BANGUI, Central African Republic -- It is no hotter than usual on the afternoon that Jimmy Carter and Bill Gates Sr. come to visit this landlocked country between the Sahara and the equator. The prime minister and his cabinet, waiting at the airport to greet them, seem comfortable in their dark, heavy suits, and the troops standing at attention have barely broken the starch of their stiff camouflage uniforms.
But the red carpet is lying like a flaccid tongue on melting asphalt, and when the two men step from the door of the chartered DC-9 they are taken aback by the furnace air. Then Carter, a compact, slightly stoop-shouldered man of 77, smiles his extravagant smile and bounds down the stairs and onto the carpet with his hand outstretched. Gates, 76, balding, basketball-player tall and slightly rumpled from the flight, follows behind, the bright sunlight glinting off his glasses.
It is a Sunday in March, and the Central African Republic is the men's fifth stop in as many days. Along with their wives, Rosalynn and Mimi, a few aides and a handful of Secret Service agents and journalists, the two septuagenarians are zigzagging across Africa to evangelize on the subject of AIDS, the disease that has killed millions on this continent in the past 10 years and almost certainly will kill tens of millions more before the end of another decade. They have spent two days each in South Africa and Nigeria, and stopped for a morning in Namibia and an afternoon in Angola. From here, they will go to Kenya.
They have known each other for several years, but Carter and Gates are not traveling buddies; this trip is based on mutual interest rather than close friendship. Beyond the physical Mutt and Jeff appearance, they are an odd couple. Carter is businesslike and formal, and you get the feeling that he sometimes doesn't really mean that smile. But there is a courtly Southern kindness that comes naturally to him, and he is not afraid of touching, with a gentle hand on a forearm or across a shoulder, to make a point.
Gates has a Westerner's disarming directness. Genial and often funny, he doesn't mind occasionally taking advantage of the liberties allowed by status and age, and can be abrupt and even cranky when he feels like it. Where Carter lists facts and figures, Gates likes to get down to what he calls "the granular."
Together this week, they have met with prostitutes and presidents, traipsed through fetid slums and sipped tea in ornate palaces. Carter has assured Nigerian Christians that Jesus Christ would have wanted adulterers to use condoms; Gates has bottle-fed the baby of an HIV-positive mother in Soweto. They have talked safe sex with African teenagers and pleaded for more action from governments whose countries are drowning in sickness and death. They have visited health projects already funded by their respective foundations, handed out some new grant money, and been hit up for more.
They have visited some tragically bleak places, but today's stop in the Central African Republic -- population 3.5 million, annual per capita income $310 -- is the bleakest of all. "It was heartbreaking," Carter would later tell Bill Gates Jr., the sponsor of their journey. "It was one of the worst things you could ever see."
One out of every seven people here is infected with the human immunodeficiency virus, HIV, which causes AIDS. There is only one small clinic, here in Bangui, to care for them, and after a brief sit-down with the government, that is where Carter and Gates want to go.
The group squeezes into a car and three dusty Land Rovers, security agents and journalists in the seatless back compartments with their knees up to their chins.
Government pickup trucks mounted with large-caliber machine guns take up the front and rear positions for the 15-minute drive along a potholed lane lined with stunted trees and wooden shacks. Standing in the truck beds, soldiers absurdly wave handguns and shoulder-fired grenade launchers at roadside gawkers.
The clinic is a compound of single-story cinder block buildings strewn along a dirt path. The visitors are expected, and a group of traditional dancers is whooping and jumping an energetic greeting outside. Just around the corner, lined up and standing silently in the dust, are dozens of emaciated women, most holding skinny, scabbed babies. Touching them and talking quietly, Carter and Gates gradually move inside the stifling rooms, where more lie dying in the stinking heat.
Their escort is a smiling Japanese woman who has run the place for the past 10 years. She explains matter-of-factly that there is no medicine here, and little to offer patients beyond food, clean water, HIV counseling and condoms for 30 Central African francs apiece. Dying patients are sent down the road to the only hospital, if there is time. Ninety percent of the beds there are occupied by AIDS victims, the Japanese woman says sadly. Carter says she reminds him of Mother Teresa.
After little more than an hour, now flushed and dripping with sweat, the visitors are back inside the DC-9, wheels up for Nairobi. For a while, everyone sits panting, chugging bottled water and not saying much. What was supposed to be just a refueling stop has seemed like a detour to Hell.
Finally, Gates lifts his lanky frame out of the seat and wanders down the aisle. "Help me out here," he says to no one in particular. "Let me know how much money we should give that woman."
Practicing Forebearance
There's an inevitability about the way Gates is introduced when it's time for him to give a speech. Here is how one Nigerian official put it:
"Mr. Bill Gates Sr. Who is important. But Junior is also important. Here is the father of the richest man in the world."
There are any number of things that Bill Sr., as the people who work with Gates call him, could have done with his retirement. Long before anyone ever heard of his son, Bill Sr. was a prominent Seattle lawyer, a partner at the firm of Preston Gates & Ellis. At one time he dreamed of adding his son's name to the brass plaque on his law office door.
Now his son's name, and the name of his son's wife, are onhis door.The Bill and Melinda Gates Foundation, funded by the son Bill Sr. calls "Trey," is by far the richest private philanthropy in the world, with assets of more than $24 billion. Bill Sr. is chief executive officer and co-chair with former Microsoft executive Patty Stonesifer; the Seattle headquarters office has a staff of 216. "Never, ever, not within 1,000 miles" did he imagine things would end up this way, he says. "It's quite extraordinary, the turn my life has taken."
The foundation gives money to many causes, but its primary focus now is global health. The hundreds of millions of dollars it distributes annually for vaccine research, disease prevention and care, particularly for HIV/AIDS, exceed the yearly budget of the U.N.'s World Health Organization.
Gates -- who also serves on the board of directors of the United Way and the University of Washington Board of Regents -- takes two or three trips a year outside the United States to visit foundation projects and to educate himself. "This is a learning experience," he tells a diplomatic reception in Nigeria's capital, Abuja, after he and Carter have spent the day in a sprawling slum listening to prostitutes explain how hard it is to get their customers to use condoms. "I sit in an office every day and I talk about AIDS, and I talk to the president of Nigeria about commercial sex workers. But I don't know a lot, really."
He says he is comfortable with his current identity, after a long and distinguished career, as "father of." But he does make a public correction after the U.S. ambassador in Nairobi introduces him and his wife, Mimi Gardner Gates, as the parents of the world's richest man. Mimi, the director of the Seattle Art Museum, "was 14 when my son was born," he explains. They were married six years ago after the death of Mary, the mother of his three children.
Waiting for Mimi to finish buying T-shirts and trinkets for grandchildren at the airport gift shop in Windhoek, Namibia, he folds himself into a tiny plastic chair and talks with seeming reluctance about his son. "The fact of the matter is, my son is a pretty phenomenal person," he says. "But I don't want to see that on the front page." He pauses, then waves his hand as if to erase that negative thought. "Between the fact of his unusual competence, and the fact that he's my son, what the heck could be better?"
Their working relationship is not familial. "I'm not sure I know the word. I guess it would be 'objective.' I don't think there's much in it, in terms of the things we do, that has much to with the family relationship. There is no authority relationship." By which he means, "I don't think I have any authority over him."
Bill Jr. rarely shows up at the converted factory that houses the foundation. They usually consult by e-mail, and they don't always agree about where the money should go. For example, Gates has been trying to convince his son that they should build "first-class medical institutions" to train doctors around Africa. "But I don't think I've made much progress."
What they do agree on is the search for a vaccine against HIV, and one of the most exciting stops on the trip is a visit to Nairobi's Kenyatta National Hospital, where the foundation is funding clinical trials. "It is his dream, his greatest hope," Senior says of Junior's interest in the project. Because the foundation doesn't have to answer to Congress or voters, "we're the perfect people to take this risk. If it all goes to hell, it's worth it."
Unlikely Babysitters
One dose of an anti-retroviral drug, given to HIV-positive pregnant women, can prevent transmission of the disease to her newborn about half the time. The Gates-funded Zola Clinic in Soweto, outside Johannesburg, is one of the few facilities in South Africa to offer the drug free to infected women and their infants. This is an issue of some contention with the South African government, which has warned the medicine might not be safe and refused to provide it in its network of federally funded clinics.
Gates and Carter have persuaded former president Nelson Mandela to visit Soweto with them to ensure maximum media coverage. Cameramen have been told not to photograph the faces of four patients and their newborns who have been brought forward to meet with the visitors, lest they be stigmatized and discriminated against for their HIV-positive status.
Carter's political instincts slip into gear as soon as he enters the meeting room; he grabs one of the infants and sits it on his lap on the makeshift stage. Two other mothers step forward and hand babies to Mandela, who seems uninterested, and Gates, who is charmingly awkward. When Mandela's begins to wriggle, a clinic worker grabs the (sleeping) fourth baby from its mother and trades him for the fussy one. Gates's starts to cry, and he is handed a bottle. "It's been a long time since I was feeding a baby," he says sheepishly. "I'm glad my daughters aren't here to see this."
Soft-spoken in private, Carter still uses his presidential voice when the occasion calls for it, lauding the local health workers and criticizing the national government. "But the true heroes in this building are the four mothers who have come here to this program," he says. "They were courageous enough to submit to a test, and when it turned out positive, they showed the epitome of a mother's love, saying, 'I want to save my baby.' "
Mandela opens his own remarks with a strange combination of self-deprecation and hubris: "The height of Bill Gates is very intimidating. I hope my height is not so intimidating to President Carter. If there is anything I can boast about, it's that I'm taller than an American president."
Gates and Carter have tried to persuade Mandela to intervene with President Thabo Mbeki to change his stance on the mother-and-child program, but the former president has been less enthusiastic than they had hoped. Mandela has his own foundation, focused on education, and before they could even make their case on AIDS he asked Gates to fund five new schools.
That happens a lot, Gates later shrugs. "It's a given. It's so normal, so natural -- there we are, with all this publicity about who we are, the amount of money we give away. I've been there. I know what it's like to have some rich person come along and to try to solicit money for a cause. . . . Who's going to fault him?"
There are more HIV infections in South Africa than anywhere in the world -- 4.7 million people, increasing by 1,800 cases every day. For reasons that are hard to fathom, Mbeki has failed to adopt measures that have worked in other countries -- aggressive efforts to promote condom use, for example -- and rejected some of the most effective anti-AIDS drugs as "poison."
In the following days, the two Americans will talk a lot about holding those babies at the clinic. Gates's eyes sometimes get red and he chokes up when he mentions them, and he shakes his head and says, "What a granular experience that was."
Taking His Time
On the way to South Africa the Carters stopped in Sudan, where their Carter Center is in the final stages of a years-long effort to eradicate Guinea worm disease. Already four days on the road, they rose early in Johannesburg to go to a nearby botanical reserve for bird-watching, something they try to do wherever they are in the world. On mornings when they are not out with their binoculars, they try to find a gym for a predawn workout. In his hotel rooms after hours, Carter plugs in his laptop to pound out memos and read the news.
There is not a minute wasted in Carter's life; one of the last things he does each night is to write down what he plans to accomplish the next day. It is something that used to exasperate his White House staff, where stories were legion about his microscopic attention to detail, down to the schedule for the White House tennis court. "When I left the White House, I figured I had 25 years of life left," he reflects one afternoon as the DC-9 sails over the Sahel region, the arid expanse south of the Sahara. "A lot of people just shut down."
If he's not traveling for the Carter Center or negotiating peace between warring factions or monitoring elections somewhere, he is writing. Carter has published 16 books, and for the last several years has been working on a novel about the end of the Revolutionary War, "when most of the important battles were fought in the South." He began by calling up published writers and academicians to ask, "How do you write dialogue? How do you develop a narrative?" His main character is a cobbler, so he spent some time learning about shoemaking in the late 18th century.
In 1978 Carter visited Liberia and Nigeria, the first U.S. president to visit Africa while in office. Although it has been 21 years since he left the White House, he is still on first-name terms with a number of the continent's current leaders -- Nigeria's Olusegun Obasanjo and Kenya's Daniel arap Moi were in office when he was. These days, Carter is equally well known in Africa for his conflict resolution efforts and the Carter Center's work on diseases such as schistosomiasis and lymphatic filariasis.
But this trip is focused on a much more famous disease with a shorter name -- AIDS -- and ways to stem an epidemic that is devastating the African continent. One important prevention measure, about which Gates and Carter have much to say, is condom use.
Carter knows that men generally don't like to use condoms, even with prostitutes and in other situations of high risk, although he quickly adds that this revelation doesn't come from experience. "I've been married nearly 60 years, and haven't had occasion to go outside." But in countries with aggressive programs, he tells Gates Foundation aides, who already know, "there are nationwide campaigns to distribute condoms, to talk to sex workers. In Senegal, there's a national leadership commitment, and when the president speaks out, then the mosques and the workers can, too." Their constant message, he says, is "If you have casual sex, use a condom."
Although Mbeki finally agrees to meet with Carter and Gates, they make little headway in persuading him to put the weight of his office behind a real national effort to prevent AIDS and remove the stigma that surrounds the disease. Mbeki has questioned what most scientists and health professionals around the world consider established facts about AIDS, including that it is caused by HIV infection. He has rejected standard treatment methods in favor of seeking an indigenous African solution. Meanwhile, the epidemic rages. Carter is amazed, he says afterward, that the president of a country can act this way. "One of the excuses he makes, which really pisses me off, is that [condoms] are a Western plot to kill off the African population. People who have casual sex don't do it to have babies."
Carter was considered a prude as president, sometimes mocked for talking like a preacher and once pilloried for acknowledging to an interviewer that he may have lusted in his heart for women other than his wife. Now, even more than then, he says what he thinks, and what he thinks is that too many people are dying of AIDS because they and their governments refuse to talk about a fatal disease that is transmitted through sex.
Just a few weeks ago, Secretary of State Colin Powell was criticized by President Bush's supporters in the religious right for suggesting to a worldwide MTV audience that those who can't resist casual sex should use condoms to avoid HIV. "In my own country and in other countries, it is sometimes almost impossible for a political leader or a religious leader to mention the word 'condom' or to talk about sex," Carter tells government officials at a conference in Nigeria, where 5.6 percent of the population is infected.
He is a Christian, Carter says, and for him the first choice is "be loyal to your own wife or husband. Don't bring this terrible disease into your own home. The second choice is to use a condom."
Carter's delivery of a Sunday morning sermon, at the presidential chapel where President Obasanjo invites Abuja citizens to worship, does present a problem, however. "I had to search my mind. What was I going to say about Jesus Christ and sex?"
What he says, in the country where two women, found guilty of adultery in the Islamic north, were awaiting the sentence of death by stoning, is this: "A woman was brought to Christ. She had been caught in adultery and the penalty before the law was death by stoning. Jesus looked at her, and wrote the words in the sand: 'Let he who is without sin cast the first stone.' "
Carter goes on, "There is no way I would stand in a Christian church and say it was permissible to have [extramarital] sex. . . . But people sin, and we know that our God is a God of forgiveness, of mercy. . . . There is a simple way for those who violate marital law to prevent getting AIDS. We all know what it is."
After Carter's sermon, the church musicians and choir swing into a snappy Bob Marley reggae, and the congregation begins to dance. "I have a short sermon," Gates begins his own remarks. "Christianity would be more successful in the United States if there were more toe-tapping, hip-swinging music."
Obasanjo, sitting in the front row, calls for another chorus and begins a stately bump and grind up the aisle toward the exit. Rosalynn Carter follows behind, her own hips gently swaying.
Kibera
More than one-third of Nairobi's 3 million people live in the part of the city called Kibera, billed as the largest slum in Africa. On a Monday morning, there is no singing or dancing here, just mud and bad smells and barefoot children and hopeless men with time on their hands. Some of the men are already drunk on homemade brew and crowd belligerently around a group of Americans making their way down a path that is strewn with garbage -- and, in a sign the visitors take as hopeful, a number of used condoms -- to a conference of AIDS activists and health officials at the Salvation Army community center.
Gates and Carter have met earlier with Kenya's President Moi, whose commitment to the fight against the disease that infects 13 percent of his countrymen has been hot and cold. It went well, Rosalynn Carter says in a quick briefing for those who were kept outside. She reads from her own notes, jotted on a hotel-room pad. "I started doing this a long time ago, in conflict negotiations, when Jimmy couldn't wait for the official note takers to type it up."
At the Salvation Army, Simon Wanyaike, a painfully thin young man who works to educate others so they don't contract the infection he has now had for some years, reads a poem he has written for the occasion: AIDS. Oh, oh, the mention of your name scares me out of my skin.
A prostitute turned AIDS activist tells of her efforts to convince her former co-workers to insist on condoms.
The dean of Moi University Medical School voices his despair: "People know what it is, people know how to prevent it. People know what it does. They know about the orphans. And yet the numbers are still going up. We need some other answers."
Carter turns to a frequent theme: what he sees as the Bush administration's puritanical stinginess with foreign aid, particularly to fight AIDS in Africa. "The primary reason my country has not been generous is a belief in Washington that money is not spent well, that it's wasted. The message we will take back home from countries like Nigeria and Kenya is that the money is being spent wisely. I feel an orphan in Kenya is just as precious as an orphan in America."
Later, as the delegation prepares to fly home, Gates reflects on the same issue. Corruption is a fact, he says, but "I kind of despair of an analysis that says there are some bad things happening here and we're going to be parsimonious about our support.
"I suppose it's my personal naivete, but I would always come out on the side of 'For God's sake, we've got to do something,' rather than say, 'Let's wait until they fix it.' "
