Miami Herald - Monday, March 29, 2004
Fred Tasker, ftasker@herald.com

While AIDS still claims 30,000 lives a year in Haiti and has left 200,000 children orphaned, innovative treatment and prevention programs have cut Haiti's HIV rate by 50 percent since 1993, Dr. Jean Pape, of the Cornell Weill Medical College and director of Les Centres Gheskio in Haiti, told the Naitonal HIV/AIDS Update Conference in Miami on Sunday.

A HUMAN RIGHT

Praising those efforts, pioneering Harvard University medical anthropologist Dr. Paul Farmer, co-founder of Clinique Bon Sauveur in the rural village of Thomonde, called for a worldwide shift looking at AIDS prevention and treatment as a human right, not a tool delivered or withheld on the basis of cost effectiveness.

Citing Universal Declaration of Human Rights' articles declaring the human right to health, well-being and adequate medical care, Farmer criticized articles in the medical journal Lancet and elsewhere arguing that prevention is more cost-effective than treating infected patients with antiretroviral drugs.

"We don't know how much it costs us as human beings not to have equity, to have a situation in which some people have access to drugs and others do not. Problems can be overcome. We know we're not going to meet the goal, but it doesn't mean we should stop trying."

With funding from the U.S. government and from the private group Project MediShare, clinics in Haiti over the past 10 years have cut mother-to-infant transmission of HIV from 22 percent to 4 percent, have increased HIV screening seven-fold and brought condom use from almost nothing to 15 million in 2003, Pape said.

The symposium was sponsored by the Green Family Foundation Initiative in Pediatric Infectious Disease & Immunology and international Health, which has granted $2.5 million to the University of Miami Department of Pediatrics and Project MediShare, a Miami-based clinic providing healthcare in rural Thomonde, Haiti.

The weekend conference is sponsored by the American Foundation for AIDS Research.

A similar human rights approach in Brazil has cut AIDS deaths by 50 percent to 90,000 a year since 1996, said Dr. Roberto Brant Campos, deputy director HIV/AIDS programs in that country's Ministry of Health. Since 1988, the Brazilian Constitution has declared healthcare to be every person's right and the government's obligation, he said.

OUTREACH CAMPAIGNS

Brazil followed up with massive outreach campaigns to army inductees, sex workers, drug users, prisoners -- even distributing free condoms to teens in all public and private high schools, he said.

"I thought macho Latin American males would never use condoms," said Dr. Fernando Zacarias, director of HIV/AIDS programs for the Pan American Health Organization. But he said condom use increased from 4 percent of all males having their first sex in 1986 to 48 percent in 1999.

Serious problems remain, especially in Haiti.

Farmer's clinic lost four ambulances to armed thugs during the recent political upheavals.

"Our workers were scared," he said. "But not a single worker failed to show up at work, and not a single patient missed a dose of medicine. I give them great credit for that."

040329
MH040310

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2004. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .