Bill Gates Foundation supplies Dr Denise L Faustman, see faustmanlab.org and pubmed.org faustman dl and pubmed.org ristori bcg.
Why is BCG not easily and widely available to all in the US Mr Heathcare man?
Who cares about exchanges and computers and records when simple things like BCG et al work.
I will pay an African girl in US dollars to shoot me with BCG and photograph the effects for a You Tube Video on its effect on plaque psoriasis. As an added bonus BCG works for MS and Type 1 diabetes et al.
Shoot BCG and send money to Africa.
Our black man in the white house has a warped view of healthcare.
He is also out of touch with the great work that took place at Fort Hamilton that produced eg The Lancet p.106 Jan. 14, 1978.
Sadly the world's greatest Doctor continues to be Hiram Maxim.
OTIMATI, South Africa — While around the world a vast majority of AIDS victims are men, Africa has long been the glaring exception: Nearly 60 percent are women. And while there are many theories, no one has been able to prove one.
In
a modest public health clinic behind a gas station here in South
Africa’s rural KwaZulu/Natal Province, a team of Norwegian infectious
disease specialists think they may have found a new explanation.
It
is far too soon to say whether they are right. But even skeptics say
the explanation is biologically plausible. And if it is proved correct, a
low-cost solution has the potential to prevent thousands of infections
every year.
The
Norwegian team believes that African women are more vulnerable to
H.I.V. because of a chronic, undiagnosed parasitic disease: genital schistosomiasis (pronounced shis-to-so-MY-a-sis), often nicknamed “schisto.”
The disease, also known as bilharzia and snail fever,
is caused by parasitic worms picked up in infested river water. It is
marked by fragile sores in the far reaches of the vaginal canal that may
serve as entry points for H.I.V., the virus that causes AIDS. Dr. Eyrun
F. Kjetland, who leads the Otimati team, says that it is more common
than syphilis or herpes, which can also open the way for H.I.V.
A Plague, a Doctor, an Idea
Gynecologists working in Africa suspect that
women there are more vulnerable to H.I.V. because of waterborne
parasites. An ambitious research project aims to revolutionize treatment
for young women.
Credit Joao Silva/The New York Times
Also,
the foreign bodies in the sores — the worms and eggs — attract CD4
cells, the immune system’s sentinels, and those are the very cells that
H.I.V. attacks.
The
worms can be killed by a drug that costs as little as 8 cents a pill.
Dr. Kjetland’s team is trying to determine whether that will heal the
sores in young women.
Some
prominent AIDS experts doubt the schistosomiasis theory, pointing out,
for example, that urban women raised far from infested water also die of
AIDS. But proponents of the theory say that two decades ago, many
experts were just as skeptical of the idea that circumcision protected men against H.I.V. It was not until 2006 that three clinical trials proved it correct.
Schistosomiasis
“is arguably the most important cofactor in Africa’s AIDS epidemic,”
said Dr. Peter J. Hotez, dean of the National School of Tropical
Medicine at Baylor College of Medicine. “And it’s a huge women’s health
issue: Everyone has heard of genital mutilation and obstetric fistulas.
But mention this, and the headlights just go dim.”
The
idea is slowly gaining ground. The Bill & Melinda Gates Foundation,
the United Nations, the National Institutes of Health, and the Danish
and Norwegian governments have all given some grant support. But leaders
of the two agencies that pay for the fight against global AIDS want
more evidence before diverting funds from their campaigns for condoms, drugs and circumcision.
“We need to track all these things down and see what’s a cause and what’s just another disease you have at the same time, like cervical cancer,” said Dr. Mark R. Dybul, executive director of one of the agencies, the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Dr. Eric Goosby, who recently finished a five-year stint as coordinator of the other agency, the President’s Emergency Plan for AIDS Relief,
or Pepfar, agreed that vaginal sores could help the virus enter. “But
it’s complicated,” he added. “A lot of women who have H.I.V. don’t have
schisto, and vice versa.”
From
her small clinic just off the highway here, Dr. Kjetland makes visits
to high schools where she has government permission to work because
their communities have the highest rates of schistosomiasis. On the dirt
roads around these hills, it can take her hours to reach each one.
Through
school nurses, she gives deworming drugs to all students, male and
female. (To her frustration, although the drug is sold by generic makers
for as little as eight cents a pill, South African patent laws permit
only the Bayer version, which costs $4.)
Then
she meets with groups of girls ages 16 and up to ask the sexually
active ones to come to Otimati for gynecological exams and blood tests.
“I am as gentle as I can be, much more gentle than sex is for them,” she said, “but even the slightest touch and they bleed.”
Gentleness
is part of Dr. Kjetland’s nature. A 49-year-old stepmother of five, she
watches like a mother over the girls in her study. She ordered that
extra rooms be built where they can cry if they test positive for H.I.V.
She tries to make sure the boys in their schools never realize she
chooses only sexually active girls. And she has KFC delivered, since it
is a treat for girls who often have only cornmeal mush to eat for days
on end.
Though
trained in Norway, she has spent most of her life in Africa, growing up
in Tanzania as the eldest of a missionary couple’s six children,
attending prep school in South Africa, and, after college and medical
school in Norway, doing graduate work in Malawi and Zimbabwe.
An
estimated 200 million Africans have had schistosomiasis. Although it is
rarely fatal, the bleeding it causes in children can lead to anemia, stunted growth and learning problems. It is caused by tiny worms that live in freshwater snails and emerge with pointed heads that can penetrate the skin of people collecting water or washing clothes.
Once
inside, the worms mate, with the female living in a cleft in the male’s
body “like a hot dog in a bun,” Dr. Kjetland said. Most nest in the
urinary tract — bloody urine is the classic symptom — but a portion end up in the vagina, creating “sandy patches” of damaged tissue and calcified eggs.
ZIMBABWE
BOTSWANA
MOZAMBIQUE
Limpopo
River
SOUTH AFRICA
Pretoria
SWAZILAND
Johannesburg
KWAZULU-NATAL
Otimati
LESOTHO
Durban
Indian Ocean
200 miles
Studies
by Dr. Kjetland in Zimbabwe and South Africa and by Dr. Jennifer A.
Downs of Weill Cornell Medical College in Tanzania have shown that women
with the patches are about three times as likely as their neighbors to be infected with H.I.V.
A
gold standard study to prove the connection would be both impractical
and unethical: Researchers would have to divide hundreds of infant girls
into two groups, give half deworming drugs and half placebos, wait
until they were perhaps 20 years old, and see how many had H.I.V. No
ethics board would approve placebos under those conditions.
So
Dr. Kjetland studies teenagers, hoping to heal their sores and see if
their H.I.V. infection rates are lower than the norm. (In grown women,
the sores persist even after the worms die.)
For
years, theories have abounded as to why African women become infected
with H.I.V.: for example, that they are more likely to have overlapping
sexual partners — not always by choice — while women elsewhere have
boyfriends or husbands in series. That rape, incest and domestic
violence are rife in southern Africa, where the AIDS epidemic is worst.
That syphilis and herpes are rampant. That impoverished, fatherless
young women are forced to pay with sex for food, clothes, grades and
even car rides.
The schisto hypothesis can now be added to that list, but to some prominent experts it remains unlikely.
One
is Daniel Halperin, an epidemiologist now at the Ponce School of
Medicine and Health Sciences in Puerto Rico. He knows how it feels to be
doubted: In the 1990s, he was the chief proponent of the theory that
circumcision protected men against H.I.V.
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He
argues that tropical West Africa, where schisto is common, has little
H.I.V., while countries with little schisto, like arid Botswana and
mountainous Swaziland, have sky-high H.I.V. rates.
Dr.
Salim Abdool Karim, a renowned South African AIDS researcher who
admires Dr. Kjetland’s work, is also skeptical. His team follows more
than 1,000 women in an area only 40 miles from Otimati with equally high
H.I.V. rates.
“We’ve studied genital tracts in detail for 20 years, photographing them sequentially,” he said, “and we see no sandy patches.”
Upon hearing that, Dr. Kjetland reached for the mounted magnifying scope she uses to examine girls.
“They’re not looking in the right places,” she said.
Most gynecologists, she explained, are trained to look for cancer,
which usually starts near the center of the cervix, while sandy patches
are tucked away in crevices that can be seen only by swinging the scope
to extreme angles. It takes her weeks to train doctors to find them
consistently, she said.
Fighting
schisto across Africa would take an extensive pill-distribution effort,
but Dr. Hotez, the Baylor dean, argues that it is worth it.
Seventy million African children could be dewormed twice a year for 10 years at a cost of $112 million, he said in an essay
titled “Africa’s 32 Cents Solution for H.I.V./AIDS” (32 cents being the
cost of two generic deworming pills twice a year). That is cheap
compared with the $38 billion Pepfar is expected to spend on AIDS in
that period, he said.
A vaccine would be even better, and several are in development, including one at the Sabin Vaccine Institute, which Dr. Hotez also heads.
But
even if one works, “it will be at least five to 10 years before the
testing is finished,” he said. “We shouldn’t wait for that.”
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