Irish doctors are set to make a significant contribution to one of the most important HIV/Aids initiatives in Africa. Iva Pocock reports.
Two Irish infectious disease experts are to join a team of medics at a state-of-the-art HIV/Aids clinic in Kampala, Uganda. Dr Ceppie Merry and Dr Peter Coakley, both founders of the HIV/Aids foundation, Realta, have already worked at the Infectious Diseases Institute in Makere University in Uganda. But from this month, they will be full-time, along with local doctors and medics from north America.
The purpose-built institute, which opened last October, is one of Africa's biggest HIV/Aids training centres. It also aims to treat 40,000 HIV/Aids patients per annum.
"The opening of the IDI clinic brings a much needed resource in which to carry out vital treatment of HIV and Aids," says Dr Merry, a consultant in infectious diseases at St. James's hospital. "It's a very exciting development."
As HIV/Aids treatment is lifelong, all patients attending the clinic must be able to either walk there, or afford transport to attend for treatment, explains Dr Merry.
Uganda, like many of its Sub-Saharan neighbours, is stricken by HIV/Aids - last year 78,000 people of a population of 25 million died from the disease, and just over half a million Ugandans are living with the virus.
However, a Ugandan government campaign, backed by strong political commitment has succeeded in reducing infection rates from 30 per cent to six per cent in a decade.
In addition to providing treatment, the institute will play a crucial role in training African physicians in HIV/Aids management techniques.
"Now for less than $1 per day you can save peoples' lives but what is needed is the skills to administer these treatments," Dr Merry says.
Since 2002 more than 250 physicians, nurses and other healthcare professionals from 13 African countries have received training from the IDI where it initially operated at a small clinic at Mulago Hospital.
These students can then play a vital role in treating the Aids/HIV epidemic which, according to Oxfam, is fuelled by poverty, conflict and inequality between women and men.
Sub-Saharan Africa is by far the world's worst-affected region. It has just over 10 per cent of the world's population, but is home to two-thirds of all people living with HIV, according to UNAIDS, the joint UN programme on HIV/Aids.
The Irish-based foundation, Realta, has already given anti-retroviral training to doctors in nine African countries and has now been invited by the Nigerian government to carry out such training programmes, explains Dr Merry, who is taking a three-year leave of absence to work in Uganda.
Dr Merry and Dr Coakley are particularly interested in establishing a pharmacology clinic at the Ugandan institute in order to research the efficacy of anti-retroviral drugs amongst Africans. To date such research has predominantly focused on the effects of such drugs on people living in the western world.
The Irish doctors are hoping to source funding for this work in optimising HIV treatments in Africa, but so far their only guaranteed salaries are from the Ugandan government. "We're looking for Irish funding to sustain the research," says Dr Coakley.
Their plans also include looking into the use of anti-retrovirals among children, an area into which there is very little research, as the majority of Western HIV/Aids patients are adults.
Another specific African problem which they hope to research is the interaction between anti-retroviral and TB medication.
A long-standing controversy over HIV/Aids treatment in developing countries, which has sparked vocal international campaigns, is the expense of patented anti-retroviral drugs produced by the world's largest pharmaceutical corporations, compared to generic drugs. The latter can cost less than €1 per day.
This led to confrontations at the biannual international Aids conference in Thailand last summer between HIV/Aids activists and the US government global Aids co-ordinator. In particular campaigners are critical of the President's Emergency Plan for Aids Relief which requires recipient countries to buy patented anti-retroviral drugs with donated funds. Some $14 billion has been committed over five years and is being channelled bilaterally to 15 countries.
Both generic and patented drugs will be used at the Infectious Diseases Institute in Uganda, which has been partly funded by the pharmaceutical company, Pfizer.
Dr Ceppie Merry will outline the work of doctors in Africa in future issues of the HealthSupplement by a way of an occasional letter from Uganda.