Finding a cure for Aids may take years, but the medical fraternity is attempting to stop the spread of the disease, writes Stuart Hess
While the world looks forward to a future in which infertile couples can have children via genetic cloning, and people with missing limbs can be given fully functional robotic hands, arms or legs, the people of Africa face a major struggle as the Aids epidemic continues its unstoppable march through the continent.
Although South Africa has been at the forefront of some significant innovations in health care this century – notably Professor Chris Barnard’s heart transplant at Groote Schuur in 1967 – those triumphs may be overshadowed as more people contract the Human Immunodeficiency Virus, and Aids-related deaths accelerate.
A researcher at the Medical Research Council (MRC), David Wilkinson, says Aids will lead to a social breakdown as many families lose breadwinners and loved ones.
“We are going to see a continued increase in the number of new infections which will place enormous pressure on the sector,” says Wilkinson. “We will see an almost total breakdown in the health system.”
Wilkinson says South Africa has made significant strides in the past two years in raising awareness of the disease and believes the country will lead the rest of the continent in finding a vaccine to kill the C-strain virus, most common in sub-Saharan Africa.
Already the MRC has developed a relationship with the community in Hlabisa, KwaZulu-Natal, to test new drugs on residents who have contracted Aids. “The community are totally open to the idea because it is addressing a crucial need,” says Wilkinson.
Research in the developing countries is still far behind work being done in Europe and the United States, where a drug has been produced which stops the virus replicating. But at a cost of $10 000 per year, it is far too expensive to be used locally.
“Finding an Aids vaccine will take years. There are hopeful signs, but there have been hopeful signs before,” says Wilkinson.
His colleague, Gita Ramjee, is studying the spread of the disease in urban centres, especially among prostitutes. Researchers at the MRC in KwaZulu-Natal have been testing a new drug with prostitutes.
Called vaginal microboside, the medication, which comes in the form of a cream, is applied inside the vagina and prevents the transmission of HIV during intercourse. The local experts are working in conjunction with scientists in West Africa and Thailand and the results of the study are expected in June 1999.
However, while the world seeks a product which will kill the Aids virus, scientists in the field of genetics want to use the virus to combat genetic ailments such as the visual impairing disease, retinitis pigmentosa, and various forms of cancer.
“We are using our molecular technology to study the Aids virus,” says the associate professor of human genetics at the University of Cape Town’s medical school, Jacquie Greenberg.
“It is a very powerful virus and it would be wonderful if we could utilise it to help rather than harm the human race. We would like to adapt the virus by nullifying its deleterious effect and then use it as a carrier to deliver healthy genes into the human body,” says Greenberg. “This way it could be used during gene therapy to replace genes or repair faulty genes.”
Genetic researchers are also concerned with the controversial topic of cloning and many believe that one day it will be possible for infertile couples to have children using cloning techniques.
Greenberg believes scientists still have a lot to study in the field of cloning before reproducing children. “Right now cloning is a very valuable tool for molecular geneticists and the more it is used, the more we learn about how it can be used,” says Greenberg. “The cloning of humans for reproductive purposes is still a long way off.”
As local scientists continue to study new ways of improving health, the government is trying to improve the quality of health care available at the 486 primary health care clinics built since 1994. The Department of Health wants to provide each clinic with X-ray machines and ultrasound equipment. The advances made in radiology mean the equipment is of a higher quality and, more importantly, it is cheaper.
A professor in radiology at the University of Natal, Peter Corr, says the next big step is to link the clinics with larger hospitals through telemedicine. “As the images [from X- ray or ultrasound] are downloaded digitally they can be linked via a network of telephone lines,” says Corr. “This will enable more experienced doctors in urban areas to help staff in rural hospitals and clinics.”
Studies done internationally have shown that, through radiology, diseases such as breast and liver cancer can be detected before they become life threatening.