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For some in Africa, it's `magic' over pills

Doctors say that HIV potion does more harm than good


Doctors say widening availability is encouraging more people to get tested, reducing stigma - and keeping people alive. A recent study found that 93 percent of the HIV/AIDS sufferers on ARV medication were alive after a year.

Some physicians believe that traditional medicine can complement Western health practices. But several doctors said they could not put uBhejane in that category because Gwala will not reveal his ingredients. "It could be dishwater," said Dr. Dennis Sifris, an HIV specialist in Johannesburg. "We have no idea what's in it. It's magic. It's hocus-pocus."

Sifris is medical adviser to Lifesense Disease Management, which tracks 8,500 HIV-positive patients for health insurers. Every week, his staff gets four or five reports of someone leaving ARVs for uBhejane.

Sometimes patients die. Dr. Goodman Vilakazi had a 36-year-old male patient who was told to stop ARVs. Vilakazi wrote that "the patient took [uBhejane] for about two weeks, developed unknown complications and demised thereafter."

Without blaming uBhejane for the death, Vilakazi called it "a case of sadness, for the patient was doing extremely well on antiretroviral treatment, with his CD4 count raised from 24 to 384." The CD4 count gauges the body's ability to fight disease, and doctors here typically prescribe ARVs when it drops below 200.

In the United States, if a company falsely claims a product can cure or treat a medical condition, the Food and Drug Administration could issue a warning letter or conduct an inspection. Depending upon the claim, the agency could require the company to apply for approval to sell it, a long process requiring scientific studies.

In South Africa, the Parliament passed a law two years ago to regulate traditional medicine. But an interim council that was supposed to draw up standards has not been formed. And on Thursday, the Constitutional Court invalidated the law, ruling that Parliament did not allow enough public participation. The court gave lawmakers 18 months to seek more input.

Despite the Health Ministry's assertion that traditional medicine therefore remains unregulated, the main opposition political party claims that uBhejane violates the Medicines and Related Substances Control Act. The Democratic Alliance has sought an investigation, and the provincial prosecutor says a probe is underway.

Before he began selling uBhejane, Gwala, 49, drove trucks across Africa. At some point his grandfather, a traditional healer who died in 1969, began visiting his dreams, he says.

It took years for him to dream about all 89 herbs. In 1997, he began mixing the substance, and for years quietly sold uBhejane ("black rhino" in Zulu and pronounced OOH-buh-johnny) as word of mouth spread.

He calls his establishment the Nebza HIV & AIDS Clinic, and a sign outside says he is "Doctor Gwala." He has a staff of eight, himself and his wife. Five work at the small factory, the others at the office he calls the clinic.

All day customers stream to the window counter. Some ride in taxis, and others drive themselves. The two-liter jugs cost $25, a hefty sum, since a third of the population lives on less than $2 a day.

A batch of 1,000 jugs can sell out in two days.

One recent afternoon, Thuli Nxele traveled an hour to pick up a supply for her father. Though she does not know if he is on ARVs, she credits uBhejane with boosting his health. "He was sick before, and now he's working," she said, walking away with two unlabeled plastic jugs filled with liquid the color of cider.

When people start on uBhejane, Gwala says, they must take two types on alternate days, one to raise the CD4 count and one to lower the viral load. After two weeks, they are to take one jug weekly of the latter type for six months, or "until your viral load is untraceable; you can stop there."

Gwala says he explains this to new arrivals. But Lydia Mabaso bought four jugs for a cousin who lives hundreds of miles away in North West Province, and all she gave the receptionist was a bank deposit slip proving she paid $100.

"They don't ask me nothing," Mabaso said later of the receptionists. They did not even ask her cousin's name.

To that Gwala replied: "We try to collect data. It's not very important to us. What's important to me is saving lives of that victim."

Later that day, M.D. Sithole stopped to buy four jugs for his 33-year-old sister, whose CD4 count is not low enough to warrant ARVs. The liquid works "if you believe it," he said outside. "It's in your mind. It's worth trying. Nobody knows what's the cure. I know plenty of people taking it."

Gwala says he wants a clinical trial. Last year he approached the deputy dean of the University of KwaZulu-Natal medical school. But the dean felt it was too soon for clinical trials and urged lab tests. Those showed that uBhejane is not toxic to cells and kills or limits bacteria. He is testing uBhejane on HIV in the lab, but results have not been released.

Gwala also asked a Catholic-run AIDS hospice if he could do research on residents. He supplied free uBhejane even after nursing supervisor Sue Bloom explained that "we can't go giving substances to patients when we have no idea of the content."

For some, the mystery of the ingredients poses less concern than do antiretrovirals.

Despite their life-extending properties, the pills are sometimes scorned as poison because of their side effects.

Wanda Xaba, 25, recently started her 6-year-old son Mxolisi on uBhejane. The boy was diagnosed with HIV this year. His mother and father both have the virus; none are taking ARVs.

Although the pills cost less than uBhejane, Xaba said she would rather scrape together money for Gwala's product. She has no intention to seek free ARVs from a clinic.

"I won't because they say uBhejane is better than ARVs. ARVs kill people, and uBhejane makes people get well and healthy."


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