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Wednesday, August 02, 2006

HIV/AIDS epidemic and Latinamerica.


staWorking with a high hierarchy journalism (interviews, visit to hospitals and slums, videos, audios, etc), http://www.aaas.org/ScienceTalk/cohen.shtml Jon Cohen, correspondent of http://www.sciencemag.org/sciext/aidsamericas/Science visited during 9 months, 12 Latin American countries including Peru, with the photographer Malcolm Linton, in order to study in alive the different preventive and treatment programs of patients with HIV/AIDS. Here we offer excerpts of 12 published articles this week in Science magazine. In Africa http://www.who.int/whr/2003/chapter3/es/index1.html there are : 25 million of infected (prevalence : 22-43%,adults), in Asia: 14 Millions (prevalence: 15%, adults ) and in all Latinamerica : around 2 million. Perhaps for that reason, donations and fund programs, are not abundant here, existing a abandonment feeling, because the number of infected is continuous ascending, in accordance with the constant increase of survivors. The gordian knot of this affection in LA, seems to reside in the island The Española, shared of old, by Haiti and Dominican Republic. With certain opposition some researchers maintain that Haitian that migrated to the Congo (1960), acquired there the virus and to their return, they scattered it by Haiti, USA, Canada and Europe. The Caribbean, has a prevalence in adults of the order of the 1.6% (but the high one of), although in groups of high risk these numbers can reach rates of 50%. By its side, Haiti has a rate of 6.2%, that hopes to reduce to 3.8% (2005), thanks to the international aid, massive use of condoms, conductual changes, modern antiretrovirals treatments and vaccine use. According to Cohen: Dominican R., recently has increasing its prevalence of HIV/AIDS and TBC. Dominican R. has a general prevalence of : 1.1% (2002), with increasing tendency. In certain very poor populations: sugar refineries, the prevalence is: 5%, whereas in female sex workers it oscillates between: 2,5-12, 4%. Peculiar, historically and according to http://www.blackwell-synergy.com/links/doi/10.1046/j.1365-4362.1999.00591.x: Ruy Diaz de Ysla [1539, pp: 693. Tractado sobre el mal serpentino. The press of Domenico Robertis. Seville], by the time in which he wrote his book (~1505), existed in The Española, a high prevalence of genital bubas (ulcers), in Spaniards who returned to España after the first Expedition of Colon…that the bubas had had contracted by sexual relations with female Indians do not affected…. and that the bubas were unequivocal mark of Syphilis.

It follows in importance to Haiti: Brazil, not only by its vast number of inhabitants, but also by the original handling of its system of health to control this disease. When in 1992 the World Bank predicted the emergency of 1.2 infected million of HIV/AIDS patients for the 2000, Brazil handled first the massive use of condoms and later (1996), antiretroviral treatments, without cost some to everyone infected with HIV/AIDS, copying formulate of antiretrovirals drugs of transnational companies. A preventive, curative, revolutionary program. Not only 90, 000 annual deaths were avoided in this way but that saved 1.2 billions of dollars when being avoided antiinfectious treatments and innecesary entering to the hospitals. IOn the other hand Brazil, decided to make generic antiretrovirals (20% of its consumption) and to construct a great http://www.giv.org.br/noticias/noticia.php?codigo=1111 national farmaceutical industry: Farmanguinhos. It has not advanced so much because the transnational companies: Big Pharma, Abbott, Merck and Roche have interposed resources of violations of patents and reclaimed rights of intellectual property. Recently, Lula threatened in 2 opportunities return to copy the formulate of new antiretroviral drugs. Argentina, also administered gratuitous antiretrovirals treatments, since the beginning of the epidemic, although not always existed a good medical mood towards this badly disease. According to statistical of 2005, Argentina has 130 000 infected and a prevalence of 0.6%. In the beginning the epidemic predominated in the high class, thanks to the use of dirty syringes, although in recent times the trasmision is heterosexual.

Mexico has the characteristic of to have ordered the conduction of the top program anti-AIDS, to a declared http://www.cimac.org.mx/noticias/00ago/00081014.html clinician gay: Jorge Saavedra and the program goes well. The rate of prevalence in Mexico is 0.3%, although some doubt her, judging by the frequent cases of HIV/AIDS that are seen in the USA-Mexico border. A study reveals that the prevalence in Tijuana is : 1.12%. In addition to many Mexicans, they do not like to use condoms and are publically homophobics although the statistics reveal that transmission is mainly man- man. Mexico grants from the 2003, gratuitous treatments. Although they are not sure numbers, some thinks that several rural communities (constant migration to USA), have high prevalences. In Peru, exist 7000 infected receiving complete and gratuitous treatment, service institutionalized from the 2004, thanks to the support of http://www.theglobalfund.org/en/Global Fund. It is known that an infected 20% of the area of Lima, does not receive treatment and a little but 70%, in provinces. The prevalence of HIV/AIDS (2005, adult), in Peru is 0.6%, although it is suspected that in Iquitos, the prevalence is greater. According to Cohen many foreign investigators, long for to come to Peru, because there are facilities to make investigations: promote conductual changes in, install brief preventive pharmacological treatments to infected people not exposed, to investigate the causes by which in Peru there are epidemics of relations Man-Man, not knowing well because one does not expand in women. An investigator affirms that it happens because the Peruvian women, are monogamous, etc

Epidemia de HIV/AIDS en America Latina

Premunido de un periodismo de investigación de alta jerarquia (entrevistas, visita a hospitales y villas miseria, videos, audios, etc), Jon Cohen, corresponsal de Science recorrió durante 9 meses, 12 paises latinoamericanos –incluido el Peru-, acompañado del fotografo Malcolm Linton, a fin de estudiar in vivo los diferentes programas de atención de pacientes con HIV/AIDS. He aquí, un extracto de 12 articulos publicados esta semana en la revista Science. En África existen 25 millones de infectados (tasa de prevalencia :22-43%), en Asia: 14 millones (prevalencia:15%) y en todo Latinoamérica (LA), alrededor de 2 millones. Quizas por ello, donaciones y programas de envergadura, no son legion en LA, existiendo una sensación de abandono, porque el numero de infectados continua ascendiendo, a tenor del incremento constante de sobrevivientes. El nudo gordiano de esta afección en LA, parece residir en la isla La Española compartida de antiguo, por Haiti y Republica Dominicana. No sin cierta oposición, algunos investigadores sostienen que haitianos que migraron al Congo (1960), adquirieron el virus y a su regreso, lo diseminaron por Haiti, USA, Canada y Europa. El Caribe, tiene una tasa de prevalencia en adultos del orden del 1,6% (la mas alta de LA), aunque en grupos de alto riesgo estas cifras pueden alcanzar tasas de 50%. Por su lado, Haiti tiene una tasa de 6,2%, que espera reducir al 3,8% (2005), merced a la ayuda internacional, masivo empleo de condones, cambios conductuales, modernos tratamientos antiretrovirales y empleo de vacunas.

Según Cohen : R.Dominicana, hace poco por contener sus crecientes tasas de prevalencia de HIV/AIDS y TBC. R. Dominicana tiene una prevalencia general del 1,1% (2002), con tendencia creciente. En ciertas poblaciones muy pobres : bateyes, la prevalencia es :5%, en tanto que en prostitutas oscila entre : 2,5-12,4%. Curiosa, historicamente y según Ruy Diaz de Ysla [1539,pp: 693. Tractado sobre el mal serpentino. Imprenta de Domenico Robertis. Sevilla], por la epoca que escribio su libro (~1505)….”existia en La Española una alta prevalencia de bubas (ulceras genitales), entre los españoles que regresaban a España, luego del primer viaje de Colon….que las bubas habian sido contraidas por relaciones sexuales con indias no afectas y que…. las bubas eran marca inequivoca de Sífilis”….
Le sigue en importancia a Haiti : Brasil, no solo por su alta población sino por el original manejo de su sistema de salud para controlar este mal. Cuando en 1992 el Banco Mundial predijo la emergencia de 1,2 millones de infectados para el 2000, Brasil masivizo primero el empleo de condones y mas tarde (1996), tratamientos, sin costo alguno a todo infectado con HIV/AIDS, copiando fórmulas de fármacos antiretrovirales de las transnacionales. Un programa preventivo, curativo, revolucionario. No solo se evitaron de este modo 90, 000 muertes anuales sino que se ahorro 1,2 billones de dolares al evitarse internamientos y tratamientos antiinfecciosos innecesarios. Por si fuera poco Brasil, decidió fabricar genéricos antiretrovirales (20% de su consumo) y construir una fábrica de medicamentos nacional : Farmanguinhos. No ha avanzado más por que las transnacionales: Big Pharma, Abbott, Merck y Roche han interpuesto recursos de violación de patentes y reclamado derechos de propiedad intelectual. Hace poco, Lula amenazó en 2 oportunidades con volver a copiar fórmulas de nuevos fármacos .

Argentina, tambien adjudicó tratamientos antiretrovirales gratuitos, desde el inicio de la epidemia, aunque no siempre existió una disposición adecuada del colectivo medico hacia este mal. Según estadisticas del 2005, dispone de 130 000 infectados y una prevalencia del 0,6%. En un inicio la epidemia predominaba en las clases altas, merced al empleo de jeringas sucias, aunque ultimamente la trasmisión es heterosexual. Mexico tiene la caracteristica de haber encargado la conducción del mayor programa anti-AIDS, a un declarado medico gay : Jorge Saavedra y el programa va bien. La tasa de prevalencia en Mexico es 0,3%, aunque algunos dudan de ella, a juzgar por los frecuentes casos de HIV/AIDS que se ven en la frontera USA-Mexico. Un estudio revela que la prevalencia en Tijuana es de 1,12%. Ademas a muchos mexicanos, no les gusta usar condones y son públicamente homofobicos aunque las estadísticas, revelen que la trasmisión es mayormente hombre- hombre. Mexico otorga desde el 2003, tratamientos gratuitos. Aunque no se disponen de cifras, se piensa que varias comunidades rurales (constantes migrantes a USA), disponen de prevalencias altas. En el Peru, existen 7000 infectados recibiendo tratamiento completo y gratuito, el mismo que fue institucionalizado desde el 2004, merced al apoyo de Global Fund. Se conoce que un 20% de infectados del area de Lima, no recibe tratamiento y un poco mas del 70%, en provincias. La prevalencia de HIV/AIDS (2005, adultos), en el Peru es 0,6%, aunque se sospecha que en Iquitos, la prevalencia es mayor. Segun Cohen muchos investigadores foraneos, ansian venir al Peru, porque hay facilidades para realizar investigaciones: cambios conductuales en afectados, tratamientos farmacológicos preventivos breves a personas no infectadas expuestas, indagar las causas por las que en Perú hay epidemias de relaciones Hombre-Hombre, no conociedose bien porque no se expande en mujeres. Un investigador afirma que sucede porque las mujeres peruanas, son monogamas, etc

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