"I know if nothing is done, I also will die one of these fine days," Patricia Ochieng, who lost her husband and child to AIDS, told Powell yesterday at a slum outside Nairobi, Kenya, before he flew to Uganda for the final stop of his African trip.
If something could be done to prolong her life, "I'd really appreciate it," Ochieng said.
"I look forward to the day when these life-saving drugs will be made available to Africa," she said.
Powell heard much the same message after he arrived in Uganda, regarded as a model for an early and aggressive response to the epidemic. HIV infection among pregnant women in Kampala dropped from 31 percent in 1990 to 14 percent in 1998.
Agnes Nyamayarwe was not among the lucky. Her son Peter died at age 6 in 1995.
"Instead of giving my children life, I gave my children HIV," Nyamayarwe told Powell at a support center for AIDS victims in Kampala. "In the U.S., I think this disease can be treated," she said. But in Uganda, she said, the necessary drugs are too expensive.
"We could do more with more resources," said Francis Omasawa of Uganda's Ministry of Health. In 10 years, AIDS could be reduced "to a normal disease," he said.
Powell, who seemed moved by the presentations, made no concrete promises beyond announcing two new programs, totaling $50 million over five years, to help Uganda prevent AIDS and care for its victims. He also said he would take the message back to President Bush.
The secretary of state spent part of yesterday discussing with Ugandan President Yoweri Museveni the 18-year civil war in Sudan and the conflict in Congo. Both countries border Uganda. He said he told Museveni that the United States "would be playing a more active role" in trying to end the war in Sudan between the government in Khartoum and rebels in the south.
To help Sudan, the United States is sending 40,000 tons of emergency supplies to address a famine that has begun to take hold after two years of drought. Powell said the United States also would work to bring a cease-fire into effect.
The aid will be given to both sides in the conflict, said Andrew Natsios, administrator of the U.S. Agency for International Development.
Museveni, whose government in the past has given shelter to anti-Khartoum rebels operating in southern Sudan, said he welcomed the U.S. decision to take an active part in diplomacy to end the war.
But Powell, a former general, also described the fight against AIDS in strikingly military terms.
"There is no war on the face of the earth right now that is more serious, that is more grave than the war we see here in sub-Saharan Africa against HIV-AIDS," he said. "You have taken the battle to the enemy," he told the volunteers and health workers in Kampala.
The majority of Africans cannot afford the $10,000-a-year cost of drugs, known as anti-retrovirals, that can ameliorate the effects of HIV, the virus that causes AIDS. Pharmaceutical firms and the Bush administration have come under increasing pressure to make the drugs available to the developing world at discount prices.
Warren Strobel's e-mail address is firstname.lastname@example.org.