The Developing World Needs More Condoms

At the XV International AIDS Conference in Thailand, Population Action International released a report claiming that developing nations are only receiving about 10 percent of the condoms needed to make a serious dent in the transmission of HIV.

In its 2004 update to its Condoms Count report, Population Action International estimated that the developing world needed 10 billion condoms in 2002, but aid agencies supplied only about 2.5 billion condoms.

It notes that in South Africa between 1998-2002, the number of donated condoms amounted to only 2.6 condoms per man per year (in contrast, more than 60 condoms are produced each year in the United States for each man).

PAI and others blame the United States in part for the Bush administration’s emphasis on abstinence as a solution to the AIDS crisis.

Source:

World falling short on condom provision. NewScientist.Com, July 12, 2004.

Counting Condoms: Donors Coming Up Short. Press Release, Population Action International, July 14, 2004.

Do Africans Follow Anti-HIV Drug Regimen Better Than Americans?

One of the long-standing arguments against the use of anti-retrovirals to treat the AIDS crisis in Africa goes like this: African countries like the health infrastructure to ensure that patients will consistently take anti-HIV drugs (which, of course, have a number of side effects). This will create a situation, the theory goes, where few patients take the full set of drugs and likely give rise to more virulent, drug-resistant forms of HIV.

But a survey of African patients in Botswana, Senegal, South Africa and Uganda found that, in fact, HIV patients in those countries were more likely to stick to their regimen of AIDS drugs than were Americans.

On average, the survey reported that AIDS patients in those four countries take about 90 percent of the prescribed drugs. That ranks favorably with American AIDS patients who, in similar surveys, reported taking about 70 percent of their anti-HIV drugs.

Interestingly, there is also evidence that African patients are more truthful in reporting their compliance with the anti-HIV regimen than American patients. According to the New York Times’ report of the survey results,

Moreover, doctors say, most African patients are zealous about their regimens. They are also more truthful when estimating their adherence, said Dr. David Bangsberg, a professor of medicine at the University of California in San Francisco who has studied compliance patterns here and abroad.

On average, he said, American patients tell their doctors that they are doing 20 percentage points better than they really are — that is, a patient who says he takes 90 percent of his pills will, when tested with unannounced home pill counts or electronic pill-bottle caps, turn out to be taking 70 percent.

A study of 29 Ugandan patients found that, on average, they estimated that they were taking 93 percent of pills and proved to be taking 91 percent.

There are a number of possible reason for the difference, including that in African nations a number of people in the AIDS patient’s extended family may be contributing to help pay for the relatively expensive drugs, and that AIDS patients in Africa have a more immediate experience with numerous fatalities from the disease given the relatively high death rate from AIDS in Africa compared to the United States.

Sources:

Africans Outdo Americans in Following AIDS Therapy. Donald G. McNeil Jr., New York Times, September 3, 2003.

South Africa Reverses Course — Will Distributed Anti-HIV Drugs

South Africa’s cabinet met in a special session in August and decided to finally distributed anti-HIV drugs . . . after it finishes a “detailed operational plan” to handle the distribution of such drugs. The decision was announced to coincide with the conclusion of an AIDS conference in South Africa.

Currently less than 30,000 South Africans take anti-retroviral drugs, though the government’s own report suggested that close to 500,000 could benefit from the availability of the drugs.

South African AIDS activist Zakie Achmat preferred to take a cautious approach to the announcement, telling the BBC,

We will wait to see the actual operational plan before celebration. But for all of us living with HIV in South Africa, and our families, this is the first sign of hope.

This is quite a turnaround from the same government whose Health Minister, Manto Tshabalala-Msimang has recently taken to suggesting that rather than anti-retrovirals, what AIDS patients in South Africa need to do to boost their immune systems is consume large quantities the African sweet potato, hypoxis. The few studies of large scale consumption of hypoxis, however, suggest that if it had any effect at all it would likely be a deleterious one for people suffering from HIV.

Sources:

SA activists hail AIDS drug U-turn. The BBC, August 9, 2003.

S. Africa to distribute AIDS drugs. CNN, August 8, 2003.

South Africa’s Population Continues to Grow Despite the AIDS Crisis

South Africa released its official census in July which found the population of the country managed to increase by a meager 10 percent from 1996-2001 despite the ever increasing toll that the AIDS epidemic is taking on that country. South Africa’s population rose from 40.5 million in 1996 to 44.8 million in 2001.

The census report painted a very odd economic picture for South Africa. On the one hand, the report claimed that many key measures of economic progress had improved dramatically since 1996. For example, the census claimed that 70 percent of South African homes had electricity in 2001 compared to only 58 percent in 1996. Similarly, South Africans had better access to education, clean water and other goods.

On the other hand, the census reported that South Africa’s employment rate sits at a whopping 42 percent. The government tried to explain part of that away by explaining that people in agriculture and those working outside the formal economy might have marked themselves as unemployed. Of course if South Africa’s informal economy is that big that’s a major problem in and of itself.

Source:

S. Africa grows despite AIDS. The BBC, July 9, 2003.

AIDS In Africa

Earlier this month someone in South Africa leaked an unpublished government report on the anti-AIDS drugs. Although the South African government has refused to buy or distribute anti-AIDS drugs due to a host of objections, the leaked report estimated that making anti-AIDS drugs available could save the lives of as many as 1.7 million South Africans over the next seven years.

Although the report was completed in March, the South African government claimed that it was simply a first draft and that it is doing all it can to treat AIDS patients.

In the past, South African government officials have trotted out every excuse from the expense of the drugs to claims that they need to be tested more thoroughly before they could be used in South Africa.

Meanwhile, in a visit to Africa U.S. president George W. Bush promised $15 billion to fight AIDS in Africa which put pressure on European nations to contribute billions as well.

Speaking before the International Aids Society conference, Nelson Mandela said that Bush had “moved the debate from hundreds of millions of dollars to tens of billions of dollars.”

Sources:

SA Aids deaths report leaked. The BBC, July 14, 2003.

Can Africa handle AIDS drugs? Patrick Jackson, The BBC, July 15, 2003.

Recipe for Disaster. The Star (South Africa), July 17, 2003.

Mandela assails global injustice of AIDS crisis. Sarah Boseley and Rory Carroll, Sydney Morning Herald, July 15, 2003.

AIDS Quackery In South Africa

Name a disease and somewhere in the world there are bound to be a group of quacks who think this or that oddball treatment will cure some disease or another. So normally it would not be at all surprising or particularly dismaying that Manto Tshabalala-Msimang believes that people in South Africa can boost their immune systems against AIDS by eating the African sweet potato, hypoxis. Of course what little available evidence there is on hypoxis suggest that, if anything, it is likely to suppress the immune system if eaten in large enough quantities.

Unfortunately, Manto Tshabalala-Msimang is not just some nutcase quack (though she definitely is that) — she also happens to be the Health Minister of South Africa. That is right, the country with the most AIDS victims in the world also has as its health minister a quack who claims that rather than anti-retroviral drugs, which South Africans really need to do is just eat more sweet potatoes (and garlic and onions).

In a sign of the times, even in the developing world, the opposition Democratic Alliance has set up a web site devoted solely to Manto’s blunders, Fire Manto that is in a weblog-style format (though with annoying Javascript pop-ups for the content). So you can scroll down and see Manto attributing the AIDS epidemic to God in a way that would make Jerry Falwell proud,

It could be a God-given opportunity for moral and spiritual growth, a time to review our assumption about sin and morality.

Manto is so hostile to anti-retroviral drugs that in 2002 she was angered when a multinational mining company urged its subsidiaries to provide anti-retroviral drugs to workers in countries where the government was unable to do so.

This is a woman who is so far gone that at one point she circulated a memorandum to various South African government officials that featured a chapter from a book claiming that AIDS was part of a conspiracy by extraterrestrials.

Bush’s recent pledge of $15 billion to fight AIDS in Africa is a good start, but not if it’s going to end up buying sweet potatoes and helping Manto push this sort of nonsense.