AIDS in Africa–We Have a Problem

It was hoped AIDS in Africa was being managed and controlled. Uganda’s victory lap appears to have been premature. It was the poster child for first ignoring the epidemic and later in managing it but now is in danger of “showing (us) how to lose the fight.”

It appears with the emphasis on treatment, prevention was deemphasized and/or mismanaged–the abstinence approach may well have failed. (not a big surprise) In addition the US is not increasing funding leading to question whether the “full $48 billion authorized by Congress by 2013” will be provided.

The challenge is enormous. Some 33. 4 million people worldwide have HIV, and under new guidelines by the World Health Organization, the number eligible for treatment has grown to 14 million, dwarfing the 4 million in treatment currently. Another 2.7 million people become infected each year. Those who don’t die first will eventually need to take antiretroviral drugs, a mixture of medications that helps the body suppress the disease and must be taken every day for life. The therapy, which doesn’t cure AIDS but allows people with HIV to live normal lives, means the number of people who need drugs will continue to grow.

One irony is that lifesaving medicine makes the prevention message harder to deliver. That much is clear in Uganda, once a leader in preventing the spread of HIV.

But the biggest distraction from prevention was likely the sudden flood of lifesaving drugs beginning in 2005. Fear of HIV dissipated as memories faded about the disease’s ravages. People gradually increased their number of sexual partners again. “Women are now more scared of getting pregnant than getting AIDS,” says researcher Phoebe Kajubi, who conducted a survey in a poor area of Kampala funded by the AIDS Prevention Research Project at Harvard University.

Medicynical Note: There are unintended consequences of introducing technology. The question is where do we go from here? We need a reinvigorated prevention/education program and less expensive medications. This is a medical emergency and patent holders should cooperate and provide generics to these countries.

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