The NewsHour with Jim Lehrer

JIM LEHRER: Good evening. I'm Jim Lehrer. On the NewsHour tonight Margaret Warner and Marcia Coyle of the National Law Journal review the Supreme Court's ruling against the medical use of marijuana; Ray Suarez looks at the rising price of gasoline; and Elizabeth Farnsworth launches her major series on the AIDS crisis in Africa. It all follows our summary of the news this Monday.

NEWS SUMMARY

JIM LEHRER: The U.S. Supreme Court today ruled against the medical use of marijuana. It refused to let an Oakland, California, club distribute the drug to the sick to ease the effects of AIDS, cancer, and other ailments. The Justices said federal anti-narcotics law made no exceptions. The ruling was eight to zero. Justice Breyer did not take part because his brother, a federal district judge, had presided over the case. We'll have more on this story right after the News Summary. The Coast Guard today announced the largest cocaine seizure in U.S. maritime history. Thirteen tons of the drug were found on a fishing boat off San Diego, California, on May 3rd. Authorities became suspicious because the vessel was outside normal fishing grounds, and it had no working fishing gear. The 10 crew members were from Russia and Ukraine; they'll now face smuggling charges. President Bush today outlined a plan to curtail gun violence. It's called Project Safe Neighborhoods. Mr. Bush told police in Philadelphia he wants to spend $550 million over two years to improve enforcement of existing laws. He said the money would go to hire more than 700 new prosecutors and to improve criminal record keeping.

PRESIDENT GEORGE W. BUSH: We need a national strategy to assure that every community is attacking gun violence with focus and intensity. It will increase accountability within our systems, and it will send an unmistakable message: If you use a gun illegally, you will do hard time. This nation must enforce the gun laws, which exist on the books.

JIM LEHRER: The President said the nation's violent crime rate dropped 20% in the last decade, but he said it remains among the highest in the industrialized world, and he called that unacceptable in America. Lawyers for Terry Nichols have renewed his appeal in the Oklahoma City bombing case. Over the weekend they filed papers asking the U.S. Supreme Court to order a new trial because the FBI failed to disclose some documents in the case. Nichols is serving a life sentence. Co-conspirator Timothy McVeigh was to be executed Wednesday, but that's been delayed until June 11. In the Middle East today, Israeli troops killed seven Palestinians in separate incidents. Thousands of protesters took to the streets after five Palestinian policemen were shot dead in the West Bank. They were manning an outpost near Ramallah. And Israeli officials said troops had taken fire from that building. In Gaza, Israeli forces shelled Palestinian security sites and soldiers killed two Palestinians after a grenade attack. A conservative coalition has won control of the parliament in Italy. It's led by media businessman Silvio Berlusconi; he's now poised to become prime minister for a second time. We have a report from Gaby Rado of Independent Television News.

GABY RADO: Silvio Berlusconi likes a song, as he showed in the final run up to the polling. He was once, in fact, a crooner on a cruise ship. Since then, however, he's acquired a few consumer durables such as three TV networks which between them account for 43% of the Italian audience and a massive amount of influence. One of Silvio Berlusconi's other acquisitions is A.C. Milan, the football club. The fact that a political leader should have a financial stake in so many aspects of life worries many Italians, though clearly not a majority. There is also the matter of his tangling with courts on charges of bribery, corruption and tax evasion, some of which he's been acquitted of on appeal, some of which is still pending, all of which he denies. Francesco Reteli, the center-left candidate lost narrowly to Seniore Berlusconi because the public grew tired of squabbling within the coalition which ruled Italy over the past five years. A familiar face internationally, Emma Bonino, the former EU commissioner, has made headlines during the campaign for her hunger and thirst strikes. She was protesting at her party, the radicals, getting virtually no TV coverage. If Silvio Berlusconi wasn't enough of a maverick, he's formed a right-wing alliance with Italy's most outrageous party leader, Umberto Bossi of the Northern League. He's called for Northern Italy to become a separate state, and has made jokes about pedophiles and freemasons running the European Union. Mr. Bossi brought down Silvio Berlusconi's previous government in 1994 after only seven months. No one can be sure he won't do the same thing again.

JIM LEHRER: In Washington, a State Department spokesman congratulated Berlusconi on his victory, but would not comment on possible changes in Italian policies. In U.S. economic news today, industrial production was down in April for the seventh straight month. The Federal Reserve reported it fell 0.3%. Tomorrow the Fed meets to consider another cut in interest rates. A presidential commission today announced an $11 billion way to stop tobacco farming. It recommended increasing the federal cigarette tax by 50%, or 17 cents a pack. Much of that money would go to growers who abandon or reduce their crop. President Clinton had ordered the report. A White House spokesman said President Bush will now review it. That's it for the News Summary tonight. Now it's on to the Supreme Court's medical marijuana ruling, gas prices going up, and the beginning of our series on the AIDS crisis in Africa.

UPDATE - MEDICAL MARIJUANA

JIM LEHRER: Margaret Warner has the marijuana story.

MARGARET WARNER: Today's eight to nothing ruling against marijuana's medical use came in a case brought by the federal government after California voters passed a 1996 initiative legalizing such use. This case marked the High Court's first foray into the medical marijuana debate. Here to discuss today's ruling and its impact is Marcia Coyle, Supreme Court correspondent and Washington bureau chief for the National Law Journal. NewsHour regular Jan Crawford Greenberg is on maternity leave.

Welcome back, Marcia.

MARCIA COYLE: Thank you.

MARGARET WARNER: First, briefly recap this case, what it's about, how it ended up in the court.

MARCIA COYLE: Shortly after California, voters adopted the referendum in 1996. A number of non-profit organizations formed by physicians and others created group clubs to provide a safe outlet for patients who had prescriptions for medical marijuana use. The federal government wanted to stop these clubs because they felt that their operation violated federal law. They went into federal court to seek an injunction to stop their operation. The Oakland, California, Cannabis Club was one of the organizations that was in court, and they fought this case all the way up to the Supreme Court.

MARGARET WARNER: So what was the Court's reasoning today in upholding the Government's position?

MARCIA COYLE: Well, this was really a very straightforward reading of federal law. The Justices unanimously said that the Controlled Substances Act of 1970 that bans the manufacture and distribution of marijuana contains no exception for the medical use of marijuana.

MARGARET WARNER: So if the federal law is so clear, why did these clubs even think they had a legal leg to stand on? And what's this doctrine of medical necessity that they cited?

MARCIA COYLE: There's a very old legal concept that's known as necessity that people can use as a defense when they break federal laws. For example, you're a prisoner in a prison that has horrible conditions; you escape. You've broken a federal law. But when you're brought up on charges, you claim as a defendant that you had to escape; it was a necessity because the conditions were so bad. You're essentially saying, "I chose the lesser of two evils here." And that's what these clubs were saying on behalf of the patients who needed marijuana; we have to break this law. In defense, it'sneeded to break this law in order for our patients to be able to live, to continue to be viable contributors to society.

MARGARET WARNER: So this majority opinion, or unanimous opinion -

MARCIA COYLE: Yes.

MARGARET WARNER: -- written by Justice Thomas, what did he say against that argument about medical necessity or necessity? Why didn't it apply in this case?

MARCIA COYLE: Justice Thomas said that Congress made it very clear under 1970 federal law that marijuana was what we call a schedule one drug. That's the most restrictive regulation of an illegal drug. If Congress had meant to include a medical necessity defense, it wouldn't have made it a schedule one drug, because one of the criteria for getting on schedule one is that there is no generally accepted medical use of the drug.

MARGARET WARNER: So, in other words, the law in this case trumped this doctrine, this idea of necessity?

MARCIA COYLE: That was Justice Thomas's view.

MARGARET WARNER: Now, Justice Stevens wrote a concurring opinion in which he agreed with the result, but he said he didn't necessarily agree with all of Justice Thomas's reasoning, and two other Justices joined in that.

MARCIA COYLE: That's right.

MARGARET WARNER: Explain what that said.

MARCIA COYLE: Justice Stevens felt that some of the language that Justice Thomas used went a little too broadly. I mean, he felt that it was true that the federal law was clear-- there's no medical necessity defense for the distribution and manufacture of marijuana-- but he said it may be possible that an individual patient could raise this defense if that patient had no alternative way of avoiding, for example, starvation or extraordinary suffering, so he left the door open for maybe a case involving individuals. Remember, this case before the Court involved clubs who were distributing marijuana, not patients who were using it.

MARGARET WARNER: And that's what federal law also talks about.

MARCIA COYLE: That's correct.

MARGARET WARNER: Manufacture and distribution.

MARCIA COYLE: Right.

MARGARET WARNER: Now, how did you read Justice Thomas's majority opinion on that point, in other words, on how broad he thought it was?

MARCIA COYLE: Well, I think Justice Thomas also left a door open. I think if an individual patient brought a case and claimed that they had violated the law but had as their defense medical necessity, that he might very well find that there was no medical necessity defense under this particular law; but what he said was, "we're not ruling today on whether there are constitutional claims that a patient might bring." For example, we have due process rights; they're violated by this federal law, or a patient who claims Congress exceeded its authority by lawmaking in this particular area.

MARGARET WARNER: Yes. He said none of that is before them, so they weren't going to...

MARCIA COYLE: Exactly.

MARGARET WARNER: Now, explain how the California voters approving this initiative plays in or didn't play in to this case.

MARCIA COYLE: Well, what was really before the Court was not whether the initiative or the referendum or even any other state law was legal or illegal; what was before the Court was an interpretation of the federal law, so what we have right now is we have about eight or nine states that have said to people who need medical marijuana, you may use it; you will not be prosecuted under state law. Now while you may not... You will not be prosecuted under those state laws, with the Supreme Court's ruling today, you may be prosecuted under federal law.

MARGARET WARNER: And how likely is that?

MARCIA COYLE: Well, I think it may be very unlikely. Most marijuana possession and use prosecutions are done under state law. They're considered low-level crimes. Unless the federal government is going to make a policy statement that it will begin to look for cancer victims, AIDS victims, and others who need marijuana for medical use, I think it's unlikely we'll see widespread federal prosecutions. I think what the Government was really concerned about here was an organization, a club, that was distributing marijuana, perhaps without clear guidelines on who should get it or for what use it should be me.

MARGARET WARNER: But, theoretically, how would a patient go about getting this? I mean, are you talking about that the exemption that Justice Stevens might have been talking about is only if say the patient grew their own? How do they then know how much to take?

MARCIA COYLE: Well, that's a very good question, and I think what happens now for patients, in states like California, these clubs did provide a safe outlet and an accurate way of receiving their marijuana under prescription, and they did that in order to keep patients from having to turn to the black market or, as you suggest, growing it in their backyard. And I think now that's pretty much left to a patient who needs it, unless maybe someday a state passes a law creating a state-sponsored outlet for marijuana. There again, though, we may see a clash with the federal law.

MARGARET WARNER: So then the only other recourse or the only other way to change this, would be politically, to go back to Congress and try to get this reclassified?

MARCIA COYLE: Yes, it definitely throws the ball back into Congress's court. But I think it was only in 1988 that Congress issued... enacted a resolution that essentially said, "states, you may be legalizing marijuana, but we have a federal law, and we're not changing it."

MARGARET WARNER: Well, Marcia Coyle, thanks very much.

MARCIA COYLE: You're very welcome.

FOCUS - PUMPED UP

JIM LEHRER: Now, the rising price of gasoline and to Ray Suarez.

RAY SUAREZ: As American road trippers once again prepare for that time of year, they're getting punished at the pump for the second straight summer.

CONSUMER: It's terrible. More than $2.00 a gallon. It's unbelievable.

CONSUMER: I used to be able to fill up my tank for under $20, maybe around $16, $17 and today it cost me $25.74.

RAY SUAREZ: Some of the highest prices in the country are in California, where the average price is $1.93 for regular unleaded, and in the Midwest, where drivers are paying $1.80. Nationally, the average price rose this past week to $1.71. In dollar terms, that's the highest ever, but adjusting for inflation over the years, it's still about a dollar cheaper per gallon than it was in March 1981, and U.S. fuel is still a fraction of what it costs in Europe. While some energy analysts are calling $3 a gallon gas a serious possibility, others say prices could come down a little by midsummer, when oil imports and refining capacity are expected to increase. Whatever happens, it's already a political issue for the White House, which is getting criticism from members of both parties. Last Friday President Bush acknowledged the problem, and he stressed two of his administration's central themes:

PRESIDENT GEORGE W. BUSH: What I say is I worry about the fact that hard working people are paying high prices at the pump; it concerns me a lot. And therefore the Congress needs to cut taxes as quickly as possible to give people money to be able deal with this situation. I also say we need to build more refining capacity. We need more supply.

RAY SUAREZ: Later this week, the President will announce his energy plan. He's expected to call for more refineries and pipelines and to step up domestic oil exploration. But some Republicans say that's not enough. They want to repeal the 18-cent-a-gallon federal gas tax immediately. Democrats, meanwhile, knocked the Bush plan for short-changing conservation and renewable energy ideas.

SPOKESMAN: The President has responded to the gathering crisis by throwing up his hands and saying, "there's nothing we can do, there's no way to give people immediate relief from blackouts and sky-high increases of the price of gasoline at the pumps." The President's do-nothing response begs the question: Is the Republican answer to our energy crisis letting the energy companies dictate our energy policy?

RAY SUAREZ: Meanwhile, economists are watching to see how motorists respond to higher prices as the peak travel season begins.

RAY SUAREZ: To walk us through the problems at the pump, we're joined by, Joseph Coughlin, director of the MIT Transportation Center; Ed Murphy of the American Petroleum Institute, which represents the nation's major oil companies-- he specializes in refining and fuel issues; and Anna Aurilio, legislative director of the U.S. Public Interest Research Group, a consumer and environmental advocacy organization. Ed Murphy, in your view, what are the push factors behind these rising gasoline prices?

ED MURPHY: Two push factors. First of all, the gasoline prices on average are now about 20 cents a gallon higher than they were at this time last year. About one-third of that increase is due to an increase in the cost of crude oil, the cost of the raw material from which we make gasoline. The remaining 2/3 reflects the fact that we have not paid adequate attention to our refining capacity in the United States and expanded the infrastructure in a way that would enable us to supply consumers with an adequate supply of - at affordable prices - of petroleum products. We are operating refineries essentially flat out; there is no excess capacity left in the system and that in fact has forced prices up because of the reductions in supply, relative to the amount that consumers are now demanding.

RAY SUAREZ: Well, we've had several straight years of economic growth, robust car sales. Who goofed?

ED MURPHY: Well, nobody goofed. What we've done now is we haven't paid attention to our energy supply infrastructure over the last ten years. We have put policies in place, which are very good and worthwhile and have environmental benefits, but we haven't asked the question of ourselves - is how are going to supply this energy and what sort of national policies do we need that are going to allow us to supply energy that consumers need to drive cars and to enjoy the lifestyle that they've - that they're entitled to.

RAY SUAREZ: Anna Aurilio, when you look at the situation, what do you see pushing gas prices?

ANNA AURILIO: I think we see things a little bit differently. We see in terms of overall energy problems that the country is facing that consumers right now are at the mercy of giant corporations that are manipulating markets to generate enormous profits, and just as an example in the world of gasoline prices the world price of oil, as we know, is controlled by OPEC, but U.S. oil companies benefit greatly when the world price goes up. It's not in their interest for the price to go down, and they're reaping enormous profits. Exxon Mobil last year had, I believe, the highest earnings of any company ever in the world, and in the last quarter alone through March of this year they reported $5 billion worth of profits. So these companies are benefiting handsomely, while we're paying the price at the pump.

RAY SUAREZ: But this in your view a supply problem.

ANNA AURILIO: I don't think it's so much a supply problem as it is - and I'll agree with Mr. Murphy - it is a long-range planning problem in that the biggest thing that we can do to reduce our dependence on oil and to reduce the shock that we get at the pump is to have cars that go further on a gallon of gasoline. And the auto industry has known how to make cars that would go up to 60% further. This would save us more oil than we import from the Persian Gulf, than we drill off California's coast combined, and even 15 times as much oil as there is potentially in the Arctic National Wildlife Refuge, which is at risk under President Bush's energy plan. So this would do all this, plus it would save us money at the pump, and we have technology to do this now, so that's what I would think is the best solution and the best way to insure against future sticker shock at the pump.

RAY SUAREZ: Ed Murphy.

ED MURPHY: I think there's no question; conservation has to be a very important part of any national energy strategy; there is no question about that. We can conserve. We should conserve. We in fact have made tremendous progress since the first Arab oil embargo in producing a great deal more with less energy than we used to use back in the pre 1973 period, but it's not the only answer. We also need to pay attention to supply. We need to ask the question of how are consumers going to be provided with environmentally acceptable fuels at reasonable and affordable prices. That's the question that hasn't been asked in the last ten years. And that's the question that's now being asked, and I'm encouraged that something may be done about it.

RAY SUAREZ: Joseph Coughlin, if we look not at this week or this month's price spikes but at American life over a broader period, is the way we use our cars, the way we organize our daily lives making us vulnerable to price increases?

JOSEPH COUGHLIN: Well, I think we're kidding ourselves if we really think that the discussion here is solely on transportation or the cost of fuel. In fact, transportation is a lot more than just getting from point "A" to point "B." Indeed, it's the guru that holds all these little activities together that we call life. And in fact over the long-term, is this - is our lifestyle completely sustainable? Probably without the supports of alternative transportation beyond the car, new fuel sources, and new technologies, perhaps not; but the strategies that we need to think about right now is how do we keep the lifestyle, the American dream, if you will, that all of us have bought into and probably is one of the chief exports of this nation - alive and working well.

RAY SUAREZ: Well, is gasoline different from other working commodities then? Is the demand as an economist might say inelastic? Can we not do without it the way we might do without the way we might do with something else that is going up in price?

JOSEPH COUGHLIN: Well, you know, unlike a lot of other things, transportation or the fuel that provides it is more indicative of other life's activities. You know, the fact that there's more congestion on the road and that in fact there may be more demand for transportation is a sign that the economy is actually robust, and it tends to feed on self. The structure of our communities where 70% of us live in more rural America or suburban America, where transportation alternatives are really not in place or not as elastic and flexible to meet the needs of getting to all those things-- the cleaners, the store, dropping kids off at the school-- possible.

RAY SUAREZ: You can't necessarily walk to do your marketing if gas goes up 10 cents per gallon.

JOSEPH COUGHLIN: Well, in fact, the biggest problem is that the majority of us live in places where there is nowhere to walk to. It's not just that we're driving more miles. We need to make more trips. In fact, transportation maybe one of the few areas where demographics is truly destiny. Women going to work in large numbers since the 70s have started their own transportation demand, continuing to have to transport kids around, no longer just to school, but to a play date or to various events - and in fact, even the nation's aging population is contributing to greater use of the automobile. Only 25% of our travel is related to going to work. The other 75%, it's called life.

RAY SUAREZ: Well, Ed Murphy, is it not just a question of how much we drive, but what Americans drive?

ED MURPHY: There's no question that Americans gave made choices in the vehicles they have purchased and there's no question that as a result of government regulations, which put a limit on the fuel efficiency of passenger cars, that there's a shift to light duty trucks and to SUV's. That has occurred; it reflects abundant petroleum at relatively cheap prices. Consumers over the long term are able and in fact do make choices to adjust their consumption of petroleum, just like they adjust their consumption of other products to reflect the prices that they're facing. The data that we have now shows that there has in fact been some adjustment. We think demand for gasoline is down somewhat largely as a result of the gasoline price increases that we've seen. Consumers do adjust and will adjust and will conserve when faced with higher prices.

RAY SUAREZ: But Ann Aurilio, if you've just bought an SUV, it's not like you're going to turn around and turn it in if gas goes up in price.

ANNA AURILIO: That's right. We actually think that we're at an energy crossroads right now. These skyrocketing prices should really force us to reconsider the road that we're on and choose a path of new technology, of new energy future. We have the technology to build cars that will go further on a gallon of gas so that we are less dependent on these price spikes, on these fluctuating markets, where some people make a lot of money and the rest of us pay a lot of money at the pump; and then the other thing is, let's not forget, that producing oil and refining oil have enormous costs. One of the things that I hear the oil industry saying in this debate, as they happily whistle their way to the bank, one of the things I hear them saying when they talk about building more infrastructure and refineries, one of the things they're actually lobbying for is relaxing standards, health standards.

ED MURPHY: No, I've got correct you on that. We are not... That's based on a false premise. There is no reason... And we should not have to choose between a clean environment, a safe environment, and adequate and affordable energy supplies. We are opposed, adamantly opposed, to a relaxation of pollution standards in response to this energy problem that we're facing right now. So that is not correct.

RAY SUAREZ: Well, in the states where they have reformulated gas that's being blamed as one of the factors for these price rises. How would the API handle that critique?

ED MURPHY: Well, one of the reasons, the driving forces, behind these energy prices is that we have a wide variety of fuels in the United States that are needed only in certain localities. We have 15 what they call boutique fuels - the underlying - this makes it more complex and reduces flexibility and thus leads to higher prices. One of the things that we have strongly recommended, in fact, one of the things that's agreed upon by our environmentalist friends as well as the petroleum industry is to do away with the requirements in law that require particular chemicals to be added to the gasoline and I'm referring to oxygenates. There was an EPA blue-ribbon panel last year that recommended that that requirement be eliminated, that we be-- which we have agreed-- we in thee petroleum industry make a commitment which we have agreed to do to maintain the environmental quality of the gasoline; removal of that mandate - the law, which serves no environmental purpose - in fact does in some cases damage the environment - and certainly leads to some of the supply problems that we have now - that should be eliminated. That's a good first step to eliminating some of the problems that we're looking at right now.

RAY SUAREZ: And you leave us in what kind of boat, Ann

ANNA AURILIO: I'm happy to hear you say that you want a clean environment, the same as we do. However, what I've heard is that the oil industry is actually arguing that refineries should be able to allow - allowed to increase operations and also increase pollution at the same time.

ED MURPHY: I -

ANNA AURILIO: The so-called new source review standards.

ED MURPHY: I don't know White House you're hearing that from. We have not argued for any relaxation of pollution standards. We have argued to maintain the pollution standards; they are necessary and appropriate. Like I said, it's based on a false premise. That false premise is that we needed to choose between adequate, affordable energy supplies and a cleaner environment; we don't need to make that choice. We have the technology to provide both and we are really anxious to do it.

RAY SUAREZ: Joseph Coughlin - you wanted to say --

JOSEPH COUGHLIN: I would suggest that both of my colleagues get out of the box. Essentially, what we're talking about is short term policy argument as to whether we use one technology that may be cheaper or another - or identify another source of petroleum, when in fact my colleague is right -- we are at a crossroads now of energy policy and indeed transportation policy. This is an agenda setting opportunity to think about alternatives to the car, how we structure our community, and to think about all these things that may be necessary for a sustainable energy and transportation policy. Indeed, we need to have fuels now for the lifestyle we have, but keep in mind it took us 50 years to have the infrastructure in place to live the way we do today. It will take easily ten, 20, 30 years to come up with an alternative that is still sustainable, so use the opportunity wisely. Use this as a method of getting out a vision of what the future is going to be and a more compelling vision perhaps then of the next American dream.

RAY SUAREZ: Joseph Coughlin, Ed Murphy, Ann Aurilio, thank you all.

JIM LEHRER: Still to come on the NewsHour tonight, the launch of our major series on AIDS in Africa.

SERIES - AIDS IN AFRICA

JIM LEHRER: The crisis of AIDS in Africa and what to do about it: That is the subject of a series we begin tonight. We will see the situation on the ground and talk with key experts. Elizabeth Farnsworth spent several weeks in Africa recently; here is her first report from the nation of Malawi, a country of 10 million people where nearly 1 million have the disease. A warning: This story contains strong and disturbing images.

ELIZABETH FARNSWORTH: It's hard to grasp the scope of the AIDS catastrophe engulfing southern Africa, until you see it up close: the hospitals overflowing with patients ill from pneumonia, meningitis, or TB -- opportunistic infections that kill as a result of AIDS; the desperately sick.... nearly all of them young; a 33 year old accountant, husband and father; a 26 year old bakery manager; and Issac Nakhupe--age 30 -- with a newborn at home. On this day his brother had to prop him up in bed. Children are sick too --- they get HIV from their mothers in utero, during birth, or while nursing. 11% of the one million with HIV/AIDS in Malawi are kids. This woman has three children; she probably has AIDS but there's no way to know, because this hospital often can't cover the cost of gloves or clean needles -- let alone the chemicals necessary to test widely for the disease. Dr. Ajib Phiri struggles to provide what care he can. He suffers from his own sorrow...

ELIZABETH FARNSWORTH: Have you lost friends and family yourself?

DR. AJIB PHIRI, Mulanje District Hospital: Yes, I have lost a sister -

ELIZABETH FARNSWORTH: To HIV?

DR. AJIB PHIRI: -- to HIV/AIDS.

ELIZABETH FARNSWORTH: When?

DR. AJIB PHIRI: It was three months ago.

ELIZABETH FARNSWORTH: Dr. Phiri's sister...... the sick in this hospital...... the almost 1 million in Malawi with HIV/AIDS. They join 25 million more in the region -- in Botswana, Zimbabwe, South Africa and the other sub-Saharan countries where rates of infection are higher than anywhere in the world. In some parts of these countries, including Malawi, 1/3 of all adults are infected. 17 million people in Africa have already died of AIDS... this is the scope of the African AIDS catastrophe, which Malawi's vice president says the rest of the world must begin to grasp....

VICE PRESIDENT JUSTIN MALEWEZI, Republic of Malawi: HIV/AIDS in Malawi and everywhere is more than a disease. It affects everyone; it affects all sectors of society, and everyone in Malawi is either affected or infected one way or the other. This is not an African problem; this is a world problem!

ELIZABETH FARNSWORTH: And there are questions the world must answer -- says nurse Maryline Mulemba of the group "Doctors Without Borders".... :

MARYLINE MULEMBA, Doctors Without Borders: Is the world ready to lose 1 million people in Malawi and 30 million people in Africa? I don't know if we really can afford this....I don't think....

ELIZABETH FARNSWORTH: Malawi, once called Nyasaland, is one of the 15 poorest countries in the world. it's also very beautiful --- especially Lake Malawi, which is rich with history. Dr. David Livingstone sailed north on these waters in his quest for the source of the Nile. But the colonial rulers that followed his explorations, and a post- independence dictatorship misused this country, and now the best land is planted in tea and tobacco for export, while most people barely survive on the corn, sorghum and beans they grow on tiny plots. Poverty -- with its accompanying malnutrition, worker migration and lack of education -- has helped fuel the epidemic, and scenes of sadness like this are now common. A three-month- old baby had died in the night in Ntonya Village not far from the southern border with Mozambique. A neighbor offered condolence and a prayer; she regularly visits the sick in this village--as part of a government health program supported by the U.S. non-profit, Project Hope. She said the baby probably died of AIDS. The mother died a few months ago; the father last year. The grandmother, Line Urwe, is caring for what's left of the family...five orphans. I asked her how she survives.

LINE URWE: (speaking through interpreter) It's difficult to take care of the children. I do piece work in the fields when I can, but it's hard.

ELIZABETH FARNSWORTH: Right now do you have enough to eat?

LINE URWE: We don't have enough food for the coming year because all of our crops were washed away with the floods.

ELIZABETH FARNSWORTH: There has often been hunger here and life expectancy has always been low...but villagers say they have never seen anything more devastating than AIDS.

INTERPRETER: Out here, there have always been diseases, but what we have now is different. our major concern is AIDS. In my lifetime, I've never seen anything like it.

MARYLINE MULEMBA: If you would say tomorrow one million people will die because of an earthquake, everybody will rush here and bring help; but people will die slowly and in silence more or less; the help coming in is still very slow.

ELIZABETH FARNSWORTH: The Malawi government, led by President Bakili Muluzi, has launched an effort -- highly praised by the United Nations and others -- to prevent more deaths. Here -- as elsewhere in Southern Africa -- the HIV/AIDS epidemic is spread mainly through vaginal sex between women and men. In every part of the country, billboards warn that "AIDS kills" and urge Malawians to "change their behavior." The government also mandates AIDS education in schools. The U.S. group, Project Hope, helps fund the "AIDS club" in this school in southern Malawi; and when we visited, the kids put on a show for their benefactors. (children singing) They sing --- "AIDS is almost everywhere. Boys and girls, don't forget that it can send you to the grave!" The government is also enlisting the help of traditional healers -- often referred to as "doctors" here -- -- who had in the past performed circumcision and other procedures without clean razor blades but who now know better. This healer is regularly preaching abstinence or safe sex...and advising patients like this one to get tested for HIV.

ELIZABETH FARNSWORTH: Do you know where you got HIV/AIDS? Do you have any idea how you caught it?

JACKSON ALLIE: (speaking through interpreter) Yes, I'm a carpenter, and I'm only 26. I move around a lot with my carpentry and go with lots of women, so I'm suspecting I got it from there.

ELIZABETH FARNSWORTH: Are you using a condom when you have sex?

JACKSON ALLIE: (speaking through interpreter) The doctor here has advised me to stop any sexual activity right now; so I've completely stopped while I'm taking this medication from her.

ELIZABETH FARNSWORTH: The healer claims the medication -- a potion made from tree roots -- cures AIDS, and in the absence of any other medical solution, many people, including highly educated ones, are seeking this kind of help. The vice president says the scientific validity of the potion is immaterial; what counts is the safe sex message.

VICE PRESIDENT JUSTICE MALEWEZI: When she gives her potion and says when I'm giving my potion there should be no sexual relationship, that is what it is important to me because it will prevent, help to prevent the transmission

ELIZABETH FARNSWORTH: The government is also doing what it can to improve care for those with AIDS but lacks the funds to do much, says the chief physician at Malawi's best public hospital, Queen Elizabeth in Blantyre.

ELIZABETH FARNSWORTH: I asked him why there isn't enough funding.

DR. C. M. NYRINDA: -- lack of money - -the lack of financial resources.

ELIZABETH FARNSWORTH: And is it just that the government doesn't have enough money or that they're not devoting the money?

DR. C. M. NYRINDA: The government hasn't got enough money. It's not only Ministry of Health - it all ministries - it's Ministry of Education, of Agriculture, it's all the ministries who are equally involved, but here we do feel we're talking life and death.

ELIZABETH FARNSWORTH: And so in villages like this one, where corn crops are uncertain, water is unclean, and some people are very sick, volunteers are stepping in to fill the gap. Goodwin Horiab is one of 72 members of a volunteer organization called SASO, the Salima HIV /AIDS Support Organization. He visits the sick in this village several times a week. He believes this woman -- Livetia Moluzi -- has AIDS. Her husband died a few years ago -- her daughter and a grandchild more recently. She lives with her three surviving children, one of whom is disabled from polio and with her orphaned grandchild, who does most of the chores.. Moluzi got an antibiotic at the hospital for sores on her head and special salts for rehydration...and Goodwin Horiab reminded her to take the medication as prescribed and to be sure to boil the water. But these medications can't save her life; and Goodwin Horiab said he's angry the AIDS drugs being used in developed countries are not available here.

GOODWIN HORIAB: (speaking through interpreter) Well, unfortunately everything good starts from those countries, and then the last scraps come to Africa. And we're always getting the bottom of everything. Since things have been that way, I guess with AIDS that's the way it's going to be.

MARYLINE MULEMBA: Of course we need to continue focusing on prevention, to try to reduce transmission and that less people get contaminated, but we need also to treat the ones who are infected because we can't afford to lose them all. And to be able to treat them we need to have the drugs in -- and we need to have the infrastructure to be able to do it.

ELIZABETH FARNSWORTH: Goodwin Horiab is convinced that he and other volunteers could be part of that infrastructure.

GOODWIN HORIAB: (speaking through interpreter) We have home-based care volunteers who have been trained to deliver medication. One way to do it would be to have the same home-based care people trained in AIDS treatment and come give the medication to patients.

ELIZABETH FARNSWORTH: SASO volunteers have already been trained to test for AIDS...and they said they could also monitor patients on AIDS drugs, if doctors had them to prescribe. The monitoring will be crucial because the virus develops resistance when pills aren't taken correctly. At Queen Elizabeth hospital in Blantyre, the government already has a very small pilot program providing antiretrovirals (ARV's) -- as they're called -- to a handful of people who can pay. But the government is also committed to making the ARV's much more available.

VICE PRESIDENT JUSTIN MALEWEZI: We are advocates for anti-retrovirals as part of the prevention as well as treatment, because, as you know, once a person is on the ARV's, the transmission rate is greatly reduced; so it is part of the prevention.

ELIZABETH FARNSWORTH: First there is much to do. The plan is to seek more financial help from abroad to get the chemicals and training to upgrade labs like this one. Pilot programs would test whether the pills can be safely administered to the very poor. Already, healthcare workers are being prepared to give the medication, which prevents mother-to-child -transmission, and groups like Doctors Without Borders are gearing up to help.

MARYLINE MULEMBA: If you want to do anti-retrovirals, it has to start somewhere, and we need to learn how to do it in this context, because actually nobody has done it in this context.

ELIZABETH FARNSWORTH: Malawi is negotiating now with a German pharmaceutical company to get the mother-to-child drug free or very cheaply, as are other governments in the region. But to serve all the people who need help, the vice president says a "huge" flow of aid from outside will be necessary. .

VICE PRESIDENT JUSTIN MALEWEZI: For Malawi the figure is about $4.6 billion over a five-year program.

ELIZABETH FARNSWORTH: So far, the United States, the United Nations and others have pledged only a little over $100 million for Malawi's anti-AIDS program. So for Livetia Moluzi and others who are sick here, the outlook is bleak. Four people have already died in these huts in the past three years. Livetia Moluzi wonders if she will be next.

JIM LEHRER: Two weeks ago UN Secretary-General Kofi Annan called for an international fund to fight AIDS. He said the aim was to raise 7 to 10 billion dollars. On Friday, President Bush said the United States would be the first nation to contribute to the fund. He spoke at the White House.

PRESIDENT GEORGE W. BUSH: We have the power to help. The United States is committed to working with other nations to reduce suffering and to spare lives. And working together is the key. Only through sustained and focused international cooperation can we address problems so great and suffering so great. For our part, I am today committing the United States of America to support a new worldwide fund with a founding contribution of $200 million. This is in addition to the billions we spend on research and to the $760 million we're spending this year to help the international effort to fight AIDS. This $200 million will go exclusively to a global fund, with more to follow as we learn where our support can be most effective.

JIM LEHRER: Following that announcement on Friday, Elizabeth Farnsworth talked with Kofi Annan about his AIDS efforts.

ELIZABETH FARNSWORTH: Thank you very much for being with us, Mr. Secretary-General.

KOFI ANNAN: Thank you very much.

ELIZABETH FARNSWORTH: President Bush has pledged $200 million towards a global AIDS fund that has been your priority. Is that enough?

KOFI ANNAN: I think, as the President himself said, this was a fund contribution and there is probably some more to come. Obviously, our target is to get $7 to $10 billion additional money applied to the epidemic, and I would hope that the President's action today would energize other leaders and other people in society to come on board. As you know, the fund is open to governments, private companies, civil society foundations, and individuals. But I think we launched it today, and I think it was an important beginning.

ELIZABETH FARNSWORTH: The President also said that he - that the fund should respect intellectual property rights as a way to make sure there are incentives to produce new drugs. Does that mean if a country in Africa, for example, wants to use generic drugs to treat people, that they couldn't use the fund's money?

KOFI ANNAN: No, I don't think it means that. I believe the message the President was trying to get across is that the intellectual property regime has to be respected so the pharmaceutical companies will have the incentive to continue their research to produce medication, cure, and vaccine for diseases like the AIDS, and that without that incentive, they will not do it. And I myself have had the opportunity of discussing this with the seven largest pharmaceutical companies, but they also have accepted that while they need incentive to produce results and medication, the medication and medicine should also get to the poor. And I think this is also one of the reasons why they are reducing the prices considerably, and some of them are even giving away the medicine free of charge. But we should be able to buy generic medication, and we

should be able to offer treatment to those who have been hardest hit by the disease.

ELIZABETH FARNSWORTH: Before I get into - we get into how the fund's going to function, let me ask you generally, you've made this, you've said this is my priority, getting this fund going. Are you sensing in the world the feeling of emergency about the catastrophe that is engulfing Southern Africa that you, yourself, see?

KOFI ANNAN: I think in the past year there has been a great sea change. We have been able to raise awareness and mobilize the world population and particularly the African leaders. When we met in Abuja two weeks ago, I made it clear that if we are going to win this battle against AIDS, we need leadership. And as the leaders of these countries, themselves, we can provide it. We need leadership all across from the North and South, and so I was very encouraged by the strong support of President Bush for this effort. And I have reason to believe that other leaders in Europe and others will come on board. In fact, President Chirac of France made a strong statement this morning supporting the approach and the fund after President Bush and I and President Obsanje launched the fund in Washington.

ELIZABETH FARNSWORTH: Mr. Secretary-General, who will administer the money? Who will make the key decisions that have to be made about this - with this kind of money?

KOFI ANNAN: We will have a board that will oversee the money and take the decisions. The board will include representatives from donor governments, from recipient governments, a civil society, including those organizations fighting the AIDS epidemic, people from the private sector and the international organization. There will be a small secretariat attached to this that will add to the day-to-day administration. But the funds will be handled by the World Bank; they will do the banking responsibilities. And of course there will be a scientific advisory body attached to it to ensure that we are aiming for the right result, and, of course, we would ensure that we are effective and we are getting value for money, and that the funds are reaching the population and the people who are in desperate need. And we would also try to mobilize people at the community level.

ELIZABETH FARNSWORTH: And the specific decisions - as you know, there's a debate about how -- especially if you don't raise the full $7 to $10 billion you want, how much goes to prevention, how much goes to treatment with the anti-retroviral drugs. Who makes those decisions, how you fund what programs?

KOFI ANNAN: I think we are setting up a single global fund with several windows. It will be a fund for AIDS and infectious diseases such as tuberculosis, as well as malaria. I have no doubt that some governments will target their contribution - that we want it used only for AIDS. Others may want it used for tuberculosis. And I hope others will give us flexibility to use the funds as we see fit. And I think the ability to draw on the fund will depend on the quality of programs governments submit. And we are working with governments, and I've asked all of them to draw up national plans for eradication of the fight against the AIDS disease. And, of course, the quality of those programs will play a role. We have also asked the governments to work with NGO's, work with women's groups, with community groups, and we will give the money to those programs that we believe are going to be-are likely to be most effective.

ELIZABETH FARNSWORTH: How much money do you have to get to move into the treatment with the anti-virals? For example, let's say you only raise $3 or $4 billion. Will you just have to concentrate on prevention and not get into the drugs with this fund?

KOFI ANNAN: That will be a judgment that the board of the fund will have to make; it would be presumptuous of me to take that decision for them.

ELIZABETH FARNSWORTH: And finally, Mr. Secretary-General, briefly, what's the next step with the AIDS fund, when will it go into action?

KOFI ANNAN: I think that the highlight will come at the General Assembly, special session on AIDS on the 25th of June here in New York. We are expecting quite a lot of heads of states come in here. I hope between now and then governments will have time to determine how much they are going to contribute to the fund -- and some would either make announcements before they get here or use a General Assembly session to announce their contributions, but I do expect a strong support for the fund at the General Assembly. And, of course, the G-8, at their meeting at the end of July, would also be taking up this issue. And so either governments - some of them - will announce before June or here in New York in June, and some may want to do it in general. But I trust they will all -- and urge that they all pay into one fund.

ELIZABETH FARNSWORTH: Mr. Secretary-General, thank you very much for being with us.

KOFI ANNAN: Thank you very much, and have a good day.

JIM LEHRER: Elizabeth will continue her look at Africa's AIDS crisis this week. Tomorrow she reports on AIDS prevention efforts in Botswana.

RECAP

JIM LEHRER: And again the major stories of this Monday, the U.S. Supreme Court ruled against the medical use of marijuana. The Coast Guard announced the largest cocaine seizure in U.S. maritime history; 13 tons. It was on a fishing boat seized off San Diego, California; and President Bush outlined a plan to curtail gun violence. He called for hiring more than 700 new prosecutors to enforce existing laws. We'll see you on line and again he tomorrow evening. I'm Jim Lehrer. Thank you and good night.