Beyond the confines of medical science

The president's AIDS cure debate

By Kebba Dibba

I have been following with keen interest, the unfolding debate both nationally and internationally emanating from President Jammeh's pronouncement that he has a cure for HIV/AIDS. This is perhaps a turning point in the struggle against one of the deadliest viral diseases that has defied medical science for over a quarter century.

It has indeed brought to the forefront, the role or potential role of spiritual and herbal therapy in the fight against a dreadful disease.

While the emphasis on medical science is not shifting, the approach to deal with the pandemic is conceivably bound to assume a multidimensional character. President Jammeh has undoubtedly brought to the fore a compelling case for international debate: the role of traditional and spiritual therapy, which for some reasons has now been relegated to the rare or totally discarded not only in the search for a cure for HIV/AIDS but also in the treatment of some common ailments. Modern medical science has monopolised disease diagnosis and treatment - a no go area for herbal and spiritual therapy, even though it has proved effective in the past.

The failure of medical science to find a cure or even a vaccine for HIV/AIDS in more than a quarter of a century has seriously undermined confidence and perhaps reinforced the need for a rethink in strategy in dealing with the AIDS pandemic. Fundamental questions are being asked regarding the apparent failures of medical science in relation to HIV/AIDS.

Even the most optimistic medical scientists would admit that the world is years away from a cure – perhaps, counting years in decades. When scientific and technological innovation is at the most defining moments, a cure or vaccine for AIDS seems to be light years away. What a paradox! Is it a question of commitment, funding or discreet indifference. Well, some basic statistical facts about the global HIV/AIDS epidemic could give some interesting insight.

Sub-Saharan Africa has about 10% of the world's population. According to UNAIDS, it has 63%, (25.8million people) nearly two in three living with HIV/AIDS. The region accounts for 72%, nearly three in every four deaths from AIDS. UNAIDS resource needs estimates for 2006 to 2008 for combating the pandemic in low and middle income countries is a staggering $55bn (fifty-five billion dollars) But the global total donated by the developed countries combined for 2005 was $168m (168 million dollars) just a small fraction. Less that 23% of HIV positive people are on antiretroviral drugs – the drug that reinforces patients' immune system.

Although there are other interest groups that are donating to the global efforts against HIV/AIDS, governments, particularly of the rich industrialised countries should assume a leading role. But if one multinational organisation's contribution to the global Aids fund could exceed the combine sum total of some rich countries of the world, then something is seriously wrong.

The statistics do not inspire hope, and the level of global commitment, particularly on the part of the richer countries does not reflect the gravity of the HIV/AIDS crisis either. Consequently, the need for a rethink in strategy has become too imperative. Africa must certainly not fold its hands in anticipation of a medical cure

In the fight against HIV/AIDS, all fronts and avenues must be opened and all options put on the table. Nothing should be ruled out and no body or region should be written off in any meaningful anti AIDS crusade. The failures of science do not in any way shut all other avenues, including spiritual and herbal therapy. Its effectiveness in treating a range of ailments has been tested and certified in the past and present. All hope cannot be gone and lost because all mighty medical science, on which we pinned our hopes for a cure for more that twenty-five years, has failed to deliver.

With absolute certainty, this approach is bound to encounter strong resistance from the pharmaceutical industry. It has a vested business interest and has committed large amounts of money but the level of success has not gone beyond antiretroviral drugs in twenty-five years of clinical research – drugs which are only available to less than 23% of the people who need them, mostly in Africa . How much longer will Africa , the epicentre of the global AIDS crisis have to wait?

When President Jammeh announced his participation in treating HIV/AIDS patients, the initial surprise or even doubts it generated was understandable because of the seeming intractable nature of the disease. But as time passes and media reports emerge of the results of his therapy, there was evidence of a breakthrough. The increases in CD4 counts of patients, the undetectable viral loads of some patients treated and the overall improvements in their health conditions, as admitted by some of them, prove beyond doubt that indeed some kind of history is in the making in small Gambia.

It is understood that only those who have been medically diagnosed as HIV positive under go treatment. The mere fact that the testing, after the first round of treatment, was done in a foreign country is testimony to the level of transparency. The results from Dakar indicate that a number of the patients have undetectable viral loads, which even from a lay man's point, means they are no longer positive. Others have very low viral loads, meaning significant improvements have been registered in the drive to flush the virus out of their system. Those who have a high viral load may still have to undergo more treatment. Indeed the president's spiritual/herbal therapy deserves some special attention and not condemnation.

The striking thing about the President Jammeh AIDS cure issue is the challenge it poses to the international community. Without doubt, Africa has been ruled out of the equation in the struggle for a cure because science and technology are not the continent's domain. There is the need for a rethink now. The multinational pharmaceutical industry is big time business but when it comes to diseases like AIDS, it is lives before business. President Jammeh's move should be seen in a positive light in medical circles.

At this point in time there could be lot of pressure on heads of international organisations, NGOs and other stakeholders in HIV/AIDS control, especially at home, apparently from powerful interest groups. But they must be true to their conscience and that their views must not only reflect pressure and policy but also the reality on the ground.

The question of risky behaviours on the part of the population in the belief that there is a cure as argued by one international civil servant and a South African professor is neither here nor there. The president is not preaching immorality or indulgence into risky behaviour. As a national leader, he has a duty to preach behaviour that falls in line with higher moral and ethical values. Besides, treatment is just one aspect of the anti AIDS campaign and I think stakeholders in the crusade will not relent in their advocacy for preventive methods as well, with or without a cure.

Dr Coumba Toure-Kane's (Senegalese doctor who verified the Dakar test results) statement has been portrayed by some critics as a move to distance herself from what is perceived in the Gambia as a breakthrough. But she has at no point in time denied the fact of the matter – that some of the patients had undetectable viral loads, others very low and others still with detectable levels. This is the information the Gambia authorities have put across. I have seen no dishonesty on the part of authorities in Banjul and if any body clams the contrary, then it baffles commonsense.

President Jammeh indeed provides a real opportunity for the international community to reassess its anti AIDS policy and strategy. What's required is a genuine partnership and a broader approach that leave no stone unturned. You may never know where the element of surprise would come from.

The international community, with the UN at the forefront, should liaise with the Gambian leader and exchange notes to enable them determine the potency or efficacy of his therapy. You may never know, the achievement of epic proportion in medical history could come from the smallest country in continental Africa . That could be the biggest surprise of the 21 st century. All hope cannot be gone and lost because medical science has failed to find a cure. In fact, beyond the confines of medical science, there could be a ray of hope.

The author is a postgraduate student at the Cardiff school of Journalism , Media and Cultural Studies, Cardiff University .