University of Zambia Medical Library

HIV/AIDS in Zambia: January 2000

"Children Orphaned by HIV/AIDS in Zambia: Risk Factors From Premature Parental Death and Policy Implications." By Namposya Nampanya-Serpell (Dissertation for the PhD degree in Policy Sciences, University of Maryland, Baltimore County, Awarded 1998)
AF-AIDS, January 31, 2000

Abstract:
This study of children orphaned by the AIDS pandemic in Zambia investigated risk and protective factors in rural and urban communities associated with the impact of premature parental death on educational, health, nutritional and emotional outcomes.

Retrospective data were collected for a cohort of 645 urban and 291 rural orphans aged 0-15, one or both of whose parents died from AIDS between 1991 and 1995. Structured interviews were conducted with 223 urban and 101 rural caregiving families in low-income neighborhoods. In both urban and rural settings, age was the principal factor predictive of nutritional and health status with younger children the most vulnerable. Educational continuity was most severely jeopardized in the urban sample for children of low-income families and girls, but in the rural sample age was the most significant risk factor: older children were often withdrawn from school to care for their younger siblings. Emotional well-being was less clearly related to familiarity of the child with the caregiver than to sibling dispersion, which was a major risk factor in the urban sample.

Implications are discussed for the design of services to reach children and families with the greatest needs. Intervention strategies should be carefully adjusted to the ecological, socio-cultural, and economic conditions of each community.

Key findings:

• Certain risk and protective factors varied between the two environmental settings: In the urban sample, the socioeconomic status of the caregiving family was a significant factor in determining the educational continuity of the children, with orphans in poorer families more likely to drop out of school. In the rural sample, age was a more critical factor, with older orphans more likely to be withdrawn from school to care for their younger siblings.
• For nutritional status, age was a critical factor in both urban and rural groups, with younger children displaying more signs of malnutrition. As regards health status, again, younger children in the rural sample were reported to have more frequent health problems; this was not the case in the urban sample.
• .For the emotional status of children: in the urban sample sibling dispersion was a critical factor, with children separated from their siblings showing more signs of emotional disturbance. In the rural sample, a larger number of adults in the caregiving family was a significant negative influence on the emotional status of those orphans residing in such households.
• A survey of key players in several agencies working with AIDS-affected families revealed a high level of general awareness of HIV/AIDS and its impact on children, families, and communities. This awareness reduced the stigma associated with AIDS, nevertheless, services provided to families was reaching less than 10% of children orphaned by AIDS and home-based care services to HIV-infected individuals and their uninfected children were poorly integrated in other systems of care.
• Most of the deaths in the urban sample were paternal and the majority of those deceased were also the bread winners for their families. Thus, their death left widows and their children economically disadvantaged. Most of those families transitioned very quickly from middle class housing to poorer neighborhoods, sometimes without running water and/or electricity

Recommendations:

• Financial aid was needed for poor urban orphans to continue their education, and for rural families, assistance was needed to compensate for labor loss so that older orphans are not withdrawn from school.
• In both settings younger children were more at risk for malnutrition and should therefore be targeted for feeding programs and additional health services.
• Sibling dispersion should be avoided where possible and financial resources provided to the caregiving family that offers to keep all the orphaned siblings in one household.
• Areas of focus at community level could include supplementary structures in schools and clinics, targeting caregivers, and integrating home-based services with services for uninfected children.
• Widows need assistance to become economically productive (e.g. with IGAs/micro-finance).

For information on obtaining a copy, contact:
Namposya Nampanya-Serpell, PhD
2703 Maurleen Court, Baltimore, MD.21209
E-mail: N. Nampanya-Serpell

"Condoms Unbiblical, says Chintala." By Kelvin Shimo
The Post, January 28, 2000

The use of condoms is not a biblical and Godly answer to solving the HIV/AIDS scourge, deputy minister in charge of the religious affairs desk at State House Reverend Peter Chintala told the House yesterday.

Contributing to President Frederick Chiluba s speech, Chintala said abstinence from sex, drugs and alcohol were the only biblical ways to contain the scourge. He said since Zambia has been declared a Christian nation, people should look at what they champion adding that bad things should be done away with.

"TIAN Drug Catches International Attention ."
Times of Zambia, January 27, 2000

The Tian Immunity Booster (TIB) HIV/AIDS drug has drawn international attention with latest enquiries coming from Namibia and Botswana. The Cable Network News (CNN) were also reportedly interested in the discovery story of the drug which some patients confirm reduces or completely erases HIV symptoms. In an e-mailed enquiry to the Times yesterday a senior official from the electoral commission of Namibia said the drug should be sent to that country so that Namibians could also benefit.

"I have just read your article about the Tian Immunity Booster HIV drug in the January 24 issue. Maybe it could also benefit some people here in Namibia. Could you possibly supply us with the address for the doctor," the official said. This newspaper first broke the story of the TIB a fortnight ago. Patients interviewed at random confirmed that the three-series drug was effective as it increased their CD4 cells, the cells which defend the body's immunity system and also reduced the viral load.

Dr Tian Shengxun, the doctor behind what may be a breakthrough of a cure for the deadly disease yesterday confirmed the international enquiries. He said many HIV infected people from Botswana were now asking for his drug made out of traditional Chinese medicines. Dr Tian also confirmed that the CNN were interested in the story concerning his drug.

At the weekend, Health Minister David Mpamba said the TIB would like any other medicines be tested to determine its efficacy. Government would support any breakthrough. Dr Tian last week said he was ready to have his drug tested in any laboratory in the world at any time.

"Chinese AIDS Will Be Tested, Says Minister."
Times of Zambia, January 24, 2000

The Tian Immunity Booster HIV/AIDS drug will be tested to determine its scientific efficacy, Health Minister David Mpamba said yesterday. Mr Mpamba in an interview said all claims of HIV/AIDS remedies would be tested by local scientists under the auspices of the Medical Council of Zambia and the Pharmacy and Poisons Board.

"I am not an expert to comment (on the Tian Immunity Booster) but the relevant bodies will conduct a scientific test to examine these claims. It needs scientific approval, and no one that claims they have found a cure will be blocked by anybody. "All those with a discovery will be supported and helped by Government," he said, adding the HIV/AIDS pandemic had to be tackled with all the energies available.

A Chinese doctor resident in Zambia Tian Shengxun has a three series medicine, the Tian Immunity Booster, which many patients have attested to reducing the viral load and increasing their CD4 cells, the cells that defend the body's immunity system. Dr Tian when contacted yesterday said he was happy that Government would move in to help with the examination of his drug. "I am very happy. Like I said last week, I am more than ready to have my medicine tested any time. My medicine works and patients can tell you that," Dr Tian said.

In another development, Mr Mpamba said the HIV/AIDS awareness campaign was working positively and this had led to a drop in the prevalence of the disease and infections among teenagers aged between 15 and 19 from 28 per cent in 1993 to 15 per cent in 1998. "We are on the right course. Cases of HIV have stabilised and the major factor is the education campaign which has been very good. Churches and other groups have helped in this area as people now maintain good morals. "The national committee of experts has also done a tremendous job and we are happy as Government with this development," Mr Mpamba said. He said the inter-ministerial committee on HIV/AIDS, a follow up to the XIth International Conference on STDs and AIDS in Africa (Icasa) which Zambia hosted last September, has already been constituted. The committee would soon start reviewing various issues to be presented to it by experts to formulate policy on the way forward in fighting the ravaging disease..

"What is Mother to Child AIDS Transmission?" By Mildred Mpundu
Times of Zambia, January 24, 2000

For decades, mothers world over have been told breast milk is best for baby. But today medical experts warn that the same milk facilitates the transmission of the HIV virus. This is but one way a mother risks passing on the deadly virus to her new born baby. Mother-to-child transmission (MTCT) of HIV has become a world concern.

Experts warn that a mother can also pass the virus to the baby during pregnancy, or labour or breast-feeding. If the mother is infected with the HIV virus before or during pregnancy, she may pass on the virus to the baby. The MTCT secretariat at the University Teaching Hospital (UTH) says research shows that when the number of viruses in the mother is high, chances of her infecting her unborn baby are very high.

"A high number of viruses are present at the time of infection or when a person starts to suffer from illnesses commonly seen in HIV/AIDS patients." "Therefore if a woman gets infected when she has already conceived, it is very likely that the child will get infected," according to information from the secretariat.

It has also been proved that one of the risky periods when a mother can infect her baby through direct contact between the baby and the mother's infected blood is during labour and delivery. The baby can also be infected through genital fluids when it is passing through the birth canal or from the infections from the vagina or cervix. Infection rate is high when there is an early rapture of membranes and injuries in the mother during an episiotomy. Breast-feeding among HIV positive mothers is said to contribute significantly to the proportion of MTCT cases. The period of infection varies according to the period of breast-feeding.

Spread of HIV is likely to be high in a culturally breast-feeding society like Zambia. Where no preventive measures are taken, the risk of a baby acquiring the virus from an infected mother ranges from 15 per cent to 25 per cent in industrialised countries and from 25 to 45 per cent in developing countries. It has been proven that the risk of transmission is increased when the mother has a higher viral load ( a case when a person is newly infected with HIV or is in an advanced stage of disease), or if the baby is highly exposed to the mother's infected body fluids during birth. The risk of infection through breast-feeding is high in developing countries because breast-feeding practices are more common there and are practices for usually longer periods than in industrialised countries.

A child born uninfected to an HIV positive mother has a one in five chance of acquiring the virus from her milk if it is breast-fed. "One child, every minute of everyday is being infected with HIV...Nearly 4.5 million children below the age of 15 years have been infected with HIV since the AIDS epidemic began, and more than 3 million of them have already died of AIDS...," according to UNAIDS, 1999 MTCT background briefs. In 1998, one in ten of all new infections was a child, and the majority acquired the virus from their infected mothers. "Though Africa accounts for only 10 per cent of the worlds population, it is home to 90 per cent of the world's HIV infected children, largely as a consequence of high fertility rates combined with very high levels of HIV infection among women," reads the brief.

MTCT is by far the largest source of HIV infection in children below the age of 15. It is said that in countries where blood for transfusion and blood products are regularly screened, and where clean syringes and needles are widely available in health centres and hospitals, MTCT is virtually the only source of infection in young children. The high rates of HIV infection among women of child-bearing age in some parts of the world is worrying. Today, there are almost 14 million women of child-bearing age throughout the world who are HIV positive. Among those women who are pregnant, the highest rates of infection have been reported from Sub-Saharan Africa.

UNAIDS reports that in urban centres in Southern Africa, for example, HIV rates of 20-30 per cent among pregnant women tested anonymously at antenatal clinics are common. And rates above 40 per cent have been recorded in Bostwana and Zimbabwe. According to data from UNAIDS, there are very few places outside Sub-Saharan Africa in which the prevalence of HIV infection among pregnant women has reached 10 per cent let alone the extremely high figures seen in this region. UNAIDS figures show that the risk of infection for women is increasing everywhere, both in developing and developed countries.

In worst-affected countries, the virus is spreading fastest among young people below the age of 24 years - the peak of fertility. Young women outnumber young men among those infected in a place where the virus is spread predominantly through heterosexual intercourse especially in Sub-Saharan Africa. Studies sponsored by UNAIDS show that in western Kenya nearly one girl in four between the ages of 15 and 19 years is living with HIV compared with one in 25 boys in the same age group. In Zambia in this age range, sixteen times as many girls as boys are infected. And in rural Uganda among 20-24 year olds, there are six young women who are HIV positive for every infected young man. It is these high rates of infection, coupled with high rates of pregnancy among women, that explain why, at the present time, Africa is also home to the vast majority of HIV positive children.

Mother to child transmission of HIV can be prevented. There has been evidence since the AIDS Clinical Trial Group 076 study of 1994, that anti-retroviral drugs and other non-drug mechanisms can reduce the infection rate among infants. Zambia and other countries in Africa like Uganda, Malawi, Zimbabwe, Tanzania, Bostwana, Kenya and South Africa are currently piloting a programme aimed at limiting the transmission of HIV from mothers to their infants. The programmes in these countries are as a result of the findings in Thailand, where government efforts to reduce MTCT through provision of anti-retroviral drugs at a cheaper administration helped to reduce the transmission of HIV to babies. These findings have been adopted by governments and there co-operating partners.

In Zambia, a working group has been established to spearhead the intervention. According to Dr Catherine Mukuka in the MTCT intervention programme at the paediatrics department of UTH, the Zambian Intervention intends to use Zidovine (AZT) and possibly Nevirapine which is cheaper. Three sites namely Lusaka's UTH and Chipata Health Centre, Kembe in Monze, Monze Mission Hospital and Mbala Hospital have been chosen for the MTCT Intervention pilot programme. Three Thousand (3,000) willing women who will give information, understand the implications and be prepared to find a way out are going to be recruited. Dr Mukuka said that drugs and infant formula would be given to mothers who will opt not to breast-feed. When the baby can take other feeds, the mother is encouraged to supplement formula with nutritious feeds. But whenever possible the mother is discouraged from breast-feeding for more than three months as this puts the infant at risk. Exclusive breast-feeding for negative mothers is still highly recommended. However, HIV positive mothers are advised to weigh the benefits and implications of various feeding options available. The programme will be a two year Ministry of Health pilot project which may be replicated depending on its impact. The idea of pilot-testing is to ensure that it is feasible, safe, sustainable, and acceptable to the general public before it is introduced more widely in a country, and to learn lessons about how best to operate the new services.

UNICEF will sponsor the salaries operations of the project and the funding component, JICA will take care of the PCR testing for detection of infection in the babies, Norad the test kits and USAIDS will take care of the communication strategy, monitoring and evaluation and also offer technical and financial assistance. The programme will also promote non-drug measures which have proved to be effective in reducing MTCT such as condom use during pregnancy to prevent viral load rise, abstinence and alternative infant feeding. The programme will try and discourage women from getting pregnant although it is difficult in a society like Zambia to tell people not to have children. During labour mothers will be encouraged to go to the hospital early so that they can have access to the drugs.

Dr Mukuka said that the first three months of breast-feeding were safe, but the longer the breast-feeding took the more likely the virus spread. Prohibitive as the costs of the anti-retroviral drugs may be for developing countries, MTCT can be prevented. After all, prevention is better than cure..

"HIV/AIDS in Zambia Worries European MP." By Mackson Wasamunu
The Post, January 24, 2000

Visiting European parliamentarians delegation leader Helen Beim has expressed concern at the HIV/AIDS problem in Zambia. Bidding farewell at the Lusaka International Airport yesterday to the Planned Parenthood of Zambia (PPAZ) and the government, Beim called for conceited efforts from the leadership and entire nation to fight the scourge.Beim observed that Zambia was in a serious problem in the area of HIV and the problem needed urgent redress.

This country is really facing a serious problem in the area of HIV. There is need to strengthen the leadership in this area and you should fight the enemy, from the President to the lowest citizen in society, said Beim. And Gelta Oodit, the African regional representative from IPPF in London, said the authority needs to invest a lot in the PPAZ because they have proved they can spearhead the fight against the enemy. As donors we are just providing services that need to be channelled through responsible agents, said Oodit.

And finance deputy minister Godfrey Simasiku said the country had a task to reduce poverty which had reached alarming levels of about 70 per cent to 50 per cent in the next five years. He thanked the international donors for their relentless support through their bilateral and multilateral assistance to the government and Non-Governmental Organis-ations (NGOs) to fight poverty. Simasiku observed that NGOs were duplicating efforts and there were about 200 NGOs in the country but the impact on development was not effective as it ought to be. He hoped that Zambia could access the Highly Indebted Poor Country (HIPC) which would cut about 80 per cent of its debt..

"Stop Dry Sex, Kankasa Advises Zambian Women." By Kelvin Shimo
The Post Zambia, January 24, 2000

Women in Zambia should desist from practising dry sex, Planned Parenthood Association of Zambia (PPAZ) national patron Chibesa Kankansa has advised. Speaking at a reception hosted for visiting European parliamentarians, Kankasa said dry sex has contributed to the rapid spread of HIV/AIDS.

Kankasa, describing AIDS as an evil in the community that has led to a high incidence of orphans, warned that with dry sex the infection rate is increased. She advised women that the traditional practice be avoided. Women should stop using drying agents as they increase chances of cuts and hence infection, Kankansa said.

She said as a government leader during the First Republic, she was in the forefront advocating against family planning and particularly the use of pill. At that time we had a population of about 3.5 million and said nothing on family planning because we were too few, Kankasa said. We had a lot of rallies on the Copperbelt and the first thing on the agenda was to ban family planning and the use of contraceptive pills. Kankansa said because of this, Zambia now had one of the highest population growth rate on the continent. She said with time she came to realise that the country was making a mistake and that prompted her to approach the then president Dr Kenneth Kaunda for an action programme to be put in place to contain the ever increasing population.

Finance deputy minister Godfrey Simasiku called for ways to be found to break the silence surrounding the HIV/AIDS scourge. 80 per cent of AIDS victims are ignorant, we must use every opportunity to talk about AIDS, he said. The country has lost man hours in burials. In my constituency in Kalabo I am losing a teacher every day. PPAZ national chairperson Alfred Masupha said a national strategy to fight the disease has to be found before many more lives are lost. We should take the scourge of AIDS very seriously or else we may face extinction. The situation on the ground is very bad, said Masupha. European parliamentarian Helen Beim, at the same function, called for change in people s behaviour.

"Test My TIAN Immunity Booster."
Times of Zambia, January 20, 2000

Amid claims by HIV/AIDS patients who have benefited from taking his medicine, Chinese doctor Tian Shengxun said in Lusaka yesterday he was ready to have his Tian Immunity Booster HIV/AIDS drug scientifically tested. Dr Tian in an interview yesterday said he would be willing to have the drug undergo laboratory tests to prove its scientific efficacy.

Dr Tian was responding to the challenge by University Teaching Hospital (UTH) head of virology laboratory Dr Francis Kasolo that the Tian Immunity Booster could not be backed because of lack of professional procedure. Currently, he treats patients who have tested HIV positive and later refers them for tests at the UTH virology laboratory. These patients after taking his drugs have clearly shown remarkable reduction of the viral load and an increase in their CD4 cells, cells which defend the body's immune system.

"I am ready to have my medicine tested anywhere, anytime. The nearest place can be South Africa, but I don't mind where. I am ready to release my medicine for tests," said the 43 year-old doctor specialising in traditional Chinese medicine and acupuncture. He branded as malicious insinuations that giving patients the Tian Immunity Booster without other scientists testing the drug was criminal.

A South African based Zambian woman said in an interview that she was on the brink of dying when her colleagues introduced her to Dr Tian. "My viral load was very high and CD4 cells were almost finished. Look at me now, I am a changed person. My friends were laughing at me and I almost stopped my course, but they are now surprised with my remarkable improvement," she said. She said she had not experienced any side effects since she started taking the medicine. Dr Tian should be given a fair hearing over his booster which reduces or completely erases HIV symptoms, she added. "Before I started seeing him, I used to experience chest pains, I had swelling legs, tuberculosis, and endless headaches with sleepless nights. I first took his medicine on May 1 last year. Two months later I took my second dose and I am here for my third one,'' she said in Lusaka. She had spent K4.5 million on other HIV cocktails before but her health did not improve. "His medicine makes you eat a lot, perhaps that's the only side affect if you may call it that. I pay about K350,000 for a complete dosage for the Tian Booster. My weight which had reduced from 95 to 70 kg now stands at 86"

A chief executive of a Lusaka firm said : " In Dr Tian's hands, people are in safe hands. My CD4 cells had gone down to 334 but from the time I started taking his medicine, they have gone up to 837." The chief executive said Dr Tian could suffer 'medical politics' as many people did not believe scientists other than those from the West could come up with a solution for AIDS.

A third patient said : "All that one needs is to have discipline when taking the medicine. You take 12 tablets three times a day. But the result for this is that you get better. I was HIV positive but now my viral load is non-detectable,'' he said. The man who is a banker in Lusaka said his viral load was 1.2 million before it slumped to zero. His diarrhoea ceased. "I have no side effects and I am very pleased. I just hope that the powers that be will move in to assist this man. Let us not underrate any scientists in this pursuit for an AIDS cure which I believe he has found.'' Dr Tian who has lived in Zambia for 10 years runs a surgery situated on Kudu road in Kabulonga.

Editor's foot note: The TIMES withholds names of HIV infected people spoken to over the drug to maintain confidentiality.

"AIDS Causes Cited."
Times of Zambia, January 10, 2000

.HIV A visiting Danish parliamentarian has attributed the high incidence of HIV/AIDS in Zambia to poverty. Fergo Tove from the Danish parliament said this in Lusaka during a Central Board of Health (CBoH) presentation on sexual and reproductive health at the Swedish Embassy.

Ms Tove who is part of a European Union (EU) parliamentary delegation in Zambia said Nordic countries such as Denmark had managed to contain the threat of HIV/AIDS due to the high standard of living. She said all the children in Nordic countries had access to basic human needs such as good nutrition, education and health care since the countries were running welfare states where such were provided by Governments. Ms Tove said HIV/AIDS in Nordic countries was mostly spread through the sharing of instruments used by intravenous drug abusers. The director of the Danish Family Planning Association Bjarne Christensen said his group was currently dealing with the problem of intravenous drug abuse.

Planned Parenthood Association of Zambia (PPAZ) chairman Charles Masupa said poverty had driven a lot of young girls into dangerous sex work which they considered fast method of earning money.Mr Masupa said sex work which was previously most rampant among the uneducated shanty town girls had now even spread to institutions of higher learning such as universities.

But Hilkka Vuorenmaa from the Family Federation of Finland said poverty was not entirely to blame because there were huge amounts of money being exchanged in the sex trade involving young girls. Ms Vuorenmaa said men should change their attitude to contain HIV/AIDS. Swedish ambassador to Zambia, Kristina Svensson, CBoH director of monitoring and evaluation Eddie Limbambala were among those who attended the presentation.

"Help on the Way for Zambian AIDS Orphans...as South-Central Africa Nation Loses it Middle Generation." By Chilufya Chilangwa
Times of Zambia, January 20, 2000

At 19, Chanda (not real name) is no different from the 300,000 to one million orphans in Zambia trying to survive without the warmth of family. Chanda's tragic story began when her father died of an HIV/AIDS related complex and a few months later, her mother succumbed to the same plague. Unable to complete her law degree at the University of Zambia (Unza) in Lusaka, Chanda returned home to look after her five younger siblings.

But more bad news awaited her arrival. Greedy relatives had divided her parents' property while an uncle repossessed the house built by the deceased couple! With nowhere to turn to, the orphaned children moved in with their unemployed grandmother and began a new life. Knowing that they desperately needed money, Chanda took up a secretarial job to help pay for some of the bills at home and put her brothers and sisters in school. Her dreams to be a lawyer were fatally shattered.

Now that two years have passed, Chanda 21, has lost her job. Her grandmother is ailing and there is no money to buy school books and uniforms for the young ones. Circumstances have forced Chanda's brothers and sisters to beg for food and money in the streets. Unemployed and not knowing who to turn to, Chanda stays at home to look after her sick grandmother. Every now and then some caring relatives give them food, but it's never enough.

She finally turns to her Catholic Church for prayers and help. At last help becomes a reality as through community service, the Church provides food and medical care for Chanda's grandmother. With the social welfare working hand-in-hand with the Church, Chanda and her siblings' begging days are over. Their needs are met and soon enough the children are happily trooping to school. Chanda is back at work again.

The term, "Children orphaned by AIDS" is now considered too derogatory and the government, Unicef and various non-governmental organisations (NGOs) prefer to look at children in such a situation as "vulnerable". Previously, the NGOs could not cope with the increasing number of children and families in need. About 19 organisations were working with orphans, but 14 of them work in one district while the Roman Catholic Church is found in eight districts together with World Vision International and the department of social welfare. By bringing the NGOs, Government and international donors together, more work is being done.

Peter McDermott, the Unicef representative in Lusaka says, "A lot of good work is going on to help orphans and vulnerable children in Zambia. "With Zambia having 75 per cent poverty rate, we should focus on the vulnerable children." It is estimated that 600,000 children are HIV/AIDS infected and Zambia has lost its middle generation (ages 20 to 40) to the disease. Policies for order have been made with the Government, Usaid, the local community, churches and NGOs.

Together they are reconstructing programmes to help families, funding Cindi Kitwe and supporting local programmes like Icasa round table on orphans, GRZ task force on orphans, Chikankata community-based support project and plans to train child-abuse counsellors and the police victim support unit. One such local programmer that is being supported is the Childcare and Adoption Society of Zambia in Lusaka Like most NGOs and orphanages, they are trying to reach out into the communities and spread the message around that help is available. By distributing pamphlets, newsletters and informing community churches, they are educating young children that they also have rights, especially relating to property grabbing, education and health care.

Working together with the community and churches helps the programmers understand what is needed to set up programmes suitable for families in need. In the past, very few organisations were collaborating on the issues of orphans and vulnerable children. For children caught up in a dilemma like Chanda, help is near. The motto for Unicef, Government, international donors and NGOs is "The mass of projects are better than massive projects". Indeed the future for our children is now promising.

"HIV Positive Politicians Advised to Open Up." ByKelvin Shimo
The Post, January 19, 2000

Come out in the open, Zambezi East MMD member of parliament Rosemary Yikona advised HIV positive political leaders yesterday. Speaking at a discussion on reproductive health at the Swedish Embassy in Lusaka, Yikona advised political leaders at national level and other spheres to come out in the open about HIV/AIDS.

Yikona, who is also a member of the parliamentary committee on health, commended HIV positive Winston Zulu and others for coming out in the open about their HIV status. She said if people at higher levels did the same the stigma attached to the scourge would be removed.

The discussion was attended by visiting European parliamentarians and some members of the Central Board of Health (CBoH). We have done a lot about HIV/AIDS as a country but I still feel there is no encouragement for the people below, saidYikona. Mwembeshi MMD member of parliament David Shimonde, cited former Zambian president Dr Kenneth Kaunda as one of the people who have spoken openly about HIV/AIDS thereby helping influence the lives of others. He also praised Zulu s coming out in the open about his HIV status. Zulu, ten years since he came out in the open, is still living, even the former head of state came out in the open about AIDS when his son died, Shimonde said. He said poverty had made the fight against AIDS difficult. It s like you tell a person that there is a lion on this path to town, but because he has to go there he will risk it, Shimonde said. It s the same with poverty, people have to make a living at times even when it means prostitution.

CBoH director of monitoring and evaluation Eddie Limbambala at the same discussion earlier disclosed that the board had targeted 400 health centres in various parts of the country for upgrading as a way of improving health care in general and reproductive health in particular. Limbambala said the upgrading would be facilitated by a loan from the World Bank. Child and reproductive health specialist, Jemmy Nyirenda, described maternal mortality and morbidity in Zambia as serious and attributed the situation to pregnancy complications. Why mothers die is at times due to delay in getting to a health facility, receiving appropriate care or HIV/AIDS, she said. Mortality rate is high - 649 for every 1000 births. She said HIV/AIDS was a serious problem as 66 per cent of young girls by the age of 18 were sexually active and by 21 would have had a child. She said the situation had been compounded by unemployment.

"Fighting HIV/AIDS - Editorial Comment."
The Post, January 19, 2000

AIDS is one of the most serious challenges facing our country today. It is a virus that we need to fight with all the tenacity that a nation is expected to exhibit when it is invaded by a fast spreading dangerous plague. HIV/AIDS is not a simple health problem that should be left in the hands of our Ministry of Health, medical doctors and other health experts. HIV/AIDS has serious social, political and economic consequences for our country which cannot be solved by health experts alone.

Like all social, political and economic problems, the HIV/AIDS crisis calls for forward-looking, committed and exemplary leadership. This type of leadership seems to be seriously lacking in our current crop of leaders. Even our former president, Dr Kenneth Kaunda, who has in the past displayed exemplary global leadership in the fight against AIDS today appears not to be doing much in Zambia. While it is a well known fact that most of our ministers and other very senior government officials are HIV positive and are on antiretroviral agents, this should not be reason for their shying away from providing leadership in the fight against AIDS.

Winston Zulu is HIV positive, and we all know about his status because he has been open about it, but this has not stopped him from caring about others who are HIV negative. His HIV positive status has not reduced his sense of humanity - of caring for others and working to ensure that their precious lives, although his hangs in a balance, are preserved. Winston is today not only one of Zambia s leading AIDS activists, he also forms part of our continent s most principled, humane, honest and articulate leaders in the fight against this horrible virus that is spreading at exponential rates - threatening us with extinction.

Providing antiretroviral drugs for oneself and a few selected top politicians is not leadership - selfless leadership - that we need is this very difficult battle for the survival of our very nation. Although we will not go to the extent of urging political leaders to come out in the open about their HIV positive status as Zambezi East MMD member of parliament Rosemary Yikona advised yesterday, we would like to see more visible and committed leadership from them in this war - a war in which there s no surrender or retreat; a war that we have to win whatever it takes or costs.

"TIAN Immunity Booster Perfect Drug for HIV/AIDS."
Times of Zambia, January 18, 2000

A Botswana-based Zambian whose brother is HIV positive has weighed his support behind the Tian Immunity Booster which he describes as perfect medicine for HIV/Aids. The man who called from Gaborone said his brother was on the verge of death before taking the Tian Immunity Booster but was now doing fine.

"It's amazing. My brother was almost dying. We had given up hope but he is now able to walk and eat. I am excited and I will be travelling back to Zambia in two weeks time with my brother so that he can meet the doctor," the man said in a telephone interview.

The Tian Immunity Booster is administered by Tian Shengxun who says he has got documentary proof to show that his three-series medicine reduces viral loads and increases the CD4 cells which defend people's immune system. The man who is a Zambian migrant worker in Botswana said when he heard about the Tian Immunity Booster, from his friends in Gaborone, he decided to travel to Zambia.

"The doctor gave me some medicines which I carried for my brother and it seems this medicine works. We had previously tried several cocktails but none seemed to work. Although my brother is not completely healed, he is likely to get better," the caller explained.

"AIDS Cure Breakthrough?."
Times of Zambia, January 17, 2000

Several HIV/AIDS patients taking Tian Immunity Booster, the Chinese herbal drugs, have shown remarkable improvement, claims a Chinese doctor. Tian Shengxun who specialises in Chinese medicine and acupuncture said he had documentary proof his conconction, produced from Chinese traditional herbs had reversed HIV symptoms in some of the infected people that had taken the three series medicine. "This is a break-through. I am happy I have done it," exclaimed Dr Tian in an interview.

The doctor said most of the patients who were tested twice at the University Teaching Hospital (UTH) virology laboratory after taking the Tian Immunity Booster had shown a remarkable reduction of the viral load and an increase in their CD4 cells, the cells which defend the body's immunity system. He said one patient tested negative in a South Africa clinic after taking his medicine. This had prompted a neighbouring country to ask for the medicine.

But consultant virologist and head of virology department at UTH, Francis Kasolo, a medical doctor and virologist Mwaka Monze and a medical microbiologist Gina Mulundu dissociated themselves from the findings. While agreeing that tests had been conducted on some of Dr Tian's patients at UTH, the experts said they cannot back his findings due to lack of normal procedure required in a medical research.

Dr Tian has produced documents containing information of people whom he treated and had a change in their viral load, an increase in their DC4 cells when their blood was later tested at UTH. One patient's viral load reduced from 1.3 million to 89,000 within three months, another patient's from 750,000 to 340,000 after two months and later to non-detectable level after one year.

Dr Tian said clinical data suggested his medicine boosted the immunity system by strengthening and purifying the blood. He said laboratory results had suggested that the white blood cells increased as well as red blood cells and haemoglobin. In a paper he has written, Dr Tian says his booster controlled anaemia, opportunistic infections, improves appetite, lessens attacks of malaria, flu, delays clinical progression of AIDS apart from improving the quality of a patient's life.

"Ninenty per cent of patients tested twice of CD4 cells count so far have improved. The figures increase are quite different, from four cells to 500 cells, within one month or three months," he said. Dr Tian said opportunistic infections such as fever, headache, pains, diarrhoea, skin and mouth ulcers, skin pimples, herpes zoster cleared completely or reduced in over 90 per cent of people who took the drug. Dr Tian said tuberculosis (TB) patients who did not respond to anti-TB treatment using other drugs were healed after taking his medicine.

But Dr Kasolo said it was difficult to know whether Dr Tian's medicine worked or not because it had not been scientifically proven. "He could be offering a cocktail and it is not for us to support his claims. He talks of CD4 cells increasing, the fact is that these cells fluctuate on any given day. They can either reduce or increase," he said. Dr Kasolo said to prove if the medicine was working required having two groups of patients, with one taking the medicine and the other not. He challenged the specialist to write his findings in a medical journal as per professional procedure. "It is even not ethical for a doctor not to tell his patients that he is using them for a study and it's criminal to claim that his medicine works because there is no known cure at the moment," Dr Kasolo said.

Dr Monze said the claims could only be backed if the research and ethics committee of the Government approved the findings. "If Dr Tian claims the booster can make people live long lives yes, this can be supported. But we cannot be expected to agree that the medicine cures AIDS," he said. Dr Monze wondered why Dr Tian had not marketed his drug abroad if it cured AIDS. She said Dr Tian should state his end points, inclusion criteria and the kind of medicine he was using.

Ms Mulundu challenged Dr Tian to write a paper in form of a protocol so other professionals can criticise his findings. "We are not told about most of the people he treats. We receive so many people coming for tests here and we cannot exactly say who is coming from where," she said. She also advised Dr Tian to publish his findings in the medical journal but he said there was no need for him to do so. He said he had done so earlier and his findings came out in the Icasa abstract which he considered more important than the medical journal.

"Scout Movement to Fight AIDS." By Kay Mumba
Daily Mail, January 13, 2000

The Scout Movement has embarked on a five-year programme aimed at making community development activities an integral part of the regular scout programme which would also include ways of fighting the HIV/AIDS epidemic. Copperbelt Scout commission Mr Joseph Samalesu, told the Mail in an interview in Ndola yesterday that the programme had been set for 2000 and 2005.

Mr Samalesu said that with the change of time, the Scout Movement was now moving away from just camping and traveling and engage in serious issues such as addressing the HIV/AIDS to mould youths morally, mentally, physically and spiritually. The movement has since lined up a series of refresher courses for district leaders. The first will be held at the Mufulira Boating Club from 13 to 16 January and will draw 35 leaders. The commissioner said that the courses will equip the young leaders with the latest knowledge about scouting in order to change its image to that of directly reaching the community.

Mr Samalesu said the movement is a supplement of education and parents must encourage children to join. He said the scout leaders were now targeting the grassroots because the movement has the power to highly contribute to the development of the nation by moulding youths morally. He said that the camps the children go to are of great benefit as they are accorded to learn new things.

Professional bodies such as the Drug Enforcement Commission have been invited to impart knowledge on abuse. Mr Samalesu also suggested the decentralisation of the movements operations to provinces saying this would make operations easier as it has been difficult for officials to always travel to Lusaka for deliberations..

"Zambia Study Suggests AIDS Campaign Success." By Ishbel Matheson
BBC Online News, January 13, 2000

Research in Zambia shows a substantial decline in the number of women testing HIV positive between the ages of 15 and 19. The survey was carried out by the Zambian Department of Health and involved 12,000 women tested at ante-natal clinics in locations throughout the country. The decline was most dramatic in the capital Lusaka, where in 1994 28% of women were testing positive. But by 1998 that figure had almost halved. These results have now been verified by an independent team from the United Nations and have been hailed as extremely encouraging by Aids campaigners.

Dr Moses Sichone, the head of the Zambian Aids programme, said this research clearly demonstrated it was possible to prevent the spread of Aids, particularly among adolescents, through education programmes. Young people, he said, were changing their sexual behaviour. This giant condom was part of an Aids awareness campaign There was less casual sex and more and more young people were using condoms. Campaigners say Zambia is only the second African country, after Uganda, to show that sustained education campaigns can reduce HIV infection levels.

The Zambian results will be welcomed by health workers throughout the sub-Saharan region who are struggling to cope with the devestating spread of the disease. But one health planner in Lusaka warned there are still bleak times ahead. Even if HIV prevalence gradually declines it is still estimated that over 1.5 million Zambians will die from the disease over the next 15 years..

"Reaching the Community."
CBR News, January 13, 2000

HelpAge Zambia is a local organisation based in Luapula province. Although much of our work is directly with older people, some of our activities are concerned with HIV/AIDS prevention and reproductive health, including family planning. These issues affect a wide range of people in the community, including older people. Although HIV/AIDS is often seen as just a health problem we also work with other areas, such as schools, churches and community groups. We aim to create an open and accepting environment and to involve the community as a whole, including people in all stages of HIV-related illnesses.

HIV prevention is an important aspect of our work. We want to change people's behaviours to make them less vulnerable to HIV/AIDS. Some of the groups who are especially vulnerable are:

• sex workers
• men who have sex with men
• injecting drug users
• young people.

We find peer education (where outreach and education is done by trained people who come from the same group) to be very valuable in reaching these vulnerable groups.

Gershom Musonda,
Project Coordinator, HelpAge Zambia
PO Box 710055, Mansa, Zambia..

"Reduced AIDS Cases Cheer UNICEF."
Times of Zambia, January 11, 2000

The United Nations Children's Emergency Fund (UNICEF) said it is impressed with Zambia's record in reducing HIV-AIDS. UNICEF country representative Peter McDermont said UNICEF was happy that HIV/ AIDS cases had been reduced by 40 to 50 per cent.

Mr McDermont said the achievements showed that Zambians understood the problem due to clear prevention messages on the epidemic in the past 15 years. He noted that despite the achievement Zambia had to find a long term solution to the AIDS scourge. He was speaking yesterday in Lusaka during a two week AIDS intervention workshop. He said Zambia's economy had faced setbacks mainly due to its labour force being claimed by the disease.

Earlier, national AIDS and Sexully Transmitted Diseases Control Programme (NASTDCP) chairman Moses Sichone called on health institutions in Zambia to unite with communities to fight the mother to child AIDS infection. Dr Sichone said Government was ready to support health institutions and their communities efforts to control the rising cases of mother to child HIV/AIDS infection. Participants felt that it was time Government revisited its breast milk policy on HIV infected mothers to avoid infecting their new born babies.

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Last updated February 1, 2000

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