Cuba Leads Way on Aids treatment Prevention
John M Cox
coxj at email.unc.edu
Wed Feb 19 11:27:37 MST 2003
February 17, 2003
Cuba leads way on Aids treatment and
By Clive Cookson in Denver
Cuba has much to teach the world about tackling Aids,
the American Association for the Advancement of Science
A wide-ranging prevention and treatment programme,
backed by strong political action, has given the
Caribbean country the lowest prevalence of Aids and HIV
infection in the western hemisphere - and one of the
lowest rates in the world.
Since 1985, when Cuba's first Aids case was diagnosed,
4,500 people have been infected and 1,050 have died of
Aids, according to Jorge Perez, the country's leading
infectious disease specialist.
Today just 0.03 per cent of the 11m population is HIV-
positive. The infection rate in the US was 14 times
higher, said Byron Barksdale, director of the Cuba Aids
Project, an American medical charity licensed by the US
government to circumvent the economic embargo of Cuba
for humanitarian reasons.
Monica Ruiz, a public health specialist with the US
National Institute for Allergy and Infectious Diseases,
said the Cuban experience "shows the important role of
political will in dealing with an epidemic. And this is
a country where public health is seen very broadly as
an important public good".
Cuba took drastic action even before Aids had reached
the country. On the advice of Dr Perez, the government
set up a National Aids Commission in 1983 and destroyed
all foreign-derived blood products.
Although this put a great strain on the country's
health system, Dr Perez's "educated hunch" enabled Cuba
to escape the transmission of HIV to haemophiliacs and
other blood recipients.
As soon as Aids appeared on the island, an aggressive
HIV screening programme swung into action, with
compulsory testing for all expectant mothers, people
with sexually transmitted diseases and sexual contacts
of HIV patients.
There was also extensive voluntary testing. More than
20m HIV tests had been performed on the Cuban
population since 1986, Dr Barksdale said. At the same
time condoms were introduced to prevent sexual
The most controversial part of the programme was
compulsory quarantining of everyone who tested positive
in special HIV sanatoria. This was relaxed in 1994, but
anyone newly diagnosed still had to go to a sanatorium
for "eight weeks of education," Dr Barksdale said.
Treatment of Cuban Aids patients has improved greatly
over the past two years, because the country's
pharmaceutical industry has started producing generic
copies of the main anti-HIV medicines.
The next challenge will be to maintain and improve
Cuba's HIV/Aids programme in the face of an enormous
increase of tourism. www.ft.com/science
Journals to curb data publication because of terrorism
The world's leading scientific journals have agreed
measures to restrict the publication of research which
could be used by bioterrorists, writes Clive Cookson.
In a joint statement released at the annual meeting of
the American Association for the Advancement of
Science, the journals' editors say concerns over
terrorism must not affect the release of valuable
But they recognise there may be occasions when new
research data should be withheld from publication
because it could be abused.
The statement was signed by the editors of 32 journals,
including Nature, Science and the Lancet, and others
will be invited to make a similar commitment.
It does not lay down blanket rules; each journal will
draw up its own procedures for identifying and, if
necessary, suppressing potentially dangerous
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