Nightmare in Africa

>> International AIDS Conference hopes to stir political will in a ravaged continent

by JOHN EDMONDS

According to its organizers, the 13th International AIDS Conference (IAC)--to be held in Durban, South Africa from July 9-14--couldn't come at a better time or place. In 1991, it was estimated that there would now be nine-million people in sub-Saharan Africa infected with HIV. But a recent UN report says the current reality is that almost 25-million people in the region are living with the virus.

The worst-hit countries are in the continent's southern cone: Botswana has an infection rate of almost 36 per cent; South Africa's rate of infection is around 20 per cent.

Globally, of the over 34-million people infected with HIV/AIDS, 95 per cent live in the developing world. Many of them don't even know they have the disease. And those that do have little access to drugs, especially the recent protease-inhibitor "cocktails" which offer hope of staying alive until a true cure is found.

According to Jewish General Hospital epidemiologist Dr. Mark Wainberg, president of the International AIDS Society, it didn't have to be this way.

"The spread was far worse than expected because we failed to properly educate people about the disease," says Wainberg. "We need leaders in Africa to get on the radio every day and tell people about HIV/AIDS and about safe sex. I could do it, but people wouldn't listen to me like they would the president of the country."

An activist approach by government leaders is credited for halving the prevalence of HIV in Uganda--once the AIDS capital of the world--while other African nations have seen rates double in the same period.

But in South Africa itself, President Thabo Mbeki made public statements two months ago challenging the scientific consensus that HIV causes AIDS.

"This is exactly the wrong thing to do. It muddies the waters and makes it harder for us to get out our message," says Wainberg.

The IAC--the world's largest HIV/AIDS conference--will see some 10,000 participants convene to discuss the social and scientific dimensions of the epidemic. Wainberg says it'll be an excellent opportunity to get the message to the African population through the regional media.

Although the venue was decided before Mbeki made his remarks, the choice was made to emphasize a new focus by AIDS agencies on the epidemic in the developing world.

In May, President Bill Clinton announced a reversal of a longstanding U.S. policy of strictly enforcing intellectual property laws, which had made it impossible for African nations to import or produce cheaper generic versions of HIV/AIDS medication.

And last month, five major pharmaceutical companies announced they would slash their African prices on many of their HIV/AIDS drugs.

"But even if a drug which used to cost $15,000 now costs only $1,000, it's still out of reach for the average African," says Wainberg. "If you were to treat people with HIV/AIDS in the developing world the same way they get treated in Canada, it would cost more than the gross domestic product of the USA and Canada combined. What we really need is a vaccine, and one that is developed for the strains of HIV in developing countries." :

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