Date and Time: 14 March 2016 5.15pm
Venue: SOAS Main Building, Russell Square, 4th Floor
There are believed to be about 37 million people in the world with the HIV virus. Of these 26 million are in Southern Africa, where more than 15% of the population carry the virus. But East Africa is not far behind. More than half of these are women, who acquired the virus through sex with men, and a small proportion of their children also have the virus. In 2002 about 12% of the pregnant women who attended ante-natal clinics in Tanzania had the virus. These statistics, and the issues they raise, were discussed at a BTS seminar held at SOAS on 14 March 2016. The main speaker was Professor Shabbar Jaffar, Head of the Department of International Public Health at the Liverpool School of Tropical Medicine. He was supported by Dr Hamza Hassan Mohamed who has worked on these matters in Tanzania and Dr Mohammed Salim, a public health specialist, currently specialising in matters relating to addiction.
The total numbers of people infected with HIV around the world continues to rise, but the rate of growth has slowed. There are three reasons for this:
1. An increase in male circumcision. Those who are circumcised have a 60% lower chance of catching the virus. This is the same order of magnitude as
the improvement which would be expected from a vaccine.
2. More care when having sex, including the use of condoms, or having fewer partners.
3. Antiretroviral drugs. Before this treatment someone with HIV could expect to live for about 10 years, and then die a most unpleasant death. Those who take the drugs now have life expectancies not much below the rest of the population. Moreover in a few months the drugs reduce the level of the virus so much that it is almost impossible to pass it on to other people.
Antiretroviral drugs are not cheap, but in Tanzania most of the cost is met by donors, especially the Bill and Melinda Gates Foundation. It is believed that about half of those affected are now on the drugs. However, as Dr Hamza pointed out, donors do not pay for the blood tests which determine if you have HIV and the dosage of drugs that is needed to control it, and for many people the nearest clinic is far away and the cost of travel a big deterrent. The drug regime is complicated, and many forget to take the drugs as prescribed, especially if they are not feeling unwell and they experience side-effects when they take them. There is then need for support and help, because there is often stigma and fear attached to HIV
– those who take them are assumed to be promiscuous and unfaithful. Continuing to drink alcohol lessens the effectiveness of the drugs, and
people who are drunk are less likely to use condoms or to take other methods to prevent transmission. Poor nutrition due to poverty affects people’s general health and makes them more at risk from malaria, chest infections, cystitis, venereal diseases, etc, and the drugs for these are often fake, expired or substandard – or just unaffordable.
The battle is not yet won. The numbers are still increasing. Resistance to the drugs which control HIV and TB is a huge threat. The position today is that we probably have the tools to fight HIV – but are we organised enough, and open enough in our education and training about health, to make the most use of them?