Got AIDS? Take Two Cloves of Garlic and Call Me in the Morning
South Africa's Ministry of Health announced on February 13th that it promotes 'free will' in regard to the use of traditional medicines by those living with HIV/AIDS. The Ministry, in other words, is officially neutral: when a South African's immune system becomes compromised by HIV, they can use drug treatment, or they can go to their local sangoma and get the latest concoction. The Ministry of Health does not want to state a preference for anti-retroviral drugs above herbs, micronutrients, garlic or whatever.
Lurking behind this position of neutrality is a longstanding battle between the South African government, health care professionals, biomedical researchers and AIDS activists. The current South African president Thabo Mbeki used to publicly state that HIV does not cause AIDS, few if any people in South Africa die of AIDS, and that anti-retroviral drugs are unsafe and part of a neo-colonial plot on the part of Western pharmaceutical companies. He no longer needs to, because now he has a Health Minister (Manto Tshabalala-Msimanga) who says anti-retroviral drugs are merely an 'option' for AIDS patients, and a healthy diet can be just as effective in controlling the virus. Mbeki has a theory, but Tshabalala-Msimanga translates it into health policy, under the fashionable guises of 'patient choice' and 'respect for indigenous culture.'
This policy of 'neutrality' needs to be evidence-based. The South African Ministry of Health should sponsor an independently monitored clinical trial comparing herbs, micronutrients, garlic, lemon rind (and whatever) against first-line antiretroviral drugs on persons with CD4 count of <200. Nearly everyone in the scientific community would predict a whole lot more death in the 'garlic' arm of the trial, but since the Ministry of Health claims they are equally effective, they at least have clinical equipoise. So they can do it. But they won't.
- Stuart Rennie
contribute a comment
Comments have been closed for this post.
comments
Such a pity to hear that these people are in positions of power in such an uneducated population. President Mbeki and his Health minister appearently need more education regarding anti-retrovirals. I am just wondering if these meds are available to the any of the upper level of society and this is the governments way of downgrading the issue. I read and commented on an earlier blog about pharmaceutical companies not getting antiretrovirals to poor or otherwise impoverished nations. Is South Africa one of them? And is this effecting thinking of the governments policy on AIDS there?
- by Karrah on Feb 20, 2006 at 5:16 PM | link
Hi Karrah,
South Africa has committed itself in principle to providing free anti-retrovirals to all those in need of them -- being the economic powerhouse of the region, it is one of the few sub-Saharan nations that may be capable doing so, and considering the impact HIV/AIDS will have there economically, it is an issue of national survival. Unfortunately, the government has been lukewarm in its commitment to the rollout of anti-retrovirals. South Africa has lagged behind WHO goals in getting AIDS treatment to patients, and the response from the South African health ministry is typical: the Ministry complained about being 'bullied' by the WHO, while sending out messages (again) about the toxic properties of AIDS drugs and the virtues of alternative means to control HIV. The ambiguity of the South African government towards HIV/AIDS, in my opinion, has seriously hindered the response to the epidemic by (among other things) continuously messing up messages to the community about the nature of AIDS, HIV prevention and AIDS treatment. Leadership in the struggle against AIDS has often had to take place despite the government, rather than in partnership with it.
- by Stuart Rennie on Feb 20, 2006 at 7:01 PM | link
I have been doing some research lately in the alternative management of different diseases.I happen to agree with the South saharan health ministry in the fact that the WHO is becoming a "bully". I give this organization credit for giving the people a choice. In the U.S. there are actually talks of prevention of the availability of these alternatives including vitamins and herbal remedies. It is a cruel fact and I am aghast. I think that nutrition therapy and other alternatives that are now being used are just as good as the "ALL POWERFUL" antiretroviral drugs which actually cause just as much damage as they do good, and people can actually die from taking these. However with the western pharmaceutical industries power it is quite common for people to believe in this.This is what they are taught. Only pharmaceuticals can "cure" a disease, it is the law here in the u.s. you cannot claim to be able to cure a disease with alternative medicine or you might go to jail! I know for one that garlic has natural antiviral properties and no one ever died from eating too much garlic... or from an increase in healthy foods or nutritional whole food supplements. So maybe the government in africa is actually doing the public a favor.
- by Amy on Feb 26, 2006 at 7:50 PM | link
Amy,
I agree with you that proper diet and the use of vitamins are very important for maintaining health for those suffering from many ailments, including HIV/AIDS. What I don't agree with is the promotion of the effectiveness of these as alternative medicines for the control of AIDS, unless they have been proven to work. Anti-retrovirals, for all their nasty side-effects in some patients, have been shown to lengthen the lives of those with AIDS. Nutritional supplements have not been proven to do so, and I do not believe that a health ministry should tell people that unproven remedies are 'just as good' as those that have been shown repeatedly to work. That is irresponsible.
Imagine that the FDA gave men with early stage prostate cancer the advice that they could use the standard of care adapted to their profile(chemotherapy, operative surgery, etc.) or they could eat tomatoes instead. I think it wouldn't be 'openminded' of them to offer these alternatives -- I think they would be responsible for foreshortening lives of US males. If one is confident of the effectiveness of an alternative medicine, then one should try to design a trial to confirm this. The recent development of a drug for malaria is a case in point -- an ancient Chinese herb (Artemesia) thought to have curative powers was taken to trial and found effective. Before being promoted as 'equally effective', African traditional medicines should go the same route, and hopefully some will prove efficacious. But we aren't there yet.
In my view -- and I don't have a rosy image of pharmaceutical companies at all -- health ministries should put out evidence-based policies, not ones built on conspiracy theories and unproven alternative remedies. That is why I think the government in South Africa is doing its citizens no favor at all.
On a personal note, I have projects in the Democratic Republic of Congo, and I think this message would kill HIV positive men, women and children there. 98% of those who need anti-retrovirals can't access it there, and they take local herbal alternatives because they have no other choice. And they are dying by the cartload.
- by Stuart Rennie on Feb 27, 2006 at 4:17 PM | link