We began the day with a very detailed briefing at the US Embassy, given by Ambassador Cameron Hume and the U.S. team in South Africa. Ambassador Hume, a career diplomat with more than 15 years experience in Africa, began his remarks by providing an overview of the U.S. government’s recent strategy for strengthening and supporting the government of South Africa, noting that the U.S. involvement is largely of an economic nature. He walked our delegation through grim HIV statistics, the country’s health care infrastructure needs, and HIV’s projected impact on the stability of the region. In addition, the U.S. Government in-country team members, which included staff from CDC, NIH, and USAID, provided highlights of their programs. The staff from the CDC reported that before their Global AIDS Program began, their presence in South Africa was focused on helping the South African government to develop a comprehensive disease control and surveillance system. As the in-country needs expanded to include responding to the HIV epidemic, CDC and USAID began to develop programs in prevention and home-based and palliative care. In addition, as many of the major corporations began to experience large numbers of employee deaths due to AIDS, USAID and CDC established initiatives to assist them in designing workplace HIV/AIDS programs.

From fellow Americans, our delegation members learned of the many successes in program development, management, and evaluation. We also prepared for two days of meetings and site visits with collaborative partners of the in-country team, including business leaders, activists, and health care professionals. During our time with Ambassador Hume, he painted a very bleak picture of the prospects for universal access to treatment due to a lack of funds and governmental leadership. However, he was also encouraged by the private sector's overwhelming interest in President Bush’s new initiative and its potential for South Africa.