Aids continues to yield grim statistics

Gift Phiri

IT will take at least another 10 years of research and vaccine trials before there is any hope of finding an effective response to the Aids scourge in Zimbabwe.



=”Verdana, Arial, Helvetica, sans-serif”>That is the grim consensus of researchers, who believe deaths from the disease will rise from their current 144 000 a year to more than 400 000 in 10 years.


A total of four million people, the majority of them young adults on whom families and economies depend, are likely to die in that period. Such appalling attrition raises a bleak, dispiriting question: just how long do we have to wait before we can rid the world of Aids? Few researchers are predicting anything but hope.


“Aids is the real global terrorist and it is going to be a very long haul before we get on top of it,” said Dr Jacinta Hurst, a consultant for Medecins Sans Frontieres (Doctors without Borders). “In the meantime, the world is being devastated. The problem is that a virus that is not allowing us to develop a vaccine against it is scientifically baffling us. Without one, and I doubt if we will have an effective one in 10 years, our only hope lies through education and political action.”


Like most countries in southern Africa, Zimbabwe is hard-hit by the HIV/Aids epidemic with high levels of morbidity and mortality reversing previous gains in health statistics. With a total population of 12,5 million people, Zimbabwe is going through a difficult period politically and economically characterised by high interest rates, low investment and high unemployment because of the international community’s reaction to the land redistribution policy.


Despite these difficult times, the United Nations anti-Aids agency UNAids says “government has shown its commitment to fighting HIV/Aids and has put in place a very strong decentralised multisectoral response with active participation of civil society, the private sector, religious organisations and development partners”.


The health infrastructure, previously very good, has steadily deteriorated because of cuts in social spending over the years. Over the past two years, highly effective cocktails of anti-Aids drugs led to a 10,2% decrease in Aids deaths in Zimbabwe. According to UNAids, 33,7 % of Zimbabwe’s 12,5 million people were HIV positive in 2002 but the figures have since decreased to 25%. But these expensive, awkward to administer treatments are of little help in Zimbabwe where a cheap, once-in-a-lifetime vaccine offers the only real hope of halting the epidemic.


“They are still many new places for Aids to take over,” Hurst said. “The disease is nowhere near reaching saturation level.”


The problem is that HIV attacks by infecting the very immune cells that are supposed to protect our bodies, said Hurst. In addition, the virus mutates and changes its outer coating, the usual target for vaccines, at very high rates. It can also lie dormant in the body for many years, ready to re-infect.

This has not stopped scientists from trying to develop vaccines, although most are given little chance of success. One vaccine candidate, known as Aidsvax and manufactured by the US biotechnological company Vaxgen, is already undergoing phase three trials.


As part of these, hundreds of HIV-positive patients have been given either the vaccine or a placebo. Next year scientists will find out whether those who received the vaccine were better protected than those on a placebo. If so, a formula could be ready for widespread use in a few years.


“The Vaxgen vaccine relies on stimulating antibodies which latch on to surface proteins on the Aids virus,” said a director of research at scientific research institute in Harare. “The trouble is the surface of the virus mutates at a very high rate. Most people, myself included, are sceptical about whether this vaccine will work.”


Trials in Zimbabwe have already begun although phase three trials — which will compare the effectiveness of the vaccine to a placebo in protecting “at-risk” individuals — will not be launched for several years.


“We have to be very careful,” said the researcher. “There are many different strains of Aids and you have to try to make a vaccine that is effective against as many as possible, or it will simply be of no use. It is terribly slow work and I don’t see us succeeding for at least seven to 10 years.”

The United States-based Merck Corporation is coordinating efforts to come up with a vaccine. However, most experts still doubt that the world will have a useful Aids vaccine for a decade.


The prospects are therefore grim. The sheer scale of the world’s Aids crisis now outstrips even the worst-case scenarios of a decade ago. Dozens of countries, most in sub-Saharan Africa, are spiralling into chaos and economic collapse after the deaths of millions of their principal breadwinners. Dozens are destined to follow suit. This year’s World Aids Day, commemorated on Wednesday, was the bleakest on record.

Yet initially science claimed considerable success in responding to Aids. Within two years of the first cases being diagnosed two decades ago, the guilty virus was pinpointed. Two years later a blood test was developed and by 1996, after careful molecular biological analysis of HIV, the now undisputed cause of Aids, the drug cocktails that saved so many lives were created.


But recently scientists have begun to point fingers at their colleagues and question governments’ commitment to dealing with Aids.


In his World Aids Day message, President Robert Mugabe reaffirmed his government’s commitment to fighting the disease.


“Our successful national responses to policy and practice challenges in the area of HIV/Aids are many, and most of these have already attracted global attention and admiration,” Mugabe said, skirting the issue of the deteriorating economic and political crisis in the country.


The problem, activists say, is that people in Zimbabwe still think of Aids as someone else’s problem that is unlikely to have any effect on them. But, as the disease spreads, a vast population of HIV carriers is being created and with it the ever increasing risk that they will infect more people.

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