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The Aids Programme In Zambia Reported As A Success

Leaders of the AIDS treatment program in Lusaka, Zambia, have explained that the programme is working well and has saved many lives in its first two years.//

The leaders made their report on Sunday at the opening of the 16th International AIDS Conference in Toronto. They explained that their new approach has proved the general thought that it is simply not possible to provide sophisticated AIDS care to patients in the poorest of countries wrong.

Dr. Jeff Stringer of the University of Alabama at Birmingham told at the conference, that contrary to predictions by many, patients took their pills regularly, came to clinics for follow-up checks and have survived. Further explaining that the survival rates could be compare to those seen in the developed world, Stringer said, 'The majority of patients that we started on therapy, had they not gained access, would have died.'

He explained that his team had treated more than 16,000 patients for around 18 months between April 2004 and November 2005, had had tested their blood, giving them the drug cocktails that could suppress the AIDS virus. He said, 'We use any drugs we can get our hands on.' The doctors had obtained their 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 explained that initially they saw an estimated 21,755 patients at clinics in Lusaka, which is the densely populated Zambian capital where an estimated 22% of adults are reportedly infected with HIV. They further explained that among those, around 16,000 were given HIV drugs, while 5,500 were considered not ready for different reasons but were watched closely.

Stringer reported at the conference that among those who were treated, 1,142 died and 3,400 did not return for appointments, and as of November, 11,591 were alive. Of those not treated, 192 died, 2,149 are alive and the rest coul d not be accounted for. He further explained that most of those who die, around 792, had met their end within 90 days of the programme having started, mainly as they were already too sick.

Stringer said, 'In our setting (the problem is) actually getting the patients to come in before they are deathly ill. They arrive literally in wheelbarrows, which is the Zambian equivalent of an ambulance.' He said that those who died were usually very thin, anemic, and infected with diseases such as tuberculosis.

In a special report in the Journal of the American Medical Association, timed to coincide with the conference, Stringers team had announced that after around 90 days the death rates had dropped considerably, and that they were now treating more than 30,000 patients.

Attributing their success to four key 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. Stringer said, that the patients are followed carefully and those who failed to keep appointments were tracked down and encouraged to come back, explaining that the key to control AIDS virus would be on taking medications on time.

Stringer had also mentioned that this and other; such smaller studies have clearly shown the approach can work in urban areas. He did mention that though in the rural areas there were a lesser availability for resources and fewer health workers, the patient follow-up is much more easier than the urban areas. Stringer said, '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.'


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