InterPress News Service (IPS); Wednesday, 28 May 1997.
Gustavo Gonzalez

The triple combination therapies have given impressive short- term results, prolonging lives and reducing infections, said the World Health Organisation (WHO).

The results suggest the Human Immunodeficiency Virus (HIV) and its development into Acquired Immune Deficiency Syndrome (AIDS) are becoming a chronic infection requiring primarily outpatient care.

The long-term future outlook of these therapies is still somewhat uncertain because their effectiveness has not been proven and there is still a risk that problems of resistence will begin to appear.

In any case, the triple combination therapies are more often prescribed in the industrialised countries, where there has been a marked reduction in hospitalisation and AIDS related deaths.

The WHO stated the application of triple therapy to pregnant women has reduced the transmission of HIV from mother to infant in nearly 70 percent of cases.

But the main obstacle is still in the exhorbitant price of the treatments, which varies between 1,000 and 1,500 dollars per month for the triple therapy.

Sums of this size are often unavailable, especially when talking about low or middle income nations.

The triple therapy prescribes between 10 and 20 pills per patient per day, with the prerequisites of drinking water and a good nutritious diet.

Many developing countries, those most hard hit by the AIDS epidemic, lack access to these basic requisites.

The WHO said that in little over a decade, AIDS had evolved from a fulminant, rapidly fatal illness into a possibly chronic, albeit incurable disease.

However, the WHO predicted the good news from the scientific field should be analysed in the light of the inequalities of access to health and the distribution of the epidemic, as 90 percent of those affected by HIV/AIDS live in the developing nations.

The scientific advances, especially the triple therapies, have prompted HIV/AIDS infected people world-wide to seek the treatment.

Meanwhile, the governments have called for health guidelines in order to deal with the problem.

The WHO response was founded on consultations with a broad swathe of sources included sufferers, health ministries, national AIDS programmes, non governmental organisations, the pharmaceutical industry, researchers and academics.

The guidelines issued made it clear the WHO objective was to obtain universal access to medical attention and treatment.

The United Nations agency warned that none of the treatments currently available is really ideal. The drugs can have unpleasant side-effects and their efficiency depends on following a very strict and complicated regime.

The supply of antiretrovirals must not be allowed to drain resources from other essential health and development programmes, nor from AIDS prevention schemes, like condom promotion projects and research into HIV/AIDS vaccines and microbicides, it said.

The WHO said that quality assurance, supply and distribution of the antiretrovirals cannot remain in the hands of the private sector alone.

The governments must take a regulatory and supervisory role, with the responsibility to regulate prices, control quality and monitor security and effectiveness through a laboratory system.

Continued treatment with antiretrovirals is essential as the mere loss of two doses of medicine within one week can reduce the effectiveness by 50 percent, said the WHO.

Most sufferers lack access to laboratories studying the side effects and effectiveness of the treatment.

The monitoring of adverse reactions, through tests of liver function and bloodcount, is a prerequisite to safe treatment.

As this life-saving treatment is hard to obtain and extremely costly, the WHO has predicted the possible development of a black market offering low quality false medicines. (END/IPS/tra- so/pc/dg/sm/97)

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