason for them to go for testing," Gomaere says. "In fact, all what they will gain by going for testing is suddenly to learn that they are positive, that they will die in less than five years, and this without appropriate care, without proper counseling. People, of course, do not go for testing. I would not go myself."

But in 1994, researchers made a discovery that for the first time gave women around the world a powerful incentive to take an HIV test. They discovered that the drug AZT could stop the transmission of HIV from pregnant women to their babies. In South Africa alone, international health organizations sathat AZT could save up to 50,000 babies a year.

But once again, President Mbeki has baffled the world's AIDS experts by refusing to provide AZT to pregnant women - even after the drug's manufacturer, Glaxo Wellcome, offered to lower its price in South Africa by 75 percent. Mbeki claims AZT is toxic, and his country does not have the resources to dispense it safely.

"That's probably the most stupid argument I heard about AZT, that AZT is toxic," Gomaere says. "Of course AZT is toxic. But AIDS is even more toxic."

In one poor township near Cape Town virtually no one was ever tested for HIV until last year. Then Gomaere's clinic offered free AZT to HIV-infected mothers. In one year, more than 5,000 of the township's 7,000 pregnant women went there for testing, knowing they would get AZT if they tested positive.

In all of South Africa, there are just three clinics that offer AZT to expectant mothers, and none has the support of the South African government. According to Dr. Glenda Gray, for every mother and infant who receives AZT, nearly 1,000 more don't.

"Every time you walk into a hospital, bed after bed, admission after admission, it's another HIV-infected person," she says. "In children, when you do a ward round, and you find a kid who's not HIV-infected, it's a nice surprise."

Mercy Makhalamayle's baby died in 1995, at age 2 1/2. After her daughter and husband died, Mercy Makhalamayle defied the AIDS stigma and spoke out publicly about the disease that her government had been so quiet about. Now she is one of South Africa's most prominent AIDS activists.

"I cannot keep quiet," she says. "My whole family was shattered. This thing has taken everything I ever wanted to have as a young woman. Now the thought of that, thinking of all the young women and men in this country, just drives me nuts to think South Africa has fought so much to get to where we are today. Why should we lose all these opportunities for our young African men and wome because of this disease?"
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