The AIDS Enigma

NVDL: One of the consequences of the current financial meltdown is that money for research - for example into AIDS - evaporates over night. It also means that money to monitor other threats - such as bird flu - slow down to a mere trickle. And then when you see outbreaks, the ability to contain these decrease. This is how civilisation gets overwhelmed, muscled out by ordinary forces of nature. Whereas we once thought we could buy whatever we needed, we now move into a world where commodities either no longer exist, or there is no money, resources or resolve to buy them if they do.

Then you get a headline like this, which is code for: Relax, it's over.

Threat of world Aids pandemic among heterosexuals is over, report admits

Okay, so we're right about that, right, I mean we're certain... even if we were wrong about other AIDS stuffs...

AIDS virus decades older than thought

"It is the question we are asked most often – why is the situation so bad in sub-Saharan Africa? It is a combination of factors – more commercial sex workers, more ulcerative sexually transmitted diseases, a young population and concurrent sexual partnerships."

"Sexual behaviour is obviously important but it doesn't seem to explain [all] the differences between populations. Even if the total number of sexual partners [in sub-Saharan Africa] is no greater than in the UK, there seems to be a higher frequency of overlapping sexual partnerships creating sexual networks that, from an epidemiological point of view, are more efficient at spreading infection."

Low rates of circumcision, which is protective, and high rates of genital herpes, which causes ulcers on the genitals through which the virus can enter the body, also contributed to Africa's heterosexual epidemic.

"The impact of HIV is so heterogeneous. In the US , the rate of infection among men in Washington DC is well over 100 times higher than in North Dakota, the region with the lowest rate. That is in one country. How do you explain such differences?"

NVDL: I think the relationship with infection rates is a combination of arrogance, ignorance and appetites. A more urbanised individual gets caught up in the sexual competition thanks to the media and a target rich environment. In some rural areas there is more ignorance, but arrogance remains a factor as the individual spends his time bedding partners in order to feel better about his/her situation. Both are certainly a factor of an appetite that is out of control.

clipped from www.independent.co.uk Aids still kills more adults than all wars and conflicts combined, and is vastly bigger than current efforts to address it. A joint WHO/UN Aids report published this month showed that nearly three million people are now receiving anti-retroviral drugs in the developing world, but this is less than a third of the estimated 9.7 million people who need them. In all there were 33 million people living with HIV in 2007, 2.5 million people became newly infected and 2.1 million died of Aids. "Aids still remains the leading infectious disease challenge in public health. It is an acute infection but a chronic disease. It is for the very, very long haul. People are backing off, saying it is taking care of itself. It is not." "It is astonishing how badly we have done with men who have sex with men. It is something that is going to have to be discussed much more rigorously."

500 000 Die Of AIDS in SA Every Year

Imagine being unfortunate enough to be born into a poor community in South Africa. Odds are, your parents will die before you're halfway to double figures yourself, and you may not be guaranteed to get there either.

Someone made the comment: 'But it's their fault; just don't sleep around or use a condom.' Not that simple. If your parents are dead, and you're starving, it is tempting to shack up with an uncle or friend of the family who has a house and an income. Unfortunately, this 'friend of the family' passes on the disease in exchange for a temporary lease on life. Don't believe me? The New York Times covered exactly this angle in an article titled AIDS, Pregnancy and Poverty Trap Ever More African Girls .

I was touched by a documentary we watched before the AIDS concert, on Nkosi Johnson. I was touched by a little boy born with AIDS and having to face that death sentence everyday. Not supposed to eat pizza, supposed to remember his medications, losing his hair...I was also touched by the white woman who took care of him, fought for and with him. But it was at the 46664 concert that the insight crystalised. Very few people at the concert are the victims of AIDS. But they - we - do need to know what is happening in a world away from our world. The message in the bottle is this:

The victims in South Africa are the poor. They are the victims of circumstance, they are the victims of neglect. They are dying in droves, many as a result of murder, many having been raped - die later suffering perhaps an even worse fate - and then, there are those who die of AIDS in South Africa. Half a million a year.

The reason this disease is so hard to imagine is because, if you have access to the internet, if you have a computer, you are alsready so disconnected from the poor, and the reality of what it means to live in a shack, vulnerable to the elements, including human rogues and the dark sicknesses they carry, this reality is impossible to imagine.

Can the rich be blamed for being disconnected to the poor? Crime essentially drives a wedge between these worlds. Why? Because the wealthy retreat behind eletrified perimeter fencing, in an effort to protect themselves. They dare not venture into squatter camps for fear of being attacked or injured. And thus the circle of poverty is reinforced, rendered incontrovertible.

The saviour of the poor, interesting enough, may turn out to come from a misunderstood and misrepresented individual. Jacob Zuma. In the Financial Mail magazine he has been described as truly a man of the people: uneducated, but importantly, a man who genuinely understands and cares about the poor. he attends funerals without a press contingent. He visits widows. He himself came from a poor background.

In my opinion what South Africa needs is to learn how to care for one another again, particularly the poor. We care by first thinking of another, not of ourselves. And perhaps, instead of seeing the poor as the squalid sprawl of shacks, there is also the beautiful landscapes of Transkei. There, on a field, with the blue sea in the distance, we can offer to help a farmer, and return in December to see what the yield is. Perhaps the farmer will give his patron a cob of corn, invite the city slicker around a fire. But the point is, South Africans need to take hands, wherever possible. If we don't do this soon, a million ghosts of this country will haunt our dreams, wherever it is that we sleep.
Also read: When a Pill Is Not Enough
A face of HIV/AIDS, Nkosi Johnson

Defective Condoms In The Country With World's Most AIDS Cases

Government faces R5bn suit after bribery scandal. Three condom suppliers, the South African Bureau of Standards, Health Minister Manto Tshabalala-Msimang and Finance Minister Trevor Manuel face a R5 billion class-action lawsuit over defective condoms the Health Department distributed earlier this year.

Mathibela James Ramahuma and 49 999 other unnamed plaintiffs are each demanding compensation of R100 000. The claims
have been served on the Health Department, the Finance Department and the SABS, said Gilford Malatji, the attorney bringing the action.

For the rest of this Sowetan Online article, go here.

NVDL: It's actually an incredibly serious F&$# Up. It means even if you have protected sex, you might contract a terminal disease, or impregnate someone and infect them, and worse, pass on the virus to the unwanted foetus you've conceived. It's a humongoid F&$# Up.

Weird: Man On ARV's Grows Breasts

by Alfred Moselakgomo
It is a wonderful thing when a young girl develops breasts, but for a 42-year-old Mpumalanga man, it has become a harrowing experience.

Sabelo Maepa – not his real name – of Sakhile township in Standerton is in need of urgent medical treatment because his breasts grow bigger by the day.

“Having female-like breasts when you are not female can be a source of shame and embarrassment,” said Maepa.

From the Sowetan: Man beats his breasts over ARV effects

Obesity a problem in HIV population

NVDL: I was of the opinion that if you had AIDS you would be losing weight. A friend who is a dietician once responded to my weight loss questions saying: "Almost all of my patients are trying to gain weight, and it's incredibly difficult when they have AIDS." Although it seems like obesity is also the lot of the HIV-positive, the truth is that untreated, AIDS causes the body to waste away.

Obesity and HIV
By ALICIA CHANG, AP Science Writer

LOS ANGELES - Early in the AIDS epidemic, people infected with the virus often lost a dangerous amount of weight, at times looking gaunt and ghostly. Today, they are facing the opposite problem. Many who have HIV, but not full-blown AIDS, are struggling with obesity, which has overtaken "wasting syndrome" as the top concern.

AIDS researchers and advocacy groups say the waistlines of HIV patients are growing right along with the girths of uninfected Americans as the disease shifts from a death sentence to a chronic condition.

Exact numbers are hard to pin down. But new research suggests that nearly two-thirds of the HIV population may be overweight or obese, mirroring the U.S. population.

Doctors say there's a growing need to screen people with the AIDS virus for obesity, which raises the risk of diabetes, high blood pressure and cholesterol problems.

"We used to worry that they would lose weight and become wasted," said Dr. Nancy Crum-Cianflone of TriService AIDS Clinical Consortium in San Diego. "Maybe we should redirect our concerns to making sure they are maintaining a healthy, normal weight."

About a million people in the United States are living with HIV or AIDS, federal statistics show. At the height of the epidemic, many had wasting syndrome, the uncontrollable loss of 10 percent of body weight along with other symptoms like fever or diarrhea.

A turning point in the AIDS crisis came with advances in modern medicine. Powerful drugs that keep the virus at bay also boost the body's immune system. The result is that more HIV patients are living longer than their counterparts two decades ago, and may be prone to poor eating habits and lack of exercise.

Some experts offer psychological explanations. Since the hallmark of HIV has been weight loss, some patients may be piling on the pounds to avoid looking abnormally thin.

"It's very clear now that HIV is no longer a wasting disease in America," said Dr. John T. Brooks, an epidemiologist in AIDs prevention at the Centers for Disease Control and Prevention. Brooks did not participate in the study.

From Yahoo.com. For more click here.

Who is Worse - Mbeki or Bush?

NVDL: It's a tough call. Bush pushed his country into a dumb war. Okay, probably his reasons were dumb, setting up a police station in Iraq to secure access to Iraqi oil was arguably not so dumb. Mbeki on the other hand is very soft on a national holocaust called AIDS. With over 5 million dead, I think it's no contest here, but I could be wrong. W. still has time to send a few more nuclear capable aircraft into US (and other) airpspace. Perhaps we shopuld hold off on answering this until we have the next South African President, who may well be the worst yet.

From The Guardian:
[Mbeki] behaves as if South Africa's Aids disaster is no such thing. It is as if another of his rivals for worst President, George Bush, were to pretend the Iraq war was a little local difficulty.

During Mbeki's first five-year term, he used to say, with the enthusiastic backing of his Health Minister, a doctor, that Aids was not a sexually transmitted disease and that the anti-retroviral drugs that have saved hundreds of thousands of lives around the world were poisonous. He also famously declared that he knew no one who has Aids.

Since then, Mbeki has been bludgeoned into grudgingly starting to have anti-retroviral drugs handed out. The government's official policy on Aids today is medically sound at last. But Mbeki continues to show an abject lack of leadership, indicating - as his firing of the Deputy Health Minister shows - that he is less than half-hearted in his commitment to the cause; that the great $64,000 question of South African politics - what the hell is going inside Mbeki's head on Aids? - remains unanswered. Because he is an otherwise eminently rational, intelligent man.

While Mbeki has battled with repression, the crisis has cried out for Diana-like theatrics. Mbeki should have gone out into the worst-affected areas and held the hands of Aids patients; he should have publicly celebrated the Lazarus-like return to life of people on the anti-retroviral programmes; above all, he should have gone out of his way to set people straight on Aids, to counter the ignorance and confusion he himself has sown, contributing immeasurably to the scale of the catastrophe.

Mandela, deep into his eighties, has done all of that and more. But out of Mbeki, not a peep. His tragically ludicrous Minister of Health continues to go about creating the impression that beetroot and garlic are as effective in countering the effects of the HIV virus as the anti-retroviral medication.

The one person in government who has had the courage implicitly to defy Mbeki both by pushing hard for the new government strategy on Aids - approved last March, when Tshabalala-Msimang was on sick leave, recovering from a liver transplant -and by showing active leadership on the matter was Madlala-Routledge. So much so that she has become a much respected figure in the global Aids community. As such, she was invited to attend an international conference in Madrid last June on the latest work in the search for an Aids vaccine.

I spoke to her last week in Cape Town, and she told me she accepted the invitation because of the opportunity it provided 'to make a strong case on behalf of the victims' to scientists and European parliamentarians who would be in attendance. She flew to Spain, but barely had she landed in Madrid than she received an order from Mbeki himself to fly straight back. Which she did, but this did not prevent Mbeki from firing her. The reason? That she had flown to Madrid without his permission.

Since then, the South African press has published an avalanche of reports on the alleged alcoholism and kleptomania of her former boss, Tshabalala-Msimang.

Under the front-page headline, 'Manto: a drunk and a thief', the top-selling Johannesburg Sunday Times claimed the Health Minister continued to booze after her transplant, and revealed that in the Seventies she was expelled from Botswana for stealing from patients at a hospital where she was a medical supervisor.

Beyond the office-holding ranks of the former heroes of the ANC's liberation struggle, the clamour has been insistent for the reinstatement of Madlala-Routledge and the firing of Tshabalala-Msimang. Mbeki's response, typical of the small-mindedness that defines him, has been to order the former Deputy Health Minister to repay the government for her trip to Madrid.

He seems oblivious to the callousness of the message he is sending in persisting with the buffoonish Tshabalala-Msimang, a drinking buddy of long-standing, in a ministerial post that Mandela would have considered the most critical in his government by far.

· John Carlin is writing a book on Mandela to be published by Penguin Press (US).