The South African government is disappointed that this week’s World Health Organisation meeting on AIDS and nutrition did not come out with ‘a clear message on the role of nutrition in delaying the progression of HIV to AIDS’.
This is according to KwaZulu-Natal Health MEC Peggy Nkonyeni, speaking on behalf of government.
Nkonyeni also expressed concern that there was ‘no clear and simple message on reducing mother-to-child transmission of HIV’ and the ‘lack of answers on appropriate dosage for supplements’.
The participants’ statement affirmed that ‘while food cannot cure HIV, adequate nutrition is essential to maintain the immune system, energy levels and improve quality of life’.
The statement also called for nutrition to become a part of all HIV treatment and care programmes, but emphasized that ‘antiretroviral drugs are essential to prolong the lives HIV-infected people and prevent HIV transmission from mother to child’.
Long a proponent of a diet of ‘garlic, olive oil, beetroot and spinach’ for people with HIV/AIDS, Health Minister Manto Tshabalala-Msimang has often suggested that such foods can be taken as an alternative to ARV drugs.
During the course of the meeting, both Tshabalala-Msimang and Daisy Mafubelu, head of the South African delegation, had suggested that, with the right diet, people with HIV could permanently delay the onset of AIDS.
But while encouraging scientific evidence was presented about how certain vitamins, minerals and trace elements can help keep a person with HIV healthy, there was none to suggest that good diet alone can permanently prevent the onset of AIDS.
Zinc, selenium and vitamins B,C and E were shown to be important for boosting the immune system. However, there was no clarity about doses of these supplements and participants called for further research before they can be recommended for people with HIV.
The importance of getting doses right was highlighted by research on iron. An overdose of iron made people with advanced HIV more susceptible to colds and tuberculosis.
Zinc was the star of the show, with scientist Dr Hendrik Friis describing as ‘very promising’ evidence that showed zinc helped to prevent watery diarrhoea and respiratory tract infections, both common in people with HIV.
Both zinc and selenium also seemed to slow the progression of HIV.
Tanzanian Dr Gerald Msamanga reported on a study which showed that the high doses of vitamins B, C and C increased the CD4 counts (measure of immunity) of HIV positive people and also reduced their viral loads.
In addition, the vitamins had a marked effect on improving the rate of stillbirths and birth of underweight babies to pregnant HIV positive women.
‘There should be an aggressive nutrition agenda in all antiretroviral therapy programmes in poor countries,’ said Dr Abraham Siika, from a small town in Kenya.
His project is treating 4000 people with ARV drugs. If patients did not have enough food, said Siika, their families were given ‘food prescriptions’ for six months.
‘After six months [of being on ARVs], they were strong enough to go back to work or to till their own land,’ said Siika, adding that during this time they were also taught income-generating skills.
The meeting was clear that good food, rather than pills and supplements, are most valuable for all people, particularly those with HIV.
Msamanga said people could get vitamins B, C and E from honey, sprouts, green vegetables, maize and grain, rather than pills.
The health department’s Lynn Moeng stressed that ‘government provision of supplements and micronutrients was costly and unsustainable’ and ‘short-term’.
Moeng added that government was in the process of developing regulations to govern the marketing and labeling of health products, aimed at preventing ‘unsubstantiated health claims’ and the exploitation of consumers.
These regulations will be published once the National Health Act has been signed into law by the President.
But Professor Andrew Tomkins, a member of the WHO technical advisory group on nutrition, added that claims about the health benefits of certain foods should also be put to the test of science.
The participants’ statement is to be presented to a range of international bodies and donors, in order to lobby for more money for nutrition in HIV/AIDS programmes and more research on its benefits.