[afro-nets] Nutrition Support for PLWHA (11)

[Ifedayo Adetifa MD <ifedayo_tiffy@yahoo.com>]

Nutrition Support for PLWHA (11)
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Hello Bradford and All,

I completely agree with Bradford's comments and the issues re-
lating to living conditions, food and home security are particu-
larly relevant in the setting I live and work. Many of these
problems related to national poverty, distressed economies, il-
literacy and the list is endless predate the accelerated HIV
prevalence and incidence we see now. They require completely
wholesome approaches by governments and peoples in sub-Saharan
Africa to get them reduced and eventually solved but what do we
do in the interim.

As you may be aware, the criteria for starting ARVs as recom-
mended for resource limited settings by the WHO differs exten-
sively from what obtains in countries like yours. Clinical cri-
teria is often used in many places where CD4 counts are not
available, viral loads are not affordable nor readily available.
Most times, physicians who are competent in HIV medicine have to
start treatment for the very sick who have clinical AIDS and as
you know, the outcomes of such treatments compare unfavorably to
treatment started appropriately. Many of these issues contribute
to the difference in the natural history of HIV infection for
example in Africans compared to PLWHAs in North America and
Western Europe.

We really need to have in place immediate short term also long
term measures to improve the physical quality of life index and
economies of most African countries. If you have a long life ex-
pectancy even without HIV, it is likely that with HIV you are
likely to also do well compared to those who live in places with
life expectancy of 47-54 years (figures from some countries here
including mine).

The million dollar question is while waiting or appreciating the
need for the improvement of the overall quality of life of peo-
ple living in developing countries what do you do about the
prevalent diseases, in this case HIV/AIDS?


Ifedayo Adetifa MD
mailto:ifedayo_tiffy@yahoo.com