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Aids Tuesday, 14 September, 1999, 17:37 GMT 18:37 UK
African countries list Aids priorities
Woman with Aids
Lack of palliative care is a problem in Senegal
Provision of basic drugs for treating Aids-related conditions can have a huge impact on patients' lives, doubling the time they survive after diagnosis, a major conference has heard.

However, often these drugs are not available in Africa, where the disease has infected millions of people.

Aids Special Report
Most reports of Aids in Africa have concentrated on the cost of expensive anti-HIV drugs and the estimated spread of the disease, but health experts say simple improvements in basic health infrastructure can make a huge difference to people's life expectancy.

On Tuesday, the Enhancing Care Initiative (ECI), sponsored by drug giant Merck, hosted a roundtable on priorities for improving the treatment of Aids patients at the International Conference on Aids and STDs in Africa being held in Zambia this week.

On the same day, the World Bank announced a $3bn strategic plan to combat HIV and Aids on the continent, and pledged every effort to ensure funds reach those most at need.

The ECI, set up under the auspices of the Harvard Aids Institute in the USA, aims to gather reliable statistics on Aids and healthcare in places where there is a significant HIV problem.

So far, ECIs have been set up in four regions, including Senegal and KwaZulu Natal in South Africa.

The initiative involves teams of health, economic and human rights experts from the countries involved identifying priority areas for research and improvement.

The teams work closely with national governments.

Accurate data

Dr Richard Marlink, director of the Harvard Aids Institute, said donors such as the United Nations Aids programme were excited about the projects because objective data on Aids in Africa was notoriously difficult to come by.

Aids education class
Aids education can help fight the stigma associated with the disease
"The initiatives mean data can be collected which allows funders to know where to put their money and where gaps need to be filled.

"It shows they are getting something for their dollars and that care is improving."

The ECIs have identified nine areas where healthcare has to be improved to tackle the Aids problem. Only one covers anti-HIV drugs, generally unavailable.

Other areas include voluntary counselling and testing for HIV and public education.

It is estimated that around 90% of people thought to carry the virus do not know they are positive.

Research shows that if care givers are familiar with the disease, patients live up to a third longer after diagnosis.

In Senegal, where a pilot project on anti-HIV drugs is being carried out, the ECI has identified three major areas which need to be given priority.

They are accurate diagnosis and treatment of the main opportunistic infections associated with Aids, such as pneumonia; how to ensure the anti-HIV drug pilot is sustainable; and care for the dying.

Dr Marlink said basic painkillers were often not available. He added that if people were properly treated for pneumonia they could double the time they survived after diagnosis - from one to two years.

Hospice care

In South Africa, which just started its ECI in the summer and which is not as poor as Senegal, areas identified as priorities include the need to ensure patients have continuity of care, strengthening community- and home-based care and improving hospice care.

Dr Marlink said that there was little connection between hospitals treating patients for HIV in KwaZulu Natal.

"They don't tend to follow-up and find out what happens to patients when they leave," he said.

He hopes there will be interest in funding and setting up more ECIs in Africa as a result of the roundtable.

Zambia has already expressed an interest.

See also:

08 Jul 99 | Aids
04 Oct 99 | Africa
04 Nov 99 | Aids
14 Sep 99 | Africa
08 Jul 99 | Aids
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