AFRO-NETS> Re: Dr Robello's Frankspeak

[Joy Olivier <joy@bridges.org>]

Re: Dr Robello's Frankspeak
---------------------------
 
I was dismayed to see this posting on AIDS day, where here in 
South Africa we are celebrating the government's turn-around to 
roll out the anti-retrovirals that will help to drastically im-
prove the health and related socio-economic status of so many of 
our citizens.
 
I forwarded Dr Robello's e-mail to Claire Kelly, the Interna-
tional Volunteer Organiser for the Treatment Action Campaign. 
This was her response:
 
You're right on one point: AIDS is not the biggest health threat 
facing our world, denialism is.
 
The link between HIV and AIDS has been empirically proven over 
and over again and denial of this lies more in political motives 
than medical evidence.
 
The truth that HIV causes AIDS compels the medical profession, 
governments, academia and society as a whole to act. Denying it 
allows them to dither. The truth also is that HIV/AIDS infects 
and affects those people most at risk in our global society: the 
poor and women and children. Those with access to education, re-
sources, adequate healthcare and the other elements of basic hu-
man rights are not vulnerable. In the developed world, there-
fore, where these facilities are freely available, this does not 
seem real. Devastation on such a grand scale is hard to imagine. 
But living in sub Saharan Africa where communities are being 
ravaged and funerals are becoming weekly even daily events, it 
is much more obvious. What is causing these deaths? The evidence 
points to HIV/AIDS. The problem is there is there is no profit 
to be made here. These people have no money. To deny the exis-
tence of HIV/AIDS allows those doing the denying to turn a blind 
eye and a continue in those practices that do bring in a profit.
 
With regards to the use of antiretrovirals... yes they are po-
tentially harmful, if incorrectly used. If incorrectly used ANY 
dug is potentially harmful. Radiation therapy for cancer pa-
tients, for example, is devastating on the body and if improp-
erly administered, lethal. The same is true for ARV's. Correctly 
managed, however, they allow HIV positive people to live active 
and productive lives. How do we account for the miraculous re-
coveries of people on antiretrovirals? Magic? Voodoo? Medical 
Science. It is also necessary to remember that AZT is not the 
only antiretroviral. There are numerous, each one suitable for a 
different stage of HIV/AIDS progression. Once again it is not 
ARV's which are the problem, it is ignorance about them that 
perpetuate fear and dangerous untruths.
 
The biggest hurdle facing us in the struggle against HIV/AIDS, 
is misinformation and denial. The solution: educate yourself. 
And I mean really educate yourself, speak to people living with 
HIV/AIDS, speak with people on ARV treatment and visit sub Saha-
ran Africa.
 
Please find the following from http://www.tac.org.za (Treatment 
Action Campaign website )for your information:
 
Links Showing That HIV Causes AIDS 
http://www.niaid.nih.gov/factsheets/evidhiv.htm 
This is the definitive National Institutes of Health article de-
bunking the myths that the AIDS denialists perpetuate.
 
http://www.sfaf.org/aboutsfaf/outreach/index.html?june00/hiv_causes_aids.html 
A simple look at the politics and history of AIDS denialism.
 
http://my.webmd.com/content/dmk/dmk_article_5462570 
An explanation with diagrams, explaining how HIV causes AIDS.
 
http://www.unaids.org/special/ 
A shorter look at the myths the AIDS denialists perpetuate than 
the NIH article above.
 
Links and Abstracts about the Efficacy of Antiretroviral Treat-
ment 
http://www.hivatis.org/trtgdlns.html 
 
These are the AIDS Treatment Information Service guidelines 
which President Mbeki has misquoted and misunderstood in order 
to excuse not treating people with HIV/AIDS. An extract from the 
summary as of August 2001 states: "... treatment should be of-
fered to all patients with the acute HIV syndrome, those within 
six months of HIV seroconversion, and all patients with symptoms 
ascribed to HIV infection. Recommendations for offering antiret-
roviral therapy in asymptomatic patients require analysis of 
many real and potential risks and benefits. In general, treat-
ment should be offered to individuals with fewer than 350 CD4+ T 
cells/mm3 or plasma HIV RNA levels exceeding 30,000 copies/mL 
(bDNA assay) or 55,000 copies/mL (RT-PCR assay). The strength of 
the recommendation to treat asymptomatic patients should be 
based on the willingness and readiness of the individual to be-
gin therapy; the degree of existing immunodeficiency as deter-
mined by the CD4+ T cell count; the risk of disease progression 
as determined by the CD4+ T cell count and level of plasma HIV 
RNA; the potential benefits and risks of initiating therapy in 
asymptomatic individuals; and the likelihood, after counseling 
and education, of adherence to the prescribed treatment regi-
men." 
(from http://www.hivatis.org/guidelines/adult/Aug13_01/text/index.html )
 
Here is the abstract of one of the most important papers pub-
lished on the efficacy of antiretroviral treatment. Further re-
search has refined some some of the conclusions below (e.g. the 
authors' findings regarding protease inhibitors), but the core 
result that "... recent declines in morbidity and mortality due 
to AIDS are attributable to the use of more intensive antiretro-
viral therapies" remains unchanged. N Engl J Med 1998 Mar 
26;338(13):853-60 Declining morbidity and mortality among pa-
tients with advanced human immunodeficiency virus infection. HIV 
Outpatient Study Investigators. Palella FJ Jr, Delaney KM, 
Moorman AC, Loveless MO, Fuhrer J, Satten GA, Aschman DJ, Holm-
berg SD. Northwestern University Medical School, Chicago, IL 
60611-0949, USA. BACKGROUND AND METHODS: National surveillance 
data show recent, marked reductions in morbidity and mortality 
associated with the acquired
 
Please look at TAC's website. Their remarkable work is achieving 
great things for South Africa. Their chairperson, Zackie Achmat, 
and the organisation have been nominated for the Nobel Peace 
Prize.
 
Many thanks,
 
Joy Olivier
Policy Associate
mailto:joy@bridges.org
http://www.bridges.org

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