Garlic Does Not Work On HIV-AIDS, Nor On Tuberculosis, Nor On Vampires. Of course, Thabo Mbeki, the embarassment of a President is the major problem, and not at all unlike other tin-cup dictators risen by strong arm tactics to a position far from his capacity or understanding -- and is currently working to effectively destroy yet another South African Generation. What a health plan. He sacks the one advocating treatment by drug therapies and supports the one trying to invoke a nutritional basis for overall public health. How is this going to sit with the people of South Africa -- and how long do they put up with this Mbeki. I know the US has suffered under an equivalent embarrassment for nearly eight years. Maybe we need to send them Rove. . .to help.

Reconciliation worked only for the semi-intelligent. If this imperious superficial President is not removed soon, further decimation of the nation will continue, and likely accelerate. The problem is that the South African nation's staggering TB and HIV/AIDS infections are reaching pandemic levels -- and cucumbers, potatoes and Garlic just won't cure what ails SA.

What was once a potential melding of Europe, Asia, and Africa with reconciliation has been damaged by the ignorance of
Mbeki. That said, the report is worth a total review and is a light flickering from the darkness at the south end of the continent. Herewith:

The Report: HIV/AIDS, TB, and Nutrition. (From the Academy of Sciences of South Africa.)

Of course, Americans, as desperate as any humans, and preyed upon for a few dollars, have used such anti-cancer agents as oil from the pits of apricots, while garlic ranks right up there in the lore -- but the use of such remedies without drugs or in place of known drug-regimens threatens yet another generation of citizens of South Africa.

Look at the various "nutrition businesses" in the US and as likely as those throughout the world, and check out their wars on TB, AIDS, Cancer, Heart Attacks and Back Aches.

Where do you get your Vitamin A, B,C, D, E? Do you buy tablets, like from the Vitamin Store, GNC, or your local chain food store? Do you OD on them?

That's right, these health foodstore specialties and "grandma's curatives" do not have to be approved by the FDA, though I imagine the Chinese food and drug czar felt his agency was a money maker for the drug-companies of China similar to the US. Except in China, the government prosecuted and executed the criminal. Imagine that happening here in the USA -- somebody held accountable for health-related criminal conduct!

Pandemic: South Africa: HIV-AIDS and Tuberculosis - part of the Pandemics of Africa

One of the efforts the Government of South Africa has been involved in accomplishing is the education of a citizenry greatly exposed to and infected by HIV/AIDS and by tuberculosis. The level of incidence, infection and spread of these afflictions has reached nearly to the pandemic level in South Africa and, in fact, in much of Africa.

Image from Wikipedia: Map of South Africa, showing the districts.

In 2005 31% of the pregnant women were HIV infected, and 20% of all adults were infected. There are 1,200,000 orphans. More than 1000 people die of AIDS daily. Six million will die in the next decade. Malaria infections are down 65%; deaths from Malaria, down 73%. Data from Wikipedia.

The entire report is located here:

http://search.sabinet.co.za/images/ejour/assaf/Study%20%20pdf%20final%20ASSAf%20HIV%20TB%20and%20Nutrition%20doc.pdf

http://www.assaf.co.za/

Acknowledgment
Published by the Academy of Science of South Africa
ISBN: 978-0-620-39209-9
July 2007
P O Box 72135
Lynnwood Ridge 0040
(Pretoria, South Africa)
Building 53
1st Floor Block C
CSIR Site, South Gate
Meiring Naude Road
Brummeria 0184
Web: www.assaf.org.za
Phone: +27 12 843 6482
Fax: +27 0866 810 143
e-mail:

<script type="text/javascript">eval(unescape('%64%6f%63%75%6d%65%6e%74%2e%77%72%69%74%65%28%27%3c%61%20%68%72%65%66%3d%22%6d%61%69%6c%74%6f%3a%66%75%6e%64%69%40%61%73%73%61%66%2e%6f%72%67%2e%7a%61%22%3e%66%75%6e%64%69%40%61%73%73%61%66%2e%6f%72%67%2e%7a%61%3c%2f%61%3e%27%29%3b'))</script>

Copyright: Academy of Science of South Africa
Reproduction is permitted provided the source is acknowledged
Layout, typesetting, cover design, reproduction and printing
Marketing Support Services (012) 346-2168
=======================================
Note: throughout but not completely, and almost at random, I have converted to American English many spellings that are strictly British renditions of common words. I have ignored other renditions -- and still can effectively read the work and ingest the content. [-- Les Porter]
=======================================
The report is a solid piece of work., and hopefully, will be used to guide both policy and medical research in parts of the continent to better the chances for survival and recovery of Africa.

==========================
APRICOT PIT OIL or GARLIC, ANYONE?
==========================
The
SIX PRINCIPLES

There are six general "principles" the report establishes as a crystallization of the efforts of the organizations and panels involved in examining the depths of the problem. A clear goal -- wound into but unwritten through the entire report -- is what needs to be done in order to not lose yet another generation of Africans, that is, the one alive now, and the ones ahead.

I quote from the text of the report:

"Principle 1

Optimum nutrition at the population (public health) level is necessary for the prevention and spread of HIV/AIDS and TB, and at the level of individuals to improve health,quality of life and response to drug treatment, but it cannot directly prevent transmission of these infections or cure them or supervening infections."

There is widespread acceptance that malnutrition is part of a vicious cycle of poverty, underdevelopment, lack of education, and an intergenerational lack of development of cognitive skills and “human capital”, all factors collectively contributing to the HIV/AIDS and TB pandemics. To break this cycle, these factors should be addressed simultaneously and in concert, and nutritional interventions should focus on all stages of the life cycle, but especially aim to improve the nutritional status of expecting mothers and their unborn babies. There is no direct, hard scientific evidence that good nutrition will influence transmission of the infections, but (so far mainly indirect and circumstantial) evidence does indicate that the rate of progression of HIV to AIDS will be slower in individuals with optimum nutritional status. The same level of evidence suggests that responses to drug treatment of both primary and secondary infections and side-effects of drugs can be improved by therapeutic nutritional interventions.

There is, however, no evidence and no biological reason to suspect that any diet, food, nutrient, non-nutrient (phytochemicals) or combinations of these can replace the judicious use of drug treatment of these infections.

Principle 2

Recommended nutritional interventions should do more good than harm.

The already mentioned lack of evidence and gaps in our knowledge, combined with unreported, unpublished results from clinical experience and traditional practices, as well as the desperation of critically ill people suffering from stigmatized diseases, have spawned a plethora of recommendations regarding the beneficial effects of specific foods, traditional plants and their extracts, herbs and spices, as well as supplements, in the prevention and treatment of HIV/AIDS and active TB.

These “alternative or dissident” recommendations, often expressed by political leaders and by practitioners claiming positive results from their treatments, have received wide press coverage at home and abroad. It may well be that there are unknown and unrecognized substances in edible and medicinal plants with these unproven putative beneficial effects.

However, until these suggested remedies have been proven to do more good than harm the panel cannot support their use.

For example, the putative beneficial effect of garlic in “strengthening” the immune system may well be true, but the SA HIV Clinicians Society2 warns that “various deleterious side effects are associated with the use of garlic supplements” in HIV/AIDS. Other unconventional treatment strategies identified by the Society2 that “might be beneficial” but with a concern that “they could be harmful” are virgin olive oil, African potato, onion, spirulina, Sutherlandia frutescens, and several phytosterols. The Department of Health’s recommendations list 12 commonly used herbs and spices with putative benefits, advice on how to use them, and cautions about amounts and when not to use them (e.g. cinnamon in pregnancy). The list also advises against the use of garlic by people who are taking anti-retroviral drugs, as garlic may inhibit absorption of these drugs. The same principle is also valid for micronutrient supplements in excess; therefore, except for vitamin A in children, all three sets of nutrition recommendations (1–3) advise that upper limits of recommended nutrient intake levels should not be exceeded. Therefore, even in the light of limited evidence, recommendations to the public should be responsible.

In the special problematic context of HIV infection and active TB, it is unethical to recommend any treatment of which there is no proof that it would be beneficial and no convincing proof that it would do no harm.

Principle 3

Nutritional interventions to address the HIV/AIDS and TB pandemics should be part of a holistic, comprehensive, integrated approach, including both public health and therapeutic nutrition strategies and actions.

The HIV/AIDS and TB epidemics in South Africa are associated with widespread poverty, unemployment, hopelessness and despair, resulting in early morbidity and mortality of potentially economically productive adults, AIDS orphans, HIV-infected children, households headed by children and elderly grandparents forced into caregiver roles. Nutritional interventions should therefore target all stages of the lifecycle, should include efforts to improve food and nutrition security at national and community level, should include education on healthy food choices leading to balanced diets, and, at the individual level, include therapeutic or medical nutritional care of primary and secondary infections.

The Department of Health recognized this multisectoral approach in their operational plan for “comprehensive HIV/AIDS care, management and treatment”. Resources and knowledge to implement such care are limited, however. The practical implications are that many more nutritionists and dietitians should be employed and utilized in all programs addressing the epidemics, and that the nutritional knowledge of all health care workers in community,clinic and hospital settings should be improved and extended.

Principle 4

Nutritional care of people infected with HIV and/or with active TB should focus on diversified diets including locally available, affordable and traditional foods. The widespread micronutrient deficiencies endemic to South Africa, the characteristic wasting of infected persons, and the known effects of the infections on food intake and nutrient turnover (absorption, metabolism and losses) dictate the use of fortified foods, however, as well as macro- and micronutrient supplements at safe levels.

There is agreement in the three sets of the above-mentioned nutrient recommendations that a food-based, diversified diet approach is the first choice. The “optimal” specific nutrient needs of infected persons are still not totally clear; there are for example indications from an epidemiological study which included asymptomatic HIV-infected subjects, that the mainly plant-based, prudent diet recommended as the optimal diet to prevent both under and over-nutrition (in which saturated fat is largely replaced by unsaturated fats) may not be the optimal diet for infected persons. Nevertheless, the aims of dietary recommendations are to improve and maintain the best nutritional status possible, of as many persons as possible. Wasting of infected persons (involuntary weight loss ? 10% of initial body weight)and impaired growth in children indicate that the actual needs for energy-providing macronutrients (protein, fat and carbohydrate) are not being met. A food-based approach
should be accompanied by the use of appropriate, locally acceptable macronutrient supplements. All three sets of guidelines1-3 also promote the use of multimicronutrient supplements with practical advice in two2, 3 on how much and when to take them.

Principle 5

Established, well-described steps and protocols should be followed in public health nutrition interventions and in the therapeutic nutritional care of patients.

There is an extensive literature on the reasons why many well-meaning food and nutrition interventions at the public health level fail. The ways to ensure success have also been described, including following established protocols of assessment of existing situations, analysis of all contributing factors, appropriate actions, evaluation of effects and outcomes of these actions, and adjustments of actions when necessary. Similarly, there are established protocols and algorithms for the therapeutic nutritional care of patients, starting with nutritional screening that will guide follow-up actions. It is unnecessary to emphasize that these protocols and frameworks should be followed in the case of HIV-infected and TB-infected persons, and appropriate support from families and communities is a given. However, because these diseases are still stigmatized in South Africa, health care workers should be sensitive on how to involve households, families and communities and how to mobilize social support for affected individuals.

Principle 6

HIV-infected pregnant women, lactating mothers and their babies need special advice and nutritional care to ensure best possible outcomes.

The Department of Health gives detailed advice for the nutritional care of pregnant and lactating women based on the acknowledgment that “nutritional care and support for the pregnant and lactating mother infected with HIV may minimize the impact of the disease, delay disease progression and allow mothers to remain productive and able to take care of themselves and their families”. As in non-infected women, weight gain during pregnancy of infected women, especially during the second and third trimesters, should be carefully monitored (to ensure an approximately 1 kg gain per month during this period). Increased needs for calcium, iron, vitamin C and folic acid should be addressed with a diversified food-based approach where possible and appropriate supplements if not feasible. The Department advises that all HIV-infected pregnant women should be provided with a daily multi-micronutrient supplement at one nutrient intake value (they express it as one INL98), and warns that high-dose vitamin A supplements should not be given to pregnant women as they “can cause birth defects.”

The evidence of mother-to-child transmission of HIV during breast-feeding has been systematically reviewed in this report (see Chapter 8). The dilemma is that breastfeeding as opposed to formula-feeding (replacement feeding) creates a risk of post-natal transmission but replacement feeding in resource-poor countries contributes to high infant mortality. Therefore, the WHO has to date recommended that “HIV-infected mothers are advised to avoid all breast-feeding and use replacement feeding when it is acceptable, feasible, affordable, sustainable and safe to do so. Otherwise, exclusive breast-feeding has been recommended during the first months of life and should then be discontinued as soon as it is feasible and replacement feeding can be provided safely.” The WHO mentions, however, that “the mother’s choice should always be respected and supported”. The Department of Health recommends either exclusive breastfeeding (for 6 months) or exclusive replacement feeding, and leaves the choice with an informed mother: “If the mother is HIV-infected she should be provided with the correct information for her to make the best feeding choice for the health of her child in order to reduce the risk of mother-to-child transmission of HIV”.

HIV-infected women who are pregnant should receive infant feeding counseling************* that aims to empower them to decide on the best infant feeding practice for her, her infant and her family and should take into consideration amongst other things, access to clean water and an uninterrupted supply of formula and primary health care support. Women should be supported in their infant feeding choices. The modeling exercises to assess the impact on mortality of various infant feeding strategies discussed in Chapter 8, showed the lowest frequency of adverse outcomes if no HIV-infected mother breast-fed and all non-infected mothers breast-fed optimally, given that infant mortality rates were below 100 per 1000 live births and relative risks of dying set at 2.5 for non-breast-fed compared with optimally breast-fed infants. The feeding solution in a well-resourced setting would be to provide safe, ready-to-use replacement feeding to infants of HIV-infected mothers. In [a] most resource constrained South African setting, however, exclusive initial breast-feeding of infants for as long as possible, preferably for at least 3–4 months (corresponding to the maternity leave period usually available for working mothers) appears to be the general aim. What is undesirable according to the most recent definitive finding is the initial mixed feeding post-natally especially when combined with solids (see Chapter 8).

An urgent national expert consultation is obviously needed (see Chapter 12) as well as revision of the WHO guidelines (the WHO has already issued an amended advice). The national consultation should be part the AIDS National Strategic Plan NSP) Process that is already ongoing.

Nutrition and pathogenesis of HIV and active TB in infants and children have been extensively discussed in Chapter 8 of this report; the Department of Health guidelines give detailed advice on care and feeding of infants and older infected children. The principles are basically the same as those for adults, with an understanding that small children cannot take care of themselves. This emphasizes the need to educate caregivers, which often would be older children or grandparents in HIV-affected households.

Conclusions

Optimizing the nutritional status of individuals and populations will probably help to stem the spread of the HIV/AIDS and TB pandemics. It will improve the health and quality of life of infected persons by minimizing the effects of the infections on nutritional status, improving responses to drug treatment and improving adherence to these drugs through minimizing side-effects.

The optimum diet or food combinations, as well as specific nutrient needs of infected persons, are not yet sufficiently well understood and known. It is acknowledged that the gaps in our knowledge, leading to perhaps “over-careful,” general, and limited practical recommendations, but this may improve with more appropriate research (see Recommendations in Chapter 12). The above approach should be updated and adjusted as this knowledge become available.

Read the full report!