Archive for the ‘AIDS’ Category

Sanday Chongo Kabange in LUSAKA, Zambia

Zambia’s Non Governmental Organisations’ Coordinating Council has joined voices calling for the arrest of researchers from the Microbicide Development Programme that administered a microbicide gel that led to 46 women to be infected with HIV at a site in southern Zambia.

MDP was behind the trials in Southern Zambia. PHOTO: dfid.org.uk

NGOCC, a consortium of civic organisations, mostly women NGOs, has condemned reports that 46 of the 1,332 women that took part in a clinical trial using a microbicide gel called PRO 2000 contracted HIV.

Group’s chairperson, Marian Munyinda, has demanded for an investigation be instituted so as to establish circumstances that led to 46 women to contract the virus.

Muyinda has demanded that researchers at the site be brought to justice as the lives of 46 infected women have been put under serious risk.

She said in Lusaka that her organisation will ensure that the rights of the 46 infected women are respected.

“ We are concerned and saddened that government has remained silent over this serious issue. We are demanding for an investigation to be instituted immediately so that we know what went wrong. The investigations should also extend to the operations of the Microbicide Development Programme because it is the organisation that spearheaded the trials. We do not want a situation where women to be used as objects in matters of life and death,” said disappointed Munyinda.

However, the Microbicide Development Programme has refuted reports that half of the 1,332 HIV-negative women who were recruited to take part in a test trial for the gel PRO 2000 were infected by the virus.

MDP Zambia principal investigator Maureen Chisembele issued a statement saying the reports were wrong and misleading.

Chisembele explained that the MDP 301 trial, which was testing whether the gel PRO 2000 would prevent HIV or not, took place in four countries, one of these centres being Mazabuka in southern Zambia.

“A lot of emphasis was put on the fact that it was not known whether PRO 2000 would work to prevent HIV, but it was known that condoms do,” she said.

She said there was a check to ensure that the women understood these two facts before they could enrol, and that repeat checks were done during follow-up.

She said condom use was promoted to all participants in the trial from the Zambian site in Mazabuka, where 1,332 women were recruited and each followed up monthly, up to one year.

“At each monthly visit, they received screening and treatment for other sexually transmitted infections; pregnancy tests and safe sex counselling including free condoms,” she said.

Chisembele said the study was completed in September 2009 and that the public release of the overall outcome of the study was done on December 14, 2009.

She said the outcome of the trial was that PRO gel 2000 was found to be safe to use but not effective against HIV, contrary to reports that half the women on the study were infected in Mazabuka.

Chisembele said the results show that only 46 out of the 1,332 women sero-converted while they were in study, meaning that there was a development of detectable antibodies in the blood directed against an infectious agent.

She said the study helped the participants as much as possible to remain negative through counselling and in condom promotions in sexually transmitted infections (STI) treatment.

Chisembele said, however, that some participants did become HIV -positive because the study was conducted in the normal environment.

She said women who became infected during the study were given further counselling and referred to local health services for anti-retroviral therapy (ART).

But Munyinda maintains that the trials that were conducted by the Microbicide Development Programme be investigated immediately.
She praised the area legislator, traditional and civic leaders for supporting the affected women and called on government to explain to the nation how the trials were sanctioned.

Meanwhile, a group of concerned Zambians planning to march to the National AIDS Council (NAC) in Lusaka where they intend to protest and petition Zambian authorities over its silent stance regarding the microbicide clinical trials in southern Zambia.

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Sanday Chongo Kabange in MAZABUKA, Zambia

A Zambian traditional leader has fumed over reports that a number of his female subjects who underwent a microbicides gel clinical trials have contracted HIV, the virus that cause AIDS.

A group of volunteers that took part in a microbicides gel clinical trials in Southern Zambia contracted HIV, 12 months after the commencement of the trial.

MDP under criticism. PHOTO: dfid.gov.uk

Zambian authorities have remained mute over the development while officials from the Microbicides Development Programme in Zambia and United Kingdom are pains to explain what went wrong during the clinical trials.

Chief Mwanachingwala who presides over the affected site in Mazabuka of southern Zambia has expressed regret at the “leaked” results of the trials.

The traditional leader has claimed that the Microbicide Development Programme (MDP) enrolled illiterate and uneducated women who did not understand the nature of the clinical trials and its consequences.

He has refused to offer audience to local officials from research site lamenting that it is pointless for him to engage in dialogue with the MDP now that the outcome of the clinical trials “cannot be reversed”.

Area legislator, Garry Nkombo has also called for a suspension of the trials until an investigation into the latest scandal is conducted and concluded.

Chief Mwanachingwala has also since asked the Lusaka government to be careful when granting authority for any research that involves human beings.

PRO 2000, a vaginal microbicidesgel, had been hailed as the most promising microbicide in a decade of research on female-controlled prevention methods. The gel contains molecules that are intended to clump around HIV before it can penetrate vaginal walls. Results of a clinical trial published early this month found no evidence that PRO 2000 reduces the risk of HIV infection.

Details related to the disastrous clinical trials have been scant as officials from the research site are desperate to conceal events that have led to a scandal that has since been coded “gel gate scandal”.

Zambia is among the nine countries in sub-Saharan Africa highly affected by HIV and any intervention to scale down the spread of AIDS is received with full blessings of government.

Sanday Chongo Kabange in LUSAKA, Zambia

Close to half of volunteers that took part in a microbicide gel clinical trials in Southern Zambia have contracted HIV due to alleged failed efficacy of the gel, meant to prevent the contraction of the virus that cause AIDS.

Zambia not spared by AIDS. PHOTO: eduinreview.com

The microbicides gel was administered to 1 340 HIV negative women by the Microbicides Development Programme (MDP) in Mazabuka, about 285 kilometres, south of the Zambian capital, Lusaka. Half of these have contracted HIV and one died two years ago, raising fears of the efficacy of the gel.

12 months after the commencement of the latest trials, it has emerged that close to a quarter of the volunteers who were enrolled on to the trial have contracted HIV.

MDP regional co-ordinator, Ruth Kasanda has declined to make any public remarks regarding the outcome of the latest trails.

National AIDS Council spokesperson, Justin Mwiinga has acknowledged existence of the trials but explained that further details would be relayed to the affected parties and the general public after intense investigations.

Similar sentiments have been echoed by Ministry of Health spokesperson, Reuben Kamoto Mbewe who stated, results of microbicide gel would be availed to the public after a detailed report is handed over to the ministry, currently embroiled in a financial scandal involving US$ 2 million.

The microbicides research trials which begun as far back as 2005 have over the years yielded discouraging results, though little has been made public.

According to classified information gathered from the latest outcome, “results of the trials have since been submitted by the Medical Research Council of the United Kingdom to the Microbicides Development Programme”.

It has also been learnt that in mid January 2010, all the women who volunteered to undergo the clinical trials would be briefed on the outcome of the research.

The research is being supported by various bodies including the Medical Research Council of the United Kingdom and U.S based Meharry Medical College’s School of Health.

Professor James Hildreth and Professor Vladimir Berthaud announced at a news conference in Lusaka in 2006 attended by this reporter, microbicides research was the next preventive measure to contain the spread of HIV in sub-Saharan Africa.

PRO 2000, a vaginal microbicide gel, had been hailed as the most promising microbicide in a decade of research on female-controlled prevention methods.

The gel contains molecules that are intended to clump around HIV before it can penetrate vaginal walls.

Results of a clinical trial published early this month found no evidence that PRO 2000 reduces the risk of HIV infection.

The trials in South Africa, Tanzania, Uganda and Zambia involved more than 9,000 women between September 2005 and September 2009.

It followed a smaller trial of the gel, which had indicated that using the gel might reduce HIV infections by a third.

The disastrous results emanating out of the Mazabuka research site in southern Zambia have come less than five months before international researchers, clinicians, scientists and journalists prepare for the 2010 International Microbicides Conference (M2010), which will be held in Pittsburgh, Pennsylvania, USA from May 22-25, 2010.

The conference is expected to review and deliberate on microbicides as an alternative HIV preventative measure.

By Sanday Chongo Kabange in CAPE TOWN, South Africa

In the midst of a sharp and lingering global economic recession and indications that world leaders are retreating on previous commitments to universal access to HIV prevention and treatment, the more than 5,000 AIDS researchers, implementers and community leaders that recently convened at the Cape Town Convention Centre in the South Africa resort city of Cape Town for the 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention warned of dire public health consequences resulting from poor financial and material support on the global fight against AIDS due to recession.

The delegates warned that reduced support to HIV/AIDS related research, programmes and projects would have severe implications on the global fight against AIDS. There is mounting fears that the economic crisis has reduced financing to various health project.

AIDS activists such as the AIDS and Rights Alliance for Southern Africa, contended that much support by wealthy nations like the G8 are channelling funds to bailing out collapsing institutions or other programme such as climate change or terrorism.

The alliance cited the use of US$ 700 000 000 000 by Barrack Obama’s administration to bail-out collapsing banks, Robert Mugabe’s lavish spending on his 85th birth of US$ 250 000 and Yoweri Museveni’s procurement of a private presidential jet at the cost of US$ 48 000 000, as some of the funds that could have been spend on finding a cure for AIDS, which has taken lives for decades.

IAS President Julio Montaner, who is IAS 2009 Chair and Director of the BC Centre for Excellence in HIV/AIDS in Vancouver, Canada said, “Despite the recession, the global response to HIV – including the commitment of sufficient resources to achieve universal access to HIV prevention and treatment, fully fund AIDS research and strengthen underlying health systems – cannot be put in a holding pattern. If we don’t move forward, we will rapidly lose ground. That is the reality we face at this pivotal moment in HIV scale-up”.

The IAS Conference series focuses on the translation of research into practice, particularly in low and middle-income countries such as Zambia.

IAS 2009 Conference South African co-chair Hoosen Coovadia said the conference took place at the right time and place.

“With reports of interruptions in drug supply and shortages here (South Africa) and elsewhere foremost on our minds, we must ensure that health delivery systems on our continent (Africa) are effective and adequately funded in order to prevent needless deaths and countless preventable infections,” he said.

The emphasis on the real-world application of science was also reflected during remarks delivered by South Africa’s Deputy President Kgalema Motlanthe.

Motlanthe stated that South Africa has made significant progress towards finding a cure for AIDS. He explained that for the first time, a South Africa generated vaccines is currently undergoing trails in the United States of America, to determine its efficacy.

He also announced the launch of trials of the first AIDS vaccine created by a developing country, South Africa. The new vaccine, developed with help from the United States, targets the specific HIV strain that has hit South African people hard and produced the worst AIDS epidemic in the world.

He said the launch is a milestone for the country’s scientists who had had to overcome deep prejudice and scepticism from colleagues as well as some of South Africa’s past political leaders who shocked the world with unscientific views on the disease.

The vaccine trial is called “Phambili,” which means “moving forward” in the Xhosa language. Volunteers will be healthy HIV negative males and females, aged 18 to 35 years, who are sexually active and not pregnant.

The trial design will compare the test vaccine to a placebo (a harmless substance) and, to eliminate bias, neither volunteers nor researchers will know who receives the vaccine and who receives the placebo. The trial will last about four years. The trial has been approved by the South African Medicines Control Council and the South African Department of Agriculture and has been reviewed by the US Food and Drug Administration. Approval has also been given or is pending by institutional ethics and bio-safety committees at all the trial sites. In addition, there will be an independent Data and Safety Monitoring Board who will carefully monitor the safety of the trial participants.

South Africa’s Treatment Action Campaign General Secretary Viyuseka Dubula, who spoke as a representative of the community, highlighted progress and challenges recorded since the 13th International AIDS Conference that took place in Durban in 2000, an event that is widely credited with having focused global attention on geographic disparities in HIV treatment and jumpstarting the move to expand access in low-income countries such as Zambia.

AIDS Free World co-director Stephen Lewis and former United Nations Secretary General’s Special Envoy for AIDS in Africa argued that what was desperately needed today was unrelenting and informed voices of advocacy.

Lewis called upon the scientific community to use both their scientific expertise and their voices to respond to the pandemic.

 


By Sanday Chongo Kabange in LUSAKA, Zambia

AIDS like many other factors has the ability to create severe impacts on developing and buoyant economies across the globe. AIDS is different from other diseases because it strikes people in the most productive age bracket that is 15 to 49 years.

Zambia is among the African countries severely hit by AIDS. It is estimated that out of a population of 12.5 million people, 1.1 million are HIV positive, of which one million are adults.

UNAIDS has conducted studies into the impact of AIDS on the Zambian economy. PHOTO: un.ik

The Joint United Nations Programme on HIV and AIDS (UNAIDS) ranks Zambia as one of nine countries in the sub-Saharan Africa region that is highly affected by the AIDS pandemic. The epidemic is having a devastating impact on various sectors of the economy.

Zambia is one of the most urbanised countries in Africa, with urban migration characterised by movement from smaller towns to bigger cities. As part of Zambia’s 2007 Demographic and Health Survey, women and men ages 15-59 were tested to determine their HIV status. The results revealed that the national HIV prevalence had declined from 15.6% in 2001-02 to 14.3% in 2007 (a drop of only 1.3% over a period 5 to 6 years). However, the current HIV prevalence rate stands at slightly above 13.5%.

The recent decline in the prevalence rate has been attributed to a series of mitigation measures by the government driven National AIDS Council.

The economic effects of HIV and AIDS vary according to the severity of the epidemic and the structure of the national economies. For an economy such as Zambia’s whose main driver is human capital, The monetised economy of Zambia which has over the years been heavily depended on the mining of copper, cobalt and zinc until recently when the global economic crisis emerged, compelling Zambian authorities to consider diversifying the economy to other sectors such as agriculture and tourism.

About 20% of total wage employment in Zambia has been in the mining sector industry, which in turn accounts for about 15% of GDP in 2008 and 80% of the country’s annual export earnings. Manufacturing industries and agriculture are the next two major sources of paid employment in Zambia. The sectors contributed 30.7% and 18.8% to GDP in 2008, respectively. The services sector contributed 38.2% of GDP and provided employment for 60% of wage-earning employees. Agriculture remains underdeveloped, and accounts for the largest proportion of the labour force, consisting of about 73.5% of the economically active population.

The economic effects of AIDS will be felt first by individuals and their families, then ripple outwards to firms and businesses and the macro-economy.

A research finding by a USAID funded Policy Project states that the loss of young adults in their most productive years is affecting Zambia’s overall economic output because AIDS is more prevalent among the economic elite. The findings indicate that the direct costs of AIDS include expenditures for medical care, drugs and funeral expenses, which have to borne by households, employers and sometimes government. Indirect costs include lost time due to illness, recruitment and training costs to replace workers and care of orphans. If costs are financed out of savings, then the reduction in investment leads to a significant reduction in economic growth.

The macroeconomic impact of AIDS is difficult to assess. Most studies have found that estimates of the macroeconomic impacts are sensitive to assumptions about how AIDS affects savings and investment rates and whether AIDS affects the best-educated employees more than others. Few studies have been able to incorporate the impacts at the household and firm level in macroeconomic projections. Some studies have found that the impacts may be small, especially if there is a plentiful supply of excess labour and worker benefits are small. There are several mechanisms by which AIDS affects macroeconomic performance.

Policy Project study states that AIDS deaths lead directly to a reduction in the number of workers available. The deaths occur to workers in their most productive years. As younger, less experienced workers replace these experienced workers, worker productivity is reduced. A shortage of workers leads to higher wages, which leads to higher domestic production costs. Higher production costs lead to a loss of international competitiveness which can cause foreign exchange shortages.

Lower government revenues and reduced private savings because of greater health care expenditures and a loss of worker income can cause a significant drop in savings and capital accumulation. This leads to slower employment creation in the formal sector, which is particularly capital intensive. Reduced worker productivity and investment leads to fewer jobs in the formal sector. As a result some workers would be pushed from high paying jobs in the formal sector to lower paying jobs in the informal sector. The overall impact of AIDS on the macro-economy is small at first but increases significantly over time.

Infant mortality rate in Zambia will be 60% higher by 2010 due to the impact of AIDS, the child mortality rate will double, the crude death rate will triple, and life expectancy will decrease from 60.1 to 30.3 years. Overall, population growth will be reduced from 3.1% to 2.1%, because of the effect of AIDS, according to data from the United Nations.

AIDS is a huge challenge for Zambia. PHOTO: eduinreview.com

A study by the Ministry of Health used a simple macroeconomic model to examine the impact of AIDS on Zambia’s economy. The study compared scenarios: First, an economy with AIDS, but without foreign assistance and second an economy with AIDS and with foreign assistance. In the first AIDS scenario, without assistance, the study estimated that GDP would be 9% less than the baseline scenario, with per capita income equal to $494, about 4% less than the baseline.

The study says if foreign assistance pays for medical costs and training of workers, GDP would only fall by about 5%. These effects are a combination of initial effects of decreased production due to reductions in the labour force and later losses in productivity due to lower investment levels initially. The final conclusion to the study said, “Without unprecedented infusions of free foreign aid to mitigate the effects of AIDS, the economy of Zambia will suffer considerable damage.”

Hammered Sectors

It is a well established fact that AIDS and its related illnesses have cross-cutting effects on different sectors of the economy. The impacts of AIDS have ripple effects on mining, banking, agriculture, education, health, construction, manufacturing, environment, water and sanitation.

Agriculture is the largest sector in most African economies accounting for a large portion of production and a majority of employment. On agriculture, studies done in some African countries have shown that AIDS has adverse effects on agriculture, including loss of labour supply and remittance income.

The mining sector is a key source of foreign exchange for many countries including Zambia. Most mining is conducted at sites far from population centres, forcing workers to live apart from their families for extended periods of time. They often resort to commercial sex. Many become infected with HIV and spread that infection to their spouses and communities when they return home. Highly trained mining engineers can be very difficult to replace, as a result, a severe AIDS epidemic seriously threaten mine production.

On industries, AIDS have a significant impact on some firms in the sense that AIDS-related illnesses and deaths to employees affect a firm by both increasing expenditures and reducing revenues. Meanwhile, AIDS affects the health sector for two reasons, first because it increases the number of people seeking services and secondly health care for AIDS patients is more expensive than for most other conditions.

The transport sector is especially vulnerable to AIDS and important to AIDS prevention because of the nature of transporters, who mostly track from one point to the other. Building and maintaining transport infrastructure often involves sending teams of men and women away from their families for extended periods of time, increasing the likelihood of multiple sexual partners. AIDS affects the education sector in at least three ways: first, the supply of experienced teachers will be reduced by AIDS-related illness and death, secondly, children may be kept out of school if they are needed at home to care for sick family members or to work in the fields and thirdly, children may drop out of school if their families cannot afford school fees due to reduced household income as a result of an AIDS death.

Zambia is aiming to kick AIDS out of its development agenda. PHOTO: host304.evoluta.com

AIDS also affects water and sanitation sector. Developing water resources in arid areas and controlling excess water during rainy periods requires highly skilled water engineers and constant maintenance of wells, dams and embankments. The loss of even a small number of highly trained engineers can place entire the water systems and possible investment at risk.

Health Minister, Kapembwa Simbao , at one time dmitted that AIDS has the ability to weaken an economy if not properly responded to. Simbao said it was for this reason that the Zambian government was doubling its response to AIDS related programmes across the country.

The need to scale up the response to AIDS programmes, comes months after Sweden and the Netherlands temporarily suspended $33 million in aid to Zambia after reports surfaced that $2 million were embezzled, allegedly by senior health ministry officials.

The frozen donor funds are about one-fourth of the $120 million total committed to Zambia for this year by the two European nations. Industry analysts have cautioned the freeze in aid may impair HIV and AIDS services in the country.