Early HIV Testing Key for Success of African Treatment Programs, Expert Says at South Africa Conference

Early HIV testing is an important factor for the successful implementation of HIV/AIDS treatment programs in African countries, Ernest Darkoh, former operations manager of Botswana's public antiretroviral drug program, said on Tuesday at the 2nd South African AIDS Conference in Durban, South Africa, Reuters AlertNet reports (Quinn, Reuters AlertNet, 6/7). About 1,000 AIDS advocates and health professionals were expected to attend the three-day conference, which opened on Tuesday and aims to evaluate South Africa's HIV/AIDS treatment programs (Nullis, Associated Press, 6/7). Darkoh, who was the keynote speaker at the conference, said it is important for people to undergo early testing for HIV to avoid a "deluge of sick people hungry for treatment," according to Reuters AlertNet. Darkoh said that Botswana's decision in early 2004 to implement routine HIV testing for incoming patients at medical clinics made a "big difference in catching people before they are too sick to work and become a bigger burden on social services," according to Reuters AlertNet. "You are overwhelmed at first by the very sick, and they are very resource intensive, if you at least get them while they are still ambulatory, you have a chance," Darkoh said. Botswana has an HIV/AIDS prevalence of about 40% of the adult population, one of the highest in the world. Darkoh said that developing countries -- including South Africa -- could learn from Botswana's experience providing antiretroviral drugs, according to Reuters AlertNet. "The issues on the ground, at an operational level, are the same," Darkoh said, adding, "You have to wake up and say you are going to do it -- it may take 20 years, but you are going to do it" (Reuters AlertNet, 6/7).

South African Military
The South African military is "fighting a war" against HIV/AIDS, which affects about 23% of the country's armed forces and is disrupting the country's ability to serve in peacekeeping missions abroad, South African Brig. Gen. Pieter Oelofse said on Tuesday at the conference, according to AFP/Yahoo! News. "From the military health perspective, we are fighting a war, a human war," Oelofse said, adding, "We are faced with a formidable enemy which is HIV and AIDS." U.N. guidelines discourage HIV-positive soldiers from serving in international peacekeeping missions, but Oelofse said that the military is a stretched and might need to depart from the guidelines if research shows that HIV-positive soldiers taking antiretrovirals can serve effectively, according to AFP/Yahoo! News (AFP/Yahoo! News [1], 6/7). A research project partly funded by the U.S. Department of Defense and NIH is examining which antiretroviral treatment regimens are most effective for treating HIV-positive soldiers, according to Reuters. South African Col. Xolani Currie, the project's leader, said that 2,779 military personnel and dependents have been screened for their eligibility to participate and that only those with the greatest need for the drugs have been accepted, according to Reuters (Quinn, Reuters, 6/7). Currie said treatment has raised the morale of those participating in the project, according to AFP/Yahoo! News. "We had members sitting hopelessly at the base with no hope," Currie said, adding, "Some of them are now running around in the mountains." However, Oelofse said that the program is still in its "early days," adding, "The data is being collected. It's a five-year project" (AFP/Yahoo! News [1], 6/7).

PEPFAR
U.S. Ambassador to South Africa Jendayi Frazer on Tuesday at the conference said that the President's Emergency Plan for AIDS Relief over the past year has treated more than 25,000 HIV-positive people with antiretrovirals, trained more than 30,000 health professionals and provided services for more than 70,000 HIV-affected orphans or vulnerable children in South Africa, according to Xinhuanet. Frazer said that in the program's first year in South Africa, prevention programs have been implemented for labor unions, school children, uniformed services and resource-poor communities, according to Xinhuanet. President Bush and South African President Thabo Mbeki two years ago agreed to work together to implement PEPFAR in South Africa. "I am pleased to let you know that just last week, President Mbeki and President Bush met again and reconfirmed their commitment to the cooperative efforts our partners are engaged in to address HIV and AIDS in South Africa," Frazer said (Xinhuanet, 6/7).

Also Discuss Other Diseases, Health Minister Says
South African Health Minister Manto Tshabalala-Msimang "caused an uproar" on Tuesday at the conference when she "questioned the necessity" of the meeting and also urged those present to discuss diseases other than HIV/AIDS, according to London's Guardian (Siegfried, Guardian, 6/8). "I hope you have come in such big numbers not just to focus on one ailment but to focus on all of them because many other people are dying of other diseases in this country," Tshabalala-Msimang said, adding, "Even though it is a conference on HIV and AIDS, you must not forget to talk about cancers, you must not forget to talk about diabetes, you must not forget to talk about other communicable diseases" (AFP/Yahoo! News [2], 6/7). The South African HIV/AIDS treatment advocacy group Treatment Action Campaign has called for Tshabalala-Msimang to resign because of her statements promoting natural HIV/AIDS treatments and her emphasis on the side effects of antiretrovirals, according to BBC News. TAC asked the minister to make an "unequivocal statement" endorsing antiretrovirals as the "most effective" treatment for HIV/AIDS, according to BBC News (Miles, BBC News, 6/7).

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