PRETORIA, South Africa—It's 8 a.m. and Dr. Theresa Rossouw is already drowning behind a cluttered desk of handwritten HIV charts -- new, perplexing cases of patients whose lifesaving drugs have turned against them.
Her cell phone chirps. Her desk phone bleats. She scribbles notes on a planner, spins in her chair, juggles requests about labs and drug regimens.
Rossouw is on the front lines of a new battle in the fight against HIV: The drugs that once worked so well are starting not to work. And now the resistance is showing up in sub-Saharan Africa, home to two-thirds of the world's 33 million HIV cases.
Ten years ago, between 1 percent and 5 percent of HIV patients worldwide had drug resistant strains. Now, between 5 percent and 30 percent of new patients are already resistant to the drugs. In Europe, it's 10 percent; in the U.S., 15 percent.
In sub-Saharan Africa, where the drugs only started arriving a few years ago, resistance is partly the unforeseen consequence of good intentions. There are not enough drugs to go around, so clinics run out and patients can't do full courses. The inferior meds available in Africa poison other patients. Misprescriptions are common and monitoring is scarce.
The story of HIV mirrors the rise worldwide of new and more deadly forms of killer infections, such as tuberculosis and malaria. These diseases have mutated in response to the misuse of the very drugs that were supposed to save us, The Associated Press found in a six-month look at soaring drug resistance worldwide.
In Rossouw's shabby little HIV clinic, the tragedy has arrived. She's increasingly bombarded with drug-resistant cases, and there's nothing in her arsenal of medicines to throw at them.
"For the first two or three years I was not seeing it. It was rare," she said, rifling through a patient's tattered record. "Now it is really daily. I think in the next five years, we are going to have such a need."
--------
It's midmorning and Rossouw's first patient slips inside from the crowded hallway where up to 200 others wait on wooden benches. Monica, who only wishes to be identified by her first name for fear of discrimination, takes a seat.
Rossouw, 37, greets her warmly in their native Afrikaans. She is the only doctor -- out of the six at Tshwane District Hospital's HIV clinic -- who speaks the language, adding translator to her litany of other duties.
Monica, 45, looks and feels healthy. It's hard to believe she's had HIV for nearly a decade. Now she's faced with a new threat, one Rossouw isn't sure the patient fully understands.
Monica has widespread drug resistance -- everything has stopped working. But she's not feeling the sting yet, and it's hard for her to believe a piece of paper that says her meds aren't working.
In sub-Saharan Africa, resistance rates have quietly climbed to around 5 percent in the past few years, and that's a substantial undercount. It's hard to pinpoint resistance because most cases in the developing world aren't tracked. In some high-risk populations worldwide, HIV drug resistance rates soar as high as 80 percent, according to studies published in AIDS, the official journal of the International AIDS Society.
The United Nations estimates $25 billion will be needed to fight AIDS worldwide in 2010, but probably only half that sum will be available. That estimate doesn't account for drug-resistant strains, which could cost $44 billion by 2010.
Monica's slip came in 2004, when, distraught over her mother's death, she went off of her treatment for two months.
"I took the death badly," she said softly. "I had an appointment with the doctor and decided that now that my mom has died, I must die as well."
The HIV drugs used in Africa are very unforgiving, unlike the newer pills used in the West. Miss a dose here or take a pill late, and the virus quickly wins control. There are only a handful of drugs available in South Africa, and once those stop working there are no more options.
Rossouw found an obsolete HIV drug at another hospital and hopes it will keep Monica alive. But she's experimenting at this point.
Saturday, 02 January 2010
HUNGER: New Warning on Food Security for Horn of Africa
By Susan Anyangu-Amu
NAIROBI, Dec 30 (IPS) - The European Commission Humanitarian Aid Department (ECHO) has raised a red flag over the worsening food security situation in the Horn of Africa.
Karel De Gucht, European Commissioner in charge of development and humanitarian aid, attributes the disastrous situation to the terrible potential of climate change.
"Large parts of the Horn of Africa have had less than 75 percent of normal rainfall this year, having already endured a series of severe droughts. The population can no longer cope with such extreme and protracted hardship which often comes on top of conflict situation. As a result, more than 16 million people desperately need help," he said in a statement released by ECHO.
Initial optimism occasioned by forecasts of El Niño rains were thwarted when November proved largely dry. El Niño refers to a periodic warming of temperatures in the Pacific Ocean, far from East Africa's shores but with impacts on the country's rainfall and weather patterns.
Samuel Mwangi, acting assistant director of Kenya's national weather forecasting services explains that El Niño has been linked with greater rainfall during the annual "short rains" in East Africa, between October and December.
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HUNGER: New Warning on Food Security for Horn of Africa
By Susan Anyangu-Amu
NAIROBI, Dec 30 (IPS) - The European Commission Humanitarian Aid Department (ECHO) has raised a red flag over the worsening food security situation in the Horn of Africa.
Karel De Gucht, European Commissioner in charge of development and humanitarian aid, attributes the disastrous situation to the terrible potential of climate change.
"Large parts of the Horn of Africa have had less than 75 percent of normal rainfall this year, having already endured a series of severe droughts. The population can no longer cope with such extreme and protracted hardship which often comes on top of conflict situation. As a result, more than 16 million people desperately need help," he said in a statement released by ECHO.
Initial optimism occasioned by forecasts of El Niño rains were thwarted when November proved largely dry. El Niño refers to a periodic warming of temperatures in the Pacific Ocean, far from East Africa's shores but with impacts on the country's rainfall and weather patterns.
Samuel Mwangi, acting assistant director of Kenya's national weather forecasting services explains that El Niño has been linked with greater rainfall during the annual "short rains" in East Africa, between October and December.
Worried consumers
Priscah Nzilani a domestic worker in Nairobi’s Eastlands area and a single mother of four says she has nothing to be cheerful about as she ushers in the New Year. She is wrought with worry about the demands the forthcoming year will place on her family.
"Since 2007 the cost of food has been increasing steadily, reaching levels that are out of reach for most Kenyans. The failed rains brought with them more troubles with the cost of electricity reaching a record high. We also had consistent water shortages which continue to persist and we are forced to dig deeper into our pockets to buy water at an extra cost. With this kind of scenario how does one find it in their heart to be cheerful about the New Year?" she pauses.
Nzilani adds that with the failure of the much anticipated El Niño rains, there is no reprieve for Kenyans.
"I am worried that my earnings as a domestic worker will not suffice to feed and educate my children as well as meet their other basic needs. We have been surviving by skipping meals and at this rate I think we shall have to make do with only one meal a day," she says with a forlorn look on her face.
ECHO warns that if the December rains are below average, parts of Kenya may suffer irreparable damage.
ECHO regional information officer Daniel Dickinson told IPS, "In the face of the unfolding drought situation, ECHO is providing 50 million euros in humanitarian aid to vulnerable drought-affected people in Somalia, Ethiopia, Kenya and Uganda. The rains have failed and people have exhausted the coping mechanisms which they had and urgently need help."
Kenya's minister for special programmes, Naomi Shaban, issued a similar warning in mid- December over the worsening food security situation across the country.
NAIROBI, Dec 30 (IPS) - The European Commission Humanitarian Aid Department (ECHO) has raised a red flag over the worsening food security situation in the Horn of Africa.
Karel De Gucht, European Commissioner in charge of development and humanitarian aid, attributes the disastrous situation to the terrible potential of climate change.
"Large parts of the Horn of Africa have had less than 75 percent of normal rainfall this year, having already endured a series of severe droughts. The population can no longer cope with such extreme and protracted hardship which often comes on top of conflict situation. As a result, more than 16 million people desperately need help," he said in a statement released by ECHO.
Initial optimism occasioned by forecasts of El Niño rains were thwarted when November proved largely dry. El Niño refers to a periodic warming of temperatures in the Pacific Ocean, far from East Africa's shores but with impacts on the country's rainfall and weather patterns.
Samuel Mwangi, acting assistant director of Kenya's national weather forecasting services explains that El Niño has been linked with greater rainfall during the annual "short rains" in East Africa, between October and December.
PrintSend to a friend
HUNGER: New Warning on Food Security for Horn of Africa
By Susan Anyangu-Amu
NAIROBI, Dec 30 (IPS) - The European Commission Humanitarian Aid Department (ECHO) has raised a red flag over the worsening food security situation in the Horn of Africa.
Karel De Gucht, European Commissioner in charge of development and humanitarian aid, attributes the disastrous situation to the terrible potential of climate change.
"Large parts of the Horn of Africa have had less than 75 percent of normal rainfall this year, having already endured a series of severe droughts. The population can no longer cope with such extreme and protracted hardship which often comes on top of conflict situation. As a result, more than 16 million people desperately need help," he said in a statement released by ECHO.
Initial optimism occasioned by forecasts of El Niño rains were thwarted when November proved largely dry. El Niño refers to a periodic warming of temperatures in the Pacific Ocean, far from East Africa's shores but with impacts on the country's rainfall and weather patterns.
Samuel Mwangi, acting assistant director of Kenya's national weather forecasting services explains that El Niño has been linked with greater rainfall during the annual "short rains" in East Africa, between October and December.
Worried consumers
Priscah Nzilani a domestic worker in Nairobi’s Eastlands area and a single mother of four says she has nothing to be cheerful about as she ushers in the New Year. She is wrought with worry about the demands the forthcoming year will place on her family.
"Since 2007 the cost of food has been increasing steadily, reaching levels that are out of reach for most Kenyans. The failed rains brought with them more troubles with the cost of electricity reaching a record high. We also had consistent water shortages which continue to persist and we are forced to dig deeper into our pockets to buy water at an extra cost. With this kind of scenario how does one find it in their heart to be cheerful about the New Year?" she pauses.
Nzilani adds that with the failure of the much anticipated El Niño rains, there is no reprieve for Kenyans.
"I am worried that my earnings as a domestic worker will not suffice to feed and educate my children as well as meet their other basic needs. We have been surviving by skipping meals and at this rate I think we shall have to make do with only one meal a day," she says with a forlorn look on her face.
ECHO warns that if the December rains are below average, parts of Kenya may suffer irreparable damage.
ECHO regional information officer Daniel Dickinson told IPS, "In the face of the unfolding drought situation, ECHO is providing 50 million euros in humanitarian aid to vulnerable drought-affected people in Somalia, Ethiopia, Kenya and Uganda. The rains have failed and people have exhausted the coping mechanisms which they had and urgently need help."
Kenya's minister for special programmes, Naomi Shaban, issued a similar warning in mid- December over the worsening food security situation across the country.
Pirate Cash Suspected Cause Of Kenya Property Boom
NAIROBI, Kenya (AP) ―
Property prices in Nairobi are soaring, and Somali pirates are getting the blame.
The hike in real estate prices in the Kenyan capital has prompted a public outcry and a government investigation this month into property owned by foreigners. The investigation follows allegations that millions of dollars in ransom money paid to Somali pirates are being invested in Kenya, Somalia's southern neighbor and East Africa's largest economy.
Even as housing prices have dropped sharply in the United States, prices in Nairobi have seen two- and three-fold increases the last half decade.
"There is suspicion that some of the money that is being collected in piracy is being laundered by purchase of property in several countries, this one being one of them," said government spokesman Alfred Mutua. "Especially at this time when we are facing global challenges of security such as terrorism and others, it is very important for us to know who is where and who owns what."
The investigation will also help the government catch tax evaders, he said.
Kenya may be the most attractive spot for pirates to launder their money because it shares a roughly 500-mile (800-kilometer) border with Somalia and has investment opportunities and a large Somali community of up to 200,000 people, Mutua said.
Property prices in Nairobi are soaring, and Somali pirates are getting the blame.
The hike in real estate prices in the Kenyan capital has prompted a public outcry and a government investigation this month into property owned by foreigners. The investigation follows allegations that millions of dollars in ransom money paid to Somali pirates are being invested in Kenya, Somalia's southern neighbor and East Africa's largest economy.
Even as housing prices have dropped sharply in the United States, prices in Nairobi have seen two- and three-fold increases the last half decade.
"There is suspicion that some of the money that is being collected in piracy is being laundered by purchase of property in several countries, this one being one of them," said government spokesman Alfred Mutua. "Especially at this time when we are facing global challenges of security such as terrorism and others, it is very important for us to know who is where and who owns what."
The investigation will also help the government catch tax evaders, he said.
Kenya may be the most attractive spot for pirates to launder their money because it shares a roughly 500-mile (800-kilometer) border with Somalia and has investment opportunities and a large Somali community of up to 200,000 people, Mutua said.
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