Facing the Reality of AIDS in Africa
New initiative sends post-doctoral residents to nations beset by the pandemic
Two graves in the front yard.
She hadn’t noticed them when she first walked up to the house. Imbi Ichile, a post-doctoral associate at Rutgers University’s Ernest Mario School of Pharmacy, was in a village in South Africa with other health care professionals to see firsthand the realities of the AIDS pandemic.
But everyone living in this little house was a child. Where were the adults?
“Their parents were buried in front of the house,” she said. “We were interviewing these children while looking at their parents’ grave sites.”
Ichile was in Africa for six months last year as the first fellow in a new initiative between the pharmacy school and Bristol-Myers Squibb’s Secure the Future Foundation. The program is sending post-doctoral residents to the region to study the challenges in southern African countries and to work with health care professionals there on solutions.
“This is part of our global mission here at Rutgers, to make an improvement in health care wherever that might be,” said Joseph A. Barone, chair of the Department of Pharmacy Practice and Administration, who has helped facilitate the program. “Our hope is that over time what we’re doing here is going to show a viable model for other schools in other areas."
AIDS has spiraled out of control in Africa largely due to decades of inaction by government officials, tribal leaders and citizens. In South Africa, the nation’s former president Thabo Mbeki had questioned whether HIV really caused AIDS and cast doubt about the safety of antiretroviral drugs. For some African nations, the situation is so dire that clinics routinely turn away new patients because their facilities and staff are overwhelmed.
South Africa’s new president, Jacob Zuma, has reversed the government’s stance. His administration launched a campaign to have at least a third of South African citizens tested for HIV by 2011. And as part of a public awareness campaign, Zuma has traveled across the country encouraging citizens to get tested. He recently admitted to engaging in unprotected sex and photos of him being tested for HIV appeared across the country. South Africa has the largest number of people with HIV in Africa, an estimated 5.7 million citizens who are HIV positive, according to UNAIDS.
Most of Ichile’s time in South Africa was spent observing the series of new efforts to increase awareness about HIV and boost access to healthcare and medications. She also offered advice to health care professionals there on ways to improve the system.
"We were looking at ways to fix the system, to make it more efficient, so that for example, once a patient was referred, their meds would be ready,” she said. “Something like that sounds so simple but what I was able to see was that there were so many different issues the health care professionals were having to deal with that they were overwhelmed.”
Ichile said she was particularly struck by how poverty and a lack of access to basic services and information exacerbate the problem. Many patients in rural areas, for example, had no access to transportation that could take them to see a doctor. Social workers were constantly struggling to keep up with the numbers of patients and the extent of the needs.
Ichile worked with a local support group to not only talk to people about the importance of taking their medications and how medications worked, but also to provide people with food when she did her talks.
“People would want to take two or three plates because they needed to take food to their kids and other people in their households,” she said.
An executive for Bristol-Myers Squibb said the program is part of the pharmaceutical giant’s continued philanthropic efforts.
“We feel, as a leader, you have to do more,” said John Damonti, vice president of corporate philanthropy. “Our foundation and our work in Africa demonstrate that we care about more than selling the drugs. We care about the patients as well.”
While the problems sometimes seemed too much to handle or contemplate, Ichile said she felt she was ultimately able to make an impact. She spent time with health care professionals, helping to come up with solutions to various issues such as getting medications to patients in rural areas, and improving ways to educate patients on their medications.
“There’s still so much that needs to be done but I feel I was able to accomplish a lot,” Ichile said. “I definitely feel like I made a difference.”