In their last joint press conference, at Kirstenbosch Gardens in Cape Town five months ago, US Vice-President Al Gore and President Thabo Mbeki wore AIDS ribbons made of ornate African beadwork and spoke movingly about their countries' joint efforts to curb the dreaded disease.
But if the protesters targeting Gore's presidential campaign trail are to be believed, that show of solidarity was just an act.
The protesters - Gore's political enemies, health and AIDS activist groups such as Essential Action, ACT UP Philadelphia, Public Citizen's Health Research Group and Public Campaign - accuse him of favouring drug-makers' profits over the lives of millions of South Africans infected with the human immuno-deficiency virus, which causes AIDS.
The campaigners claim that next year's Democratic Party presidential candidate has threatened Mbeki, and has said the US would impose sanctions if South Africa proceeds with its aim to manufacture low-cost generic versions of patented drugs used to treat AIDS. The protesters have pledged to disrupt Gore's campaign events until they have won a shift in the US administration's trade policy.
What gives? How could the US vice-president - who recently phoned Mbeki and congratulated him on his inauguration as president, expressing confidence in the future of the South African-American friendship and adding that "America is fortunate to have such a partner and I am fortunate to have such a friend" - try to hurt the economy and damage the health of a nation he has worked to befriend?
His political enemies in the upcoming presidential elections have accused Gore of selling out for drug-makers' campaign contributions to boost his presidential ambitions.
Gore's aides say his critics are ill-informed. They say he has actually proposed a framework to help make these drugs available and "more affordable".
Even some health officials say the protests are unfounded. "They missed the mark. The true culprit is not Al Gore but the drug companies," said AIDS Action Council director Daniel Zingale.
A closer look at the facts confirms that AIDS activists, who have heckled him during his campaign appearances and sought to drown him out with chants of "Gore's Greed Kills", have ignored or manipulated and distorted the facts regarding the vice-president's efforts to forge a compromise between protecting US patent law and addressing an AIDS crisis in southern Africa.
The real culprits are protectionist pharmaceutical companies and enemies of free trade led by Congressman Rodney Frelinghuysen.
US pharmaceutical companies see the Medicines and Related Substances Control Amendments Act - which allows South Africa's health minister to bring in less-expensive imported AIDS drugs or locally produced generics - as an infringement of their patent protections.
Two of the main companies producing the drugs - Bristol-Myers Squibb and Glaxo-Wellcome - have given the bulk of their corporate contributions to the Republican Party in recent years. The South African law angered the US pharmaceuticals industry, which fears that widespread licensing of its products will lead to a global "grey market" in low-priced drugs and undermine its profits and incentive to spend on costly research.
"It is a form of patent piracy," said Thomas Bombelles, of the Pharmaceutical Research and Manufacturers' Association (Pharma), the industry trade group. "It's stealing."
It is this sentiment that has prompted dozens of American and European pharmaceutical giants to challenge the law in a South African court, where they recently won a temporary injunction.
Here, the pharmaceutical companies, led by Pharma, wrote to US trade representative Charlene Barshefsky and Al Gore, urging them that in their annual review of foreign trade barriers, they should label South Africa a "priority foreign country", which would set a deadline for it to change its disputed policy before trade sanctions would take effect.
But Gore urged Barshefsky to reject the drug companies' recommendation. "The vice-president took the position that the health crisis in South Africa really needed to be taken into account," said Assistant Secretary of State for African Affairs Susan Rice.
But the AIDS activists are sticking to their story, even where it is easily disproved.
Bending the facts, they say Gore authorised Barshefsky to conduct "a sweeping new review of South Africa policies".
The so-called "sweeping new review" was actually Barshefsky's annual review that kept South Africa on the watch list, the lowest-priority category of foreign trade barriers, where it had been the year before. Gore had nothing to do with that. It was an annual review demanded by Congress since the 1970s.
In another distortion of facts to damage Gore's bid for the presidency, it was not Gore, as the AIDS activists claim, but Frelinghuysen who, under pressure from his heavy pharmaceutical constituency in New Jersey, demanded that the US government stop development aid to South Africa until Pretoria had repealed its Medicines Act.
When Frelinghuysen could not get his way, he forced the State Department to insert a rider or clause in a report to the US Congress saying the US administration was "making use of the full panoply of leverage in our arsenal, including the vice-president, to gut the South African law". The report said during his meeting with then Deputy President Mbeki last August, Gore made the issue a "central focus of an assiduous, concerted campaign" by top US officials to persuade South Africa to change the law.
To the AIDS activists, this document was the smoking gun to prove Gore's underhand tactics and insensitivity toward the scourge of AIDS.
American and South African officials who attended the Mbeki-Gore meeting said Gore had made no threats to South Africans or Mbeki. Actually, Gore had assured Mbeki and his colleagues that he realised the disease was "a major threat to the welfare and even the future stability" of South Africa.
Gore has pledged his support for South Africa's Partnership Against AIDS campaign, launched by Mbeki on October 9 last year.
According to Leon Fuerth, Gore's national security adviser, the US leader has proposed to Mbeki a framework that would provide South Africans with lower-cost medicines, in a way consistent with international agreements.
Their discussion to resolve the impasse is being delayed by the lawsuit the drug companies have launched against South Africa.
In addition, the US will support the South African Government's HIV/AIDS programme by providing $10-million (R60 million) over five years, through the US Agency for International Development (USAid).
Gore and Mbeki agreed to work on an import agreement to let South Africa shop for the best price for AIDS drugs worldwide and then import them in bulk - something which will be controversial with drug companies. The two leaders committed themselves to a mutually acceptable solution.
Given that an estimated six million South Africans are infected with HIV, compared with about one million in the US, medicines in South Africa are indeed among the most expensive in the world, ranking in the top five, and accounting for 30% of medical costs in the private sector. Also, more than R2 billion, or 11 percent, of South Africa's health budget is spent on medicines.
On the other hand, many patients in the US use a "cocktail" of three AIDS drugs often costing more than $1 000 (R6 000) a month. Sure, South African patients may buy the cocktail for about $800 (R4 800) a month, but the new law - which has yet to take effect because of a court challenge - would pave the way for far lower prices.
For example, AZT, a drug made by Glaxo-Wellcome that has been found to inhibit transmission of HIV from pregnant women to their foetuses, costs about $240 (R1 440) a month in South Africa. In India, drug firms manufacture a generic version of the drug that costs $48 (R288) a month. Jamie Love, director of the Washington-based Consumer Project on Technology, estimates the price of most AIDS-related drugs could be reduced 50 to 90 percent if local firms were allowed to produce generic versions to counter national health emergencies.
Gore's political rivals have deliberately manipulated the facts for political expediency in a more complicated debate. AIDS activists are either ignoring facts or have been hired by Gore's enemies. This is a debate with no easy solutions. - Foreign Service
