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University of Notre Dame forum examines AIDS crisis in Africa (Haiti)

By JOSEPH DITS

Tribune Staff Writer

SOUTH BEND ? Dr. Miriam Laker Opwonya runs a program for HIV and AIDS drugs at a clinic in her native Uganda where patients walk away empty-handed because they cannot afford a 50 cent drug.

?I look at this place and think there's not anything like this in Uganda,? said Opwonya, sitting inside the relative opulence of the Joyce Center at the University of Notre Dame. ?You people have been given a lot.?

Her point is that the United States can afford to help fight AIDS. A disease that kills at least 3,000 people a week in Zimbabwe alone. A disease for which only 4 percent of the 24.5 million people with HIV in sub-Saharan Africa can afford the life-saving drugs.

?Knowledge is power,? Opwonya said. ?A lot of people in America do not know exactly what is happening in Africa.?

She and two noted minds in global health issues came Thursday to clue in about 3,600 students and faculty at the University of Notre Dame, where classes stopped for the forum. An estimated 400 people watched a webcast of the forum.

Questions were fired by moderator Gwen Ifill, who is managing editor of the PBS show ?Washington Week? and correspondent for ?The NewsHour with Jim Lehrer.?

Dr. Paul Farmer showed two pictures of hope. The first was of Joseph, a Haitian man with AIDS and tuberculosis whose skin looked vacuum-packed against his bones. The second was of Joseph six months later, fleshy and holding a baby, thanks to treatment at Farmer's clinic.

In spite of political turmoil in Haiti, Farmer said, people are working together to make headway against health issues.

He said it's critical to build up the whole health sector in these areas and to ensure doctors have what they need to cure people. He has worked extensively with the poor of Haiti and founded an organization, Partners in Health, to provide health care to the world's poorest.

Economist Jeffrey Sachs says that 90 percent of the solution is understanding the problem, 10 percent is ?getting Paul Farmer the right medicines.?

He pointed out that malaria, a mosquito-borne disease that is ?100 percent curable,? will kill more than 2 million people this year ? many of them children.

One day of spending on the Iraq war would easily pay for mosquito nets across Africa to prevent malaria, he argued.

?Don't let anyone ever tell you we can't afford this,? he said, gaining the crowd's applause.

He spoke of the United Nations Millennium Project that he leads. The project invested $3,000 into building materials for a five-room clinic in Kenya that now sees 200 people a day.

The problem in so many developing nations like Uganda, he said, is that the governments are impoverished and unable to provide HIV drugs.

Most of the HIV drugs in Uganda are paid for with foreign aid, said Opwonya, who coordinates clinical trials for anti-retroviral drug therapy for HIV and AIDS at Makerere University in the city of Kampala.

She said that education about risky sexual behavior helped to whittle Uganda's HIV rates from 23 percent in 1989 to 6 percent in 2000.

At 29, she said behavior education affected the decisions she made in life.

In Africa, she said, children are raised to believe they should marry. In some cultures, marriage happens when a man and woman simply move in together. Given the AIDS risk, the pressure to marry can turn fatal if you aren't careful.

?Behavior change is teaching a woman you can be a person even when you are not married,? Opwonya said.

She said that in the last five years there has been great concern over HIV-positive mothers transmitting the disease to their newborn babies via breast milk.

Mothers, fearing the HIV stigma, face an awkward situation when family members come to the home and wonder what is going on when a child isn't breast-fed, she said.

One option out there is to breast-feed for three months, then go strictly to a bottle. Other efforts look for donations of healthy breast milk from the public. Or they use boiled milk, but that requires a refrigerator that many people don't have.

Farmer said that any use of tainted breast milk is bad: ?We will never eradicate HIV among children if one of the options is HIV-infected breast milk.?

Staff writer Joseph Dits:

jdits@sbtinfo.com

(574) 235-6158