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Free AIDS testing, drugs save Zambians-study
Published in Saudi Press Agency on 13 - 08 - 2006


Committed treatment with free
testing and free drugs has saved the lives of thousands of
Zambian HIV patients, researchers said on Sunday, according to Reuters.
They said their new approach proves wrong the perceived
wisdom that it is simply not possible to provide sophisticated
AIDS care to patients in the poorest of countries.
Contrary to some predictions, patients took their pills,
came to clinics for follow-up checks -- and have lived, Dr.
Jeff Stringer of the University of Alabama at Birmingham told
the International AIDS Conference in Toronto.
Survival rates compare to those seen in the developed
world, Stringer told a news conference.
"The majority of patients that we started on therapy, had
they not gained access, would have died," Stringer said.
His team treated more than 16,000 patients for the 18
months between April 2004 and November 2005, testing their
blood and giving them the drug cocktails that can suppress the
AIDS virus.
"We use any drugs we can get our hands on," Stringer said.
They got funding from the U.S. government, the Elizabeth
Glaser Pediatric AIDS Foundation, the Global Fund for AIDS,
Tuberculosis and Malaria and the Zambian government.
They initially saw 21,755 patients at clinics in Lusaka,
the densely populated Zambian capital where an estimated 22
percent of adults are infected with HIV.
Of these, about 16,000 were given HIV drugs. Another 5,500
were considered not ready for various reasons but were
watched.
Of those treated, 1,142 died and 3,400 did not return for
appointments. As of November, 11,591 were alive, Stringer told
the conference. Of those not treated, 192 died, 2,149 are alive
and the rest could not be accounted for.
Most of those who died -- 792 -- died within the first 90
days of the program, Stringer said. This is largely because
they were already too sick, he said.
"In our setting (the problem is) actually getting the
patients to come in before they are deathly ill," Stringer
said.
"They arrive literally in wheelbarrows, which is the
Zambian equivalent of an ambulance." Those who died were
usually very thin, anemic, and infected with diseases such as
tuberculosis.
But after the first 90 days, the death rate plummeted,
Stringer's team reports in a special issue of the Journal of
the American Medical Association, timed to coincide with the
conference.
Now they are treating more than 30,000 patients.
Stringer attributed the program's success to four factors:
1) funding; 2) a solid commitment from the Zambian government including making the drugs available free; 3) using
physician's assistants because of a doctor shortage and 4)
developing electronic records that made it easy to track a
patients' progress and to study the results.
The patients are followed carefully. Those who failed to
keep appointments were tracked down and encouraged to come
back, because taking medications on time is key to controlling
the AIDS virus.
But Stringer said this and other, much smaller studies show
the approach can work in urban areas.
In rural areas there are fewer resources and fewer health
workers, but patient follow-up is far easier.
"There are no secrets in these villages and everyone knows
somebody is supposed to be taking the medicines. The idea of
losing someone to follow-up in a village is unheard of,"
Stringer said.


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