Prof. Ngu

A gloomy atmosphere surrounds the clinic. A vivid picture of helplessness, despair and resignation sharply contrasts with the clinic's attributes "hope". Young and old patients who, seem to have given up hope take their positions in corridors, lost in thought. Elise 18, stood at the entrance of the clinic, desperately sobbing, a few days ago. When we sought to know her problem, she sobbed even more revealing that "I have been tested HIV positive, I do not know how to break the news to my mother who forced me to do the test." Elise dropped out of school a few years back, undertook the trade of hair dressing but lacked basic capital to establish a shop after completion. The girl insisted on knowing whether she could be cured by Vanhivax. A single word "yes" was her panacea which we lacked the capacity to pronounce. Elise is not alone. Several teenagers undergo similar agony many screening centers.

Not only hope has been psychologically beaten out of the patients, but the atmosphere at the clinic is gripped by fear; the fear of being declared seropositive and the fear of death. Anne 31, whose blood sample was collected last week, came for the result, but was stripped of courage to pick up her medical booklet. She quietly begged the gate keeper to smuggle it to her. The lady almost lost stamina when the task was turned down. "I do not have the courage to go in," she said, "what will become of me if my results read positive!" the she exclaimed. Anne's only anxiety was to be reassured that Vanhivax saves. Unfortunately, no one could pronounce the greatly expected "yes". Those who are advised to seek treatment elsewhere because of full blown AIDS are completely downcast. Moving away from Clinic of hope, according is moving toward the grave. Mr. Bonaventure who received a similar piece of advice simply smiled and wondered aloud whether it was "normal for a patient to return from the hospital without drugs." He intimated that the Professor might have read signs of death on his forehead.

Some patients, though drooping with fatigue, also spend time playing hide and seek with mischievous individuals who have taken delight in peeping and eaves-dropping around the clinic at peak consultation hours. A patient who spoke with her face buried in her palms said "I was embarrassed last week when a friend hinted me that it is rumoured that I am HIV positive because I visit Clinique d'Espoir regularly." She suggested that the gate of the clinic should be permanently barred and entry strictly regulated. The complainant said she has a particular disease that needs constant check-up, not HIV/AIDS.

It was against this backdrop that, Dr Nana of African Synergy, a few weeks ago, reiterated the need for pre and post counseling in HIV/AIDS screening centers. He said HIV has become as common as malaria, cancer and other killer diseases, but regretted that many victims still feel ostracized. Yet some screening centers have not taken counseling seriously. "It is not only the job of a medical practitioner; psychologists and sociologists must get involved if stigmatization must be completely eradicated,"

Picture above Shows Kilian Songwe, President/Founder of A Global Healthcare Public Foundation and Prof Victor A. Ngu Inventor of VANHIVAX

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Although HIV diagnostics have not received the same media attention as antiretroviral drugs, they are a significant part of the cost of HIV/AIDS treatment and limited funding has lead doctors in some developing nations to stop administering viral load tests and to make limited use of CD4+ tests. The tests -- which are standard in the United States -- help doctors determine when to begin administering antiretroviral drugs and whether the drugs are working (Kaiser Daily HIV/AIDS Report, 1/14). Under the new agreements, the cost of CD4+ tests will drop from $8 to $10 per test to $3 to $5 per test, BD Chair and CEO Edward Ludwig said. Roche Molecular Diagnostics Vice President Robin Toft would not discuss in detail the price agreement on the more expensive viral load test but said that the price would be 20% lower than what the company is currently charging developing nations (Dugger, New York Times, 1/15). The companies will not require up-front payment for the expensive testing equipment and will delay payment collection until the system is in place and staff are trained, according to the Associated Press (Dobnik, Associated Press, 1/14).

Expanded Treatment Access
Ira Magaziner, a long-time Clinton aide and head of the foundation's AIDS initiative, and a team of management consultants and AIDS experts visited the companies' manufacturing plants to help them develop ways to cut costs. The foundation used a similar tactic in October to secure a deal with Ranbaxy Laboratories, Cipla, Matrix Laboratories and Aspen Pharmacare that reduced the prices of commonly used three-drug antiretroviral regimens to 38 cents per patient per day, down from the already discounted price of 55 cents per patient per day (Kaiser Daily HIV/AIDS Report, 1/14). The new agreement, combined with the October agreement, will cut the cost of treating an HIV-positive person from $800 a year to $250 a year in the 13 developing nations where the foundation is operating, Clinton said (New York Times, 1/15). The foundation expects that the deal will allow five million more HIV-positive people to access treatment by 2008 (AFP/Yahoo! News, 1/14). South Africa will be the first to benefit from the plan and within two months is expected to finalize a deal that could save the country almost $300 million over the next five years, Lynn Margherio, executive vice president of the foundation's HIV/AIDS Initiative, said. Mozambique, the Bahamas, Tanzania and Rwanda are expected to be the next countries to benefit from the deal, according to Reuters/Post (Reuters/Washington Post, 1/15). The foundation is receiving private funding for its treatment project and has received pledges from several developed countries -- including Canada, Ireland, Norway and Sweden -- to contribute directly to programs in specific developing countries (Associated Press, 1/14).

Reaction
Company executives attending the press conference said that they planned to make up for lower profit margins with higher sales volume, the AP/Long Island Newsday reports (Dobnik, AP/Long Island Newsday, 1/14). "We are systematically changing the economics of AIDS treatment," Clinton said, adding that the companies had done an "astonishing service" by agreeing to the deal (Barber, Financial Times, 1/15). "By pushing down the price of HIV/AIDS medicine and laboratory tests, we are ramping up the ability of developing countries to treat millions of people, and to do so with the kind of quality of care that people with AIDS in the developed world usually receive," Clinton said (AFP/Yahoo! News, 1/14). Richard Feachem, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, said that the Clinton Foundation "has made a major contribution to the fight against HIV/AIDS" (New York Times, 1/15).

Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2003 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.