Your daily Selection of IRIN Africa PlusNews reports, 7/25/2006

[Guest guest]

U N I T E D N A T I O N S

Office for the Coordination of Humanitarian Affairs

Integrated Regional Information Network (IRIN) - 1995-2005 ten years serving the

humanitarian community

[These reports do not necessarily reflect the views of the United Nations]

CONTENT:

1 - COTE D IVOIRE: ARVs reduce deaths due to TB-HIV co-infection

2 - SWAZILAND: Anti-AIDS text messaging campaign raises hackles

1 - COTE D IVOIRE: ARVs reduce deaths due to TB-HIV co-infection

BOUAKE, 25 July (PLUSNEWS) - The arrival of antiretroviral (ARV) drugs in the

rebel-held north of Cote d'Ivoire is having a dramatic impact on

tuberculosis-related deaths.

" Antiretroviral medications have considerably reduced the death rate of the

patients in our care. The situation was catastrophic, " said Dr Francis

Coulibaly, head of the pneumonia department at the University Hospital Centre in

Bouaké, headquarters of the New Forces rebel movement.

" About 80 percent of tuberculosis patients at the hospital are HIV positive, "

explained Dr Coulibaly. " Before we started to care for HIV-positive patients, my

department was a place where people were being left to die. "

The hospital received its first ARVs from the national AIDS programme in April

2005, three years after the start of the conflict that split the country in two.

ARVs are also extending the lives of TB patients in the New Forces-held town of

Danané, on the western border with Liberia. The hospital, run by medical charity

Médecins sans Frontières (MSF), also began receiving anti-AIDS drugs last year.

" It is clear that tuberculosis is becoming a serious problem, " said

, an MSF doctor in Danané, where more than half the hospital patients are

believed to be HIV positive. " If we are to succeed in curing them, we will have

to treat the two infections, HIV and TB, at the same time. "

In Cote d'Ivoire TB has become the main cause of death for HIV-positive

patients; more than 70,000 new cases were reported in 2005 by the National

Programme to Fight Tuberculosis.

TB and HIV co-infection speeds up the progress of both diseases and considerably

shortens the survival of people living with HIV/AIDS. HIV infection is the most

potent risk factor in converting latent TB into active TB.

Treating patients with both infections is complicated. TB patients are usually

required to take a course of powerful antibiotics for six months under a

labour-intensive directly observed treatment strategy (DOTS) that requires

health workers to be present when the pills are taken.

The bulk of health workers in the north of Cote d'Ivoire fled when the conflict

began, adding to the difficulties faced by Coulibaly and his remaining staff.

" It is difficult when there is a war ... but Cote d'Ivoire must use the DOT

strategy to ensure that the patient does not become TB-drug resistant because he

does not take his medication regularly. "

Patients have to visit the university hospital in Bouaké every Wednesday,

swallow their TB medication in front of the nurses, and collect their pills for

the week - a system Coulibaly acknowledges is not foolproof.

" The DOT strategy needs many health workers, and we have problems with regard to

the treatment being followed. Patients throw away the tablets, refuse to take

them, or just cannot swallow them due to the state of their health, " said Dr

Louis Kakudji, medical coordinator of the MSF team at the regional hospital in

the western town of Man.

MSF in Danané and Man are using mobile medical teams for patient follow-up to

try to reduce treatment interruption, one of the chief causes of

multidrug-resistant TB, which has become a major public health problem.

" In this establishment, where HIV is the main reason for hospitalising adults,

48 percent of the patients had abandoned their TB treatment, " said Kakudji.

DOTS normally achieves a cure rate of up to 95 percent after six months of

treatment, but some forms of drug-resistant TB require extensive chemotherapy

for up to two years.

//This report is part of a series by IRIN's HIV/AIDS service PlusNews looking at

treatment and care in communities in crisis. Visit:

www.plusnews.org/DFIDproject.asp

[ENDS]

2 - SWAZILAND: Anti-AIDS text messaging campaign raises hackles

MBABANE, 21 July (PLUSNEWS) - In one of the biggest demonstrations seen in

Swaziland in years, HIV-positive people marched on the offices of the prime

minister and the national AIDS council this week to protest an " insulting " new

media campaign.

The project by the National Emergency Response Council on HIV/AIDS (NERCHA)

seems to suggest that HIV is caused by sexual infidelity. It was launched last

month without consulting people living with the virus.

" The campaign further stigmatises the HIV infected. It is an insult, we are

angry. It is time we are involved in matters pertaining to us, " said protest

leader Vusi Matsebula, chairperson of the Swaziland National Network of People

Living with HIV/AIDS (SWANNEPHA). Around 1,000 people participated in the

demonstration.

The media campaign, called " Makhwapheni " , SiSwati slang for illicit lovers, has

sent out tens of thousands of cellphone text messages mimicking secret lovers

arranging a sexual rendezvous.

The marketing company behind the initiative was quoted in the local press as

saying its critics failed to understand the campaign's creative rationale, and

said cellphones were the primary means of communication for couples having

affairs.

But to Swaziland's growing number of people living with HIV and AIDS - over 40

percent of the sexually active adult population - the campaign smacked of cheap

sensationalism.

" HIV is not just spread by cheating husbands and secret lovers - this insults us

all, " said Senzo Nkhosi, a protestor who said he was HIV-positive.

A survey by the Times of Swaziland found the general public split on the merits

of the campaign. Supporters, none of whom said they were HIV-positive, contended

the approach was meant to startle and provoke discussion.

NERCHA did not return IRIN's phone calls on Friday, but in previous press

statements the organisation, which falls under the authority of the Prime

Minister's office, has argued that Makhwapheni was a dramatic attempt to change

people's behaviour.

However, SWANNEPHA has accused NERCHA of arrogance, and its staff of making a

living off the AIDS crisis, which NERCHA has denied. The protestors also claimed

NERCHA was concentrating its media efforts on uninfected Swazis while ignoring

people in the advanced stages of opportunistic diseases brought on by AIDS.

The Makhwapheni campaign has become the catalyst for AIDS groups to raise other

objections. At the march they delivered petitions to NERCHA and the prime

minister demanding universal access to care and treatment for people living with

the virus, and legislation protecting the rights of those who are HIV positive.

SWANNEPHA, an umbrella body of community-based AIDS support groups that receives

funding from NERCHA, gave the AIDS council until the end of the month to address

its concerns. Protestors vowed to begin a sleep-in vigil at NERCHA headquarters

if they were not satisfied.[ENDS]

This is non-reply e-mail. Please do not hesitate to contact us at

Mail@....

Principal donors: IRIN is generously supported by Australia, Canada, Denmark,

ECHO, Japan, Netherlands, Norway, Sweden, Switzerland, the United Kingdom and

the United States of America. For more information, go to:

http://www.IRINnews.org/donors

[This item comes to you via IRIN, a UN humanitarian news and information

service, but may not necessarily reflect the views of the United Nations or its

agencies. All IRIN material may be reposted or reprinted free-of-charge; refer

to the copyright page (Http://www.irinnews.org/copyright ) for conditions of

use. IRIN is a project of the UN Office for the Coordination of Humanitarian

Affairs.]

PLUSNEWS

Tel: +27 11 895-1900

Fax: +27 11 784-6759

Email: Mail@...

To make changes to or cancel your subscription visit:

http://www.irinnews.org/subscriptions

Subscriber: AIDS treatments

[Guest guest]

U N I T E D N A T I O N S

Office for the Coordination of Humanitarian Affairs

Integrated Regional Information Network (IRIN) - 1995-2005 ten years serving the

humanitarian community

[These reports do not necessarily reflect the views of the United Nations]

CONTENT:

1 - COTE D IVOIRE: ARVs reduce deaths due to TB-HIV co-infection

2 - SWAZILAND: Anti-AIDS text messaging campaign raises hackles

1 - COTE D IVOIRE: ARVs reduce deaths due to TB-HIV co-infection

BOUAKE, 25 July (PLUSNEWS) - The arrival of antiretroviral (ARV) drugs in the

rebel-held north of Cote d'Ivoire is having a dramatic impact on

tuberculosis-related deaths.

" Antiretroviral medications have considerably reduced the death rate of the

patients in our care. The situation was catastrophic, " said Dr Francis

Coulibaly, head of the pneumonia department at the University Hospital Centre in

Bouaké, headquarters of the New Forces rebel movement.

" About 80 percent of tuberculosis patients at the hospital are HIV positive, "

explained Dr Coulibaly. " Before we started to care for HIV-positive patients, my

department was a place where people were being left to die. "

The hospital received its first ARVs from the national AIDS programme in April

2005, three years after the start of the conflict that split the country in two.

ARVs are also extending the lives of TB patients in the New Forces-held town of

Danané, on the western border with Liberia. The hospital, run by medical charity

Médecins sans Frontières (MSF), also began receiving anti-AIDS drugs last year.

" It is clear that tuberculosis is becoming a serious problem, " said

, an MSF doctor in Danané, where more than half the hospital patients are

believed to be HIV positive. " If we are to succeed in curing them, we will have

to treat the two infections, HIV and TB, at the same time. "

In Cote d'Ivoire TB has become the main cause of death for HIV-positive

patients; more than 70,000 new cases were reported in 2005 by the National

Programme to Fight Tuberculosis.

TB and HIV co-infection speeds up the progress of both diseases and considerably

shortens the survival of people living with HIV/AIDS. HIV infection is the most

potent risk factor in converting latent TB into active TB.

Treating patients with both infections is complicated. TB patients are usually

required to take a course of powerful antibiotics for six months under a

labour-intensive directly observed treatment strategy (DOTS) that requires

health workers to be present when the pills are taken.

The bulk of health workers in the north of Cote d'Ivoire fled when the conflict

began, adding to the difficulties faced by Coulibaly and his remaining staff.

" It is difficult when there is a war ... but Cote d'Ivoire must use the DOT

strategy to ensure that the patient does not become TB-drug resistant because he

does not take his medication regularly. "

Patients have to visit the university hospital in Bouaké every Wednesday,

swallow their TB medication in front of the nurses, and collect their pills for

the week - a system Coulibaly acknowledges is not foolproof.

" The DOT strategy needs many health workers, and we have problems with regard to

the treatment being followed. Patients throw away the tablets, refuse to take

them, or just cannot swallow them due to the state of their health, " said Dr

Louis Kakudji, medical coordinator of the MSF team at the regional hospital in

the western town of Man.

MSF in Danané and Man are using mobile medical teams for patient follow-up to

try to reduce treatment interruption, one of the chief causes of

multidrug-resistant TB, which has become a major public health problem.

" In this establishment, where HIV is the main reason for hospitalising adults,

48 percent of the patients had abandoned their TB treatment, " said Kakudji.

DOTS normally achieves a cure rate of up to 95 percent after six months of

treatment, but some forms of drug-resistant TB require extensive chemotherapy

for up to two years.

//This report is part of a series by IRIN's HIV/AIDS service PlusNews looking at

treatment and care in communities in crisis. Visit:

www.plusnews.org/DFIDproject.asp

[ENDS]

2 - SWAZILAND: Anti-AIDS text messaging campaign raises hackles

MBABANE, 21 July (PLUSNEWS) - In one of the biggest demonstrations seen in

Swaziland in years, HIV-positive people marched on the offices of the prime

minister and the national AIDS council this week to protest an " insulting " new

media campaign.

The project by the National Emergency Response Council on HIV/AIDS (NERCHA)

seems to suggest that HIV is caused by sexual infidelity. It was launched last

month without consulting people living with the virus.

" The campaign further stigmatises the HIV infected. It is an insult, we are

angry. It is time we are involved in matters pertaining to us, " said protest

leader Vusi Matsebula, chairperson of the Swaziland National Network of People

Living with HIV/AIDS (SWANNEPHA). Around 1,000 people participated in the

demonstration.

The media campaign, called " Makhwapheni " , SiSwati slang for illicit lovers, has

sent out tens of thousands of cellphone text messages mimicking secret lovers

arranging a sexual rendezvous.

The marketing company behind the initiative was quoted in the local press as

saying its critics failed to understand the campaign's creative rationale, and

said cellphones were the primary means of communication for couples having

affairs.

But to Swaziland's growing number of people living with HIV and AIDS - over 40

percent of the sexually active adult population - the campaign smacked of cheap

sensationalism.

" HIV is not just spread by cheating husbands and secret lovers - this insults us

all, " said Senzo Nkhosi, a protestor who said he was HIV-positive.

A survey by the Times of Swaziland found the general public split on the merits

of the campaign. Supporters, none of whom said they were HIV-positive, contended

the approach was meant to startle and provoke discussion.

NERCHA did not return IRIN's phone calls on Friday, but in previous press

statements the organisation, which falls under the authority of the Prime

Minister's office, has argued that Makhwapheni was a dramatic attempt to change

people's behaviour.

However, SWANNEPHA has accused NERCHA of arrogance, and its staff of making a

living off the AIDS crisis, which NERCHA has denied. The protestors also claimed

NERCHA was concentrating its media efforts on uninfected Swazis while ignoring

people in the advanced stages of opportunistic diseases brought on by AIDS.

The Makhwapheni campaign has become the catalyst for AIDS groups to raise other

objections. At the march they delivered petitions to NERCHA and the prime

minister demanding universal access to care and treatment for people living with

the virus, and legislation protecting the rights of those who are HIV positive.

SWANNEPHA, an umbrella body of community-based AIDS support groups that receives

funding from NERCHA, gave the AIDS council until the end of the month to address

its concerns. Protestors vowed to begin a sleep-in vigil at NERCHA headquarters

if they were not satisfied.[ENDS]

This is non-reply e-mail. Please do not hesitate to contact us at

Mail@....

Principal donors: IRIN is generously supported by Australia, Canada, Denmark,

ECHO, Japan, Netherlands, Norway, Sweden, Switzerland, the United Kingdom and

the United States of America. For more information, go to:

http://www.IRINnews.org/donors

[This item comes to you via IRIN, a UN humanitarian news and information

service, but may not necessarily reflect the views of the United Nations or its

agencies. All IRIN material may be reposted or reprinted free-of-charge; refer

to the copyright page (Http://www.irinnews.org/copyright ) for conditions of

use. IRIN is a project of the UN Office for the Coordination of Humanitarian

Affairs.]

PLUSNEWS

Tel: +27 11 895-1900

Fax: +27 11 784-6759

Email: Mail@...

To make changes to or cancel your subscription visit:

http://www.irinnews.org/subscriptions

Subscriber: AIDS treatments