Kaiser Daily HIV/AIDS Report - Tue, 4 Sep 2001
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Democratic Republic of Congo, Ghana Take 'Rare' Steps to Provide Ac-
cess to Anti-HIV Drugs
The Democratic Republic of Congo and Ghana are taking "rare" steps to
prevent the spread of HIV, starting efforts to provide access to AIDS
treatments, the AP/New York Times reports. In the Republic of Congo,
two Brazzaville clinics this week will begin providing the AIDS
treatment nevirapine free of charge to HIV-positive pregnant women.
The drug, being provided by the German company Boehringer-Ingelheim,
has been effective in reducing vertical transmission. The project is
part of a larger campaign to educate women about the risk of trans-
mitting HIV to their children and how to prevent such transmission. A
second part of the campaign is aimed at encouraging women to take HIV
tests. Gertrude Kani, head of one of the private groups that is work-
ing with the Congolese government in the "My Child Will Live" cam-
paign, said, "Our job in convincing expectant women to take [an HIV]
test before delivery is making clear that today there's a different
outlook for the disease: that is to say, it's one you can live with."
Meanwhile, Ghana's government is pursuing importing lower-cost nevi-
rapine and other AIDS treatments, Health Minister Richard Anane said.
In addition, the government is working with the World Health Organi-
zation to begin manufacturing HIV drugs locally by importing the for-
mulas for generic drugs from Thailand and the raw materials from an-
other country (AP/New York Times, 9/1).
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Nigerian Program to Supply Generic Antiretrovirals Delayed
A Nigerian pilot program that would provide discounted generic an-
tiretrovirals to HIV-positive citizens did not begin on Sept. 1 as
planned, Reuters/ABCNews.com reports. Touted as "Africa's most ambi-
tious generic AIDS treatment program," the pilot project plans to
provide 10,000 adults and 5,000 children with generic copies of anti-
retroviral drugs. The Nigerian government purchased the drugs from
Indian drug maker Cipla Ltd. for $350 per year per person, and plans
to subsidize up to 80% of the cost. Reuters/ABCNews.com reports that
the launch of the program has been delayed for several reasons -- the
technicians who will monitor and evaluate the program have not been
trained, the government has not indicated "where or how" the medi-
cines will be distributed and no list has been released naming those
who will receive the drugs. Dr. Oni Idigbe, the director general of
the Nigerian Medical Institute of Research and a member of the com-
mittee in charge of the program, said that the program "might start
on Sept. 7." Dr. Sani Gwarzo, the program's technical director,
stated that the program will move to an accelerated phase within two
years to reach thousands more people with HIV. The government hopes
to eventually supply antiretrovirals to all HIV-positive Nigerians.
AIDS Advocates 'Skeptical'
Reuters/ABCNews.com reports that AIDS advocates and HIV-positive
citizens remain "skeptical" about the program and whether the govern-
ment will live up to its promises. Lt. Nsikak Ekpe, a navy engineer
who counsels people for the Nigerian AIDS Alliance, said his organi-
zation "does not know of anyone who has been told they will receive
the drugs." He added, "There are problems with everything. They said
this would commence Sept. 1. ... Everything regarding the costs, the
mode of distribution, etc. -- these things should have been worked
out before" (Doran, Reuters/ABCNews.com, 8/31). New York Times
Reports on Research into African Chimpanzees as Source of HIV-1
In a continuation of its "AIDS at 20" series, the New York
Times today reports on the discovery of a virus highly similar to
HIV-1 in a "long-dead" chimpanzee that may be "the missing link in
the search for the origins of AIDS." In 1998, Dr. Beatrice Hahn of
the University of Alabama-Birmingham and an international team of 11
other scientists examined the organs of a dead chimpanzee and "un-
ravel[ed] the mystery of the origin of the epidemic." The chimp,
which died a decade earlier while giving birth, came from west-
central Africa, a region thought to have been the "place where the
human AIDS epidemic began," as genetic sequences of HIV are most di-
verse there, indicating a long-time presence of the disease. In addi-
tion, some people in west-central Africa eat chimpanzees, making it
"entirely reasonable to think that an infected animal's blood gave
the virus to a person who was handling the chimpanzee meat, infecting
the person and setting the stage for an AIDS epidemic," the Times re-
ports. But until Hahn's examination of the chimp, many scientists had
remained unconvinced that the animals were the source of the human
epidemic. While researchers continue to find HIV-like viruses in
other animals and primates in Africa, none are as closely related to
HIV-1 as the virus found in Hahn's chimpanzee and two other viruses
isolated earlier from two different chimps. Researchers now say they
have identified two more chimps captured in the west-central African
nation of Cameroon that carried a virus like HIV-1. >From viral muta-
tion calculations based on the chimp evidence, researchers estimate
that the epidemic began in 1931, plus or minus 15 years, and "almost
certainly infected humans repeatedly as they killed and ate chimpan-
zees over the years." Some researchers say that the epidemic was not
detected until much later because "the conditions were ripe" for the
disease to spread only after Africans began moving into cities and
attending clinics where physicians often reused needles. Others sug-
gest that it simply took many years for enough people to become in-
fected to draw attention to the disease (Kolata, New York Times, 9/4
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