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Uganda AIDS battle |
AIDS
Uganda’s womens organisations are apprehensive about
the project in which
thousands of expectant mothers
in this East African nation will get a single
dose of Nevirapine
to prevent them passing the virus to their offspring
Beatrice Were, co-ordinator of the National Council of Women Living with AIDS, is disturbed by the fact that the project leaves out women who take care of the offspring of those who have died from AIDS. This is even more worrying in a country with inadequate facilities to cater for the number of children orphaned by AIDS, many of whom are on the streets, and who are estimated by the Uganda Aids Commission (UAC) (a government body) to be about 1.7 million.
Her outcry comes at a time with the discovery that mothers face an early death due to maternal depletion syndrome, where women already weighed down by the virus and delivery, are exhausted by breast feeding. The London based Lancet early this year quoted a Kenyan study that showed a 69% risk of maternal death due to breastfeeding as early as six weeks after delivery.
Winnie Mwebe is another Ugandan active in the fight against AIDS. She is critical of the government for giving inadequate information so as to allow women to make informed choices. She says: «While AZT monotherapy (Editor’s note: AZT is a drug used to treat patients infected with HIV) was abandoned in favour of a combination therapy, there is little study on Nevirapine side effects, which include lymphomas (cancer of the immune system), and no study has been done to show its effect on children».
In the midst of present worries, it should be noted that the infection rate among expectant mothers has decreased in the past decade. Health Ministry charts displayed in some hospitals, show a steep decline in HIV prevalence among pregnant women attending antenatal clinics — down from 30% in 1990 to 15% in 1998. This is partly due to increased consciousness about the disease that has claimed nearly one million lives since 1983 when AIDS was first reported.
Anti-AIDS programme
Buoyed by earlier success in the anti-AIDS programme, Uganda has intensified its present anti-AIDS programme by enlisting 14,000 expectant HIV/AIDS-positive mothers on a free programme, where they get Nevirapine to prevent their offspring from acquiring HIV. 700 mothers are offered a single dose when in labour, and another to the new-born within 72 hours of delivery. The number on treatment is set to double by the end of this year.
The project follows a 2-year study conducted jointly by the United States and the Ugandan governments, on 600 pregnant women who were put on AZT and Nevirapine. It was discovered that there is a 70% risk reduction when a single dose of Nevirapine is applied. The programme was actually devised in 1997 but has been late in starting because the government and multinational drug firms have been increasing the necessary requirements for its administration.
«It required a lot of logistics-testing, counselling and infrastructure. Hopefully we should be able to provide the service throughout the country by the end of this year», says Dr Iyarlumun Uhaa, Director of UNICEF‘s health and nutritional department in Uganda.
Multinationals
Multinational corporations like Organnon & Teknika, Merck and Pfizer’s among others, have boosted Uganda’s diagnostic and viral load monitoring technologies, while another six firms have helped to establish a Medical Access Programme that runs medical stores which handle antiretrovirals (ARV)s in the country. Also, Western firms which have considerably reduced prices of their AIDS drugs in Uganda, are anxious to put the South African Court battle over patents (which showed them as being nothing short of callous) behind them. They are now parading Uganda as a text book case for others to follow.
Multinationals now regard Uganda as a strategic partner in spreading the drugs, and a three day summit from September 6 will develop strategy towards this effect, when a three-hundred strong delegation from 15 African countries will come to Uganda.
Yet we can’t help having a nagging feeling that multinationals want to secure their market. It has already been stated that international firms prefer to offer drugs at generous prices, rather than expose their prices (considered to be ten times higher than the cost of producing and distributing them) for all to see. They loath the fact that firms offering low-cost drugs seem to be taking over.
Welfare concerns
In spite of everything which has been done, there have been concerns about the way various projects have been conducted. For example — there’s a new project underway which aims to block the transmission of the AIDS virus to infants. But while expectant HIV/AIDS-positive mothers in wealthy countries are put on drugs 14 weeks into pregnancy until one week after delivery, Ugandan women in a similar situation only get a single dose at the onset of labour. Also, the United States which has 23 AIDS-related projects in Uganda, was criticised in 2000 by several international agencies, for exposing thousands of Ugandans to the virus and of refusing to treat those discovered to have AIDS who had volunteered for test studies.
On a more positive note, the Ugandan government has updated its AIDS programme to treat the epidemic as a developmental concern, and has already incorporated it in its anti-poverty action programme. The government’s Universal Primary Education Programme targets female children. By providing the possibility for girls to remain longer in school, the risk of them getting pregnant is reduced (and hopefully, the risk of contracting the HIV/AIDS virus).
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PeaceLink 2001 - Reproduction authorised, with usual acknowledgement