1508AIDS in Africa
- Jul 10, 2000***************************************************************
"Is AIDS in Africa a Distinct Disease?"
Science (www.sciencemag.org) (06/23/00) Vol. 288, No. 5474, P.
2153; Cohen, Jon
AIDS in Africa varies from AIDS in the Western world by more than
a few reasons. South African President Thabo Mbeki has
questioned if HIV causes AIDS, raising the issue of how the virus
is mainly spread there by heterosexual sex. HIV has moved
quickly through Africa, which has several strains throughout the
continent. Researchers are not sure what causes these
differences, and if they find out, better treatment strategies
could be determined. Tuberculosis is the number one AIDS-related
disease in Africa and is the largest killer of patients. In the
United States, TB is rare for AIDS patients, but pneumocystis
carinii pneumonia (PCP) is quite common in HIV-infected people.
Africans have antibodies to the protozoa for PCP and chiefly
remain unaffected. James Whitworth of the U.K. Medical Research
Council believes PCP may be under-diagnosed in Africa, and he
does not believe that HIV progresses more quickly in Africa.
Studies from Nairobi show that sex workers develop AIDS about
five years after HIV infection, but pregnant Nairobi women
developed it much slower, similar to the United States' rate of
an average 10 years before AIDS develops. Whitworth's own study
in Uganda revealed that after eight years of HIV infection, 40
percent of the people studied had AIDS. HIV has spread so
rapidly in Africa that researchers have looked to the effects of
untreated sexually transmitted diseases and overall lack of
healthcare for answers. They also wonder if Africans are more
vulnerable to HIV and if the strains in Africa are more
infectious. Mario Clerici of Milan and Matthew Lukwiya of Lacor
Hospital compared the immune systems of people living in Gulu,
Uganda, or Milan. The researchers found that the immune systems
of those people living in Africa, including those of Italian
descent, were more active, due to the exposure to more diseases.
This suggests that regional location may play a role in HIV's
ability to target CD4 cells.
"Disease Spread Faster Than the Word"
Washington Post (www.washingtonpost.com) (07/07/00) P. A1; Vick,
Andrecus Miruka of Masogo, Kenya, first heard mention of AIDS in
1990. Once he learned all he could about the disease, he spread
the knowledge around his community. Staying informed is the only
way many Africans can fight AIDS, but information about AIDS took
four years to travel just three miles in Masogo. The Luo, one of
Kenya's largest tribes, has an HIV infection rate believed to be
around 70 percent. The people in Masogo know they are isolated
and were slow to understand AIDS, which is sometimes known as
chira, an illness caused by breaking traditions. Miruka shared
his knowledge of AIDS with people mostly at funerals. A British
agency called Futures Group International works with Kenya's
Ministry of Health to train volunteers to be community health
workers. These workers stress the need to end wife-sharing of a
widow and to use condoms. The Ministry of Health, which relies
on foreign aid, has few resources or means to reach the people.
Rural Africans do not talk about sex, and the conservative nature
of their lives has added to the stigma associated with AIDS.
Many do not know the risk factors of AIDS since sex is rarely
discussed in detail. Miruka's son Bernard learned about the risk
factors for AIDS but kept them private because of others' belief
in chira and their unwillingness to discuss sex. The silence in
Kenya, compounded with other risk factors, led to increased
potential for sexually transmitted diseases. However, the Luo
people did not believe HIV was present until AIDS developed.
When people started dying in late 1999 and this year, the public
burials brought long-needed attention to the epidemic. As more
people became informed, more questions rose about how to prevent
infections. Some prostitutes thought that by offering anal sex
they were safe from AIDS. One success story has been Uganda,
which has reduced its rate of new HIV infections. The health
minister in Masogo learned about AIDS in September 1998 and
trains health workers now. However, Kenyan schools do not teach
about AIDS, and if so, it is only a brief mention. Sex education
traditionally takes place in the home, but the message of condom
use is not reaching young males. Men like Eric Owino, age 23,
say condoms are not reliable and that women oppose using them.
Kenya still has a long way to go to educate the people about STDs
"A Call for Fair Access to Future AIDS Vaccine"
New York Times (www.nytimes.com) (07/07/00) P. A9; Altman,
The International AIDS Vaccine Initiative, a research consortium
funded by government and private grants, announced that steps to
offer simultaneous access to an AIDS vaccine to rich and poor
countries should be created now, even though a vaccine to prevent
AIDS is still many years away. Vaccine Initiative President Seth
Berkley suggested that steps be taken now in order to avoid
problems similar to those caused by the limited availability of
HIV drugs in sub-Saharan countries and delays seen in the
eradication of diseases like polio in developing countries. Two
vaccines--Aventis Pasteur's Alvac canary pox vaccine and a
vaccine that integrates both the Alvac vaccine and one prepared
from a molecular component of the surface of HIV--are currently
in phase II clinical trials, while VaxGen's vaccine has entered
phase III trials, although data from that trial are not expected
until 2002 at the earliest. Biotech concern Chiron is also
working on a vaccine.
"South Africa HIV Testing Plans Undermine Prevention"
Reuters (www.reuters.com) (07/06/00); Sithole, Emelia
South African AIDS activists oppose their president's decision
for a panel to study the experimental HIV ELISA test, claiming
that it will hamper efforts to stop the spread of AIDS. Mark
Heywood, head of the AIDS Law Project, believes the presidential
advisory panel is sending confusing messages by focusing
attention outside of the need for HIV screening. Heywood
emphasized that a large problem in South Africa is that few
people are tested for HIV, and the new studies will undermine
awareness efforts. Morna Cornell, director of the AIDS
Consortium, called research into the ELISA test a waste of time.
"AIDS in Angola Means Stigma, Death"
Reuters (www.reuters.com) (07/06/00); McClelland, Colin
In Angola, a country plagued by civil war since the 1960s, AIDS
means death, according to Dr. Marilia Afonso of the Josina Machel
Hospital in Luanda. Afonso can treat patients only for
opportunistic infections like tuberculosis, candida and herpes.
Antiviral drugs for HIV are too expensive, and the majority of
the 13 million Angolans live in poverty. In this country, AIDS
carries such a stigma that few will acknowledge and seek
treatment for the disease, making it a much quicker fatal
infection than for those who treat their illness.
"Bristol-Myers Finds Pledging AIDS Aid Is Easier Than Giving It"
Wall Street Journal (07/07/00) P. A1; Waldholz, Michael
Bristol-Myers Squibb's 1999 announcement of a five-year $100
million donation to Botswana and four other African countries
appeared at the time to be a much-needed boost to the ailing
nations in their losing battle against HIV and AIDS, but
activists and African humanitarian workers in the region are
discovering that the funding is not easy to use because of
restrictions and regulations put in the way seemingly at random
by Bristol-Myers. Bristol-Myers executives' complaints that the
difficulties are frustrating to them demonstrates the cultural
differences between Western corporations and African nations,
where Bristol-Myers has little understanding and less experience
and is working at odds with the region's AIDS goal of preventing
future illness, not treating those already very ill.
Bristol-Myers was surprised in the early stages of the
philanthropy by the low quality of grant proposals, but activists
note that writing skills are reserved for the elite few in
Africa, and those interested in helping the poor and sick often
have little formal education and less experience with the
bureaucratic processes common to Western organizations, as grant
competition is unknown in Africa. The drugs company placed the
restrictions on its donations, such as requiring strict record
maintenance, denying the purchase of furniture or the rental of
office space, and limiting the hiring of multiple employees, to
prevent notoriously corrupt African governments from using the
funding for purposes other than AIDS relief; however, these
restrictions have essentially prevented small nonprofit
organizations in Botswana from performing the relief work despite
donations as large as $400,000.
"AIDS Counseling for Peacekeepers Urged"
Washington Post (www.washingtonpost.com) (07/07/00) P. A18;
The United States has proposed a measure to the U.N. Security
Council that urges all United Nations peacekeepers to counsel
troops on sexually transmitted diseases and to track AIDS among
soldiers. The resolution reiterates the fact that AIDS is
considered a threat to security and peace in Africa and abroad.
U.S. Ambassador to the United Nations Richard Holbrooke said the
measure has support but no vote is pending. The resolution does
not call for mandatory HIV testing due to its cost. However,
AIDS prevention training would be given to 35,000 peacekeepers
worldwide. Holbrooke realized that U.N. peacekeepers may be at
risk for AIDS when in 1992 he saw Cambodian soldiers visiting
brothels at night. David Wimhurst, a spokesman for the United
Nations, said there is no AIDS crisis among the peacekeepers and
that condoms had been given to soldiers in Sierra Leone.
"Pfizer Plans to Start Free-Diflucan Project in South Africa in
Wall Street Journal (www.wsj.com) (07/06/00) P. B12
Pfizer has announced that it will initiate its program to offer
supplies of cryptococcal meningitis drug Diflucan at no charge to
South African patients with AIDS this fall. Pfizer belives that
up to 100,000 cases of crytococcal meningitis, a brain infection
that occurs in roughly one in 10 patients with AIDS, causing
death, can be treated under the program. Although South African
health ministry officials stated in June that they may ignore the
offer considering that the program included too many
restrictions, South African Minister of Health Manto
Tshabalala-Msimang has expressed her complete support of the
program. Pfizer intends to expand the program to other areas,
including Asia, Latin American, and other parts of Africa.
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