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1508AIDS in Africa

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  • Bell, Elizabeth
    Jul 10, 2000
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      "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
      and prophylactics.

      "A Call for Fair Access to Future AIDS Vaccine"
      New York Times (www.nytimes.com) (07/07/00) P. A9; Altman,
      Lawrence K.
      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;
      Lynch, Colum
      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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