What is AIDS?

By F. Merlin Flower

The pregnant woman was admitted to St. John's Hospital, a prominent medical college in Bangalore, India. The next evening she had labour pain. But before the child was born, her husband died in the same hospital. The cause of death was HIV/AIDS. The mother and the child were also diagnosed with the same disease. Reads like a story? It is! But a real story. The husband was one among the three million people who die annually due to HIV/AIDS.

The Human Immunodeficiency Virus (HIV) causes AIDS. AIDS is Acquired Immune Deficiency Syndrome ("syndrome" means a collection of illnesses). HIV destroys a certain kind of blood cell (CD4+ T cells) which is crucial to the normal functioning of the human immune system. Thus people with AIDS have a weak immune system, making them an easy target for germs which otherwise would have been quite harmless and controllable with medicines. But usually the virus remains in the body for years before damaging the immune system. Thus there can be cases where people can have HIV infection but show no symptoms of the disease. The advent of powerful anti-retroviral therapies has reduced the progression time between HIV infection and the development of AIDS. But so far no cure has been found for the disease. There are a few scientists, as well as South African president Thabo Mbeki, who claim that HIV doesn’t cause AIDS, however the argument can be rejected, as they haven’t substantiated their claims with evidence.

"There are cases where the husband is HIV-positive while the wife is HIV-negative and vice versa. In such cases it’s the doctor's responsibility to handle the cases with care," said Veena, a counselor at Vanivilas Hospital, Bangalore. At Vanivilas, blood tests of pregnant women are the most common way of finding patients with HIV/AIDS. The patients thus identified are given group counseling and then counseling on a one to one basis.

They are told that the Human Immunodeficiency Virus (HIV) usually spreads through four ways:

The social taboos attached to the disease are enormous. There were cases in the Indian state of Kerala where people refused to bathe in the pond used by a HIV/AIDS patient. The taboos attached to the disease make people shun the HIV/AIDS patients. Even the children with the disease aren't spared. The doctors in Vanivilas take special care to give counseling to the relatives, in an attempt to remove these taboos.

But Veena felt that it's very difficult to remove the misconceptions associated with the disease. The most common is the assumption that the virus spreads through insect bites. Though the virus is present in body fluids like saliva, semen, blood and sweat, insects can't transmit the virus. Many people shudder to touch HIV/AIDS patients when the fact remains that the virus does not spread through a hug or a handshake. Most of the scientists agree that HIV does not survive outside the human body and hence dismiss the notion of the virus spreading through the environment. A kiss is also safe as long as it's not a French kiss, involving the saliva. Here too there isn't much evidence to prove the transmission through saliva. But it’s better to make sure that the barber uses a disposable razor as the virus can spread through a razor.

"It's difficult to give these facts to illiterate people, but with repeated counseling they understand the disease," said Veena. There are a lot of rules the doctors follow while disclosing the blood tests. If the wife feels that her husband shouldn't know her disease, the doctors don't disclose it. This then becomes a confidential report.

The pregnant women diagnosed with HIV/AIDS are given the drug zidovudine (also known as AZT) to minimize the transmission risk from the mother to the child. But even after the medicine is administered, there is a 30 per cent risk that the child too would get the disease. The couples are advised to have healthy food and regular exercise. HIV/AIDS patients usually have a weak immune system, so they are given two groups of medicines. One group helps the immune system to fight illnesses caused due to a weak immune system and the other group of medicines is given to slow the spread of HIV. Some patients' viruses are resistant to certain drugs, and it is the duty of the medical practitioner to note the resistance shown to the drugs and give appropriate treatment.

HIV/AIDS is detected through both direct and indirect methods. Noting the antibodies people produce against the disease is the simplest and cheapest test done for detecting HIV/AIDS. In the direct method, the test used is called ELISA. This can be confirmed with another test called Western Blot. The tests can give negative results during the first few months after infection, the "window period." Therefore, a second test is done after six months to confirm the absence of disease.

Some of the symptoms of HIV/AIDS are diarrhea, thrush (yeast infection of the mouth, leaving a persistent yellow or white coating on the teeth), weight loss, fatigue, nausea and vomiting, burning and tingling of the feet and hands, depression and sinus infection (There is pounding in the head and face, and the head feels congested.). This short "seroconversion" illness may appear two to six weeks after being infected. Following this there may be periods with no outward signs or symptoms. In some cases these symptoms may appear in the initial stages and continue without disappearance. During advanced stages the person may develop many infections considered to be indicators of AIDS: toxoplasmosis, Pneumocystis carinii pneumonia (PCP), cytomagalovirus disease (CMV), and Candidiasis (thrush) in the oesophagus, throat or lungs. Tuberculosis is the most common cause of death in patients with HIV/AIDS. It is hard to predict the life span of a HIV/AIDS victim. It may take only a year or decades for the symptoms to appear.

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The patient who has AIDS has a responsibility towards himself and others. He should take several precautions:

The doctors and nurses too should take necessary precautions. When injecting a patient, if the doctor or nurse pricks herself/himself the virus could be transmitted, and hence they should be very careful.

"What a HIV/AIDS patient needs are a little love and understanding and not stares from people," said Veena. "People should be given awareness and help the HIV/AIDS patients live a life with dignity."

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Marshall 2: A Plan To Wipe-Out Poverty

By Larry Baum

Britain has proposed a major plan to fight world poverty. Gordon Brown, the UK's Chancellor of the Exchequer, is urging rich countries to double global aid to the developing world to $100 billion a year. The scheme would benefit the world's poorest countries by reducing trade barriers, cancelling all national debt, and giving financial assistance. The basis of the plan would be an International Finance Facility, which would issue bonds using as collateral the long-term funding commitments by rich countries. Brown urges the world's richest nations to cancel the $80 billion in debt owed by poor countries to the World Bank, the International Monetary Fund, and the African Development Bank. He has dubbed his project the modern day Marshall plan, after the former US secretary of state George Marshall, who initiated a large program that helped rebuild Europe's economy after World War 2.

The plan would help in the effort to meet the Millenium Development Goals adopted by the UN in 2000. All 191 UN member states have pledged to meet these goals by 2015. They include the following points:

This year, Britain occupies the revolving presidency of the Group of Seven (G7) industrialised nations. Brown is using Britain's presidency to push for the plan as G7 finance ministers convene today and tomorrow. France and Italy have already backed the IFF. German Chancellor Gerhard Schroeder announced his country's support at the World Economic Forum in Davos, Switzerland: "The British Government has come in and made a proper proposal here. They have said we should have an International Financial Facility that will help us in the short run ensure we reach the Millennium goals with a greater degree of certainty. I think the proposals of the British Government are good proposals and therefore we should discuss them properly and hopefully implement some of them during the G8 summit."

The other G7 members, Japan, Canada, and the US, have not yet accepted the plan. The US is reportedly sceptical of the project. US President George Bush had launched his own aid program, the millennium challenge account, which allocates foreign aid to governments based on their anti-corruption measures, transparency, and good governance.

US actor Danny Glover urged support for such efforts, saying, "I believe in reparations for slavery and colonisation as well, in the shape of a Marshall Plan." Former South African president, Nelson Mandela, has called for an accelerated fight against poverty. At an anti-poverty rally organised by the Make Poverty History campaign, in London, he said that the fight against poverty was as important as the fight against slavery. He will meet with the G7 finance ministers today to discuss plans to end world poverty.

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