Progress in AIDS Program in Haiti

It is possible to successfully treat AIDS patients at a squatter's settlement where there is no reliable electricity, virtually no laboratory testing, and little more than the right drugs, eager patients and the will to bring the two together. That was the message brought from Haiti and presented to the 14th International AIDS Conference.

Paul Farmer, an American physician who has worked in Haiti for two decades, said he and his colleagues have been treating about 200 people with three-drug antiretroviral therapy for several years. Scrounged from myriad sources, the medicines are dispensed through "directly observed therapy" (DOT), the strategy used with great success to treat TB. Farmer's rural health center occasionally sends blood samples to a Harvard Medical School lab to see whether the medicines have suppressed the growth of AIDS. "Yes, the patients are suppressed. It's not as if poor people are a different species. These drugs work for everyone," Farmer told the conference delegates, to applause and cheers.

Over the next year, Zanmi Lasante ("Partners in Health" in Creole) will provide antiretroviral treatment at four more sites in Haiti. About 2,000 of Zanmi Lasante's patients are infected with HIV. In addition to the 204 now taking three-drug combinations, about 250 with advanced AIDS are in critical need of the medicines, Farmer said. He expects the caseload to double in the next year as people come forward to be tested, knowing that treatment is possible. Antiretroviral treatment is only used in patients at the symptomatic stage of the disease, and not all of them can get it. Three measurements are required to start or continue treatment: an AIDS test, a white blood cell count and the patient's weight. Zanmi Lasante is sharing a $67 million award to Haiti made in May by the Global Fund to Fight AIDS, Tuberculosis and Malaria.

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