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NEWS: Michael Day AIDS expert doubts vaccine will be found in near future BMJ 2007; 334: 1133-a [Full text]

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'ALARMIST' - AIDS EXPERT DOUBTS....!

Edwin M. Mapara   (9 June 2007)

'ALARMIST' - AIDS EXPERT DOUBTS....! 9 June 2007
Edwin M. Mapara, HIV/AIDS SPECIALIST COMMUNITY HEALTH ACTION TRUST (CHAT) Send response to journal: Re: 'ALARMIST' - AIDS EXPERT DOUBTS....!	This makes very interesting reading! Almost twenty years ago, in 1989, I was called an 'alarmist', one of the many names I have been given in a career that has seen three or four 'best practices' come up in HIV/AIDS prevention, care and support activities in Zambia (Livingstone Anti-AIDS Project (LAAP):1989), Botswana (Athlone AIDS Awareness Programme(AAAP): 1990 and Athlone Health Resource Centre (AHRC):1999) and now Brent (Pictures in AIDucation:2005) in the UK. This was after I made a statement that due to "...the way the virus changes its skin and intestines, getting a vaccine, let alone a cure, will be very difficult...I do not see it happening in the next 20 years! The best vaccine we have is education. Let us work on prevention initiatives in overdrive!" That did not go down well with many people in authority, as I was using "Shock tactics...being an alarmist!" I strongly believe, that we have sacrificed Prevention and Care initiatives for vaccine and treatment research. True, it would be wonderful if we found a vaccine. True it would be wonderful if we could put all our clients on treatment, that need treatment, but how realistic is that with the inertia and politics of those who pull the strings of the purse!? We know how the virus mutates and the possible results and implications. The other day I was stunned when a colleague told me that "... in Botswana, the HIV Type 1, sub-type C has 53 variants..." It was news to me and naturally, ignorance is no defense, so I communicated with friends in Botswana to find out the truth of this 'fact'. I was told that a paper had been written about it and it was common knowledge and "...not all the variants were significant!" FOOD FOR THOUGHT! Working in the villages of Africa, an extra 10% effort in prevention initiatives would make a very big difference in preventing new infections, reducing stigma and giving better care to people living with HIV/AIDS. I have used "Pictures in AIDucation", an awareness raising strategy that uses pictures to teach, share experiences and to empower community members. It is basically HIV/AIDS made visible for the villagers. To many, including some of our politicians, HIV/AIDS is invisible. Empowerment through pictures has helped many a community organisation look at HIV/AIDS differentally and to take positive action that leads to reduced transmission of HIV/AIDS. With these long awaitted words from the AIDS Expert, I hope more resources will be put into prevention and care projects and programmes in the developing countries. Where are the carers? In the villages. The village carers (Unsung heroes) have always been there even before the "brain-drain" to Europe or the hundreds of non-governmental organisations (NGO) came to Africa from Europe to earn the donor money that is supposed to be given to these village carers, as they look after our people, orphans and address other issues that arise from living with HIV/AIDS every day. Who better than the natives to look after their health concerns? The AIDS Expert is only saying what many of us have looked at with a question mark! Not being pessimists, but simply realists! Performance Management Systems (PMS) has taught us to always leave room for 1% error. My 1% has been reduced to 0.5% by "AIDS expert doubts vaccine will be found in near future." Competing interests: None declared