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South Africa will lose 2,5 million people unless antiretroviral treatment is urgently scaled up, Professor Linda-Gail Bekker says.
She is the chairperson of the 4th SA Aids conference – under the banner Scaling up for success – and was opening the conference.
“This is an epidemic of unprecedented proportions. We are in the red zone in Southern Africa,” Bekker said, pointing to a map illustrating how bad it is.
Bekker, deputy director of UCT’s Desmond Tutu HIV Centre, said the conference was intended to identify:
* scientific evidence of what works and how to scale it up;
* the priorities;
* the next steps;
* how to remove obstacles; and
* how to work together with every sector.
So that’s what I’ll be looking out for.
“I’m on the scale up and start to role numbers back (campaign),” she said, demonstrating how HIV could disappear from the map. “Yes, we can.”
Dr John Hargrove from SACEMA (which does epidemiological modelling) gave a sweeping overview of why Southern Africa has been worst hit by the epidemic.
He looked at migratory patterns, medical male circumcision, religion (Muslim countries are less at risk), women’s education levels, the spatial influences on HIV infection and the disruption of families.
When it comes to spatial influences, HIV spreads much slower in communities where people sleep only with other residents, “with their neighbours wives only, rather than with their neighbours wives most of the year and 10% with random” partners. With the 10% random partners thrown in, the infection rate explodes.
Another issue he tackled was that of HIV spreading along trucking routes. But he said: “The problem is not roads but (Cecil John) Rhodes”, explaining how forcing men into migrant mine labour had disastrous consequences for families.
He also expanded on the Lancet debate of treatment as a way to end the epidemic.
“Use ARVs as an offensive weapon to kill the epidemic not just as a defensive (weapon),” he said, advocating early treatment for people living with HIV, especially the youth.
“I want to throw away the CD4 count machine,” he commented, explaining that if everyone was tested once a year voluntarily and treated without delay “that would kill the epidemic by 2010″.
Other keynote speakers Emeritus Archbishop Desmond Tutu and Luyanda Ngcobo also made powerful statements but that report is in The Times tomorrow.
Deputy President Baleke Mbete replaced Health Minister Barbara Hogan as the final speaker, much to the disappointment of Hogan’s supporters.
She is expected to close the conference on Friday. Till tomorrow.
This is my 5th Aids Conference in Durban.
The 1st was the World Aids Conference in 2000 when Nkosi Johnson, then 11, called for better access to treatment for people with HIV/Aids like himself and an end to discrimination. It was an unforgettable speech. When he died in 2001, South Africa and the world mourned the loss of an HIV hero.
The 2003 Aids conference was another landmark event. At that conference HIV/Aids doctors and activists demanded antiretroviral treatment, urgently. The same week as the conference, on the Friday night, Cabinet promised that they would roll out treatment.
High on the agenda for the 2009 Aids conference is the difficult issue of prevention – how to make prevention work. And the revolutionary idea of annual testing and early antiretroviral treatment to stop the epidemic.
Another major issue is sustainable funding and steady drug supplies for the antiretroviral programme which, Aids Law Project director Mark Heywood warns, is buckling under the load.
On the activist agenda is lobbying support for the smart, efficient, dedicated and courageous Health Minister Barbara Hogan, who is under fire for publicly criticising the South African government’s decision to refuse the Dalai Lama a visa. She is a rare leader: a principled politician. And everyone I’ve spoken to here wants Hogan and her impressive deputy, Dr Molefi Sefularo, to be re-appointed.
Now the drums are rolling for the opening session, at which Emiritus Archbishop Desmond Tutu and Luyanda Ngcoba will be delivering the Nkosi Johnson. Time to go.
Medical male circumcision is back in favour with mounting evidence about its health benefits.
Turns out that it not only reduces the risk of HIV among heterosexual men, but also the danger of getting two common sexually transmitted infections.
The New England Journal of Medicine reports today that medical male circumcision significantly cuts the risk of getting the herpes simplex virus type 2 (HSV-2, causes genital herpes) and human papillomavirus (HPV, can cause cancer and genital warts).
But it had no impact on the risk of getting syphilis – famously linked to gangster Al Capone’s death and Beethoven’s deafness.
Researchers at Uganda’s Rakai Health Sciences Programme collaborating with the US’s Johns Hopkins University Bloomberg School of Public Health, Uganda’s Makerere University and the US NIAID conducted the studies among nearly 4000 men between 15 and 49 years old.
They found that circumcision lowered the risk of HSV-2 by 28% and of HPV prevalence by 35%.
Dr David Serwadda, co-principal investigator from Makerere University, stated that “these findings have significant public health implications for the control of HIV, genital herpes and HPV in areas of high prevalence, such as Africa, and further suggest that efforts to scale-up male circumcision could have tremendous benefits”.
Circumcision more than halves risk of HIV infection among heterosexual men.
Most posts will be short but there will be exceptions – and Jo’s story is one.
I’ve written a story for the Sunday Times today about telling children they have HIV. This was prompted by Jo’s (not her real name) testimony.
She has courageously confronted HIV in her own life and her child’s, and they are living healthy and happy lives.
But for 11 years after her son was born, she struggled with how to tell him his status.
This is her account:
Jo wishes she had known she was HIV positive when she was pregnant so that she could have prevented mother-to-child HIV transmission.
“I was 25 years old and this was a planned pregnancy in a stable relationship so my gynae didn’t advise me to take an HIV test. She said I shouldn’t worry about it so I never thought of doing it.”
But Jo realised when her baby was eight months old that something was wrong.
“At the immunisation clinic they told me he wasn’t putting on weight and I went to consult a private paediatrician.
“He advised me to take an HIV test and tested the baby. I was shocked and devastated at the result.”
Her ex-husband, who she believes infected her since he was the first person with whom she had unprotected sex, abandoned them.
Jo was referred a doctor at a government hospital where she met a “very knowledgable and good doctor”.
“He sat me down and counselled me, and I was very lucky to be put on a clinical trial for medication as my medical aid would not pay. At that time in 1999 it was dual therapy.
“We are living testimony that antiretrovirals give you life.
“I’ve never been ill and my child has never been ill apart from common children’s infections like bronchitis,” she says.
Sam (not his real name) has never been admitted to hospital or missed school because of opportunistic infections, which are common among people with HIV not taking the daily tablets.
“But it was hard for him to understand why he was taking medicines when he was not sick and why he could not sleep over at friends (because he needed to take medicines away from curious onlookers) and he felt deprived.”
Jo says she avoided talking about HIV. She would change the topic or switch TV programmes if the topic veared too close to home.
An HIV advertisement flighted for World Aids Day on December 1 ( Don’t give your child HIV. Give your child love) made her heartsore.
Jo says: “I would switch the channel. Of course if I had known my status I would have taken medication and protected my child.”
This is still an urgent issue for thousands of pregnant women in South Africa even today. If they do get tested for HIV, they can protect their unborn babies against the virus as the medication is readily available.
Yet an estimated 60 000 babies every year are still born with HIV.
Jo says she delayed talking to Sam partly because her siblings were so shocked when they found out.
“They did not take it well at all and it was a traumatic experience.
“I had to assure them that I was fine. For them it just meant death.
(Now they understand and are supportive.)
Also what Sam was learning at school about HIV was so negative. “They were sending the wrong messages,” Jo says.
Luckily there was one positive programme on TV about inspiring teenagers with HIV and how they coped.
One morning over the holidays, Sam asked his mother why he needed to take daily medication.
“I wasn’t ready to tell him,” she says.
“But he said: ‘Mummy I’m big now, tell me.’ So I told him we are HIV positive and he said: ‘M-u-m!’
“ He said that he didn’t believe it as he was not sick. He wept, and I counselled him.
“Half an hour later he said that he was fine. I thought we would have a miserable festive season but we had a wonderful Christmas and New Year.”
They celebrated the 2009 New Year together are even closer now than they had been before.
None of her fears about disclosing to her child — shared by thousands of parents and caregivers in South Africa — were realised and she is so happy she told her child.
“You have to tell your child ultimately. They have to know and it is best they know from you.”
Now Jo and her fiance, who is also HIV positive, plan to have a second child and they will be careful to make sure HIV is not passed on.
* For more information on how to disclose to children visit http://www.childrensrightscentre.co.za/site/files/6592/pub1.pdf
HIV vaccine scientists have been fighting an uphill battle for 25 years searching for a way to block the rapidly mutating virus.
Now a new approach to finding a vaccine has shown potential, the results of which are published this week online by Nature
Scientists at the the Rockefeller University in New York said they have identified “a diverse team of antibodies in ‘slow-progressing’ HIV patients.
“(Their) coordinated pack hunting knocks down the virus just as well as their super-antibody cousins fighting solo”.
Several HIV vaccine studies so far have focused on the ‘Famous Four’ — a few powerful, engineered antibodies that block a protein (gp140) HIV needs to infect immune cells.
But efforts to jolt the human body into producing them have failed.
Lead scientist of this research Michel Nussenzweig, head of the Laboratory of Molecular Immunology at Rockefeller University, said: “We wanted to try something different, so we tried to reproduce what’s in the patient.”
The team isolated 433 antibodies that “specifically targeted the envelope protein (gp140)”.
They cloned these antibodies and identified which part of gp140 these antibodies neutralised, and how effectively.
Nussenzweig said these antibodies have limited impact individually but as united teams they were “quite powerful” — and could shed light on how to develop an effective vaccine.
The latest research suggests that “an effective HIV vaccine may come from a shotgun approach using of a wide range of natural antibodies rather than an engineered magic bullet”, reports EurekAlert.
72 hours. That’s all the time there is to prevent HIV infection after rape and sexual assault. Survivors must be treated as soon as possible with post-exposure prophylaxis (antiretroviral drugs) and definitely within three days.
This is the message from Medecins Sans Frontieres/Doctors Without Doctors, which treated more than 12000 victims of sexual assault in Liberia, Burundi, DRC, South Africa, Colombia and other countries in 2007.
In its Shattered Lives campaign launched online this week, MSF urges that emergency medical care be made available to all people who have been raped.
In South Africa estimates are that a woman is raped every 26 seconds.
Meinie Nicolai, MSF operational director, explains: “Each (victim) tells a story of horror, pain and degradation, often inflicted by the very people who should provide protection, such as fathers, uncles, neighbours, or soldiers. And all of the victims are at risk from serious long-term health consequences as a result of the assault.”
“Men and boys make up a small minority of the people seen by MSF in its sexual violence projects (around 6 per cent in the projects in Khayelitsa, South Africa and Masisi, DRC).”
Near to Khayelitsha survivors of sexual violence can go to the one-stop centre Simelela for treatment and support — and last year more than 1000 new patients were treated at this centre, with 80% of rape survivors assisted within 72 hours.
Stories don’t always live up to their promise. But the inauguration of the Wits Ndlela Research and Clinical Trials Unit in Bushbuckridge (now the Bohlabelo district) in rural Limpopo yesterday exceeded expectations.
Ndlela truly is a first-class scientific site in the middle of nowhere or, to be more precise, on edge of the Kruger National Park and Mpumalanga.
After landing at the Kruger Mpumalanga International Airport early morning, we drove nearly two hours – though only 100km – past citrus, banana and timber plantations, a cellphone mast and a No Stress Barber shack.
The tar road turned into a corrugated mud road which becomes impassable in heavy rains. Villagers living there cannot access health care or any other services in a hurry, even in emergencies.
Despite this, top Wits scientists led by Dr Eftyhia Vardas with partners from Italy are committed to doing research here. Equally impressive, they have the machines and lab needed to conduct clinical trials – at the highest international standards – into HIV, TB and other infectious diseases.
They will focus on the impact of these diseases in the local communities as well as ways to prevent them, for example, vaccines.
They have already started a PIME (prevalence, incidence and molecular epidemiology of HIV) study in the community, who seem supportive of the project.
Ndlela will build on demographic surveillance data collected annually in Agincourt (a subdistrict of Bohlabelo) for the past 16 years by the Wits/Medical Research Council Rural Public Health and Transitions Research Unit.
Ndlela is a new unit, funded by grants, of the Wits Faculty of Health Sciences.
Stefano Butto, director of Italy’s National Aids Center (a partner of Ndlela) and Derek Hanekom, the deputy minister of Science and Technology, were among those excited to be at the inauguration.
Are people’s sex lives really influenced by soap operas and scandalous celebs?
Young people in South Africa told the research NGO CADRE that they modelled themselves on the confused affairs of soapies, took what they saw on tv and tested it out in real life.
Read More…