Kampala's Record Improves As Global HIV/ Aids Cases Soar
The Uganda AIDS Commission (UAC) has expressed concern over the latest figures contained in a new report launched yesterday by the Joint United Nations Programme on HIV/AIDS (UNAIDS).
The report says HIV/AIDS cases have increased with over five million new infections globally since December 2000, a figure UAC Director General, Dr. Kihumuro Apuuli, has described as "staggering".
By last year, scientists were expressing hope of controlling new infections with the level of awareness achieved internationally, but Apuuli said the increase from 36 million cases by December last year to 40 million today, shows the need for intensive work against the virus.
Apuuli was addressing journalists at Hotel Havana in a joint press conference called by UNAIDS and the World Health Organisation yesterday.
The UNAIDS report, AIDS Epidemic Update 2001, indicates a continuing decline in adult HIV/AIDS cases in Uganda, but shows that the epidemic is spreading fastest in Eastern Europe. Uganda's prevalence rate is now estimated at 6.3 percent down from 8.3 percent a few months ago, and almost 30 percent less than ten years ago.
However, despite Uganda's minimal featuring in the report, it shows that of the five million new infections this year, 3.4 million are in sub-Saharan Africa with countries like Botswana and Swaziland recording an over 30 percent prevalence rate. West African states including Nigeria, which had a very low prevalence rate, have also increased infections this year, the report says.
"Low national prevalence rates can, however, be very misleading. They often disguise serious epidemics that are initially concentrated in certain localities or among specific population groups and that threatens to spill over into the wider population," the report reads in part.
Apuuli said Ugandans are still faced with potential dangers of the epidemic and warned against complacency. He said this year's World AIDS Day would be marked Dec. 1 at the Centenary Park in Kampala.
AIDS saps farm skills, biodiversity in Africa -FAO
ROME, Dec 4 (Reuters) - The HIV/AIDS pandemic in Africa is ravaging rural communities, draining local skills and diminishing crop variety, the United Nations food body said on Tuesday.
"Innovation often dies with the farmers," said Marcela Villarreal, a senior official with the Rome-based U.N. Food and Agriculture Organisation (FAO).
"They have developed ways to adapt their crops to the environment, and when they die so does their knowledge," added Villarreal, chief of FAO's population programme service and an authority on AIDS.
Villarreal told Reuters that labour shortages caused by AIDS were forcing farmers to plant a narrower range of crops.
"Biodiversity is threatened because in times of acute labour shortages, people plant fewer varieties of crops to save time and money," she said, speaking before an FAO conference in Rome on combating AIDS in agriculture which runs from December 5-7.
FAO, which monitors food supplies around the world, estimated that in Africa's 25 worst affected countries, seven million agricultural workers had died from AIDS since 1985 and 16 million more might die by 2020.
As farm workers disappeared, there were fewer people left to pass knowledge from one generation to another, such as types of seeds to be used during drought, Villarreal said.
Social safety nets were undermined, leaving the old in charge of households and millions of AIDS orphans.
AFRICA BEARS BRUNT OF AIDS
Of the 13.2 million AIDS orphans worldwide, more than 12 million are in Africa.
The loss of farming skills in Africa was particularly alarming because of the sheer numbers of HIV-infected people. In Kenya, for example, only seven percent of orphan-headed households reported that they had enough agricultural knowledge to carry on farming.
"The fundamental roles of biodiversity and indigenous knowledge in sustaining the agriculture of Africa's poorest people have often been neglected in the agricultural and rural development sector," said Josep-Antoni Gari, an FAO consultant.
"They represent local resources with enormous potential in the fight against food insecurity and the devastating impact of HIV/AIDS," he added.
Gari, who is studying the potential role of local knowhow and biodiversity in easing hunger and illness in AIDS-affected households in Tanzania and Uganda, said that where labour was short, the farm workload had to be spread throughout the year.
"This way, the farmer is not overwhelmed at harvest time," he said. Saving the diversity of crops should ease the strain of rural communities hit by AIDS as different crops ripen at different times.
"Growing a variety of crops also provides a wider range of nutrients and strengthens food security because a single pest will not attack all of someone's crops," Gari said.
FAO web site: http://www.fao.org
Good News On HIV/Aids; But Danger Waits
According to the latest report of the Joint United Nations Programme on HIV/AIDS (UNAIDS), Uganda's success story in combating the AIDS epidemic is starting to bear fruit.
The report says that as other countries in sub-Saharan Africa experience plummeting figures in life expectancy, Uganda, whose life expectancy at birth is 42, will see her citizens live to an average of 46 years by 2005.
However for other countries in Southern Africa, for example, life expectancy is dropping by more than 20 years in some places due to AIDS.
UNAIDS attributes Uganda's success to focusing heavily on information, education and communication, as well as decentralized programmes that reach down to the village level.
Uganda's efforts have also boosted condom use across the country. In Kampala, almost 98 percent of sex workers surveyed in 2000 said they had used a condom the last time they had sex, according to the report.
It's not only in Africa that AIDS is continuing its grim march around the planet. Countries of the former Soviet bloc now face the world's fastest growing infection rate.
Even in Western Europe, with all its sophisticated media and highly developed health facilities, AIDS is also on the rise as the safe-sex message fades and therapies that prolong lives are mistaken for cures.
It is this latter fact that is particularly relevant to Uganda. We have made this point before, and will continue hammering away at it: There can never been "enough" information or awareness on AIDS/HIV. If Uganda was to sit on its haunches and celebrate its achievements, as we have seen in the West, safe sex messages will fade away and people will return to dangerous behaviour.
And everyone working on AIDS/HIV should be careful not to harp too much about anti-retrovirals (ARVs). ARVs are not cures but many people, their minds clouded by the overpowering universal appeal and temptations of sex, might drop their guard mistakenly believing they will go and get a cure tomorrow if they get infected today. They are wrong.
Uganda therefore needs to continue shouting about the dangers of unprotected sex, and the menace of AIDS/HIV until the pandemic has been truly defeated.
HIV/Aids Top Killer of Truck Drivers
Most truck drivers die of AIDS, a report has revealed
Titled Study and Recommendations about Long Distance Truckers in Uganda, the report has recognised the fact that irresponsible sexual behaviour was largely responsible for HIV transmission among truckers.
"The main factor that makes this group of transport workers behave in a manner that exposes them to the risk of HIV infection is linked to the adverse conditions under which they carry out their work," reads part of the report.
It says 75 percent of truck drivers die due to AIDS.
"The population of the border crossing points is predominantly engaged in trade and provision of services to the passing traffic. Activities that are visibly thriving on the traffic that passes through these centres is the selling of alcohol in bars, commercial sex, lodges and hotels, which truckers have immensely subscribed to," further reads the report, compiled by officials from the International Transport Workers Federation (ITF).
The report, whose primary data was collected from the border crossing points at Malaba, Busia, Mirama Hills and other truck stopovers at Naluwerere, Kampala, Entebbe, Lukaya, Lyantonde and Ntungamo.
Expectant mothers to receive free HIV
Government will soon offer Nevirapine to all pregnant women who test for HIV positive, the minister of state for Primary Health Care, Dr Beatrice Wabudeya has said.
"Very soon health centres will be able to administer Nevirapine to all expectant mothers who are HIV positive to protect children from infection," Wabudeya said.
She said that government is planning to build health centres in all sub counties to provide the drug and antenatal services to pregnant women.
When administered to the woman at the onset of labour and again to the infant 72 hours after delivery, Nevirapine can reduce the risk of transmitting HIV by 50%.
Wabudeya revealed this yesterday at the ongoing three day national conference at Hotel Africana. The aim of the conference is to evaluate the Nutrition and Early Childhood Development Project (NECDP).
The project is being implemented in 25 districts and has benefited 4,370 communities. It is funded jointly by government and the World Bank.
She said that government is committed to improving the welfare and growth of children through the NECDP as stipulated in 1992 Uganda National Plan of Action for Children.
"Government realises the importance of giving our children a healthy start as a strategy that leads to improvements in the quality of life of children and of the population as a whole," Wabudeya said.
She said the project is aimed at providing emotional, cognitive, health education and nutrition to children aged six and below, in the country.
She said that government is soon embarking on a nation wide campaign to deworm all children every six months as part of its strategies to improve child welfare in the country. A pilot project is currently going on in Mbale, Pallisa, Tororo, Busia and Iganga.
She cautioned district co-ordinators charged with implementing the project against misusing the funds and said they would be penalised for their actions. "I am going to follow it to make sure that whoever misuses the funds pays for their sins," she said.
The permanent secretary of the ministry of health, Richard Muhenda, said NECDP is going to be extended to cover all districts following the mid term review of the project in March next year.
HIV/Aids Becomes Drug Resistant
The woes of AIDS patients are deepening as the Human Immuno-deficiency Virus (HIV) rapidly becomes resistant to drugs.
The Washington Post, a prestigious newspaper in the United States, reported on December 19, that half the Americans living with HIV had strains that were resistant to at least one drug.
Ugandan experts on Thursday told The New Vision that the situation is not as bad here, but it is certainly going to get worse.
The anti-retroviral drugs that have since 1996 been used to prolong the lives of AIDS patients, normally suppress HIV to the extent that the virus can not be detected in blood. Patients who had been on their death beds have returned to work as a result of the treatment, a situation that doctors now refer to as the "Lazarus effect."
But the Washington Post, citing a paper presented during a scientific conference in Chicago, reported that the virus has now developed resistance in 49% of the people taking the drugs in the US.
The findings suggest that an unusually large number of people face the risk that their HIV infections may become difficult to treat. Moreover, the resistant virus can spread from one person to another through sexual intercourse or blood contact.
American physician Douglas D. Richman said: "It's a wake-up call that we've created a lot of resistance with the use of our drugs, and that it's happened in a short period of time."
Dr. Peter Mugyenyi, Director of the Joint Clinical Research Centre, said they have detected patients in Uganda who carry the resistant strains of HIV. He, however, said it is not as bad as in the US. This is because the drugs are not used in Uganda as widely as in the US.
"The Americans have used these drugs longer and on a larger number of people. So when we compare ourselves with them we have got less resistance," said Mugyenyi.
Mugyenyi, one of the first doctors in Uganda to begin treating patients with anti-retroviral drugs, warns that it's going to get worse as the number of people on the drugs increases. "The resistance will come. That is why people must use the drugs very carefully," he said. He said in Uganda the cost of HIV treatment increases at least five times when someone gets the resistant strain of HIV. Currently the cheapest three-drug combination recommended for most beginners costs sh72,000 per patient per month. But if the virus becomes resistant to any of the three, doctors have to introduce a new drug. This hikes the cost from sh72,000 to more than sh300,000. If doctors substitute two drugs then the price could be much higher. "You may use four or more drugs to get somebody out of resistance, then the old prices come back," he said.
Patients who cannot afford the new prices caused by drug resistance might drop out of the treatment and possibly die. Besides, the new combination to overcome resistance is a bit more complicated. Instead of taking the drugs once or twice a day, the patient has to take it several times a day.
But where does the virus get resistance? Doctors say it is the consequence of taking medicine for too long without clearing the virus. Patients take the anti-retroviral drugs daily, indefinitely. With experience, the virus develops means to evade the drugs. It's like rats that learn to evade a trap after it has killed a number of their friends.
"When you use anti-retroviral drugs resistance is inevitable. But you can minimise the chances and delay it as much as possible," said Mugyenyi.
He said that people taking anti-retrovirals should strictly follow medical advice to minimise the chance of their infection becoming resistant to drugs. He also said people should get treatment only from qualified doctors who have been trained on how to handle the drugs.
HIV/Aids Depleting Police Force, Says IG
The Police force is being depleted of useful personnel by the AIDS scourge, the Inspector-General has warned.
Maj. Gen. Katumba Wamala who was addressing Police officers in Kasese district yesterday, said, "I do not advocate for the so-called protection using condoms. The only way to avoid the scourge is to live a responsible life as a spouse and parents," he said.
Wamala said the number of officers losing their lives in the line of duty is minimal compared to those who die of AIDS.
Katumba, who was in the district to familiarise himself with Police problems, said everyday, Police vehicles carry dead cops from one place to another.
He said the temptation of having sex often overpowers the use of condoms to the extent that sometimes one may forget the condom in the pocket only to find it the next day after the deadly act. Wamala, who later toured the Police barracks in Kasese town, criticised the appaling sanitary conditions there. He was conducted around the barracks by the Kasese District Police Commander, Pius Mutabazi, who said the sewage system had collapsed.
Katumba was throughout the tour forced to jump over ridges caused by the sewage breakdown in the barracks.
African Diaspora HIV/AIDS Summit for Faith Leaders January 16-20, 2002
The Balm in Gilead to Host Historical African Diaspora Faith Leaders HIV/AIDS Summit
NEW YORK, Jan. 15 /PRNewswire/ -- More than 60 religious leaders from Africa, the Caribbean and the United States are attending the first African Diaspora HIV/AIDS Summit this week to discuss the impact of AIDS throughout the African Diaspora. This historical conference will convene the religious heads to examine the critical reality of AIDS among Black people worldwide. This four-day conference begins Wednesday, January 16, 2002, at the Tarrytown House Conference Center in Tarrytown, New York.
The goal of this historical summit, hosted by The Balm In Gilead, the nation's only organization dedicated exclusively to mobilizing churches to address HIV/AIDS in the Black community, is to develop a strategic document on how faith communities throughout the Diaspora can address the AIDS pandemic. The Summit will also launch The Balm In Gilead's Africa HIV/AIDS Faith Initiative in Cote d'Ivoire, Kenya, Nigeria, South Africa, Tanzania and Zimbabwe. Funded by the Centers for Disease Control and Prevention, this initiative is designed to build the capacity of faith communities to respond effectively to the destruction of AIDS in Africa.
The week's activities will include round table discussions on the role of faith communities in dismantling stigma, HIV prevention and how these leaders can mobilize their constituents to act.
The Rockefeller Foundation will host a reception honoring this historical summit on Thursday, January 17, 2002 from 5-7 p.m. Activities will conclude at Grace Baptist Church in Mount Vernon, NY on Sunday, January 20 at 11:00 a.m.
"Africa's children are over burden by the AIDS epidemic worldwide," states Pernessa Seele, Founder/CEO of The Balm In Gilead. "The AIDS epidemic in Sub-Sahara Africa, the Caribbean Islands and among African Americans in the United States is an urgent cry for religious leaders to find courage in their faith and begin to tackle the difficult issues of AIDS in the world's black community."
The opening session on Wednesday, January 16 will begin with introductions from Seele and a discussion on The Impact of AIDS Throughout the African Diaspora by Dr. Helene Gayle, senior advisor, HIV/AIDS of The Bill and Melinda Gates Foundation. Later that day, Bishop Reverend Barnabas R. Halem'Imana, Chairman of the Uganda AIDS Commission, and Dr. Randall Bailey, professor at the Interdenominational Theological Center will lead a discussion on The Scripture as a Support or Barrier to Addressing HIV/AIDS?
Other conference highlights include: Components of Effective Church-Based HIV/AIDS Programs; Guiding Principles for The Church's Response to HIV/AIDS; and The Response of the Local Church to Prevention & Care.
About The Balm In Gilead
The Balm In Gilead is a not-for-profit, non-governmental organization with an international mission to stop the spread of HIV/AIDS throughout the African Diaspora by building the capacity of faith communities to provide AIDS education and support networks for all people living and affected by HIV. Over the past 13 years, The Balm In Gilead's pioneering achievements have enabled thousands of churches to become leaders in preventing HIV by providing comprehensive educational support to encourage those infected to seek and maintain treatment. 01/15/2002 13:31 EST http://www.prnewswire.com
HIV/Aids Drugs Prices Slashed
THE monthly cost of AIDS treatment using anti-retroviral drugs has reduced from over US$1,000 (sh1.7m) to $40 (sh72,000) per patient between 1998 and now, health minister Jim Muhwezi said on Monday.
Muhwezi said the price reduction had motivated many more people to take HIV tests and enroll for treatment.
The least expensive combination of three drugs now costs sh72,000 while the most expensive combination costs sh400,000 per patient per month.
"People are coming (for HIV tests) more willingly to know their status and access treatment," Muhwezi told the Ivory Coast First Lady, Mrs. Simone Gbagbo. She is in Uganda to understudy the country's HIV/AIDS control strategies.
The meeting at the Kampala International Conference Centre was attended by the First Lady, Mrs. Janet Museveni, ministers Prof. Gilbert Bukenya for the presidency and Bakoko Bakoru for gender, among others.
'HIV/Aids is More Than a Health Problem'
MRS. Janet Museveni, wife of the President, has said social problems have accelerated the HIV/AIDS problem in Africa and that the disease was no longer a mere health problem which can be solved by medical solutions.
She made these remarks on Monday at the International Conference Centre, where the visiting First Lady of Ivory Coast, Mrs. Simone Gbagbo and her group of experts were briefed about the different approaches that Uganda had adopted to attain positive results in the fight against HIV/AIDS.
Mrs. Museveni said poverty, malnutrition, poor housing facilities, famine, poor sanitary conditions, inaccessibility to public health services and illiteracy, among other social problems prevailing in our societies, had accelerated the HIV/AIDS epidemic in Africa.
She urged all those involved in fighting the disease to put emphasis on these problems.
HIV/Aids Test Fee to Drop in February
BLOOD tests to monitor the progress of AIDS treatment will become 90 times cheaper beginning next month, state minister for health, Mike Mukula, has said.
Mukula said this yesterday while opening a five-day health advocacy workshop for the Commonwealth countries at the Sheraton Hotel, Kampala.
The development comes only days after officials announced a reduction in the cost of AIDS drugs from $1000 (sh1.7m) to $40 (sh72,000) per month.
Mukula said the cost of measuring the concentration of HIV in blood, called viral load, will reduce from $150 per month to $10 every six months.
This implies that the annual cost of testing for the viral load would reduce from $1,800 (over sh3m) to $20 (sh34,000).
"These reductions are part of the new strategies contained in the new clinical analysis and management of HIV/AIDS in the country," Mukula said.
"We also want as many people to know their HIV status through voluntary testing," Mukula said.
About 6.1% of Ugandans are HIV positive.
The common tests used to detect HIV positivity cost a few thousand shillings, but cannot be used to monitor how the disease progresses.
Prof. Francis Omaswa, the Director General of Health Services, said whereas in the past the viral load tests were carried out monthly, the new technology would enable doctors to know the progress of their patients with tests done after every six months.
Delegates from 14 former British colonies in east, central and southern Africa are attending the workshop.
The Commonwealth Regional Health Community has its headquarters in Arusha, Tanzania.
He is At the Helm of the HIV/Aids Vaccine Research
AS Uganda prepares for the HIV vaccine trial that is likely to begin in June 2001, Dr. Pontiano Kaleebu is the main scientist to commend.
He is the principal investigator (PI) of the DNA-MVA that is to be tested in Uganda in conjunction with the International AIDS Vaccine Initiative (IAVI).
As the PI, Kaleebu is the focal point for the development of protocol. He is supposed to see that the vaccine trial is done in the proper scientific and ethical manner. He has to see that the necessary infrastructure is set up and that there are trained personnel to do the job.
"The first trial will take us two years and if the vaccine appears successful, we hope to go into phase II in 2004," says Kaleebu, who was also one of the main scientists in the Alvac, the first vaccine to be tried in Uganda in February 1999.
Vaccine preparations at the Uganda Virus Research Institute (UVRI) have been going on since 1990 through training of personnel and setting up the laboratories with international collaborators.
A lot of research work generated from this institute and published various in international scientific journals is also being used to develop vaccines.
Kaleebu says the DNA-MVA vaccine is the same vaccine that is being tested in Kenya and the UK but "we are just changing the doses and it will be given in combination."
Preparations for this vaccine have been going on for the past three years.
"We have found that the major HIV subtypes in our country are A and D. This is a vaccine based on subtype A," says Kaleebu, whose professional life has been dominated by HIV/AIDS works.
A year after he completed his studies at Makerere University Medical School in 1986, Kaleebu concentrated on nothing but HIV/AIDS. It was only in 1987 that he did clinical work at Nsambya Hospital.
Kaleebu joined UVRI in 1988, a time when the institute was beginning to prepare itself for HIV research.
"I think that was the time when AIDS became a major issue and I saw opportunities," he states in a matter-of-fact manner.
He got funding from the Overseas Development Administration (now DFID) and the World Health Organisation (WHO) to study immunology and virology in the UK. He graduated with a Ph.d after five years.
"My major work was describing the different HIV subtypes and immune responses that may be relevant for vaccine development," he says.
"Since my return, I have worked with the Medical Research Council (MRC) programme on AIDS in establishing and conducting research in Virology and Immunology to answer questions such as: 'why do some people progress faster than others using the cohorts set up by MRC in Masaka'," says Kaleebu, who also heads the Basic Sciences of the MRC programme.
"I think it is exciting to see that the preparations we have had for many years are leading us into a vaccine trial of this nature," he says, as he eagerly waits for the approval of the DNA-MVA vaccine trial.
"I can see it as another way that Uganda is still at the fore front in the fight against HIV/AIDS. We have done well in different areas of prevention. It is exciting to see that Uganda and Ugandan scientists are playing a leading role in HIV vaccine related work," he adds.
"The other thing that I am very happy about is that more and more scientists are being trained - we are developing capacity in different areas," he says.
He observes that many people look at developing a vaccine as a simple thing. "They think that you are somewhere mixing some substances and from a laboratory, you look at people to inject, which is not the case," he says.
"They forget the complication of trying to understand that there is a lot that we don't know on how an HIV vaccine operates that needs to be understood in the laboratory before human trials," states Kaleebu.
Because of the nature of his work, Kaleebu is in office at 8.30am and in most cases, does not leave until 9.30pm. He works over the weekend as well.
"I am a workaholic - I enjoy my job. It is exciting. I have had a good working relationship with my colleagues," says Kaleebu, also the head of UVRI immunology department.
The busiest moment during the different stages of planning vaccine trial was when they were preparing to launch the project.
"We had to go through all the legal technicalities like Solicitor General's office and Ministry of Health formalities. But the more challenging activities are yet to come," relates Kaleebu.
Right now, Kaleebu is working on getting volunteers.
"We hope to go to communities around Entebbe and Kampala. We shall look for adults between 18 and 55 years. These are real volunteers who are coming in without coercion but accepting to participate after getting all the necessary information," states Kaleebu.
"Our biggest challenge is to educate the communities and population to understand the need for such trials," he adds.
Volunteers will get three shots of the vaccine. They will first get the DNA and two subsequent shots of MVA at five and seven months.
Kaleebu's interest in research started off as a child while at Jinja Kaloli Primary School, Kawempe, St. Mary's College, Kisubi, Makerere University Medical School and the University of London.
As a child his aspirations kept on changing but a big part of his life knew that he wanted to be a doctor although even as he ventured into medicine, he never thought of getting into research.
"I wanted to become a paeditrician but it was after my internship that I knew I wanted to move away from routine clinical work," he says.
In 1999, Kaleebu received the prize for young scientist for 1999. The prize was jointly awarded by the Third World Academy of Sciences (TWAS) and the Uganda National Council for Science and Technology (UNSCT).
In all his work, Kaleebu's family has been very supportive.
"My family has been appreciative of my busy schedule. They have realised how my busy schedule leaves me little time to be with them. My wife has been supportive. I have been with her from the time I was training in the UK.
But I try to find some time for the family whenever I can. The fortunate thing is that I work near my home. When I am tired I can go back and play with my four children," says the busy scientist.
This man, who has also been actively involved in the WHO/UNAIDS network for HIV isolation and characterisation, says the frustrating thing about his work is the lack of an answer about the vaccine.
"People hear you are working on a vaccine and when they ask you as to when they would get a successful vaccine, you have no answer. That way, you somehow feel bad. You are working on something day and night but saying you don't know," he says, the frustration apparent on his face and in his voice.
"We also need to go to phase three and by the time you finish, it is like ten years. So, you ask yourselves, is this vaccine worth pursuing?" he says.
Does that mean that he finds his career frustrating at times?
"I have not been disappointed. I am proud of my achievements. The sad thing is that we are doing all this research but up to now we are still telling people we have no cure or vaccine for AIDS. That is the most frustrating thing," concludes Kaleebu