The experiences with the spread of HIV/AIDS, especailly in sub-saharan Africa, have shown that the prevention strategies described in this book are still very much needed. This conclusion is supported by the results of the most recent international conference on HIV/AIDS in Vienna. Therefore, the re-publication of a revised edition of the book may be useful.
HIV/AIDS: Knowledge Protects
New and specific approaches to contain the spread of HIV in developing countries
Heinrich Repke and Edward S. Ayensu
Foreword by Kofi Annan, who was Secretary General of the United Nations at the time of the first
publication of the book in January 2002.
Heinrich H. Repke, Ph.D., D.Sc.
Lives in Berlin, GERMANY, and has spent many years in academic research in immunology, virology and drug research. He has held senior faculty positions in Pharmacology and molecular biology in Germany and the United States before becoming the head of a biotech-company. He was conducting and supervising various basic and applied research projects on diagnosis and therapy of HIV/AIDS and has adviced various government on AIDS policy in developing countries. Among other activities, he is currently the owner of FAGULON-Verlag.
Edward S. Ayensu, Professor, Ph.D., FGA
Lives in Accra, GHANA, and has conducted extensive research on medicinal plants of the world. He has held leading positions in many renowned international organizations, including the post of Secretary-General of the International Union of Biological Sciences. He has a comprehensive track record in promoting scientific research and cooperation between developed and developing countries. Formerly a Director and Senior Scientist at the Smithsonian Institution in Washington D.C., he is Chairman of the Council for Scientific and Industrial Research (CSIR), Ghana. Until 2003, he was the Chairman of the Inspection Panel of the World Bank in Washington, D.C.
At the commencement of the Special Session of the UN General Assembly on HIV/AIDS held on June 25 2001, I recalled five key objectives which I had first laid out for the African AIDS Summit at Abuja, Nigeria. These points outline a world-wide strategy on HIV/AIDS: it includes the prevention of the further spread of the virus; arrest of mother-to-child transmission; the provision of care and treatment for all infected persons; advancement of the scientific search for a vaccine and a cure; and the protection of those whom the disease has rendered most vulnerable, especially orphans.
I find it gratifying that all of these issues are addressed in one form or another in the present volume. Many other related matters appear in some detail. In addition, the authors maintain that current efforts to stem the tide of AIDS could be undermined by the assumption, often unwitting, that approaches which have worked in the developed countries will also work with success in developing countries. They are of the view that failure to recognize adequately this basic misconception could stultify many well-intentioned AIDS strategies, especially in Africa, where the large majority of the world’s HIV/AIDS cases occur.
I find that the Question and Answer mode of presentation within which all the scientific and socio-cultural issues are discussed contributes to the usefulness of this work. The book’s primary value, though lies with its core concept that developing countries, if properly enabled, can erect internal barriers to what must now be termed a pandemic. The enabling process involves mass screening not only for HIV/AIDS victims but for a variety of endemic diseases that impede progress throughout the developing world. A worldwide campaign is envisioned to include personal counseling of individuals and couples who join national programs.
While not everyone will agree with the specific strategies proposed by the authors, I believe that this book will stimulate constructive debate which will brings us closer to the objective of worldwide AIDS prevention and control.
Secretary General of the United Nations October 2001
We believe that the Knowledge Protects Concept presented in this book is currently the most realistic way to contain the further spread of HIV/AIDS in developing countries. We have coined the term “Shielded Testing and Counseling” (STC) for our practical approach.
We present a comprehensive action plan for containing the spread of HIV/AIDS in developing countries and discuss all the essential tools for implementing and financing this strategy.
This book uses Africa as an example because the vast majority of HIV-infected people of the world live there. Modifications of the concept which address the different cultures of Asia, the Pacific, Latin America, and the West Indies, can be made readily without detracting from the effectiveness of the program.
Finally, we hope that decision-makers – both North and South – will examine the contents of this book from a very pragmatic standpoint to enable them assist in providing a practical solution to stem the tide of this epidemic.
List of Contents
1. Concepts which have been successful in the developed world have proven inadequate or plainly wrong in developing countries
2. Questions which need to be raised to trigger the development of new concepts and actions
3. It is a business decision in the interest of the developed countries to finance the fight against HIV/AIDS in the developing countries
4. The Domino effect is the cause of the exponential spread of HIV-infections
5. The conversion of the conditioned reflex of fear and denial into a conditioned reflex of protection.
6. The principles of “Shielded Testing and Counseling” programs
7. Practical implementation and content of the pre-test education phases 1, 2 and 3.
8. Content and conduct of post-test counseling
9. The technical requirements for diagnostics suitable for Shielded Testing and Counseling (STC) programs in developing countries
10. Does Shielded Testing and Counseling really work?
11. Mandatory testing and counseling
12. Role of authorities, traditional customs and religion in the support of STC in a developing country
13. Actions required to make the effect of STC programs sustainable
14. Cost calculations and annual national budget for STC for the first three years
15. Specific proposals for projects to be funded within the framework of a national STC program
16. Proposals for international competitive bidding (ICB) and negotiated contracts for goods and services required
17. How can people infect themselves with HIV?
18. How does HIV destroy our natural defense against diseases: the immune system?
19. The options for treating HIV/AIDS: hopes and illusions in developing countries
20. Vaccines against HIV: neglected because of lack of profit prospects or because of the scientific challenge?
21. Each number is the fate of a human being: the statistics of human suffering and deaths.
Glossary of abbreviations and terms