UNAIDS and WHO welcome approval of HIV drug

The Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organisation (WHO) have welcomed the recommendation of an anti-infection drug for use among HIV-positive
patients in Africa.

In a joint statement issued in Geneva, the two UN agencies said experts had agreed to recommend the use in sub-Saharan Africa of cotrimoxazole, a drug that has proved to be effective in warding off some of the opportunistic infections to which HIV-infected patients are prone. The recommendation was made following an AIDS consultation last week in Harare attended by scientists, activists, clinicians and heads of national AIDS programmes in Africa.

"Because of the gravity of the HIV epidemic in Africa, this is the best possible decision, based on the limited data that we have," Regional Director for WHO-Africa Dr Ebrahim Samba said.

Studies in Cote d'Ivoire last year had demonstrated that the drug reduced the frequency of opportunistic illnesses - and even deaths - among HIV-infected people. In addition, preliminary results from a study in Malawi indicate that cotrimoxazole had a "significant beneficial effect on mortality," according to the news release.

However, some scientists had argued that the use of cotrimoxazole in sub-Saharan Africa was questionable because the parasitic type of pneumonia that it was routinely used to prevent in the West was not as prevalent in Africa. Concerns have also been expressed that most patients in Africa will not have access to, or be able to afford, alternative drugs
if they develop resistance to cotrimoxazole.

Despite these issues, the experts in Harare agreed to recommend the drug as a medium-term solution while awaiting the results of research into other anti-microbial agents.

"It is essential to weigh the question of cotrimoxazole against the two challenges of differing infections and possible resistance," Executive Director of UNAIDS Peter Piot said. "But on a continent where antiretroviral drugs are still beyond the reach of most, it is urgent to help prevent opportunistic infections in people living with HIV/AIDS."

In sub-Saharan Africa, where 23.3 million people live with HIV or AIDS, 3.7 million have already died because of the epidemic. In 1999 alone, 3.8 million people were infected.