- PRETORIA, South Africa --
Good food is no substitute for anti-retroviral drugs in combating AIDS.
That's the finding of an "exhaustive" study by top South African
scientists of all scientific research on the links between improved nutrition
and the treatment of South Africa's out-of-control epidemics of HIV-AIDS
plus tuberculosis (TB).
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- The panel included nutritionists, immunologists, biochemists,
infectious disease physicians, paediatricians, policy experts, epidemiologists
and generalists. They warmed that the 'nutrition versus medication'[ debate
which was directly fueled by the country's health minister -- particularly
in relation to the country's "two major concurrent epidemics"
of HIV combined with TB, had resulted in "serious differences"
in the approach to public policy dealing with the impact of these diseases.
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- Health workers have previously warned of the virulent
effects of the combination of the twin epidemics of AIDS+TB. This has become
particularly problematic in South Africa, with the emergence of extensively
drug-resistant TB. XDR-TB+AIDS is a virulent, airborne-transmitted TB+AIDS
infection -- incurable, without vaccines, the combination of drug-resistant
Tuberculos+AIDS is proving to be so deadly that it kills its victims within
twenty days in South Africa.
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- It is now killing a large number patients in all nine
provinces of South Africa. The health minister has however not provided
any new death-rates since February 2007, when the death toll stood at more
than 650 -- but this was the death-rate before it had started spreading
from its original source in KwaZulu-Natal province.
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- However it is known that at least 3,5-million people
have already died of the combination of TB+Aids in South Africa since at
least 2003, and that more than 2,5-million of the many millions of AIDS-infected
people in SA also are co-infected with TB.
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- The death rate in SA from these twin-epidemics now is
so high that at least two cities -- Durban and Cape Town -- have run
out of cemetery space for empoverished black residents -- at least five
years earlier than had been anticipated. In Cape Town, some cemeteries
are now burying the dead in water-logged soil, while others are carrying
out duplication-burials, stacking the dead on top of each other or in upright
coffins.
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- The cemeteries of the giant townships of Khayelitsha
and Gugulethu near Cape Town -- which have the highest infection rates
-- both are full and its residents now have to travel as far afield as
Atlantis some 30 kilometres to the north to bury their dead. Cremation
is no option: black South Africans traditionally do not cremate their dead
due to their traditional forefather-veneration cults.
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- The nutrition study was chaired by Professor Barry Mendelow
of Wits University and the National Health Laboratory Service, and included
Dr Mohamed Ali Dhansay of the Medical Research Council, Dr Clive Gray of
the National Institute for Communicable Diseases and Dr Helen Rees and
Dr Francois Venter of the Reproductive Health and HIV-AIDS Research Unit
in Johannesburg.
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- The 300-page report, released on Wednesday, follows a
study by a 15-member panel of the Academy of Science of South Africa, which
started in 2005. The scientists "found no evidence (for the ongoing
claims by its recalcitrant Minister of Health) that healthier eating is
any substitute for correctly-used medical drugs", said its chief operations
officer, Dr Xola Mati.It is likely to contribute to the widespread calls
for the firing of Health Minister Manto Tshabalala-Msimang.
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- The minister no longer publicly rules out the use of
antiretroviral medication to treat victims of AIDS as she used to do in
the past. However, she is still primarily known - and widely criticised
- for her strong over-emphasis on nutrition in battling it.
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- This has contributed to the ongoing conflict between
the minister, health professionals, Aids activists and opposition parties."One
of our most important findings has been that nutrition is important for
general health, but is not sufficient to contain either the HIV and Aids
or the tuberculosis epidemic," said panel member Dr Dan Ncayiyana,
editor of the South African Medical Journal.
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- "The controversies about nutrition have been harmful,"
said the panel of scientists.
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- They said the debate on the impact of nutrition on immunity,
particularly in relation to the "two major concurrent epidemics"
of HIV infection plus TB, had resulted in "serious differences"
in the approach to public policy dealing with the impact of these diseases.
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- The minister of health received a copy of the report
two weeks ago - as has the entire government executive council. She
has yet to respond to it publicly.The entire report can be read on http://</outgoing.php3?URL_to=http://www.assaf.org.za./>www.assaf.org.za
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