Monday, July 16, 2007

research and evaluation in the developing world

According to Ansbert Ngurumo, the Sunday editor for the Swahili-language newspaper Tanzania Daima, it has been a smooth start as 42 journalists from Estonia to Mexico began the tenth Journalist to Journalist programme organised by the US-based National Press Foundation (NPF) ahead of the International Aids Society (IAS) conference in Sydney Australia. Between 5,000 and 6,000 delegates from various countries are expected to attend the conference next week.

Ngurumo, who is also a member of the World Federation of Science Journalists' peer-to-peer mentoring programme, said NPF president Bob Meyers asked journalist to do two things: learn from each other, and ask presenters as many questions as possible.

Among speakers on the opening day was Dr David Cooper of Australia's National Centre for HIV Epidemiology and Clinical Research (NCHECR). Dr. Cooper, who is also co-chairing the IAS 2007 conference, emphasised the importance of research and evaluation of anti-retroviral drugs in developing countries. So far, he said, the research and evaluation of anti-AIDS drug roll out was still "negligible" - and the risk was that if anything went wrong, both researchers and governments might jump to the wrong conclusions about how to remedy the matter because of this lack of evaluation and research.

On the need for early treatment, Dr. Cooper noted that there have been cases whereby people who only accessed anti-retroviral drugs late in the progress of the disease have died in the first year of treatment. Their deaths gave rise to the myth about patients dying of the treatment, when in fact the cause was the delay (for a variety of reasons) in accessing the medication. "If this roll out doesn't go well, if there's a glitch, we won't have an evidence base on which to work it out," he warned. "We've to try to convince our people to come out earlier than they are doing avert the myth of treatment killing patients."

In sub-Saharan Africa alone, about a million people are on anti-retroviral drug treatment. Dr. Cooper said the number should be as high as between 3 and 5 million.

He also said there was a need to do thorough research on the correct dosage required for patients in developing countries because there was a concern that most of the inexpensive drugs currently in use in the developing world might be too toxic. He said there was a concern that some patients were given doses, based on research from more affluent nations, that might not be appropriate for poorer patients' weight and nutrition.

The constraint, he noted, was in finding the research finance because most health departments in these countries were "highly stretched." Although optimistic about US President George W. Bush's emergency PEPFAR plan, he noted that the emergency funding specifically excluded research.

Among new findings to be revealed at the upcoming IAS conference, Dr Cooper highlighted the importance of treating the children of HIV+ mothers at an early age. The latest research now recommended that such children should be treated in their first year without waiting to verify if they were infected. This significantly reduced mortality among children, 20 to 30 percent of whom, untreated, die in their first year.

* In addition to his journalism work available at every Sunday, Ansbert Ngurumo is studying for an MBA at the University of Hull in the UK, working night shift at a factory, helping to raise two daughters in two countries (Uganda and Tanzania), running a Swahili blog at and is sadly bereft of his luggage, which was lost on Qantas flight 32 from London.

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