E-drug: Re: Access to AIDS treatment in Honduras
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A very personal view
The situation that Richard Stern found in Honduras though tragic is one
that occurs many times in developing countries. A few things bother me.
Stern describes how he gave a Spanish magazine to Maria Elena, a woman on
her death bed informing her about the availability of antiretroviral drugs in
obviously developed countries only. A little further on, we read about
Merck providing medications but as usual they have to give a little back by
enrolling in a study.
The dilemna of AIDS devastation in developing countries and the problem
and cost of paying for medication let alone AIDS medication is once again
brought to light. Two things that I would like to point out
1. How ethical is it to show/tell or give information on antiretroviral
drugs to patients who have virtually no hope of every getting the
medication? Should we even put our efforts into providing the medication?
800 dollars for one treatment course (which I think is a month) is to say
the least out of the question in many developing countries. Stern
mentions that some drug companies are willing to sell this at a discount
to countries. Which companies? Only Glaxo announced they would discount
their product earlier this year and the logistics of how those drugs will be
distributed is still being worked out. Furthermore it appears that the
only time that HIV/AIDS patients get antiretroviral medication is when they
are enrolled in a study. We are abusing thousands of desperate souls in
these attempts to understand this century's scourge.
2. Some considerable effort is being put into supplying "essential" drugs
for HIV but what we do not see is efforts and research that would assist
communities, families and health care workers in coping with HIV. In many
developing countries, the extended family is often the source of social
support and care..how can we use this to encourage families to take care
of their HIV infected members instead of casting them out of the family
unit. From where I sit.. I would like to see us develop more coping
strategies rather than put so much effort in providing extremely expensive
medication that we probably cannot sustain and despite which patients will
eventually die. How about quality of care, The dying process.. many of
these patients will die in an institution instead of in their family? What
and who takes care of their dependants like in Maria Elena case. Developed
countries have various resources to be able to provide both medication and
support.. but do we in developing countries? Therefore our (developing
country) strategies for combatting HIV/AIDS need to be markedly different
from those in developed countries.
Josephine T. Maundu, RPh
Graduate Student, MPH
Department of Epidemiology
University of Washington
Box 357236
Seattle, Wa 98195-7236
Tel:206-616-2080
Email:thitu@u.washington.edu
"African women are the hope of Africa"
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