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"HIV
management"
The
Star (www.thestar.com.my)
(26/09/05)
ONE of the biggest obstacles in the battle against HIV/AIDS is the high cost
and scarcity of many essential drugs, especially in Africa and Asia.
Understandably, the poor will turn to low-cost remedies for HIV-related
illnesses.
In Uganda, there is one doctor for every 20,000 people. This compares with
one traditional health practitioner (THP) per 200 to 400 people. So it is
only inevitable that people suffering from AIDS should turn to THPs for
treatment.
“Traditional health practitioners can play an important role in delivering
an AIDS prevention message,’’ said Prof Gerard Bodeker from University of
Oxford Medical School, Britain.
Some THPs may be able to offer treatment for opportunistic infections.
Although there are concerns about unsafe practices and a growth in claims of
traditional cures for AIDS, the partnerships between the modern and
traditional health sectors can serve as the cornerstone for the building of
a comprehensive HIV/AIDS strategy,” said Prof Bodeker, who is also also
Adjunct Professor Epidemiology at Columbia University, United States.
He was speaking during the recently concluded Women’s Health & Asian
Traditional Medicine Conference held in Kuala Lumpur..
His research interests include the study of patterns of use of complementary
medicine in Britain and traditional medicine use in developing countries,
particularly for malaria and HIV/AIDS.
Prof Bodeker cited examples of collaborative AIDS programmes in many African
countries such as Malawi, Mozambique, Uganda, Senegal, Swaziland and Zambia.
Through the sharing of information and educational programmes in South
Africa, THPs have been able to provide correct HIV/AIDS advice as well as
demonstrations of condom use.
In Brazil, there is face-to-face educational intervention with THPs blending
traditional healing with scientific medicine. In China and other parts of
Asia, traditional Chinese medicine is used in HIV management.
Clinical trials are underway in Shanghai and Kunming, and studies are being
conducted on Qian-kun-nin, a Chinese herbal formulation considered to have
powerful medical properties which is being evaluated for its anti-HIV
effects.
At present, India has the second highest number of HIV cases in the world.
Prof Bodeker said it is expected to be the highest within the next five
years.
Some reports suggest that there may be more than two million folk
practitioners in rural India.
“If the South African training experience has any relevance to India, this
mass of practitioners has the potential to reach the population of India in
less than a year with HIV prevention messages,” he added.
He indicated that some plants in India known to inhibit HIV replication
include seeds of Arecha catechu (betel nut), and the bark or stem bark of
plants such as Eugenia jambolana and Terminalia arjuna.
Neem-based cream, which has been used as a contraceptive due to spermicidal
effects is also being investigated for its viricidal effects.
As an example of “local” management of HIV treatment by THPs, Prof Bodeker
cited the Gandeepam Programme which focuses on medicinal plant production,
sale and use.
Gandeepam, a non-governmental organisation, has been active in Tamil Nadu,
southern India, for 15 years. It offers low cost and accessible Siddha
medical treatment, especially to poor and rural families.
The Oxford University Global Initiative For Traditional Systems (GIFTS) of
Health, an international health policy collaborative which Prof Bodeker
chairs, has designed a model for randomised clinical trials of Siddha HIV
treatment together with Gandeepam Siddha medical personnel.
Gandeepam has been treating HIV patients according to Siddha guidelines and
local traditions for 12 years and refining HIV treatment for eight years.
To refine the treatment, Gandeepam has offered treatment to 200 people with
HIV free of charge.
“Siddha medical theory identifies three mind/body types – Vatha, Pitta and
Kapha. An individual’s mind/body type will tell the diagnosis and determine
the most effective treatment.
“All Siddha treatments, including those for HIV, are prescribed specifically
for an individual’s mind/body type,” explained Prof Bodeker.
Some of the main concerns raised in the programme are funding, and guarding
against false claims of the effectiveness or safety of traditional medicines
against HIV.
There is also reluctance by mainstream health workers and researchers to
accept traditional medicine and practices. Likewise, sometimes there is also
resistance from THPs participating in HIV prevention education, especially
when some of the practices are not in line with their cultural and religious
values.
“There will be many other challenges but if we exclude the traditional
sector from HIV control then we would be excluding the largest – and often
the most familiar and trusted – healthcare resource available in most
developing countries,” said Prof Bodeker.
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