The NewsHour with Jim Lehrer

TJIM LEHRER: Good evening. I'm Jim Lehrer. On the NewsHour tonight the cloning story with an update and four different perspectives; a report on the impact of new drugs in the fight against AIDS; a debate about how African-Americans should view Africa; and an Anne Taylor Fleming essay about the Wild West. It all follows our summary of the news this Wednesday. NEWS SUMMARY

JIM LEHRER: The scientists who cloned a sheep said today they plan to clone a cow next. Researchers at Scotland's Roslin Institute said also they plan to create a genetically manipulated animal clone that contains human genes. Both projects are expected to be completed by the end of the year. A congressional hearing on the ethics of such experiments was held today in Washington. Dr. Harold Varmus, head of the National Institutes of Health, said making human clones for scientific purposes was offensive. The director of the Oregon Primate Research Center defended the idea of cloning animals in order to preserve endangered species. We'll have more on this story right after the News Summary. Also in Washington today FBI Director Louis Freeh defended the Bureau's crime lab. Freeh was questioned at a House hearing about complaints by a former crime lab scientist. He alleged his fellow technicians were careless in their handling of evidence in important criminal cases.

LOUIS FREEH, FBI Director: I do not believe that any FBI investigations or state investigations where we've done forensic work have been compromised by the report, as I know it. Now, a federal judge or a state judge could disagree with that, and we certainly want to get all the information to the defense counsel involved so they can make their motions. But my current belief is that no major investigations have been compromised.

JIM LEHRER: Vice President Gore mis-spoke Monday when he said he used a Democratic Party credit card to solicit campaign contributions. An aide said today Gore used a card issued by the Clinton-Gore Re-election Campaign to pay for the calls made from his White House office. The general counsel of the campaigns said it would seek reimbursement from the Democratic National Committee for those calls. President Clinton said today he had no reason to believe the Chinese government sought to influence the 1996 campaign with illegal donations. But he said he wanted to get to the bottom of such charges. The Justice Department is currently investigating the matter. The President spoke to reporters during a gun control ceremony in the Oval Office. At that event the President signed an executive order directing federal law enforcement agencies to install child safety locks on every firearm they issue. He also took steps designed to keep weapons from foreign visitors.

PRESIDENT CLINTON: Today I'm announcing that the Bureau of Alcohol, Tobacco, & Firearms will immediately require applicants to certify that they have been residents for at least 90 days in the state where they are trying to buy a gun. But this is not enough. I call on Congress to pass a bill sponsored by Senators Kennedy and Durbin and Congressman Schuman that will prohibit all foreign visitors from buying or carrying guns in the United States.

JIM LEHRER: Mr. Clinton said the action was needed after a Palestinian man killed one person and injured six in a shooting at the Empire State Building in New York last month. In addition, the President once again urged Congress to outlaw so-called "cop killer" bullets that can pierce body armor. Floods in the Midwest claimed four more lives today, bringing the death toll to 55 since the tornados and storms began last weekend. The worst flooding was along the Ohio River, where powerful thunderstorms dumped more rain, triggering flash floods. The river crested in Huntington, West Virginia, at its highest level since 1955. President Clinton declared 16 counties disaster areas in Ohio and 9 counties in Kentucky. Vice President Gore toured the region and spoke to reporters in Cincinnati.

VICE PRESIDENT GORE: The entire United States of America will come together to help Cincinnati and the surrounding areas on both sides of the river to recover from this flood; help families make their lives whole wherever that is possible; help businesses get back to where they're functioning and can open their doors, and ring their cash registers; to help communities rebuild their infrastructure, and put their lives back in order.

JIM LEHRER: The bad weather forced the Vice President to counsel portions of his tour of flooded areas in West Virginia and Kentucky. There was an important meeting about Korea today in New York City. For the first time in 25 years representatives of North and South Korea and the United States sat down together to talk peace. A state of war technically still exists between the North and South 44 years after the end of the fighting during the Korean War. The U.S. and South Korea have proposed a series of peace talks that would also include China. A spokesman described today's session as pleasant. Overseas in Albania today government jet fighters attacked a town near the Adriatic port city of Sarande. Citizen protesters commandeered an army tank and fired assault rifles at the jet. Albania's president declared a state of emergency earlier this week after an army arsenal was raided in the South. While traveling in Germany today U.S. Defense Secretary Cohen said it was not yet necessary to evacuate the 1600 American citizens living in Albania. Cohen said Navy ships were standing by in the Adriatic in case of an emergency. And that's it for the News Summary tonight. Now it's on to more on the cloning story, an AIDS update, Africa and African-Americans, and an Anne Taylor Fleming essay. FOCUS - DOUBLE TROUBLE

JIM LEHRER: The cloning story continues and so does our coverage as our lead story tonight. And for it, we go to Margaret Warner.

MARGARET WARNER: Scottish scientists touched off fascination and furor last week when they told the world about Dolly. The seven- month-old sheep is a scientific breakthrough, the first reported genetic copy of another adult animal. She's the result of 23 years of work by Dr. Ian Wilmut of the Roslin Institute just outside Edinburgh. This was the science behind Dolly's creation. Dr. Wilmut and his colleagues removed cells from the udders of female sheep, put them in test tubes, and made them inactive or dormant. Then they removed DNA, or genetic material, from the unfertilized eggs of other female sheep. They inserted the DNA from the udder cells into the eggs and then exposed them to an electric current, fusing them together into one cell that could develop into an embryo. The resulting embryos were then implanted into 13 surrogate mother sheep. Only one became pregnant. She delivered Dolly. Then last weekend a group of Oregon scientists announced they had cloned two Rhesus monkeys, not from adult animal cells, as Dolly had been, but from fertilized embryos. It was the first successful cloning of embryos from primates, animals closely related to humans. Both the Oregon and the Scottish scientists said they had no intention of expanding their research to attempt to clone humans, but their announcements touched off a major debate on the prospects and ethics of that possibility anyway. The cloning developments have also captured the imagination of popular culture, from magazine headline writers to cartoonists. Comedians David Letterman and John Stewart had fun with the subject as well.

DAVID LETTERMAN: What do you think of these people cloning the monkeys?

JOHN STEWART: Cloning the monkeys?

DAVID LETTERMAN: Yeah. Cloning sheep and monkeys.

JOHN STEWART: I hope they clone good monkeys, the kind like the one on "Friends," not the bad monkeys like in "Outbreak." [laughter among audience] I want them to clone monkeys that can juggle and don't mind wearing people's clothes. Do you think Michael Jackson saw that and went, "I should have waited. I should have waited."? [laughter among audience]

MARGARET WARNER: Debate on the serious issues involved came to Washington this week. Yesterday, President Clinton imposed a ban on using federal funds for human cloning experiments, warning scientists against, as he put it, trying to play God. He also urged a voluntary moratorium on privately funded human cloning experiments.

PRESIDENT CLINTON: This new discovery raises the troubling prospect that it might someday be possible to clone human beings from our own genetic material. There is much about cloning that we still do not know, but this much we do know. Any discovery that touches upon human creation is not simply a matter of scientific inquiry. It is a matter of morality and spirituality, as well. My own view is that human cloning would have to raise deep concerns, given our most cherished concepts of faith and humanity. Each human life is unique, born of a miracle that reaches beyond laboratory science. I believe we must respect this profound gift and resist the temptation to replicate ourselves. At the very least, however, we should all agree that we need a better understanding of the scope and implications of this most recent breakthrough.

MARGARET WARNER: On Capitol Hill today the House Science and Technology Subcommittee convened the first congressional hearing on the subject.

REP. JAMES SENSENBRENNER, [R] Wisconsin: The standing-room-only crowd in this room is testimony to the fact that this is something that is really tops on the agenda not only of the science community but the public at large. In the area of cloning embryos it is obvious that science is ahead of both the law and morals and ethics.

MARGARET WARNER: Dr. Harold Varmus, director of the National Institutes of Health, was the first panelist to speak.

DR. HAROLD VARMUS, National Institutes of Health: To make human clones for scientific purposes to me is an offensive idea, one that is not scientifically necessary. After all, we already have spontaneously occurring identical twins reared apart, reared together. We have animals in whom the questions of interest can be answered. We have cultured cells in which many of the experiments of interest can be carried out.

MARGARET WARNER: Three bills have been introduced to limit or ban research into cloning humans. President Clinton has asked the National Bioethics Advisory Commission to review the legal and ethical issues involved and report to him in three months.

MARGARET WARNER: Now, to further explore the scientific and bioethical issues involved we have four guests, three of whom testified today. Thomas Murray is an ethicist who teaches at Case Western Reserve University's School of Medicine. He heads the genetic subcommittee of the Bioethics Advisory Commission that will be reporting to the President. Dr. Harold Varmus is director of the National Institutes of Health. NIH is a major biomedical research center and also dispenses the bulk of federal research funds to American scientists everywhere. And James Geraghty is president and CEO of Genzyme Transgenics, a biotechnology firm in Massachusetts that uses genetic engineering technology to produce drugs and other human therapies. They are joined by Bonnie Steinbock, a philosophy and bioethics professor at the State University of New York at Albany. Thank you all for being with us. Dr. Varmus, did the President do the right thing, the necessary thing, in putting a ban on federal funds and asking for a moratorium on human cloning?

DR. HAROLD VARMUS, National Institutes of Health: Yes, I believe he did. Now, it is the case that NIH is forbidden by the mechanisms from supporting such research.

MARGARET WARNER: Anyway?

DR. HAROLD VARMUS: Yes. But the President did a very good thing in reassuring the public that no human cloning was going on at the moment, allowing the public to debate this issue openly, allowing the commission on which Dr. Murray serves to consider the issues that have been raised, and allowing us to proceed through a period of public debate without a need to rush to legislation, a legislation which could harm the scientific enterprise.

MARGARET WARNER: Bonnie Steinbock, how do you feel about--what's your opinion of the President's decision?

BONNIE STEINBOCK, State University of New York: Well, I think that probably it was a good thing to do politically because I think obviously people are getting upset and seem to need reassurance, and I think it's always a good idea when we have scientific new things happening and breakthroughs to have a commission as well qualified and intelligent as the NBAC is to consider very carefully these issues. But I think there's also a tendency of people to react in a kind of knee-jerk way to assume that anything new is going to be scary and going to be bad, and to not look as carefully as they might on the positive things. I don't think that it's intuitively offensive to consider any of these things. I do think it's offensive to let people die of diseases when they could have been cured.

MARGARET WARNER: Jim Geraghty, how about you, how do you feel about the President's decision?

JAMES GERAGHTY, Genzyme Transgenics: I welcome, and I think the whole biotechnology industry welcomes it as a reasonable and measured response. Our hope actually is that we can use this event and the way it has captured the popular imagination as an opportunity to engage a broader segment of society in the dialogue about the benefits of this kind of medical research and the acceptable limits of such research. And I think the commission's review provides an excellent opportunity to do that.

MARGARET WARNER: Tom Murray, this was designed in good part to give your commission time to consider this. Do you think it was a necessary step?

THOMAS MURRAY, Case Western University: I don't know if it was necessary or not. I think it was a reasonable response to a lot of fears that I've certainly become familiar with in the past week and a half. We also should mention that it included a call on private scientists, scientists without federal funding to observe a voluntary moratorium on any research in human cloning. I think that was a valuable addition.

MARGARET WARNER: All right. Before we get more into this discussion, let's try to explain a couple of terms here. First of all, Jim Geraghty, to help us understand, how close is science now to human cloning, and which brought us closer, Dolly, the sheep, or the Rhesus monkeys? JAMES GERAGHTY: I don't think as a matter of reality science is very close to it at all. As a matter of technical feasibility, it's hard to tell whether it's feasible or not. I think, more importantly, as a matter of social responsibility and the realities of why people are engaged in this kind of work today. No one engaged in this work seriously has any consideration of doing that kind of work at this time.

MARGARET WARNER: All right. But scientifically, how close, Dr. Varmus, do you think we are?

DR. HAROLD VARMUS: Well, these experiments have to make all of us acknowledge that the cloning of a human being is a possibility. I would agree with Dr. Geraghty that there is no one I have heard of who inside or outside the federally funded domain of science who would entertain doing such work, but the experiments carried out by Dr. Wilmut over many years, other scientists, the scientists in Oregon, indicate that it is conceivable.

MARGARET WARNER: Explain one other term for us. What exactly is a clone, a cloned animal, let's say?

DR. HAROLD VARMUS: Yeah. I think that's an important distinction because a clone can be just a series of cells derived from a single cell. A cancer is a clone of cells. We are all clones of our original fertilized egg from which we arose. What's being described here is an experiment that was actually undertaken in a--undertaken many times over the last 60 years--to answer a fundamental question about the potential of our cell nucleus. The nucleus is the part of the cell that contains our chromosomes and our genes. And our embryologists, developmental biologists, have worried for many, many years whether every cell in our body contains the potential to make a new individual. This is more than an idle speculation because in the process of making many different kinds of cells we have, cells of our lips and of our--and of our liver and of our hearts. Cells have undergone traumatic changes in the way in which they turn on, read out the different opponents of our genetic collection which numbers about 80,000 genes. So the fundamental question is can we--can a cell unlearn what it learned and start over again? And the answer is it can.

MARGARET WARNER: And a clone, put simply, is an identical twin genetically?

DR. HAROLD VARMUS: That's correct. In fact, an identical twin, as we experience it in life--

MARGARET WARNER: In real life.

DR. HAROLD VARMUS: --is actually more identical than--than Dolly is to her parent.

MARGARET WARNER: All right. Tom Murray, I'm sure all of you being involved in this field in the last week you've heard--people have asked you a lot of questions. What are the most common misconceptions out there about what a clone is and what a human clone possibly could be?

THOMAS MURRAY: Well, probably the two most prevalent are that if I were to clone myself I would, the clone would be a 50-year-old copy of me. In fact, it would be an embryo, and I would also be 50 plus years old--older than it.

MARGARET WARNER: Older.

THOMAS MURRAY: The second one is--and I think this is a very important misconception--is a belief that it would somehow be just like me in all respects.

MARGARET WARNER: You mean, when it grew up.

THOMAS MURRAY: When it grew up. When I was talking with someone last week, they asked me if it would be possible, and they were willing to have a ban in human cloning as long as we could make an exception for Mel Gibson. And I said, well, the good news is the clone would probably look like Mel Gibson; the bad news is that probably--it wouldn't be Mel Gibson. It certainly wouldn't.

MARGARET WARNER: And why not?

THOMAS MURRAY: Because we're not just the product of our genetic ground plan. We are the product of the lifetime of experiences we've had. And this person would not have Mel Gibson's parents, Mel Gibson's childhood, wouldn't fall in love with the people Mel Gibson has fallen in love with. It wouldn't make the mistakes he's made. It would be a different person.

MARGARET WARNER: Bonnie Steinbock, what kind of misconceptions do you think are out there?

BONNIE STEINBOCK: Well, I think that people have a kind of a boys from Brazil view of cloning; that there's something very scary, that you would get these robotic-like creatures who could be easily brainwashed and take over the world. And, of course, that's all nonsense. There's no more reason why a clone could be easily brainwashed than an identical twin. So I think all the thing that Tom is saying is exactly right. I also think it's important to realize that it's just asexual--I don't know if reproduction is the right word or replication--as opposed to sexual reproduction. It's not, I think, in itself necessarily a scary thing. But every time we have something new, whether it's artificial insemination or in vitro fertilization, when a sperm and egg cell are joined together in a petri dish, always people are frightened of. We now have people who have pig valves in them. But when that was first done, the idea that you can put an animal part in a human being was regarded as just absolutely terrifying. So I think part of the thing we have to realize is that whatever new is scary, and that doesn't necessarily mean that it's morally wrong.

MARGARET WARNER: All right. But, Jim Geraghty, then let's turn to the practical effect of say this moratorium that the President's asked everyone to observe, where do you draw the line, as Bonnie Steinbock seemed to be suggesting, between say genetic engineering that your firm does and human cloning, which is--the President's asked no one to do?

JAMES GERAGHTY: I think there is actually a very clear line. I think what we hope people will realize during this moratorium and during the discussion we hope it will generate are the things that really are being done today, not the kinds of fantasies and fictions that were just talked about, but the fact that genetic engineering is being used to develop cures for diseases that can't be cured any other way, and that even things like transgenic animals and the application of this technology in--

MARGARET WARNER: Explain what transgenic animals are. JAMES GERAGHTY: Sure. In fact, it was related to the story that led the NewsHour this evening about these cows now that are being developed to contain a human gene. Well, that can sound very scary. These are animals that contain human genes somehow. In fact, they're going to contain one human gene that's going to cause them in their milk to produce one human protein that hopefully will be a successful therapy for, for example, cystic fibrosis, a product which may not be able to be made any other way. And that's the research that we hope will be supported, and then people will understand the value of.

MARGARET WARNER: Do you have any concern that in the controversy over and all the misconceptions we talked about that your ability to do that kind of research or development is going to be constricted at all?

JAMES GERAGHTY: That could be a concern, and that is one of the reasons we welcome this opportunity today. The congressional hearing, I felt, was a very reasoned, thoughtful response. My sense is that as people learn more about this and actually talk as we're talking here today about the scientific and ethical issues in more depth, we will help avoid that problem and help allow positive, valuable science to go forward, while things are not ethically and socially accepted today are held off.

MARGARET WARNER: Tom Murray, back to this where do you draw the line, Bonnie Steinbock seemed to be suggesting that, you know, it's just another kind of reproductive technology advance potentially. Where--do you see any problem drawing the line between what is cloning humans and all these other advances that now people use, such as in vitro fertilization?

THOMAS MURRAY: That's an important question. I think there are a variety of kinds of arguments, both philosophical, ethical arguments, and also religious arguments that the commission wants to hear. We have hearings scheduled at the end of next week, the full Bioethics Commission. And we've invited a wide scope of religious leaders to come in and speak with us. We are inviting some people who are very skeptical about human cloning and other people who, like Bonnie, say, well, let's at least hear the best arguments; we're going to have a pro-con conversation take place with the commission. So, I mean, I think we should--we shouldn't immediately and with a completely closed mind say this is impossible, but I have exactly the same response of initial repugnance that many people have. I would also encourage us to think about this--the issue of human cloning in terms of its impact on how we view good relations between parents and children, what's the meaning of worth of the child, what's the meaning of parenthood. I think it goes to questions like that which are not easy to say, state philosophically, but I think they're very fundamental and important questions.

MARGARET WARNER: Dr. Varmus, where--our Online NewsHour has been conducting a forum about cloning, and we're getting hundreds of questions. And one I'd like a couple of you to address that so many people ask is: What happens to genetic diversity with cloning; that is, isn't the strength, you know, the evolutionary strength of any species the fact that we're constantly mixing genes, and are clones potentially more susceptible to disease and so on?

DR. HAROLD VARMUS: Yes, of course, they are, and I think this is a question that's been particularly pertinent in the animal husbandryarea or the plant husbandry area, where one has to--if one amplifies a good meat-producing strain of cattle, one has to also be aware that you may be depending very heavily on one genetically identical line of animals that is susceptible to one agent. In the case of humans it seems to me that even if we were to identify as a result of deliberations of the commission some very rare circumstances under which cloning was considered acceptable, that we would never be doing on any mass scale the--

MARGARET WARNER: So in the human it's not an issue but it might be on animals.

DR. HAROLD VARMUS: That's right.

MARGARET WARNER: Bonnie Steinbock, this might be an unfair question to ask you, but I'll ask you anyway. Do you think all scientists in America will conform to this moratorium if it were to go on for a long time?

BONNIE STEINBOCK: I really don't know the answer to that question but I assume that they would probably go along with what was considered acceptable because there would be a great deal of bad publicity if there wasn't. And I think the important ethical issues have to do with the problems of getting results that you don't expect, unintended side effects. And I'm sure that's one of the major reasons for going very slow and being very careful.

MARGARET WARNER: Tom Murray, you wanted to get back in on that.

THOMAS MURRAY: We have at least I think one good example of a voluntary moratorium of a kind that seems to have been universally observed, and that is on what's called germ line gene therapy; that is, going in and trying to change the genes of a human sperm or egg or embryo. So far as I know, no one has tried to do that, and no one is going to try to do that.

DR. HAROLD VARMUS: It's very important that there was no legislation on that issue. There was a scientific debate and a decision.

MARGARET WARNER: On this issue.

DR. HAROLD VARMUS: On the issue of germ line gene therapy, and we all recognize that there is enormous potential for using our ability to manipulate genes in the form of DNA to deliver it to patients with cystic fibrosis or other diseases, and the ethical boundaries that have been established forbidding by regulation, not by law, the use of germ line therapy has been very useful.

MARGARET WARNER: All right. Well, thank you all very much. I know we'll be coming back to this topic.

JIM LEHRER: Still to come on the NewsHour tonight an AIDS update, Africa and African-Americans, and an Anne Taylor Fleming essay. UPDATE - WAR ON AIDS

JIM LEHRER: Now an update on the war on AIDS and the impact of the latest drugs developed to fight the disease. Spencer Michels reports.

SPENCER MICHELS: Like thousands of people with AIDS, 52-year-old Krandall Krause of San Francisco goes through the ritual of taking 20 pills several times a day on a rigid schedule.

KRANDALL KRAUSE: That's the only way I can do it. If I take them one at a time, I'd be here until Tuesday.

SPENCER MICHELS: Krause, who is a writer, takes a combination of medicines that includes a protease inhibitor, a new class of drugs that foil the ability of the AIDS virus, HIV, to reproduce itself. Before those drugs became available Krause and others were convinced that all they had to live for was the present.

KRANDALL KRAUSE: I thought, well, my life is coming to an end. So most of us didn't deny ourselves anything. We went on trips. We bought things. We bought new televisions. We bought a new car. We'd help our friends.

SPENCER MICHELS: Krause's health improved dramatically, but with a new lease on life, thanks to protease inhibitors, he has had to adjust.

KRANDALL KRAUSE: All of a sudden you have to put on the brakes. It's very different. You have to start thinking--you have to start budgeting your money. You have to start finding things that you're interested in doing. I'm active enough so that I can sit at the computer for a couple of hours at a stretch and the time that I've started taking the protease I've finished a novel, I've finished a play, and I've started two new books.

SPENCER MICHELS: Many HIV positive patients are now coping with the reprieve of what only recently seemed like a death sentence. Just two years ago 19 patients in Dr. David Senachek's practice of 600 people with AIDs died; last year, only four. But patients like Marcus Wonacott and Andy Pesce aren't sure how to handle the extra time that's been handed them.

MARCUS WONACOTT: All of a sudden, bam, I've been plunged into the whole idea of I'm not going to die tomorrow, next week, or next year. Most likely, I'm going to have a fairly long life again. That is a wonderful, exciting thing to have, but it creates the whole dilemma of now, what am I going to do with my life?

ANDY PESCE: We were preparing for the end. And it's going to take some time for us to reintegrate ourselves into mainstream life. We have three options essentially: stay on disability, go back to the employer where you were before to continue your previous benefits, or jump off a cliff and look for a different job with no benefits and the possibility of getting very ill again, because without these medicines, there's no illusion here, we're completely dependent upon the protease inhibitors and the other medicines we take.

SPENCER MICHELS: There are other complications. For one, there hasn't been time for long-term studies of the new drugs.

KRANDALL KRAUSE: Everybody thinks that because of protease inhibitors we should be happy, and initially you are. And then you realize you're out in no-man's land again. You're taking a drug. You're feeling good. And any day, it could end.

SPOKESMAN: Nofinivir, Thyrimmune, Thydex, and Xered all are four specifically for HIV.

SPENCER MICHELS: Doctors do know that if a very strict regime of pill taking is not followed, the virus can develop resistance and the pills won't work. 42-year-old Bill Sprick, a computer expert, complies to the letter, but so far, the protease inhibitors have not worked for him consistently. In fact, about 30 percent of people with AIDS have not been helped by the new drugs, especially if they have taken a long series of other AIDS medicines. Sprick hasn't given up. He's now on an experimental protease inhibitor.

BILL SPRICK: It's a roller coaster. You feel really great when it looks good, but then when the numbers come crashing down, you get pretty depressed. It's like, oh, no, here we go again, this is another one that doesn't work. And I think the thing that right now is worrying me the most is I've taken all the drugs that are presently available that are released, plus I'm taking one that isn't released, and it's kind of a time game.

SPENCER MICHELS: Unlike Sprick, 32-year-old Danny Cohen, a radiation therapist, essentially gave up on protease inhibitors because they made him feel worse.

DANNY COHEN: I was exhausted all the time and nauseous. Basically, my entire quality of life was gone. I was on vacation in Amsterdam, and I just decided not to take 'em anymore, and three days after I stopped, I felt great.

SPENCER MICHELS: Cohen says it's easier just to accept the notion that he will die.

DANNY COHEN: I'm certainly not interestedin having a prolonged period of suffering, or a prolonged period where I feel so bad about myself because of my health status that I don't want to be out in the world, or something like that. So I don't think of death as really that bad of a thing.

DR. MARCUS CONANT, AIDS Specialist: I know what happens if you don't take the medication. Those patients die.

SPENCER MICHELS: Dr. Marcus Conant, a pioneer in the treatment of AIDS, hates for anyone to give up on protease inhibitors. He thinks the new drugs may be the way to stop the spread of HIV, which now infects 1 million people in the United States.

DR. MARCUS CONANT: We perhaps can stop the transmission of this disease and ultimately eliminate AIDS in the United States. Now, that's not going to work in China, in India, in Africa.

SPENCER MICHELS: Protease inhibitors have yet to have an impact on the millions of infected people outside North America and Europe. That's because of their high cost, up to $25,000 a year. In the United States, the tab is often covered by insurance companies, at least most of it.

AIDS PATIENT: Right now for me it comes out to about $800/$900 a month in co-pay.

SPENCER MICHELS: Co-payments.

AIDS PATIENT: So, I tell you, this stuff is doing what it's supposed to do, so we really have no choice about it.

SPENCER MICHELS: For those without insurance but not on Medicaid state and federal assistance programs pay for the drugs. But even in the U.S. there are road blocks. Some states, unlike California and New York, have not allocated enough money to get the drugs to all those who are HIV positive. And some people, like the illegal drug users living in San Francisco's Tenderloin district, are not regarded as good candidates for the medication.

DR. MARCUS CONANT: Where are the diseases going to go, is in the under-served, drug-using community which is huge in this country, who do not have either the resources or the skills to utilize these new tools.

SPENCER MICHELS: Mesha Irizarry works in the Tenderloin for a social service agency.

MESHA IRIZARRY, Shanti Project: A lot of our clients are active users and have no intention to stop drugs.

SPENCER MICHELS: Do you try to get these people on protease inhibitors, or other drugs?

MESHA IRIZARRY: We inform them. It's tricky because we don't have the--

SPENCER MICHELS: Irizarry says the need to take the new drugs regularly makes this clientele difficult to manage.

MESHA IRIZARRY: There is obscene poverty, lack of hygiene. Protease inhibitors require that people take them faithfully four times a day. If there is any speed or crack involved, of course, they're not able to maintain a schedule. If they get off the schedule, they develop a resistance to the drug, therefore, they're no longer a candidate, and they will surely die.

SPENCER MICHELS: Nearly 3/4 of the residents of the rundown Ambassador Hotel, where Irizarry often sees clients, have AIDS, mostly contracted through illegal drug use. For these people there have been no new leases on life, no worries about how to handle the reprieve. In fact, protease inhibitors play no role in the lives of people like 41-year-old Robert Brightshue.

SPENCER MICHELS: They say this can save your life.

ROBERT BRIGHTSHUE: I know, I know, I know. When I start getting down, I'm going to get on it, but they say once you get on it, you got to stay on it, you know. And I'm not prepared for that.

SPENCER MICHELS: Why are you unprepared for it?

ROBERT BRIGHTSHUE: I'm just--I'm afraid of it right now. I'm afraid of it because I'm afraid if something's goingto happen--it can backfire and you can be immune to it, or it won't work anymore. You know what I mean?

SPENCER MICHELS: Some here don't trust the government, doctors, or, like Lee Burnside, the medications. San Francisco Health Director Dr. Sandra Hernandez, herself an AIDS specialist, does not think doctors should routinely withhold the new drugs from patients they consider irresponsible.

DR. SANDRA HERNANDEZ, San Francisco Health Director: One of the public health's responsibility in this arena is where people choose to take them but are poorly organized, for whatever reason, to do so, that we devise programs to be able to support that. And, in fact, we've done that in San Francisco.

SPENCER MICHELS: For poverty-stricken and more well-to-do AIDS patients alike, taking protease inhibitors remain fraught with uncertainties. Researchers and health officials are still learning how to use the new drugs and are planning to issue new guidelines for HIV therapy later this year. FOCUS -OUT OF AMERICA

JIM LEHRER: Now a debate about Africa and African-Americans. Charlayne Hunter-Gault recorded it last week.

CHARLAYNE HUNTER-GAULT: What has triggered the debate is a new book by Keith Richburg, the "Washington Post" correspondent in Africa from 1991 to 1994. From that experience has come a provocative memoir, "Out of America: A Black Man Confronts Africa." Here are some examples that are provoking some of the heated exchanges. Of the brutality in Africa he wrote: "If Rwanda was different, it was because the violence, the death, was up close and personal, and unprecedented on the scale of savagery. Here the militias wouldn't shoot you in the head, Somali style. They would carve off your arm first and watch you bleed and scream in pain. Then, if you didn't pass out, they would chop off one of your legs, or maybe just a foot. If you were lucky, they might finish you off with a machete blow to the back of the head. Otherwise, they might carve off your ears, your nose, and toss your limbless torso atop the pile of dead bodies, where you could slowly bleed to death." And of his connection to Africa, Richburg writes: "Maybe if I had never set foot there, I could celebrate my own blackness, my own African-ness. But while I know that Afrocentrism has become fashionable for many black Americans searching for identity, I know it cannot work for me. I am a stranger here. I am an American, a black American. And I feel no connection to this strange and violent place. Africa chewed me up and spit me back out again."

CHARLAYNE HUNTER-GAULT: With us now is Keith Richburg, and joining him in our discussion is Salih Booker, a senior fellow at the Council on Foreign Relations' Africa Studies Program. And starting with you, Mr. Richburg, "Africa chewed me up and spit me out." What caused you to have such dark vision of the continent?

KEITH RICHBURG, Author, "Out of America": Charlayne, I think it was perhaps that I went into it thinking that things would be different. When I went to Africa in 1991, the Africanists, the academics, the people who follow Africa in the U.S. were saying this would be Africa's decade of democracy. This was a unique time for Africa. The Cold War had ended. This was a unique time for Africa. The Cold War had ended. The United States no longer had need to support some of these dictators who were in place. We saw the fall of Mengistu in Ethiopia, the fall of Siad Bari in Somalia. It looked like elections were coming along, but you had democracy in Zambia sort of making a start with the election of Frederick Chiluba. And it really looked as if in many of these countries we were going to see dictators falling and democracy sprouting, the same way it had in Eastern Europe, the same way it had in parts of Asia, the Philippines, South Korea, and the same way it had in Latin America, where the military dictatorships were swept aside. But, you know, after three and a half years, three years and three months actually, to be precise, I came away far more disillusioned because this great opportunity seemed to be lost, and I ended up spending most of my time not covering democratic developments but following one civil war after another, watching states collapse like Zaire, watching states wallow in their own misery, watching economic gains be reversed in some places. Kenya would be a good example.

CHARLAYNE HUNTER-GAULT: And you write that it was Somalia through which--that came to represent the prism through which you would see the rest of Africa. Why was that?

KEITH RICHBURG: It was sort of like an epiphany for me because, you know, I personally--and, you know, you were there as well-- invested a lot of time in that story, because here we had a massive famine. And if you remember those horrific pictures, they really stirred the conscious, the imagination of the West and the world. This was the new world order. We could go in. We could intervene in a big way with a military force. And we're all behind it. It was an exciting time to be there on the beaches when the Marines landed, because we knew this was the way the world could work in the absence of the Cold War, the West coming in to help starving Africans. And what happened, that mission deteriorated. It became a guerrilla war, and ended with bodies being dragged through the streets. We've had friends and colleagues who were killed there, journalists beaten to death by a mob for doing nothing except their jobs. And that whole episode--the great hopes we had when the Marine intervention commenced, followed by their hasty departures to the deaths of 18 Marines or 18 Army Rangers in the streets of Mogadishu--it was the highest and then the lowest all capsulized in this one desolate country.

CHARLAYNE HUNTER-GAULT: Does that scare with your vision of Africa, Salih Booker, seen through the prism of the death and destruction and degradation of Somalia?

SALIH BOOKER, Council on Foreign Relations: No, it doesn't. I would differ with Mr. Richburg rather severely. I think the 90's are still very much possibly the decade of not just democratization for Africa but a sort of second independence. Since the beginning of the 90's, we have seen the end of more wars and serious conflicts on the continent than we have seen the start of new conflicts. We've seen an end to the war in Mozambique and Angola, South Africa, itself, as he mentioned, Eritrea and Ethiopia. We have seen the advent of multiparty electoral democratic systems. It's no panacea, and it's no short process. The United States is just one example of our own ancestors who were here for several hundred years before we had the right to vote. And we're still working out our own democratic apparatus. I think--

CHARLAYNE HUNTER-GAULT: So the bleak picture that he painted--

SALIH BOOKER: Well, it's exaggerated.

CHARLAYNE HUNTER-GAULT: Exaggerated, Mr. Richburg, Keith Richburg?

KEITH RICHBURG: Well, you know, I mean, obviously, one of the criticisms you get when you write a book like this is that people will say, well, you didn't point out this country or that country where things are going well. And within the book I do point out what I say were the bright spots. I devote a lot of time and attention to South Africa, for example, and I say that Nelson Mandela was one of the real moral leaders on the continent. I do point out, for example, talking about democracy, that there were multiparty elections. I covered the multiparty election in Malawi. I mention that in the book. I mention also that some of the other places where we thought democracy was taking root like Zambia, for example, I think is far less of an ideal situation than perhaps my friend and colleague there because if you look at the last election, there's no way we could say that was a free and fair election. And the international observers there called it deeply flawed.

CHARLAYNE HUNTER-GAULT: And your overall conclusion about democratization and reform in Africa is that it's not headed anywhere, right?

KEITH RICHBURG: Well, my conclusion and, again, because I know journalists often get accused of laying out problems without putting in solutions, my conclusion of the book actually lays out some things that we should look at. And in that I say perhaps we rushed too quickly into pushing, using our aid money in the West to push African countries into holding elections. Elections do not equal democracy, and what I say in my book is that what possibly we should be doing is pushing for things on another scale, pushing for reform of constitutions to get away from these imperial presidencies, strengthening NGO's, strengthening groups on the ground, strengthening the independence of the Judiciary, working for an independent press.

CHARLAYNE HUNTER-GAULT: All right. What about that, Mr.--

SALIH BOOKER: Well, I agree with all those elements. The contradiction is when you paint such a bleak picture of Africa's prospects, and, in my view, an accurate picture, what you do is you undermine the will of the legislators in the United States and the U.S. government to be engaged in Africa, to provide the kind of assistance to strengthen civil institutions, et cetera. Africa-- assistance to Africa and U.S. engagement in Africa has been declining precisely at a time when there's great potential, when there has been greater economic growth, contrary to what Mr. Richburg said, in the last several years. A majority of African countries have experienced the highest economic growth in the past decade and projections from the World Bank and elsewhere is that that trend is likely to continue.

CHARLAYNE HUNTER-GAULT: Mr. Richburg?

KEITH RICHBURG: I mean, talk about American engagement, the biggest American engagement in Africa was when we sent 20,000 Marines onto the beaches of Mogadishu to help starving Somalis that ended with 18 dead Army Rangers and a new doctrine basically that seems an American foreign policy that we don't want to get involved in these conflicts anymore. So we stood by while the Rwanda conflict went on. It was a genocide against the Tutsis that killed up to a million Tutsi, and we stood by and basically let it happen because we didn't want to cross what's now being called the Mogadishu line.

CHARLAYNE HUNTER-GAULT: Salih Booker.

SALIH BOOKER: Well, I agree with the problem of the so-called Mogadishu line but I would say our greatest engagement in Somalia was not Operation Hope, but it was American support of Siad Bari for several decades during his dictatorship where he abused the human rights of his population, where we propped up with our aid dollars and our military support a dictator. The same is true in Zaire, the same is true in Liberia, Sudan, and Kenya as well. These five sort of traumatized countries that Mr. Richburg points out in his book and uses as examples of Africa's failures, these were the five main recipients of the United States assistance during the past 30 years.

CHARLAYNE HUNTER-GAULT: Let me just go back to another point you made, Keith Richburg, in your book; that African- Americans are deluding themselves when they--and that they're basically ignorant of Africa. An example you gave was of them coming to Africa, applauding dictators, and people who repress their own people.

KEITH RICHBURG: Well, that's right. And I was referring very specifically to the people who are the luminaries, the name figures of the American civil rights movement who became popular name figures in America for standing up for the rights of black people and minority people and oppressed people on this soil. Why is that when they go to Africa I find them hobnobbing with the likes of General Bobangita, the dictator of Nigeria, the likes of the president of Gabon, the likes of Valentine Strasser, who was the military--the military officer who overthrew the government and took over Sierra Leone? I mean, we shouldn't be siding with these dictators. The side of--these people should be on the side of those out there suffering every day, struggling, trying to get the same democratic rights that we enjoy and take for granted here in the United States.

CHARLAYNE HUNTER-GAULT: He's right about that, isn't he, Salih Booker?

SALIH BOOKER: Well, I'm a fierce critic of those African-American leaders who would embrace African dictators, but the larger majority of African-American leadership has historically--and I'm talking back at the dawn of the 20th century--people like W.E. DuBoise, et cetera, who had been committed to and have contributed significantly to African independent struggles against colonialism to the anti-apartheid struggle, to protests against U.S. support for dictators in Zaire, in Liberia, in Kenya, et cetera. The great majority of the African-American political leadership has been on the right side of people's rights, of economic development, and democratization. But I would agree, you know, and I would fiercely criticize any American public officials or political leaders who embrace dictatorships. But during the Cold War that was largely the role that was played by our national political leaders in the White House.

KEITH RICHBURG: Can I add something here?

CHARLAYNE HUNTER-GAULT: Yes, briefly.

KEITH RICHBURG: There seems to be a propensity among a lot of African-Americans or black Americans who go to Africa not to want to criticize these governments. It's as if we don't want these disputes to spill out of the family. We think it's not a good idea for blacks to be criticizing black governments.

CHARLAYNE HUNTER-GAULT: Finally, let's briefly get you, Mr. Richburg. You come to the conclusion that black Americans should not be searching for their identity in Africa; you reject this Afrocentric notion that that is America's home. You came away feeling as a complete stranger. Could you just elaborate on that briefly.

KEITH RICHBURG: What I meant by that was, you know, I understand that a lot of American blacks are feeling alienation here. There is discrimination. You know, I don't need to go through a litany of urban problems, the drug problem, the crime problem, the problem of unemployment in the cities. There is a feeling that integration is not working and so therefore there is now a tendency that seems fashionable to resegregate ourselves and to look back to a mythologized or romanticized time when we could hold our heads high as kings and queens in Africa. And the point I tried to make in that section was, you know, having been there, I've kind of realized that, you know, 400 years or more that we have been on American soil has really ruptured any tie culturally that we have with Africa.

CHARLAYNE HUNTER-GAULT: Ruptured our cultural ties, Mr. Booker?

SALIH BOOKER: I don't think it's ruptured the ties. I think those ties are very much alive. I think part of the problem is it's not a problem for black Americans or white Americans differently, it's an American problem, and that is this society is largely ignorant of Africa. So most people, whether they have a romantic embrace of Africa or whether they have an overly-pessimistic negative view of Africa have views that are based on bad information. The majority of people, white and black, who are knowledgeable about Africa, who work in Africa, who travel and live in Africa, as I have for eight years, come away with a sense of a reality of Africa that is positive, and real connections, human connections. Africa is like anywhere else in the world, and I never felt alienated during my experiences there.

CHARLAYNE HUNTER-GAULT: All right. Well, I'm sure this debate will continue. Keith Richburg and Salih Booker, thank you for joining us.

KEITH RICHBURG: Thanks for having me. ESSAY - DON'T FENCE ME IN

JIM LEHRER: Finally tonight essayist Anne Taylor Fleming looks at the disappearance of the Wild West.

ANNE TAYLOR FLEMING: I am western through and through. That's what I tell my East Coast friends; that I am a child of the wide open spaces, conjuring up for them those vast vistas of open plains and Rocky Mountains, of beaches that go on forever, and lakes so cold and deep you shiver just to look at them. Other places in the country, I say, with sweeping hyperbole, feel small by comparison, sooty, urban, claustrophobic. I say all this absolutely believing it, even though my home turf is none other than Los Angeles, as sooty and urban and densely packed city as any in the country. But I hide this truth even from myself, remembering it as it was 40 years ago, just a palm-line playground of small towns that called themselves a city and a place of breath-taking beauty. I look at it now, I realize, through a nostalgic haze as thick as the smog, refusing to focus on the min-malls and endless tract houses and clogged freeways. I live in denial because I cannot bear what happened here--what we let happen. As Joni Mitchell said, "He paved paradise and put up a parking lot."

JONI MITCHELL: [singing] He paved paradise, put up a parking lot, with a pink hotel, a boutique, and a swinging hot spot.

ANNE TAYLOR FLEMING: And the others who can't accept the reality, plenty of them have absconded for other less damaged turf. They've gone North to Seattle and Portland and East to Las Vegas and Phoenix, Salt Lake, and Denver, carrying their dreams of what was, of cities without grime and gridlock, where you can raise your kids, of unspoiled mountain playgrounds where you can teach them to hike and ski and have a little reverence for nature. That's the dream, of course. But along with the dream, the immigrants have taken with them the seeds of destruction which are being sewn now all through the increasingly citified West. The joke's on us Westerners. Forget the wide open spaces, the horses cantering through unsullied sunsets, the 13 Western states are now "the" most urban regions of the country. Utah, Mecca for Mormons and skiers, and people looking for high-tech jobs, now has more city dwellers per capita than New York, and the air quality of the Salt Lake City region is worse than that of the metropolitan New York-New Jersey area. Las Vegas, meanwhile, reads like LA boiled down to a glitzy, greedy essence. Once all theme park hotels and casinos, the city through the 90's has been the fastest growing in the country, leaking out into the desert in tracks of shiny new homes studded with artificial lakes and thirsty golf courses. Las Vegas now has some of the worst air in the country and will be out of water in 10 years. Didn't anybody listen? Didn't they see what we had become, and what pains they'd have to take not to become one of LA's sprawling offspring, or did greed just get the best of them, as it did us? Las Vegas did make a temporary try, putting a moratorium on building in the early 90's. But the builders squawked and the band went away. Let's bogey. Let's build. We're on a roll. The market's hot; employment's high. Leave all the laments to the echo wimps, the wide open spaces belong to the entrepreneurial cowboys. Only relatively small Portland, Oregon is trying to do it differently, drafting a really tough anti-sprawl law and making everyone live and work in a contained area so the great outdoors can be preserved for all. Portland is not talking about keeping people out, but, rather, keeping them in. Is anyone listening out there? I think people are starting to listen, but they don't know how to slow the juggernaut. But what you do pick up now, sometimes faintly, all through the West is a sense of chagrin and shame, a quiet but unmistakable refrain under all the banging and booming sounds of construction.

JONI MITCHELL: [singing] Don't it always seem to go that you don't know what you've got till it's gone? We paved paradise, put up a parking lot.

ANNE TAYLOR FLEMING: I'm Anne Taylor Fleming. RECAP

JIM LEHRER: Again, the major stories of this Wednesday, the scientists who cloned a sheep said they plan to clone a cow next and then create a genetically manipulated animal which contains human genes. And floods in the Midwest claimed four more lives as thunderstorms caused flash floods along the Ohio River. We'll see you online and again here tomorrow evening with a Newsmaker interview with Secretary of State Albright, among other things. I'm Jim Lehrer. Thank you and good night.