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Note: This document is from the archive of the Africa Policy E-Journal, published by the Africa Policy Information Center (APIC) from 1995 to 2001 and by Africa Action from 2001 to 2003. APIC was merged into Africa Action in 2001. Please note that many outdated links in this archived document may not work.

USA: AID Chief Displays Racism, Ignorance

USA: AID Chief Displays Racism, Ignorance
Date distributed (ymd): 010608
APIC Document

+++++++++++++++++++++Document Profile+++++++++++++++++++++

Region: Continent-Wide
Issue Areas: +US policy focus+


This posting contains a press release from Africa Action and a letter to Secretary of State Colin Powell from Africa Action, the Religious Action Network and the Health Gap Coalition, protesting the racist remarks by USAID Adminstrator Andrew Natsios in an interview with the Boston Globe yesterday. Natsios said antiretroviral treatment for AIDS was not practical in Africa because 'Africans don't know what Western time is' (see full quote below). The posting also contains excerpts from comments from Natsios on antiretroviral treatment made to reporters on the Secretary of State's Africa trip last month, along with corrections from Paul Davis of ACT UP Philadelphia.

For those who might want to send their comments or corrections to Administrator Natsios directly, use the link:
or send a message to

For additional background see


+++++++++++++++++end profile++++++++++++++++++++++++++++++

Africa Action Press Release


Contact: Ann-Louise Colgan, (202) 546-7961
Aisha Satterwhite, (212) 785-1024

Letter to Powell Protests Racism at USAID

Top Official's Remarks Suggest U.S. Opposes Saving Lives of Africans living with HIV and AIDS

Friday, June 8 (Washington, DC/New York City) - Africa Action, the Religious Action Network and the Health GAP Coalition today issued the attached letter to US Secretary of State, Colin Powell protesting the racist remarks of Andrew Natsios, Adminstrator of the United States Agency for International Development, reported in yesterday's Boston Globe. Natsios is opposing treatment and care for 25 million African living with HIV and AIDS as too costly and has used the false argument that the antiretroviral treatments commonly used in rich countries to restore health and prolong life are inappropriate for Africans.

Responding to Natsios' remarks arguing that Africans can't tell time, Africa Action's President of the Board of Directors, Rev. Dr. Wyatt Tee Walker, stated that, 'Such blatant racism is becoming the defining feature of U.S. policy toward the AIDS pandemic in Africa.' Walker served as Chief of Staff for the late Dr. Martin Luther King. Salih Booker, Executive Director of the organization, added that, 'The administration is unwilling to spend appropriate amounts of money to help save African lives and has now stooped to using ignorant and racist arguments to justify their policies.'

This is the second time in the past two months that Africa Action has condemned the racism that seems to be a central determinant of US foreign policy as far as this administration's response to the global AIDS pandemic is concerned. On April 30th, a similar letter to Secretary of the Treasury, Paul O'Neill, requested that he identify and publicly repudiate the unnamed senior official in the Department of the Treasury who told the New York Times that Africans lacked a requisite 'concept of time' necessary to benefit from HIV drugs. 'Secretary O'Neill responded this week with an insulting form letter that dismissed our concerns,' said Booker.

The letter to Powell calls for the dismissal of Natsios.

For more information visit our website:

To Contact the Health GAP Coalition: (215) 731-1844 and

Letter to Secretary of State Colin Powell

June 8, 2001

Dear Secretary Powell,

We are writing to express our deep sense of outrage at the shockingly racist comments made by your Administrator for the U.S. Agency for International Development, Andrew Natsios. We represent organizations and churches advocating equitable access to treatment for people with HIV/AIDS around the world and especially in Africa where - as you are well aware - the majority of people presently living with HIV and AIDS reside.

According to an article in yesterday's Boston Globe, Mr. Natsios said that Africans 'don't know what Western time is,' and that 'Many people in Africa have never seen a clock or a watch their entire lives. And if you say, one o'clock in the afternoon, they do not know what you are talking about.'

We are writing to demand that you repudiate this offensive behavior. Someone such as Mr. Natsios, with such ignorant and bigoted views does not belong in a policy-making position, and should be fired. We request that you issue an official apology and retraction on behalf of the State Department of which USAID is a subordinate, and state publicly that the Department itself does not endorse these racist views.

This is the second time in the past two months that we have been forced to condemn the racism that seems to be a central determinant of US foreign policy as far as this administration's response to the global AIDS pandemic is concerned. On April 30th we wrote a similar letter to Secretary of the Treasury, Paul O'Neill, requesting that he identify and publicly repudiate the unnamed senior official in the Department of the Treasury who told the New York Times that Africans lacked a requisite 'concept of time,' implying that they could not benefit from HIV drugs. This week we received an insulting form letter response from Secretary O'Neill that ignored the very issues we raised making clear his insensitivity to the racism in his department. It has been suggested that he may have been the unnamed senior official himself quoted in the Times article of April 29th. We hope that we will receive a more enlightened response to this letter.

US officials involved in shaping international AIDS policy should have a working knowledge of African realities, as well as treatment issues. If US officials lack such knowledge, we suggest they visit any of the numerous clinics run by local health care providers, governments, and NGOs, to learn for themselves about the capacity that exists to deliver HIV/AIDS drugs in Africa. A US policy that refuses to address the imperative of treatment access - using such ignorance as an excuse - has deadly implications.

The comments also reveal a lack of expertise on issues of HIV/AIDS among US officials shaping international AIDS policy. New combinations of anti-HIV drugs involve as few as six pills a day, and already are being administered in settings in the developing world including in Africa.

Arguments about the inability of people to adhere to anti-HIV treatment regimes are often trotted out as an excuse for inaction. However, adherence rates achieved in developing countries are already comparable to those in the United States. US policy must be based on facts and not bigoted stereotypes

More important than the views of any individual, however misguided, are the policies of the administration. The nations of the world seem finally ready to begin addressing the AIDS pandemic in a way that is remotely proportionate to the scale of the tragedy. It is time for the U.S. to announce its commitment to increase its contribution to the Global Fund proposed by United Nations Secretary General Kofi Anan to address HIV/AIDS, as well as TB, malaria and other infectious diseases.

Given the moral imperative of providing life-saving treatments to the more than 25 million HIV-positive people in Africa, the administration and this fund must commit to do exactly what Mr. Natsios is advocating against: invest in treatment - the purchase and delivery of life-saving medicines - on a scale at least proportionate to investments in prevention.

We respectfully request an immediate and direct public response to this matter.


Rev. Dr. Wyatt Tee Walker, President, Africa Action Board of Directors, and Founder, Religious Action Network

Salih Booker, Executive Director, Africa Action

Sharonann Lynch, Health GAP Coalition

cc: President George W. Bush
The Honorable Paul O'Neill, Secretary of the Treasury Walter H. Kansteiner III, Assistant Secretary of State for African Affairs (designee)
The Honorable Kofi Annan, Secretary General, United Nations Dr. Peter Piot, Executive Director, UNAIDS
The Congressional Black Caucus
Zackie Achmat, Chairperson, Treatment Action Campaign

Quotes from Boston Globe, June 7, 2001

WASHINGTON - The Bush administration's top foreign aid official said yesterday he wanted the new Global AIDS and Health Fund to focus almost completely on prevention and include little if any money for anti-retroviral drugs for those living with AIDS.


Natsios said the only money on drugs should be for anti-malarial and TB medication for those with HIV/AIDS, as well as nevirapine, which interrupts the transmission from mother-to-child.


Natsios, who spent a decade in aid work in Africa, said many Africans ''don't know what Western time is. You have to take these (AIDS) drugs a certain number of hours each day, or they don't work. Many people in Africa have never seen a clock or a watch their entire lives. And if you say, one o'clock in the afternoon, they do not know what you are talking about. They know morning, they know noon, they know evening, they know the darkness at night.

Natsios Comments during Africa Trip, with corrections

Paul Davis
Health GAP Coalition, ACT UP Philadelphia
+1.215.474.6886 direct tel.; +1.215.474.4793 fax;
+1.215.731.1844 ACT UP

June 7, 2001

USAID head Andrew Natsios seems strongly inclined to advertise his deep ignorance of AIDS treatment regimens. Interspersed within his comments to reporters below (from Sec. Powell's Africa journey, found on State Department web page), I inserted a few factual corrections [in brackets].

USAID Administrator Natsios Press Remarks on HIV/AIDS in Africa

Andrew Natsios, Administrator,
United States Agency for International Development Press Remarks En Route to South Africa with Secretary Powell

May 24, 2001


QUESTION: Andrew, can you explain why AID programs are focused so much on prevention? Are you saying that to treat the problem is just too hard and too big and too expensive?

MR. NATSIOS: Well if we can -- just go back to the United States. Forty percent of the people who know that they have HIV/AIDS in the United States are not in a treatment program. And that is not because they cannot afford it. A friend of mine in Boston -- a prominent talk show host [name off the record] -- and the rigor you have to go through to take this medication....

[FACT: in spite of quiet resistance from the pharmaceutical industry, US AIDS treatment guidelines were finally revised this year to reflect the data-driven conclusions that the initiation of therapy should be delayed _until_needed. We do not start therapy immediately upon diagnosis. Most people living with HIV are not taking medicine now because it is not clinically indicated. Drug companies had supported the dangerous but profitable position of immediate treatment initiation since 1996.]

..It's 17 to 25 pills a day...

[UNTRUE. People with HIV initiating treatment would now have take from one to three pills in the morning, and one to three pills at night, with no food restrictions or tight schedules. Some combinations are working where all pills can be taken once at midday. Additionally, the willingness of generic drug manufacturers to combine products originating from different patent holders into a single pill promises to further simplify complexities of treatment regimens. DISCLOSURE: treatment for opportunistic infections can increase pill burdens, although ARV therapy has been shown to prevent many OIs.]

Every two hours....

[UNTRUE except for the very treatment experienced individual who has spent years 'using up' treatment regimens that often began with monotherapy or other suboptimal regimens.]

.. And you have to change the cocktail -- the mix of drugs -- every three or four months, or you can die from the toxicity of the drugs.

[The premise and conclusions of this sentence is incorrect. People with HIV change cocktails after some of the drugs they use have started to fail. People have delayed initiation of therapy in part due to toxicity, and the NIH and public entities are studying the effectiveness of 'pulsing' ARV treatment in part due to toxicity. What is inarguable is that access to medicine dramatically cuts death and dying as well as rates of new infections.]

And it does not always work. There are some people who are HIV-positive where the drugs simply will not keep you alive....

[TRUE. The unknown percentage of people with HIV who will eventually fail treatment may be high. But the additional 15 years of life we can afford to purchase right now allows time for the newly promising vaccine research to bear fruit. And the outcomes of untreated HIV is already known.]

.. So you have to have a very high level of infrastructure, higher levels of education, levels of education, you have to have a cold (inaudible) because some of the drugs have to be refrigerated....

[UNTRUE save for a single ARV that is rarely used in its refrigeration-required formulation due to extreme side effects]

..Now if you apply that to Africa, and if we can't get forty percent of the people who are HIV-positive to take the drugs in the United States,...

[IGNORANCE DISPLAYED AGAIN: 40% of US people living with HIV are not clinically indicated to be receiving ARV treatment.]

This material is distributed by Africa Action (incorporating the Africa Policy Information Center, The Africa Fund, and the American Committee on Africa). Africa Action's information services provide accessible information and analysis in order to promote U.S. and international policies toward Africa that advance economic, political and social justice and the full spectrum of human rights.

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