Vulindlela, a small, dusty community outside Howick, was put on the map yesterday (Tues) when one of the most powerful US officials ever to come to KwaZulu-Natal chose it as his main stop.

US Secretary of Health and Human Rights Mike Leavitt described Vulindlela as ‘€œthe epicentre of hope’€ because of the HIV/AIDS treatment, prevention and research that is being conducted there.

Most of the HIV/AIDS initiatives at Vulindlela by the Centre for AIDS Programme of Research in SA (Caprisa) are funded by US agencies.

Community leader and researcher Getwane Makhaye thanked Leavitt for the US support, saying: ‘€œSince Caprisa started working here, the number of funerals has really gone down.’€

Leavitt responded by saying that it was the ‘€œmoral undertaking of the US people because it is the right thing to do’€.

He spent a number of hours listening attentively to community members who were either living with HIV, or whose family members had died of AIDS-related illnesses.

At the end of the day, Leavitt urged US lawmakers to support the extension of the US President’€™s Emergency Plan for AIDS Relief (Pepfar) for a further five years, and to increase the amount of aid to $30-million.

Although Vulindlela is mainly a research site, Caprisa set up an HIV/AIDS treatment centre for local people, funded by Pepfar, as ‘€œwe felt it wasn’€™t right to conduct research but not to do anything for the community’€, said Caprisa’€™s site leader, Professor Quarraisha Abdool Karim.

Since 2004, people have been able to get antiretroviral drugs from the treatment centre adjoining the Mafakathini Clinic. Over 1000 people are now getting ARVs from the centre, while a further 1 600 people with HIV are under the centre’€™s care.

Before Caprisa set up a treatment centre, Vulindlela residents had to travel to hospitals a good 40 minutes’€™ drive away in Pietermaritzburg for HIV treatment. But most people could not afford the taxi fare in the impoverished community.

The presence of the treatment centre has meant that many people with HIV have come forward for treatment and the disease is now spoken about openly, said Abdool Karim. This has helped to raise awareness about HIV/AIDS which in turn has helped to decrease the spread of the virus.

In 2003, the HIV prevalence rate in the community was 42.7%. It had declined to 39.4% by last year.

‘€œAlthough there has been quite a substantial drop in HIV prevalence, this decrease is not enough,’€ said Adbool Karim.

‘€œWe need to see a decrease in the incidence [of new infections]. For every one person we get on treatment, there are seven to 10 others who need it. Treatment will always be a stop-gap unless we address prevention.’€

Caprisa is thus focusing on two potentially crucial research projects aimed at preventing new HIV infections: microbicides and vaccines.

Vulindlela residents are being recruited to test a micobicide — a vaginal gel containing the ARV tenofovir in it — in the hope that it will be able to act as a barrier to protect women against HIV.

Next year, residents are also going to take part in an HIV vaccine trial.

‘€œWe would not have been able to do all the work we are doing without the support of the local inkosi, who has been very supportive of our work because he has seen the impact of HIV and AIDS on his community,’€ said Abdool Karim.

Inkosi Sondelani Zondi explained to Leavitt that he was pleased that Caprisa had come to Vulindlela as he had been battling to address the impact of HIV/AIDS alone.

Community members are involved in the research via a special committee, the community support research group, that meets monthly to discuss all new developments at the site.

Caprisa has been trying to get its Vulindlela treatment centre accredited by the Department of Health, but the national accreditation team has not yet visited the site.

‘€œIt would be easier if we were a government-accredited site because then we would be able to refer our stable patients to the eight government clinics in the area to be managed by them and we could then enrol more patients on treatment,’€ explains Dr Sibusiso Ntsele, project director of the treatment programme.

May Zuma, head of health for the uMgungundlovu district, said that she appreciated the partnership with Caprisa as ‘€œthe Department of Health cannot reach everyone it needs to on its own’€.

‘€œFor us, research in a community like this is very powerful because it is not taking the research away. It is strengthening us,’€ said Zuma.

Ntsele said the centre’€™s next challenge was to start treating children wit ARVs.

‘€œThe children are being referred to Edendale and Grey’€™s hospitals. But this is not ideal because it means the parents can come here but their children must go elsewhere. By the end of October, we are going to phase in treating children starting with older children.’€ ‘€“ Health-e News Service.