HIV treatment 'failing' in Africa

BBC News, Tuesday, 16 October 2007

More than a third of patients on HIV medication in sub-Saharan Africa die or discontinue their treatment within two years of starting it, a survey shows.

The study found that many were too late taking up anti-retroviral (ARV) drugs, while for some it was impractical to travel to distant clinics.

The US researchers also found evidence that in cases where patients had to pay for ARVs, some stopped treatment. But it showed success rates vary depending on the programme and country.

Daily stress
Details of the study by the Boston University School of Public Health are published online by the Public Library of Science.

The researchers looked at antiretroviral programmes for HIV patients in 13 sub-Saharan countries. They found that two years on from the commencement of treatment, only 61.6% of all patients were still receiving medication. The researchers say there are many reasons for the fall-out rate. Many patients were too late in taking up ARVs in the first place and died within a few months of commencing treatment. Other patients dropped out because of problems with accessing the drugs - they may live some distance, for example, from the clinic which provided the medication.

There was also evidence, the researchers say, of patients discontinuing treatment because of the cost of the drugs in those cases where patients were charged for their ARVs.
Boston University's Dr Christopher Gill says in many cases, taking the ARVs may take a back seat to more pressing daily needs. "Receiving the drug itself is a major investment of a patient's time, so if you live 8 km from the nearest clinic and have to go there once a month and you don't have a ready means of transport it's a huge investment of your own time," he told the BBC.
"And if you're feeling well and you're worried about other things in terms of finding enough to eat or maintaining a job or finding a job I suppose if you were feeling well you might be tempted to see treatment as being a second-order priority.

Poverty
For the director of the Association of People with Aids in Kenya, poverty, a lack of education and an element of stigma are all part of the problem. "If people are not well educated on how to take the drugs, then some patients fall out, and if they do fall out then they develop resistance," Roland Gomol Lenya told the BBC. "We find some people also suffer from stigma: in some workplaces, people are not able to carry their ARVs and take their ARVs freely at workplaces.
"I think there are also the issues of poverty, and the people who administer ARVs should also look at the poverty element, because sometimes because of poverty people are not able to access the centres. "The centres are normally far away from where people live, and that has been a problem." The study shows that retention rates between individual ARV programmes vary widely across Africa. One programme in South Africa retained as many as 85% of their patients after two years while another in Uganda retained only 46% of patients after the same period of time.

Study Finds HIV Infection Rate in Ethiopia Rose By 26 Percent

The rate of the number of people tested for HIV/Aids in Ethiopia since February-August 2007 and found to be positive showed 26 % increase; compared to similar test conducted from November, 2006 -January 2007, a report compiled in September, 2007 disclosed.

The report entitled Millennium Aids Campaign Ethiopia (MAC-E) prepared FHAPCO (M&E Department) states the plans and actual performances carried out on HIV council ling and testing, ART treatments and the momentum for the continuation of the campaign to the third phase where the first two are already completed.

According to the report, in the first phase of the campaign that lasted from Nov 2006-Jan2007, 705,619 people were tested for HIV/AIDS and 37,943(5.4%) were found to be positive.
In the second phase, out of the 982,452 people tested, 70,470 were found to be positive (7.3%), according to the report, which showed a 26% increase by the end of August 2007.

The two major objectives of the campaign in the first phase were testing 320,000 people and enrolling 22,000 new patients to ART service; and more than double were tested. The ART plan for new patients fell short of the set target 11,582 but nevertheless a substantial increase from the previous trend, the report states.

In phase II of the campaign, though it was planned to test and council 1.8 million individuals over the seven months period, 982,452 were actually tested (53%) and 31,359 new individuals started ART (77%) from the 40, 710 planned to initiate.

In a round table discussion prepared yesterday at Internews meeting room, Dr. Yibeltal Assefa, health program officer at HAPCO discussed about the plan for the third phase of the program and the comprehensive Universal Access Program (UAP) set for 2010. He said, "three million test kits are prepared for the new year which will render by far better testing and counseling services than the past years." Sensitization, social mobilization and community conversation are also the major areas of emphasis given in the third phase, according to the officer. In the (UAP), it is planned to achieve to have one health center one test post in each woreda o f the country, Dr. Yibeltal indicated.

Daily Monitor (Addis Ababa)NEWS

Posted to the web 8 October 2007

By Endale Assefa

'Dawn of Hope' in Ethiopia

'Dawn of Hope' in Ethiopia (World Bank News)
June 12, 2007 - In 2000, while finishing a university degree in plant sciences and then working as an agronomist, Sileshi Betelei suffered two serious bouts of illness and found out he had HIV. Counseling helped him find the courage to tell his family, and they were very supportive. He believes their positive attitude stemmed from their understanding that anyone can get HIV.

He returned to work and continued to live a normal life, until 2001 when his CD4 (T-cell) count dropped to a dangerously low level, and he became extremely weak. Though Sileshi wanted to start on antiretroviral medications, he could not afford the drugs then available in Ethiopia. He refers to this period of his life as “the disaster time.”

A year later, Sileshi learned about Dawn of Hope – a local nongovernmental organization in Ethiopia that supports people infected and affected by HIV. He decided to join them, and work on the advocacy campaign to get public provision of free anti-retroviral treatment (ART). During this period he received drugs for opportunistic infections through Dawn of Hope – financed by the Ethiopia MAP. This enabled him to manage his health well enough to keep going, and to get married. His wife is also HIV-positive.

As an activist, Sileshi and others lobbied the government as well as officials from UNAIDS and the Global Fund to Fight AIDS, Tuberculosis and Malaria. In 2004 Ethiopia’s ART program was launched, with money from the Global Fund.

After 18 months on treatment, Sileshi’s CD4 count improved and he felt strong enough to start a second university degree in management. Seeing a future for themselves, Sileshi and his wife began a family. Today, Sileshi is a leader in the Ethiopian AIDS community, representing people living with HIV on the National AIDS Council and the National AIDS Committee Management Board. He is also the proud father of an 18 month-old son, who is HIV-negative, thanks to treatment to prevent transmission from mother-to-child. While it is access to free antiretroviral drugs that is keeping him and his wife healthy today, Sileshi says that they and many other Ethiopians with the virus would not have survived if not for the free drugs to fight opportunistic infections, financed by the World Bank’s Multi-Sectoral AIDS Program.

“The MAP made a big difference in people’s lives,” Sileshi says. “Before treatment, people were dying of opportunistic infections. The MAP enabled us to arrive at the era of antiretroviral treatment.”. He also points out that counseling and home-based care provided through the MAP were essential. “Without counseling, there is no positive living, there is no hope.”

Cadila launches drug production

By Andualem Sisay
Capital

Addis Ababa, Ethiopia - A new 100 mln birr medicine factory, Cadila Pharmaceuticals Limited, which is operating in 43 countries throughout the world, has begun production in Akaki-Kaliti sub city.

The factory is an Indo-Ethiopian joint venture with local company ALMETA Impex and Indian parent company Cadila Pharmaceuticals, with the expatriates holding the majority shares. According to Mr. Nalini Nayak, Marketing Manager of Cadila, the factory will be the first of its kind in East Africa, when it will soon be qualified by the United States Food and Drug Administration (US FDA).
Cadila India has recently qualified to the World health Organization (WHO) Good Management Practice (GMP). "Ethiopia has a very good potential market, which is not yet explored," said Mr.Nayak. Besides, we are happy to work in Ethiopia; where there is a strict drug regulation. It is difficult to find such an atmosphere in other African countries," he said.
Nearly 200 employees have begun operations at CADILA Pharmaceuticals. Anti biotics, anti-malarias, anti-acids, anti-fungal and multivitamins are the medicines that the company is currently producing. Anti-tuberculosis and anti-AIDS drugs are also being planed for production.
In addition to local demand, CADILA Pharmaceuticals will also export its products to neighboring markets such as Kenya, Sudan, Uganda and Djibouti.
Sunshine, Addis, Bethlehem, Pharmacur and Epharm Pharmaceuticals are the existing factories engaged in medicine production. The opening of CADILA Pharmaceuticals will raise the number of medicine factories to six.

Latest & Newest HIV Medication: Prezista for Ethiopia

Aspen signs HIV med deal

Wednesday, April 04, 2007

Tibotec Pharmaceuticals Ltd. Of Ireland on Wednesday announced that it has signed a royalty-free, non-exclusive license agreement with the South African company Aspen Pharmacare.
According to a press release from the two companies, Aspen will register, package and distribute the protease inhibitor PREZISTA (darunavir, DRV) in sub-Saharan Africa.

Source: Health24.com

Traditional Medicine: the cure of ages

“The Wogesha Will See You”
Traditional Ethiopian Medicine, Then and Now
By: Worku Abebe

Traditional medicine has been defined by the World Health Organization (WHO) as “the sum total of all knowledge and practices, whether explicable or not, used in the diagnosis, prevention and elimination of physical, mental or social imbalances and relying exclusively on practical experience and observation handed down from generation to generation, whether verbally or in writing.” This system of health care is also known as folk medicine, ethnomedicine, or indigenous medicine. In some countries, including the US, the terms complementary or alternative medicine are used interchangeably for traditional medicine.

Curtsy of Tadias magazine

Issues that affect Public Health From Environmental Health Perspecitve (ehp)

Unhealthy Landscapes: Policy Recommendations on Land Use Change and Infectious Disease Emergence
Abstract: Anthropogenic land use changes drive a range of infectious disease outbreaks and emergence events and modify the transmission of endemic infections. These drivers include agricultural encroachment, deforestation, road construction, dam building, irrigation, wetland modification, mining, the concentration or expansion of urban environments, coastal zone degradation, and other activities. These changes in turn cause a cascade of factors that exacerbate infectious disease emergence, such as forest fragmentation, disease introduction, pollution, poverty, and human migration. The Working Group on Land Use Change and Disease Emergence grew out of a special colloquium that convened international experts in infectious diseases, ecology, and environmental health to assess the current state of knowledge and to develop recommendations for addressing these environmental health challenges. The group established a systems model approach and priority lists of infectious diseases affected by ecologic degradation. Policy-relevant levels of the model include specific health risk factors, landscape or habitat change, and institutional (economic and behavioral) levels. The group recommended creating Centers of Excellence in Ecology and Health Research and Training, based at regional universities and/or research institutes with close links to the surrounding communities. The centers' objectives would be 3-fold: a) to provide information to local communities about the links between environmental change and public health ; b) to facilitate fully interdisciplinary research from a variety of natural, social, and health sciences and train professionals who can conduct interdisciplinary research ; and c) to engage in science-based communication and assessment for policy making toward sustainable health and ecosystems. Key words: biodiversity, deforestation, ecosystems, emerging infectious diseases, land use, Lyme disease, malaria, urban sprawl, wildlife, zoonosis. Environ Health Perspect 112:1092-1098 (2004) . doi:10.1289/ehp.6877 available via http://dx.doi.org/ [Online 22 April 2004]