Rwanda's Prostitutes Love Bush

Prostitutes may or may not be George Bush's natural lovin' constituency but Rwanda's prostitutes have wonderful things to say about him, although their clients, regard the American president as a walking criminal against humanity.

Bush is in Africa today, to start a five-country tour, he will be welcomed by prostitutes for saving the lives of more than a million people with HIV.

The $15bn President's Emergency Plan for Aids Relief (Pepfar) is in its fifth year and is a "revolution" that is transforming Africa, it is the most significant aid programme ever, in Africa.

Bush's contribution will be, extending millions of lives, even though the programme, has been criticised for emphasising abstinence in Aids education and using religious organisations to deliver the aid.

"This is the best thing that ever happened to the poor people I work with," said Father Phillips, a priest overseeing the distribution of life-saving antiretroviral drugs in Nairobi, Kenya. "It's one of the few times I've seen US government money, really reach down to the poorest of the poor. It's kept a hell (tut tut, Father, language) of a lot of people alive."

Dr Venter, head of HIV Clinicians Society in South Africa, is providing 200,000 people with ARVs, is one of a number of Aids doctors, almost disbelieving in praise of Bush. "I look at all the blood this man has on his hands in Iraq and Palestine, I can't quite believe myself but I would say, it's a bold experiment from the last person in the world I would expect to do it, and it is saving a lot of lives. To intervene on such a scale and make such a difference is huge," he said.

Pepfar's ultimate target of providing treatment and care to 20 million people with HIV, in Africa and the Caribbean. It is already supplying ARVs to about 1.5 million people. Congress doubles Pepfar's budget later this year.

The US programme owes its success to combining large amounts of money to fund drugs, with broadening assistance beyond the individual with HIV. Pepfar is supplying medical equipment and training large numbers of healthcare staff. It is also reaching into households, hit by Aids with programmes, to put children through school and help those with HIV to carry on working.


In Rwanda - on Bush's tour, one of Pepfar's 15 priority countries - Dr Bigwaho, the head of the national Aids council, says the US programme, is the major contributor to a tenfold increase over the past four years, in the numbers of Rwandans on ARVs to nearly 50,000 people. Today about 70% of Rwandans who need the drugs receive them. "The impact is huge. The average life expectancy of Rwandans has improved by four years because of Pepfar," she said. "The impact is also really big in the health sector, because of the equipment and training. It is putting children through school."

An American group, CHF International, is using money to pay for 39,000 children to go to school in Rwanda, because Aids orphans and other young people left without support, are more likely to prostitute themselves, like colleagues in the USA, to survive.

Ms. Smith, in Kigali - who says she is personally keen on a change in the White House - says the unprecedented amount of money provided by George, has changed how Rwanda deals with Aids.

"The scale of the money coming in, has really changed everything. If someone in a household has HIV, it used to be we only focused on them. Now we look at the health of everyone in the household, because if a parent has HIV, that has implications for their ability to provide and care for their children. We can now treat the children for other diseases, because that is a consequence of HIV in the household," she said.

But religion has come in for strong criticism because its Aids education programme, ABC - Abstinence, Be faithful, Condomise - pushes the first two over the third.

Democrats including Senator Obama want to scrap the emphasis on abstinence, when legislation comes up for renewal later this year. Many Aids workers in Africa, think the Bush administration's obsession with the issue is misplaced but say its impact is minimal because government programmes in most countries emphasise the use of condoms.

Senator Obama has criticised the large numbers of "faith-based" organisations funded such as Phillips' Eastern Deanery Aids Relief Programme, which distributes ARVs to 7,000 people in the poorest parts of Nairobi. Its $3.3m slice of Pepfar's $386m budget in Kenya last year has funded expansion, to a network of more than 10 clinics and 300 staff.

Church policy and programmes do not distribute condoms - but the Kenyan government's emphasis is on condoms. "The prevalence of Aids has dropped significantly in Kenya. It's down to the various education campaigns by the government, by communities and that people saw that people were dying. You can draw your own conclusions," said Phillips, a leading church figure.

Mr. John Dunlop, who heads one of the health team in Rwanda, said the relationship had less to do with evangelicals in Washington, than with practicalities in Africa. "These are very pious communities; the church runs through every component of life. So if you ignore these church networks, as a means of pushing out messages of change, you're ignoring a huge resource," he said.

The HIV budget in Kenya will rise to more than $500m this year. It already pays for 90,000 people to receive ARVs, nearly half of all those taking them in the country, as well as home care for those with HIV, including food and finance, so they can make a living.

Mr. Warren Buckingham, head of the Pepfar programme in Kenya, found himself pressing the Kenyan government, on behalf of the very people, the American Judea-Christian right most despises. "If there is resistance it is not in Washington. The people we have to push, are the public health officials here, to recognise neglected populations and highly stigmatised groups, gays, intravenous drug users, sex workers," he said.

In a busy Kigali bar, Linda, a 24-year-old HIV-positive prostitute, explained that she had originally was fearful of being tested because she didn't want to know that she might soon die. "Then they said, they could make us well, they have these drugs. So I got tested and I have the drugs," she said.

So whom does she like?

"The American, Georgy Bush and don't you bring no Senator Obama round my door but you can always bring Bill Clinton, he is the best of them all, I hope his wife gets elected."