The first thing that has really struck me about this conference is how we have lost the expanded definition of treatment and now only talk about ARVs. There is little in the programme about other important treatments like good nutrition and practical remedies for OIs. Although there is no doubt that ARVs are important, it will still be some time before they reach countries which are hardest hit by the epidemic. Even when they are available, not all PLHA will need, or indeed want, to take them.

Some 80% of people in developing countries go first to traditional healers for treatment which is affordable, often highly effective and sustainable. We should also be talking more about how to incorporate natural indigenous medicine practitioners into the health system for strengthening immune health and for counseling.

I was encouraged to hear at the opening ceremony, as well as at an OVC session, talk about economics directly and indirectly fuelling the epidemic. Privatisation and trade liberalisation put us in the South deeper and deeper into poverty. Even if we end up convincing the drug companies to provide affordable antiretrovirals, we still need to address poverty. We will be moving one step forward and two steps back if in ten years’ time my child is still at risk of HIV infection through poverty.

One challenge with regard to antiretroviral and OI treatment in developing countries is that medical practitioners that administer at public and private institutions as well as at trial points remain uninformed. Hence we as PLHA end up having little or no information about the medications that we take. We need to find ways through our ASO networks to ensure that the information on the ever-changing treatment picture gets to all PLHA and is user-friendly in terms of culture and language.

Fezeka Ntsukela Kuzwayo

AIDS 2002 Conference News produced by Health & Development Networks/Key Correspondent Team