"We describe a number of pitfalls that may occur with the push to rapidly expand access to antiretroviral therapy in sub-Saharan Africa. These include undesirable opportunity costs, the fragmentation of health systems, worsening health care inequities, and poor and unsustained treatment outcomes. On the other hand, AIDS "treatment activism" provides an opportunity to catalyze comprehensive health systems development and reduce health care inequities. However, these positive benefits will only happen if we explicitly set out to achieve them. We call for a greater commitment toward health activism that tackles the broader political and economic constraints to human and health systems development in Africa, as well as toward the resuscitation of inclusive and equitable public health systems."
Equity and HIV/AIDS
Near hysterical media reports last week reported on a strain of HIV resistant to drugs from three main classes of antiretrovirals. But this article from HIV information site www.aidsmap.com says that perhaps the reason for the reaction to the case- reported in New York - and its reporting lies not in its medical significance, but in its importance to current US debates on comprehensive or abstinence-only HIV prevention. Visit the site to read the full article.
Between 1997 and 2002, according to a new report from Stats SA, South Africa's official statistics agency, the number of recorded deaths in the age group from 20 to 45 more than doubled, from a little over 100,000 to more than 200,000. Although most deaths likely to be linked to AIDS are officially recorded as due to associated diseases such as TB and pneumonia, the age and disease pattern provides strong evidence of the growing impact of AIDS. Other previous studies, such as those from South Africa's Medical Research Council, have provided similar indications. But the issue is still contentious, as AIDS denialists have used the relatively low numbers attributed directly to AIDS to claim that researchers are exaggerating the problem. The latest issue of the AfricaFocus Bulletin contains postings that examine the issues in detail.
The UN has warned that the Millennium Development Goals (MDGs) adopted by governments to curb poverty and promote gender equality by 2015 could fail unless developing countries make HIV/AIDS a priority. A new report, 'Hope: Building Capacity: Least Developed Countries Meet the HIV/AIDS Challenge', said priorities must include the aggressive pursuit of policies that promote women's empowerment and the eradication of AIDS-related discrimination.
By the end of 2004, 700 000 people living with AIDS in developing countries were receiving antiretroviral (ART) treatment thanks to the efforts of national governments, donors and other partners. This is an increase of approximately 75% in the total number receiving treatment from a year ago, and is up from 440 000 in July 2004. At a joint press conference at the World Economic Forum’s Annual Meeting, Switzerland, the World Health Organization (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United States Government and the Global Fund to fight AIDS, Tuberculosis and Malaria revealed the results of their joint efforts to increase the availability of ART in poor countries. However all the organizations warned that major, continued efforts are needed in countries and internationally to continue working towards the goal of access to treatment for all who need it.
Signed by the African Network for the Campaign on Education for All (ANCEFA), African Womens Development and Communications Network (FEMNET), African Centre for Democracy and Human Rights (ACDHR), Center for Democracy and Development (CDD), Pan African Movement (PAM), Pan African Development Education and Advocacy Programme(PADEAP), West African Students Union (WASU), Womens Rights Advancement and Protection Alternatives (WRAPA), Development Network of Indigenous Voluntary Agencies (DENIVA), Fahamu, ActionAid International, Oxfam GB
Summary
The fourth Ordinary African Union Summit of the Heads of States takes place at a time when the consequences of poorly financed and collapsing public health services across the continent can only be described as a public health emergency. Returning to Abuja where four years ago they committed themselves to accelerate the fight against HIV/AIDS, Tuberculosis and other related infectious diseases, it is clear that key obstacles continue to prevent hundreds of millions of Africans from realising the right to health. African Governments and the African Union must reinvigorate the fight against the violation of HIV/AIDS and health related rights.
Recommendations
- African Governments must commit to increasing GDP allocation for health by three per cent each year in order to reach the 2001 Abuja Summit commitments of 15%. - African government should ensure that treatment of AIDS and infectious diseases is provided free, reaches vulnerable groups and in an accountable manner. - African Governments, who have to yet ratify the AU Protocol on the Rights of Women, must do so. It is a major instrument in securing the right to health for Africa's women and girls. - The African Union Commission must lead on lobbying the G8 in 2005 for debt cancellation and measures from industrialised countries to compensate for the brain drain of African health workers. - The African Union Commission must lead on lobbying the G8 in 2005 for debt cancellation and securing measures from industrialised countries to compensate for the brain drain of African health workers. - African Governments must mandate the African Union Commission to champion for enabling laws and policies in member states and a coordinated global advocacy approach towards the WTO Hong Kong Inter-ministerial in December 2005.
South African generic AIDS drug manufacturer, Aspen Pharmacare, has become the first African firm to win approval from the US Food and Drug Administration (FDA) for its production plant. The FDA conducted a pre-operational review and close inspection to ascertain good manufacturing practice at Aspen's Port Elizabeth facility in September last year. As a result of this approval, funds from the US President's Emergency Plans for AIDS Relief (PEPFAR) can be used to purchase Aspen-manufactured drugs for use in countries where the local drug regulatory agency has approved them.
Malawi aims to more than triple the number of HIV-positive people in the country who are receiving antiretroviral drugs at no cost by July with the help of a $14 million grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria, a Malawian health official said on Monday, AFP/Independent Online reports. Malawi in May 2004 began a five-year, $196 million nationwide program to provide antiretroviral drugs to HIV-positive people at no cost.
As the world intensifies its fight against the global AIDS epidemic, African countries have begun to develop largescale prevention and treatment programmes. A combination of funds from African governments and international donors are paying for drugs, diagnostics, clinic and laboratory infrastructure, and medical personnel. Although these funds, which reach into the billions of dollars, will pay for antiretroviral therapy for many thousands of HIV-positive Africans, there is almost no chance that African countries will have the human, infrastructural, or financial resources to treat everyone who is in need, at least in the early years.
Commentators are beginning to raise other fundamental questions about the Tsunami disaster, reports the latest edition of the Africa Focus Bulletin. "Most significantly, can the response to the tsunami be carried over to even more devastating crises that are less photogenic, such as AIDS, global health, conflict, and poverty? Or will the effect be to reduce resources for implementing programs that have not been scaled up for lack of political will and resources? " Despite significant expansion of programs in the last two years, only four percent of the estimated 3.8 million people in need of such treatment in Africa now have access. Global spending on HIV/AIDS in low and middle-income countries was estimated at $6.1 billion in 2004, with the need projected at $12 billion for 2005.