THE storm gathering over southern Africa鈥檚 AIDS catastrophe grew fiercer as
the World AIDS conference opened in Durban this week.
South African President Thabo Mbeki again downplayed the significance of HIV
as the killer of millions of black Africans. Poverty, he said, was more a more
important factor. His remarks were a direct snub to the 5000 leading medical
scientists who signed last week鈥檚 declaration stating that HIV is the sole and
unambiguous cause of AIDS.
Privately, WHO officials say Mbeki鈥檚 stance is born of the fear that orthodox
AIDS science will lead to a relentless campaign for drug therapies by the 4
million South Africans who are HIV-positive鈥攕omething the country can鈥檛
possibly afford.
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Around 35 million people worldwide are infected with HIV, but southern Africa
is by far the worst-affected region. Figures from the United Nations body UNAIDS
now predict that half the teenage boys alive in South Africa today will die from
AIDS. This is also the region least able to afford anti-HIV drugs, even with the
80 per cent price cuts offered by some drugs companies.
In London last week, Martin Foreman, AIDS programme director at the campaign
group Panos, said that prices of antiretroviral drugs would have to fall even
further before sub-Saharan Africa could afford them.
And even if drugs were available, Berhard Schwartman, chief epidemiologist at
UNAIDS, points out that there are not enough facilities or trained staff. 鈥淲e
would never be able to get the drugs out there so they could be administered in
the way that they should.鈥�
But a report in the latest issue of The Lancet suggests that despite
no sign of a vaccine, there is glimmer of light for those not yet infected.
Leaders of countries such as South Africa, bracing themselves for economic
devastation wrought by the AIDS virus, will appreciate that it doesn鈥檛 rely on
costly, high-tech drugs.
Voluntary HIV testing and counselling given to 4292 people in Kenya, Tanzania
and Trinidad proved to be a highly effective way of altering sexual behaviour.
Testing and counselling reduced risky behaviour by over 35 per cent, compared
with 13 per cent for people given health education alone. The results confirm
Uganda鈥檚 experience in educating its people and encouraging behavioural
changes.
But even this approach is not free of controversy. In May, the journal
Africa Health reported that the Supreme Council of Kenya Muslims is
vigorously opposing the building of a condom factory in Nairobi, which the
council says would 鈥渆ncourage immorality and promiscuity鈥�.
In Durban, UNAIDS director Peter Piot called for annual AIDS spending in
sub-Saharan Africa to rise from $350 million a year to $3 billion
a year. Much of this money would go towards treatment of AIDS complications such
as pneumonia鈥攁nd provide some incentive for infected people to come
forward.
For these measures to work, people need to realise that AIDS is caused by
HIV. That鈥檚 why, say health workers and medical researchers, the game Mbeki is
playing is such a dangerous one.
