A humanitarian group urged U.S. drugmaker Abbot Laboratories Inc. on Wednesday to make a new HIV drug accessible in developing countries, especially Africa.

The relief organization Medecins Sans Frontieres said a new formulation of Abbot's lopinavir/ritonavir drug had critical advantages for patients in poor countries including lower daily pill count, storage without refrigeration and no dietary restrictions.

"It is a cruel irony that although this drug with no need for refrigeration seems to have been designed for places like Nigeria, it is not available here," MSF's Helen Bygrave said at a news conference in Lagos, Nigeria's biggest city.

Sub-Saharan Africa has about 10 percent of the world's population but 60 percent of people living with HIV/AIDS. Nigeria, with 3.5 million people living with HIV/AIDS, has the world's third-biggest caseload after South Africa and India.

More than 3 million Africans became infected with HIV in 2005, representing 64 percent of all new infections globally and more than in any previous year for the impoverished continent, according to UNAIDS.

MSF provides anti-retroviral drugs for over 60,000 patients in nine countries in Africa, Asia and Latin America. It said it urgently needed the new drug because refrigeration is unavailable to many people in poor countries.

The new formulation, marketed under the name Kaletra, is in tablet form and does not melt at high temperatures unlike the old version which is in capsules.

UNAVAILABLE DRUG

MSF said the new version of Kaletra, which was approved by the U.S. Food and Drugs Administration last October, was not available in any developing country.

It urged Abbot to register the new version in developing countries, sell it at less than $500 per patient per year and remove patent barriers to allow production of generic versions.

In a response on its Web site, Abbott said it was pursuing registration for the new formulation in developing countries as rapidly as possible. It also said it was making its HIV medicines available in 69 of the world's poorest countries.

"While pricing for the new lopinavir/ritonavir tablet formulation has not yet been established in countries outside the U.S., Abbott has taken a responsible approach to pricing its HIV medicines and will continue to do so," the firm said.

Kaletra is a "second-line" drug which can be used when standard anti-retroviral drugs stop working.

MSF said that in 2005, 6 percent of its patients who had been on anti-retroviral drugs for three years had needed to switch to second-line drugs. One MSF program found that after four years of ARV treatment, 16 percent of patients needed second-line drugs.

"These data underline the acute and growing need for access to newer, field-adapted second-line drugs," MSF said.

Ibrahim Umoru, one of 1,200 patients at the MSF clinic in Lagos said: "Thousands of people like me need this new drug. For many of us it is a matter of life and death."

Umoru, who has been on the old version of Kaletra for about five weeks, said he has to refrigerate his medicine at a friend's place several streets away from his home.

Women and girls are far more vulnerable to AIDS than men and need their own U.N. agency to defend them, just as the U.N. children's fund UNICEF protects young people, a top U.N. envoy said on Friday.

"What has happened to women is such a gross and palpable violation of human rights that the funding must be found," said Stephen Lewis, Secretary-General Kofi Annan's special envoy for AIDS in Africa. "We must right the wrong."

Lewis, just back from a trip to Lesotho and Swaziland in southern Africa, said 56 percent of pregnant women between 25 and 29 years old in Swaziland were infected with HIV, the virus that causes AIDS, according to a recent government survey.

"That's the highest prevalence I have ever encountered in the last five years. The mind fractures at the thought of it," he told a news conference.

In Lesotho, roughly 30 percent of girls 15 to 17 years of age were infected, he added. "This is obviously a disaster for the country, but it reconfirms yet again the wildly disproportionate vulnerability of women and girls."

An estimated 57 percent of infected adults 15 to 49 years old in Lesotho are women, while 43 percent are men.

Lesotho and Swaziland broadly reflect what is happening across Africa, the continent hardest hit by the pandemic, he said, arguing that the situation would be different had a well-funded and powerful agency representing women's interests been in place.

"Not only would the women of Lesotho and Swaziland now be far better off, but we could at this point mount an unbridled campaign to demand that gender equality be legislated and enforced in these two countries," he said.

"Years from now, historians will ask how it was possible that the world allowed AIDS to throttle and eviscerate a continent -- and overwhelmingly the women of that continent -- and watch the tragedy unfold in real time while we toyed with the game of reform." he said.

Across all of sub-Saharan Africa, home to more than 60 percent of the world's infected individuals, an estimated 4.6 percent of young women age 15 to 24 are infected with HIV, compared to 1.7 percent of young men, according to the latest available U.N. statistics.

The World Health Organization unveiled a new strategy on Friday to fight tuberculosis, an infectious disease that kills about 1.7 million people worldwide each year.

The strategy, which aims to expand existing treatment programs, improve diagnosis and prevent co-infection with HIV/AIDS, underpins the WHO's $56 billion global plan launched in January to halve TB prevalence and death rates and save 14 million lives by 2015.

"The new Stop TB Strategy injects new energies to make efforts more comprehensive and effective," Dr Mario Raviglione, director of the WHO's Stop TB Department, said in a statement.

Patients with TB are treated with the DOTS (Directly Observed Treatment, Short-course) program -- a multi-level approach that involves government commitment, patient surveillance and drug treatment.

The program is running in 183 countries, but multi-drug resistant tuberculosis (MDR-TB), particularly in eastern Europe, and co-infection in patients with HIV/AIDS in Africa present new problems.

More than 260,000 people who died of TB in 2004 were co-infected with HIV.

"We must involve a much broader array of actors in TB control and adapt DOTS to HIV co-infection, MDR-TB and other special challenges if we're going to achieve 2015 targets of the Global Plan ..," said Dr Marcos Espinal, executive secretary of the Stop TB Partnership.

The strategy outlined in The Lancet medical journal also highlights the need for more research into new treatments and vaccine and the strengthening of local health systems in poor countries which are hardest hit by TB.

The bulk of patients with TB live in the most populous countries in Asia. Bangladesh, China, India, Indonesia and Pakistan account for 48 percent of the new cases that are diagnosed each year.

Infection rates in Africa are also high.

Laura Bush got another honorary title to add to first lady on Monday, when a group of HIV-positive mothers visiting from South Africa said they consider her their "grandmother."

Mrs. Bush invited the women to the White House after meeting them during a trip to their country last year. She said she was inspired by the work the women are doing to help each other cope with the devastating diagnosis, which many discover for the first time during prenatal care.

"As a mother, I know it must seem like the end of the world to learn that you have HIV or AIDS, and to think that your baby might be born with HIV, too," the first lady told dignitaries gathered in the East Room to hear the women tell stories and sing together.

Babalwa Mbono, the senior site coordinator at a maternity unit Mrs. Bush visited outside Cape Town, told how she discovered she was HIV-positive in 2002 when she was pregnant with her second child. She said her sister had already died from AIDS and it turned out her husband had the virus, too. But she said she has learned to live well with the diagnosis and is helping others cope.

"We would like to say to Mrs. Bush, keep up the work that you're doing with HIV/AIDS," she said. "We want people to be able to help groups like this that we have in South Africa in Cape Town, who can be able to be strong and beat up the HIV."

The women were part of The Mothers' Programmes, a private organization that receives some assistance through President Bush's five-year, $15 billion anti-AIDS effort.

"We're including Mrs. Bush," Mbono said as she introduced the rest of her group. "Mrs. Bush is our grandmother."

Mrs. Bush also announced a new partnership between the U.S. government, drug companies and international organizations to develop more effective treatments for children with HIV and AIDS. The groups are sharing information and plan to develop a budget after their first meeting on April 19, federal officials said.

Nigeria has opened 41 new AIDS treatment centers to give wider access to free anti-retroviral therapy for people who are HIV positive, the government's anti-AIDS agency said on Tuesday.

About 3.5 million people are living with the deadly virus in Africa's most populous country of around 140 million people, the third-highest number after India and South Africa.

Nigeria started giving out free anti-retroviral drugs (AVRs) in January from 33 treatment centers to about 40,000 patients, scrapping a 1,000 naira ($8) subsidy that patients previously had to pay every month.

"We have added new treatment centers, bringing the total number to 74," Babatunde Osotimehin, chairman of the National Action Committee on AIDS (NACA), told Reuters. The centers are spread across Nigeria's 36 states and the capital Abuja.

"We plan to set up more centers over the next few months to bring treatment as close to the people as we can," he added.

Two-thirds of Nigerians live on less than a dollar a day and campaigners say many HIV-positive people are too poor to pay for the life-saving drugs which cost between 3,000 to 7,000 naira per month on the open market.

Medecins Sans Frontier, which campaigns for wider access to free AIDS treatment in Nigeria, lauded the new program, but said many patients still cannot pay for a series of monthly medical tests for AVRs to be correctly administered. Many more cannot afford treatment of opportunistic infections.

NACA plans to expand the anti-retroviral therapy to 250,000 patients by year-end, with funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria, the United States government and other major donors, and savings from the debt write-off granted Nigeria in 2005 by the Paris Club.

Osotimehin said the government is also studying ways to subsidize the battery of medical tests while treatment for tuberculosis, one of the most common illnesses among AIDS patients, was already free in Nigeria.

He said full HIV/AIDS care including tests was free for children and pregnant women -- a key part of efforts to prevent the transmission of the virus from mother to child.

($ = 127.5 naira)

Beatrice Were says she did just what her government recommended — shunned sex until her marriage and stayed faithful to her husband.

What she didn't realize is that he was unfaithful. Soon after their first child was born, he caught the AIDS virus and unwittingly infected her.

The question of why Ugandans like her husband didn't use a condom is at the heart of a dispute between some health activists and the U.S. government. The activists, as well as some Ugandan officials, accuse the United States of blunting the condom message in favor of abstinence, while the Americans say they are victims of misinformation and have actually increased nearly tenfold the number of condoms they supply to this African nation of 26 million.

Moreover, abstinence is an option promoted not just by faith-based U.S. groups but by many Ugandan charities, including one headed by the conservative Christian wife of President Yoweri Museveni.

The debate has unfolded in a country that was once among Africa's worst AIDS victims, with a million deaths and an estimated 900,000 additional infections. Uganda is also the pioneer of a groundbreaking strategy credited with cutting HIV prevalence by more than half since 1992 to about 7 percent. The multipronged approach, known as A, B, C, calls for abstinence until marriage, being faithful to one's partner, and correct condom use.

"By assumption, you are saying that when you are married, marriage is a safety net — which is not true," said Were, who now campaigns to protect others with the international anti-poverty group ActionAid. She does not blame America for her plight, but said U.S. policies threaten the lives of young Ugandans.

Billboards urging condom use have disappeared from the capital, Kampala. In their place are posters, some funded by the U.S. government, urging youth to delay sex until marriage. The Ugandan office of Washington-based Population Services International, a leading supplier of free and subsidized condoms, says it was ordered to take down posters and pull radio ads in Uganda in 2004.

Its deputy director, Dr. Susan Mukasa, said the portion of the group's U.S. funding that is spent on prevention was not renewed and its funding from PEPFAR, the U.S. President's Emergency Plan for AIDS Relief, dropped from $600,000 to $100,000.

"We got a call from the PEPFAR people and were told what we were doing was unacceptable," said Mukasa. "We also got a lot of pressure from faith-based groups in Uganda who wanted the condom message removed from the general public."

PEPFAR, a $15 billion package to combat AIDS in the world's 15 worst-hit countries, won praise when Bush announced it in 2003. But Dr. Sam Okware, a senior Health Ministry official and architect of the ABC plan that has become the model across Africa, says PEPFAR had initially skewed the message away from condoms.

"PEPFAR really shifted the emphasis to A and B just because of the amounts of money being put into these programs," said Okware.

He said the government has redressed the balance by using funds from other sources to promote condoms, including the World Bank. But an official with the government-appointed Uganda AIDS Commission disputed that, saying abstinence and fidelity programs still dominate. He spoke on condition of for fear of repercussions.

Dr. Mark Dybul, the U.S. deputy global AIDS coordinator in Washington said government policy is to support all three components of the ABC plan.

In a telephone interview, Dybul said he doubted anyone would have called PSI's work "unacceptable." But he said U.S. officials want to move away from simply mass marketing condoms and support more door-to-door and peer education plans.

"Mass marketing is important, but it doesn't change a lot of behavior. It just provides information and provides awareness," he said.

Last year, the U.S. government spent $9.7 million on promoting abstinence and fidelity in Uganda, compared with $6.5 million on condoms and related activities, while the number of U.S.-supplied condoms has surged from 7 million to 47 million in the last five years, Dybul said.

"Tough to argue we're pushing away from condoms in Uganda with numbers like that," Dybul said, adding: "There is so much misinformation about what our policies and approach are that I wouldn't be surprised it's having an impact on people in the field."

President Museveni, who once championed condoms, now considers them more appropriate for people considered at high risk of infection, such as prostitutes and soldiers. Special clubs and rallies encourage teens to sign virginity pledges, and a legislator has promised university scholarships for top students who keep the promise.

First lady Janet Museveni's National Youth Forum, which received $180,000 from the U.S. emergency plan last year to help 12- to 25-year-olds protect themselves from AIDS, says it's willing to answer the public's questions about condoms but does not teach how to use them.

"In our traditional society, girls used to marry when they were virgins. Why has this changed?" asked Margaret Kiwanuka, the forum's national coordinator. "Abstinence is 100 percent effective. That is our message."

The Anglican Church, which received $86,620 from the plan last year, helps educate sexually active adults about condoms but not under-18s.

"Why give an alternative and have them take a risk?" said Rev. Sam Lawrence Ruteikara, who heads the church's AIDS program.

But some activists not affiliated with churches worry that the prevention message is becoming blurred, jeopardizing hard-won gains. HIV prevalence crept up to 7.1 percent in 2004-2005, after stagnating at around 6 percent the preceding three years, according to government figures.

"Young people are confused," said Dr. Abeja Apunyo, country representative for the U.S.-based Pathfinders reproductive health group. "Of course I have no problem with the abstinence approach, but you have to be realistic and offer an alternative for different situations."

About 20 percent of U.S. assistance globally is channeled through faith-based groups, many of which counsel only abstinence and fidelity. They are valued because of their strong community ties and reach into some of the remotest corners of Africa.

Emergency plan rules do not require such groups to discuss condoms — other U.S.-funded organizations do that. But nor may they denigrate condoms. Any condom promotion must include a component on abstinence and fidelity.

Museveni's wife has angered some activists by suggesting that promoting condoms encourages promiscuity and can cause genital warts.

"Now, someone is free to do whatever they want to do without U.S. government money. We can't control that," Dybul said. "But no one who receives money from the U.S. government can provide such medical misinformation. It's not only our policy but it's in the law."

The rape trial of South Africa's former deputy president Jacob Zuma heard testimony on his risk of contracting AIDS after allegedly raping an HIV-positive woman.

Zuma, 63, once a frontrunner to succeed President Thabo Mbeki, has admitted to having sex without a condom with the 31-year-old AIDS activist, which he says was consensual.

Virologist Desmond Martin told the Johannesburg high court that Zuma had had a higher risk of contracting HIV from the alleged victim because her CD4 count, which measures the strength of an HIV sufferer's immune system, was low at the time of the alleged rape.

"The risk of acquiring infection will increase a fewfold," he told the court, explaining that the lower the CD4 count in the body, the higher the viral load.

Other risk factors included a lack of lubrication during sex and injury. The court earlier heard that the alleged victim had sustained a small tear in her vaginal area as a result of the sex.

Judge Willem van der Merwe postponed the trial until March 23.

State prosecutor Charin de Beer said the state would use the adjournment to decide whether to close its case or call more witnesses, after which the defence would start calling its witnesses.

Zuma's political fortunes have plummetted over the past ten months, following corruption allegations that prompted Mbeki to fire him as deputy president in June. He is due to stand trial for corruption in July.

He was charged in December with raping the woman at his Johannesburg home on November 2 and pleaded not guilty last week to the charge.

Zuma's supporters claim that the charges are part of a political plot to prevent him from succeeding Mbeki when he steps down after two office terms in 2009.

If convicted of rape, he could face a possible sentence of between five and 15 years in jail.