Sadiyya Sheik
Sadiyya Sheik

Why we’re losing the war against HIV

I assume that I will be hung, drawn and quartered for the insinuation of this post. As such, you are advised to read the following disclaimer.

DISCLAIMER: What follows is an observation by the author of this post. These sentiments are by no means that of the medical community at large. Please feel free to visit your nearest public hospital for a healthy dose of denial, the roll-out programme which has been postponed due to the public servants’ strike.

Below are two patient scenarios based on the type of patient commonly seen at public hospitals in KZN. I want you to read these with the following in mind:

1. HIV is an incurable disease. Antiretrovirals (ARVs) are effective in slowing disease progression when started early and when adherence is good.

2. South Africa has the highest number of people infected with HIV in the world.

3. Current projections are of 1 400 new infections a day

4. A projected 5.8 million are living with HIV in
South Africa, 709 000 of which are on ARVs.

5. South African public hospitals are resource-poor areas, starved of health-care workers, medicines and medical equipment.

Scenario 1: A 17-year-old female, HIV-positive, diagnosed one year ago, CD4 count of 20, not on ARVs. (A count less than 350 is an indication to start ARVs.) She is brought in by family members with the complaint that she has had first-time seizures, right-sided weakness and an altered mental state. The patient is admitted and a CT scan of her brain is done. The scan reveals a possible tuberculoma (TB lesion in the brain and a poor prognosis). She is started on medication for TB. The plan is to start ARVs as soon as possible but the patient is unable to complete the training because she is poorly responsive at best. Eventually, family members are convinced to complete the training on her behalf. She is started on ARVs. At this point, her hospital stay has lasted 3 weeks due to the waiting times involved for CT scans, blood results and ARV classes. Once ARVs have been started, there is no further intervention we are able to offer. Nevertheless, the patient remains in hospital with an invisible “not-for-active-resuscitation label”. This is not malicious, it’s realistic. She is not eligible for ICU care if needed and to prolong life will do nothing for quality of life. A week later, she demises.

Scenario 2: A 33-year-old male, diagnosed with HIV one month ago, CD4 count pending. He looks fairly well but the chest X-ray reveals an extensive pneumonia. There is debate about whether he should be admitted for IV antibiotics or managed with oral medication at home. The debate is settled by a lack of available hospital beds. The patient goes home with his oral antibiotics and instructions to follow up on his CD4 count result.

Two years later the same patient is seen at the outpatient clinic. He is emaciated and breathless and he still doesn’t know his CD4 count. His current doctor reads the notes made by the previous doctor. Now there is no doubt about him being admitted.

Very simply, hospitals are being run as hospices. We are admitting patients we can have no hope of saving at the expense of those we can and as a result losing the war against HIV.

  • http://ZolaD Zola Dotwana

    FIRSTLY,I do believe HIV exists and it DOES cause AIDS. SECONDLY,I do believe ARVs do reduce the viral load in a patient. HOWEVER, that is not the issue in terms of Sadiyya’s question “Why we’re losing the war against HIV”
    The OVERWHELMING reasons we continue to lose the war against HIV are:
    1. INTELLECTUAL RIGIDITY: The phenomenon of “experts” who will insist that CREDO MUTWA said his plant will CURE, when he clearly stated:”I do not claim that this plant, dramatic as the results are is the cure for Aids. I say it is a stopgap, which must be used by all human kind in order to halt the disease of Aids.”
    1. Conspiracy or no conspiracy, the INTENDED PURPOSE for the creation of HIV was that nobody but its creators should be capable of winning the war against it. It is a plan that was established with military precision.
    2. The penchant of the SA educated elite to intellectualise every detrimental challenge and always try to explain excessively intelligently how and why we should continue to TOLERATE OR CO-EXIST with a detrimental challenge. The phenomenon is conspicuous in the political sphere where spin doctors tell us daily and eloquently how and why we should tolerate and co-exist with corruption.
    3. DELIBERATE INDIFFERENCE towards the origins of HIV whereas common sense shows therein lies a propable antidote.
    4. ARVs are also a stopgap like Credo Mutwa’s plant!!!

  • http://ZolaD ZolaD

    With the level of intelligence and levels of education among those who are ultra-sensitive about their ARVs ONLY doctrine, notwithstanding other folk sincerely advising about alternatives in boosting the Immune System, NOT cure AIDS, one is strongly tempted to believe another conspiracy about doctors who secretly REJOICE about the Aids phenomenon since it fills their surgeries with millions of victims of opportunistic diseases who can’t distinguish between a certified HIV Clinician and a doctor who is as dumbfounded by Aids as any commoner. The general perception of the public is that “every doctor knows”.
    HIV/Aids Policies and palliative care advocacy will not answer the question: “Why we’re losing the war against HIV”.

    Being curious about the theories BEYOND the preposterous “a green monkey bit the bum of a pigmy in Africa” and demanding an open debate about the profound conspiracies that $10m was provided in 1970 to investigate the establishment of a synthetic disease causing virus to be distributed in Africa, India and China.
    Go ahead and google ‘HB15090′ and seriously consider the links contained in this site:

    There is overwhelming co-relation between the challenges we have in Africa with HIV/Aids and the revelations about how it was developed. An inquisition about these revelations is not an anti-ARV advocacy nor is it an argument about whether HIV causes Aids. Read objectively about HB15090 and leave the Lesegos/Kalalas alone!!!