A while back we had discussed the issues in curbing the spread of AIDS especially in sub saharan Africa and the responsibility of companies, versus limitations of infrastructure to distribute and to ensure compliance.
I just read an interesting article on that which i wanted to share.
Many countries where there’s a great need for anti-retroviral drugs don’t have the infrastructure to deliver them reliably.
But Professor Lange was also critical of the concept itself.
“Obviously it’s good to get attention; but at the same time we need to make plans that take into account things that are not taken into account now,” he told the BBC.
“Just putting a number out and trying to get as many people on therapy as quickly as possible without actually making sure the structures are there to support that I think is not actually the most productive way forward.”
World's apathy to AIDS in Africa is really a black mark against the whole human race at present time.
I am not sure if these anti-retroviral drugs actually stop the spreading of AIDS to other people or do they sorta cure those who are already affected?
Secondly, its probably a rhetorical question, but many of these African societies, what are they doing to actually change their life-styles so as to reduce the spread of AIDS?
Fraudz,
This is a very complex and difficult issue.
It is a misconception that drugs alone cure AIDs. At best, a precisely monitored Aids regimin, with substantial and ongoing testing can hold off AIDS nearly indefinitely. The real problem is that AIDS mutates. If you do not keep the number of bugs pounded down into virtual submission, they can rebound in new and dangerous ways. There are a number of AIDS discussion boards on the internet, run by reputable docs. Missing only a few doses of medication at the precise times can lead to a flare up of new, mutated, and stronger virus.
In efforts in africa there are a huge number of complications to care. First, people who are receiving the drug sell it on the black market, or give it away to relatives. Second, drugs need to be taken in a precise order, and at precise times. Africans tend to be very relaxed with regard to time, and it takes a great deal of teaching and monitroing to keep them on schedule. There is an art to the starting and stopping of particular drugs. AIDS can mutate around a drug, and render it ineffective for an individual. Only speedy testing, and entry into a new regime quickly can prevent the AIDS blossom from running wild again. Lastly flooding an area with drugs used ineffectively will only guarantee that the virus mutates quicker, and quickly defeats the only drugs that are effective. This poses risks for the population of Africa, as well as for all humanity. It is highly likely that flooding Africa with cheap drugs would create a super virus.
Thus the problem has to be from the ground up. Docs need to be educated. Testing labs need to be developed. Education and patient tracking programs need to be set up, and then and only then do the drugs have a chance. Needless to say the above steps require money, a coordinated government, peace and stability, education and not ignorance, and a substantial medical infrstucture.
Let's face it, Sub Saharan Africa cannot even control Malaria, and Tuberculosis, diseases that have been defeated easily in most other parts of the world. Defeating AIDS is even tougher. More than likely the disease will burn itself out, the worst possible outcome, but the medical community is so far behind, it may well be impossible to catch up...
What would be the worst case outcome of all this, in term of percentage fatalities of the total population?
MS,
That is a big unknown. Obviously Aids could stop tomorrow if behavior changes, as it did in most of the world. Here is a summary that is about as good as it gets:
http://www.nationmaster.com/graph-T/hea_hiv_aid_dea
The problem is, that the secondary effects of AIDS deths are no being felt. In some areas there is now famine, because there are so few workers available to harvest. If the bug mutates, to where it can be passed more easily, then we are all in trouble. Because the bug is so slow in developing, a victim can go six months or more before they understand they are infected.
worst case is literally tens of millions, but whter this is at the low end or the high end no one knows. Even gathering statistics is a difficult task, as there is no central registry of disease and deaths in a lot of these countries. Many of the deaths in South Africa were not recorded as AIDS, but by the proximate cause, ie pneumonia.
Would AIDS lead to a change in the ethnic make-up of Africa is the follow up question....
Taking one of the most extreme cases where AIDs is rampant, Zimbabwe, 98% of them are African (and 80% of them have Bantu roots) so no ethnic changes is foreseeable.
OG
I am on the same page as you on the drug compliance issues, having worked on projects for bio-tecm speciality and chronic medications PBMs, i know that companies in US have had issues with compliance for chronic drugs..this would mean major issues for compliance in countries where a good delovery, follow up, and compliance tracking approach is not in place.
This current threads stems from a previosu discussion we had here qwhere phram companies were blamed solely rather than looking at the broader issues and the needs.
Faisal
the drugs in question contain HIV from blossming into full blown AIDS. But the virus is still transmittable..so unless the behavior changes the spread will continue, a proper management of HIV positive ppl means that they will delay/avoid having AIDS. If they do not follow teh drug regimen properly and the virus becomes resistant..than anyone who gets that strain will not be helped by the drug which was being used by the first guy in question.
This is indeed a tough situation, but without the right infrastructure in place, without ensuring compliance..we are at the risk of having drug resistant strains, and then what.