Concerns that children born with HIV and are denied access to proper pediatric Anti-retroviral (ARVs) drugs has been voiced by those involved in the provision of the life saving drugs to children.
Dr Edwin Libamba, head of HIV and AIDS department in the Ministry of Health blamed it on what he said was "lack of user friendly pediatrics formulation when it comes to ARVS."
"The other problem is that we have to wait until 18 months before we can diagnose HIV in pediatrics using the antibodies test that we have," he however added that the current treatment used for children needing ARVs was having positive results. " I would like to inform you that the research that we had in this country is encouraging. We can split the tablets that we use for adults and use them for children."
Since the availability of ARVs, the country has had no special anti-retroviral treatment for children due to financial constraints.
The situation had taken a turn for the better since the American Abbott Fund, Baylor College and the Government opened the country's first pediatric HIV clinic in the capital Lilongwe in December last year.
Executive Director of the Baylor-Abbott Fund Children's Clinical centre of Excellence Dr Peter Kazembe said the introduction of the clinic in the country would go a long way in addressing the suffering children.
"A lot of children were dying unnecessarily because of lack of treatment," says Dr Kazembe.
According to Dr Kazembe, the Clinic staffed with about13 doctors targets to treat 1,300 children with HIV by the end of the year.
Minister of Health Marjorie Ngaunje before the clinic was opened, had said the country had no capacity to address the complex needs of the thousands of children with HIV.
"I'm happy that we can now expand our capability to treat our youngest and most vulnerable children," Ngaunje said.
About 14 per cent of the country's population of about 12 million people has the virus. Statistics say at least 60,000 Malawians living with HIV are on the national anti-retroviral treatment programme.
It is estimated that more than 83,000 children in the country are living with HIV.
Tuesday, 8 May 2007
Dilemma - Government, Faith Community - Daggers Drawn on Sex Education and Condom Use
At a time when government is mobilizing resources and appealing for concerted efforts aimed at finding effective alternatives to scale down the escalation of HIV and AIDS, there still remains the religions and faith beliefs that need to be ironed out in the promotion of condom use and sex education.
Despite overwhelming evidence in favour of it, the faith community still regard the practice of using condoms as protection against HIV/AIDS as a taboo and have said the condoms have pinprick size holes that let the virus through.
Despite the stand of the faithful the evidence in favour of sex education and condom use is too strong to permit religious taboo to prevent their use, particularly where HIV/AIDS, STI's and unwanted pregnancies are prevalent
National AIDS Commission (NAC) complained that their efforts in promoting condoms as a shield to help contain the spread of the disease are not bearing the much needed results because of a stand taken by some religious organisations that are in the forefront condemning condom use.
"Yes it is true that the use of condoms has received resistance from the faith community. We have had discussions with them (faith community) and indicated to them that we are not saying that condoms are 100% perfect," commented NAC Chairman Nicholas Chitimba. He pointed out that even the users are clearly told that condoms are not of maximum protection "but better use them than nothing."
"What we are saying is that among the weapons we have against HIV/AIDS, STIs and unwanted pregnancies, a condom is one of them and even if we are saying that condoms are 80% effective, better use them than nothing," Chitimba emphasised. " Yes there is perceived resistance from the faith groups based on religious beliefs but all in all, we are doing everything to make them understand and soften their stance."
However, Chitimba explained that it is interesting that though faith leaders do not come in the open to say condoms are effective in minimising the spread of HIV/AIDS and other related problems, they still admit that a lot of people fail to live up to expected standards when it comes to abstinence.
"Surprisingly they have admitted that indeed there are certain people who do not behave the way they should behave in terms of abstinence and if those individuals are in that sort of position, who are the faith groups to insist that they should not use condoms," he queried.
He said the option of using a condom is a human right issue and people should be left to make an individual decision to use or not to use a condom.
Chitimba advised those who failed to abstain from sex to make sure that they use some protection against HIV infection
"These religious groups will not let you use the condoms, they do not come in the open but if you are in a dangerous situation, always use a condom. It is an individual decision to use a condom or not."
Referring to the perceptions that condoms are promoting bad behaviour in terms of sex especially among the youth Chitimba challenged those who have the research evidence to expose it. "No let them show me research paper that shows that this is the case," he says bluntly.
"My own stand is that I would not deny people access to condoms. If indeed there are other means available on the market where people can protect themselves from getting infected with the virus, then I would encourage people to explore all those options," says Executive Director of Malawi Network of Religious Leaders living or personally infected by HIV/AIDS (MANERELA) Reverend Father MacDonald Sembereka. "And without encouraging and compromising one's faith, I would encourage them to use the best option that we have so far which is basically a condom."
He explained that if the role of faith community is to preserve human life and if there is enough data that condoms are also measures for protecting people's lives, people should explore it.
"Basically the role of faith community is to preserve human life which emanates from the fact that life is sanctity and as such we have to protect it.
"If condoms are at all measures for protecting life and there is enough data to substantiate the fact that it is not to the contrary as the faith community puts it, then I would not have any problem," he said.
Father Sembereka said he is very aware that what is preached to the faithful every Sunday will make people abstain from casual sex "and it would be foolish to indulge in unprotected sex which on most occasions leads to HIV/AIDS, STIs and unwanted pregnancies and on the over-all, untimely death."
"I would not have problems if people use condoms as long as they use them within the defined context. Of course I know pretty well there are people we preach to but very often they still go out and have sex. They will be foolish if they do it without protecting themselves," emphasised Father Sembereka.
He said he does not subscribe to ideologies that condoms promote promiscuity.
"No, for a long time people have been promiscuous not that the advent of condoms has escalated the levels of promiscuity. I don't think there is a research to that effect. We are aware of incidences where people have condoms right in their pockets and they do not use them when having sex and we are mindful of the fact that within the faith community, we are talking of people who have the virus. Do we encourage them to abstain, can we encourage married couples to abstain, can we encourage people who are staying together to abstain, what are the option that we give them?" Father Sembereka wondered.
With regard to condom use and sex education, maintaining an open dialogue and exploring arguments objectively rather than through heated debates may help everyone to review the evidence and consider their stand and come up with a compromise that will benefit people in all walks of life.
Surely the aim of everyone is to see a reduction in teenage and unwanted pregnancies and reduced infection of HIV/AIDS and STIs within the nation.
Despite overwhelming evidence in favour of it, the faith community still regard the practice of using condoms as protection against HIV/AIDS as a taboo and have said the condoms have pinprick size holes that let the virus through.
Despite the stand of the faithful the evidence in favour of sex education and condom use is too strong to permit religious taboo to prevent their use, particularly where HIV/AIDS, STI's and unwanted pregnancies are prevalent
National AIDS Commission (NAC) complained that their efforts in promoting condoms as a shield to help contain the spread of the disease are not bearing the much needed results because of a stand taken by some religious organisations that are in the forefront condemning condom use.
"Yes it is true that the use of condoms has received resistance from the faith community. We have had discussions with them (faith community) and indicated to them that we are not saying that condoms are 100% perfect," commented NAC Chairman Nicholas Chitimba. He pointed out that even the users are clearly told that condoms are not of maximum protection "but better use them than nothing."
"What we are saying is that among the weapons we have against HIV/AIDS, STIs and unwanted pregnancies, a condom is one of them and even if we are saying that condoms are 80% effective, better use them than nothing," Chitimba emphasised. " Yes there is perceived resistance from the faith groups based on religious beliefs but all in all, we are doing everything to make them understand and soften their stance."
However, Chitimba explained that it is interesting that though faith leaders do not come in the open to say condoms are effective in minimising the spread of HIV/AIDS and other related problems, they still admit that a lot of people fail to live up to expected standards when it comes to abstinence.
"Surprisingly they have admitted that indeed there are certain people who do not behave the way they should behave in terms of abstinence and if those individuals are in that sort of position, who are the faith groups to insist that they should not use condoms," he queried.
He said the option of using a condom is a human right issue and people should be left to make an individual decision to use or not to use a condom.
Chitimba advised those who failed to abstain from sex to make sure that they use some protection against HIV infection
"These religious groups will not let you use the condoms, they do not come in the open but if you are in a dangerous situation, always use a condom. It is an individual decision to use a condom or not."
Referring to the perceptions that condoms are promoting bad behaviour in terms of sex especially among the youth Chitimba challenged those who have the research evidence to expose it. "No let them show me research paper that shows that this is the case," he says bluntly.
"My own stand is that I would not deny people access to condoms. If indeed there are other means available on the market where people can protect themselves from getting infected with the virus, then I would encourage people to explore all those options," says Executive Director of Malawi Network of Religious Leaders living or personally infected by HIV/AIDS (MANERELA) Reverend Father MacDonald Sembereka. "And without encouraging and compromising one's faith, I would encourage them to use the best option that we have so far which is basically a condom."
He explained that if the role of faith community is to preserve human life and if there is enough data that condoms are also measures for protecting people's lives, people should explore it.
"Basically the role of faith community is to preserve human life which emanates from the fact that life is sanctity and as such we have to protect it.
"If condoms are at all measures for protecting life and there is enough data to substantiate the fact that it is not to the contrary as the faith community puts it, then I would not have any problem," he said.
Father Sembereka said he is very aware that what is preached to the faithful every Sunday will make people abstain from casual sex "and it would be foolish to indulge in unprotected sex which on most occasions leads to HIV/AIDS, STIs and unwanted pregnancies and on the over-all, untimely death."
"I would not have problems if people use condoms as long as they use them within the defined context. Of course I know pretty well there are people we preach to but very often they still go out and have sex. They will be foolish if they do it without protecting themselves," emphasised Father Sembereka.
He said he does not subscribe to ideologies that condoms promote promiscuity.
"No, for a long time people have been promiscuous not that the advent of condoms has escalated the levels of promiscuity. I don't think there is a research to that effect. We are aware of incidences where people have condoms right in their pockets and they do not use them when having sex and we are mindful of the fact that within the faith community, we are talking of people who have the virus. Do we encourage them to abstain, can we encourage married couples to abstain, can we encourage people who are staying together to abstain, what are the option that we give them?" Father Sembereka wondered.
With regard to condom use and sex education, maintaining an open dialogue and exploring arguments objectively rather than through heated debates may help everyone to review the evidence and consider their stand and come up with a compromise that will benefit people in all walks of life.
Surely the aim of everyone is to see a reduction in teenage and unwanted pregnancies and reduced infection of HIV/AIDS and STIs within the nation.
Transport Problems Contributing to High Maternal Mortality Rate
At only 13, Zione (not real name) has a very daunting and demanding responsibility. She looks after her two younger sisters. She bathes them, prepare them food and does all the household chores in the home to make their lives bearable.
Little Zione's 'workload' and responsibilities are large when equated with her tender age. The role she has in her home would have been her mother's role if only she were alive.
If only her mother was alive, Zione herself could have been taken care of together with her sisters. Zione would have been in school. The mother would have been there for her children all the time. She would have tried her best to give the children their basic and essential needs.
Unfortunately for Zione and many other children in the country, her mother died when she was very young. She died soon after giving birth to her third child, Zione's sister who is now a year old. The hospital personnel attributed her death to her late arrival at the hospital.
The hospital was 'sure' that the mother would have survived had she arrived there earlier.
"Life has not been the same since my mother's death. My father left soon after her death and married another woman from a nieghbouring village. We had no option but stay with my grandmother who is very old," laments Zione who had to drop out of school to look after her sisters.
To make matters worse, her father has not been providing any financial or material assistance to the children despite him having a job as a security guard at a nearby school.
The death of Zione's mother is but one of the many pregnancy related deaths the country continues to experience. Malawi is said to have one of the highest maternal mortality rates in the continent.
As Minister of Health, Marjorie Ngaunje puts it; Malawi's staggering maternal mortality ratio of 984/100,000 live births is still unacceptably too high."
In simple terms, out of every 100,000 mothers who give birth, 984 of them die to pregnancy related complications. These deaths result into a lot of problems in the homes considering the great role that mothers play in their homes and in society as a whole.
"Death of a pregnant woman or mother in any family is a catastrophe. I am saying this because such a death, deprives the household of vital income as well as love and affection," says Ngaunje.
She says loss of women's lives has a direct effect on family structure and it also affects society as a whole since it has to cope with orphaned children who are left behind.
The Minister says it is sad to note that one of the reasons why the country still has a high maternal mortality ratio is failure to bring patients to the appropriate health facilities in time.
She explains that this normally happens due to transport problems to ferry the patient to the health facilities.
Ngaunje says it is the wish of government through her Ministry to ensure that measures are put in place to save the situation.
"It is therefore important that everything possible should be done to save the lives of our beloved mothers who are key to new generations in our society," says the minister.
She says that her ministry's goal is to ensure that maternity cases should be referred from Health Centres to District Hospitals or from District Hospitals to Central Hospitals in time before complications arise.
Ngaunje adds that government and its development partners are sparing no effort to bring in interventions aimed at ensuring a transport system that will move referral patients from one facility level to another.
Speedy handling of clients through the provision of transport in good time is one of the strategies in the road map that has been recently launched by the ministry.
The road map is yet another move by my ministry towards reducing the high maternal mortality ratio. The road map stipulates several strategies which will guide policy makers, programme managers, development partners, the civil society and other stakeholders in their support to government's efforts towards accelerated attainment of the millennium development goals related to maternal and new born health," says Ngaunje.
The ministry has of late encouraged the use of motor cycle ambulances as an intervention in the ambulatory services.
The motor cycle ambulances are indeed proving to be effective to the communities especially those in the rural areas where most of the roads are really in bad shape.
Little Zione's 'workload' and responsibilities are large when equated with her tender age. The role she has in her home would have been her mother's role if only she were alive.
If only her mother was alive, Zione herself could have been taken care of together with her sisters. Zione would have been in school. The mother would have been there for her children all the time. She would have tried her best to give the children their basic and essential needs.
Unfortunately for Zione and many other children in the country, her mother died when she was very young. She died soon after giving birth to her third child, Zione's sister who is now a year old. The hospital personnel attributed her death to her late arrival at the hospital.
The hospital was 'sure' that the mother would have survived had she arrived there earlier.
"Life has not been the same since my mother's death. My father left soon after her death and married another woman from a nieghbouring village. We had no option but stay with my grandmother who is very old," laments Zione who had to drop out of school to look after her sisters.
To make matters worse, her father has not been providing any financial or material assistance to the children despite him having a job as a security guard at a nearby school.
The death of Zione's mother is but one of the many pregnancy related deaths the country continues to experience. Malawi is said to have one of the highest maternal mortality rates in the continent.
As Minister of Health, Marjorie Ngaunje puts it; Malawi's staggering maternal mortality ratio of 984/100,000 live births is still unacceptably too high."
In simple terms, out of every 100,000 mothers who give birth, 984 of them die to pregnancy related complications. These deaths result into a lot of problems in the homes considering the great role that mothers play in their homes and in society as a whole.
"Death of a pregnant woman or mother in any family is a catastrophe. I am saying this because such a death, deprives the household of vital income as well as love and affection," says Ngaunje.
She says loss of women's lives has a direct effect on family structure and it also affects society as a whole since it has to cope with orphaned children who are left behind.
The Minister says it is sad to note that one of the reasons why the country still has a high maternal mortality ratio is failure to bring patients to the appropriate health facilities in time.
She explains that this normally happens due to transport problems to ferry the patient to the health facilities.
Ngaunje says it is the wish of government through her Ministry to ensure that measures are put in place to save the situation.
"It is therefore important that everything possible should be done to save the lives of our beloved mothers who are key to new generations in our society," says the minister.
She says that her ministry's goal is to ensure that maternity cases should be referred from Health Centres to District Hospitals or from District Hospitals to Central Hospitals in time before complications arise.
Ngaunje adds that government and its development partners are sparing no effort to bring in interventions aimed at ensuring a transport system that will move referral patients from one facility level to another.
Speedy handling of clients through the provision of transport in good time is one of the strategies in the road map that has been recently launched by the ministry.
The road map is yet another move by my ministry towards reducing the high maternal mortality ratio. The road map stipulates several strategies which will guide policy makers, programme managers, development partners, the civil society and other stakeholders in their support to government's efforts towards accelerated attainment of the millennium development goals related to maternal and new born health," says Ngaunje.
The ministry has of late encouraged the use of motor cycle ambulances as an intervention in the ambulatory services.
The motor cycle ambulances are indeed proving to be effective to the communities especially those in the rural areas where most of the roads are really in bad shape.
SWAM in the Fight Against HIV/Aids in Nkhota Kota
In it's efforts in the fight against HIV/AIDS, the Society for Women Against AIDS in Malawi (SWAM) is implementing a two year project in Nkhotakota District aimed at empowering the youth, girls and young women in particular to have increased access to Sexual and Reproductive Health rights.
SWAM, a non governmental and non profit making organization embarked on the project whose goal is to reduce the susceptibility and vulnerability of young women and girls to HIV/AIDS by building the capacity of local communities to fight HIV/AIDS in a rights perspective.
The organisation's Executive Director, Gavelet Mzembe said in an interview that through the project, the youth in the district have been equipped with knowledge in sexual and reproductive health rights.
"As a result of a successful community mobilization, youth clubs were established and trained in sexual and reproductive health and life skills. Through discussion forums and community outreach in these clubs, the youth have reached out to more than 2,500 people with messages on life skills and Sexual and Reproductive Health," Said Mzembe.
She said her organization embarked on the project in Chia and Lozi areas in the district because of their proximaty to the lake where a lot of fishermen were demanding sex from women in exchange for fish.
"We as SWAM wanted to come in and help reduce the Fish for sex practice which was increasing the HIV prevalence rate in the area," said Mzembe.
She said her organization has managed to train 20 fishermen of which 3 were women as peer educators in Gender and Sexual reproductive health rights. Amongst the group were also 2 representatives from Nkhotakota AIDS Support Organisation (NASO) and Fisheries Department who work closely with the fishermen.
Mzembe explained that the training was aimed at equipping the fishermen with peer education skills so that they can reach out to their fellow fishermen resident in the area and other fishermen coming from other areas.
According to Mzembe, the project is already achieving results as some of the women and fishermen involved in the practice have come out in the open to testify and condemn it.
A lady from Kampanje Village who opted for anonymity testified being a victim of fish for sex as she used to buy fish for sale at the lake.
"I am a victim of fish for sex. I used to buy fish from the lake for resale. This is where I used to have sexual intercourse with the fishermen in order to gain favors so that I get more fish. I am HIV positive and can testify about the evils of this practice and advocate for change," said the lady.
Mzembe said SWAM in partnership with the communities, has established 5 Income Generating women groups and through their initiatives, they developed constitutions and opened bank accounts for the groups.
The women groups are trained in business management skills and have already identified houses to be used for bakeries in Chia and Lozi areas.
She said the women were given money to start up their businesses and the Malawi Economic Justice Network (MEJN) organized a Trade Literacy Workshop .
Mzembe said her organization is so far impressed with what the project has achieved in the area and was optimistic that a lot more would be achieved.
"Through this project, lives have been transformed, through this project we have managed to impart knowledge and skills among women and girls," she said.
Emily Zakeyo, a woman from Lozi was all praises to SWAM from bringing the project to the area which she said had really changed her life in various aspects.
"In the past, I had very little knowledge of HIV/AIDS issues but with the coming of this project by SWAM, I have learnt a lot of issues in as far as HIV/AIDS, sexual and reproductive health issues are concerned," She said.
Zakeyo said her life had also been transformed as she is now able to manage her home financially, courtesy of the business skills and capital that she got from SWAM.
She explained that she used to rely on money or fish given to her by fishermen who would demand to have sex with her in exchange of whatever they gave out to her.
"I did not realize that I was putting my own life at risk until SWAM came to this area with this project," she said.
The project is being funded by DanChurch Aid.
SWAM, a non governmental and non profit making organization embarked on the project whose goal is to reduce the susceptibility and vulnerability of young women and girls to HIV/AIDS by building the capacity of local communities to fight HIV/AIDS in a rights perspective.
The organisation's Executive Director, Gavelet Mzembe said in an interview that through the project, the youth in the district have been equipped with knowledge in sexual and reproductive health rights.
"As a result of a successful community mobilization, youth clubs were established and trained in sexual and reproductive health and life skills. Through discussion forums and community outreach in these clubs, the youth have reached out to more than 2,500 people with messages on life skills and Sexual and Reproductive Health," Said Mzembe.
She said her organization embarked on the project in Chia and Lozi areas in the district because of their proximaty to the lake where a lot of fishermen were demanding sex from women in exchange for fish.
"We as SWAM wanted to come in and help reduce the Fish for sex practice which was increasing the HIV prevalence rate in the area," said Mzembe.
She said her organization has managed to train 20 fishermen of which 3 were women as peer educators in Gender and Sexual reproductive health rights. Amongst the group were also 2 representatives from Nkhotakota AIDS Support Organisation (NASO) and Fisheries Department who work closely with the fishermen.
Mzembe explained that the training was aimed at equipping the fishermen with peer education skills so that they can reach out to their fellow fishermen resident in the area and other fishermen coming from other areas.
According to Mzembe, the project is already achieving results as some of the women and fishermen involved in the practice have come out in the open to testify and condemn it.
A lady from Kampanje Village who opted for anonymity testified being a victim of fish for sex as she used to buy fish for sale at the lake.
"I am a victim of fish for sex. I used to buy fish from the lake for resale. This is where I used to have sexual intercourse with the fishermen in order to gain favors so that I get more fish. I am HIV positive and can testify about the evils of this practice and advocate for change," said the lady.
Mzembe said SWAM in partnership with the communities, has established 5 Income Generating women groups and through their initiatives, they developed constitutions and opened bank accounts for the groups.
The women groups are trained in business management skills and have already identified houses to be used for bakeries in Chia and Lozi areas.
She said the women were given money to start up their businesses and the Malawi Economic Justice Network (MEJN) organized a Trade Literacy Workshop .
Mzembe said her organization is so far impressed with what the project has achieved in the area and was optimistic that a lot more would be achieved.
"Through this project, lives have been transformed, through this project we have managed to impart knowledge and skills among women and girls," she said.
Emily Zakeyo, a woman from Lozi was all praises to SWAM from bringing the project to the area which she said had really changed her life in various aspects.
"In the past, I had very little knowledge of HIV/AIDS issues but with the coming of this project by SWAM, I have learnt a lot of issues in as far as HIV/AIDS, sexual and reproductive health issues are concerned," She said.
Zakeyo said her life had also been transformed as she is now able to manage her home financially, courtesy of the business skills and capital that she got from SWAM.
She explained that she used to rely on money or fish given to her by fishermen who would demand to have sex with her in exchange of whatever they gave out to her.
"I did not realize that I was putting my own life at risk until SWAM came to this area with this project," she said.
The project is being funded by DanChurch Aid.
Microbicide Trials On HIV Transmission Prevention Halted
Malawi will continue with phase 3 Trials on the efficacy of a microbicide gel that is being tested for HIV prevention in women despite trials of a similar kind being halted in other participating countries.
A statement made in January by International Partnerships for Microbicides (IPM) informing the public that CONRAD, a reproductive health research organization had halted the phase 3 efficacy trials of its Cellulose Sulfate (CS) based microbicides has resulted in the public asking why the trials on being carried out by John Hopkins Foundation in Malawi are still continuing.
According to Dr Newton Kumwenda, Director of the John Hopkins Foundation, the research in Malawi will not be affected by IPM's statement to stop the CS trials because the products are different.
"The trials in Malawi are not affected in any way be the stopping of the Cellulose Sulfate trials since the products are different" he said.
Kumwenda confirmed that trials are on track, will continue and are progressing well.
Malawi is currently involved in phase 3 human trials of the Pro 2000 and Buffer Gel microbicide being carried out in two centers based in Blantyre and Lilongwe. Approximately 500 women are involved in each of the two centers.
Trials in Malawi on the Pro 2000 and Buffer Gel started in 2005 and data has regularly been monitored by a safety monitoring board. Reviews since trials began have already taken place 4 times with another review due to take place shortly.
According to Kumwenda, the past reviews have revealed no problems so far thus the continuation of trials. "We hope that if trials are stopped at all, it will be due to successful results rather than other problems," he said.
Asked how participants are selected for the trial, Kumwenda said all trials are being conducted with utmost care following both local and international guidelines for the welfare of the participants as well as the scientific integrity of trial.
Participants should be 18 years or older, sexually active, healthy and be willing to be tested for HIV.
Before participating in the trials, women are counseled and informed on the importance of continuing to use other forms of protection against HIV.
"They are counseled that the products are only being tried if they can protect against infection, but we do not know for sure if they work therefore they need to protect themselves against HIV all the time by using condoms which we know for sure are effective," Kumwenda said.
Counseling is continuing and available for participants whenever a request is made. At every opportunity a participant is available, counseling on risk reduction is provided.
Kumwenda confirmed again that CS is a completely different product from Pro 2000 and Buffer Gel being tried in Malawi and that it was unlikely that the different products will have the exact same effects. "We hope that the Buffer Gel and Pro 2000 will have different and positive results."
The trials on Pro 2000 and Buffer Gel taking place in Malawi are at present being carried out in Philadelphia USA, South Africa, Zambia and Zimbabwe.
Effort to develop a microbicide gel for use by women to prevent them from contracting HIV suffered a significant setback when the phase 3 human trials were halted end of January this year.
Phase 3 of the trial involved the participation of women in order to determine the efficacy of the Cellulose Sulfate based gel but preliminary results indicated that Cellulose Sulfate could lead to an increased risk of HIV infection in women who use the product.
Trials on the CS have been carried out in Benin, India, South Africa, Uganda and Nigeria. A target total of 4,734 women were scheduled to participate in the trials.
Although problems were observed in the other countries, no such problems were observed in the Nigerian trials and data is still being examined further to shed some light on the apparent observations so far and their implications.
It has been confirmed that increasingly women and girls bear the brunt of the HIV/AIDS pandemic.
In the year 2006 statistics reveals that over 59% of the people living with the virus in sub-Saharan Africa were women.
In Malawi, over 52% of the people living with HIV are women.
Traditions, culture and social differences are some of the most significant factors that have made women more vulnerable to becoming infected with HIV.
The development of a microbicide is expected to have given women, especially those in a stable relationship or married some control over protecting themselves from becoming infected with HIV or other sexually transmitted Infections (STIs). Not requiring the participation of the male partner, microbicides had been seen as a positive move towards empowering women to protect themselves from HIV and STI infections.
A significant number of women in Asia and Africa have been involve in large scale efficacy trials
"With these microbicide candidates in large scale efficacy trials and a new generation of microbicides well into safety studies, microbicides could be available in five to seven years," is a statement by IPM in November, 2006.
The safety concerns that caused the discontinuation of the CS trials is seen as a set back and will have a significant effect on the future development and availability of a microbicide that will empower women to protect themselves against HIV the world over.
A statement made in January by International Partnerships for Microbicides (IPM) informing the public that CONRAD, a reproductive health research organization had halted the phase 3 efficacy trials of its Cellulose Sulfate (CS) based microbicides has resulted in the public asking why the trials on being carried out by John Hopkins Foundation in Malawi are still continuing.
According to Dr Newton Kumwenda, Director of the John Hopkins Foundation, the research in Malawi will not be affected by IPM's statement to stop the CS trials because the products are different.
"The trials in Malawi are not affected in any way be the stopping of the Cellulose Sulfate trials since the products are different" he said.
Kumwenda confirmed that trials are on track, will continue and are progressing well.
Malawi is currently involved in phase 3 human trials of the Pro 2000 and Buffer Gel microbicide being carried out in two centers based in Blantyre and Lilongwe. Approximately 500 women are involved in each of the two centers.
Trials in Malawi on the Pro 2000 and Buffer Gel started in 2005 and data has regularly been monitored by a safety monitoring board. Reviews since trials began have already taken place 4 times with another review due to take place shortly.
According to Kumwenda, the past reviews have revealed no problems so far thus the continuation of trials. "We hope that if trials are stopped at all, it will be due to successful results rather than other problems," he said.
Asked how participants are selected for the trial, Kumwenda said all trials are being conducted with utmost care following both local and international guidelines for the welfare of the participants as well as the scientific integrity of trial.
Participants should be 18 years or older, sexually active, healthy and be willing to be tested for HIV.
Before participating in the trials, women are counseled and informed on the importance of continuing to use other forms of protection against HIV.
"They are counseled that the products are only being tried if they can protect against infection, but we do not know for sure if they work therefore they need to protect themselves against HIV all the time by using condoms which we know for sure are effective," Kumwenda said.
Counseling is continuing and available for participants whenever a request is made. At every opportunity a participant is available, counseling on risk reduction is provided.
Kumwenda confirmed again that CS is a completely different product from Pro 2000 and Buffer Gel being tried in Malawi and that it was unlikely that the different products will have the exact same effects. "We hope that the Buffer Gel and Pro 2000 will have different and positive results."
The trials on Pro 2000 and Buffer Gel taking place in Malawi are at present being carried out in Philadelphia USA, South Africa, Zambia and Zimbabwe.
Effort to develop a microbicide gel for use by women to prevent them from contracting HIV suffered a significant setback when the phase 3 human trials were halted end of January this year.
Phase 3 of the trial involved the participation of women in order to determine the efficacy of the Cellulose Sulfate based gel but preliminary results indicated that Cellulose Sulfate could lead to an increased risk of HIV infection in women who use the product.
Trials on the CS have been carried out in Benin, India, South Africa, Uganda and Nigeria. A target total of 4,734 women were scheduled to participate in the trials.
Although problems were observed in the other countries, no such problems were observed in the Nigerian trials and data is still being examined further to shed some light on the apparent observations so far and their implications.
It has been confirmed that increasingly women and girls bear the brunt of the HIV/AIDS pandemic.
In the year 2006 statistics reveals that over 59% of the people living with the virus in sub-Saharan Africa were women.
In Malawi, over 52% of the people living with HIV are women.
Traditions, culture and social differences are some of the most significant factors that have made women more vulnerable to becoming infected with HIV.
The development of a microbicide is expected to have given women, especially those in a stable relationship or married some control over protecting themselves from becoming infected with HIV or other sexually transmitted Infections (STIs). Not requiring the participation of the male partner, microbicides had been seen as a positive move towards empowering women to protect themselves from HIV and STI infections.
A significant number of women in Asia and Africa have been involve in large scale efficacy trials
"With these microbicide candidates in large scale efficacy trials and a new generation of microbicides well into safety studies, microbicides could be available in five to seven years," is a statement by IPM in November, 2006.
The safety concerns that caused the discontinuation of the CS trials is seen as a set back and will have a significant effect on the future development and availability of a microbicide that will empower women to protect themselves against HIV the world over.
Malawi: 'Brain Drain' in Health System Continues Unabated
Most nurses who have left Malawi have immigrated to the United Kingdom (UK), offering that country their services in the past. But now the United States of America (US) is fast becoming another attractive destination after many nurses are having an extension to their working visa being rejected in the UK, even after having worked there for nearly 5 years.
The American Hospital Association has reported that the US last year needed an extra 118,000 nurses, a demand that will rise to 800,000 by 2020. In order to cater for this shortage a little un-noticed provision in the Immigration Bill is expected to be used. This could intensify the drain of nurses from the developing world.
Reaction has been swift and filled with outrage with Physicians for Human Rights (PHR), a US advocacy group saying that this provision could undermine the multi-billion dollar effort by the US to combat AIDS and Malaria by potentially worsening the already existing shortage of health workers in poor countries like Malawi.
"We're pouring water in a bucket with a hole in it, and we (US) drilled the hole," declared Holly Burkhalter from PHR when the proposals were first made.
There is no doubt, the public health sector in Malawi is already badly hit by the "Brain Drain" in the large exodus of medical professional personnel leaving the country for greener pastures in the developed world.
It has been reported that over the past five years 52% of health administrators, 64% nurses and 85% physicians have left the government health system either to join private medical providers, join other NGOs or have left the country to join overseas health systems.
Freda* has just come off her night shift in one of the largest referral hospital in Lilongwe, Kamuzu Central Hospital (KCH). Working on the Female General Ward 2A had been totally exhausting for her, and if it were not for the patients' guardians helping her during the night, some of the patients would have been left unattended for long periods while she paid attention to the patients that required immediate attention.
The ward has 31 beds with an overflow of patients sleeping on the floor and on the verandah with an estimate of 38 patients to care for. Freda has one auxiliary nurse to help her. Sitting on a chair and looking more like she has been running a marathon, Freda says she is fast burning out and after working at the hospital, she barely has the energy to take care of her family.
"I have been working for many years as a nurse and at one time we were many on the ward and we were all working as a team.The burden of caring for patients was shared; we were even able to take time to have a cup of tea."
She says it is difficult to take a break without feeling as though there are more important things she should be doing.
"You feel as if it is time wasted if you stop; and even if guardians are many and disturb you when you have to give special care to a patient, we can not do otherwise since they do help in caring for their relatives because the nurse patient ratio is so bad."
She says when she became a nurse it was never her intention to work in any other organization but one of the major hospitals in the country.
Asked if she would consider leaving the country to join the medical profession overseas, Freda says now she would indeed consider it: "Before, I would have problems but now, even although nursing my own people is my passion, I feel that I am not able to give my best because I have to care for so many patients at one time. How can I give my best?" she asked adding, "besides, I have heard that very good working conditions and higher salaries have benefited many of my colleagues. Maybe it is time to look somewhere else for a job that will benefit me and my family."
Is Freda about to become a "Brain Drain" statistic in Malawi?
Recent media reports on the Senate Immigration Bill with a small but significant provision that will make it possible for an unlimited number of health care workers and their immidiate family to live and work in America makes the US another possible destination for nurses from Malawi. The Senate Bill 2611 already passed by the Senate Judiciary Committee will make it possible for more foreign nurses to live and work in the US.
The provision is intended to assist the US government fill the gap of a shortage of nursing staff needed for their health system.
At present the US has 500 special visas for nurses each year that makes it possible for nurses and their immediate family members to get a green card and live in the US.
The possibility of recruiting foreign nurses to cater for the needs of the US has drawn some negative responses from experts from within the US and Africa who have been following the situation of the "Brain Drain" from the African continent
The American Hospital Association has reported that the US last year needed an extra 118,000 nurses, a demand that will rise to 800,000 by 2020. In order to cater for this shortage a little un-noticed provision in the Immigration Bill is expected to be used. This could intensify the drain of nurses from the developing world.
Reaction has been swift and filled with outrage with Physicians for Human Rights (PHR), a US advocacy group saying that this provision could undermine the multi-billion dollar effort by the US to combat AIDS and Malaria by potentially worsening the already existing shortage of health workers in poor countries like Malawi.
"We're pouring water in a bucket with a hole in it, and we (US) drilled the hole," declared Holly Burkhalter from PHR when the proposals were first made.
There is no doubt, the public health sector in Malawi is already badly hit by the "Brain Drain" in the large exodus of medical professional personnel leaving the country for greener pastures in the developed world.
It has been reported that over the past five years 52% of health administrators, 64% nurses and 85% physicians have left the government health system either to join private medical providers, join other NGOs or have left the country to join overseas health systems.
Freda* has just come off her night shift in one of the largest referral hospital in Lilongwe, Kamuzu Central Hospital (KCH). Working on the Female General Ward 2A had been totally exhausting for her, and if it were not for the patients' guardians helping her during the night, some of the patients would have been left unattended for long periods while she paid attention to the patients that required immediate attention.
The ward has 31 beds with an overflow of patients sleeping on the floor and on the verandah with an estimate of 38 patients to care for. Freda has one auxiliary nurse to help her. Sitting on a chair and looking more like she has been running a marathon, Freda says she is fast burning out and after working at the hospital, she barely has the energy to take care of her family.
"I have been working for many years as a nurse and at one time we were many on the ward and we were all working as a team.The burden of caring for patients was shared; we were even able to take time to have a cup of tea."
She says it is difficult to take a break without feeling as though there are more important things she should be doing.
"You feel as if it is time wasted if you stop; and even if guardians are many and disturb you when you have to give special care to a patient, we can not do otherwise since they do help in caring for their relatives because the nurse patient ratio is so bad."
She says when she became a nurse it was never her intention to work in any other organization but one of the major hospitals in the country.
Asked if she would consider leaving the country to join the medical profession overseas, Freda says now she would indeed consider it: "Before, I would have problems but now, even although nursing my own people is my passion, I feel that I am not able to give my best because I have to care for so many patients at one time. How can I give my best?" she asked adding, "besides, I have heard that very good working conditions and higher salaries have benefited many of my colleagues. Maybe it is time to look somewhere else for a job that will benefit me and my family."
Is Freda about to become a "Brain Drain" statistic in Malawi?
Recent media reports on the Senate Immigration Bill with a small but significant provision that will make it possible for an unlimited number of health care workers and their immidiate family to live and work in America makes the US another possible destination for nurses from Malawi. The Senate Bill 2611 already passed by the Senate Judiciary Committee will make it possible for more foreign nurses to live and work in the US.
The provision is intended to assist the US government fill the gap of a shortage of nursing staff needed for their health system.
At present the US has 500 special visas for nurses each year that makes it possible for nurses and their immediate family members to get a green card and live in the US.
The possibility of recruiting foreign nurses to cater for the needs of the US has drawn some negative responses from experts from within the US and Africa who have been following the situation of the "Brain Drain" from the African continent
SA, Malawi sign co-operation agreement
Foreign Minister Nkosazana Dlamini-Zuma and her Malawian counterpart Joyce Banda signed a co-operation agreement between the two countries at Zimbali Lodge near Durban on Monday.
Zuma said that the Joint Permanent Commission for Co-operation Agreement created a "framework" for the two countries' future co-operation in bilateral relations.
Banda said: "There are so many areas where we can co-operate. This brings the guarantee to that co-operation."
In 2005 Malawi was South Africa's 10th largest export destination in Africa.
Zuma was expected sign a number of agreements ahead of the two-day African Union retreat being hosted by Zuma at Zimbali Lodge.
The retreat begins on Tuesday
Zuma said that the Joint Permanent Commission for Co-operation Agreement created a "framework" for the two countries' future co-operation in bilateral relations.
Banda said: "There are so many areas where we can co-operate. This brings the guarantee to that co-operation."
In 2005 Malawi was South Africa's 10th largest export destination in Africa.
Zuma was expected sign a number of agreements ahead of the two-day African Union retreat being hosted by Zuma at Zimbali Lodge.
The retreat begins on Tuesday
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