Monday, May 10, 2010

NYT Article: "In Uganda, AIDS War is Falling Apart"

Today the New York Times ran an excellent and very sad series of article on the AIDS situation in Uganda and across the world. Read them here:

In Uganda, AIDS War is Falling Apart

As the Need Grows, the Money for AIDS Runs Far Short

After Long Scientific Search, Still No Cure for AIDS

Cultural Attitudes and Rumors Are Lasting Obstacles to Safe Sex

Below are few quotes from the first article...

Uganda is the first country where major clinics routinely turn people [seeking HIV drugs] away, but it will not be the last. In Kenya next door, grants to keep 200,000 on drugs will expire soon. An American-run program in Mozambique has been told to stop opening clinics. There have been drug shortages in Nigeria and Swaziland. Tanzania and Botswana are trimming treatment slots, according to a report by the medical charity Doctors Without Borders.

And, most devastating of all, old-fashioned prevention has flopped. Too few people, particularly in Africa, are using the “ABC” approach pioneered here in Uganda: abstain, be faithful, use condoms.

For every 100 people put on treatment, 250 are newly infected, according to the United Nations’ AIDS-fighting agency, Unaids.

That makes prospects for the future grim. Worldwide, even though two million people with the disease die each year, the total keeps growing because nearly three million adults and children become infected.

Even now, the fight is falling short. Of the 33 million people infected, 14 million are immuno-compromised enough to need drugs now, under the latest World Health Organization guidelines. (W.H.O. guidelines are conservative; if all 33 million were Americans, most clinicians would treat them at once.)

Instead, despite a superhuman effort by donors, fewer than four million are on treatment. Just to meet the minimal W.H.O. guidelines, donations would have to treble instead of going flat.

Uganda is a microcosm of that: 500,000 need treatment, 200,000 are getting it, but each year, an additional 110,000 are infected.

“You cannot mop the floor when the tap is still running on it,” said Dr. David Kihumuro Apuuli, director-general of the Uganda AIDS Commission.

“I’m worried we’ll be in a ‘Kampala situation’ in other countries soon,” said Ambassador Eric Goosby, the Obama administration’s new global AIDS coordinator.

“What I see is making me very scared,” agreed Michel SidibĂ©, executive director of Unaids. Without a change of heart among donors, Mr. SidibĂ© said, “the whole hope I’ve had for the last 10 years will disappear.”

Donors give about $10 billion a year, while controlling the epidemic would cost $27 billion a year, he estimated.

His predecessor, Dr. Peter Piot, said he had seen optimism soar and then fade.

American officials who spoke on the condition of anonymity confirmed the financing freeze.

“The decision was made late in the Bush administration to cap Uganda at $280 million,” one said. “That’s an industrial amount of money.”

United States Embassy officials debated adding $38 million, he said, but cabinet-level Ugandan ministers had been caught stealing from other donors and, though forced to repay the money, were not jailed. The government “hasn’t shown the leadership or commitment to transparency to earn additional funds,” the official added.

Also, he said, Uganda contributes too little. Oil was recently discovered near Lake Albert and the government promised to spend the royalties on roads and electricity, but did not mention AIDS.

“And now the paper says they’re buying Russian jets,” another official added with obvious disgust. Uganda is negotiating for a $300 million squadron of Sukhoi fighter-bombers.