/ 8 June 2007

SA conference united in war on Aids

Researchers, scientists and healthcare workers resolved on Friday to open a new front in South Africa’s war on Aids, encouraged by the government’s fresh approach to the crisis and improved weapons to protect those most at risk of infection.

The call came at the end of a major Aids conference in South Africa, where an estimated 12% of the 47-million population are infected with HIV and about 1 000 people die each day of Aids and related conditions.

”We recognise that collectively we have the means to reverse the [pandemic],” said a declaration approved by about 4 000 delegates at the Third South African Aids Conference in Durban.

While praising the government’s pledge to expand the roll-out of antiretroviral drugs (ARVs) and increase HIV testing and counselling, delegates said more must be done to counter domestic abuse and rape, and prevent infections in girls and women, who make up most the 1 500 new HIV cases reported each day.

It urged President Thabo Mbeki’s administration to promote the use of female condoms and make them more available throughout the country.

Broad consensus

Although HIV/Aids continues to exact a staggering toll in South Africa and its neighbours, the four-day conference was marked by a broad consensus on how to tackle the pandemic and lacked the rancour that marred other high-profile Aids meetings.

South African officials, including Mbeki and Health Minister Manto Tshabalala-Msimang, have infuriated Aids activists and scientists in the past by questioning accepted Aids science, pushing unproven treatments and refusing to make ARVs readily available to all those in need.

Tshabalala-Msimang, dubbed ”Dr Beetroot” for her promotion of beetroot, garlic and other foods as a treatment for HIV/Aids, withdrew from the conference earlier this week because she was reportedly upset at not being given a prominent speaking slot.

Delighted delegates pushed on without her.

Many credited the government for unveiling in March a revamped national plan to fight HIV/Aids, which includes a targeted fivefold increase in the number of HIV-positive people accessing ARVs by 2011. About 700 000 needy South Africans currently cannot get the medications.

David Allen of the Bill and Melinda Gates Foundation, which is funding the battle against Aids and other diseases in Africa, said South Africa’s government had put in place ”clear and identifiable targets”, but he added that flexibility and new ways of thinking were required for it to be successful.

”We know that the HIV [pandemic] is not slowing,” Allen said in a presentation on Friday. ”We have to do things differently if we are going to achieve the objectives.”

One of the more controversial ideas mentioned at the conference was for a mass male-circumcision programme in Southern and Eastern Africa, where circumcision rates are relatively low in comparison to other parts of the continent.

The proposal stemmed from studies in Kenya, Uganda and South Africa, which showed the risk of contracting HIV was as much as 60% lower in those who had been circumcised. While stopping short of backing the proposal, delegates adopted a recommendation to promote safe male circumcision as part of a broad HIV-prevention strategy.

There was discouraging news for those hoping a vaccine might halt the pandemic. Researchers said HIV’s astonishing ability to mutate combined with the vast number of different HIV subtypes in Africa had stymied efforts on that front.

There was also little progress reported in the development of HIV microbicides, which are compounds that can be formulated as gels, creams and other solutions and applied inside the vagina and rectum to kill sexually transmitted infections. — Reuters