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AFRICA: WHO conference focuses on nutrition and HIV/AIDS
PLUSNEWS 2005-04-15
As the global drive to provide anti-AIDS drugs to Africa's HIV-positive citizens gains momentum, antiretrovirals (ARVs) are now taking centre stage, overshadowing all other treatment efforts.
It has long been recognized that good nutrition is essential for
strengthening the immune systems of people living with HIV/AIDS, but
nutrition remains a source of confusion and controversy on the
continent. People living with HIV/AIDS have been swamped by a flood of
nutritional supplements, immune boosters and herbal remedies - some even
claiming to cure the disease. With little guidance on the impact of
multivitamins and supplements on the virus, and limited scientific
research into traditional and herbal medicines, the confusion has grown
deeper by the day. In South Africa, in particular, the issue of
nutrition has been marginalised by political debates that tend to frame
it as an alternative to ARV drugs.
A high-profile media campaign by the US-based Rath Foundation, claiming
that vitamins and nutrition therapy alone could prevent AIDS deaths, and
that ARVs were toxic, has fallen on fertile ground. The World Health
Organisation (WHO) held a four-day consultation with health experts in
South Africa's port city of Durban this week to look at the issues
around nutrition and HIV/AIDS. At the end of the meeting, a consensus
statement and recommendations for immediate action to improve the
nutrition and health of HIV-infected people in southern and east Africa
will be used to inform WHO's global strategy. Over the past few days,
however, it has become clear that many countries still have a long way
to go towards integrating nutrition into their HIV/AIDS programmes.
According to Dr Robert Mwadime, regional HIV/AIDS specialist for the
Food and Nutrition Technical Assistance Project (FANTA), most countries
were in the process of reviewing and developing policies on nutrition,
but this was still being done haphazardly. "There are still very
few plans and strategies on implementing these policies, and not enough
long-term commitment in terms of funds and technical assistance,"
he noted. Dan Raiten, a researcher with the National Institute of Child
Health at the US Department of Health and Human Services, said a close
relationship existed between food and ARVs. "ARVs are essential to
save lives and halt the spread of the epidemic, while food is essential
to all life." The challenge, he said, was to ensure that both
components were integrated into programmes providing long-term clinical
care for people living with the virus, including pregnant HIV-positive
women, and children living with, and orphaned by, HIV/AIDS.
The participants' statement at the end of the WHO meeting acknowledged
that "there is a need for national governments to have a very
strong political commitment on the positioning of nutrition, HIV and
AIDS at the national level". However, translating the scientific
evidence and policies into practical action remains difficult.
"There's been a lot of focus on policies, but nothing on what's
happening at the clinic level and the lessons learned there," Dr
Mickey Chopra from South Africa's Medical Research Council, told
PlusNews. During the meeting, Zambia's recently completed nutrition
guidelines were presented as a best practice example of a successful
plan of work for nutrition and HIV/AIDS.
But it was still unclear as to how this new policy would impact on the
influx of dodgy food products and nutrition supplements for HIV-positive
Zambians, Beatrice Kawana, a nutrition and AIDS focal person at Zambia's
Food and Nutrition Commission, told PlusNews. FANTA's Mwadime said not
much would be achieved without adequately trained staff. "We need
to be hiring more nutritionists and dieticians for our national AIDS
programmes, and creating model sites to show us how it's done," he
pointed out. With Africa in the treatment era, all the participants
agreed that integrating nutrition into HIV/AIDS programmes, particularly
treatment guidelines, was crucial.
Nigel Rollins, chair of the WHO technical advisory group on nutrition
and AIDS, called for the participants to "recover the lost time and
implement what we already know works".
(Source: PLUSNEWS, April 13, 2005)
 
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