AIDS in Africa: A Continent in Crisis
EILEEN O'CONNOR, HOST: Today on a special edition of YOUR HEALTH, AIDS in Africa, a continent in crisis. Scientists from around the globe meet in South Africa to discuss the world's fastest-growing epidemic. One new weapon in the battle, the first trial of an AIDS vaccine. But it's too little, too late.</s>DR. GLENDA GRAY, CHRIS HANI BARAGWANATH HOSPITAL: What I find really devastating is the fact that (inaudible) is a special child who -- his (ph) dreams won't be realized.</s>O'CONNOR: It's estimated that one in four sub-Saharan Africans will die of AIDS, and experts say it's creating a generation of orphans and wiping out another generation of workers. We'll look at the search for answers, from transmission, to new drugs, to what it all means for the rest of the world. I'm Eileen O'Connor. Welcome to this special edition of YOUR HEALTH. The 13th International AIDS Conference was held in Durban, South Africa, this week. We're at the King Edward's Hospital. With one in four infected in this region, this is the epicenter of a pandemic experts say must be stopped.</s>SINGER (singing): No, no, no more...</s>O'CONNOR (voice-over): In an emotional televised opening ceremony, South African President Thabo Mbeki defended his questioning of the source of AIDS, saying for Africa the answer lies not simply with the HIV virus.</s>THABO MBEKI, PRESIDENT OF SOUTH AFRICA: The world's biggest killer and the greatest cause of ill health and suffering across the globe is given the code Z-59-5. It is extreme poverty.</s>O'CONNOR: Twenty-four and a half million adults and children are living with HIV, the virus that causes AIDS, in sub-Saharan Africa. It is estimated that one in four here will die of the disease, now the leading cause of death. Over 2 million died in the last year alone. Experts say that AIDS is wiping out an entire generation, affecting the workforce, killing trained doctors, teachers, engineers, leaving orphans who cannot afford to go to school or who cannot find someone to educate them.</s>PETER PIOT, DIRECTOR, UNAIDS: There will be for the first time more people in their 60s and 70s than people in their 30s and 40s.</s>O'CONNOR: Worsening already dire economic conditions. Three billion dollars is what experts say is needed worldwide just for prevention. That doesn't even take into account the tens of billions more that are necessary in Africa to build the infrastructures required to deliver the necessary treatments -- investments American officials say are in everyone's interest.</s>RICHARD HOLBROOKE, U.S. AMBASSADOR TO THE UNITED NATIONS: Anyone who thinks that AIDS in Africa can be restricted to that continent alone is living in a dream world. You can't (inaudible) -- you can't build a Berlin Wall around a single continent and keep a disease on -- inside it.</s>O'CONNOR: Still, some health officials here say the president's attempt to focus attention on poverty's contribution to the spread of AIDS may have backfired in his own country.</s>DR. SAADIQ KARIEM, HEALTH DEPARTMENT, CAPE TOWN, SOUTH AFRICA: In my training session (ph), people, people have thrown the condoms in the bin (ph). They seem to be not interested in your HIV awareness messages.</s>O'CONNOR: AIDS experts here say it is up to African leaders like Mbeki to match word with action, shifting resources away from building armies and into building clinics, and speaking out frankly on social customs in these male-dominated societies that are also fueling the spread of AIDS. But AIDS activists also accuse the developed world, particularly the pharmaceutical companies, of not doing enough.</s>UNIDENTIFIED MALE: The infrastructure argument is bull (expletive).</s>UNIDENTIFIED MALE: Infrastructure, yes, is important as (inaudible). Thank you.</s>O'CONNOR (voice-over): Manufacturers of AIDS drugs and their supporters came under attack despite announcements that Merck Pharmaceutical and the Bill and Melinda Gates Foundation will jointly send $100 million to fight AIDS in Botswana, a country where nearly one in two are infected with HIV, the virus that causes</s>AIDS. UNIDENTIFIED MALE: This is a complex problem, and we're all trying to do something constructive to improve access.</s>O'CONNOR: Abbott Pharmaceuticals announced they too would spend millions helping orphans in Tanzania. Even with that and an agreement to lower the cost of antiretroviral AIDS drugs, AIDS activists accuse Western companies of not doing enough.</s>UNIDENTIFIED MALE: At what point in time will the industry agree to provide antiretrovirals to those countries and programs that request them at the marginal costs of actual costs of actual production?</s>O'CONNOR: But this is a country where many don't have access to clinics, the means to get the drugs regularly, and treatments for side effects. In addition, the numbers of infected are estimates based on those who actually do get tested, which is a minority. That is why health officials here say even free drugs would not be a cure-all.</s>DR. ZWELI MKHIZE, PROVINCIAL MINISTER OF HEALTH: You need to invest in, an estimation has been made of a figure of about 15 billion rand between now and the next 10 years to actually make sure that you can build our infrastructure.</s>O'CONNOR: That's $7 billion in South Africa alone. Yet other experts say that is not an excuse to deny these drugs to those they can reach.</s>DR. HELENE GAYLE, CENTERS FOR DISEASE CONTROL AND PREVENTION: We need to figure out how to get those drugs more widely available, at the same time making sure that the infrastructure is there to be able to provide access safely and effectively.</s>O'CONNOR: And that takes political will and resources, both of which have been lacking here and in the developed world. But AIDS experts say it will take joint action to battle this crisis. Coming up, a promising new vaccine from an unlikely source. Stay with us.</s>O'CONNOR: Experts here say the way to end this pandemic is through prevention, and they heard some good news on that front. A new vaccine is set to begin phase I clinical trials, a vaccine with promise.</s>SALOME SIMON (voice of translator): I believe I slept with men who have slept with my colleagues who died.</s>O'CONNOR: That makes Simon a unique gift to science, to doctors trying to develop a vaccine for</s>AIDS. DR. OMU ANZALE, RESEARCH INSTITUTE FOR GENETIC AND HUMAN THERAPY: I think there are about 80 to 100 of them that -- who we observe that were resistant to HIV infection.</s>O'CONNOR: Dr. Omu Anzale is director of a clinic in Nairobi studying HIV and other sexually transmitted diseases. For some prostitutes here, their initial exposure to HIV had not infected them but protected them.</s>ANZALE: What it did is to prime the immune system in producing the part of the immune system we call T-cells.</s>O'CONNOR: It's those T-cells that fight HIV, the virus that causes AIDS. Usually the body doesn't recognize the virus quickly enough to produce enough of the T-cells needed for an effective defense. Knowing that a little HIV exposure could produce T-cells meant a vaccine, usually a mutation of the virus, could be effective.</s>ANZALE: Our hope is that once somebody has been given the vaccine, they will respond vigorously by producing the T-cells.</s>O'CONNOR: Vaccines created by studying these prostitutes may also become vital in treating HIV. A lab in Italy has developed a vaccine worn in a patch which joins a mutation of the virus with another virus that the immune system recognizes and responds to. The goal is to teach the body's own natural defenses to hunt down the HIV virus and kill it itself.</s>UNIDENTIFIED FEMALE: And after you vaccinate these patients, we are hoping that they develop this immune response and they can stop antiretroviral treatment and control HIV in the absence of therapy.</s>O'CONNOR: Government officials say they would put to use even a vaccine that was 40 percent effective. With all those currently in trials, one could be in use within five to seven years.</s>DR. SETH BERKLEY, INTERNATIONAL AIDS VACCINE INITIATIVE: At that point we will know which of those seem to have an effect, and therefore we can make improvements from those to create our final vaccine.</s>O'CONNOR: Health workers caution you only have to look at history to know a vaccine is not a quick fix.</s>O'CONNOR: The problem with vaccines is they may make people feel too safe and engage again in risky behavior like unprotected sex. In addition, it's important to remember, it was over 100 years from the creation of the smallpox vaccine until that disease was eradicated. Here in South Africa, it's estimated that nearly half of the p under the age of 20, some 8 million, will die of AIDS before they reach the age of 35. Many of them have children. Up ahead in YOUR HEALTH, we'll take a look at a place that's trying to create home and family for the orphans of AIDS. Stay with us.</s>HOLLY FIRFER, CNN MEDICAL CORRESPONDENT (voice-over): Welcome back to YOUR HEALTH. I'm medical correspondent Holly Firfer with this week's YOUR HEALTH headlines. Researchers gathering at this week's World Alzheimer's Congress are reporting two key developments in the fight against the disease affecting some 12 million people in the United States. Scientists say initial studies suggest an experimental vaccine designed to fight the disease appears to be safe in humans. In earlier studies in mice, the vaccine halted and in some cases reversed the plaque buildup associated with Alzheimer's. Researchers also believe they're close to a consensus on exactly what causes the disease and how it progresses. Debate has centered over which comes first, the characteristic brain plaques or tangles. Most scientists believe the amyloid plaque forms first, followed by the tangles, leading to brain cell death and the patient's gradual loss of the ability to think and remember. And those are this week's YOUR HEALTH headlines.</s>O'CONNOR: Coming up on YOUR HEALTH, new ways to prevent transmission of the HIV virus from mother to child. But first, this week's YOUR HEALTH quiz.</s>O'CONNOR: One of the tragedies here in Africa is how many pregnant women are infected with the HIV virus. Doctors are trying to come up with ways to prevent them from passing on the virus to their newborns. But social stigma, tradition, and economics stand in the way.</s>DR. GLENDA GRAY, CHRIS HANI BARAGWANATH HOSPITAL: How's your baby?</s>BUSISIWE ZLULU: She's doing fine.</s>GRAY: She's doing well.</s>O'CONNOR (voice-over): Busisiwe Zlulu is 15 years old and a first-time mother. She's also HIV-positive.</s>GRAY: How did that make you feel?</s>ZLULU: I feel (inaudible) bad.</s>O'CONNOR: Zlulu says she only had sex once with an 18-year-old man who ran away as soon as he heard she was pregnant, before she could tell him that she and he were carrying the virus that causes</s>AIDS. ZLULU: I didn't think that he has HIV-positive.</s>GRAY: Why?</s>ZLULU: Just -- he looked normally to me.</s>O'CONNOR: Yet she is one of the lucky ones. Access to clean water enables her to bottle feed Nadzu (ph). That and doses of AZT means Zlulu's daughter may escape her mother's death sentence and remain free of the disease. (on camera): South African officials here at this AIDS conference say they are prepared to widen the use of drugs like AZT, especially Naveripine (ph). Studies show just two doses of that drug, one given to the mother at the onset of labor and one to the baby immediately after, can cut mother-to-child transmission rates in half. (voice-over): Dr. Glenda Gray, director of the clinic here in Soweto, says until now, she has had to enroll these young women in clinical trials just to access the medications. Because these drugs were never that expensive, she believes the South African government could have made this move earlier but didn't, sending this message to the mothers she treats.</s>GRAY: I don't think that I value your life enough to give you a drug that costs four years' (ph) dollars, that costs 24 rand. You're not important to me, and I rather let your child die of</s>HIV. O'CONNOR: It's a feeling 15-year-old Busisiwe Zlulu knows all too well.</s>ZLULU: If you're HIV positive, no one wants you, no one treats you the way they (inaudible). It's like they hate you.</s>O'CONNOR: Dr. Gray says Zlulu is special because, unlike many here, she is willing to talk about her disease in the hope that by breaking the silence, she can prevent others from suffering her fate.</s>GRAY: What I find really devastating is the fact that (inaudible) is a special child who you -- his (ph) dreams won't be realized.</s>O'CONNOR: Dreams that included watching her own child grow.</s>O'CONNOR: Too often here, babies like Nadzu are left alone, orphans. But some lucky ones have found a haven, and sometimes a family.</s>AIDS. FATHER ANGELO D'AGOSTINO: Many of them come as abandoned infants in hospitals, so many have never had a mother or don't know a mother or never had a home.</s>O'CONNOR: Father Angelo D'Agostino founded Nembani after seeing how HIV-positive infants were left untreated at local orphanages. As the need grew, so did Nembani, from a small rented house with three children to a larger property designed around 10 family-style units, each with an assigned mother. For the 70 children they now take in, this is all the family they know.</s>D'AGOSTINO: When the parents die, the relatives don't want them around.</s>O'CONNOR: By their ninth month, three out of four HIV-positive babies turn negative, losing their mother's antibodies. Disease free, some, like Sarah (ph), are adopted. Others are not so lucky. Rose Gashere (ph) was just 9 when she died of AIDS. Found on the streets at age 4, she spent three years in a juvenile detention home before the Sisters of Charity took her in, malnourished and HIV-positive. Because AIDS drugs cost $300 a month per child, only those Father D'Agostino can find sponsors for receive the medication. Rose was not one of the lucky ones. He and others in Africa welcome the Clinton administration's promise not to prosecute drug makers or buyers of cheaper generic AIDS drugs for breaking the intellectual property rights of the U.S. drug companies that developed them. Having buried 16 before Rose, Father D'Agostino cannot help feeling frustrated knowing a faster way would be for U.S. companies to simply price the drugs more cheaply themselves.</s>D'AGOSTINO: It makes me furious and ashamed of being an American, really, to know that this is mainly American companies that are so greedy that they're withholding the medicine they could bring on to prolong these children's lives.</s>O'CONNOR: Prolong them long enough to answer his prayers for a cure.</s>O'CONNOR: That wraps up this special edition of YOUR HEALTH. If you'd like to know more about AIDS and this 13th International AIDS Conference in Durban, South Africa, click on our Web site at cnn.com/health. It's produced in conjunction with WebMD. From the entire CNN health team, I'm Eileen O'Connor. Thanks for watching.