WASHINGTON (FinalCall.com)�Sub-Saharan Africa is "the world�s most affected region," and has become the world�s biggest health challenge, according to the Joint United Nations Programme on HIV/AIDS (UNAIDS). The agency issued the report Nov. 30, two days before World AIDS Day.

"The AIDS situation in Africa is catastrophic and Sub-Saharan Africa continues to head the list as the world�s most affected region," said Dr. Peter Piot, UNAIDS executive director. The report says 3.8 million people became infected with HIV in that region during the year, bringing the total estimate of Africans living with HIV/AIDS to 25.3 million. Nearly a million more than in 1999. Ninety-five percent of the world�s AIDS orphans, according to UNAIDS are African. Since 1981, 83 percent of all HIV/AIDS related deaths have been in Sub-Saharan Africa.

UNAIDS and the World Health Organization (WHO) claim AIDS is the fourth leading cause of death worldwide, yet the leading cause of death in Black Africa.

How is it that Sub-Saharan Africa, which represents just one-tenth of the world�s population, for nearly two decades is the most affected region of the world?

"The AIDS crisis thrives on poverty, social disruption and ignorance," commented Dr. Dorothy Logie of Medact, a health professional group based in the United Kingdom.

Debt and structural adjustment, said Dr. Logie, have been instrumental in creating the current AIDS pandemic. The World Bank, International Monetary Fund (IMF) have forced impoverished nations to charge "user fees" for health care, which poor people can�t afford, she said. The result, say critics of the policy is that the poor simply don�t go in for health care or any diagnosis. According to the World Bank, the debt owed by Sub-Saharan nations stands at $15.2 billion.

"They must stop this whole thing about user fees for primary services to the poor. We have to pay for water and pay for health care. Poor people and poor societies don�t have access to affordable medicines. The Third World debt is crippling the countries from providing a way to deal effectively with the AIDS crisis," said Archbishop Njongonkulu Ndungane of Cape Town, South Africa.

Speaking with The Final Call while attending the White House World AIDS Day Summit 2000, Nov. 29-Dec. 5, the Archbishop said African nations must reject $1 billion in loans, proposed by the Clinton administration, to pay for anti-AIDS drugs.

"We need affordable drugs, not loans that would increase our debt," he said, urging the U.S. to help bridge the gaps between human needs, scientific support and profits.

The reluctance of America and pharmaceutical conglomerates to reduce prices, offer grants and lift restrictions that prohibit purchase of low cost generic AIDS drugs from other countries, suggests that its interests abroad are not completely humanitarian.

"The G8 nations promised last year to write-off $100 billion worth of poor country debt," said Phil Bloomer, head of advocacy for Oxfam, a pharmaceutical company monitor. "But little of that has been delivered. To offer these same poor countries another $1 billion of debt is just wrong-headed," he said.

Sandra L. Thurman, a presidential special envoy and director of the Office of National AIDS Policy, told The Final Call loans could be one workable approach, if constructed properly and done in conjunction with private firms. Some countries are able to absorb and repay the loans, which would purchase medicine they otherwise would not receive, she argued.

"U.S. Ambassador (Richard) Holbrooke at a recent session on AIDS at the UN, told us that after consultation with the Brookings Institute and Rand Corporation, IMF and World Bank think tanks, AIDS became a matter of international security," observed Dr. Arthur Lewis, president of Africans Helping Africans, Inc. in New York.

"It wasn�t the health departments of these countries nor America, it was these corporations and robber barons who heightened the level of threat. Then through massive propaganda campaigns they hammered home the idea of a pandemic. Therefore convincing you to buy the drugs placing your country in more debt. Not only do you incur more debt, but the drugs destroy you," he charged. "Just check the Physician�s Desk Reference against these drugs. Assuming that what they say is true, for the drugs to work, they have to attack the DNA and the RNA of the virus, but in attacking those bodies, it also destroys your DNA in the process," he said.

Dr. Lewis also cited a Food and Drug Administration decision last year to fine Abbott Laboratories, a world leading pharmaceutical company, $100 million for the defective manufacture and distribution of the Elias HIV/AIDS test. This is one of the tests for HIV Dr. Lewis maintains is on the list of recommended practices in Africa.

Many Sub-Saharan Africa analysts also contend AIDS in developing countries must be seen as an education and welfare issue, not just a medical challenge. They argue much of the world at risk of AIDS can�t read, have never used condom, thinks they don�t have the disease and don�t know anyone who is infected. These same people are unlikely to get tested and most people in the world cannot afford AIDS drugs, activists add.