US to reduce support for HIV/AIDS fight

FACING a growing deficit and political demands to cut spending, the Obama administration is planning to scale back US support for global HIV/AIDS programmes and is pushing to unload some of the burden onto other countries.

The shift comes at exactly the wrong time in the 30-year fight against the virus, activists say.

There are a record 34,2-million people worldwide living with HIV/AIDS and the virus killed more than 4000 people a day last year, according to the World Health Organisation (WHO). In SA alone 18% of those aged 15 to 49 are infected, the data show.

Most drugs 'are ineffective'

A senior executive with Britain's biggest drugs company has admitted that most prescription medicines do not work on most people who take them. Allen Roses, worldwide vice-president of genetics at GlaxoSmithKline (GSK), said fewer than half of the patients prescribed some of the most expensive drugs actually derived any benefit from them. It is an open secret within the drugs industry that most of its products are ineffective in most patients but this is the first time that such a senior drugs boss has gone public. His comments come days after it emerged that the NHS drugs bill has soared by nearly 50% in three years, rising by £2.3 billion a year to an annual cost to the taxpayer of £7.2bn. Dr Roses, an academic geneticist from Duke University in North Carolina,spoke at a recent scientific meeting in London where he cited figures on how well different classes of drugs work in real patients. For example drugs for Alzheimer's disease work in fewer than one in three patients, whereas those for cancer are only effective in a quarter of patients. Most drugs work in fewer than one in two patients mainly because the recipients carry genes that interfere in some way with the medicine, he said. The vast majority of drugs more than 90% - only work in 30% or 50 % of the people, Dr Roses said. The idea is to identify responders - people who benefit from the drug - with a simple and cheap genetic test that can be used to eliminate those non-responders who might benefit from another drug. Dr Roses said doctors treating patients routinely applied the trial-and-error approach. I think everybody has it in their experience that multiple drugs have been used for their headache ... or whatever. It's in their experience, but they don't quite understand why. The reason why is because they have different susceptibilities to the effect of that drug and that's genetic, he said. (Source: The Independent via The Cape Times, 10 December 2003)

HIV drugs for brass only at Anglo

Anglo American, the London-based resources group, cannot afford to supply antiretroviral drugs to all its HIV/AIDS infected workers in South Africa, according to the company's medical department. Brian Brink, Anglo American's senior vice-president (medical), said the company's 14 000 senior staff would receive antiretroviral treatment as part of their medical insurance, but that the provision of drug treatment for lower income employees was too expensive. About 21% of Anglo American's employees in South Africa are HIV-positive. The company employs 160 000 people in sub-Saharan Africa, the bulk of them in South Africa, which has one of the highest HIV/AIDS infection rates in the world with about 250 000 people forecast to die of related diseases this year. Brink said that medicines at cost were too expensive, strict adherence to drug protocols uncertain and the extent of a company's obligation to treat current and ex-employees and their dependants too daunting. An antiretroviral treatment costs about R1 500 a month. Most large employers, including mining companies, have also shied away from costly commitments to providing antiretroviral treatment, restricting their use to pregnant mothers and children. (Source: Financial Times via Business Day, 9 October 2001)

Condemning Condoms

The use of condoms as a key HIV/AIDS prevention strategy, was critised by the vice-president of the Southern African Catholics Bishops Conference, Bishop Michael Coleman, following a plenary meeting of the conference in Pretoria, last Sunday. The promotion of condom use not only sent the wrong moral message to youth but had proved to be ineffective, he said The church would rather advocate abstinence before marriage and faithfulness thereafter. Also the use of condoms between marriage partners to prevent HIV transmission was not opposed. AIDS experts, church leaders and NGOs fighting the spread of disease and those working with people infected by HIV/AIDS have expressed disappointment at this decision. Sibani Mngadi, spokesperson for Health Minister Manto Tshabalala-Msimang, said the minister hoped the bishops' decision would not have an effect on the way people understood the value of condoms and the spread of the disease. Mngadi said, There are clear scientific results which show that condoms reduce not only the chances of contracting HIV/AIDS but also other sexually transmitted diseases. And they prevent teenage pregnancies. (Sources: SAPA, 30 July 2001; and The Star, 1 August 2001)