February 20, 2006

Bird flu could hobble Africa’s AIDS fight-UN

By Andrew Quinn

DAR ES SALAAM (Reuters) - Bird flu poses a major threat to
Africa's fight against its AIDS epidemic, challenging
overburdened healthcare systems and stretching economies
already hit by the impact of HIV, the U.N.'s AIDS chief said.

UNAIDS Executive Director Peter Piot said a human outbreak
of bird flu in Africa - where the deadly H5N1 strain of the
virus was detected in poultry in Nigeria this month - could be
a massive blow to the campaign to rein in AIDS.

"We are on very thin ice here," Piot told Reuters in Dar es
Salaam, where he was on an inspection mission.

"AIDS has made a mess of Africa's health care systems, and
none of the factors that created the AIDS disaster have gone
away. But with bird flu, we could be looking at things getting
worse in a matter of months, not decades."

Cases of H5N1 have been confirmed on four farms in the
northern Nigerian states of Kano and Kaduna and in the central
state of Plateau. There have been suspected outbreaks in at
least five other states in the center or north of the country.

No human bird flu case has been found in Africa so far. But
detecting such a case will be difficult because mortality rates
are high from other diseases and health services are almost
non-existent in rural areas, where people are often buried
without a medical check.

Officials are now increasingly worried the likelihood of
human transmission could rise if the virus spreads to other
countries in the region - many already suffering from
widespread malnutrition, poverty and the effects of the world's
worst HIV/AIDS pandemic.

"Africa is fragile, and this could really overburden its
systems," Piot said.

"We have not seen a human outbreak yet. But if we do, the
resources are going to have to come from somewhere. That is a
real concern for everybody involved in development."


Piot said scientists were studying the possible interaction
of bird flu and HIV, the virus which causes AIDS and which has
already infected some 26 million people in sub-Saharan Africa.

While some theorise that those whose immune systems are
weakened by HIV might die faster in a bird flu outbreak, others
say that because bird flu overstimulates the immune response,
HIV-positive people might not die themselves but instead become
"supercarriers" that spread the virus.

Piot said precautionary measures such as poultry culls
could spell disaster in their own right on a continent where
many people survive on subsistence farming and keep chickens to
feed their families.

"For many people in Africa, chicken is either the major
source of protein or the major source of income. If we try to
eliminate chickens it would be an economic catastrophe, and
that has clear implications for AIDS," he said.

Piot - who has spent a decade at the helm of the U.N.'s
AIDS effort - said he was encouraged by the rapid global
response to the bird flu threat but that much more needed to be
done both to organize an effective response.

"The first lesson from AIDS is to act early and not to wait
until you've got a big problem," he said. "That's what happened
with AIDS in Africa, and look at the impact now."