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AFRO-NETS> Kaiser Daily HIV/AIDS Report - Mon, 14 Jan 2002

  • Subject: AFRO-NETS> Kaiser Daily HIV/AIDS Report - Mon, 14 Jan 2002
  • From: Cecilia Snyder <csnyder@ccmc.org>
  • Date: Mon, 14 Jan 2002 16:26:58 -0500 (EST)

Kaiser Daily HIV/AIDS Report - Mon, 14 Jan 2002

* HIV/AIDS Presents 'Profound Threat' to South African Education Sys-
tem, Study Says
* Nine-Month-Old Rape Victim Receives Course of AZT, Drawing Atten-
tion to Varied Post-Exposure Treatment Practices in South Africa
* NPR's 'Weekend Edition Saturday' Profiles Former Zambian President
Kenneth Kaunda's AIDS Efforts

HIV/AIDS Presents 'Profound Threat' to South African Education Sys-
tem, Study Says

South Africa's HIV/AIDS epidemic is killing students and teachers and
is "dramatically reducing" school enrollment, threatening the entire
education system, USA Today reports. A recent University of Natal
study found that 275,000 school-aged students in KwaZulu-Natal prov-
ince -- a region of South Africa where one in three adults is HIV-
positive -- are not attending school. Since 1998, enrollment in first
grade has dropped 60%, and the decline is even more dramatic for
girls, "suggesting a growing gender imbalance in the system after
years of near equity." Sick or dying parents often "never bother to
enter their kids in school," the report said, adding that those who
are enrolled in school often leave before graduation to "care for dy-
ing parents and later, siblings." In addition to the drop in numbers
of students, the study reported that 85% of schools in the province
have reported the death of teachers "presumably" from AIDS-related
illnesses. As many as 70,000 new teachers, often drawn from a less
experienced and younger population with "even higher HIV infection
rates," will be needed in the province over the next 10 years, as
AIDS deaths among teachers are expected to rise "dramatically." As
schools lose students and teachers, the already financially strained
school systems are experiencing a "financial crisis." The "poverty-
stricken" community, which was poor before AIDS arrived, is even
poorer now, making many people unable to pay the school fees, on time
or at all, which fund teacher salaries and school maintenance. "The
education system is under a profound threat. We're seeing a decline
in the quality of education. And the productivity and potential of
the country will be negatively affected," Peter Badcock-Walters, the
report's author, concluded (Singer, USA Today, 1/14).

Nine-Month-Old Rape Victim Receives Course of AZT, Drawing Attention
to Varied Post-Exposure Treatment Practices in South Africa

Officials at a hospital in South Africa's Northern Cape province have
been "scold[ed]" by provincial health officials for administering AZT
to a nine-month-old baby who had been raped, but some medical profes-
sionals say that doctors in several provinces have "quietly" been
giving post-exposure antiretroviral treatment to rape victims "for
some time," against national government policy, the Johannesburg Mail
& Guardian/AllAfrica.com reports. The South African Department of
Health in 1999 issued national guidelines for antiretroviral treat-
ment that barred doctors from giving the drugs in government hospi-
tals, even to victims of rape. According to the guidelines, post-
exposure antiretroviral treatment is only supposed to be given to
health care workers who may have been exposed to HIV-contaminated
blood. However, doctors at a Kimberley hospital gave a full course of
antiretroviral treatment to the infant who had been raped. After
"widespread media coverage" of the incident, Northern Cape Health
Minister Elizabeth Dipuo Peters called hospital CEO Deon Madyo to
"cross-questio[n] him" on why the baby received the drugs and whether
"the practice was widespread" or represented an isolated incident.
The Mail & Guardian/AllAfrica.com reports that Madyo has repeatedly
said that the baby's treatment with AZT was a "mistake" and that the
hospital is "the only state institution in the province where such an
incident had occurred." Provincial health officials have said that
the baby was given antiretroviral treatment because an "outdated cir-
cular" issued by the province for doctors in 1997 -- two years before
the creation of the national guidelines -- said that "doctor discre-
tion should be used" in the administration of antiretroviral treat-
ment in rape cases. The doctor who gave the drugs to the baby told
Madyo that he was not aware that the policy on antiretroviral treat-
ment had changed. After the recent case was publicized, the hospital
released a circular on Dec. 4 "reminding" doctors that they cannot
dispense antiretroviral treatment to victims of rape.

Isolated Incident or Widespread Practice?

Although Madyo described the baby's treatment as an isolated inci-
dent, the Mail & Guardian/AllAfrica.com reports that "other sources"
say that the policy recommending that physicians use discretion when
prescribing antiretroviral treatment in cases of rape "was never re-
viewed and continued to be followed [by the hospital] -- with the
full knowledge of the health authorities -- until the media arrived"
to cover the event. The Mail & Guardian/AllAfrica.com reports that
"[i]t appears that as in many other provinces, doctors had been ad-
ministering antiretroviral drugs despite national government policy."
Beatrix Weber, a doctor who recently worked at the Kimberley hospi-
tal, said that the facility "had a policy of administering the drugs"
and had prescribed them at physicians' discretion "for some time" be-
fore recent case came to light. AIDS activists and doctors say that
several provinces have "quietly" continued to provide post-exposure
antiretroviral treatment, but Weber said that the media attention of
this case "may well be fatal to future Northern Cape rape victims"
because it prompted the hospital to announce formally that antiretro-
viral treatment would not be provided (Magardie/Deane, Johannesburg
Mail & Guardian/AllAfrica.com, 1/11).

Opposition Party Expresses 'Disgust'

Members of opposition parties expressed "disgust" at Peters' reaction
to the infant's treatment with AZT. "[Peters] should be charged with
attempted negligence," Dr. Costa Gazi, a health spokesperson for the
Pan Africanist Congress, said. Gazi said that the doctor who gave the
drugs to the baby should "stand his ground" because there is "plenty
of support" for his actions. Dr. Ruth Rabinowitz, a spokesperson for
the Inkatha Freedom Party, called Peters' reaction "appalling," add-
ing, "It suggests the government has no desire to help anybody." Of-
ficials from the Greater Nelspruit Rape Intervention Project (GRIP),
which provides post-exposure antiretroviral treatment to rape vic-
tims, also criticized Peters' action. GRIP CEO Barbara Kenyon said
that it was "absolutely ridiculous to tell doctors not to do what
they have been trained to do -- prescribe medication" (South African
Broadcasting Corporation, 1/11).

NPR's 'Weekend Edition Saturday' Profiles Former Zambian President
Kenneth Kaunda's AIDS Efforts

NPR's "Weekend Edition Saturday" this week profiled Kenneth Kaunda,
Zambia's first president and one of the few African leaders who
"waged an early and public fight" against HIV/AIDS. "[T]he specter of
AIDS was already rising" in the country when Kaunda left office in
1991, and the president decided to call attention to the disease be-
fore stepping down. Before he left office, Kaunda publicly announced
that his son had died of AIDS-related causes, "something no other Af-
rican leader has since done," NPR reports. Kaunda now travels all
over the world to talk about AIDS and to persuade donors from wealth-
ier nations to give money to some of his "many projects," which in-
clude shelters for orphans, school fees to educate children and radio
stations that "will break the silence that keeps Africa in the grip
of AIDS." Kaunda hopes that his experience as a public leader will
help him garner more donations for his Children of Africa Foundation.
"We need others to sacrifice, also, for the sake of Africa, for the
good of Africa. Come and help fight AIDS, otherwise the continent
will perish," Kaunda said (Wilson, "Weekend Edition Saturday," NPR,
1/12). An audio version of the Kaunda profile can be found online at
the NPR Web site.

The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org,
a free service of The Henry J. Kaiser Family Foundation, by National
Journal Group Inc. © 2002 by National Journal Group Inc. and Kaiser
Family Foundation. All rights reserved.

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