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26734: (news) Chamberlain: Low-cost HIV treatment effective in Haiti (fwd)
From: Greg Chamberlain <GregChamberlain@compuserve.com>
By Gene Emery
BOSTON, Nov 30 (Reuters) - Low-cost treatment can triple the AIDS
survival rate in poor countries, research showed on Wednesday, defying
fears that such therapy can cause complications and do more harm than good.
Malnourishment, scarce laboratory testing and the risk of
complications have raised doubt among some researchers over the value of
AIDS treatment in developing regions.
"This will put to rest a lot of concerns," said Daniel Fitzgerald,
author of the study of 1,004 AIDS sufferers in Haiti. The study will be
published in Thursday's edition of The New England Journal of Medicine.
"The skeptics will be surprised. The people in the field who have been
doing it won't be surprised," he told Reuters.
About 90 percent of the 40 million people infected with the AIDS virus
worldwide live in developing countries.
Some lessons learned in the Haiti experiment "may be applicable to
real tough neighborhoods in the U.S." where care for people with the AIDS
virus may be sub-standard, Fitzgerald said.
Typically only 30 percent of AIDS patients survive for one year in
Haiti, the poorest country in the Western Hemisphere where the HIV
infection rate is about 3 percent among adults.
But integrating drug care -- usually generic drugs -- with nutritional
support, tuberculosis treatment, counseling and other public health
programs brought the survival rate up to 87 percent for adults and 98
percent for children, said Fitzgerald of the Weill Medical College of
That's comparable to the success rates in U.S. medical centers.
Most of the 1,004 patients, treated in the capital Port-au-Prince from
March 2003, earned less than a dollar a day.
Fitzgerald and his colleagues said the annual cost of giving a
three-drug combination to fight the AIDS virus was about $500 for generic
medicines and $750 for brand-name drugs.
"We estimated the overall cost per patient per year (including
medicine) as about $1,600," they said.
The "truly remarkable" result "vindicates the decision to link the
treatment program with nutritional supplementation and existing social
programs," said Jim Yong Kim and Charlie Gilks of the World Health
Organization, in a Journal editorial.
Fitzgerald said the benefits go beyond helping infected individuals.
"From a larger societal perspective, the person with HIV is often the
Mom or Dad. If you get them back to work or get them back functioning,
you're helping everyone in that family."
The study was done in conjunction with GHESKIO (the Haitian Group for
the Study of Kaposi's Sarcoma and Opportunistic Infections), an
organization that works with the Haitian government and helps train,
research, and provide care for HIV patients.
"It has often been said that our generation will be judged by our
response to the HIV and AIDS pandemic," said Kim and Gilks. "Although there
is much more to do, the GHESKIO project and responses from many other
developing countries give us hope that the final judgment may be less harsh
than we had feared."
Fitzgerald said the U.S. doctors simply jump-started the project. From
there, the Haitian doctors, nurses, health care workers and counselors who
were infected with HIV themselves provided care even in the midst of
serious political unrest.
"The clinic never shut down. They were even dodging burning tires to
get there," said Fitzgerald. "Our role was helping get the financial
assistance, and provide training and technical support. Once they got that,
they took off and they were amazing."