U.N. is warned on anti-AIDS strategy

Drugs alone might fail poor nations, panel says

November 01, 2001|By Frank D. Roylance | Frank D. Roylance,SUN STAFF

Making anti-viral drugs available to developing countries at reasonable prices won't be enough to curb the global AIDS epidemic, according to an international panel that will advise the United Nations how to spend a $1.5 billion global AIDS fund.

The panel - more than 80 medical researchers and public health officials from the United States, Europe, Africa and Asia meeting in Baltimore this week - concluded that the anti-AIDS drugs will be wasted if the United Nations does not also provide funding for AIDS prevention programs and strengthened public health services in poor countries.

"Our experience in Europe and North America is that the availability of drugs [to fight AIDS] has increased risky behavior," said Dr. Ronald Gray, a professor in the Johns Hopkins Bloomberg School of Public Health. "We have to prevent that from occurring in the developing world, or we could see the epidemic getting worse as a result."

In a report to be presented later this month to the United Nations' Global Fund to Fight AIDS, Tuberculosis and Malaria, the panel will endorse funding for programs that provide AIDS-prevention counseling and encourage voluntary AIDS testing.

Anti-viral medicines are needed, but "we can't just dump therapy" on these countries, said Dr. John G. Bartlett, chief of infectious diseases at the Johns Hopkins School of Medicine.

The panel agreed that developing countries must be assisted in training workers who can provide proper care to patients and assure that they take all their medications; prevent AIDS transmission from mother to child; prevent and treat opportunistic infections such as tuberculosis; provide palliative care for the dying; and conduct the studies needed to measure patient outcomes.

"The U.N. has identified AIDS as the greatest health crisis on Earth, and the epidemic of AIDS threatens the political, social and economic fabric of a substantial part of the world," Bartlett said. And that poses a security threat to everyone else.

He said $1.5 billion has so far been pledged by U.N. member nations for the global AIDS fund's first year. The first grants are expected to be made in January.

But "the necessary resources are estimated at $10 billion per year," Bartlett said. "The hope is that by 2005 they will have those sorts of resources."

The panel's recommendations to the United Nations are not binding but are expected to be influential.

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