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DECEMBER 30, 1996/JANUARY 6, 1997 VOL. 148 NO. 29
While researchers were celebrating the latest AIDS advances in Vancouver this summer, Rosemary Omuga had other things on her mind. Since testing positive for HIV in 1992, the Kenyan mother of four has lost both her job as a midwife and her home. Today she barely earns enough to keep her children alive and cover her $12 monthly rent on a tin-roof shack in one of Nairobi's most fetid slums. Treating her illness is low on her list of priorities. In a good week, when she gets paid to give talks about AIDS to employees of the local railway company, she manages to scrimp enough to buy a palliative for her recurrent diarrhea or a dose of the latest herbal AIDS "cure." But even those she considers luxuries. "We are dying because we don't have medicines," she says. "I heard that there are new treatments. But I cannot afford them." For Omuga, this year's good news on AIDS underscores a bitter truth: the new combination therapies are of little use to 90% of the people suffering from the disease. In Africa, India, Thailand and to a growing extent Central and Eastern Europe, the treatment's price tag of up to $20,000 a year puts it way beyond the grasp of all but the superrich. "With this discovery, the AIDS gap only becomes wider," laments Dr. Peter Piot, executive director of the U.N.'s AIDS program. To most AIDS researchers, it has become painfully obvious that drugs of any kind, no matter how effective, are not the solution to the world's deadliest epidemic. But a vaccine, which would address the problem, is not a top priority in Western laboratories. Indeed, with the new optimism on AIDS, some are beginning to talk about reducing funding for basic research. That, according to Piot, would be a fatal error. "As long as HIV exists somewhere in the world," he says, "it threatens us all." Meanwhile, AIDS is tightening its grip outside the U.S. and Western Europe. In India, researchers estimate that by the year 2000, anywhere from 15 million to 50 million people could be HIV positive. Half the prostitutes in Bombay are already infected, and doctors report that the disease is spreading along major truck routes and into rural areas, as migrant workers bring the virus home. In Central and Eastern Europe, countries that had largely escaped the epidemic are seeing an explosion in the number of cases, mainly among IV drug users and their heterosexual contacts.
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