The Archbishop of Cape Town, Njongonkulu Ndungane, will be among an exclusive group of international delegates to the White House World AIDS Day Summit and representatives of the denominational and faith-based development community in the US (about 35 people in all) who are scheduled to meet President Bill Clinton today at 4pm (SA time).

The archbishop, John Ibekwe president of the Nigerian Association of People Living with AIDS and Buddhist theologian Thic Nhat Khan have been invited to address the president and I attach for your interest a copy of the archbishop's comments.

Address by the Most Revd Archbishop of Cape Town at the White House

Mr President I bring with me the deep gratitude of a continent that recognises the efforts you have made on our behalf, particularly in calling for consideration of 100 percent debt relief for those countries bowed by the burden of unpayable and unjust debt.

I am especially honoured by this opportunity to address you on the HIV/AIDS pandemic in a Southern African context. In the short space available I hope to do so in human, not statistical terms. I do this because I am convinced that unless and until we approach the problem from a human perspective, we who subscribe to the concept of human rights will fail dismally. I do so comforted by the fact that, while your country is the most powerful in the world it has also consistently defended the principles of justice for all. It is why I ask your government to rally the whole world under the banner of "the family of God for God's families".

While, I fully appreciate that statistics are important to people like epidemiologists, government planners and healthcare actuaries, I am convinced that the numbers and percentages we all reel off are so mind-numbing that they seriously affect our ability to react. There is an urgent need, for example, to translate into reality the fact that the virus has reduced the average life expectancy of South Africans from 62 years to 40 years.

This means that many, many households in my country are headed by children in their early teens. Boys and girls about 13 years old, in a harsh urban environment, who have buried both parents and are bracing themselves for the death of their toddler siblings. It is about the emotional agony of a dying woman, often unwittingly infected by an unfaithful partner, who knows that she has passed a death sentence on to her baby. It is about the pain of a mother who knows only too well the legacy of hardship and deprivation she leaves behind because our social system is collapsing under the weight of millions of orphans.

Under the apartheid regime nearly a whole generation of protesting urban black children skipped formal education for ideological reasons. They are dying without having enjoyed the fruits of freedom, as will millions of the next generation.

The realities of our HIV statistics are about the implications of a national productivity that declines by five percent annually and how we all fail in terms of the United Nations Universal Declaration on Human Rights. May I remind you that it says that all individuals and their families have a right to a standard of living adequate for health and well being. Yet in the six countries that make up Southern Africa up to a quarter of our practising doctors are expected to die within the next five years. In the rural areas our agricultural knowledge and management skills are being lost and the cultivation of labour-intensive crops is being abandoned due to AIDS related diseases. The economists measure all this in financial terms and talk about the impact on developed as well as developing nations. I urge you to measure it in human pain and suffering and your own responsibility to all creation.

Although there are no social or economic barriers to HIV/AIDS, a household's initial poverty level clearly affects it ability to cope with illness and death and increases the cycle of vulnerability to HIV infection. It is almost impossible to educate the poor or to make them productive in their own and the world's interest.

What are the solutions for the sub-Saharan continent?

Interestingly, the World Health Organisation points out that contrary, to popular belief, health does not follow wealth. A nation needs a healthy, productive population in order to attain wealthy nation status. This, against the backdrop of globalisation and the economic interdependence of the world's nations, is as good an argument as any for the developed world to find innovative solutions to making affordable medicines available to their poor counterparts.

Typically, South Africa has the highest incidence of tuberculosis in the world and the rise in HIV cases has contributed to the increase in drug-resistant strains. Yet I am assured that research in this arena is minimal, simply because there is no profit for the pharmaceutical companies to become involved. This is understandable, they are not charity organisations. But I firmly believe that with the likes of TB and HIV related drugs there are solutions. Solutions that lie within business and government co-operation and cross subsidised markets. We need to find a way to bridge the gulf between human needs, scientific research and market forces.

I appeal particularly to the pharmaceutical giants. I do understand that they are not humanitarian organisations and that they have a responsibility to their shareholders. I assume, however, that their market share in our sub-continent warrants an interest in our economic and social stability - both of which are acutely threatened by our AIDS pandemic. We desperately need affordable medicines and besides bottom line issues, there are the humanitarian and moral aspects to be considered.

We are constantly warned that the New Economy demands a different approach. I would suggest that the imperatives of an ethical global society also demand that we tackle HIV and AIDS with minds open to new and very different solutions. It is a challenge I place before you today.

I would strongly suggest that one of the first steps is to break the cycle of poverty. A community which is able to channel resources into education, training and healthcare, is one which can cope with most problems. I must emphasise that we Africans know only too well the pernicious impact of hand outs. We don't want charity we want justice.

We seek a justice that recognises that many African countries have repaid their loans to developing nations several times over and are caught in a never-ending interest spiral. More money flows northward from the poor countries in the south than the other way round. In South Africa, for example, the second highest item on our national budget is for servicing debts. Debts incurred to sustain the apartheid regime. It is as much in your interest as in ours that those funds be re-channelled to address the HIV/ Aids pandemic.

We don't ask that our debts are simply wiped out and that our governments can do as they choose with the money that we now use to service them, we would understand if you insisted that it is spent on health and education.

As we shift to a global economy, leading economists are questioning whether the developing regions will survive. Yet the recent World Economic Forum, in which I also participated, recognised the interdependence of the developed and developing countries and the need for creative partnerships and solutions. On this rests the survival of humanity.

The present unjust economic systems and structures entrap billions of people in a cycle of poverty, with all its consequences of disease, human deprivation and despair - through no fault of their own.

The recent e-Praxis Inter-Religious e-mail Conference recognised that HIV/AIDS is now too pervasive and too deeply embedded in society to be "managed" through top-down public health approaches alone. Moreover, the relationship between poverty and HIV/AIDS is bi-directional. While poverty is a factor in HIV transmission and exacerbates its impact, HIV intensifies the level of poverty which, in turn, has a disproportionate affect on women, girls and the aged.

We must never forget that people are made poor through inequitable socio-economic structures.

Against this backdrop I believe that a multi faceted approach is needed.

We need to intensify the call for the cancellation of unpayable and odious debts. We need transparent and good governance to ensure that the monies rerouted from debt repayment is used to alleviate the inhuman conditions that prevail among the poor.

I believe there is an urgent need to establish a Millennium Vaccine Fund, to provide affordable medicine to the poor.

We need to generate capacity and skills within local communities in care giving for people with AIDS and the millions of AIDS orphans. It is as much about human support as medical assistance.

And, lastly, I call for an African Recovery Programme similar to the highly successful Marshall Aid Plan which not only brought a post war Europe from the brink of collapse but acted as a welcome impetus to the US economy.

In all this our actions would reflect economic reality, morality and justice. The situation calls for innovative and creative action and it is my sincere hope that I can encourage you to extend your influence in an arena that affects us all.