AIDS Pandemic Sweeps Africa

(ENS) -- Developing countries struggling to combat the growing AIDS crisis need international help to address a critical shortage of qualified health care workers, according to a study by the Institute of Medicine of the National Academies.

There is concern that the growth of the epidemic could overwhelm some developing nations, further stunting economic development and leaving them unable to respond to other pressing concerns, including the protection of natural resources and biodiversity as well as the struggle against infectious diseases such as malaria.

The report outlines that given substantial cuts in antiretroviral drug prices and an influx of billions of dollars in donations, it is this shortfall that stands as the greatest obstacle to successfully slowing the AIDS epidemic in the resource-poor countries where it is most severe.

It recommends addressing the shortfall through partnerships, technology transfer, and the mobilization of a Peace Corps-like "HIV/AIDS corps" of technical specialists.

"While we should proceed with caution and care given the many challenges that lie ahead, we should not delay; we must act now to rein in the global AIDS catastrophe," said committee co-chair James Curran, dean and professor of epidemiology; and director, Center for AIDS Research, Rollins School of Public Health, Emory University, Atlanta.

The study comes in the wake of United Nation report on AIDS released July 7 that outlines a dire picture for millions around the world.

• The 2003 infection rate was the highest ever, with an estimated 4.8 million people newly infected with HIV.
• Some 38 million people are now living with AIDS, with 25 million residing in sub-Saharan Africa.
• Some 20 million have died since the first cases of AIDS were identified in 1981.
• Half of all new HIV infections are now found in the 15 to 24 year-old age group, with more than 6,000 contracting the virus every day.

The "2004 Report on the Global AIDS Epidemic" from the Joint UN Programme on HIV/AIDS (UNAIDS) says it is time "to embark boldly upon the next agenda -- an agenda for future action that adopts the essential, radical and innovative approaches needed for countries to reverse the course of the epidemic."

The UN report says that without drastic action, the global AIDS epidemic "will continue to outpace the response."

The National Academies study notes that some six million individuals need antiretroviral therapy now, but only some 400,000 people in developing nations have access to treatment.

"Solving the AIDS crisis will take more than just inexpensive drugs, however," said co-chair Haile Debas, director, global health sciences, and professor of surgery, University of California, San Francisco. "Success now hinges more on having adequate infrastructures to distribute therapies and sufficient numbers of trained health care workers in developing countries.

"Even if we had enough money right now to buy all the necessary drugs to treat every infected individual, global expansion of treatment and prevention could fail just because of the scarcity of trained personnel."

The UN reports that the world spent some $4.7 billion fighting the disease in 2003 - less than half what is estimated to be needed in 2004 and only a quarter of what is believed necessary in 2007 to mount a comprehensive global response to the epidemic.

Significant expansion of HIV/AIDS treatment and prevention will require tens of thousands of health care workers with the experience and training to treat millions of people who have a disease that requires a complicated and long-term regimen of care.

The lack of an adequate work force in poor nations reflects the underlying crisis of inadequate access to high-quality education throughout the developing world, the report says.

A variety of innovative government and private-sector programs should be developed or expanded to bring a corps of volunteer medical and other professionals from resource-rich nations into developing countries to train their citizens in HIV/AIDS treatment and prevention and provide technical assistance, the committee said.

This "HIV/AIDS corps" initiative would strengthen long-term ties among health professionals and others working to fight the disease in all countries, the report says.

The committee calls for donors financing the global fight against HIV/AIDS should encourage partnerships among clinics, hospitals, and other medical institutions within and across national borders.

A world summit on AIDS starts this weekend in Bangkok, Thailand. Participants will hear how the AIDS pandemic is affecting the environment, as researchers have begun to observe.

Preparing coffins for AIDS patients in Tanzania (Photo courtesy Global Concerns Maryknoll) According to new research by attorney Dr. Jane Dwasi, a law lecturer at University of Nairobi, Kenya, there is a thriving coffin-making industry in most trading centers of Sub-Saharan Africa where AIDS is prevalent, increasing timber consumption across the region.

Dr. Dwasi presented her findings in early June at the Fourth Regional Global Biodiversity Forum for East and Southern Africa countries in Darussalam, Tanzania.

In a report of that meeting written by environment and development consultant Emmanuel Koro, president of the Sub-Saharan Africa Forum for Environment Communicators, Dwasi said that in some areas, medicinal plants have been harvested unsustainably. Poaching and gathering of wild foods is on the increase, she found, because people with AIDS are too weak to perform the heavy labor of agriculture.

In Kwazulu Natal province of South Africa, people who believe turtle eggs can cure AIDS go on egg collecting "rampages," Dwasi said, and the turtle situation is comparable to the over-harvesting of the African potato in Zimbabwe in the belief that the potato "is a cure for AIDS."

Forum participants said that because many donors are now putting their money into HIV/AIDS programs, African conservation programs are losing funding support.