HIV Testing Blog

Any development that accounts for more deaths of people who would otherwise be alive at the end of 2009 as they were at the start of the year should by all accounts be the overwhelming choice for the year’s top news story.
Forget about transitory political issues (though those issues impact on Swaziland’s ability to cope with the AIDS crisis), the parade of personalities (mostly the notorious individuals who garner attention through scandal or venality) and the trumpeting of programmes devoted to this and that, even the dire economic news of 2009 has had far less life and death impact on Swazis as HIV and AIDS.
How many people died of AIDS in Swaziland this year?  No one knows.  The taboo persists about the disease.  Despite the national emergency, essential data does not exist.
Testing is still voluntary, though some dissenting voices were raised against this long-standing policy which remains sound human rights policy (privacy as manifested in the desire to be ignorant of one’s medical condition is a human right) if disastrous public health policy.
The way things have worked has been called into question this year.  In South Africa, the government of Jacob Zuma reversed the Mbeki-era approach toward AIDS.
In Swaziland the biggest AIDS-related development of 2009 was the meteoric interest in male circumcision.
Critics called the upswing in the numbers of young men undergoing the procedure as safe sex avoidance, but medical practitioners who did the procedures insisted that all patients were adequately counseled that MC was one part of the HIV-avoidance package, and not in itself a 100% avoidance tool.
This was the year that the first clinic devoted to men was opened in Swaziland, the Letsemba Letfu Clinic in Matsapha.
Even before the clinic was officially opened, 1 000 young men had visited to undergo the procedure.  Each day 35 patients are circumcised by appointment, with ‘walk in’ patients handled as well.
There is no charge for the procedure.  Importantly, 92% of patients who underwent MC also took an HIV test.
Global Warming was 2009’s top environmental issue, climaxed by this month’s Copenhagen Summit, and the topic even had ramifications for HIV and AIDS.
Researchers calculated that global warming would threaten crop production in areas where there were a large number of people living with HIV and AIDS; generally poorer countries whose HIV-positive population segments would have their ARV treatments compromised if they failed to obtain enough food for proper nutrition.
Tuberculosis received the attention of an emergency regional summit in October here in Swaziland because of TB’s link to HIV and AIDS – the disease is the primary opportunistic disease affecting people living with HIV and AIDS, both here and throughout Southern Africa.
So serious has the growth of tuberculosis in Swaziland, a disease once close to being vanquished in our country until the advent of AIDS, that health officials are now calling TB and AIDS ‘a dual epidemic.’
“When you look at the history of TB in Southern Africa you see that it was considered a very serious disease in the 1950s but seemed to be under control by the 1980s.  But with the arrival of HIV and AIDS, TB rates have really gone out of control,” said Dr. Alan Whiteside, Executive Director of HEARD at the University of KwaZulu Natal told AIDS LIFELINE.
Médecins San Frontiéres Head of Mission in Swaziland Aymeric Peguillan told conference delegates, “The Kingdom of Swaziland is in the midst of an HIV/TB epidemic.  The management of the co-epidemic represents the country’s most serious health-related challenge.”
2009 was a typical year in that once again individuals announced they had discovered the AIDS ‘cure.’  And also as usual, they were not qualified researchers and sought not to share with humanity but to sell to desperate people living with AIDS their potions.
NERCHA and the Ministry of Health and Social Welfare more than once had to remind the public that, sadly, there is no AIDS cure.
However, progress was made in 2009 toward an AIDS vaccine, the Holy Grail of research into the prevention of HIV infections.  Trials in Thailand proved promising.
Much work has to be done before the vaccine is available, but for the first time such words as ‘never’ and ‘impossible’ have been dropped from medical discussion on the subject of a possible AIDS vaccine.
For Swaziland, such an AIDS preventative would be a life saver, because 2009 repeated the history of all previous years of the AIDS epidemic in one important respect: no measurable change was found in people’s sexual behaviour modification. AIDS remained a preventable disease in 2009.  That did not change.  Nor in any appreciable way did people’s sex lives change according to various surveys.
Prevention remains a person’s the best hope to avoid AIDS.  However, all efforts to inspire people on a large scale to look after themselves again fell short in 2009.
But the year was not without its accomplishments, from the stream of young men seeking male circumcision to wider debate of sexual matters once considered taboo – even though the greatest taboo unfortunately remains, the reluctance of most people to recognise the reality of HIV in themselves and their loved ones.

For the complete article, please refer to The Swazi Observer.

Today the Global Fund to Fight AIDS, Tuberculosis and Malaria announced its latest prevention and treatment numbers, noting in particular that Global Fund-financed programs have put 2.3 million people on treatment for HIV/AIDS, 5.4 million people have been treated for tuberculosis, and 88 million insecticide-treated nets have been distributed to prevent malaria infection. In addition, more than 500,000 HIV-positive pregnant women have been treated to prevent their babies from being born with HIV.

These latest results strengthen evidence that investments during the past five years have resulted in the most significant progress ever achieved in the global fight against these three diseases. Recent evidence suggests that global mortality from tuberculosis is now declining, AIDS mortality among adults in several high-burden countries in Africa is declining, and malaria elimination efforts have made tremendous progress, with reductions in the number of cases and malaria-related child mortality falling between 50% and 80% in a growing number of countries.

Together, AIDS, tuberculosis and malaria kill about six million people per year. With grants worth $16 billion in 140 countries around the world, the Global Fund has become the world’s leading global public health financier.

For the full article, please refer to http://www.medicalnewstoday.com/articles/156875.php

The World Health Organization (WHO) has warned that the tuberculosis (TB) vaccine is of great risks to HIV-infected infants, Tanzanian local daily the Guardian reported on Thursday.

Through its research published in the International Public Health journal, the WHO noted that HIV-infected infants risked contracting a deadly form of tuberculosis from the Bacille Calmette-Guerin (BCG) vaccine instead of receiving protection against the disease, the report quoted a WHO statement issued on Wednesday in Dar es Salaam as saying.

For the complete article, please refer to http://news.xinhuanet.com/english/2009-07/02/content_11641405.htm.

The 2009 Global TB control report reveals that one out of four TB deaths is HIV-related, twice as many as previously recognized. In 2007, there were an estimated 1.37 million new cases of tuberculosis among HIV-infected people and 456 000 deaths.

“These findings point to an urgent need to find, prevent and treat tuberculosis in people living with HIV and to test for HIV in all patients with TB in order to provide prevention, treatment and care. Countries can only do that through stronger collaborative programmes and stronger health systems that address both diseases,” said Dr Margaret Chan, Director-General of WHO.

For the complete article, see http://www.who.int/mediacentre/news/releases/2009/tuberculosis_report_20090324/en/index.html.