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AIDS Fighters Hear Good News From Haiti

The Miami Herald
2004-03-29
Section: Front
Edition: Final
Page: 5A

Despite the stealing of ambulances by thugs during the recent violence, despite experts' saying AIDS cannot be fought effectively in poor, rural settings, prominent AIDS fighters said Sunday there's good news from Haiti.

While AIDS still claims 30,000 lives a year in Haiti and has left 200,000 children orphaned, innovative treatment and prevention programs have cut Haiti's HIV rate by 50 percent since 1993, Dr. Jean Pape, of the Cornell Weill Medical College and director of Les Centres Gheskio in Haiti, told the Naitonal HIV/AIDS Update Conference in Miami on Sunday. A HUMAN RIGHT

Praising those efforts, pioneering Harvard University medical anthropologist Dr. Paul Farmer, co-founder of Clinique Bon Sauveur in the rural village of Thomonde, called for a worldwide shift looking at AIDS prevention and treatment as a human right, not a tool delivered or withheld on the basis of cost effectiveness.

Citing Universal Declaration of Human Rights' articles declaring the human right to health, well-being and adequate medical care, Farmer criticized articles in the medical journal Lancet and elsewhere arguing that prevention is more cost-effective than treating infected patients with antiretroviral drugs.

``We don't know how much it costs us as human beings not to have equity, to have a situation in which some people have access to drugs and others do not. Problems can be overcome. We know we're not going to meet the goal, but it doesn't mean we should stop trying.''

With funding from the U.S. government and from the private group Project MediShare, clinics in Haiti over the past 10 years have cut mother-to-infant transmission of HIV from 22 percent to 4 percent, have increased HIV screening seven-fold and brought condom use from almost nothing to 15 million in 2003, Pape said.

The symposium was sponsored by the Green Family Foundation Initiative in Pediatric Infectious Disease & Immunology and international Health, which has granted $2.5 million to the University of Miami Department of Pediatrics and Project MediShare, a Miami-based clinic providing healthcare in rural Thomonde, Haiti. The weekend conference is sponsored by the American Foundation for AIDS Research.

A similar human rights approach in Brazil has cut AIDS deaths by 50 percent to 90,000 a year since 1996, said Dr. Roberto Brant Campos, deputy director HIV/AIDS programs in that country's Ministry of Health. Since 1988, the Brazilian Constitution has declared healthcare to be every person's right and the government's obligation, he said.

OUTREACH CAMPAIGNS

Brazil followed up with massive outreach campaigns to army inductees, sex workers, drug users, prisoners - even distributing free condoms to teens in all public and private high schools, he said.

``I thought macho Latin American males would never use condoms,'' said Dr. Fernando Zacarias, director of HIV/AIDS programs for the Pan American Health Organization. But he said condom use increased from 4 percent of all males having their first sex in 1986 to 48 percent in 1999.

Serious problems remain, especially in Haiti.

Farmer's clinic lost four ambulances to armed thugs during the recent political upheavals.

``Our workers were scared,'' he said. ``But not a single worker failed to show up at work, and not a single patient missed a dose of medicine. I give them great credit for that.''

PROGRAM UPDATE

Today at the National HIV/AIDS Update Conference: A report on AIDS in Africa, a plenary session on AIDS in youth, adolescents and seniors, and the screening of a new AIDS-fighting film, A Closer Walk, starring Glenn Close and Will Smith. The conference ends Tuesday. Sessions are not open to the public, but a town hall meeting, ``Speak out, Florida!'' is open to the public on Tuesday 12:45 to 2:45 p.m. at the Jasmine Room of the Hyatt Regency Hotel, 400 SE Second Ave, Miami.