The NewsHour with Jim Lehrer

JIM LEHRER: Good evening. I'm Jim Lehrer. On the NewsHour tonight an update from Lima on the Peru hostage story, a look at the business of assisted reproduction, a status report on the fight against AIDS, a Monday after assessment of the Super Bowl spectacle by NewsHour regulars Barnicle, Page, Gigot, and Johnson, and a Monday night essay by Roger Rosenblatt about dog owning. It all follows our summary of the news this Monday. NEWS SUMMARY

JIM LEHRER: Bad weather affected many areas of the country today. A band of 19 states, from Illinois to New England, were under winter storm watches. In Kansas City, a morning sleet storm, followed by heavy snow, shut dozens of schools. Zero and below temperatures prevailed in the upper Midwest. In California a major highway closed by floods in the city of San Jose reopened just before the peak of morning rush hour. High water had blocked the road for more than 24 hours. Residents were forced to wade through the streets or row to their destinations. Overseas, it was election day in the Russian republic of Chechnya today. We have more in this report from Julian Manyon of Independent Television News.

JULIAN MANYON, ITN: Today, people went out to vote for a new president and parliament in a land free of Russian troops. Security was tight, with Chechen soldiers guarding the international observers. The two leaders in the race for president are both heroes of the war: Aslam Maskhadov, the former rebel chief of staff, and the guerrilla leader, Shamil Basayev, who was the most wanted man in Russia. Basayev got one vote from Louisa Butaeve, whose husband died fighting the Russian army, leaving her with six- year-old daughter. Louisa lives in a shell-smashed apartment building. She's hoping that the new president will do something about it.

LOUISA BUTAEVE: [speaking through interpreter] The first priority is shelter. There are so many people living in impossible conditions.

JULIAN MANYON: Whoever wins these elections the results will hold little comfort for the Russian government. All the leading candidates are firmly committed to the idea of full independence for Chechnya.

JIM LEHRER: Russia has agreed to allow the Chechens self-rule for the next five years. The tenth week of anti-government protests began today in Serbia. Marchers combined today's demonstration with a pageant in honor of St. Sava. St. Sava was the founder of the Serbian Orthodox Church and is a symbol of Serbian nationalism. Chanting priests led 100,000 people in Belgrade's largest religious procession since World War II. Police have prevented protesters from marching in the city's center in the last few days. And in Albania today, anti-government marches turned violent again. Troops were deployed throughout the country after protesters assaulted the foreign minister yesterday. In the capital, Tirana, mobs stormed a police station and set the city hall on fire. The demonstrators blame the government for money lost in pyramid investment schemes.. They have held daily protests across Albania for the past week and a half. Gunfire came from inside the Japanese ambassador's residence in Lima, Peru, today. It happened after police played loud music and staged an armed display in front of the building. Seventy-two hostages have been held there by terrorists since December 17th. The government of Japan asked Peru today to limit police maneuvers at the hostage site. Previously, police have flown helicopters overhead and moved armored vehicles into the area near the Japanese ambassador's residence. The terrorists holding the hostages have responded in the past by firing shots in the air. We'll have more on the Peru story later in the program. Switzerland's ambassador to the United States resigned today over a memo he wrote about the funds of Holocaust victims. Jewish groups have claimed Swiss banks hold up to $7 billion belonging to Jews who died in the Holocaust. Amb. CarloJagmetti sent a confidential memo to the foreign ministry last month urging Switzerland to wage war over the allegations against it. He said the country must fight and win on two fronts, foreign and domestic. In Washington, a State Department spokesman had this to say.

NICHOLAS BURNS, State Department Spokesman: If it's true that the Swiss ambassador made these remarks, it betrays a fundamental lack of understanding about the commitment that the United States government has to its own citizens and to the search for justice for people who were--had their human rights fundamentally violated during the Second World War. It would be most unfortunate if these remarks and these leaks prove to be accurate. We hope that they were not accurate because any ambassador in Washington who advocates waging a public relations campaign against American Jewish groups and against Holocaust survivors is just wrong-headed. It's just not the right thing to do.

JIM LEHRER: The Swiss ambassador said the excerpts from his memo were taken out of context. He said he regretted he had offended anyone. The State of New York sued six major tobacco companies today. Attorney General Dennis Vacco accused them of deceiving New Yorkers about the dangers of smoking. Vacco also sued the Tobacco Institute and a tobacco research group for fraud. He charged they were supposed to conduct impartial studies on the effects of tobacco but failed to do so. And that's it for the News Summary tonight. Now it's on to the Peru hostage situation, assisted reproduction, an AIDS update, the Super Bowl as spectacle, and a Roger Rosenblatt essay. FOCUS - HOSTAGE STANDOFF

JIM LEHRER: We go first tonight to an update of the Peru hostage story and to Charlayne Hunter-Gault, who prepared this report a short while ago before the gunfire at the embassy.

CHARLAYNE HUNTER-GAULT: The hostage crisis at the Japanese ambassador's resident in Lima, Peru, is in its 41st day. Seventy- two hostages have now been held since they went to a December 17th party celebrating the emperor's birthday. Today Japan's prime minister called for a curtailment of the latest police activities around the compound. Those include fresh troops with high-powered rifles and night vision equipment, heavily-armed vehicles, regular helicopter fly-overs, and barricading the rear and side entrances to the residence, leaving the main gate as the only exit. Police also threw stones and garbage into the grounds. The Japanese officials expressed concern that the new security measures could unsettle the rebels and threaten the safety of their hostages. The guerrillas continued to insist that they will not meet with government officials unless their demand for the release of about 400 jailed comrades is met. After officially releasing 378 of the original 450 hostages, the rebels have released only two captives since early January, both on medical grounds. For more on this story, we turn to a reporter on the scene, Jonathan Miller. He's been covering the story for National Public Radio. Jonathan, what has been the Peruvian government's response to the Japanese request to curtail their police activity?

JONATHAN MILLER, Journalist: [Lima, Peru] Well, they've actually gone the opposite direction. Today in the afternoon the police set up some--a sound system, a mixer, and amplifiers, large speakers, right outside the Japanese ambassador's residence, and in the late afternoon they started playing military music at full volume, and they brought out four military vehicles, armored vehicles, fully loaded with men with guns, andthey've circling, they circled the residence several times, stopping at the front gate, aiming their weapons, so, if anything, they've turned up the volume of this sort of what the rebels consider to be provocative activities, and what the Japanese consider to be worrying activities there at the ambassador's residence.

CHARLAYNE HUNTER-GAULT: Well, what do you think? Do you have any information on why the government is doing this? Are they getting ready to storm the embassy, or preparing to prepare people to do that?

JONATHAN MILLER: President Fujimori has said that this is not a precursor to an attack. The government chief negotiator said that they were just preparing for the eventuality that talks would begin, and they'd need to step up security for that. They've been trying to deny that, or they have been denying that there's any impending attack, any impending rescue effort underway. The rebels feel that they're being provoked. The Japanese feel that the situation is getting a little bit more tense. And that certainly is the feeling right around Lima today; that things are getting a little bit more tense. It's been suggested that one of the reasons that the police might be sort of turning up the volume, in fact, literally today turning up the volume on their presence is that they want to disturb the sleep patterns of the hostage- takers. The hostages, of course, have to sleep in shifts during the day, and so the more noise outdoors, helicopter flights are very noisy, they've been going very close to the residence, now this military music, the more noise they can create during the day, the more difficult it is for the hostage-takers to sleep.

CHARLAYNE HUNTER-GAULT: Well, is there any sense about, you know, the Japanese concern that this will unsettle the rebels and lead to a bad situation?

JONATHAN MILLER: The Japanese are concerned both with unsettling the rebels but I think more with unsettling the hostages. One third of the hostages in there now, there are 72, and one third of them are Japanese. Half of those are diplomats. Half are businessmen, and the Japanese government is very concerned about, about their state of mind, their--certainly their safety, but also their psychological state. So when Prime Minister Hashimoto made his remarks over the weekend that he was very concerned about the unsettling effects that all this police activity might be having, I think he was equally concerned that the hostages, themselves, were going to be unsettled.

CHARLAYNE HUNTER-GAULT: All right. Is there any indication that the Peruvians--you say they've escalated their police presence, instead of toning it down. I mean, what's going on between the Japanese and the Peruvians?

JONATHAN MILLER: The Japanese have said that they are fully supportive of what President Fujimori is doing in this crisis. That said, they've also mildly criticized things that he's done over time, if not criticized then at least stated their concern about the way things were going, their worry that if things didn't get resolved more quickly that things might break down a little bit. So one can assume that they are talking, but President Fujimori has said that while is trying to bring the Japanese along on this, it's his call, and what happens here in Peru is the business of President Fujimori and not of the Japanese.

CHARLAYNE HUNTER-GAULT: The rebels made a statement today something to the effect of vanquish or die. I mean, what is their situation now and their position?

JONATHAN MILLER: They have said repeatedly that they're prepared to die if they don't get what they've come for, and people who know their movement say that that's probably true; that they are prepared to die. The leader, Nestor Cerpa, is a man who has a lot of patience but also might be--might be willing, people say, to play a martyr, to be a martyr. That might be something of value to him. That makes negotiation, of course, very difficult.

CHARLAYNE HUNTER-GAULT: But what is the status of the talks between the government and the rebels, if there are any talks at all, or communication?

JONATHAN MILLER: There clearly is communication between the two sides. And there are a couple of people who are carrying messages certainly between the two sides, nothing substantive. They're not talking about demands, but the Roman Catholic Archbishop Juan Luis Cipriani, who's a personal friend of President Fujimori, has been going in regularly to visit with the hostages, and also, it can be assumed, carrying messages. And the Red Cross has played that role to some extent as well. So the two sides are talking. In a sense, they're communicating, but they're not really talking. They're not sitting down at the table, not negotiating, and that's where I think the nervousness now is coming in. That's, I believe, behind the Japanese nervousness too of the two sides that have taken an awful long time to sit down at the bargaining table. And there's no sense right now when that's going to happen.

CHARLAYNE HUNTER-GAULT: Well, is there any sense that there's anything to bargain over? I mean, has Fujimori given any indication that there's any bend in his position that he's not going to release prisoners that Tupac Amaru wants released, or have the rebels given any indication that they're willing to bend in their demand?

JONATHAN MILLER: Well, both sides stated their positions really early in this. The rebels stated their goal, which was to get their comrades in jail released right at the outside, and President Fujimori, it took him a few days, but I think it was the fourth day he said that that is simply out of the question. They have not budged on those positions since then, but things have--time has passed, and things have developed, and more items have sort of percolated onto the agenda. President Fujimori said that he'd be willing to talk about just about anything in negotiations but being willing to talk about it and being to give in on any of these things are a completely different matter according to him. The rebels, for their part, have held even firmer than that. They've said that they came to get their comrades out of jail, and they're not going to leave there until they do, or else they'll accept that they might have to die in this.

CHARLAYNE HUNTER-GAULT: One statement I saw today said was issued by the rebels saying that if the embassy were stormed and their commando units throughout Peru prepared to unleash attacks on targets of the state and various other installations. Is there any indication that they have that capacity?

JONATHAN MILLER: They have some capacity certainly, and I think that over the course of this crisis people have come to realize that they have maybe a little bit more capacity than their military had let on or had even known up until a month or five weeks ago. But they are not really a viable fighting force. They certainly aren't the sort of force that threatens to take over state power to topple the government. They have people in the field in various places. They don't control any territory, and the military estimates they have a few hundred fighters at most.

CHARLAYNE HUNTER-GAULT: Is a violent outcome of this situation reduced or enhanced by so much time passing? I mean, is there a ticking time bomb here, so to speak?

JONATHAN MILLER: Well, that's a great question of how the two sides will use time in this--in this whole affair. For the hostages, they're surviving. Time is--makes it every day I think it gets a little bit more difficult, but they're sort of treading water. For the rebels, they've said that they have as long as it will take to get their objectives accomplished. They are very patient people. They've been fighting this war for a dozen years, and it's been slow going. For the government, time is also--they feel that time is on their side. But it's not certain how long they'll be--they'll be willing to say that. They appear to be in no great rush to get this resolved, but at a certain point certainly they're just going to want to get on with business and have this behind them.

CHARLAYNE HUNTER-GAULT: And just briefly, what is the condition of the hostages still inside?

JONATHAN MILLER: The hostages are by all accounts being treated quite well. Several have been sick and have been removed from the residence at the request of the Red Cross, but they're being fed; they're getting sleep; there is contact with their families. They're getting fresh clothing. The sanitary situation is okay. So, that's one bit of good news: They seem to be doing okay inside.

CHARLAYNE HUNTER-GAULT: All right. Well, Jonathan Miller, thank you for joining us. FOCUS - NEW FRONTIER

JIM LEHRER: Now, the growing business of helping couples have babies. Fred De Sam Lazaro of KCTCA-St. Paul-Minneapolis reports.

FRED DE SAM LAZARO: Nineteen years ago, when the world's first test tube baby was born, Louise Brown was hailed as a miracle, the result of hundreds of attempts to combine egg and sperm from an infertile couple in a petri dish. The embryos formed were then implanted back in the uterus.

SPOKESPERSON: So here's the injecting needle going in. And it depresses against the egg shell and against the egg, itself.

FRED DE SAM LAZARO: Two decades later, in vitro fertilization has made huge strides, resulting in 26,000 babies in the U.S. alone. Instead of injecting millions of sperm into a dish with eggs to cause fertilization, doctors can now go directly into the egg with a single sperm, using sophisticated microscopic tools.

SPOKESPERSON: So that's one egg injected.

FRED DE SAM LAZARO: St. Paul embryologist Dr. Hugh Hensleigh says men who are virtually infertile can now become fathers. It's one reason the success rate with embryos transferred to the uterus has gone up three to four-fold in the last decade.

DR. HUGH HENSLEIGH, Embryologist: Here we've been running an ongoing pregnancy rate of 30 to 40 percent per transfer, in there. So there's been a huge increase in the pregnancy rate each cycle, and it's due to better stimulations, you know, better medications used for the stimulations, better procedures in the lab, more freezing.

FRED DE SAM LAZARO: Advancements in technology, coupled with huge demand, have made assisted reproduction extremely lucrative. This fierce competition for the business of an estimated 5 million infertile couples, like Jodean Thronson and her husband, John Riemer. They often spend tens of thousands of dollars, most of it out of their own pockets, trying to have a baby.

JODEAN THRONSON: We paid Reproductive Health $15,000, and probably our drugs were probably about $750 maybe, $600 or so.

JOHN RIEMER: I got to say it's probably more than that.

JODEAN THRONSON: Yeah.

JOHN RIEMER: In vitro is not a cheap procedure.

FRED DE SAM LAZARO: Thronson and Riemer shopped around and were attracted to this clinic, Reproductive Health Associates in St. Paul. Last year, it became the first in vitro clinic in the world to offer both a fixed price and a warranty. If you don't have a baby, you get your money back. For a flat fee, ranging depending on their age from fifteen to seventeen thousand dollars, patients are allowed three attempts at pregnancy. A la carte each of these embryo transfers costs about $7500. So the package price is about 25 percent off the pay-as-you-go plan unless, of course, a couple is successful on their first try. Dr. Jacques Stassart is a clinic partner.

DR. JACQUES STASSART, Fertility Specialist: What we tell our patients and we tell them very bluntly when we give them our orientation is that the ones who become pregnant the first time around are going to be subsidizing the ones who take three attempts to become pregnant, and, most importantly, the ones who do not become pregnant at all, even in spite of three attempts. The ones that take two attempts we can pretty much break even. It's a lottery. And how much we think we know, we never know who's going to get pregnant and who's not going to get pregnant.

FRED DE SAM LAZARO: Thronson and Riemer find it a worthwhile gamble. They say the warranty provides a sense of certainty, a beginning and end of an experience fraught with anxiety and uncertainty.

JODEAN THRONSON: We pay them the lump sum. We'll go through three tries, and really that'll be it for us because I can't imagine having to make that decision each time and having to come up with the money each time because it would, I think Dr. Stassart compared it to gambling, it would be like when are we ever going to stop? We know if it doesn't work, we will take that money then and build our family an alternative way.

FRED DE SAM LAZARO: But the money-back guarantee has drawn widespread criticism from the American Medical Association, among others. Dr. Paul Kuneck, who works for a Minneapolis clinic, does not question the integrity of his St. Paul competitors but in the free-wheeling in vitro business, Kuneck fears some clinics could use a guarantee as a marketing tool, inflating both the hopes and even the medical risks of patients.

DR. PAUL KUNECK, Fertility Specialist: There's always a concern that there will be a pressure to achieve a pregnancy faster. There's always a concern that rather than putting back three embryos, they might put back five embryos; that rather than using 3 M's of drug, they might choose to use 5 M's of drug. In a money- back program there is a greater financial inducement to potentially use poor medical judgment.

FRED DE SAM LAZARO: Critics have long maintained that the unregulated American in vitro industry, as it is, provides the wrong incentives to doctors. Dr. Robert Winston, one of Britain's leading in vitro specialists, appeared on the NewsHour in the 1994 story.

DR. ROBERT WINSTON, Fertility Specialist: There's a lot of evidence in the United States which suggests, for example, that clinics are practicing which have a very low success rate, often exploiting patients. There were large sums of money to be made, and we see a lot of American patients. They come across the Atlantic regularly for treatment. And I think there are occasions when we feel that the treatment that we have--actually are reviewing is treatment that we would be very reticent to approve.

FRED DE SAM LAZARO: But Dr. Stassart insists his clinic has not changed its guidelines, the typeof patient it admits, or the number of embryos it will transfer to the womb. They remain the same for patients on the warranty program and those on the pay-as- you-go plan.

DR. JACQUES STASSART: We tried to come up with an option, which, by the way, it is. I mean, half our patients go the traditional way, they pay as they go and take their chances and the other half like the idea of having a safety net so that if they do luck out then they'll pay a little more than what they would have paid, paid as they went, but if they do not luck out, then they don't, they still maintain the option of adopting.

FRED DE SAM LAZARO: The commercial flavor of terms like "money- back guarantee" and "lottery" also add to a more fundamental criticism of the in vitro fertilization industry. It comes from some anti-abortion groups and most prominently the Catholic Church. Richard Berquist is a Professor of Philosophy at the University of St. Thomas in Minnesota.

RICHARD BERQUIST, University of St. Thomas: Every human being must be brought into the world for its own sake, as valuable in itself. And the process of in vitro fertilization doesn't recognize this. It treats the embryo as a kind of product which is made by technicians.

FRED DE SAM LAZARO: Berquist says the most egregious example of this disrespect to embryos was a law passed in Britain that resulted in the discarding of an estimated 6,000 unclaimed embryos belonging typically to couples who have not communicated with their clinic for five years, presumably having given up pregnancy attempts or completed their families.

RICHARD BERQUIST: So I suppose the first thing one has to do is to make people aware of exactly what they're dealing with. This is not just a question of disposing of biological material. This is a question of human beings in their embryonic state with a dignity and a value and rights.

FRED DE SAM LAZARO: However, the parallels the Church draws with the abortion controversy has not slowed down the thriving business of assisted reproduction. Dr. Hensleigh says a few patients in his clinic always use newly fertilized embryos to avoid the specter of discarding frozen ones. But the typical patient is likely to be like Joe McKinley and his wife, Penelope Phillips, whose in vitro attempts succeeded after two years of trying. Although her pregnancy is the result of a thawed embryo, Phillips claims no emotional attachment to embryos.

PENELOPE PHILLIPS: I'm not attached at all. That sounds so callous when you think about it now, it really does, but it was very--it was very intellectual, wasn't it? And you would always get to see them too. They'd always say, would you like to see your embryos before--come look at the kids--but you never--you know, you never--it's simply--you don't make that connection. But I don't know if that's an ethical, moral issue, or just kind of I'm a pragmatist. And this is what I wanted was a family.

FRED DE SAM LAZARO: Phillips and McKinley say they'd be willing to donate any surplus embryos to another couple; however, they speak from the luxury of just delivered a baby boy, Edward. Riemer and Thronson, whose first attempt at in vitro pregnancy failed, say they too would be willing to donate embryos, but only after they've had a baby.

JODEAN THRONSON: If were successful and end up with a baby, I think the answer of destroying our frozen embryos would be, yes, that we would have no need for them any longer.

FRED DE SAM LAZARO: Again, if you're not successful--

JODEAN THRONSON: I do like the idea of having them ask how long would you keep them frozen. I like the idea of having a finite amount of time. It would be two years after we're done with this whole process, or even a year, or just to put closure on it.

FRED DE SAM LAZARO: Emotional as such closure is for some couples, there's also strong economic pressure for it. It costs $50 per year to store each frozen embryo, the down side perhaps of an all-business in vitro system. Yet, it's the lucrative nature of the science that some experts say has advanced it so quickly and increased the chances such couples will bear children.

JIM LEHRER: Still to come on the NewsHour tonight an AIDS update, what has the Super Bowl become, and a Roger Rosenblatt essay. UPDATE - PROGRESS REPORT

JIM LEHRER: Now, to the latest on AIDS and to Margaret Warner.

MARGARET WARNER: Are scientists on the verge of making AIDS a manageable disease? There was positive news on that issue but some caution too at the fourth Annual Conference on Retro-viruses and Opportunistic Infections that ended in Washington yesterday. Last year's conference had reported dramatic advances in treating the disease using a new class of drugs called protease inhibitors. For an assessment of the latest developments we turn to Dr. Anthony Fauci, Director of the National Institute of Allergy & Infectious Diseases, and reporter Laurie Garrett of "Newsday." She's followed the AIDS epidemic from the beginning and wrote a book about infectious diseases called "The Coming Plague." Welcome, both of you.

DR. ANTHONY FAUCI, National Institute of Allergy & Infectious Diseases: Good to be here.

MARGARET WARNER: And Dr. Fauci, starting with you, what do you think has been the most important progress in fighting the disease that's been made in the last year?

DR. ANTHONY FAUCI: Well, in the last year we've taken that next step. Last year at this time it was shown that these combinations of drugs, including protease inhibitors, could drop the level of virus in the blood to below detectable levels. That has been sustained in a proportion of patients--not all patients by any means. Now, for a year, a year later, we're starting to look at the lymphoid tissue, or what we would consider the sanctuaries or hiding places and reservoirs for the virus. And what has been found is that the level of virus replication in many, not all of these--

MARGARET WARNER: Explain that--level of virus replication.

DR. ANTHONY FAUCI: Virus replication means the virus's ability to reproduce itself is markedly depressed, if not absent; however, there are remnants of the virus there. If you look at the virus's gene that inserts itself into the cell, in many of the cells it's still there. What we don't know is whether or not it is able to be reborn, as it were, to start replicating again. The hope is that if you continue the therapy for a period of time, over a period of time, those cells will actually, themselves, die off. So there's virus that's still there. The proof of the pudding will always be when you stop the therapy, will the virus then come back? There are people that have had the therapy, stopped in them for one or another reason, and we've seen the virus come back, which means in the short range we still haven't had enough time to be able to completely suppress it without it coming back. It's good news though, good news.

MARGARET WARNER: And, Laurie Garrett, based on the past year's clinical experience, is a consensus emerging about when to use these drugs, with which patients, at what stage in the disease?

LAURIE GARRETT, Newsday: I wouldn't say a consensus but certainly at thismeeting the overwhelming message I came away with was the earlier you start, the better, and if you have never taken any of the anti-HIV drugs before, your chances of having a powerful response to a combination of three or more of these drugs are far better than the odds for people who have already tried and failed AZT, already tried and failed--

MARGARET WARNER: That being one of the older anti-AIDS drugs.

LAURIE GARRETT: --EDI--yeah. These are all, you know, various drugs that are out there, and I should say, though, that there are some patients that have been described at this meeting and at a few previous meetings in the last couple of months who had as many, you know, tens of billions of viruses in their bodies, from the highest viral load, as it's called, count that one could imagine, and when they've gone on these triple combination therapies, their virus levels have gone down to below the limits of what current technology can detect, which the best current technology detects down to the level of 20 viruses were milliliter, or tiny droplet of blood.

MARGARET WARNER: That's amazing. And when you say go in early right away with this full treatment, are you talking about when someone is diagnosed with HIV positive, or do you wait till they have full blown AIDS?

LAURIE GARRETT: Well, I can only tell you what the scientists are saying and what the physicians are saying. And all the evidence seems to indicate that your immune system, your own body's ability to fight off disease and fight off this virus really severely deteriorate quickly, and that after the sixth month point of infection--

MARGARET WARNER: And you're talking about just HIV?

LAURIE GARRETT: Right. Long before most people have any idea they're infected. After that six-month point you've already got some pretty serious damage, irreparable damage, as far as we can tell at this point, done to your immune system. So if you can get in there and treat before that damage occurs, logic dictates you're going to have a better response.

MARGARET WARNER: All right. So, Dr. Fauci, are we at the point or what stands between getting to the point of calling this say a manageable disease, something like say diabetes, which someone may have to stay on treatment all their lives, but they can live with it?

DR. ANTHONY FAUCI: Well, you know, we don't know that right now. We know in the short run that it appears that we're getting towards that point of making it manageable. We certainly are able to manage patients better by our ability to decrease that virus very, very low, sometimes to below detectable level. We know there's a correlation between the level of virus and the prognosis of a person, so it makes sense by extrapolation that if you bring it down as low as possible, the person will do better. What we don't know is in the long range whether the other confounding issues, like cumulative toxicities or the emergence of resistance might overcome that positive beneficial effect. We think not, but we can't say right now in the beginning of 1997 what the long-term and the long-range clinical benefits would be. Were we to predict, it looks good because of that correlation between virus and prognosis, but our experiences with viruses, particularly with this virus, causes us to be optimistic but very cautiously optimistic. The ball game is certainly not over yet.

MARGARET WARNER: And what does it cost for a patient to be on this?

DR. ANTHONY FAUCI: Well, it's quite expensive. If you talk about a standard--and it varies by a few thousand dollars, depending on the drug--the standard triple combination, it's anywhere between fifteen and twenty thousand dollars, if you consider the protease inhibitors plus two of the standard first generation drugs. And then you add on to that the other drugs that some patients who have very suppressed immune systems need to be on to prevent the occurrence of the complicating infections, you put that altogether, it becomes a very expensive proposition, usually above $20,000 a year.

MARGARET WARNER: So, Laurie Garrett, how are patients that are taking these, how are they paying for this?

LAURIE GARRETT: With great difficulty, unless they have excellent insurance or they live in a state that has state-subsidized access to the drugs, and certainly many people who ought to be on these drugs aren't on them, if you follow the current logic. I think one of the most shocking little factoids I heard in the whole meeting came from Dr. Peter Piat, who's head of the United Nations' global effort to control AIDS. He noted that current costs, the costs that Dr. Fauci just described, are 5,000 times the per capita annual spending on all health care combined for the nation of Zimbabwe, where the HIV rate is so high that 40 percent of all the women of pregnancy age, child-bearing age, are already infected. So you can see that we have a tremendous skewing occurring globally. In the wealthy countries where HIV rates are comparatively low it's already a burden to try and pay for this. In the poor countries, it's impossible. But there is one positive note, and, again, it's only relevant to the wealthy countries of the world. There were several papers presented at this meeting where they attempted to compare on the one hand this horrendous cost for the drug, but on the other hand the savings that you may accrue in hospitalization and acute care costs because the drugs are keeping people from having to be hospitalized. And the most striking such study I saw came from Northern France, where they compared hospitals that aggressively promote triple combination protease inhibitor therapy to their patients to ones that don't, and found that the aggressive hospitals are saving a quarter of a million dollars a month on average in hospitalization costs over and above the costs of the drugs, while the hospitals that haven't been promoting these combination therapies are losing a hundred thousand a month.

MARGARET WARNER: So, in other words, it was really cost efficient to go ahead for the hospitals, pay for these drugs, because they were going to make it back.

LAURIE GARRETT: Indeed, the government of France pays for everybody's drugs.

MARGARET WARNER: Do you see the costs coming down anytime soon, Dr. Fauci, here?

DR. ANTHONY FAUCI: No. It's very tough to say. The good thing about the protease inhibitor is that unlike the situation that we had very early on in the epidemic, where you had one drug and only one drug for several years, there are--we have three already approved--one that's in expanded access and a few more coming along. Whenever you have a situation where you have more than one company who's making a drug of the same class, there's that internal among the companies competition that would hopefully drive the cost down.

MARGARET WARNER: The good old market.

DR. ANTHONY FAUCI: I hope so, right.

MARGARET WARNER: And Laurie Garrett, what's been the practical effect of the use of these drugs, that is, on death rates? I saw that New York City's death rate dropped from AIDS 30 percent last year. Is that elsewhere? What about infection rates?

LAURIE GARRETT: Well, let's back upa second. I don't think there's any evidence that anyone would argue the drop--the very striking drop in AIDS deaths in New York City is due to protease inhibitors, and these drug combinations, because it preceded the availability of these drugs; it's due to other factors having to do with congressional support for a variety of medical care access programs for people who don't have health insurance and can't qualify for Medicaid, but we are seeing a dramatic decrease in hospitalization in all the major cities that have large populations of people with HIV disease. And that's clearly very powerful. I think--

MARGARET WARNER: Yet, you think that is, you can tie that to the drugs?

DR. ANTHONY FAUCI: You can tie it to the combinations drug. What Laurie is saying that the proteases weren't readily available when the trend--the protease inhibitors--when the trend started, but prior to that and for a considerable period of time, the concept of combination therapies were in vogue then, so it was a combination, as Laurie said, not only of having drugs that we use in combination, even though we just anti-dated the protease inhibitor availability, but it was the ability to get access to the people of New York City because the Ryan White funds were increased greatly from one year to the other. So people who the previous year wouldn't have been able to afford drugs now had the ability to pay for the drugs.

LAURIE GARRETT: Margaret, I think that points up a crucial point here. What I came away hearing from most of the physicians who were at this meeting and the physicians I deal with here in New York City and the patient population I deal with is that we've reached the stage where the real obstacles day to day have less to do with biology in conquering this problem than with the sort of social context, the economic context of people's lives. These drugs are not easy to take, and let's not make this sound like this as cough syrup. This stuff is tough to tolerate. There are a lot of side effects. You have to take them on special schedules, some with food of certain kinds, some without food of certain kinds. One of the drugs requires a massive amount of water in order to avoid kidney stones. We can go on and on and on. Some of them have to be taken on scheduled that would interfere with people's work lives.

MARGARET WARNER: We're just about out of time but go, just finish.

LAURIE GARRETT: Well, the point is that the real barriers are social barriers, getting them out for the people who need them, get people in early to get tested, and finding ways to make it easier for people to tolerate and take these drugs.

MARGARET WARNER: All right. Well, Laurie Garrett and Dr. Fauci, thank you both very much.

DR. ANTHONY FAUCI: Good to be here.

LAURIE GARRETT: Thank you. FOCUS - SPORT OR SPECTACLE?

JIM LEHRER: Now to the question what was that yesterday, that thing called a Super Bowl, a sporting event between two teams of superior athletes that showcased America at its best, or a gross display of excess, show biz, and bad manners that did just the opposite? We pose that Monday after question to four NewsHour regulars: Clarence Page of the "Chicago Tribune;" Author/Journalist Haynes Johnson; Mike Barnicle of the "Boston Globe," which is in New England; and Paul Gigot, a "Wall Street Journal" columnist who is a Green Bay native. Haynes, America at its best yesterday? Or something less?

HAYNES JOHNSON, Journalist/Author: It was all the things you said. It was great athletes and wretched excess. I mean, I kind of thing, you know, if a cultural anthropologist looked at America a hundred years from now, or a space traveler, they wouldn't read the historians; they wouldn't read us pundits and journalists and interpreters. They'd unearth the archives of Super Bowl. It can't be just a game or a championship. It's got to be super. It can't be just the 31st championship; it's got to be Roman numerals, like we're all gladiators. You look in the sky, and all the commercialization, and then you sort of reflect and say, you know, a hundred and thirty million people watch this thing; that's almost twice as many voted for president. So it tells you something about America, good and bad, I think.

JIM LEHRER: Do you agree, Mike?

MIKE BARNICLE, Boston Globe: Well, Jim, it occurred to me watching Charlayne's piece at the top of the hour about the psychops warfare in Peru that if they played the entire tape of the half-time show these hostages and the terrorists would be begging for us to accept their surrender. [laughter among group] I mean, I was watching the show. You had James Brown, and clearly they've been lying to us about how starchy those prison foods truly are. You had John Goodman, part of the Blues Brothers, who looked like he "ate" the Super Dome. You had ZZ Topp who looked like stunt doubles for Ted Kaczynski, the alleged unabomber, and you had 400 bikers looking around like they were trying to avoid contact with their parole officers, and they call this amusement and entertainment, and all of it, to my mind, increasingly each year gets in the way of the actual game, itself, where you have people Farr and Ben Coats for the Patriots who would absolutely play football for nothing, 6 AM in the parking lot, they'd play, and yet, we clutter this thing up with this incredible commercialism.

JIM LEHRER: Incredible commercialism, Clarence?

CLARENCE PAGE, Chicago Tribune: I'm shocked, shocked to hear the Super Bowl is being commercialized. What are we talking about here? We're talking about an entertainment industry known as professional sports. This is the epitome, the epitome, as we've just heard, super, super, top echelon of modern-day professional sports. I say modern day. You know, the Super Bowl, unlike the World Series, unlike so many of the Olympics, so many other tests of who's really the best in athletics, this was created in the second half of this century. This is very modern, and it's the biggest because they're so much in tune with the way we live today in America. Americans love winners. We're a nation of competitors. It's part of our national culture. I wish that college football had a Super Bowl, so we would stop just arguing over drinks as to who's really the best. We have all these various Bowls, and I think there's a real value to this. As far as a half-time show, I've got to say--and this is part of my Chicago roots here--I enjoyed that half-time show. I was happy, although the House of Blues which produced this, you know, is to Chicago blues what Red Lobster is to Boston seafood there, Mike, but, nevertheless, you know, this is a commercial enterprise. It's designed to pull in big audiences. There are a lot of people who dashed out to the refrigerator during the game so they wouldn't miss the commercials.

JIM LEHRER: Well, Paul, your team won.

PAUL GIGOT, Wall Street Journal: I can't top any of--well, this- -I agree about the broader cultural point. This is a country where the most popular movie now is a movie about a sports agent called Jerry McGuire where the signature line is, show me the money. I mean, that's, that's what a lot of this has become. One of the ironies here is that Green Bay is probably the least commercial team in professional sports because it is--it can only survive because of profit-sharing by the rest of the league, and it's, of course, owned by the citizens of the town, a small irony, but they have to--in order to survive, they have to participate in this broader spectacle.

JIM LEHRER: What about Clarence's point? I think--I'm going to extrapolate what you said, Clarence-- CLARENCE PAGE: Be my guest.

JIM LEHRER: --that the more gross we become as a society, the more gross our Super Bowls are going to become, because it's keeping right up with this, because all of us could--all of us are old enough to remember the first Super Bowl. It was nothing like what--like yesterday, and our times were nothing like what they were yesterday, is that correct?

PAUL GIGOT: I think that we are a nation that likes to do things to excess, commercial, movies. When Michael Johnson, the great sprinter, who was the greatest sprinter of all time, ran in the Olympics, he ran in gold shoes before he won. But I think it also is, it is also we do appreciate excellence, and I think we shouldn't forget that point, that these are athletes, incredibly disciplined. They worked incredibly hard. And there's an awful lot at risk for them too in this, in their reputations, and we celebrate that.

JIM LEHRER: Well, speaking of the athletes, Haynes, there was another thing that struck a lot of people yesterday. It's been going on now increasingly for years, is that after a player does something terrific and commits an athletic something that is terrific, tackles somebody, scores a touchdown, there's this gloating process that goes over.

HAYNES JOHNSON: Hot dogging--and all this stuff, and you--

JIM LEHRER: Is that also our society catching up?

HAYNES JOHNSON: May I confess to sort of a personal childhood sort of memory, and Mike Barnicle won't like this maybe, being a Boston Red Sox fan. I grew up in New York worshiping Joe DiMaggio because he was classic and sort of self-effacing and performed brilliantly and flawlessly. And none of this--you have the idea of Joe DiMaggio hot dogging as he ran around the bases in baseball, is just an anathema. But this is now the way we do it. We've got to get up there and show off and loud mouth or Dennis Rodman will kick somebody or wear these crazy clothes, and it's all part of the game, part of the aspect.

JIM LEHRER: Does that bother you, Mike?

MIKE BARNICLE: Well, the mere thought of Joe DiMaggio going around the bases bothers me.

JIM LEHRER: Right. Okay. You're a Red Sox fan. Forget it. Right. He did that a lot in Fenway Park.

MIKE BARNICLE: 1929 killed us in the last week in September, killed us. I mean, you want to talk about that, I can talk about that.

JIM LEHRER: No, that's all right.

MIKE BARNICLE: The whole thing, I mean, the spectacle of Desmond Howard stopping at the goal line, going into the goal line, and duking his way in, to me is akin to the half-time show, and it's not gross so much as it is unbelievably lame. And yesterday I thought there was a vivid contrast where you had the Green Bay Packers and they ought to know better playing a team where the players are banned from doing anything like that. When they sack Brett Farr they don't stand there pointing over him and they don't run around in the end zone and spike the ball; they act as if they'd been there before. They didn't get there that often yesterday, but they act as if they've been there before. And I don't know what to tell kids, you know, if you coach Little League or you coach, you know, Pee Wee Hockey, I don't know what you tell kids about that, you know, that it's not a good thing to do. Don't show up your opponent. If you're good enough to win, win, look at the score, and go home with a smile on your face. You don't have to do that.

JIM LEHRER: Clarence.

CLARENCE PAGE: You know, there's sort of a dilemma that professional sports has insofar as that sort of behavior because all people like it, and to a certain degree it puts the spotlight on the individual which enhances the ability to get the big commercial endorsements, where the real money is in professional sports, the--you dye your hair a funny color, or do the macarena in the end zone. This sort of thing is part of that commercialization, which Americans say is so troubling on the one hand, but on the other hand, it is rewarded commercially. Now they have set rules insofar as any kind of intimidating gestures that are made, you know, if you spike the ball and then, you know, clown in such a way as to provoke your opponent into wanting to punch you out. They've tried to set rules, boundaries against that. But at the same time, there's a certain amount of that, of that flashy behavior that is all part of the commercialization of the game.

HAYNES JOHNSON: And you put your finger on something. You reward it commercially.

CLARENCE PAGE: Yes.

HAYNES JOHNSON: And this is not true just of the football. It's true of the athletes--go from there into the courtrooms, and the O.J. trial, and the lawyers act like they're in the Super Bowl, passing out autographs and getting their multi-million dollar contracts, so that wretched excess extends beyond the gridiron.

PAUL GIGOT: Let me disagree with these guys a little bit in this sense. I mean, some of the most admired athletes we have are the people who don't strut. Michael Jordan in--

HAYNES JOHNSON: Yes, absolutely.

PAUL GIGOT: --basketball is a class act in part because he doesn't need to. Reggie White and some of the others, Eugene Robinson, some of the other players in the Patriots yesterday expressed their spirituality. Now, it doesn't run to my taste to broadcast that over nationwide television, but they feel they should do that. They live their creed, and they're respected for it. They're not people who show up their opponent, and I think that a lot of Americans admire them for that.

JIM LEHRER: What about Mike's point, Paul, that you see this great athlete do that, and then he taunts the person and then he goes like this and says to the crowd, you know, cheer me, cheer me, cheer me, what does that say to all the kids about what sportsmanship used--or am I just being old-fashioned about this?

PAUL GIGOT: No. I played rugby as a kid, and one of the reasons I liked it was because, you know, you didn't show up your opponent. You shook hands. It was a great game. You go and had a beer with your opponent afterwards. It's rude behavior, but it's rude if it's on a subway as much as it is if it's on--you know, in your office, or on the field.

HAYNES JOHNSON: There's a great lesson. We have to win. What if you lose? How do you learn how to handle loss? This was all about winning. It's not about handling defeat gracefully. Life is a lot of defeats. Mike's point is right, I think, about how you teach kids, what's the emulation, and I think that is part of this process.

JIM LEHRER: That's a good point, is it, Mike? How do you--if this is the new way to win, what's going to be the new way to lose? Is there a new way to lose?

MIKE BARNICLE: Well, you know, it's funnywhen Paul is talking about all the sports and other athletes. One of the great moments in sports in the last quarter century had to be Cal Ripken breaking Lou Gehrig's record.

HAYNES JOHNSON: Right, exactly.

MIKE BARNICLE: And he didn't run around the bases going I'm No. 1. You know, he didn't, you know, taunt Lou Gehrig's family, what's left of it, things like that, and he plays perhaps our greatest sport, not our most commercialized sport, not a sport that has become the object of our biggest spectacle, the Super Bowl, but perhaps our greatest sport, baseball. It's played over the longest of seasons, and it teaches any child at any level beginning to play it, it teaches them one thing above all else; that you have to learn how to lose in order to play that game. If you hit the ball three out of ten times, you go to Cooperstown, and I don't know that we teach kids in this country the importance of learning how to deal with loss, not accept it, but deal with it.

JIM LEHRER: All right. We're going to leave it there. Thank you. ESSAY - MAN'S BEST FRIEND

JIM LEHRER: Finally tonight our Monday night essay. Roger Rosenblatt considers the joys of dog owning.

ROGER ROSENBLATT: The psychology of dogs is becoming a major specialty of veterinary medicine and literature and of life. The past couple of years have produced important books about dogs: "The Dog Who Loved Too Much," by Nicholas Dodman; Elizabeth Marshall Thomas's "The Hidden Life of Dogs;" "Do Dogs Need Shrinks?" by Peter Neville; and "Dog Love," by Marjorie Garber. There are summer camps for dog owners, such as Camp Gone to the Dogs in Vermont, which includes such classes as Understanding Your Dog's Personality. There are subspecialties in dog psychology that deal with blanket sucking and compulsive licking. All such thing are devised to allow us to know our dogs better and to help us understand why we keep them around. People admire dog virtues, we are told, their courage, their loyalty. They give us solace. German dog psychologist Professor Reinhold Berger, author of "Man and Dog," says, "Dogs possess certain characteristics that are seen to be socially desirable in humans." Well, maybe, but I have a less exalted view of the subject. I think we love dogs because dogs are ridiculous. I think we keep them around for laughs. To wit, a dog's barking. No stand-up comedian can come close to the preposterous effect of a barking dog.

STEVE MARTIN: [talking to dog] Well, what is it boy? Are you lost?

ROGER ROSENBLATT: Steve Martin made the most of this wonderful feature in "The Jerk" when he interpreted his dog's pointless yammerings as a warning that he was in danger.

STEVE MARTIN: [talking to dog] Is it an accident, a drowning, a fire? [dog barking] Fire?

ROGER ROSENBLATT: The bit was derived from the old radio show Sergeant Preston of the Yukon in which the Canadian Mountie hero would have long and complex conversations with his dog, King. Lassie, as everyone knows, barked in paragraphs.

ACTOR: Folks, false alarm. There's no fire.

ROGER ROSENBLATT: What's funny about a dog's barking, of course, is that no one has the slightest idea what it's about. He presents us with his profile and yells at nothing, or more often at some other dog doing the same thing. Does a human being shout because he hears another human being shout a few blocks away? What is it boy? O.J.'s other glove? The stare of a dog is even funnier than the bark, especially when the stare is accompanied by the wagging tail. No deadpan comic in history, not George Burns, Jack Benny, or BusterKeaton, could compare with the combined effect of a dog's enthusiastic tail wagging while the animal maintains his absurdly expressionless face. I spend many hours in blissful amusement watching our dog, Hector, wagging and staring, or simply sitting and staring. I'm amused by Hector's name, Hector. I think we give dogs human names because that's funny too. Hector is quite funny on his own. He growls like a tiger if I approach his dish of food. I swear to you, I've never eaten his food, never even attempted, but that's Hector. Then there's that sniffing business, sniffing for hours in total ecstacy. Nonsense. It's all quite ridiculous but touching too. We keep dogs around to have something to laugh at, and they probably keep us around for similar reasons. But they are a lot funnier than we are, and they never laugh, themselves, or even smile wryly or otherwise. I've told Hector some stories that are hilarious, not a titter, not a chuckle. What is most touching about dogs is they only do about seven things. They sniff; they bark; they lie down; they perk up; they eat; they do the consequences of eating; and, of course, they stare. [talking to Hector] Hector, a man takes a dog into a bar--oh, you've heard that one. Hector, a man goes to a psychiatrist, says, "Doc, I think I'm a dog." The doctor says, "How long have you thought so?". He says, "Since I was a puppy." [laugh track] He says, "Since I was a puppy." I'm Roger Rosenblatt. RECAP

JIM LEHRER: Again, the major stories of this Monday, 19 states from Illinois and New England were under winter storm watches as snow and sub-zero cold worked its way across the country, and Peruvian rebels holding 72 hostages fired at armored police vehicles outside the Japanese ambassador's residence in Lima. We'll see you on-line and again here tomorrow evening. I'm Jim Lehrer. Thank you and good night.