Where you live is life or death if you have HIV :: Namibia Internet Gateway cc ::

Articles: Where you live is life or death if you have HIV

Posted by admin on Monday, July 12, 2004 - 01:02 AM

As thousands of physicians, disease experts, activists and others concerned about the planet's leading health threat converge on Bangkok, Thailand, this week for the 15th International AIDS Conference, it might be worth considering basketball legend Earvin "Magic" Johnson.
Johnson represents the difference between AIDS in the United States and much of the rest of the world. More than a dozen years ago, he announced he was infected with HIV. Today, he's a successful businessman, a sports commentator and part owner of the Los Angeles Lakers. Magic Johnson is doing well, apparently, and his HIV status is no longer news. In many poor nations, where the virus is still continuing to spread at an increasing rate, it's a different story. "The inequity is just intolerable," said Dr. Stephen Gloyd, director of the University of Washington's international health program and someone who has worked closely with the Clinton Foundation to make anti-AIDS drugs more affordable and accessible in Africa. Every day in the developing world, 5,000 people die from AIDS. Unlike Johnson and others with HIV in the developed world, most of those in poor nations don't have access to the drugs that can suppress the virus enough to make HIV a chronic, manageable infection. Of the 6 million people in the developing world who are sick and need these drugs right now, Gloyd said, only about 400,000 are getting them. Gloyd, who is not attending this AIDS summit, said the Bangkok meeting's theme of "Access for All" may signify that the situation finally has become so intolerable that the international community is going to back up its rhetoric with its money. Several initiatives, such as the Clinton Foundation's AIDS program, the international Global Fund for AIDS, Tuberculosis and Malaria, the World Health Organization's AIDS initiative and the Bush administration's Emergency Plan for AIDS Relief, have promised to mobilize billions of dollars toward closing the AIDS treatment gap between developed and developing countries. "There are encouraging signs that donors are taking this (need for expanded access to AIDS treatment) seriously," Gloyd said. "People are now talking about how to do it, not whether to do it." But the question of how is not insignificant or simple, noted Dr. Helene Gayle, head of AIDS programs for the Bill & Melinda Gates Foundation and the incoming president of the International AIDS Society, which organized this week's Bangkok meeting. Speaking by telephone from Bangkok, Gayle said she expects the issue of expanding access to anti-AIDS drugs worldwide will be one of the primary topics at the conference. But it would be a serious mistake, she said, if the need for expanding treatment overshadowed the equally urgent need for expanding disease-prevention efforts. "The rates of HIV worldwide are still increasing," Gayle said. Beefing up prevention efforts in Asia is especially urgent, she said, as there are signs in some of these nations that the virus is beginning to branch out from "high risk" groups -- prostitutes, drug users -- and into wider circulation within the general population. "We can't let down our guard on any of these fronts," Gayle said. She noted that more than 5 million people will become newly infected this year and without a serious boost in prevention efforts, the treatment programs will be in the same position as people who frantically try to bail water from a sinking boat. Others added that the simple distribution of anti-AIDS medications worldwide could actually make the pandemic worse by creating drug-resistant strains of the virus. A panel of experts convened by the National Academy of Sciences' Institute of Medicine raised that dire possibility last week when it called both for immediate expansion of the drugs worldwide and caution. The AIDS specialists warned against "sowing the seeds of failure" if the humane desire to help obscures just how complex this endeavor promises to be. Dr. James Curran, an AIDS expert at Emory University in Atlanta, and co-chairman of the panel, stressed that these anti-AIDS drugs are not "magic bullets" but must be taken over a lifetime under the supervision of trained health care workers. Some experts have said at least 100,000 more physicians and health care workers trained to handle these medications will be needed in Africa alone. Failure to increase the number of health care professionals and establish a system for monitoring the use of these drugs in poor nations, they said, could create drug-resistant strains of HIV -- an almost unimaginable catastrophe that would transform the current pandemic into an entirely new kind of monstrous threat, for the developed world as well. "We need to make sure we're striking the correct balance on both prevention and treatment," Gayle said. Treatment gets most of the attention now, she said, but it will be prevention that determines whether the disease is ultimately brought under control. Gloyd said everyone agrees that a balanced approach is needed to fight AIDS, but even two decades into the pandemic there is still no agreement on where to strike it. "We don't really have a coherent strategy," Gloyd said.

· 82 Reads ·