The Boston Globe
WASHINGTON - Three advocacy groups yesterday called on Secretary of State Colin L. Powell to fire Andrew Natsios, US administrator for foreign aid, for his comments on Africa that they called "shockingly racist."
Twice this week, Natsios, a former Massachusetts official who only a month ago started his job as head of US Agency for International Development, said administering AIDS treatment in Africa would be extremely difficult because of a paucity of health infrastructure and because most Africans don't have clocks or watches and thus could not take medication at specific times.
He made the comments in an interview with the Globe and before the House International Relations Committee on Thursday.
In many parts of Africa, "people do not know what watches or clocks are," he said before the committee. "They do not use Western means to tell time. They use the sun. These drugs have to be administered in certain sequences, at certain times during the day. You say, take it at 10 o'clock, they say, what do you mean, 10 o'clock?"
Some people in the packed hearing room gasped.
According to an agency spokeswoman last night, Natsios feels that he "said what he has to say, that he said what he needed to say in testimony."
The groups demanding his dismissal were Africa Action, the oldest US advocacy group for Africa; Religious Action Network, a group of about 300 churches; and Health Gap Coalition, which works on
HIV/AIDS issues globally.
Global health specialists, including two USAID officials speaking on condition of anonymity, pointed out that in several ongoing AIDS drug trials, African physicians are successfully distributing pills twice a day, in the morning and at night; in the United States, some new drug regimens have been simplified to a single pill containing three anti-HIV drugs.
"Some of Mr. Natsios' comments are just wrong. He should be corrected," said Dr. Paul Farmer, a Harvard infectious disease specialist who has for more than two years supervised the use of AIDS drugs in rural Haiti, in which patients take medication twice a day. A State Department official said last night there was no reaction yet to the letter from the organizations to Powell, who oversees the US Agency for International Development. A USAID spokeswoman also said her office had no immediate reaction.
The letter from the three groups also objected to Natsios' stance against paying for treatment in Africa, where 25 million people are infected with
HIV/AIDS. Natsios stressed that prevention should be the main focus in fighting AIDS, but he backed the distribution of a drug that blocks transmission from mother to child, as well as drugs fighting secondary infections from malaria and tuberculosis.
"For us, the main problem is the policies, because they are dangerous to the lives of people living with HIV/AIDS in Africa," said Salih Booker, executive director of Africa Action. "But it's the racism that leads to dangerous policies."
Representative Barbara Lee, a California Democrat, also strongly objected to Natsios' comments, saying in an interview the comment on clocks "was outrageous."
She also found fault with his hesitation to begin treatment programs because of the lack of health infrastructure in Africa. "You don't deny treatment because there's no infrastructure by US standards," she said. "I'm not saying there's a great infrastructurein Africa, but we need to develop the roads and the clinics, and at the same time utilize traditional African ways of disseminating information and disseminating condoms."
Inside USAID, several officials said yesterday they were concerned that the furor over Natsios' comments would hurt their efforts, which account for the single largest international block of funds against AIDS in Africa.
"His comments threw us for a loop," said one USAID official, speaking on condition of anonymity. "You can't do prevention without adding treatment in there."
John Donnelly can be reached at donnelly@globe.com