Academy of Science of SA releases HIV/AIDS statement

25 May 2002
SENIOR Deputy Vice-Chancellor Professor Wieland Gevers has issued the following declaration on behalf of the Academy of Science of South Africa, of which he is President:

"The ASSAf believes that if unchecked the progression of the pandemic of HIV infection in South Africa will disastrously affect the ability of the country to achieve its high ideals. In fact, it will result in the destruction of scarce human capital, crucial to our economy, business and global competitiveness, and stifle the New Partnership for Africa's Development.

"Understanding the nature and scale, and interpreting the impact of the pandemic of HIV infection requires the whole range of scientific disciplines represented in the Academy.

"The direct causal relationship between infection with the Human Immunodeficiency Virus (HIV; now one of the best-studied of all viruses) and the later development of a specific, acquired immunodeficiency disease (AIDS) has been established beyond any doubt: this is the slow but almost invariably fatal illness that is now a very serious threat to South Africa's future.

"Prolonged HIV infections are associated not only with the specific immunodeficiency mentioned above (which allows a range of micro-organisms that do not cause serious illness in uninfected people to produce often-lethal infections in persons with advanced HIV infection) but also with direct organ damage as in the case of HIV-induced "brain failure" (dementia) or a form of cancer (Kaposi's sarcoma).

"Much has already been discovered about the natural history of HIV infection -- it is a continuous process in which the virus, always present infectively in body fluids, progressively kills nearly all the body's content of a particular kind of white blood cell needed for immune defences, creating a very specific form of immunodeficiency. Detectable Anti-HIV antibodies are present in the blood of infected persons soon after a "window" period following the first infective episode, making them "HIV-positive" from that time onwards.

"Both the infective process and the immune response in individual persons are complex but, while variable in certain respects, they follow the same overall course.

"Factors that enhance the likelihood of infection during sexual intercourse (by far the most common mode of transmission) are: unprotected sex; sexual assault; high viral load in body fluids; simultaneous presence of other sexually transmitted disease(s); specific (not yet fully understood) susceptibility factors in the immune response.

"Factors known to extend the time course and diminish the severity of HIV-induced specific immunodeficiency are: effective (highly active) anti-retroviral therapy, in a variety of regimens; specific (not yet fully understood) resistance factors in the immune response; and good nutrition and health care.

"The drugs used in highly active anti-retroviral therapy are mostly expensive products still under patent protection. They can, however, be purchased cheaply from a number of other countries, or manufactured at low cost in South Africa's pharmaceutical manufacturing plants. The incidence of HIV infection in the South African population and the rate of new infections are probably the highest in the world.

"We face a national emergency equivalent to a war. We must accordingly obtain the drugs cheaply or manufacture our own anti-retroviral drugs and use them to treat every proven case of HIV infection encountered by health professionals, according to the best available protocols and regimens. The drugs have side-effects (as do all drugs) but these are vastly outweighed by the lethal nature of the HIV infection itself (doctors have treated cancer patients for many years with far more toxic drugs and other forms of treatment).

"The Academy of Science of South Africa accordingly calls for the resolution of patent-related issues in respect specifically of anti-retroviral drugs in South Africa on the valid grounds of a real national emergency: a pandemic which is estimated already to affect over a quarter of all adults in several of our more populous provinces. South Africa must be able to use these drugs for appropriate medical care, as is the case for all other serious diseases affecting people in this country.

"Doing this will make HIV infection and AIDS a chronic disease like any other, remove the stigma associated with it, and provide therapy which will sustain both work capacity and life for persons found to be infected with the virus.

"HIV-AIDS, while not yet curable, is both a preventable and a treatable disease and we must therefore deal with it by a dual strategy based on social upliftment, behavioural change and prevention of infection, on the one hand, and effective treatment and holistic care, on the other.

"The HIV/AIDS pandemic should be one of the most urgent matters on the national agenda. Every South African hospital and clinic knows that there is a crisis of huge proportions that can only get worse if it is not dealt with effectively.

"The Academy calls for well-coordinated and properly resourced action based on a combination of science (prevention; health-care; research; and drug production) and effective delivery (public health systems), in accordance with the comprehensive Partnership of Hope programme against HIV-AIDS announced by the Government.

"Finally, the Members of the Academy of Science of South Africa pledge their active personal support and involvement in this major national emergency – a viral infection that is out of control and has the potential to destroy our national dreams of a well-functioning, prosperous democracy and a prominent role in the African Renaissance."

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