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Will Africa Benefit From New AIDS Drugs? - 2002-07-12

There's been much talk about vaccines and new medications at the 14th International AIDS Conference in Barcelona. But how much will Africa benefit?

Dr. Vincent Idemyor is the director of pharmaceutical services at Chicago's Bethany Hospital and is on the faculty at the University of Illinois College of Medicine in Chicago.

He says simply providing Africa with two or three anti-retroviral drugs won't solve the long-term problems for those in need. He says currently in the developed nations 16 drugs are used in various combinations. Varying the combinations of the drugs is necessary, Dr. Idemyor says, because patients can build up a resistance to their medications and HIV can quickly multiply.

"Fifty percent of the patients who received anti-retroviral therapy from 1996 to 2000 (surveillance from about nine cities in the United States) clearly showed that 50 percent of these patients were resistant to at least one drug," he said. "At least one anti-retroviral therapy. Then, the number goes down, the percentage goes down, when you look at whether you have two drugs or three drugs."

Dr. Idemyor says based on studies of drug resistance in developed countries, it doesn't take long for that resistance to develop.

"The durability is based on what we found in the Western world for most of these anti-retroviral drugs before we start changing combinations. It's anywhere between 1.5 to two years," the doctor said.

Dr. Idemyor says if Africa receives all the latest medications, it will be better able to deal with the resistance problem.

He says while the world waits for a cure and a vaccine, the development of a microbicide, a gel or a suppository that kills HIV, would be of great benefit to Africa and elsewhere. A microbicide can be used by a woman during sexual intercourse for protection without her male partner's knowledge. Dr. Idemyor says this could help protect women when their partners refuse to use condoms. A number of microbicides are in development, but none are on the market.