Diary Prequel Package — page 27

arm and led me to the stage saying that the President very much wanted me to sit down next to him during his speech. I was told that the President has long been an admirer of me and respected all that I had done for AIDS. The President greeted me with a handshake and began his speech by recognizing me to the audience. After his speech, Dr. Rugunda asked me to say some words. I extemporaneously spoke into the microphone directly to the President and told him that he was a model of African leadership and that he was highly respected in the USA and throughout the world for his sensitivity, insight and leadership in the fight against AIDS, and that we often refer to the "Uganda Model". I told him that when I returned to the USA part of my responsibility was to report back to my Minister of Health, Secretary of DHHS, Gov. Tommy Thompson and the staff of the White House. I said that I would tell them that what we have heard about President Museveni was true and that you were indeed an inspired leader and that we look forward to continuing to work with him. He was obviously very pleased with my remarks and gave me a hearty handshake and a very warm smile. At dinner that night, The Rockefeller Foundation hosted a working dinner for several of the participants to discuss the meeting. I was asked to serve as rappateur for my table and we had lively discussions about where we go next in this process. April 20, 2001 - Last day of meeting and my day of departure. Discussions continued and we all realized how difficult it would be to accomplish this lofty goal of providing antiretroviral therapy for Africans. There was good news during the meeting that the consortium of drug companies had withdrawn their ill-advised lawsuit against South Africa for trying to distribute drugs outside of patent restrictions. Now the South African government (which has been extremely problematic at best with President Mabeki showing bizarre behavior regarding whether HIV causes AIDS) would have to move to start treating their people since the drug companies could no longer be considered the obstacles. Lincoln Chen of the Rockefeller Foundation gave a very nice summary of the meeting as the last speaker and used many of my direct quotes from my talk and my discussions to make important points. One in particular was my warning to beware of the "ethical police" who would only want us to do studies in Africa that would be acceptable and relevant in the USA. This centers around the issue of the Declaration of Helsinki which states that the control arm of any trial in a developed country (or anywhere) would have to be the best possible therapy for the disorder. By "best possible therapy", they mean best anywhere. This would make research to answer questions that are relevant to Africa virtually impossible. We all agree that high ethical standards are necessary; but to demand the best therapy anywhere as the control arm in a nation where there is virtually no health care and which would not be relevant to Africa is unrealistic. Everyone in the audience agreed and gave me a long applause. After the meeting, we drove to the Uganda Virus Institute in Entebbe on the way to the airport to visit Dr. Sylester Sempala, a well known Ugandan virologist whom I had met previously at a meeting in Naples, and Mary Meehan. It was a nice facility (by African standards) and the view was magnificent. It was perched overlooking the shores of Lake Victoria.