These pharma-sponsored programs offer tangible benefits. BI's program spurred Abbott to donate its HIV rapid-test Determine,
and together they created a foundation in which countries could piggyback additional care services. And the WTC helped establish
new models of treatment for the working population that is the hardest hit by the disease. But those gains haven't been without
lessons: countries complained that BI's PR around the donation—which was slow to ramp up because of low rates of testing—outstripped
the donation itself. And though the GSK funding allowed the WTC to subsidize ARVs, the funding eventually stopped, driving
prices back to normal levels so that some patients were forced to stop taking the drugs.
Outreach for All
Inside a dark hut, a father sits by his son, both infected by the disease. The pair try to sit up, their struggle only partially
shrouded by a curtain. The lesions are apparent. So is the thrush—big white sores that dot their tongues, making it hard to
eat. Their limbs are weak, their bodies speckled by bedsores.
They used to receive help from St. Francis Nsambya hospital, a local religious institution. Health workers brought medication
to treat opportunistic infections along with porridge and sugar. But a few months ago they stopped. Maybe their funding dried
up. Maybe they just had too many patients of their own. No one seems quite sure.
Nsambya Hospital received a small PEPFAR grant in 2004, enough to put 164 adults and 24 children on ARVs, says Pastorali Katwebaze,
director of the AIDS Widows Orphans Family support program at the hospital. But Nsambya serves more than 100,000 people in
the poorest sections surrounding Kampala. That translates to 4,000 AIDS case—or more likely 15,000 or 20,000. Multiply that
by the number of districts in Uganda, by the number of countries in Africa, and you begin to understand the issues still facing
the scale-up of PEPFAR.
Pastor Paddy Luzige prays with the father and son—using his one infinitely renewable source of hope. When he leaves, the sick
are still sitting, still waiting. Maybe tomorrow.