Take Charge of Your Health
An article by Dr. Kirtland Culmer

The Aids Pandemic
It is WORLD AIDS DAY today as this article is being penned. The day started very early, as I joined millions of folks all over the world praying at their various places of worship for an end to this dread disease. A recent magazine article suggests that AIDS is likely to achieve the dubious distinction of overtaking the Black Death as the worst pandemic in human history. During the 14th century, the Black Death or Plague killed more than 40 million people in Europe and Asia, and did not stop until the 16th century. AIDS has already killed 25 million people worldwide, and another 40 million are living with the disease. In Africa now, there are populations where 25 to 30 percent of the young adult population and 15 percent of the children are infected.

Very early in this pandemic, there was a great initial momentum to fight AIDS. This momentum seems to have been lost because it is a chronic disease, and now, seemingly “old hat” to so many people and countries. Although recent initiatives by the United Nations will help improve the situation, it is a small fraction of what will be needed.

To answer the question of how the Bahamas is doing with the AIDS problem, Dr. Perry Gomez our Director of the National AIDS program heartily agreed to grant me a telephone interview even though he had just arrived home, deadly fatigued, after a long trip from Washington D.C. Dr. Gomez concurs that, although there is nothing about AIDS to cheer about, there have been some interesting trends that should spur us on to continue to TAKE CHARGE to contain, diminish and eventually to eradicate this disease.

From 1985 up until the year 2000, there has been an upward trend in the incidence of reported HIV infections. In 2000 and 2001, there has been a decrease in the incidence. There has also been a decrease in the death rate from AIDS, and the bed occupancy due to the AIDS infection has decreased. There is a 14-bed ward at the Princess Margaret Hospital for children with AIDS. It used to be occupied, it is now empty.

What is responsible for this recent trend? Dr. Gomez indicates that education has played some part, but the most obvious factor seems to be the effect of treatment. Medication gets rid of the viral load as far as science can measure, but unfortunately, it is not a cure. Although the patient on medication enjoys good health for an indeterminate length of time, the virus eventually returns and death ensues. It is speculated that the viruses may hide in organs like the spleen and brain, and possibly the lymphatic system, and finally reappear to cause disease. They also may eventually develop resistance to the drugs.

However, the treatment has also reduced the incidence of transmission of the disease from pregnant mothers to their unborn children from 30 percent to 7 percent. The treatment reduces the spread of the virus to uninfected partners. Because of the United Nations Commitment in June 2001 to reduce the price of HIV drugs, and also because of the availability of generic drugs, more patients are being treated. 500 patients are being treated at government’s expense, 150 of them are children. It costs the Government $3,900 per year for each public patient. The cost to each private patient can be as much as $15,000 per year.

Having been given this kind of information, it is quite clear that we need resources to provide more education, and to make treatment available to more patients. We need personal and political commitment to continue the effective fight against HIV. To do this we must

· try to develop a high personal and national moral profile. Abstinence is still the safest preventive measure,
· use condoms to avoid the risk of infection,
· have monogamous relationships rather than promiscuous ones,
· urge government to continue to use influence to reduce the price of HIV drugs and to endeavor to find funding to make more treatment available to those who cannot afford to pay and,
· treat infected pregnant women even after they have delivered.

There are 7000 reported cases of HIV infection in this small community. This is a serious disease, and it causes a spin-off of many other serious infectious diseases and even heart attacks. It is therefore most imperative that we try even harder to TAKE CHARGE for the sake of ourselves, our children and the world. Take notice also this is WORLD AIDS DAY…The World is watching.