Unicef is discussing bringing an HIV/AIDS suppression drug to Cambodia next year for a trial run, although the National AIDS Program chief on Friday expressed concern for the program’s long-term prospects.
The trial is designed treat hundreds of pregnant women for 34 weeks leading up to the planned birth to prevent transmission of the virus to the unborn child.
The suppression drug, AZT is touted as an effective weapon against AIDS in countries where HIV is widespread. Critics contend it is too expensive for the Cambodian public health sector to maintain and activists say the money can be better spent on stopping the disease’s spread.
Activists closely watched a similar test in Thailand, which yielded positive results, they said.
“We are actively studying this and researching and possibly early next year, we might start,” country director for the UN Children’s Fund and UNAIDS chief Leonard de Vos said in an interview last month. “We’ll do a trial most probably next year. This is being discussed, there is no deadline, there is no date.”
The proposed trial run will encompass 400 to 500 people, de Vos said.
In a June 29 dispatch from Geneva, UNAIDS announced an initiative in about 30 countries, including Cambodia, to start the program.
Project countries were chosen on the basis of whether “women of childbearing age have high HIV infection rates” and whether the local health system could support the trial.
Unicef will heavily sponsor the trial with technical support from the World Health Organization.
However, prospects for use of AZT beyond the trial may be problematic, said Dr Tia Phalla, director of the National AIDS Program. He said Friday that the government can’t afford to provide the drug on a regular basis to patients beyond the trial.
“We create the demand by initiating the research, the survey, the trial,” he said. “People will come up now that we know it’s efficient and say, ‘Why doesn’t the government provide us drugs?’”
Asked if there was a better approach, he said AZT will at least attack one way that people become HIV-infected.
“The basic thing is to prevent our people from getting infected and if the people get infected, little can be done in that we have little to help us survive,” he said.
De Vos said that the program will face challenges in finding HIV-infected women early enough for the trial to be effective. “For the moment, we only know about cases that come into the hospitals and for one reason or another are tested for HIV,” he said. “We don’t know about the others and there has to be more testing.”
In addition, the program may have trouble finding people to consent to taking the drug and continuing with the follow-up tests for the full course of treatment, he said.