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AFRO-NETS> Kaiser Daily HIV/AIDS Report - Fri, 25 Jan 2002

  • Subject: AFRO-NETS> Kaiser Daily HIV/AIDS Report - Fri, 25 Jan 2002
  • From: Cecilia Snyder <csnyder@ccmc.org>
  • Date: Fri, 25 Jan 2002 16:20:08 -0500 (EST)

Kaiser Daily HIV/AIDS Report - Fri, 25 Jan 2002

* AIDS Death Toll 'Likely' to Surpass That of Bubonic Plague, Expert
Says in British Medical Journal Special Issue on HIV/AIDS
* Political Will, Drugs Needed
* BMJ Challenges Community
* AIDS Drug Distribution in KwaZulu-Natal Put on Hold by Province
Health Minister; Premier Reiterates 'Principled Stand' on Plan

AIDS Death Toll 'Likely' to Surpass That of Bubonic Plague, Expert
Says in British Medical Journal Special Issue on HIV/AIDS

AIDS -- which has already killed 25 million people worldwide -- will
overtake the bubonic plague as the "world's worst pandemic" if the 40
million people currently infected with HIV do not get access to life-
prolonging drugs, according to a public health expert, Reuters/Contra
Costa Times reports. "Despite the impressive advances in medicine
since [the time of the bubonic plague], HIV/AIDS is likely to surpass
the Black Death as the worst pandemic ever," Peter Lamptey, Family
Health International AIDS Institute president, writes in a report in
the Jan. 26 issue of the British Medical Journal, which is a theme
issue on HIV/AIDS (Reaney, Reuters/Contra Costa Times, 1/24). Bubonic
plague, which is also known as the Black Death, killed 40 million
people in Asia and Europe in the 1300s, wiping out about 25% of
Europe's population, the Hamilton Spectator reports. Similarly, 25%
to 30% of young adults in some African populations are HIV-positive.
Lamptey noted that 95% of the 14,000 people who become infected with
the virus each day live in the world's poorest countries, where drug
treatment is not readily available and HIV prevention programs often
fail because of a lack of resources and international commitment. "We
need the resources, we need the political commitment and will to be
able to reverse the situation," Lamptey concluded (Bouchez, Hamilton
Spectator, 1/25).

Political Will, Drugs Needed

"[L]ack of political will" is keeping these drugs from HIV-positive
people, Zackie Achmat of South Africa's Treatment Action Campaign
writes in a separate commentary in the journal. According to Insti-
tute for Healthcare Improvement President and CEO Donald Berwick,
writing in an "Education and Debate" column, drug companies "could
hold the key to fighting AIDS," as "modern drugs can improve the
lives of people with HIV by years, even decades, but their high costs
are often cited as the reason why poor countries cannot develop ef-
fective infrastructures for the care of patients." However, GlaxoS-
mithKline Chair Richard Sykes writes in a commentary that the cost of
drugs is "too eas[ily]" named as the primary barrier to treatment for
those in developing countries (BBC News, 1/25).

BMJ Challenges Community

In an editorial, BMJ said that the special issue is meant to "chal-
leng[e] the global community to overcome its amnesia and fatigue, mo-
bilize its ample collective resources, and make 2002 the turning
point in tackling HIV." The editorial says that the need for justice
"dominates" the issue, adding that "authors in this week's BMJ demand
actions that are based on justice: the distribution of antiretroviral
drugs to the world's poorest people; the empowerment of women; the
urgent search for an HIV vaccine; and the care and education of chil-
dren orphaned by AIDS" (Yamey/Rankin, BMJ, 1/26). The entire issue is
available for free online.

AIDS Drug Distribution in KwaZulu-Natal Put on Hold by Province
Health Minister; Premier Reiterates 'Principled Stand' on Plan

The KwaZulu-Natal health minister on Wednesday said that the eastern
South African province would not be able to "immediately" distribute
to HIV-positive pregnant women the AIDS drug nevirapine -- a WHO-
approved antiretroviral that may be able to reduce mother-to-child
HIV transmission by up to 50% -- "counter to a pledge" made Monday by
province Premier Lionel Mtshali, the Associated Press reports. Zweli
Mkhize, health minister of "South Africa's most AIDS-stricken prov-
ince," said that the drugs could not yet be distributed because "ade-
quate backup systems were not yet in place" to administer the drug.
The Associated Press reports that it was not clear whether the an-
nouncement by Mkhize, who is a member of the ruling African National
Congress, was politically motivated (Associated Press, 1/23). How-
ever, Mtshali, who is a member of the Inkatha Freedom Party, which
controls KwaZulu-Natal, yesterday said in a statement, "No amount of
political pressure would make me renege on this principled stand. If
it means paying a political price for it, so be it." Mtshali added,
"I reiterate for the whole to understand clearly, that I stand reso-
lutely by the announcement I made on Monday" (South African Press As-
sociation, 1/24). The announcement that the province would provide
nevirapine to all HIV-positive women was "seen as a direct challenge"
to the South African government's stance on the drug. Despite a court
order last year that country officials begin distributing nevirapine,
the ANC maintains that the safety of the drug is "unproven" and an
infrastructure to provide counseling and backup treatment to drug re-
cipients "has to be put in place" before the drug can be distributed
(Associated Press, 1/23).

'Desperate Situation'

Although the drugs would be provided for free to all HIV-positive
pregnant women under KwaZulu-Natal's distribution plan, the "problem-
atic costs 'lie in the provision of counseling and other staff needed
to run the mother-to-child transmission program and space at institu-
tions to run the program effectively," Mkhize said. "When [Mtshali's]
announcement was made, none of us were actually ready. Yes, nevirap-
ine will be rolled out, but we want to take all the problems into ac-
count," Mkhize said in an interview with South African Broadcasting
Corporation public radio (Agence France-Presse, 1/23). However,
Mtshali yesterday said that any anticipated problems must be pre-
sented to the provincial Cabinet "so that they can be dealt with
swiftly." He added, "Saving lives is what we as government are called
upon to do. As premier I would not like to be relegated to the dust-
bin of time for failure to act decisively and promptly to alleviate a
desperate situation" (South African Press Association, 1/24). Nearly
one quarter of pregnant women in South Africa are HIV-positive, and
more than 70,000 infants are infected with HIV through vertical
transmission each year (Agence France-Presse, 1/23). South Africa's
national government, led by President Thabo Mbeki, who has questioned
the link between HIV and AIDS, has continually "come under fire for
its haphazard approach" toward fighting HIV/AIDS (Kaiser Daily
HIV/AIDS Report, 1/22).

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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