OUR SPECIAL ENVOY TO KAMPALA.

OUR SPECIAL ENVOY TO KAMPALA. The good news from Africa are rare. All the more reason to salute the countries that fight against a scourge that is ravaging the continent: infectious diseases. Uganda is one of those good students regularly put forward by western institutions. Since the mid-1990's, a country of nearly 30 million people embarked on prevention and access to care for patients suffering from HIV AIDS. Within a decade, the prevalence rate has increased from 15% of the adult population to 6.6% today, according to UNAIDS. Approximately 110,000 patients are currently receiving anti-retroviral (ARV) and the government boasts to bear half of the patients (1). The official figure is to be taken with caution. It should be brought up another: "one million AIDS orphans currently indicated. At the summit in Abuja in 2001, African countries pledged to spend 15% of their national budgets to health. For the moment we are not there. While among the leaders, Uganda spends only 7% of its budget to this position, half of which comes from external donors. "A quarter of the state's resources goes to the military and there is a lot of corruption," regrets an official doctor at the Ministry of Health in Kampala. Neighbours unpredictable It is true that the country is bordered by neighbours remuants and unpredictable. In northern Sudan, in the western Democratic Republic of Congo, Rwanda to the south and east Kenya. Recently Uganda, Kenya and Rwanda have announced a cooperation agreement copy. But it is neither health nor education. It seeks to protect mountain gorillas threatened with extinction. On the health front, the landscape is quite different. With a per capita income of $ 1,100 per year, Uganda is one of the poorest countries in the world. Approximately 40% of the people are content with less than $ 2 per day. The result, the living conditions in the suburbs of Kampala are an affront to human dignity. As often happens in Africa, the economic challenge is coupled with a heavy geographical constraint: 80% of Ugandans live in rural areas with very limited infrastructure. The Taso (The AIDS Support Organization) is one of the oldest African institutions to aid the sick. Established in 1987, the center has an annual budget of about $ 15 million provided solely by external donors. He receives about thirty patients a day in conditions of caring and listening. A contribution of about half a dollar is requested to patients. This practice designed to empower patients is actually quite flexible. "Many of our customers accumulate illness, money and food," says Harriet Mabonga, director of central Kampala. One of the big problems is the late detection of patients. "Some arrive with CD4 zero," says Harriet Mabonga. This extreme situation causes the appearance of a severe syndrome-specific sub-Saharan Africa: Iris (2). Similarly, the co-infection with TB affects between 40% and 50% of HIV-positive. The country is also a chronic shortage of health care personnel (doctors and nurses), which share much abroad (for better salaries) is siphonnée or by the organizations and Western institutions in the country. This situation leads to an interview without phone call from Jack Watters in charge of humanitarian programs at Pfizer. "There's a lot of money to treat AIDS in Africa, but there will never be enough. The next challenge will be to track all those who need to be put on treatment. These objectives can be achieved only through foreign investments. "A sign of the times, the American group was ready to transfer the production of a new drug (anti-CCR5) on concessional terms to developing countries. "We will start with trials of a microbicide (3)," says Jack Watters. Laboratory dilapidated The Institute of Infectious Diseases (IDI) plays the same role with different means. Despite a laboratory for analysis dilapidated, this structure treats more than 18,000 patients per year. Installed within the Faculty of Medicine at Makerere, he also tries to instill a spirit research in the country. In February, teams of researchers have presented several scientific papers at the Annual Meeting on AIDS, held in Boston (CROI). "We focus on clinical research and the topics that concern the African people," says Alex Coutinho, who heads the center. This doctor born Gao is a leading figure in the fight against HIV in Africa. "ARVs have given life to people. Today, they want to live a normal life and have children. "This year is expected to start manufacturing drugs in a factory near Kampala. Built with the help of Indian producer of generic Cipla, it will produce fixed-dose triple therapy (Triomune) and anti-malarials to national needs. It is even expected to export part of the production among neighbours in the Great Lakes region and mountain gorillas.