Carolyne Nakazibwe
5 September 2003
Kampala — Aids: Ugandans complying well in taking drugs
Ugandans living with HIV/Aids are less likely to develop resistance to anti-retroviral drugs than their American counterparts, a recent study has shown.
The study done in Botswana, Senegal, South Africa and Uganda, showed that the 29 Ugandan patients surveyed were taking 91 percent of their pills.
The results of the study, published in Thursday's edition of the US daily, The New York Times, show that Ugandans were doing better than American patients whose compliance lies at 70 percent.
This has dispelled fears that Africans cannot manage the strict dosage of Aids drugs, hence running a risk of causing severe drug-resistance worldwide.
Dr David Bangsberg, a professor of medicine at the University of California in San Francisco, studied the compliance patterns in the United States and Africa.
"Though poor, more than 80 percent of the Ugandans had jobs?and most earned less than $50 [Shs 100,000] a month. Most were women in their 30s, and paying $27 [Shs 54,000] a month for their twice-a-day, three-drugs-in-one pill called Triomune, made by Cipla Ltd. of Bombay," the paper reported.
Prof. John Rwomushana, the director of Aids Research and Policy Development at the Uganda Aids Commission, told The Monitor yesterday that the high compliance levels are attributable to the newness of the drugs in Uganda.
Rwomushana said that the Aids Commission, in its own study, had found similarly high compliance levels among Ugandans.
He also said that unlike in the West where people have had access to the drugs for several years, anti-retrovirals are just picking up in Uganda and, therefore, pose less risks of drug resistance.
At least 150,000 Ugandans with Aids need anti-retrovirals.
Government is in advanced stages of making available free drugs to all Ugandans who need them.
"When we get a chance to live again, we take it seriously. [The people in the West] take it for granted, and some of them don't even give up alcohol, smoking, and the rest," Maj. Rubaramira Ruranga, a Ugandan who has lived with the virus for more than 18 years, said yesterday.
"Ugandans who get a chance to get these drugs really cherish them, so there can be no drug resistance in the short run."
He also said that he has a CD4 count of more than 1,000, a fact that points to consistent use of the drugs. A person living with HIV needs to start using drugs when the CD4 count falls to below 200.
"I will use these drugs for a long time," he said. According to the New York Times, Dr Merle A. Sande, a professor at the University of Utah Medical School who also works in Uganda, said that extended families in Uganda help buy drugs for a member and in a sense that compels him or her to not fail them with the drugs.
"If the whole family is pooling its resources to pay for you," he said, "you damn well better take your drugs."
The paper also quotes Dr Elly Katabira of Makerere University Medical School. He attributes the good compliance levels in Uganda to the stage at which patients start therapy, which makes the drug look like a miracle worker.
Other African countries such as Botswana and South Africa also showed good compliance rates of 85 percent and 95 percent respectively, a trend widely attributed to the generic drugs' presence.
Pharmaceutical companies in India are now making triple drug cocktails in as few as two pills a day, a technique unknown in the United States due to patent laws.
People living with HIV in the United States have to take several pills a day to complete the three-drug combination, which makes adherence difficult.
A USAID administrator kicked off a storm in 2001 when he said that anti-retrovirals would not work in Africa because many Africans do not use clocks and do not know what Western time is.
The study comes in the wake of the discovery that 10 percent of all new HIV infections in Europe are resistant to at least one drug.
Be the first to Write a Comment!
Copyright © 2003 The Monitor. All rights reserved. Distributed by AllAfrica Global Media (allAfrica.com). To contact the copyright holder directly for corrections — or for permission to republish or make other authorized use of this material, click here.
AllAfrica aggregates and indexes content from over 125 African news organizations, plus more than 200 other sources, who are responsible for their own reporting and views. Articles and commentaries that identify allAfrica.com as the publisher are produced or commissioned by AllAfrica.
