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Concern in Africa over private doctors giving AIDS drugs

Patients are at risk because the medicine is not being prescribed correctly, experts say.

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Here in this poor mountain kingdom, as across the African continent, the price of AIDS drugs has plummeted. A full regime of AIDS medicine, consisting of three separate drugs to be taken daily, once cost thousands of dollars a month. Today, after pressure from activists, the price is less than $50.

That's good news for people who have fought for years to bring AIDS treatment to the developing world. But anecdotal evidence indicates that many private doctors, some of whom lack specific training for AIDS care, are prescribing only part of the drug regimen, are failing to properly monitor patients for toxic side effects, or are failing to provide patients with accurate information about the importance of sticking with the program over a long period of time. Such therapeutic "anarchy," as critics call it, endangers both the patient's health and the long-term success of growing efforts to bring AIDS treatment to developing countries.

"Doctors feel that they should at least give something, and they don't realize that in the long term what they're doing isn't in the interest of the patient or the community," says Des Martin, president of South Africa's HIV Clinicians Society.

Effects on patients

Public health experts have long worried about the rise of resistant strains of HIV, the virus that causes AIDS, if medications, called antiretrovirals (ARVs), were inappropriately administered in the developing world. Such fears were heightened by the announcement earlier this month about a new strain of HIV, found in a man in New York, that leads to the rapid onset of AIDS and is resistant to virtually all known ARVs. The UN estimates that 2.9 million people died because of AIDS in 2003, most of them in Africa.

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