Re: [ujeni] AIDS in Africa
- They go to a hospital this year on this day. They count the AIDS victims.
Then they come back next month, next year, etc., and count the umber of
cases, minus the number who have died, then they have their new
number...Very scientific, just like their extrapolations of 33% infection
among city dwellers they were tossing around about five years back.
Get more from the Web. FREE MSN Explorer download : http://explorer.msn.com
- "AIDS Drugs for Africa"
Scientific American (www.sciam.com) (11/00) Vol. 283, No. 5, P.
98; Ezzell, Carol
The AIDS epidemic in Africa faces many obstacles, but the
chief one is finding affordable antiretroviral drugs to prevent HIV
transmission to newborns and to treat those already infected.
Most developed nations now routinely offer antiviral therapies to
HIV-infected mothers; however, there are few clinics in Africa
that can offer the drugs to these women. Cost is a determining
factor, as the drugs often cost more than many Africans'
salaries. Five companies have agreed to cut their drug prices to
Africa by 80 percent, but that alone will not be a solution.
According to David Bloom, a professor at Harvard University
School of Public Health, AIDS is tied into poverty and a lack of
health infrastructure. Lower drug costs must be accompanied by
testing to measure the drugs' success in each patient. Rampant
poverty in South Africa makes the drug AZT unattainable. With
the help of a discounted price, AZT costs 40 cents for each
100-milligram pill. Nevirapine is another drug that offers hope
to prevent HIV transmission to infants. It requires only three
doses and has been shown to reduce transmission to 14 percent for
a trial of 652 pregnant women. AZT, by contrast, requires months
of treatment. South Africa has not accepted an offer of
nevirapine from Boehringer Ingelheim, as Health Minister Manto
Tshabalala-Msimang said they do not believe the only answer to
AIDS is antiretroviral therapy. The government's plan to prevent
HIV is to treat AIDS-related infections, and form home-based
care, she said. Tshabalala-Msimang noted that even an 80 percent
reduction in price would still not be affordable for the 4.2
million HIV-infected individuals in South Africa. If the issue
of price is ever overcome, patients would then face the need for
resistance testing. HIV's ability to mutate quickly requires
careful monitoring of a patient's therapy. Testing CD4 cells and
viral load is expensive, however, and not stressed in places like
Thailand. Christopher Ouma, a worker for Doctors Without Borders
in Nairobi, Kenya, believes Africa cannot wait for viral load
testing to become the norm, since they need the drugs now. And
even after antivirals become widely available to Africa, the
trick will be adhering to the difficult therapy, which requires a
strict timetable and food requirements.
"U.N.'s Annan Demands War Against AIDS in Africa"
Reuters (www.reuters.com) (12/07/00); Murray, Kieran
Speaking at a conference in Addis Ababa, Ethiopia, United
Nations Secretary-General Kofi Annan said African leaders must make
fighting AIDS their top priority. Annan noted that the disease
has taken the lives of millions of people, and it is also a key
impediment to fighting poverty in the developing world and could
affect political stability. The official called for concerted,
comprehensive action against AIDS; however, he pointed out that
while the world is prepared to spend billions of dollars battling
the disease, African officials must work to make sure the money
goes where it is needed most. Annan also said that while the
majority of AIDS cases are in Africa, the disease is also
spreading rapidly in Eastern Europe, Russia, and India, and these
regions could face a situation like the one in Africa unless
aggressive steps are taken.
"More Evidence Supports Congo as the World's HIV-1 Epicenter"
Reuters Health Information Services (www.reutershealth.com)
A team of researchers from France, Congo, and the United
Kingdom has identified a high level of genetic diversity within
HIV-1 group M in the Democratic Republic of Congo. The scientists
studied 247 HIV-1 isolates from three parts of the country and
characterized them for diversity within the HIV-1 envelope
protein V3-V5 region. According to their report in the Journal
of Virology (2000;74:10498-10507), the most common subtype was
subtype A; however, all known HIV-1 group M subtypes were
identified in the samples. The researchers, noting a high level
of intrasubtype genetic diversity in the isolates and high levels
of possible recombinant viruses, said the findings lend support
to Congo being the epicenter of HIV-1 group M viruses.
"Bottled Up: As UNICEF Battles Baby-Formula Makers, African
Wall Street Journal (www.wsj.com) (12/05/00) P. A1; Freedman,
Alix M.; Stecklow, Steve
Between 1.1 million and 1.7 million infants, mostly in Africa,
have contracted HIV from breast-feeding. Often in the developing
world, HIV-infected mothers are not told that infant formula is
an alternative to breast-feeding that could help protect their
children from AIDS. The issue has pitted the $3 billion
infant-formula industry, which says it is prepared to donate
loads of free formula to infected women, against UNICEF, which
will not approve the donations because it does not want to
support an industry that it has accused of abusive practices in
developing nations. During the 1970s, Nestle SA and other
formula companies aggressively promoted formula in developing
nations; however, by the time the free samples were used up, the
women were often no longer producing their own milk and the
formula was too expensive for them to buy. As some women diluted
the milk to make it last longer and some babies starved as a
result, a global boycott of Nestle was organized by activists and
UNICEF began to reject cash donations from any of the large
formula makers--something it has also done with land mine
producers and cigarette companies. In the 1980s, UNICEF and the
World Health Organization developed a voluntary marketing code
for formula makers, one which restricted advertising and
virtually prohibited the distribution of free and low-cost
formula. But that code was not developed with the AIDS epidemic
in mind, and many experts say UNICEF should look past previous
events to help poor mothers with HIV and their babies. However,
UNICEF head Carol Bellamy asserts that "breast is best," and she
points out that the lack of adequate sanitation in many areas
poses its own risks for formula users, possibly exposing babies
to diarrhea and other deadly diseases, while antibodies in breast
milk could help prevent such illnesses. Research indicates that
about 15 percent of HIV-infected pregnant women in Africa will
transmit the virus to their infants via breast-feeding. UNICEF
officials have also voiced concerns that giving formula to
HIV-infected mothers could affect support for breast-feeding
among healthy mothers. Two years ago, UNICEF and other United
Nations agencies modified their position on breast-feeding in the
developing world. The "informed choice" policy holds that
infected women should be told about the benefits and risks of
breast-feeding and of alternatives like formula, but the
statement does not say how poor HIV-infected women who want to
use formula are supposed to obtain it.
- "Suddenly, a Plan to Treat AIDS in Africa"
Boston Globe (www.boston.com/globe) (02/13/01) P. A1; Donnelly,
In response to the recent pricing drop for AIDS drug cocktails in
the world's poorest nations, economists, scientists, AIDS
specialists and politicians have designed a "blueprint" for
treatment to be used in countries where the greatest need is.
The blueprint calls for wealthy nations to pay for the drugs,
paring the price of AIDS cocktails down to $500 annually per
patient, and the selection of two African nations and more than
one dozen projects to be set up as working models. When
successful, the models could be replicated and repeated across
Africa. Initially, the projects will focus only on individuals
with full-blown AIDS, and the plan also calls for piggybacking
treatment with existing tuberculosis-control programs.
"World Bank Grants $473 Million Loan to Ethiopia"
Reuters (www.reuters.com) (02/14/01)
Ethiopia has been granted a $473 million loan from the World Bank
to aid in the nation's post-war efforts to rebuild. According to
Wednesday's announcement by the ministry of finance, $65 million
of the loan will be used toward the fight against HIV. An
estimated 3 million Ethiopians have HIV or AIDS.
"South Africa Mining Firms Test Workers for AIDS"
Reuters (www.reuters.com) (02/13/01); Swindells, Steven
Anglo American Platinum, a major South African mining firm,
has gained the union's approval to begin testing miners in the
country for HIV. The results of the anonymous testing is
expected to have a significant impact on the overall mining
business, which represents the majority of Africa's foreign
exchange revenue. Economic consultants from WEFA South Africa
estimate that 4 million semi- and unskilled South African
laborers could die from the disease between 2010 and 2015, with
the most significant impact among miners. Health experts said
Tuesday that an estimated 25 percent of South Africa's 500,000
miners may be infected with HIV.
"Zambia: Government Sets Aside K31 Billion for AIDS Fight"
Africa News Service (www.africanews.org) (02/13/01)
Zambia's finance and economic development deputy minister Godfrey
Simasiku said the government has earmarked 31 billion kwacha for
the battle against AIDS. Simasiku, speaking to group of
businessmen and civic leaders at a budget meeting in Solwezi last
Friday, also said that the number of AIDS orphans in the country
could increase from about 700,000 now to 1 million in the next
four to five years.
- "Toward a Global AIDS Fund"
New York Times (05.02.01)
"The public attention given in recent months to Africa's
AIDS crisis has not been matched with money," began the editors.
"Last year the world spent about $1 billion on AIDS in
developing countries-a sum that will not even buy adequate
prevention campaigns, much less health infrastructure, care for
AIDS orphans and necessary medicines for the sick." The editors
noted UN Secretary-General Kofi Annan's speech last week at the
African AIDS summit in Nigeria, which "lays out a solid basis
for a global attack on AIDS, tuberculosis and malaria." In his
speech, Annan called for a global AIDS fund totaling $7 billion
to $10 billion a year to help stem the epidemic.
The editors projected how a global AIDS fund would be used.
"At least initially," they wrote, "a large part of the money
will go toward building a health infrastructure in the African
nations most ravaged by AIDS." The editors are encouraged that
"African leaders from 43 nations have pledged to increase their
spending on health, and especially on AIDS," which "is a welcome
sign that African leaders are taking AIDS and health issues more
But the global AIDS fund will depend on more than Africa's
commitment to improving its AIDS-fighting programs, and the
editors fear that US contributions won't be enough. "The global
AIDS fund ... is likely to be handicapped by a lack of leadership
from the United States. While Bush administration officials speak
about AIDS as a catastrophe, the president's 2002 budget adds
less than 10 percent to this year's spending for AIDS overseas....
Former President Clinton suggested to the Nigeria AIDS conference
that Washington should provide a quarter of the global AIDS fund.
President Bush's budget falls more than $1 billion short of
that," the editors concluded.
"First Rule of AIDS in Africa: Do No Harm"
Wall Street Journal (05.02.01) Holman W Jenkins, Jr
The editorial addressed the ongoing debate surrounding the
pharmaceutical industry's price reductions for AIDS drugs,
specifically for those countries in Africa ravaged by the
disease. "There is no doubt that a strictly applied drug regimen
could prolong millions of African lives, but high prices have
nothing to do with why it's not happening," insisted the author.
"If Africans and other Third Worlders are left out, it's not
because of 'corporate greed' but because there is no price at
which they would become customers for antiretroviral therapy,"
the author said, citing that several drug companies offered AIDS
drugs to African governments at or below manufacturing cost, but
"There were no takers."
The author discussed the difficulty that delivering and
managing drug treatment in Africa would present. He quoted a
recent issue of Patient Care that concurred: "'Patients need to
be told specifically about the serious consequences of
nonadherence and that treatment failure may result if even a few
doses are missed.'" The author pointed to a San Francisco
General Hospital study that found that "anything less than 95%
compliance can raise to 50% the chances of treatment failing and
a resistant virus emerging." And, "This is to say nothing of the
long-term toxicities that have emerged," which include liver
failure, kidney failure, a weakening of the bones, nausea,
diarrhea, vomiting, lactic acidosis and a skewed fat metabolism.
The author also noted how "many of the drugs come with stringent
dietary restrictions" that are much easier to adhere to in the
Western world where "patients have access to adequate nutrition
in sanitary conditions and clean water."
"Today's high prices represent not an absence of
competition but an absence of piracy," the author continued.
Drug companies have brought out 20 antiretrovirals since AZT was
introduced, he said, and such "progress doesn't come cheap." He
warned in conclusion, "This work will come to a screeching halt
if the mau-mau crowd wins the day because recovering [research
and development] costs would become impossible. And somewhere
down the road lies a drug that really would help save African
"What the World Needs Now"
POZ (05.01) Gregg Bordowitz
Leaders of the three-year-old South Africa-based Treatment
Action Campaign (TAC) have succeeded in issuing a wake-up call to
governments and pharmaceutical companies around the world. Last
July, TAC activists seized the world stage with a massive protest
before the AIDS Conference in Durban. In November, TAC led the
way to the first-ever waiver allowing importation of a generic
medication for South Africa's 4 million people with HIV. And it
was TAC's call to make HIV and opportunistic infection medicines
available to all HIV-positive South Africans that finally brought
drug companies to the negotiating table regarding price
reductions for AIDS drugs in developing countries.
At TAC's helm is 38-year-old, gay, HIV-positive activist
Zackie Achmat, who was jailed and beaten by police for his anti-
apartheid efforts in the late 1970s. In October he was arrested
and charged with illegal importation of drugs for bringing 5,000
capsules of Biozole, the Thai version of Pfizer's patented
fluconazole, into South Africa. Yet Achmat refuses to take
medications himself. Supporters have offered to purchase
antiretroviral drugs for him outright, but he has publicly
declared that he will not take any drugs unless they are
available to everyone in South Africa. "I have decided not to
take antiretrovirals because I don't want to live in a world that
devalues the lives of poor people simply because they are poor. I
could never look those people in the eye, and I couldn't lead
them, if I was taking my medicines while they were going
without," Achmat told POZ.
Achmat's pledge is a display of the kind of leadership that
could turn around the AIDS epidemic. In three short years, TAC
has not only pushed the South African government to expand HIV
drug access, it has also helped establish an activist network
among poor nations producing, procuring and distributing quality
medicines despite trade restrictions and drug industry pressure.
"It's the activism that pushed my CD4 counts up. It's the fact
that I have so many more friends now-people with and without
HIV-because they realize that we are doing something together
and we can win. Not because of the stand I've taken, but because
TAC is giving them hope," Achmat said.
"Annan Speaks About the Fight Against AIDS"
Associated Press (05.01.01) Gina Cappello
"The world has the resources to defeat this epidemic if it
really wants to," UN Secretary-General Kofi Annan said of the
global AIDS epidemic Monday. "But at present, there's a lot of
confusion about how the money should be raised, where it should
be directed and who can ensure that it's well spent." Annan
addressed more than 2,000 philanthropists and business leaders at
the 52nd annual conference for the Council on Foundations, urging
public and private organizations to work together to fight the
spread of HIV and AIDS. Annan once again suggested the creation
of a global fund dedicated to the battle against HIV/AIDS and
other diseases to be brought before the June 25 special UN
session on HIV and AIDS.
"IMF Urges Countries to Contribute to AIDS Fund"
Associated Press (05.01.01) Harry Dunphy
At the conclusion of the spring meetings of the
International Monetary Fund and World Bank, finance ministers and
central bank governors announced their support for the
establishment of a global fund to combat AIDS and other diseases.
The ministers pledged there would be a substantial increase in
funds to fight AIDS and other infectious diseases in poor
countries. "What's clear now is that the commitment is growing
by leaps and bounds, particularly among finance ministers in the
industrialized countries as we saw this weekend," said Chris
Lovelace, director of World Bank's unit for health, population
- I have a new hero:
"Catholic Bishops to Fight AIDS"
South African Press Association (07.27.01)
Catholic bishops from across southern Africa gathered on
Wednesday at St. Peter's Seminary in Garsfontein, Pretoria, to
attend the Southern African Catholic Bishop's Conference (SACBC).
Bishop Reginald Cawcutt, spokesperson, said the six-day
conference was aimed at preventing the spread of HIV/AIDS. A
substantial part of the conference's discussions will focus on
the AIDS and a proposal that the church reconsider its ban on
condoms to combat the spread of disease, he said.
Almost five million South Africans are HIV-infected. Earlier
this month in the United States, Rustenburg Bishop Kevin Dowling
proposed that the church's ban on condoms be lifted, saying AIDS
was killing so many people he felt he could not duck the issue.
Dowling was supported in his proposal by the Catholic newspaper
Southern Cross, which said condoms provided one way of stemming
the AIDS pandemic. The newspaper called on the church to
reconcile its total ban on contraception with the philosophy of
the sanctity of life.
SACBC President Cardinal Wilfrid Napier said Dowling's
statement would be weighed against not only the church's
teachings, but also scientific evidence on the effectiveness of
condoms in preventing infection. The conference will also focus
on Angola, whose government the church has accused of encouraging
sexual permissiveness through a recently launched campaign to
promote condom use. The conference wraps up on Monday.
"World Education Leaders Sound Alarm over AIDS Pandemic"
Agence France Presse (07.26.01)
The AIDS pandemic has had a bigger effect on teaching than
any other profession and threatens to wipe out the trade in
Africa within 10 years, a global conference heard Thursday. "The
percentage of teachers who have died or carry the HIV virus is
higher than for most professional groups," said Fred van
Leeuwen, secretary general of Education International (EI). The
confederation of about 300 teaching unions and organizations from
155 countries is holding a conference in Thailand focusing on
teaching in the age of globalization.
Some 35-40 percent of secondary school teachers in Botswana
are infected with HIV, the EI said. "In the next 10 years, if
nothing is done, the ranks of teachers will completely disappear
in Africa," said Monique Fouiloux, EI's AIDS specialist. There
are also concerns that teachers are abusing their position to
sexually exploit children under their care, helping fuel the
transmission of the deadly disease. This year in conjunction with
other international institutions including UNESCO, EI intends to
make AIDS prevention an integral part of its education mission.
In the process, it will have to counter significant cultural
barriers that hamper frank discussion of AIDS, a problem that is
particularly severe outside the cities. "In Botswana, the only
place where it is difficult to talk about AIDS is in rural
areas," said Japhta Radibe, a representative of the Botwsana
Teachers Union. "Even before HIV/AIDS, we had a shortage of
teachers, but the pandemic has aggravated it," she said.
"AIDS Costs Kenya Heavily"
According to Kenya's National AIDS Control Council, the
nation is losing about $2.6 million daily to the HIV/AIDS
epidemic. Speaking at the Nairobi Provincial AIDS Control
Committee workshop this week, Chair Mohammed Abdullah said that
certain practices are spreading the disease and his council is
now advocating an attitude change and measures to reduce
transmission. Chris Kirubi, a council member, urged the
government to end and criminalize female genital mutilation and
blamed the practice for helping the spread of HIV/AIDS. Other
measures recommended include ending prostitution along Nairobi
streets and curbing the influx of child prostitutes. Kenya is one
of the sub-Saharan African countries hardest hit by AIDS: 1.1
million Kenyans have died of the disease since 1984, and 2.2
million others are living with HIV.