AIDS: Science at a Crossroads

The most important Chinese herb in HIV disease, and the most extensively studied, is astralagus.
It increases the production of antibodies in healthy humans and stimulates several factors in the
immune system in mice. Many Chinese herbalists have prescribed it as part of an immunestimulating compound for HIV-positive people.
Other important Chinese herbs used to treat HIV include: Andrographis paniculata - which is
used to treat TB, and inhibits HIV in the test tube; Hypericum performatum (in synthetic form,
hypericin), which is used to treat Hepatitis B virus infection in China and inhibits HIV in the test
tube; and Viola yeodensitis, which inhibits, but does not kill, HIV. Doctors in San Francisco are
currently testing a Chinese herbal formula in people with HIV. A short-term collaborative study in
Tanzania between Chinese practitioners and Tanzanian doctors suggested that symptoms were
relieved in most of a small number of cases. However, long-term health was not reported (11).
* Other herbal treatments: In many developing countries where traditional medicine is still practised,
traditional herbalists have tried various approaches to treat AIDS or associated illnesses. In
Zimbabwe, after a spate of spurious AIDS cure claims by traditional healers, limited trials were
carried out by the Blair Research Laboratory on herbal cures from traditional healers. These trials
showed that some herbal preparations can be effective in alleviating some of the symptoms linked
with AIDS, such as diarrhoea and weight loss. However, none of the compounds tested could cure
AIDS or rid the body of HIV.
A study conducted in Kigali, Rwanda (before the recent conflict) and in Kampala, Uganda, found
that most women were using both traditional healers and modern medicine to treat AIDS and other
diseases. The study also found that traditional healers were usually interested in collaborating with
modern medical practitioners, and that all the healers questioned knew the symptoms of AIDS and
the routes of transmission of HIV (13). There is also evidence that in many countries, traditional
healers can sometimes help people with HIV or AIDS by providing psychological support and
counselling.
* Acupuncture, another Chinese traditional therapy, can benefit people with AIDS, both in long-term
programmes and in hospices for those receiving terminal care.
The cost of AIDS treatments
AIDS is expensive. The direct medical cost of treating the disease has been assessed in a number of
different countries (14). In the developing countries, on average, it is roughly equal to per capita GNP.
In the rich countries, it often exceeds per capita GNP. For example in the US, in 1991, the cost of treating
each AIDS patients was estimated at US$ 32,000 a year - or 161% of GNP per capita. In Zambia, the
cost was US$ 374, or 96% of GNP. And in Zaire, the cost varied dramatically between US$ 132 and
US$ 1,585 - which translates into anything between 78% and a staggering 932% of GNP (2).
In much of sub-Saharan Africa, care provided at home in a person's village may be extremely cheap
while hospital care in a major city will be 50 times as expensive - and this is without antivirals.
The World Bank reported in 1993 that even in Tanzania, where the government pays a large share of
health costs, affected households had spent on average a crippling US$ 60 - equivalent to a year's
rural income - on treatment and funerals (1). In Thailand, a small study in Bangkok in 1990 found
that the total direct cost of diagnostics and drug treatments was just over US$ 1,300. Some 80% of that
was for drugs; AZT alone accounted for two-thirds of the total drug costs (2). But in most developing
countries, AZT is not even an option. In Malawi in 1994, the estimated cost of treating AIDS patients
without any expensive antivirals, but just routine drugs such as aspirin, was estimated to be US$ 20
million. This was expected to more than treble by 1998.

15 - Panos Briefing: AIDS: SCIENCE AT A CROSSROADS