ICASA Continues Amid Protests; Studies Released on AIDS Orphan Care, Role of Traditional Medicine in HIV Treatment

The 13th International Conference on AIDS and Sexually Transmitted Infections in Africa, the biggest regional forum on the disease, on Wednesday entered its fourth day amid protests over delays in access to antiretroviral treatment, Agence France-Presse reports (Agence France-Presse, 9/24). The six-day conference, which concludes on Friday, has brought together about 7,000 scientists, social and political leaders from Africa and other parts of the world to discuss trends in the management of HIV/AIDS and other sexually transmitted diseases and to come up with strategies to improve access to care (Xinhua News Agency, 9/24). Several dozen AIDS advocates on Wednesday staged a "noisy" protest, demonstrating at the exhibit booths of USAID and pharmaceutical companies GlaxoSmithKline and Bristol-Myers Squibb (Agence France-Presse, 9/24). The protestors demanded immediate action from governments to ensure the implementation of national antiretroviral treatment plans in order to achieve the World Health Organization's goal of treating three million HIV-positive people by 2005, according to a Pan-African AIDS Treatment Access Movement release (Pan-African AIDS Treatment Access Movement release, 9/24).

Mock Trial
On Tuesday, James Kamau, a Kenyan AIDS advocate who has refused to take antiretroviral drugs until the government provides the drugs for all Kenyans, together with about 100 other AIDS advocates, staged a mock trial for people he said have made HIV-positive people's lives difficult. A panel of judges, including a Roman Catholic priest, a Kenyan pop musician and a 13-year-old boy, found the plaintiffs -- the government, pharmaceutical companies, the World Trade Organization, "stigma," "denial" and "discrimination" -- guilty (Nyambura, Reuters, 9/23). Also on Tuesday, African first ladies attending the Organisation of African First Ladies Against HIV/AIDS satellite conference signed what they called the "Nairobi declaration," which calls for increased access to affordable care and a scaling up of antiretroviral drug programs (Openda, East African Standard, 9/24).

Teixeira, Piot To Speak
Paulo Teixeira, director of HIV/AIDS for WHO, and Peter Piot, executive director of UNAIDS, on Wednesday are scheduled to hold a joint press conference at ICASA to outline new strategies for the prevention and treatment of HIV/AIDS in Africa, Xinhua News Agency reports. Teixeira is expected to discuss WHO's "three by five" program (Xinhua News Agency, 9/24). WHO plans to announce by Dec. 1 its new strategy, which will use rapid response techniques to deliver antiretroviral treatment and will provide emergency response teams to governments requesting assistance in expediting drug delivery (Kaiser Daily HIV/AIDS Report, 9/23). Piot is expected to highlight new UNAIDS prevention and care strategies for Africa. The United Nations on Tuesday released two reports, including a progress report on goals set by the 2001 U.N. General Assembly Special Session on HIV/AIDS and a report on political attention and funding issues for HIV/AIDS in Africa (Xinhua News Agency, 9/24).

Save the Children Reports
Save the Children on Monday expressed concern about the rising number of children in Africa being raised in residential care settings, Xinhua News Agency reports. An estimated eight million children worldwide are living in residential care, and the number is rising in Africa due to AIDS, dislocation and poverty, according to a Save the Children report. The report defined residential care as "a group living arrangement for children in which care is provided by remunerated adults" (Xinhua News Agency, 9/22). In addition, the group on Monday released research conducted in the Democratic Republic of the Congo that found that people who live in conflict areas are more vulnerable to HIV/AIDS than people living in areas without conflict. About 15 million young people worldwide are directly threatened by HIV/AIDS in armed conflict and humanitarian emergencies, according to Save the Children estimates (Xinhua News Agency, 9/22).

Faith-Based Groups and Orphans
UNICEF officials on Tuesday announced the results of a survey of 505 religious organizations operating in Kenya, Malawi, Mozambique, Namibia, Swaziland and Uganda that showed that 95% of the organizations support orphans and operate almost entirely without outside funding, the Boston Globe reports. The survey, conducted by UNICEF and the World Conference of Religions for Peace, found that in the six countries, more than half of the religious congregations and groups had started providing aid to orphans within the past four years. Of the 505 groups, 71% provided clothing or food, two-thirds gave school assistance and more than 50% worked on HIV prevention among orphans. In addition, the groups have established orphanages and day-care centers and visit orphans in their homes and provide medical care, counseling and psychological support to them. UNICEF plans to use the report to encourage its country directors to increase contacts with faith-based groups. "The question now is what can we do to provide more substantial resources to these organizations," Mark Stirling, a senior UNICEF official, said, adding, "The challenge is to support faith-based organizations that are working in the grass roots in Africa and not to put all the money into faith-based groups in America that want to work in Africa." The law authorizing funding for President Bush's five-year, $15 billion AIDS program specifically mentions funding for faith-based organizations (Donnelly, Boston Globe, 9/24).

Role of Religion in African AIDS Epidemic
Religious leaders this week at ICASA are discussing the changing role of faith-based organizations in addressing the AIDS epidemic in Africa, the Christian Science Monitor reports. African religious groups' approach to AIDS has moved from "silence or even condemnation toward compassion and openness," according to people working on the issue, the Monitor reports. In addition, the Symposium of Episcopal Conferences in Africa this week plans to devote two days of its annual meeting to the discussion of HIV/AIDS. National Christian and Muslim bodies have begun to make it official policy for their groups to accept and support HIV-positive people, and more religious leaders are talking about the disease during church services. However, more needs to be done in the community, James Cairns, director of the World Conference of Religions for Peace, said, adding that encouraging condom use is still unacceptable in most religious groups. Such policies have made many funding agencies reluctant to support HIV prevention programs run by faith-based groups. However, proponents of faith-based initiatives say that such funding agencies are "missing out," because an estimated 85% of Africans are actively involved in a religious community, according to the Monitor (Crawley, Christian Science Monitor, 9/24).

Traditional Medicine
Supporters of traditional medicine on Tuesday at ICASA said that Metrafaids and Taibao, two herbal remedies, were safe and less expensive alternatives to antiretroviral drugs, Agence France-Presse reports. Many of the 30 million HIV-positive people in Africa seek the advice of traditional healers for their health care, according to Agence France-Presse. A three-year study of 62 HIV-positive people ages 18 to 58, funded by the Ford Foundation, found that Metrafaids, a treatment made from five plants, reduced HIV viral loads and boosted CD4+ T cell counts, according to Prometra, a Senegal-based traditional medicine group (Morland, Agence France-Presse, 9/23). Wang Jin, director of the AIDS department of the Institute of Basic Theory of China Academy of Traditional Chinese Medicine, said that traditional Chinese medicine could "strengthen the body's resistability against diseases through enhancing the immunity in dealing with HIV/AIDS," adding that traditional medicine could also be used to deal with the symptoms of HIV. Li Chuan, a Chinese doctor working in Kenya, said that Taibao, an oral herbal preparation that is used by 45 HIV-positive people in the Nairobi neighborhood of Kibera, "appears to have the potential to delay the early introduction of antiretroviral treatment given its efficacy for those who have CD4 counts about 200." Some conference participants criticized "treatments" for which there are no scientific bases, calling for a system to differentiate between effective traditional treatments and ineffective ones, according to Xinhua News Agency. Jimmy Munobwa of the Traditional and Modern Health Practitioners Together Against AIDS and Other Diseases called for a regional collaborative initiative to increase cooperation among traditional healers involved with AIDS prevention and care (Xinhua News Agency, 9/23).

Unsafe Needle Use
WHO is "seriously underestimating" the role of needle reuse in the spread of HIV in Africa, Lillian Salerno, director of the International Association of Safe Needle Technology, said on Tuesday, Reuters reports. Needle reuse and unsafe medical practices could account for as much as 30% of new HIV infections, according to research conducted by IASNT organization, Salerno said. By attributing only 2.5% of new HIV cases to needle reuse, WHO officials are ignoring the danger, Salerno said, adding, "This is not only misleading, it is also dangerous. We cannot solve this terrible health care crisis until we recognize it exists." Salerno applauded the U.S. Senate for considering funding for providing clean needles to African countries but said that such funding would probably be spent on "auto-disable" syringes, which cannot be reused because the plunger locks after a single use. However, she said that medical workers are still at risk of needlesticks with auto-disable syringes. The money, if approved, should instead be spent on "safety-engineered" needles, which retract after a single use, Salerno said (Reuters, 9/23). A WHO report released in December 2002 cites four different studies claiming that unsafe medical practices are responsible for 8%, 15%, 41% and 45% of HIV transmission in sub-Saharan Africa, respectively. The report concludes that "the lowest attributable fraction calculated on the basis of the data provided ... (8%) exceeds our 2.5% modeled attributable fraction, suggesting that our estimate is conservative" (Kaiser Daily HIV/AIDS Report, 6/9).

NPR's "Morning Edition" on Wednesday discussed the Save the Children report and examined Swaziland's HIV/AIDS epidemic (Beaubien, "Morning Edition," NPR, 9/24). The full segment is available online in RealPlayer.