| HEALTH:
AIDS Conference Puts Spotlight on Poverty
By
Marcela Valente
BUENOS
AIRES, Jul 10 (IPS) - Science may soon have the means to control
HIV/AIDS, but the disease will continue to be devastating for poor
countries, even if a vaccine is developed, just as other preventable
or curable ills persist in the developing world .
Such
is the forecast of infectious disease specialist Pedro Cahn, of
Argentina, chair of the first International AIDS Society Conference
on HIV Pathogenesis and Treatment, underway in Buenos Aires through
Wednesday, with the participation of more than 3,000 scientists,
officials and activists from around the world.
''AIDS
(acquired immuno-deficiency syndrome) has put the spotlight on problems
like poverty, hunger, lack of housing and the total absence of bio-safety
in the hospitals, all issues that predate the arrival of the virus''
Cahn told IPS.
The
short life expectancy in Ethiopia, just 45 years, was a problem
before HIV (human immuno-deficiency virus), the precursor to AIDS,
began to spread in that country, he cited as an example.
HIV,
which causes the progressive deterioration of a person's immune
system, is currently carried by nearly 40 million people worldwide,
and causes the deaths of some three million annually. Seventy percent
of the cases are recorded in sub-Saharan Africa, the world's poorest
region.
The
differences between poor and rich countries as far as access to
treatment for the disease became starkly evident during the first
day of the Buenos Aires meeting, Sunday.
Anti-retroviral
treatments, which combine several medications and are known as ''cocktails'',
reduce mortality rates 95 percent, but regular and uninterrupted
access to these drugs varies greatly from one region to the next.
Stefano
Vella, president of the Stockholm-based International AIDS Society,
believes it is essential that the industrialised North pay higher
prices for the medications and that the developing South receive
them at cost, without paying patent rights to the pharmaceutical
transnationals - a practice Brazil and South Africa have already
adopted.
The
two countries were the protagonists in a heated international dispute
with the drug companies and with the United States government as
they vindicated their right - during public health emergencies involving
HIV/AIDS - to abstain from recognising intellectual property rights
over the necessary drugs.
Within
the last few months, the United States withdrew a case against Brazil
pending before the World Trade Organisation, and a group of 39 transnational
drug labs cancelled their case against the South African government
in that country's courts.
Malawi's
minister of Health and Population, Feliz Salaniponi, told the conference
in the Argentine capital about his proposal to control HIV/AIDS
using the same infrastructure utilised in fighting tuberculosis
and malaria, attempting to take advantage of the same human resources,
though with some additional training.
The
financing of the initiative was the main target of the criticisms.
Who will pay the cost of the drugs? Who will make sure that the
patients have transportation to and from the clinics for treatment?
How will the quality of the lab tests be verified?
The
questions were left without answers. Sakaniponi's presentation was
followed by that of doctor Jens Lundgren, of the Department of Infectious
Diseases at the Hvidovre Hospital in Denmark, in which he outlined
the results achieved in HIV/AIDS treatment in Europe.
There,
it has been clear that results are very good when patients are assured
access to the HIV/AIDS drugs and to ongoing treatment, though it
is too soon to say that the disease can be kept under control in
all cases, said Lundgren.
Nearly
all experts from industrialised countries at the conference agreed
that the combined anti-retroviral treatments still have two major
obstacles to overcome.
First,
there is fear that the virus will mutate and develop new strains
that are resistant to the cocktail treatment. Second, the drugs
have adverse effects, which is a key concern in a patient's acceptance
of treatment. Among the negative effects is a predisposition to
cardiovascular problems.
Along
those lines, the presentation of Anthony Fauci sparked a great deal
of interest. The doctor, head of the Washington-based Institute
of Allergy and Infectious Diseases, has studied the results of implementing
the anti-retroviral cocktail every other week.
According
to Fauci's tests, HIV remains undetectable in the blood of the patients
following this treatment schedule, which curbs the adverse effects
of the medications on the body and, at the same time, reduces the
costs of the therapy itself.
This
variation of the cocktail is being implemented - though only among
small groups - in the United States, Spain, Italy, France, and soon
in Brazil. Argentina is also experimenting with this approach, though
with even longer periods between drug administrations.
David
Ho, director of the Diamond AIDS Research Centre in New York, cautioned
that the combined treatments have not yet achieved complete eradication
of the HIV. The virus tends to remain, for example, in the t-cells
of the body's immune system.
Furthermore,
said Ho, the drugs available today do not block reproduction of
the virus 100 percent, though he stressed that the cocktail is currently
the most effective tool in treating HIV/AIDS, as long as there is
adequate control and follow-up in the administration of the drugs.
That
is the most difficult part of treatment in developing countries,
which lack resources to ensure effective control and consistent
treatment for patients with HIV/AIDS.
Because
of this, and despite the fact that the Buenos Aires conference focuses
on the exchange of experiences in achievements and failures in treating
the disease, the scientists gathered here continue to emphasise
that prevention is still a top priority. (END)
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