African
Journals Online
The Zimbabwe Science News
Volume 35 (1+ 2) 2001
ABSTRACTS
A review of the HIV/AIDS situation in Zimbabwe
E. Gomo and S.K. Chandiwana
Blair Research Institute, Ministry of Health and Child Welfare, P O Box CY 573, Causeway, Harare. Email
:[email protected] ; [email protected]
Abstract
Human immunodeficiency virus (HIV) infections continue to spread at alarming rates, particularly in developing countries. The United Nations AIDS organization (UNAIDS) and World Health Organization (WHO) estimate that nearly 40 million people including adults (37.2 million) and children (2.7 million) worldwide were living with HIV by end of 2001, more than 70% of these in the developing world. Not surprisingly, the developing world accounts for over 95% of the estimated 3 million AIDS related deaths in 2001, largely among young adults who would normally be in their peak productive and reproductive years. Sub-Saharan Africa, the global epicenter of the pandemic, harbours over 70% of the people living with AIDS and accounts for nearly 80% of all AIDS-related deaths. It is estimated that almost 90% of all new infections in children under 15 years in 2001 occurred in Africa and that over 95% of all AIDS orphans are also in Africa. All this against the backdrop of a population that is only a tenth of the world's population. Southern African countries are the hardest hit in the world with respect to HIV/AIDS. In Zimbabwe, in particular, HIV sentinel surveillance through antenatal screening shows an increasing prevalence in both urban and rural areas. Zimbabwe, like other southern African countries, unfortunately harbours the virulent HIV-1 subtype C. This paper examines the current epidemiology of HIV/AIDS in Zimbabwe and looks at the demographic, social, and economic impact of the disease. The Zimbabwe response to the epidemic is discussed in terms of AIDS and STD policy, information, education and communication, condom availability, mother to child transmission, care, support and research.
Why has HIV spread so rapidly in Southern Africa?
S.K. Chandiwana
Blair Research Institute, Ministry of Health and Child Welfare, P O Box CY 573, Causeway, Harare. Email
: [email protected]
Abstract
Zimbabwe, like most countries in southern Africa, has one of the most devastating HIV epidemics seen to date According to available information, HIV is thought to have begun to spread rapidly within Zimbabwe in the mid-1980s with adult HIV prevalence reaching approximately 9% by 1990. The most recent published sentinel surveillance figures for Zimbabwe suggest that the national level of HIV prevalence among women attending antenatal clinics increased from 29% in 1997 to 35% in 2000. Even after adjusting for likely selection bias in sentinel sites, it was estimated that HIV prevalence amongst adults in Zimbabwe had increased from 25% to 30% during the intervening 3-year period. In trying to explain this trend most analysts have focused on behavioural and sociological aspects of why HIV has spread so rapidly in southern Africa. These include studies on patterns of infection and demographic impact by socio-demographic risk group and relative levels of HIV infection among more and less educated people. A comprehensive review of HIV/AIDS in southern Africa has recently been produced covering a broad perspective of the problem, ranging from epidemiology, psychosocial and cultural determinants, government policies and country level experiences. This paper examines social and biomedical perspectives in an attempt to provide plausible explanations of the rapid spread of HIV in southern Africa.
Effect of traditional herbs on immunological and virological markers of HIV disease progression
E. Gomo1, S. K. Chandiwana1, A.S. Latif2, M. Sebit3, F Makoni1,
P.D. Ndhlovu1 and J. Vushe4
1 Blair Research Institute, Ministry of Health and Child Welfare, P.O.Box CY573, Causeway, Harare, Zimbabwe. E.Gomo: E-mail
[email protected]
2 Dept. of Medicine, University of Zimbabwe Medical School, Box A178, Avondale,Harare
2 Dept. of Psychiatry, University of Zimbabwe Medical School, Box A178, Avondale,Harare
3 House 1030, Muripisa Road, Unit G, Seke, Chitungwiza, Zimbabwe
Abstract
HIV/AIDS is proving to be the most costly disease in recent history to prevent, control and manage. Current anti-retroviral drugs, beset with problems of cost, availability, compliance and viral resistance, are unlikely to be available to most developing countries at a public health level. A large proportion of the Zimbabwean population still consult traditional medical practitioners and this provides alternative and relatively cheaper management of HIV/AIDS. However, the effect of traditional herbs on the HIV disease has not been scientifically documented. Thus a study was carried out to assess the effect of traditional herbs on clinical and biological markers of HIV disease progression, by comparing these outcome variables in HIV/AIDS patients on traditional herbs (Phytotherapy, PT) and those on conventional medical care (CMC) alone. Of 150 adult HIV/AIDS patients (76 males; 74 females), 115 volunteered for PT and 35 for CMC. Patients were followed up every 3 months for 12 months. Patients on PT showed significant increases in clinical condition at all follow up levels compared to those on CMC. Immunological status (measured as CD4 counts) increased in both groups but more so in patients on PT. Patients whose immune system was severely compromised(CD4 counts <200 cells µL-1) responded better to both treatments than less compromised patients (CD4 counts >200 cells µL-1). There were no significant changes in the amount of virus in blood of patients on PT or CMC. The findings suggest that traditional herbs improve clinical and immunological status and hence they have a role to play in the management of HIV/AIDS patients and add value to standard CMC.
The Manicaland HIV/STD Prevention Project:
studies on HIV transmission, impact and control in
rural Zimbabwe
S.Gregson1 and S.K. Chandiwana2
1 Biomedical Research and Training Institute, P.O. Box CY1753, University of Zimbabwe Campus, Harare and Imperial College Faculty of Medicine, St. Mary’s Campus, Norfolk Place, LondonW2 1PG.
Email: [email protected]
2 Blair Research Institute, Ministry of Health and Child Welfare, P O Box CY 573, Causeway, Harare.
Abstract
The Manicaland HIV/STD Prevention Project is a major collaborative scientific research initiative that has been underway in rural areas of eastern Zimbabwe since the early 1990s. The principal collaborating institutions in the project have been the Biomedical Research and Training Institute and the Blair Research Institute, each based in Harare, Family AIDS Caring Trust, based in Mutare and Rusape, and the Department of Infectious Disease Epidemiology at Imperial College in London (formerly based at the University of Oxford). In its early years, the primary aim of the project was to assess the severity of the HIV epidemic in rural areas of Zimbabwe. Two rural areas in Manicaland were chosen as the initial sites for the study on the basis that one (Honde Valley in Mutasa District) was relatively accessible by tarred road to urban centres whilst the other (Rusitu Valley in Chimanimani District) had a similar cultural and socio-economic background but lay in one of the most remote corners of the country. In this article, we describe the main findings of the Manicaland HIV/STD Prevention Project to date. In the process, we highlight some of the principal challenges faced in the search for effective measures to control the HIV epidemic. We also emphasise the need to identify and develop HIV control strategies that reflect spatial and temporal variations in the local socio-economic and epidemiological context.
Zimbabwean capacity for HIV/AIDS research:
current situation and new demands
S.n Chandiwana1, S.Gregson2 , E. Gomo1, E.W.Marowa3 and D.Matanhire3
1 Blair Research Institute, Ministry of Health and Child Welfare, P O Box CY 573, Causeway, Harare Email:
[email protected]
2 Biomedical Research and Training Institute, P.O. Box CY1753, Causeway, Harare and Imperial College Faculty of Medicine, St. Mary’s Campus, Norfolk Place, London W2 1PG.
3 National AIDS Council, P O Box MP 1311, Mt Pleasant, Harare
Abstract
It is now almost 20 years since the AIDS virus was first identified and considerable energy and resources have been invested in attempts to control the HIV epidemic. However, the epidemic has continued unabated and many people in Zimbabwe and other sub-Saharan African countries continue to succumb to the disease. This paper describes the establishment and function of the National AIDS Council (NAC) of Zimbabwe. The NAC mobilises national funds through an AIDS levy to support local HIV/AIDS activities. The NAC would like to ensure that the HIV/AIDS activities it supports are based on scientific evidence. The aim is to enhance effectiveness of funds from the NAC, through properly targeted evidence-based socio-behavioural interventions to prevent further spread of the virus particularly among young people. The NAC therefore funds projects by local non-governmental organizations (NGOs), public sector and private organisations through a district based approach. Local researchers could play an important role in monitoring and evaluating these projects to ensure effectiveness and value for money and to make certain that maximum resources reach the intended beneficiaries. The paper also describes the ZIMAIDS Information Portal initiative. This portal will provide information on HIV/AIDS for the utilisation of different stakeholders, people living with HIV, policy makers, health care givers, research workers and the public. The purpose is to deliver a comprehensive and heterogeneous collection of information sources through a secure access layer. The information system will be available in many versions— online, offline version, voice and print. To close the digital gap between urban and rural areas in Zimbabwe, this initiative will establish at district and eventually at village level, information way stations, which are equipped to access health information electronically.
A framework for HIV/AIDS vaccine research in Zimbabwe
E. Gomo and S.K. Chandiwana
Blair Research Institute, Ministry of Health and Child Welfare, P.O.Box CY 573, Causeway, Harare . Email
[email protected]
Abstract
Two decades into the HIV pandemic, sub-Saharan Africa continues to bear a disproportionate burden of the HIV infections. Whilst most countries in sub-Saharan Africa have established National AIDS Control Programmes, interventions such as behaviour modification, condom promotion and treatment of other sexually transmitted infections have not been sufficient to significantly reduce the incidence of HIV infections. Zimbabwe has not been spared by the epidemic, and currently records one of the highest HIV prevalence rates in the world. Whilst efforts to promote known interventions for HIV prevention must be strengthened, preventive HIV vaccines remain the best long-term solution to control the HIV pandemic. However the search for an HIV/AIDS vaccine has been dogged by serious scientific, ethical and operational challenges. Firstly, there currently is no data that unequivocally establishes the existence of sterile immunity against HIV in humans. Secondly, HIV/AIDS vaccine development has been hindered by the extensive variation of HIV, with the various types and subtypes being found in different geographical locations. This genetic variation poses serious challenges to vaccine development. It is not clear whether a vaccine based on antigens of one subtype can protect against a different subtype. This cross protection is essential since the various subtypes are now widely spread all over the world. Operationally, most developing countries where the burden of HIV is highest, lack the capacity to participate effectively in vaccine development, due not only to lack of expertise but more importantly the financial and technical resources for project management, process development, scaling-up and manufacturing issues for vaccine research and development. Furthermore, there are no harmonized international ethical guidelines and regulations for HIV/AIDS vaccine development including requirements for entry into clinical trial, progression through advancing stages of clinical trials, and licensure. In recognition of these challenges, the international scientific community (International AIDS Vaccine Initiative) and other stakeholders have accelerated global vaccine efforts to search for HIV/AIDS vaccine. Although several African countries have participated in international collaborative projects, including HIV prevention trials, infrastructures and capabilities to conduct HIV vaccine trials are virtually non-existent on the continent. It is also recognised that the proactive participation and effective coordination of African scientists, institutions and the community is necessary in order to ensure that appropriate HIV vaccines are developed for Africa. In recognition of this need, African scientists convened a consultative meeting in Kenya under the auspices of the Joint United Nations Programme on AIDS (UNAIDS) to discuss strategies to accelerate the development of HIV vaccines in Africa. This paper presents a framework, based on the recommendations of the Nairobi consultative meeting, on an African Strategy for an HIV Vaccine, that could be adopted for the implementation of the various facets of HIV vaccine research in Zimbabwe.
The Zimbabwe Academic and Research Network ZARNet http://www.zarnet.ac.zw
In 1998, the Government of Zimbabwe with the assistance of the United Nations Development Programme (UNDP) initiated the establishment of the Zimbabwe Academic and Research Network (ZARNet). In 2000, the network became functional. ZARNet is operating under the auspices of the Research Council of Zimbabwe (RCZ). RCZ is keen to promote access to information and to electronic communications facilities as these are essential for the proper functioning of research and development and for further development of scientific, social and research capabilities in Zimbabwe. ZARNet’s primary objective is to provide connectivity and inter-linkages between various academic, educational, scientific and other institutions nationally and internationally through wide area networks and the Internet. ZARNet has also indicated that it can directly strengthen data communication and information infrastructures in Zimbabwe, permitting research and development, academic, educational, scientific institutions and non-governmental organizations to access external databases, global data and electronic mail networks and computers operated by other institutions through internet facilities. ZARNet is able to provide Internet connectivity to urban and rural schools that would not otherwise afford the services provided by commercial Internet Service Providers (ISPs). Regional/provincial nodes will be set up to encourage the use and development of information and communication technologies at affordable rates within various communities countrywide. Users from outside Zimbabwe will also be able to access uniquely Zimbabwean information centres and ZARNet provides a medium for the interchange of electronic mail between Zimbabwean communities and the rest of the world.
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