Conditions ripe for HIV/AIDS explosion

Multiple troop movements and population displacements in the DRC, and to and from neighbouring countries with high HIV prevalence rates, have left the DRC well set for “an explosion of HIV/AIDS”, according to WHO focal point Dr Tshioko Kweteminga, cited in an agency situation report late last week. “I can hardly think of a better vector than tens of thousands of young men with hard currency roaming around the country,” the agency cited another observer as saying. A new action plan drawn up by the Programme Nationale pour le Lutte contra SIDA [National Programme for the Struggle Against AIDS] in collaboration with UN agencies and international NGOs has yet to attract firm funding commitments, despite increased donor interest in the HIV/AIDS situation in the country. Norway had recently donated the equivalent of US $400,000 to improve surveillance and testing, but proposals for supporting supplies, health education and palliative care in the home for related conditions such as the fungal infection candidiasis, were still “on the starting blocks,” according to WHO. Meanwhile, the situation in the DRC in relation to contraceptive supplies and the availability of safe blood (for transfusions and operations) remained dire, the agency stated after a joint health sector assessment mission with UNICEF in late July [mission report at: http://www.who.int/eha/disasters]. Health education was hardly taking place at all, with health zones and indigenous NGOs citing lack of basic equipment - even paper and pens - as morale-sapping obstacles even to voluntary work, it stated. National statistics collected through the health information system suggested that there were just under 10,000 new HIV cases last year but public health authorities have estimated - based on information from five regional sites - that there were in the region of 173,000 new HIV cases each year in the DRC, and almost 1.3 million adults and children living with HIV. The five sentinel sites - in Kinshasa, Karawa (Equateur Province), Mikalay (Kasai Occidentale), Kibondo (Orientale) and Sendwe (Katanga) - were currently producing limited data on the HIV/AIDS pandemic in the DRC but an in-depth, countrywide investigation of the situation was long overdue, WHO reported . Similarly, circumstantial evidence suggests that prevalence rates throughout the country are believed to be much higher than the quoted average of 5 percent. Recent investigation of apparently healthy blood donors in Kalemie, North Katanga, found that over one-third were HIV-positive, WHO stated. Another study of patients in Bukavu, North Kivu, in eastern Congo, found a prevalence rate of 32 percent among adult men, 54 percent among adult women and 26.5 percent among children, it added. The key message of a joint WHO and UNICEF health mission to the DRC in late July was that health care must be redirected from the current “facility-based curative care” to “a public health approach focused on the main killer conditions” in order to address unacceptable mortality and ill health. The nine-person mission also called for “a massive effort” on HIV/AIDS and malnutrition, which, they said, provided “an increasingly frightening underlay” to a generally appaling public health situation.