Re: Anti Retroviral Therapy in resource poor settings

[Guest guest]

There is a simple and cost effective answer to this question and that is that

for every positive person who is already tested they should be thoroughly

examined for O.I's and gut bugs that can interfere with nutrient absorbtion and

for all those problems to be eliminated.

Of course it would be good to have some base line data about viral load and CD4

counts only to see whether these holistic treatment options can be valuable but

whether or not, If it is suspected that cd4 is below 200, prophylaxis should be

commenced immediately, but only after explaining what prophylaxis actually means

and what it seeks to achieve in the minds of the positive person. It should be

daily and it will regulate the onset of severe illnesses that can cause death,

but it won't happen without some other initiatives around hygiene and nutrition.

And the cost to India is negligible if only there were more dedicated doctors to

carry this through.

Not everyone will need ART's, but some will before they fall below the level

where immune recovery is impossible and that is not just one set of numbers.

For those who know they can't afford a lifetime of treatment they should not

begin at all and they should certainly be clear that once started it is a

lifetime treatment until a cure is found so the sale of family assets is

problematic.

Once the number of those whose access to ART's becomes imperative additional

lobbying should begin. We have been doing some work in Jaipur that suggests that

the costs of ART's at a subsidised price could well offset the alternative

losses in GNP and overall employment skill losses in all classes of the affected

which includes those of workforce age between the ages of 15 and 49.

These are my hasty comments to this thread in the internet cafe time that my

visit to India have thrust upon me.

Geoffrey

E-mail:gheaviside@...