Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.
AIDS Drugs for Africa
Scientific American (www.sciam.com) (11/00) Vol. 283, No. 5, P. 98 Ezzell, Carol
The AIDS epidemic in Africa faces many obstacles, but the chief one is finding affordable antiretroviral drugs to prevent HIV transmission to newborns and to treat those already infected. Most developed nations now routinely offer antiviral therapies to HIV-infected mothers; however, there are few clinics in Africa that can offer the drugs to these women. Cost is a determining factor, as the drugs often cost more than many Africans' salaries. Five companies have agreed to cut their drug prices to Africa by 80 percent, but that alone will not be a solution. According to David Bloom, a professor at Harvard University School of Public Health, AIDS is tied into poverty and a lack of health infrastructure. Lower drug costs must be accompanied by testing to measure the drugs' success in each patient. Rampant poverty in South Africa makes the drug AZT unattainable. With the help of a discounted price, AZT costs 40 cents for each 100-milligram pill. Nevirapine is another drug that offers hope to prevent HIV transmission to infants. It requires only three doses and has been shown to reduce transmission to 14 percent for a trial of 652 pregnant women. AZT, by contrast, requires months of treatment. South Africa has not accepted an offer of nevirapine from Boehringer Ingelheim, as Health Minister Manto Tshabalala-Msimang said they do not believe the only answer to AIDS is antiretroviral therapy. The government's plan to prevent HIV is to treat AIDS-related infections, and form home-based care, she said. Tshabalala-Msimang noted that even an 80 percent reduction in price would still not be affordable for the 4.2 million HIV-infected individuals in South Africa. If the issue of price is ever overcome, patients would then face the need for resistance testing. HIV's ability to mutate quickly requires careful monitoring of a patient's therapy. Testing CD4 cells and viral load is expensive, however, and not stressed in places like Thailand. Christopher Ouma, a worker for Doctors Without Borders in Nairobi, Kenya, believes Africa cannot wait for viral load testing to become the norm, since they need the drugs now. And even after antivirals become widely available to Africa, the trick will be adhering to the difficult therapy, which requires a strict timetable and food requirements.
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Always watch for outdated information. This article first appeared in 2000. This material is designed to support, not replace, the relationship that exists between you and your doctor.
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Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.
