Bolaji Aluko IAAN Secretary wrote:
I have followed the "controversies" surrounding Dr. Geshekter's claims, and I have four questions for him, as my sincere "welcome" to him to the list:
1. What, according to his studies, is/are the best indicator test(s) for HIV/AIDs ?
2. What his best estimate of the actual number of HIV/AIDS patients/sufferers in Africa now ?
3. What can be done about such patients - by government and by the patients themselves ?
4. What can happen if NOTHING is done about them ?
It is most likely that all of these questions can be answered by going through many of the references to which Dr. Dr. Geshekter referred, but I have asked them simply to see whether one can get simple answers to the questions. If not, I am prepared to wade through the references.
Thanks.
Dr. Geshekter Replies:
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Dear Bolaji:
My answers will be very brief for now since I am about to leave on holiday. I can elaborate if you wish in a week or so.
#1 First of all, it is crucial that we separate or distinguish any discussion about HIV antibodies from the discussion about the clinical symptoms that define (according to the WHO) and AIDS case in Africa.
#2 There is no way of answering this question based on the available evidence given the contradictory definitions of an HIV case or an AIDS case being counted, the shabby nature of record-keeping in much of Africa, or the fact that nearly all "estimates" are based on the flimsiest of data. South Africa has the best system of vital statistics in Africa. Ask someone involved with AIDS in South Africa to tell you the number of HIV cases actually recorded in Gauteng Province for 2000 and 2001, and the number of AIDS case in Gauteng for 2000 and 2001, and have them break those numbers down by age, race, and gender. As they prevaricate, you will why it is nearly impossible to make sweeping statement about all of Africa when people cannot provide specific numbers for a major Province in South Africa. I would also ask them to provide mortality numbers for Gauteng for 1995, 2000, 2001 and 2002, giving cause of death and the other relevent breakdown categories.
#3 This is best answered by my two physician colleagues, Dr. Sam Mhlongo and Dr. Claus Kohnlein, both of whom have considerable clinical experience with patients said to suffer from "AIDS." The only thing I can add is that the physician typically should treatment the patient's clinical symptoms - fever, cough, diarrhea, or weight loss - NOT some surrogate marker like HIV antibodies or viral load. I believe the term is "clinical endpoints."
#4 I would once again defer to my two physician colleagues on this matter. The key question to be answered is what is the patient suffering from? Once that is answered, then the possible range of treatments can be considered.
I hope this helps as a very rapid response.
Best regards,
Charles Geshekter
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