The NewsHour with Jim Lehrer

JIM LEHRER: Good evening. I'm Jim Lehrer. On the NewsHour tonight, Kwame Holman updates Congress' drive toward tax cuts; Margaret Warner looks at new federal guidelines on cholesterol; Elizabeth Farnsworth, in part two of her series on AIDS in Africa, reports from Botswana; and Gwen Ifill examines the comeback of Silvio Berlusconi in Italy. It all follows our summary of the news this Tuesday.

NEWS SUMMARY

JIM LEHRER: The Federal Reserve cut a key interest rate again today. Its Open Market Committee lowered the Federal Fund's rate half a point to 4%-- the lowest in seven years. Banks charge that rate on overnight loans to each other. It was the fifth reduction this year. In a statement, the Fed said it still saw weakness in the economy, leaving open the possibility it might cut rates again. House Democrats today announced their alternative to President Bush's energy plan. They gathered at a gas station near the capitol and said they'd increase production and reduce demand. They called for federal caps on electricity prices, restrictions on drilling in federal lands, and tax incentives for energy- efficient cars and homes. House Minority Leader Gephardt said it was a balanced approach.

REP. RICHARD GEPHARDT: We believe we can have more than adequate supplies of energy and save our environment at the same time if we do the right things in research on renewables, on conservation and on new sources of energy in high technology. We do not accept the belief that this administration apparently has that we have to drill our way out of this problem.

JIM LEHRER: President Bush is to announce his plan on Thursday. It's expected to put greater emphasis on finding more energy and building more production capacity, plus taking a new look at nuclear power. He has opposed price controls. A runaway freight train rolled across Northwest Ohio for nearly an hour today. It was unmanned as it crossed at least two counties and downtown Bowling Green at speeds of up to 45 miles per hour. Police said the southbound CSX train got away while the engineer was operating a switch at a stop near Toledo. It finally slowed and a company official managed to climb on and stop it-- about 55 miles from Columbus. CSX said the cargo aboard the 47-car train included a non- explosive, industrial acid. No one was injured. In the Middle East today thousands of Palestinians protested the anniversary of Israel's founding in 1948, and fierce fighting erupted across the West Bank and Gaza. We have a report from Louise Bates of Associated Press Television News.

LOUISE BATES: More than 30,000 Palestinians marched on the main square of the West Bank town of Nablus in the largest demonstration against Israel seen for several years. The event was organized to mark the "Great Catastrophe." That's the name Palestinians give the anniversary of the creation of the state of Israel in 1948. (Gunfire) Many of the demonstrators headed to Israeli checkpoints after the rallies. When an Israeli soldier removed a Palestinian flag, he was jeered by the angry crowd. At a traffic circle near Ramallah, a regular flashpoint during the Intifada, clashes with the Israeli soldiers turned violent. Across the West Bank and Gaza, four Palestinians were killed and more than a hundred were injured.

JIM LEHRER: Since that report was filed, Palestinian doctors put the number of wounded at more than 200. And the Israeli military said an Israeli woman was killed in the West Bank after nightfall. In Jerusalem today a Palestinian bus driver was convicted of murdering eight Israelis last February; he drove his bus into a crowd near Tel Aviv. It was the single deadliest incident since the current violence began last September. Back in this country today, more aggressive treatment of high cholesterol was proposed today by a federal medical panel; it had been convened by the National Institutes of Health. A group of experts said the change could triple the number of people who take cholesterol-lowering drugs and dramatically reduce deaths from heart disease. But they said doctors need to make it a higher priority.

DR. JAMES CLEEMAN: There is a clear under treatment of people who need cholesterol-lowering that is a chronic problem. We have put out guidelines and information and said that this deserves aggressive attention, and we have to do more to make it easy to implement all of these guidelines and make it possible to apply them in actualpractice.

JIM LEHRER: It's estimated that more than 50 million Americans have high cholesterol. The new guidelines recommend different tests to screen for the problem. They also revise the recommended levels for good and bad cholesterol. We'll have me on this story later in the program tonight. Married couples with children now make up less than a quarter of all American households. The Census Bureau said today they accounted for 24% of U.S. homes in the year 2000. Their overall number grew 7% in the 1990s, but the number of un-married people living together grew 71%. And women living with children, but without a husband, increased 25%. That's it for the News Summary tonight. Now it's on to moving toward tax cuts; fighting cholesterol; our second AIDS in Africa report; and the Italian elections.

UPDATE - TARGETING TAX CUTS

JIM LEHRER: Kwame Holman has our tax cut story.

KWAME HOLMAN: A majority of members in Congress agrees America deserves a sizeable tax cut. They declared that last week when both Houses passed the budget resolution. Approved at $1.35 trillion over 11 years, the tax cut would be the largest in 20 years.

SPOKESMAN: Good morning, especially good morning to the members of the committee who will have a big day ahead of them.

KWAME HOLMAN: Today, however, it fell to the Senate Finance Committee to figure out just how to deliver the tax cut and to whom. The Committee's chairman and ranking Democrat, Iowa's Charles Grassley and Montana's Max Baucus, are in their first year in those roles and for weeks their colleagues have pressured them on how to write the tax bill. This morning they said they'd done the best they could in an evenly divided Senate.

SEN. CHARLES GRASSLEY: Some people around here have been preaching bipartisanship, but then they turn around and attack bipartisan compromise reflected in this bill. So that begs a philosophical question for members: Is bipartisanship appealing only when you get exactly what you want? Well, of course, I hope not.

SEN. MAX BAUCUS: And of course, we are meeting here, in open committee for the purpose of debating and amending the bill. No back room kabuki. Debate and amendments, up or down. So I thank you, Mr. Chairman. I think you've done a great job.

KWAME HOLMAN: And many members of the committee also took turns praising Grassley and Baucus for their efforts, then criticizing what they finally produced. West Virginia Democrat Jay Rockefeller.

SEN. JAY ROCKEFELLER: I have to say that while I admire both of you so very much, personally, I believe that you are sadly misguided in the path that you have chosen.

KWAME HOLMAN: Texas Republican Phil Gramm.

SEN. PHIL GRAMM: Let me first say that, while I'm not happy with the bill as it now exists, I'm happy to be here talking about cutting taxes to the American people. As I listen to my Democrat colleagues, I feel a little better.

KWAME HOLMAN: The Grassley-Baucus plan preserves much of what President Bush proposed to reduce current income tax brackets, including the creation of a new 10% bracket. However, the top bracket - currently at 39.6% -- would be lowered only to 36%, instead of the 33% the President proposed. And taxpayers wouldn't feel the impact of some tax cuts for several years. The new tax brackets wouldn't go into full effect until 2007. That's why most Republicans complained about the bill.

SEN. PHIL GRAMM: I thought the Bush proposal of 33%, that no American should pay more than 33% of their income in income taxes was a reasonable proposal.

KWAME HOLMAN: Tennessee Republican Fred Thompson.

SEN.FRED THOMPSON: This 36% does not kick in fully until 2007-- a 1% reduction in 2002, another 1% reduction in 2004, and it doesn't get down to 36% until 2007.

KWAME HOLMAN: Majority Leader Trent Lott.

SEN. TRENT LOTT: I think that the rates remain too high. They don't actually take effect until too far out, and I think there are too many brackets.

KWAME HOLMAN: Some Democrats complained about the tax cut bill for completely different reasons.

SEN. JAY ROCKEFELLER: It spends too much, it saves too little, and it invests far too little in America's long term needs.

KWAME HOLMAN: North Dakota Democrat Kent Conrad.

SEN. KENT CONRAD: The rate where the vast majority of taxpayers pay taxes, the 15% bracket, is the only one that doesn't get a rate cut. And I guess we know why that would be true: Because they need the money to give the lion's share of the break to the wealthiest among us.

KWAME HOLMAN: Minority Leader Tom Daschle.

SEN. TOM DASCHLE: And there is no doubt, Mr. Chairman, this bill will raid Medicare and Social Security-- that is not even a question-- not to mention all the other important priorities: Education, prescription drug benefits, the array of investments and valuable services that we provide that the American people are counting on.

KWAME HOLMAN: There are, however, other elements of the bill that have broader appeal: A reduction in the so-called marriage penalty tax; the eventual repeal of the estate tax; an increase in contribution limits for Individual Retirement Accounts and 401(k) plans; and the doubling of the child tax credit to $1,000. Taken as a whole, the package of tax cuts written by Senators Grassley and Baucus received more favorable reviews by the committee's moderates. Louisiana Democrat John Breaux.

SEN. JOHN BREAUX: That is s a three-point reduction in all of the marginal rates. Obviously, to those in the top brackets, that means more money going back to them, but they in fact pay a lot more money. I have no problems with that.

KWAME HOLMAN: Maine Republican Olympia Snowe:

SEN. OLYMPIA SNOWE: And when I look at this tax package in its aggregate, I really do believe that it is structured with a political and fiscal balance that will be necessary, in this 50-50 committee and this 50-50 Senate, in order to achieve a significant tax package for the American people.

KWAME HOLMAN: New Jersey Democrat Robert Torricelli:

SEN. ROBERT TORRICELLI: It is a difficult enough assignment to lead this committee, but in your opening months as chair of the committee and ranking member, to have before you one the most significant pieces of legislation the committee has ever considered was an enormous challenge. The people of Iowa and the people of Montana should be very proud of both of your service. This is an extraordinary effort.

KWAME HOLMAN: However, neither Grassley nor Baucus was under the illusion that the plan would be approved as written. In fact, Finance Committee members filed some 170 amendments. But several agreed to withhold their efforts to change the tax bill until it goes before the full Senate.

SPOKESMAN: And these amendments, which I will withdraw and offer on the floor...

KWAME HOLMAN: This afternoon Chairman Grassley said he's committed to voting out the tax bill by tonight to give Republican leaders maximum time to push a final bill through the Senate well before Congress recesses for Memorial Day at the end of next week.

FOCUS - FIGHTING CHOLESTEROL

JIM LEHRER: Now, new guidelines for cholesterol and to Margaret Warner.

MARGARET WARNER: Tens of millions more Americans could be judged at risk for heart disease under today's new standards for cholesterol testing and management. The new guidelines come from the National Cholesterol Education Program, under the auspices of the National Institutes of Health. Here to tell us about them is the program's coordinator, Dr. James Cleeman. Welcome, Dr. Cleeman.

DR. JAMES CLEEMAN: It's a pleasure to be here.

MARGARET WARNER: Okay. First of all, remind us: What is cholesterol; why is it so important to overall health?

DR. JAMES CLEEMAN: Cholesterol is a waxy substance that is necessary for many bodily functions, including, for example, making of hormones, but if there is too much cholesterol in the blood, it is deposited in the walls of the arteries, causes plaque, eventually blockage of the artery can occur, and if a clot forms on top of that plaque, it can actually cause a heart attack. So high cholesterol is known to be an important case of heart attack.

MARGARET WARNER: Now, you last issued guidelines, or this program did, just eight years ago. Why revise them now?

DR. JAMES CLEEMAN: What we have now is new evidence about how serious a problem elevated cholesterol is and new evidence about how effective it is to lower cholesterol. There are millions of Americans who are at higher risk for heart disease and heart attack than we have previously recognized. And lowering their LDL, bad cholesterol, is enormously beneficial. We see from the clinical trials and

from the studies that if you lower LDL cholesterol, you reduce the risk for a heart attack, for death from heart disease, and for the overall death rate actually comes down also. So this is an enormously important maneuver.

MARGARET WARNER: All right. Let's talk about the so-called LDL and explain what it is and why it's bad and then how much tougher your new standards are.

DR. JAMES CLEEMAN: LDL cholesterol is called bad cholesterol because the LDL is low-density lipoprotein. That's what LDL stands for. A lipoprotein is a mixture of lipid fat and protein. Fat can't travel in the blood very well because the blood is watery, so it's got to be mixed with a protein and travel in that form. And the cholesterol that is brought by LDL is on its way to the bodily tissues, including the arteries where it is deposited and causes plaque, blockage and heart attack; whereas good cholesterol, HDL cholesterol, high density lipoprotein, is cholesterol on its way back from the bodily tissues on its way to the liver for processing and therefore is being removed from the body.

MARGARET WARNER: So you all have-- we have got a graphic to show this-- lowered or revised the standards for risk with this bad cholesterol. Why don't you just explain. Here is the old standard.

DR. JAMES CLEEMAN: Okay. The old standard, as you can see, had a level of less than 130 as desirable. That was the finest cut we made as... in terms of the low levels. The other levels have not been changed, 130-159 was then borderline. 160 and above was high. But now....

MARGARET WARNER: The new one.

DR. JAMES CLEEMAN: In terms of the new one you see below 130 there is now a cut. Less than 100 is identified as optimal and 100-129 is both near optimal, if you are coming down from a very high level, you are getting close to optimal, it's near optimal. But if you started at that level and have a cholesterol problem, it is actually above optimal.

MARGARET WARNER: So how many millions more Americans are now at risk that didn't know yesterday they were at risk?

DR. JAMES CLEEMAN: Well, what's important about the new guidelines and their risk estimation is not just that they change the cut points for LDL, but that they identify many people who have just as high risk for a heart attack as people who have heart disease itself. And these include people with diabetes and people with two or more risk factors for heart who find when the risk is calculated that their risk for a heart attack within a decade exceeds 20%. That doesn't... That may not sound like a lot, greater than 20%, but it is the very risk level of a person who already has heart disease and they have five to seven times as high a risk of heart attack as somebody walking around without heart disease.

MARGARET WARNER: Really today, your... you're saying or you're releasing data that shows that you could have a higher risk than you thought -- either because your cholesterol -- your bad cholesterol is higher than now it should be or that you have diabetes or that you have some of these other risk factors.

DR. JAMES CLEEMAN: In combination with your LDL, these other risk factors can multiply the risk and you may find out that somebody who had a fairly innocuous looking total cholesterol, today we talked about an example of somebody who had a total cholesterol of 190 which under the previous guidelines was a desirable total cholesterol and still is today and nevertheless because of other risk factors may actually have as high a risk for heart attack as a person with heart disease. Those people need to have their LDL's lowered to less...

MARGARET WARNER: The bad cholesterol.

DR. JAMES CLEEMAN: The LDL bad cholesterol to less than 100, and that will, in many people, require a combination, excuse me, require a combination of therapeutic lifestyle changes, diet, physical activity, weight control and medication.

MARGARET WARNER: All right. Let's talk first about the lifestyle changes, because we've always heard, all right, less fat, more exercise. That's what you've got to do. What's new here?

DR. JAMES CLEEMAN: What's new here is that the combination of therapeutic lifestyle changes beg recommended is far more effective than what had been seen previously. We are recommending that the patient not go to a stepped approach to lowering the saturated fat and cholesterol in the diet but go straight to the lower level, less than 7% of calories from saturated fat, less than 200 milligrams a day of cholesterol. In addition, if that doesn't produce enough lowering of the bad cholesterol, there is available the addition to the diet of what we call stanols and sterols; these are substances that are now available in foods like margarine and salad dressings that can help lower the bad cholesterol by blocking the absorption of cholesterol in the first place and also the addition of fiber to the diet. We now have better evidence than ever before that those maneuvers actually help lower bad cholesterol. And then you have added emphasis on physical activity and on weight control. You put them altogether, what you get is a greater than 20% reduction in the bad cholesterol. That's much more effective than had been the case previously.

MARGARET WARNER: Just explaining for people who don't know, saturated fat, the bad fat is all the fat that comes from animal products, the dairy products....

DR. JAMES CLEEMAN: Saturated fat is fat that is hard at room or refrigerated temperature. It largely comes from animal sources. There is actually a couple of plant sources that are saturated fat also: Palm oil, palm colonel oil and coconut oil, those are also saturated.

MARGARET WARNER: All right. Now on to the cholesterol lowering drugs because that's a big part of your news today. You think a lot more people may need to be on these drugs.

DR. JAMES CLEEMAN: Because so many more people are at risk for heart attack, those with diabetes, those with multiple risk factors, and a high decade's risk, a high ten-year risk for having a heart attack, those people need to lower their cholesterol, their LDL bad cholesterol down to less than 100; and in order to get there for very many of them, the therapeutic lifestyle changes will do a lot but may not get them the whole way. And so you have to add medication. We think that whereas previously 13 million people would have qualified to have medication added to the mix, now 36 million people will need to have medication added to the mix.

MARGARET WARNER: That's nearly one in five Americans.

DR. JAMES CLEEMAN: That's...

MARGARET WARNER: Adult Americans.

DR. JAMES CLEEMAN: That's not surprising, given the fact that we have an epidemic of coronary disease in this country and that coronary disease, heart disease, is the number one killer of women and men despite the progress that has been made against both heart disease and cholesterol in the last decades. So we know there are a lot of risk factors out there. We know that people with diabetes have a very high risk of a heart attack. And we have to do something about it in an aggressive way if we really want to make a dent in this problem.

MARGARET WARNER: So finally to sum up, how many people, how many Americans are really aware of this problem, are aware of their own levels and are doctors and patients doing enough now to, one, increase their awareness and, two, to do something about it?

DR. JAMES CLEEMAN: This is a good news, bad news story. The good news is things have gotten much better since before the program was launched.

MARGARET WARNER: Your program.

DR. JAMES CLEEMAN: -- Cholesterol Education Program. We have data. We have data that tell us that in 1983, which was two years before the launch of the program, only 35% of the American public had ever had their cholesterol checked. In 1995, that level had come up to 75% of the American public. The difference of 40%, from 35% to 75% is an absolute difference of 80 million Americans who had done something to find out. Now while that's good new, not enough is really being done to treat those cholesterol levels. We know, for example, that about 80 to 85% of people with heart disease itself would benefit from bad cholesterol lowering, LDL cholesterol lowering. Only half of those people are getting treated for lowering their bad cholesterol.

MARGARET WARNER: Why?

DR. JAMES CLEEMAN: And only 20% are reaching their goal level. I think it's because there hasn't been enough clarity about what needs to be done and because there's been a little concern about how high you can go with the doses of the drugs involved. But now with the new data and the new evidence telling us both how beneficial it is and how safe it is, I think we will see-- and well with our efforts to try to encourage implementation of the guidelines-- I think we will see them really take effect.

MARGARET WARNER: All right. Well, Dr. Cleeman, thanks for bringing some clarity to this for us. Thanks.

DR. JAMES CLEEMAN: Thank you.

JIM LEHRER: Still to come on the NewsHour tonight: AIDS in Africa, Part Two; and Berlusconi of Italy, Act Two.

SERIES - AIDS IN AFRICA

JIM LEHRER: Elizabeth Farnsworth has the second part of our AIDS in Africa series, this one from the nation of Botswana.

(Singing )

ELIZABETH FARNSWORTH: An early morning funeral in Francistown, Botswana, the first of many burials on this Sunday in April. This cemetery was opened in 1998 to provide graves for the growing number of victims of AIDS. About 36% of Botswana's adults are believed to have the virus that causes AIDS. But here in Francistown, the rate of infection is even higher - between 45 and 50% -- perhaps the highest rate of HIV infection in the world. We've come to Francistown to answer basic questions about Africa's AIDS epidemic. The mounds of earth in this cemetery cover the young, who died at an age when they should begin to really live. Why? What's being done about it? And what can the rest of the world do to help? Francistown lies in northern Botswana, at the intersection of highways heading in and out of Namibia, Zambia, Zimbabwe, and points north, where the AIDS virus is believed to have originated. The main highway into South Africa passes through here, too. Crossroads like this, where young, fairly prosperous and mobile people congregate, seem to provide fertile ground for the virus. President Festus Mogae has warned repeatedly that if the epidemic can't be stopped, the country's very existence is threatened.

PRESIDENT FESTUS MOGAE, Republic of Botswana: E face no less than extinction, because we are seriously affected as a nation, and it is the most productive age groups of the population-- productive in an economic and productive in a population sense-- that are most seriously affected.

ELIZABETH FARNSWORTH: AIDS has flourished in Botswana in the midst of relative prosperity. The per capita income is about $3,700 a year, while in most of sub-Saharan Africa, it averages closer to $300. The capital, Gaborone, is a vital, growing city. The countryside looks much as it has for centuries. Botswana is about the size of Texas, with more than three million cattle and only 1.6 million people. Dr. Banu Khan heads the National AIDS Coordinating Agency.

DR. BANU KHAN, National AIDS Coordinating Agency: We have a certain culture of having about four homes: A home where you work; a place where you work, a home where you come from; a place where you have your lands, where you farm; and a place where you keep your cattle. And we are much more developed in terms of the other African countries in terms of infrastructure, particularly good roads, and that I think does facilitate the spread, that people can travel so easily.

ELIZABETH FARNSWORTH: She said a low rate of marriage also plays a role. Only about 20% of people of an age to be married are. This may go back to the days when men regularly left Botswana to seek work in South Africa's mines. Diamonds were discovered in Botswana just after it won independence from Great Britain in the 1960s, and mines like this one at Jwenang are now among the most lucrative in the world. A succession of democratic governments poured diamond profits into development, and by the 1980's, Botswana had attained high rates of economic growth, literacy, and life expectancy-- until AIDS.

PRESIDENT FESTUS MOGAE: We had attained a life expectancy of 67 years for females and 65 for men. It is estimated that it is in the process of being reduced by at least 20 years to 40- something.

ELIZABETH FARNSWORTH: But the president, with help from the U.S. Centers for Disease Control, Harvard University, and others, is determined to reverse that trend. And Dr. Tom Kenyon, who represents the CDC here, is optimistic.

DR. TOM KENYON, U.S. Centers for Disease Control: We have years of prosperity, political stability, and a strong health infrastructure so things are possible here that may not be possible elsewhere.

ELIZABETH FARNSWORTH: Dr. Kenyon said the government's number one priority is prevention, and he is helping set up the widespread testing crucial for that. This woman allowed us to film her getting an HIV test but not to show her face. The location was a center set up at Gaborone last year. A new method of testing is used that produces almost immediate results. To protect anonymity, no names are used. Everyone is given a number. During the two days we visited, about one-third of the people tested positive. Each person is carefully counseled about the disease. This woman said her husband refused to use condoms, and she wept as she described how her children would suffer if she died. But, to her great relief, the results were negative. She joins the majority of people here who are negative. 36% of sexually active adults are HIV-Positive. For the population as a whole, the number is about 20%.

DR. TOM KENYON: We want to keep the 80% of the general population who's HIV-Negative, we want to keep them that way. The key is knowing your status.

ELIZABETH FARNSWORTH: To that end, rapid testing centers like this one are being set up around the country. Young health workers are also going out into the country to urge people to get tested under a program called "total community mobilization." The goal is to reach every household in Botswana. The man who was the main target of this visit had already been tested. He politely answered questions about whether he understands the dangers of AIDS, and then left to take his cattle to water. He told us he knows AIDS kills, and is using a condom when he has sex, but his friends aren't.

MAN: In most cases, when you talk about AIDS, they don't take it serious. Maybe they think it is just a joke. But I have learned that AIDS is death.

ELIZABETH FARNSWORTH: The government is also actively working to stop the transmission of the virus from mother to child, which happens in the uterus at birth or while nursing.

DR. TOM KENYON: Approximately 60,0000 deliveries occur each year. Of those, 40% of those women are HIV-Positive, so we have 24,000 HIV-Positive women delivering a baby each year. The risk of transmission from mother to baby is around 40%, so that gives us 9,600 babies who are born each year with HIV infection.

ELIZABETH FARNSWORTH: The main public hospital in Francistown has been providing an anti-transmission drug, Retrovir or AZT, as part of a pilot program for the past two years. Botswana got the drug cheaply with help from the manufacturer, Glaxo Smith Kline, and UNICEF. Loeto Mazhani is the doctor in charge of the national mother- to-child program.

ELIZABETH FARNSWORTH: So when is your plan to have it available to mothers through the whole country?

DR. LOETO MAZHANI, Nyangabwe Hospital: We are working on a target of December 2001, and so far, we've covered seven districts out of 24 health districts, so we still have a long way to go.

ELIZABETH FARNSWORTH: He said they also have a long way to go in getting women to agree to be tested.

ELIZABETH FARNSWORTH: Did you decide to get tested for HIV/AIDS?

WOMAN: No, I didn't.

ELIZABETH FARNSWORTH: Why not?

WOMAN: I don't want to frustrate myself.

ELIZABETH FARNSWORTH: You'd rather not know?

WOMAN: Yes.

ELIZABETH FARNSWORTH: Why?

WOMAN: If I know, I can kill myself, so I don't want to know.

ELIZABETH FARNSWORTH: So even though it's possible that by not knowing, you're transmitting it to the baby, you still don't want to know?

WOMAN: No, I don't want.

ELIZABETH FARNSWORTH: Nearly all the women in the pre-natal ward-- who asked us not to show their faces-- also refused to be tested. They said if a mother has HIV, a doctor will tell her not to breast-feed. Then families and neighbors will know she tested positive, an because HIV Is stigmatized here, she could be rejected. To deal with these concerns, the government announced late last month that it will give an anti-transmission drug toll women to want it at the time they give birth, whether or not they've been tested. This means some women who don't have the disease may end up taking the drug, but the consensus was that the risks are outweighed by the benefits. But these mothers raised still another concern. The drug is to save the baby, not the mother.

MOTHER: I'm asking myself why the mother is not protected. She's the one who is supposed to take care of that baby. What about if she dies?

PATRICIA BAKWINYA, AIDS Activist: It doesn't make much sense to save the baby and let the parents die.

ELIZABETH FARNSWORTH: Patricia Bakwinya runs a volunteer organization that works with children of AIDS victims.

PATRICIA BAKWINYA: We used to depend on extended families, but now the extended families are overextended themselves. Some of the people, the relatives who are left with the children, are dying themselves. And finally, the whole family gets wiped out. (Singing)

ELIZABETH FARNSWORTH: These are some of those children. They sing, "My mother died before I could know her. My mother died before I could even see her face." (Singing ) The kids are part of a program called Shining Stars, which Patricia Bakwinya and a group of volunteers have set up on the edge of Francistown with some help from the U.S. Embassy. Most of the kids are orphans. The rest are what Bakwinya calls "vulnerable children."

PATRICIA BAKWINYA: Some of the vulnerable children are those children whose parents have tested positive, but they're still alive, and they want their children to be prepared for come what may. Every day, we have people bringing children.

ELIZABETH FARNSWORTH: Can you handle them?

PATRICIA BAKWINYA: Yes, we can.

ELIZABETH FARNSWORTH: The kids don't live at Shining Stars, but they come during the day or after school to learn useful skills, like sewing and reading. Bakwinya has taught the children how to counsel each other in their grief, using music to say what can't be otherwise spoken. ( Singing ) They sing, "This Shining Star is crying to wake up the dead. She's trying to wake the dead." On the Shining Stars' soccer team, each child has a story. Tsepo Phale lost both parents last year, and he's caring for two younger brothers on his own. Keabetswe Guluzwa lost his father and two sisters. Now his mother may be dying. Their home is in the monarch neighborhood of Francistown, which has been particularly hard hit by the epidemic. Keabetswe's mother has never been tested for AIDS, and she's getting no treatment, but Patricia Bakwinya says she recognizes the symptoms of the disease. Keabetswe and his little sister count on shining stars for emotional support, and like many of the kids, they idolize Patricia Bakwinya.

PATRICIA BAKWINYA: A lot of them have come forward and asked me to be their mother.

ELIZABETH FARNSWORTH: What do you say?

PATRICIA BAKWINYA: If it is just to give them love, then I am there for them. But to offer them material things, like food and clothing, it is very difficult for me. ( Singing )

ELIZABETH FARNSWORTH: Bakwinya has five children of her own and no husband. She has tested negative for the HIV virus, and counts herself lucky. She's devotingher life to saving parents and preventing children from becoming orphans.

PATRICIA BAKWINYA: It is quite possible that we might all end up being positive in our country, and the whole nation will be wiped out. And it also very unfortunate, because it is such a peaceful country. We have never been to any wars.

ELIZABETH FARNSWORTH: It's tragic. Is the government doing enough, do you think?

PATRICIA BAKWINYA: The government is doing a lot.

ELIZABETH FARNSWORTH: To stop the dying, the government has now promised to provide anti-AIDS drugs to all who need them. But it will take time. And in that time there will be more graves here, more people for Patricia Bakwinya to mourn.

JIM LEHRER: Tomorrow night Elizabeth will look at the Botswana government's plan for getting anti-AIDS drugs to those who need them and at the international role in that effort.

FOCUS - WINNING ITALIAN-STYLE

JIM LEHRER: Finally tonight, a second act for the new leader of Italy and to Gwen Ifill.

GWEN IFILL: Italy's next prime minister, business tycoon Silvio Berlusconi, yesterday appeared on one of the television networks he owns to proclaim victory.

SILVIO BERLUSCONI (translated): You asked for a government that lasts a full five years and you did it with a clear indication of change.

GWEN IFILL: Berlusconi is a $13 billion man who has compared himself to Napoleon. But he has overcome criticism at home and abroad of his ties to right-wing groups and of allegations of corruption. On Sunday, his coalition defeated a center-left alliance led by Francesca Ritelli, a former mayor of Rome, to lead what will be Italy's 59th post- war government. The results came after a long election night; some polling stations staying open till 4:00 in the morning to accommodate long lines of voters. The colorful Berlusconi-- who some call "the cavalier"-is the richest man in Italy and the 14th richest in the world. His fortune includes three national television stations, a publishing company, which controls a third of the magazine and book markets, and a popular professional soccer team. Critics have said his business ties will inevitably conflict with his government responsibilities. During the campaign, Berlusconi ran on five promises: More jobs and public works, higher pensions, lower taxes and bureaucracy. He said he would accomplish all this in five years, or resign. In one television interview before the election, Italy's top capitalist also pledged a closer relationship with the U.S..

SILVIO BERLUSCONI (translated): I am called "the American." I'm blamed with having brought American culture into Italy and Europe, like with private TV stations. I opened the doors to American products. Therefore, from my point of view I want to have a cordial relationship with the U.S.A., to be in Europe the closest and best friend of America.

GWEN IFILL: The first reaction from official Washington was positive.

SPOKESMAN: We would first of all congratulate Mr. Berlusconi and his coalition on the apparent victory Sunday in the Italian parliamentary elections; we are confident that the United States will continue enjoy a cooperative and fruitful relationship with the next Italian government.

GWEN IFILL: But in parts of Europe, political and media leaders in France, Spain, Belgium and Great Britain worried that the center-right coalition might also promote anti-immigrant policies. Over the years, Berlusconi has also been charged with corruption, false accounting, tax fraud, bribing a judge, and other violations. Three convictions have been overturned, but others are still pending. Before the election, an editorial in the "Economist," a British magazine, declared Berlusconi unfit for the job, saying: "The known facts rule him out for high office. The election of Mr. Berlusconi as prime minister would mark a dark day for Italian democracy and the rule of law." Berlusconi's party will now control a sizeable majority in both houses of the Italian parliament.

GWEN IFILL: Joining us now for analysis of Italy's new prime minister are: Mario Calvo-Platero, us editor of the Milan Financial Daily Il Sole 24 Ore; Daniel Serwer, who was deputy chief of mission at the U.S. embassy in Rome from 1990-93, and before that its economics minister. He's now with the U.S. Institute of Peace; and, Alexander Stille, author and journalist...who writes frequently about Italy, the country where his father was born. He is the author of "Excellent Cadavers: The Mafia and the Death of the First Italian Republic".

GWEN IFILL: Mr. Serwer, "colorful" doesn't seem to quite capture Silvio Berlusconi. Tell us a little bit about him.

DANIEL SERWER: He's certainly the triumph of image and popular appeal over the traditions of Italian politics. Italy was once known as a partitocracy, a country run by parties. It wasn't run by colorful personalities like this. This election seems to have ended that and created really something quite new for the Italians and Americans are quite familiar with this kind of politics.

GWEN IFILL: Mr. Stille, what's your take on Silvio Berlusconi?

ALEXANDER STILLE: Well I think he's an extremely telegenic and charismatic figure. I think the problem is not really with his programs, which are fairly standard conservative programs of cutting taxes and limiting government; the problem is represented, I think, by the exceptional situation of a man who owns the three largest private television networks and will now control the three large public networks which gives him effectively control over 90% of the television audience. The other problems are posed by some of the things you mentioned in your film segment, which are the fact that he is the criminal defendant in a number of rather important investigations, which are very serious and should be allowed to proceed without interference, and it's very difficult to understand how someone can both be a criminal defendant and rewrite the Italian penal code, how they can help Italy become a modern economy and own significant portions of the private economy.

GWEN IFILL: Mr. Platero, you were home in Italy for the election. Give us a sense of how he is viewed by people who cast votes in this election, how someone with all of these issues that we've just had outlined, how he came to win.

MARIO CALVO-PLATERO: Well, as you can imagine all of his issues have been part for months of the political debate in Italy. For years, probably, Mr. Berlusconi was a prime minister and then lost his coalition and basically had to leave his position, so Italy has been very familiar for quite a while with his problems and potential conflict of interest, so these are facts and issues that are being discovered now presumably by the large international public because he's been elected. But the mood in Italy at this point is to look beyond this. Even the opposition party leaders have declared that the elections have been perfectly legitimate and the people are those that go to vote and not newspapers like the economists that may be less familiar with some of the issues than the Italian people. So the Italian people are now looking forward and hoping that he will do what is promised and keep his word.

GWEN IFILL: Were the elections as raucous and chaotic as they seemed to be from us looking at this distance.

MARIO CALVO-PLATERO: I'm afraid they were. I'm afraid they were. There were huge lines. That was one of the consequences of trying to cut expenses, so they decided to cut from 60,000 polls to 30,000 so that created huge lines. And the polls were supposed to be closed at 10:00. I think in the Southern Italy, the last voter exited the poll at 5:00 AM, but everybody got a chance to vote in the end even if it was rather strange and tiring.

GWEN IFILL: Mr. Serwer, as we just saw, Silvio Berlusconi made a lot of promises, a lot of very optimistic promises. What is the likelihood that he can begin to even keep them?

DANIEL SERWER: I think it's going to be difficult. Italy has tight budgetary situation. He's promised to increase expenditure and cut taxes. That's also a message that might be familiar to us. But Italy has a lot less flexibility also because it has to stay within Europe and within the rules of the new European currency, the euro. I think really the flexibility is quite limited, and he's going to have a rough time delivering everything.

GWEN IFILL: How different is this Belusconi going to be from the 1994 when he was in office for seven months and then gone?

DANIEL SERWER: Well, it looks like he's in office in a much more solid way this time. His coalition is together in a way that it wasn't previously. And he doesn't apparently depend on the votes from Umberto Bossi, the Italian political leader who withdrew his support and caused the last Berlusconi government to fall. I think we're about to see probably the strongest Italian political leader in a long time, maybe since Mussolini.

GWEN IFILL: Mr. Stille, what's your reaction to that? Do you think he has the potential to be a very strong political leader in Italy?

ALEXANDER STILLE: Yes, I think so. I think as Daniel mentioned, he enters power this time with a much stronger majority and clearly with the validation of the Italian public. I think that doesn't entirely do away with the problems that he's likely to encounter in the day-to-day governing when through the problem of conflict of interest. It's almost impossible for Berlusconi to take any measure without, in some way, either benefiting or damaging his own private interests.

GWEN IFILL: Because he owns the television stations, the newspaper.

ALEXANDER STILLE: But also financial companies and so forth. The previous government, for example, took... made a law that limited discounting of books to 15% below the cover price. If that had been done by Berlusconi's government, immediately there would have been accusations of self-dealing. Many people have discussed the need to privatize part of the state TV empire. That would be very difficult for Berlusconi as the owner of the three private stations to oversee that process.

GWEN IFILL: What should he do to overcome the potential for conflict of interest?

ALEXANDER STILLE: I think the example actually was set by the Bush administration. Everyone in the Bush administration from the President and the Vice President on down sold all of their private interests and all of their stock and stock options on coming in to power. I think the norm there was that serving in government is a great privilege and that there should be no suspicion that your public actions are in some way benefiting your private interest. I think that should be... anything short of total divestment of all of his holdings would leave him open to the problem of conflict of interest. And this, I think, should be the standard as opposed to a kind of fake divestment of the kind that Berlusconi has engaged in in the past. He was, for example, obliged by a previous antitrust law to sell the daily newspaper based in Milan. He, quote unquote, sold it to his brother and it remains essentially a Berlusconi newspaper and he's vehemently in favor of Berlusconi and his party.

GWEN IFILL: Mr. Platero, what about Mr. Berlusconi's politics? There have been so many questions raised about, for instance his first congratulatory phone call came from York Heider from Austria who was condemned by the European Union for his right wing views. And he has other internal domestic political ties of the same sort. Do you think that that's something that would dog him?

MARIO CALVO-PLATERO: In a way, yes. But for different reasons. The problem is that some of the smaller parties in his coalition are old-style right- wing parties. And we have many of those in Europe; have them in France. We have them in Germany that are very much in favor of statism, of state ownership. So they will resist some of the measures that Mr. Berlusconi would like to bring forward. But the fact that he has got quite a strong majority will probably give him much more of a hand than he had in the past. And some of those parties also have evolved. So the policies will be tried. We have to see and watch whether he's going to be able to succeed. He's always said that being as rich as he is, his only objective is to try to make Italy better. So, you know, we have to see now if he's going to do it for sure.

GWEN IFILL: Mr. Serwer, what about these outstanding corruption charges, which are still pending still have not been resolved?

DANIEL SERWER: Well, I think that could cause him serious problems if some of them are resolved in a way that makes him guilty in the final court of appeals, which is the way the Italian system works. You're not guilty until the last court has decided. But, look, this is certainly a threat to decency but it's not a democracy. Italy has strong democratic institutions -- even this problem that Alexander refers to of his ownership of a vast business empire, I agree, there is no avoiding conflict of interest as long as he owns that. But that can be dealt with through the Italian institutions well, it seems me. Something interesting has happened within Italy, but I don't think the United States or even other Europeans should be terribly concerned about it.

GWEN IFILL: Mr. Stille, from the U.S. point of view we look at this election and we think 58 different changes of government since World War II. Why does it happen that way in Italy?

ALEXANDER STILLE: Well, I think first of all that figure can be a little misleading because there actually is an election every five years to elect a new parliament. Many of these governments are governments that are patched together that are essentially similar to the ones that precede them. I suspect the center left government that ruled for the last five years had two or even three different governments but it was basically the same team in place. I expect that you'll see that here too. But it's true that there's an enormous amount of instability as a result of the Italian constitution that was put into place after World War II. There was great fear of the return of fascism and fear of the strong man who would dominate the political scene. So they put into place a proportional electoral system, which led to a large number of parties and a lot of fragile coalitions that would quickly fall apart. Peoplehave been working to try to... There was a reform of this in 1993, and the current electoral system that was just used seems to be producing a slightly more stable kind of majority than we've seen. There are still proposals out there to reform it further, but at the moment I think... And Berlusconi himself and his principal partner of the national alliance have proposals out there to promote a kind of presidential system giving more power to the executive.

GWEN IFILL: Mr. Platero, what do you think will be the outcome of this instability on this new prime minister?

MARIO CALVO-PLATERO: Well, I think that he, you know, I think that we should think in terms of what Italy is. I mean one should not forget that Italy is the fifth largest industrial country in the world that has quite a solid system, that there is a president o republic, who was elected two years ago by the parliament who is a very solid person and a great guarantor. He will certainly provide the underlying stability that is needed both to protect Mr. Berlusconi from political attacks that could be related from his conflict of interest and the opposition or the Italian people from Mr. Berlusconi taking advantage of his position. So we have a bit of a guarantee over there. Go ahead.

GWEN IFILL: I was just going to say thank you very much. We're out of time. Thank you for joining us.

RECAP

JIM LEHRER: Again, the major stories of this Tuesday: The Federal Reserve cut a key interest rate again. It lowered the Federal Fund's rate half a point to 4%. House Democrats announced their alternative to President Bush's energy plan. They said it would increase production and reduce demand, and California's Public Utilities Commission voted late today to raise electricity rates by 36 to 50% for business and industry homeowners' rates would rise nearly 55% for all power used over a baseline amount. We'll see you online and again we'll see you online and again here tomorrow evening. I'm Jim Lehrer. Thank you and good night.