Africans resigned to long wait before drugs are available

The news of progress in medical trials in Thailand was greeted in Africa with a combination of excitement and resignation yesterday.

Nearly two-thirds of the world's Aids-affected population live on the continent and as many as 24 million Africans are HIV-positive, 1.5 million of whom die each year. But the anticipation of a vaccine is tinged with the knowledge that any wonder drug will arrive in Africa last.

The biggest advance to date, anti-retroviral (ARVs) drugs that slow the progress from HIV to full-blown Aids, have been available in the industrialised world since 1996. Thirteen years later, ARVs are only reaching one in four HIV-positive Africans.

An estimated 17 million people have died in sub-Saharan Africa from the Aids epidemic, a figure greater than the combined populations of London and New York City.

The biggest impact in recent years was made by the $15bn (£9.3bn) spent on the US President's Emergency Plan for Aids Relief (Pepfar), which has saved close to two million lives by getting ARVs to HIV-infected patients and slowing the deadly rate of mother-baby transmission.

HIV prevalence is still on the rise in Botswana, Namibia, Lesotho, South Africa and Zimbabwe, which is the worst-hit, with one in four adults infected. In South Africa, the largest economy, there are six million HIV sufferers, a figure that has overwhelmed the health system.

The impact of these devastating infection rates has been stark: there are more than 12 million Aids orphans in Africa, and life expectancy, which would otherwise stand at an average of over 60, is 47.

Experts warn that the challenge of meeting the Aids crisis goes beyond pharmaceutical breakthroughs, with the lack of a functioning transport system seen by many as one of the main impediments. The UK-based Riders for Health has been working with governments in Africa for 20 years battling to deliver the transport and logistics to make sure health care reaches rural communities.

"A vaccine against HIV has huge potential value for humanity, but this value will not be realised if it fails to reach those who need it in Africa," said Barry Coleman, executive director of Riders for Health. "Advances in medical science like this are only part of the solution.

"If we repeat the mistakes of the past, this will be another breakthrough that does not reach those who need it most."

47

Average life expectancy for Africans because of Aids.