An Irish doctor will today start a global campaign to combat AIDS/HIV and the proliferation of tobacco use in the developing world.
Dr Michael Boland, a Skibereen GP and director of the Postgraduate Resource Centre at the Irish College of General Practitioners, assumes the presidency of the World Organisation of Family Doctors (WONCA) at a ceremony today in Durban, South Africa.
He has four major goals for his presidency:
Assist developing nations set up family medicine services;
Tackle the devastating AIDS epidemic in Africa;
For WONCA to work closely with the World Health Organisation to prevent the proliferation of tobacco in underdeveloped countries;
Set global standards for the primary care management of cardiovascular disease and cancer.
Given the venue for WONCA 2001, Dr Boland sees the AIDS epidemic in Africa as a fitting priority. "The disease looks set to kill more people than both World Wars combined," he says, "especially if the trends in India and South Asia, which are lagging only a few years behind Africa, continue." At present the southern cone of Africa is home to 70 per cent of the world's AIDS patients. Twenty per cent of South Africa's adult population have the disease, the majority of whom are not aware of their diagnosis. Botswana's birth rate is likely to drop so precipitously due to AIDS in women of child-bearing age that the elderly will become the predominant group within 20 years.
Dr Boland welcomes the recent climbdown by the international pharmaceutical industry on the issue of generic AIDS drugs, but he warns this does not automatically mean the continent's HIV patients will now get treatment. "South Africa's Ministry of Health says it cannot even afford the much reduced non-patented drugs, so we need to look at ways of providing funding. I plan to lead WONCA into a coalition with the World Trade Organisation and other non-governmental organisations to fund the purchase of generic drugs for the people of Africa," he told The Irish Times.
He also questioned whether the pharmaceutical industry could be looked upon as a global one. "Ninety per cent of their products are sold in the West, producing 25 per cent annual profit increases. In order to maintain this growth, they are unlikely to shift their focus to the Third World." Tobacco control is the other key goal of his presidency. As chairman of the Office of Tobacco Control in the Republic, he fully endorses the WHO Framework Convention on Tobacco Control. "Tobacco use is not an issue which can be solved by doctors or health services alone. I hope to lobby governments to emphasise the need for tight sales regulation, incorporating high taxes on tobacco." Dr Boland is aware that tobacco companies are focusing on teenagers, especially in developing countries. "Once they have hooked 14- to 16-year-olds on tobacco products, the majority will be unable to quit," he says.
He has been building contacts with family doctor organisations in Africa and South America, and he is hopeful that a bloc of seven or eight Latin American countries will join WONCA during his presidency. The former Soviet Union is another target area, where WONCA would hope to assist emerging countries by facilitating contact with colleges of general practice. These would then provide valuable guidance in developing primary care health services.