Independent-on-Line, 21 October 2002, Huge Aids grant gives new hope to SA families

The biggest-yet grant for the treatment of South Africans with Aids, worth R230 million, is expected to offer new hope to whole communities.

In the Western Cape, the grant from the United States's National Institutes of Health will entrench the switch here from focusing on the prevention of mother-to-child transmission of the virus, to treating not only the mothers too, but entire families.

As concern grows over predictions of millions of Aids orphans, the grant offers Aids specialists the chance to prove that treatment of communities will ensure families stay together longer.

Announced in Johannesburg this morning, the grant will bring together specialists from universities across South Africa, treating up to 1 000 infected adults and children both here and in Soweto.

Between 300 and 600 people will be treated

It will also combine the skills of top Aids scientists Professor Robin Wood, associate professor of medicine at the University of Cape Town, Professor Estrilita Janse van Rensburg, head of Stellenbosch University's department of medical virology, Dr Mark Cotton, who heads the paediatric HIV unit at Tygerberg Hospital, and Dr Linda-Gail Bekker, head of the infectious disease clinical research unit at UCT's Lung Institute.

They will be joined by doctors James McIntyre and Glenda Gray, co-directors of the perinatal HIV research unit at Chris Hani Baragwanath Hospital, who earlier this year were honoured with the 2002 Nelson Mandela Award for Health and Human Rights.

In the Western Cape, the spotlight will fall on Masiphumelele, near Noordhoek, which has been selected as the site where every community member who needs antiretrovirals will get them.

Wood, with Bekker and Cotton, will run the programme which they regard as a coup in their bid to show that the key to addressing HIV/Aids is by "safeguarding the household".

Janse van Rensburg will take responsibility for the laboratory tests, to record both CD4 counts which measure the body's ability to fight the disease, and viral loads which measure the amount of virus in the body.

'The community is small enough to have an impact on the entire population'

She will run another concurrent study to characterise the different HIV strains circulating in different centres.

Between 300 and 600 people will be treated here and about the same number by Gray and McIntyre in Soweto.

In Masiphumelele, Cotton will take responsibility for paediatric treatment of HIV with anti-retrovirals, Wood for the adults, while Bekker will examine how anti-retrovirals influence tuberculosis and the types of TB in the community.

Cotton will also run a paediatric vaccination study, examining the efficacy of especially pneumonia vaccines in HIV-positive children with and without antiretrovirals.

Wood also heads the Gugulethu anti-retrovirals programme started a month ago which, courtesy of other overseas funding, is set to treat 150 people with end-stage Aids.

This is the first all-South African project of its kind, run in co-operation with the provincial health department. Wood said it was a forerunner of the Masiphumelele project, also giving priority to people like mothers who had taken drugs to prevent them passing on HIV to their children.

In Masiphumelele we will be treating everyone in the family who needs anti-retrovirals," Wood said.

The aim, said Bekker, was that eventually everyone in the community would know their HIV status.

Masiphumelele, an accredited vaccine trial site by the South African Aids Vaccine Initiative for when clinical trials of vaccines start, was selected because the specialists already have "a good relationship with health authorities there".

"The community is small enough to have an impacton the entire population," Bekker said.