Combination therapy in Africa (2)
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Source: procaare@usa.healthnet.org
May I add some additional items to Dr. Paul Wangai's list of drawbacks
to HAART:
8. It requires very disciplined compliance for ever.
9. In addition to requirement for monitoring liver and renal functions
(item 4), it also requires immediate and frequent access to viral
load testing. In future it will probably also require similar ac-
cess to resistance monitoring and blood drug level monitoring
tests.
10. It diverts scarce resources from more important opportunities to
address basic healthcare - and survival - problems.
11. It requires doctors who are knowledgeable and experienced in its
use.
It seems to me that the evidence is becoming overwhelming that similar
attention paid to other STDs would have much greater impact on the pre-
vention of the spread of HIV.
In addition, anticipating that short-course AZT therapy will be proved
to be beneficial, we must move very rapidly to implement this therapy
for all who need and want it. So far we have heard that even the cost
of this is way beyond the means of most mothers and most health serv-
ices. But it is not an impossibly huge amount to raise and we *must*
make a determined effort to provide this therapy. It seems to me that
this would be a much more equitable use of funds available from UNAIDS
or other sources. Discussion on this has been very muted.
Are we to wait until the proof is published in NEJM before we start to
take action?
Chris
--
Chris W. Green
Jakarta, Indonesia
Tel: +62-21 846-3029
Fax: +62-21 846-1247
mailto:chrisg@rad.net.id
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