ANB-BIA SUPPLEMENT

ISSUE/EDITION Nr 359 - 01/01/1999

CONTENTS | ANB-BIA HOMEPAGE | WEEKLY NEWS



Côte d'Ivoire

The age of anti-viral regimes


by K.K. Man Jusu, Côte d'Ivoire, November 1998

THEME = AIDS

INTRODUCTION

Côte d'Ivoire with its 6,000 officially registered AIDS patients and 800,000 people HIV-positive,
is among the countries most affected. That's why it has been chosen by UNAIDS
for its programme of anti-viral regimes

For a long time, Côte d'Ivoire was pinpointed as the African country with the highest incidence of AIDS - 10% of the population being infected with the HIV virus. AIDS spread throughout the country from Abidjan where 86% of prostitutes have AIDS. In 1993, such statistics meant that Côte d'Ivoire had the doubtful reputation of being one of the world's most affected country's. These are statistics taken from the report by Professor Daniel Tarantola from Havard University (USA) presented at the International Conference on AIDS and Sexually Transmitted Diseases in Africa (CISMA 97), held in December 1997, in Abidjan, Côte d'Ivoire.

But according to the 1997 report published by the United Nations Programme for Combatting AIDS (UNAIDS), there were 22.6 million people in Africa having the HIV virus. Côte d'Ivoire was reported as having 6,000 AIDS cases, with an infection level of 55% among the prostitutes of Abidjan, as compared to 80% among the prostitutes of Nairobi (Kenya). Be that as it may, Côte d'Ivoire's 6,000 people with AIDS, is nothing short of catastrophic! And in sharp contrast to other countries of the same region, Côte d'Ivoire is reported as having 800,000 of its citizens with the HIV virus.

So what's the reason for the spread of AIDS in Côte d'Ivoire? Firstly: the high number of immigrants entering the country. Out of a total population of 15 million, there are said to be 5 million foreigners - practically a third of the country's population. Most of the prostitutes are foreigners coming from nearby countries, mainly Ghana and Nigeria. This explains, perhaps, why the first people hit by the disease were foreigners living in Côte d'Ivoire - as many of them were the prostitutes' "clients", they were the first to have contracted the HIV virus and AIDS from the prostitutes.

Everyone's concern

Côte d'Ivoire's population cannot remain indifferent to the developing situation. Even if the prostitutes are said to be the underlying reason why AIDS came into the country, there are other reasons: The late identification (in 1985) of the disease in Côte d'Ivoire; the delayed widespread distribution of condoms; the use of dirty hypodermic syringes, especially in private clinics which have sprung up like mushrooms in Abidjan and where even the elementary rules of hygiene are completely ignored.

But looking beyond statistics and reasons why AIDS has spread in Côte d'Ivoire, it's even more important to know what's being done to control the pandemic. It seems the government, if belatedly, has decided to take the bull by the horns in going all out against this century's terrible disease.

Awareness programmes come first of all. The government, private organisations (as distinct from non-governmental organisation [NGO]s, NGOs, local groups, religious organisations, have all joined together to fight against the pandemic. There are a multiplicity of associations and NGOs involved in the fight against AIDS. In 1997, there were 52 of them working together as an umbrella group - the Federation of NGO's for the Fight against AIDS in Côte d'Ivoire (COSCI). The NGOs are committed to giving voluntary help. Unfortunately, internal squabbles sometimes set in, especially when it comes to money. Mrs Célestine Navigué, a former COSCI president, has often been accused of embezzlement - but nothing has ever been proved. These quarrels always end by creating a climate of suspicion, among Federation members and between the authorities and the various NGOs and associations.

The National Programme

All AIDS-related activities in Côte d'Ivoire are registered with the National Programme for the Fight Against AIDS, under the guidance of the National Committee for the Fight Against AIDS (CNLS). There are three stages in this programme: short; medium; long-term. Its aims are: to create awareness; to inform and educate people; to control the outbreak; to undertake appropriate research and treatment. Also, there's a definite policy of providing adequate care for those inflicted with AIDS.

Particular note should be taken about the Progamme's research and caring aspects.

Research: There are three major research Centres: The Centre for the Development of Research into AIDS (CEDRESS) - a French- sponsored project; Retrovirus - Côte d'Ivoire (RETROCI) - a joint project between Côte d'Ivoire and the Atlanta (USA) centre for Preventing and Controlling AIDS; the Ivoirien Centre for Bioclinic Research (CIRBA) founded by Luc Montagnier (from France). CIRBA was inaugurated in 1998 by Côte d'Ivoire's President Konan Bédié, in the presence of UNESCO's director- general, Frederico Mayor.

Treatment: Côte d'Ivoire, together with Uganda, Chili and Viet Nam, has been chosen for a three-year pilot project, under the auspices of UNAIDS, dealing with the treatment of AIDS patients. The project's aim is to provide the necessary funding so that patients can be treated with anti-viral regimes: the two- therapy treatment (treatment combining two drugs); the triple therapy treatment involving three drugs). What does all this cost? The combined subsidies from UNAIDS and the government, working through the National Solidarity Fund, means that some 600 million CFA francs have been injected into the project. This has enabled the cost of the bi-therapy treatment to be reduced from 500,000 CFA francs per year: to 100,000 CFA francs for those who are paying for their own treatment; to 50,000 CFA francs for the destitute; to 25,000 CFA francs for pregnant women and members of the various Associations For People with HIV/AIDS.

Selection criteria

The above-mentioned project concerns 4,000 out of the 6,000 with AIDS or the 800,000 HIV-positive. Obviously, then, a certain selection has had to be made to determine who is going to benefit from the programme. Priority is given to pregnant women screened as being HIV-positive, plus members of Associations For People With AIDS. Eight special Centres have been set up for treatment purposes: The Treichville University Hospital Centre for Infectious Diseases; the Mobile Health and Advice Unit (USAC); the Adjamé Anti-tuberculosis Centre; the army hospital; the Yopougon University Hospital Paediatric Centre: the Cocody University Hospital Centre For Treatment of the Lungs; the National Blood Transfusion Centre's Observation Centre. There are similar Centres at Bouaké, Korhogo and Bondoukou.

The situation regarding AIDS in Côte d'Ivoire gives cause for great concern. Indeed, for some time there's been complete panic among the population. They're scared because no cure for AIDS has been found and they can't afford the high cost of any treatment on offer. All this means that those peddling bogus remedies are making a quick dollar. People such as Mian Ehui with his "Sitrakko" which is supposed to have beneficial uses against AIDS; and Professor Tahiri Zagret with his "Kabiex" which was the talk of the town in Côte d'Ivoire.

Côte d'Ivoire's civil and medical authorities have taken a strong stance against these quack medicines and those who dispense them, describing them as "false promises" made to sick people desperate for a cure - people who are open to any abuse. A curious fact - since the arrival of UNAIDS' anti-viral regimes and the possibility of checking the spread of HIV, nothing more is heard of these so-called "practitioners".

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