And there is AIDS. Most of the world's AIDS cases are in sub-Saharan Africa, and most of those cases go untreated, while the number of HIV-positive people is increasing by 15 percent each year.

One of the goals of Powell's trip was to push African heads of state to come out and openly declare AIDS a crisis caused by sex that requires self-control, condoms, abstinence and monogamy to be defeated. Leaders in Senegal and Uganda have done so, and seen infection rates decline.

But Powell was partially rebuffed by South African President Thabo Mbeki, who gave no indication after their meeting in Pretoria that AIDS was a big issue. Mbeki has even said that HIV may not cause AIDS, that poverty is the cause, and he has refused to provide anti-AIDS drugs to his people, despite the fact that about 25 percent of South Africa's sexually active people are HIV positive. The graveyards are rapidly overflowing and food production is being disrupted because so many farmers have died.

In Nairobi, at an AIDS center on the edge of the slum, Powell attended an AIDS awareness demonstration by young girls acting out ways to resist having unprotected sex. Outside the center, the teeming Kenyan poor circulated along muddy roads pitted with sewage. Many still have unprotected sex because they are unconvinced they are vulnerable to HIV infection.

Powell sang and danced with HIV-positive men, women and children, as he did in every other capital he visited, sharing touching moments with those suffering from the disease.

Agnes Nyamayarwe, 49, told Powell and his wife, Alma, that she has had HIV/AIDS for nine years and watched her husband and 6-year-old son die of the disease, lacking the costly anti-retroviral medicines that might have kept them alive. "It was difficult to see the young boy die," she said, weeping. "Instead of giving my children life, I gave them HIV. I live with the guilt that I infected my own child." Her surviving daughter is attending a university with help from U.S. funds.

Powell met another HIV-positive woman in Soweto, outside Johannesburg, South Africa. Florence Ngobeni said when her child got sick, her in-laws blamed her and didn't even tell her when her child died. "They said I didn't deserve to go to his funeral."

She told Powell of her hopes that, as a black American, he will change things for the continent. "I see you as a role model to the men in South Africa," said Ngobeni. "You have come to show us the light even though you have not brought us anything, as the media said. Your visit means a lot to us."

But some who work on the AIDS crisis in Africa say that to really make a difference, the administration must help public health agencies get drugs to those infected. "It's easy for Colin Powell to come around and listen to everyone singing and dancing, but it's another thing to do something," said Samantha Bolton of Doctors Without Borders.

At a clinic in Nairobi, Bolton described the ongoing fight to get low-cost AIDS drugs. "Only one or two thousand people get treatment but millions have HIV in Kenya." Drug firms meanwhile are fighting to keep control over their patents and are pushing for laws in Kenya and other countries that will bar generics or other copies. Bolton said that the Bush administration won campaign contributions from pharmaceutical firms, and she believes those firms are putting pressure on the U.S. government to protect their African markets -- even though Africa accounts for only 1 percent of their sales.

In a breakthrough development recently, drug companies dropped a suit against the government of South Africa. But even if the drugs become more available and affordable, AIDS experts say a responsible and complex healthcare delivery system must be set up to administer the drugs. If used improperly, the drugs could create drug-resistant forms of AIDS, gravely worsening the epidemic. According to Dr. Nils Daulaire of the Global Health Council, drug-resistant AIDS mutations are already appearing in America.

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