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REVIEWS: Elinor Moore HIV is changing the face of tropical medicine BMJ 2006; 332: 1280 [Full text]

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Medicine in Africa

Fredrick Asirwa   (31 May 2006)

Medicine in Africa 31 May 2006
Fredrick Asirwa, internal medicine resident Indiana University, IN46202, Indianapolis Send response to journal: Re: Medicine in Africa	I appreciate the observations made the author on Tropical Medicine in Africa-The Malawi experience, as i will call it. I took my Undergraduate Education in a Kenyan Medical school/government run referral hospital and worked as a medical officer at a well-run missionary hospital after which i worked in an NGO that is treating well over 16,000 HIV/AIDS patients in Kenya. I will speak from my experience. The real problem as i see it is not that tropical diseases have been forgoten, it is that the funding organisations direct the way things should be done while the governments sit by. For instance a lot of resources has been poured towards Malaria eradication campaigns.Disjointed, vested interests and double talk has seen no progres in tackling these problem. When several donor organisations say that they will fund a certain disease eradication campaign for 3,4,5 years in a small community in the country several questions beg for answers: -where will the resources to continue with the project come from? -what happens to the other parts of the country? -what will make the situation better after your 5 years? This is basically the reason why each project started is abandoned before any realisation of the intended goals---Health for all by the year 2000 when we can not even guarantee safe drinking water for a quarter of the population in these countries! Is it any wonder then that trypanosomiasis research has now taken a back seat for more hype-related diseases like HIV? Diarrheal diseases continue to account for high numbers of infant/child mortalities in a country like Kenya but now if it is not in a HIV patient who is being funded by some external source, whose motivation is any one's guess, the child could as well be dead. What happens when Riftvalley fever starts killing us in trackloads? or bird flu? will we then leave some to the mercy of mutations and explosion of their viral loads in hot pursuit for the NEW? For the author of that article this is my take:Until people like you and me go back to our countries and and start implementing what we envision we shall continue being like the journalist who covers a great story on starvation/famine in Northern Kenya during the day, but reclines in a sofa with sandwiches,burgers and chips at night, totally oblivious of the corpses next door. Fredrick chite MD. resident. Competing interests: None declared