Morts du sida en Afrique du Sud: la politique de santé en question

AFP

L'incapacité des autorités sud-africaines à fournir aux patients souffrant du virus VIH les médicaments adaptés a causé la mort de 365.000 personnes entre 2000 et 2005, selon une récente étude de l'université Harvard.
Selon des chercheurs de l'école de santé publique de Harvard (HSPH), le gouvernement sud-africain aurait pu empêcher ces décès s'il avait fourni des antirétroviraux aux patients ainsi que des médicaments pour les femmes enceintes, afin qu'elles ne transmettent pas le VIH à leurs enfants.

L'étude, publiée en ligne en octobre et reprise cette semaine par le Journal of Acquired Immune Deficiency Syndromes, conclut à la responsabilité directe dans ces centaines de milliers de décès du gouvernement du président Thabo Mbeki (1999-2008), fortement critiqué pour son refus d'appliquer des réponses scientifiques au virus du sida.

"Beaucoup de vies ont été perdues par suite de l'incapacité à accepter l'utilisation de (médicaments antirétroviraux) pour prévenir et traiter la survenue du VIH-sida en temps utile", selon ces chercheurs.

La ministre de la Santé de Thabo Mbeki, Manto Thsabalala-Msimang, a été largement discréditée pour avoir proposé de traiter le virus à l'aide de jus de citron, d'huile d'olive, d'ail et de betteraves.

L'Afrique du Sud est le pays comptant le plus grand nombre de séropositifs au monde, avec plus de 5,5 des 48 millions d'habitants porteurs du virus.

Les chercheurs de Harvard ont établi que le pays avait perdu un total de 3,8 millions d'années de vie par suite des décès de 330.000 adultes qui n'ont pas bénéficié des traitements adéquats et de 35.000 bébés nés avec le HIV et qui n'ont pas survécu.

Pour leur modélisation, ils ont comparé l'Afrique du Sud avec le Botswana et la Namibie voisins, qui souffrent également de l'épidémie mais ont mis en place une politique de traitement adaptée.

Selon l'Organisation mondiale de la santé, 33 millions de personnes sont infectées par le virus du VIH-sida à travers le monde, et environ 2 millions en sont mortes en 2007.

Sens Commun a dénoncé depuis des années les croyances stupides de la ministre de la santé d'Afrique du Sud, qui reprend plus ou moins les théories du soi-disant Dr Rath et de ses boutiques de vitamines, ainsi que la passivité de l'ex-président Mbeki. Le nouveau devra éponger les dégâts humains et économiques.

Vitamins do not reduce cancer risk, says study

James Randerson, science correspondent (The Guardian)

Taking vitamin A and E supplements does not lower your risk of cancer, according to the results of a large clinical trial involving nearly 15,000 men in the US.

Both vitamins are powerful antioxidants - substances that can tackle harmful byproducts of the body's metabolism which can cause DNA damage and hence trigger cancer. However, the study shows that taking the vitamins in supplement form has no effect at all on cancer.

"There have been a number of previous studies that have suggested that vitamin E and vitamin C might be important in the prevention of cancer," said Dr Howard Sesso, an epidemiologist at Brigham and Women's hospital in Boston, Massachusetts. These were mostly small lab studies or research on animals. But a 1998 study of men in Finland suggested that vitamin E supplements reduced prostate cancer cases by 32% and deaths by 41%.

"The lack of an effect that we observe for vitamin E or C on cancer does convince us that these particular doses that we tested really have no role for recommendation for cancer prevention," said Sesso.

His team recruited 14,641 male doctors and assigned them to four groups which took a different combination of the supplements or their placebos. The team looked at the number of deaths from cancer and found no statistical differences.

Sesso reported the results of the Physicians Health Study II trial at the American Association for Cancer Research's meeting in Prince George's county, Maryland.

Ed Yong, health information manager at Cancer Research UK, said there was growing evidence vitamin supplements did not prevent the risk of cancer. He said having a healthy diet was more important.

Voilà qui déplaira aux adeptes des théories de Linus Pauling, qui prétendait que des mégadoses de vitamine C permettait de lutter contre le cancer. Ces théories ont influencées des générations de parents éblouis par l'autorité du Prix Nobel de Chimie dans un domaine où il n'avait pas d'expertise. Il n'existe plus grand monde pour soutenir ces théories aujourd'hui, sauf les adeptes de la pseudo-médecine "orthomoléculaire", tels Matthias Rath et son lucratif business de cocktails vitaminés pour malades du tiers-monde.

Fall of the doctor who said his vitamins would cure Aids

Sarah Boseley, health editor, The Guardian

Matthias Rath, the vitamin campaigner accused of endangering thousands of lives in South Africa by promoting his pills while denouncing conventional medicines as toxic and dangerous, has dropped a year-long libel action against the Guardian and been ordered to pay costs.

Rath sued over three Guardian articles that condemned his promotional activities among Aids sufferers in South African townships.

A qualified doctor who is thought to have made millions selling nutritional supplements around the globe through his website empire, Rath claimed his pills could reverse the course of Aids and distributed them free in South Africa, where campaigners, who have won a hard-fought battle to persuade the government to roll out free Aids drugs to keep millions alive, believe Rath's activities led to deaths.

The Dr Rath Foundation focuses its promotional activities on eight countries - the US, the UK, Germany, the Netherlands, South Africa, Spain, France and Russia - claiming that his micronutrient products will cure not just Aids, but cancer, heart disease, strokes and other illnesses.

The collapse of the case will have repercussions around the world. International authorities on Aids welcomed the outcome. Prof Brian Gazzard, one of the UK's leading HIV/Aids experts, who advised the Guardian on its case, said he was delighted at the result. "The widespread provision of anti-retrovirals in sub-Saharan Africa is one of the most important public health measures of this century," he said. The confusion caused by suggestions that giving undernourished people vitamins and minerals was an alternative to taking Aids drugs was "extremely harmful".

Mark Wainberg, director of the McGill Aids centre in Montreal, said: "It is clear that he [Rath] has done enormous harm to people with HIV." Rath was linked to the Aids deniers who convinced people, he said, that Aids was not dangerous and that "you can treat yourself with medicines that are a complete waste of time".

John Moore, professor of microbiology and immunobiology at Cornell University in the United States, said: "The promotion of micronutrients and vitamin pills as effective remedies for HIV harms infected people. If they stop taking the anti-retroviral drugs that we are know are effective, their health suffers."

After the high court awarded initial costs of £220,000 to the Guardian, its editor, Alan Rusbridger, said: "We are very glad that Rath has dropped his libel action, doubtless designed to discourage other journalists - in Britain and abroad - from looking too closely at his dubious claims and methods. We will seek to recover the costs of defending our journalism."

The Guardian articles appeared in January and February last year in the Bad Science column written by Ben Goldacre, who said Rath "aggressively sells his message to Aids victims in South Africa that Rath vitamin pills are better than medication".

Goldacre praised Zackie Achmat, founder of the Treatment Action Campaign (TAC) in South Africa, for winning his long-running battle with the government for the distribution of free Aids drugs. This victory, said one of the articles, was deeply damaging to Rath and his colleague Anthony Brink, a barrister and former spokesman for Rath's organisation who actively campaigns against anti-retroviral drugs.

Rath wanted to exclude from the court's consideration part of one of Goldacre's articles, which mentioned Brink's attempt to have Achmat indicted for genocide at the international criminal court in The Hague. In February, Mr Justice Tugendhat ruled that the entire article must be considered. Had the case proceeded, the court would have been presented with details of Brink's complaint to The Hague, which called for Achmat to be permanently confined "in a small white and concrete cage, bright fluorescent light on all the time to keep an eye on him" and force-fed his Aids drugs or, "if he bites, kicks and screams too much, dripped into his arm after he's been restrained on a gurney with cable tied around his ankles, wrists and neck". The complaint was described by the Rath Foundation in January last year as "entirely valid and long overdue".

Rath, who describes himself as German-born though is also listed as Dutch in Companies House documents, began operating in South Africa in 2004.

In a pattern that has been repeated in other countries, he began by running newspaper adverts attacking the pharmaceutical industry and promoting natural remedies for diseases. Eventually he was stopped by the South African advertising standards authority for making unsubstantiated claims about the benefits of vitamins in the treatment of Aids.

In 2005, Rath began to offer his nutritional supplement VitaCell to people with Aids in Khayelitsha, a township outside Cape Town. He claims he was running a trial, that participants were suffering from advanced Aids and that none were on or had been on anti-retroviral drugs. Some died, however, and relatives have given statements claiming that some of them had been on ARVs but were told to stop using them.

In June this year, TAC won a ruling from the high court that the trial was illegal. VitaCell was being promoted as a medicine, the court said, and therefore it needed permission. The court also ruled that the South African government had breached the law by not clamping down on unlicensed remedies. Rath has been given permission to appeal against this ruling.

The Rath Foundation recently expanded its reach into Russia, where Aids has been on the increase. In an advertisement in Izvestia in February, Rath attacked the pharmaceutical industry and suggested that heart attacks, strokes and cancers could be cut to a fraction of the present level through "natural health approaches".

Parmi les nombreux charlatans de la santé, le 'Dr' Rath est un des plus sinistres. Le négationnisme du virus du SIDA est un énorme business comptant sur le désespoir des malades des pays défavorisés pour leur extraire le peu d'argent qu'ils peuvent se permettre de dépenser.

Sida: campagne de protestation des ONG contre la politique de Pretoria

LE CAP (AFP) - La coalition d'ONG sud-africaines Treatment Action Campaign (TAC) a annoncé mardi le lancement à partir de jeudi d'une campagne de protestation contre la politique gouvernementale de lutte contre le sida.
Les militants de TAC entendent notamment occuper des bâtiments publics et perturber des rencontres gouvernementales, a affirmé à l'AFP Zachie Achmat, président de TAC, précisant que ce mouvement visait à réclamer la démission de la ministre de la Santé, Manto Tshabalala-Msimang.

"Nous pousserons nos alliés à l'étranger à écrire au gouvernement et encouragerons les opérateurs investissant en Afrique du Sud à utiliser leur argent comme moyen de pression sur le gouvernement sur la question (du VIH-sida)", a expliqué M. Achmat.

"Il est regrettable que nous devions enfreindre la loi pour que le gouvernement prenne nos revendications au sérieux. Mais nous n'arrêterons pas tant que le président n'aura pas démis la ministre" de la Santé, a-t-il ajouté.

Mme Tshabalala-Msimang est extrêmement controversée en Afrique du Sud en raison en particulier de ses propos très ambigus sur le rôle exact de la nutrition dans la lutte contre le sida.

Quarante-quatre membres de Treatment Action Campaign (TAC) ont été brièvement interpellés la semaine dernière à l'issue d'une manifestation. Quarante-trois d'entre eux, dont le président de TAC, Zachie Achmat, ont comparu mardi devant un tribunal du Cap, qui a renvoyé leur procès au 7 septembre.

Les appels à la démission de la ministre de la Santé se sont multipliés depuis que l'envoyé spécial de l'Onu pour le sida en Afrique, Stephen Lewis, a violemment mis en cause Pretoria pour sa politique anti-sida la semaine dernière.

L'Afrique du Sud est le seul pays "dont le gouvernement reste obtus, dilatoire et négligent dans la mise à disposition des traitements" antirétroviraux (ARV), avait déclaré M. Lewis le 18 août, à la clôture de la conférence mondiale sur le sida à Toronto, au Canada.

Selon Pretoria, l'Afrique du Sud compte 5,54 millions de personnes, sur 47,4 millions, vivant avec le VIH-sida.

On se rappelera des déclarations de la ministre de la santé sud-africaine qui soutenait implicitement les thèses du 'Dr' Matthias Rath, charlatan du SIDA ayant accusé l'industrie pharmaceutique de génocide. Le président sud-africain Mbeki aavait emboîté le pas à sa ministre, ce qui est particulièrement inquiétant pour leur pays qui est maintenant un des plus touché au monde par l'épidémie de SIDA.

Un remède contre le sida, objet d'une arnaque par mail

Par Marc Rees, rédaction de PC INpact

Nouvelle escroquerie par mail au goût douteux. Ce scam promet sans sourciller un remède à base de plantes qui guérit le SIDA. « Ces courriels, provenant d’une adresse Yahoo, prétendent que l’expéditeur de 19 ans a découvert une racine qui peut guérir le SIDA, et que des hôpitaux ont confirmé que des patients ayant testé ce remède ne seraient plus positifs au HIV ». Evidemment, le mail demande de l’aide financière pour pouvoir importer ce remède vers les pays développés.

« C’est particulièrement désolant de voir des escrocs se servir de la maladie pour arnaquer les internautes » indique sans trop de mal l’éditeur de solution antivirale Sophos, par la voix d’Annie Gay, Vice-Présidente de Sophos Europe Continentale, Moyen-Orient et Afrique. Une version beaucoup moins morale des scams ‘nigérians’ ou « 419 », déjà assez bas dans l’échelle des valeurs humaines…

Il d'agit peut-être d'une nouveauté pour le spam, mais ce genre d'escroquerie existe en boutique et sur Internet depuis plusieurs années. Le Dr Matthias Rath répand, à travers ses boutiques, ses cocktails de mégadoses de vitamines contre le cancer et le VIH, avec pour conséquence la mort des gens qui abandonnent les thérapies efficaces.

Scientist supporting herbal HIV remedy suspended

Researcher faces university investigation after work with unproven AIDS treatment.

Natasha Bolognesi

Mysterious medicine: Secomet V is made from the red clover, Trifollium pratense.
The University of Cape Town in South Africa has closed down the laboratories of one of its top scientists, who has been supporting an unproven herbal AIDS remedy.

Girish Kotwal, head of medical virology at the university's Institute of Infectious Disease and Molecular Medicine, has been temporarily suspended from his research duties so the university can investigate his association with the plant extract Secomet V, which is manufactured and distributed by the Stellenbosch-based company Secomet.

Secomet V has found a champion in Kotwal (see 'Bad Medicine'). But there have as yet been no clinical trials of the product.

Kotwal has published some data from a trial with four individuals showing that the herbal extract, which comes as a Coca-Cola-coloured liquid, acts as a broad-spectrum inhibitor of viral entry. But Kotwal's work has also shown that it can be toxic to cells, at least in the test tube. He acknowledges that much more testing is needed before the product should be used clinically.

Two AIDS patients in Stellenbosch died earlier this year after sudden liver failure. Neither had been on antiretroviral drugs (ARVs), says their doctor Lisa Hellstrom, but both were taking Secomet V. Another of Hellstrom's patients, who has taken both ARVs and Secomet V, has been found to have abnormal liver enzymes.

The product does not seem to be properly registered in the country as a herbal or complementary medicine, and some have raised potential ethical concerns about the university's sales royalty agreement with Secomet.

This royalty agreement will be reviewed by the university on completion of their investigation, says the university's manager of marketing and communications, Skye Grove.

Taking action

The institute's director Greg Hussey has said that Kotwal was dealing with Secomet in a personal capacity, and has said that his behaviour regarding the product is unacceptable. The matter was brought to the attention of higher university authorities by the investigations of Nature Medicine, which first reported on Kotwal's involvement with Secomet on 28 June 2006 (see 'Bad medicine').

Cheryl de la Rey, deputy vice-chancellor of the university, told news@nature.com they are taking the matter seriously.

Certain allegations of possible professional misconduct in respect of Kotwal are under investigation, says Grove. "The preliminary investigation committee convened on Monday 3 July to decide what the charges against him will be. He has been temporarily suspended from his research duties, and his laboratory has been closed, pending the outcome of this," says Grove.

Kotwal told news@nature.com that he cannot communicate with the press until the investigation has been completed.

Secomet, meanwhile, continues to sell their product. Their website says that the herbal extract "is not intended to diagnose, treat, cure or prevent any disease" but adds that: "patients generally experience a lowering of viral load, which allows their CD4 count to stabilize and then to start improving."

Chairman of South African Medicine's Control Council (MCC), Peter Eagles, told news@nature.com that "Secomet cannot trade making medicinal claims. The company's conduct will be discussed at an MCC meeting on Friday 7 July when the matter will be put forward for further clarity and investigation." Secomet refused to comment to news@nature.com.

L'Afrique du Sud est un havre pour les médecines 'alternatives' contre le SIDA soutenues par certains politiques, dont le président Mbeki et son Ministre de la Santé, Manto Tshabalala-Msimang. On se rappellera notamment le cas des pilules multivitaminiques du Dr Rath censées combattre le SIDA, des cancers, etc. Il est donc intéressant de constater qu'il n'est quand même pas possible d'y faire du n'importe quoi médical, comme de recommander des produits potentiellement dangereux sans tests scientifiques, avec en plus un lien financier pouvant générer un conflit d'intérêt.

Référence:
Article du Skepdic sur le Dr Rath

Procès contre les charlatans du SIDA

Libération.fr

Des militants sud-Africains pour l'accès gratuit aux antirétroviraux pour les malades du sida manifestent leur colère devant le palais de justice du Cap, vendredi. La Treatment Action Campaign (TAC), une coalition d'ONG, poursuit en justice la fondation de l'Allemand Matthias Rath, un farouche opposant des traitements à base d'antirétroviraux. A leur place, Rath, qui a ouvert des boutiques dans plusieurs townships du Cap, préconise un régime nutritionnel à base de vitamines, d'acides aminés et de minéraux.
Si elle a affirmé ne jamais avoir approuvé la thérapie préconisée par Matthias Rath, la ministre sud-africaine de la Santé dénonce elle aussi «les effets collatéraux» des antirétroviraux et a répété à plusieurs reprises qu'un régime nutritionnel à base d'ail, d'huile d'olive et de peaux de citron ne devait pas être négligé. TAC réclame que 200.000 personnes soient traitées aux antirétroviraux d'ici à 2006 en Afrique du Sud où, selon l'ONU, le VIH touche plus d'un adulte sur cinq, soit environ 5,3 millions de personnes sur une population de 44,8 millions.

Malheureusement, avec des politiciens de ce genre, le virus du SIDA a de beaux jours devant lui