U of M continues work to curb spread of AIDS in Kenya
http://www.winnipegfreepress.com/local/U-of-M-continues--137558193.htmlWinnipeg Free Press - ONLINE EDITION
By: Dan Lett
Posted: 01/18/2012 6:54 AM | Comments: 0 (including replies)
So much has changed, and so much has stayed the same.
A decade ago I travelled to Nairobi to see, firsthand, the work of
Kenyan and University of Manitoba researchers who were studying a
group of HIV-resistant sex workers. The U of M maintained a small
clinic in Nairobi's Pumwani district, a deeply impoverished place, and
provided free medical treatment to both the non-infected sex workers,
and those who had contracted deadly virus. In exchange, the
researchers gathered valuable data on the lives and habits of the
resistant women. That data has provided insight into the human immune
system, and is being used in one of the world's most promising vaccine
initiatives.
But that was not all the U of M brought to Africa. The project grew,
bringing public health education and preventative strategies to stop
Kenyans from getting infected in the first place. It was at that time
a unique approach, a blend of research, primary medicine and public
health.
I met the Manitobans on the front line of the battle against HIV and
AIDS. The founders of the project, doctors Allan Ronald and Frank
Plummer. Researchers like Dr. Stephen Moses, who made history by
linking circumcision to HIV prevention. And Kenyans like Dr. Joshua
Kimani, who did much of his medical education and graduate training
through the U of M and now leads the U of M's work in Kenya.
A decade later, the U of M programs have grown both in size and
sophistication. "Ten years ago, we focused our work on a couple of
research initiatives and the Majengo clinic," said Dr. Keith Fowke, a
professor of medical microbiology and one of the leaders of the Kenyan
projects. "Now, we have reached out to other areas of Nairobi."
In addition to Majengo, the U of M operates four more clinics in other
districts of Nairobi to both provide front-line medical care and
education on how to prevent HIV infections, Fowke said. The clinics
focus their work on sex workers, who have the highest infection rates
among all Kenyans. Last year, more than 40,000 sex workers received
medical treatment at U of M clinics, and more than two dozen medical
and graduate students — Canadian and Kenyans — trained in these
programs.
Perhaps the biggest change experienced by the U of M researchers is
the type of treatment they are providing. A decade ago, only a handful
of Kenyans had access to anti-retroviral medication (ARVs), the
principal drug therapy for suppressing HIV. While ARVs had become
standard for victims in developed countries, those in developing
countries were essentially denied access on economic grounds. However,
a global campaign put increasing pressure on developed countries to
make ARVs available to all.
This ultimately led to ARV programs through UNAIDS and the Global Fund
to Fight AIDS, and the creation of the U.S. President's Emergency Plan
for Aids Relief (PEPFAR). Together, these and a few other smaller
programs are providing drug therapy to more than five million HIV/AIDS
victims in the poorest countries. The U of M has accessed funding
through the Gates Foundation and PEPFAR to expand its network of
clinics, and to bring its unique blend of prevention and research to
other countries including Columbia, India, Pakistan and China.
The progress is undeniable, but Fowke admits there is very little
sense that they are anywhere close to winning the war on HIV/AIDS.
Although prevalence rates are down, the total number of people living
with the disease — in large part because more victims are living
longer while on ARV therapy — has nearly doubled to two million. Of
greater concern, new infections continue at an alarming rate. And
looming over the global fight against the disease is a precipitous
drop in international funding.
In large part because of the global recession, the countries that
support the programs that treat victims and fund research into a
vaccine fell by approximately 10 per cent. This has led to a drop in
funding to specific projects around the world.
The challenges remain but there is a sense of optimism. Dr. Allan
Ronald, one of the founders of the U of M's projects in Kenya, said
there have been many positive consequences. New infection rates are
down in most African countries by as much as 40 per cent from peak
levels in 2004-2005, he said.
Other advances include building a greater capacity in Kenya for
medicine and research. Ronald noted that the U of M programs in Kenya
are now, for the most part, overseen by Kenyan doctors. This is a huge
advantage to a country struggling with such an enormous public health
crisis, he added.
On the vaccine research side, Ronald said he and many other of the
founders of the program are somewhat disappointed that the secrets of
the HIV-resistant sex workers has not been decoded. "There have been
some small advances, but we've not had that big breakthrough I think
we all thought would come," he said.
Overall, Ronald is still encouraged by the work in Africa. "You can
get discouraged at times," Ronald said. "But in the end, there is
enough to make us encouraged. The glass is definitely half full."
dan.lett@freepress.mb.ca
--
Truth resides in every human heart, and one has to search for it there, and to be guided by truth as one sees it. But no one has a right to coerce others to act according to his own view of truth. - Mohandas Gandhi
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