SOUTHERN AFRICAN DEVELOPMENT COMMUNITY (SADC)
MINISTERIAL CONSULTATIVE MEETING ON
NUTRITION AND AIDS

Johannesburg, January 20 and 21, 2003

“I submit to you that scientists have not yet explored the
hidden possibilities of the numerous seeds, leaves and fruits
for giving the fullest possible nutrition to humanity”
Mahatma Gandhi 1944

BRIEF REPORT

Prepared by Roberto Giraldo, MD, New York.

A preliminary meeting on “Nutrition and AIDS” was held on November 28 and 29, 2002, in Johannesburg. A brief report of that meeting is available on my website.

On January 20 and 21 the consultative meeting was attended by the Ministers of Health of the SADC member states.

1. ORGANIZATION.

The meeting was organized by the Health Sector Coordinating Unit of SADC and the Departments of Health of the 14 SADC member states; Angola, Botswana, Democratic Republic of Congo, Lesotho, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, Tanzania, Zambia, and Zimbabwe.

2. GOALS OF THE MEETING.

2.1. The role of nutrition in improving the health of people living with HIV/AIDS.

2.2. The role of traditional and indigenous therapies in improving the health of people living with HIV/AIDS.

2.3. The range of food supplements and traditional/indigenous herbal products available as immune boosters to improve the health of people living with HIV/AIDS in SADC member States.

2.4. Regulations guiding the use of food supplements and herbs to improve the health of people living with HIV/AIDS in SADC member States.

2.5. Ways in which food supplements and effective traditional and indigenous herbal medicines can be integrated into the national health delivery systems of SADC member States.

3. WHO ATTENDED?

4. OPPENING AND CLOSING REMARKS.

Both prsented by the Minister of Health of the Republic of South Africa, Dr. Manto Tshabalala-Msimang.

In her opening address the Minister recalled that a year ago the SADC Health Ministerial Meeting concluded: “Poverty is at the root of much of the untenable burden of disease worldwide. We also noted that the poverty that increases vulnerability to ill-health is multidirectional. We further noted that economic underdevelopment, unemployment and low incomes, environmental degradation, shortfall in agricultural production, inequitable land reform, lack of education, poor infrastructure and the oppression of women are but some of the drivers of poverty — emphasizing the need for broad intersectoral interventions.”

“During our extraordinary meeting in August 2002, the Ministers discussed the role of nutrition, nutritional supplements and traditional therapies in the management of HIV and AIDS. Mention was made of various immune boosters; garlic, micronutrients, anti-oxidants, African potato, and other products that are used by people to improve their health. This should by no means sound strange, as traditional medicines, be they African, Homeopathic or Chinese, have always been part of the response to ill-health in our countries and beyond.”

“This meeting should mark the beginning of a process of putting nutrition in its rightful position as one of the most critical elements of our health programs and interventions. Nutrition can no longer be neglected and left to become the Cinderella of our health system.”

“Good nutrition is one of those elements of Primary Health Care that, when implemented adequately, can prevent a whole host of diseases. It is therefore a shame and a tragedy that we have over the last decades failed to prevent ill-health by not adequately promoting food security and proper nutrition. Instead we have tended to focus and rely too much on cures for all our ills.”

“A review of the food and nutrition situation in the region contained in a Commonwealth, Eastern, Central, and Southern African report for 2001 indicated that stunting affected about 40% of young children in East, Central and Southern Africa. A similar number of children were also undernourished. Over 50% of women in their reproductive ages suffered from iron and vitamin A deficiency and other forms of malnutrition, leading to high mortality and low birth weight for children born to these mothers. The decline in production and consumption of indigenous foods was leading to household food insecurity.”

“In the 1980s, malnutrition was seen as an underlying factor in more than one third of infant mortality cases in rural and urban districts of many African countries, and 20 to 80 percent of maternal mortality.”

“We are in the grip of one of many famines that have afflicted our region over the past decades. This famine comes at a time when our populations are already undernourished, immunocompromised, and poor.”

“…As SADC Health Ministers, we are committed to play our role in finding sustainable solutions to the challenges facing us. These solutions should be affordable and based on locally available products and technologies. Their ultimate end result should be the empowerment of our communities, enabling them to make a contribution to their own development.”

In closing remarks to the meeting the Minister insisted that nutrition and traditional therapies are African solutions to the health problems of the people of Africa and the world and are part of the African Renaissance.

5. ISSUES ADDRESSED.

Opening session:

5.1. Overview of nutritional status in SADC. Olivia Yambi, Ph.D. Regional Nutritional Advisor UNICEF, Nairobi, Kenya.

5.2. Overview of the nutritional/food supplements, and immune boosters used to improve the health of people living with HIV/AIDS in the region. Nceba Gqalini, Ph.D. Director, Centre for Occupational and Environmental Health, University of Natal, Durban, South Africa.

5.3. HIV/AIDS and famine in the SADC region. Mr. B. Makinwa, UNAIDS.

5.4. Regional response to famine in SADC. Mr. M. Mkomba, SADC Secretariat.

Some of the facts elaborated in this session:

• Poverty levels have been on the increase in the last decade in most SADC countries. In Zambia, for example, poverty affects above 80% of the total population.

• Malnutrition is increasing in SADC countries and is worst in Lesotho, Malawi, Mozambique, Swaziland, Zambia and Zimbabwe, where about 26 million people are in need of food.

• More than 40% of the SADC population have protein energy malnutrition, 50% of children under the age of 5 have stunted growth and more than 33% of children under 5 years are underweight. Thirty percent (30%) of adults, especially women, have a body mass index less than 18.

• 50% of children and 80% of pregnant women in the SADC region have anemia. Forty percent (40%) of the population has iron anemia.

• In SADC countries 78% of the population is deficient in Vitamin A.

• UNAIDS estimates highest “HIV-prevalence” in the poorer SADC countries: Botswana (38.8%), Lesotho (31%), Swaziland (33.4%) and Zimbabwe (33.7%).

• In Mauritius the “HIV-prevalence” is around 0.08% and only 4-12% of children under the age of 5 years are undernourished.

• Nutritional supplements available in SADC countries include, but are not limited to, multivitamins, soya products, probiotics, kimea, and mageu (mahewe).

• It is estimated that 80% of the world’s population, mostly from developing countries, depends on traditional medicines for primary health care. Every year 1500 tons of traditional medicines are sold in markets in the city of Durban, South Africa and this industry is worth up to 2.3 billion South African rand per year (About 290 million dollars). In the SADC region 80% of the population uses traditional medicines and herbs.

• Some of the traditional herbs widely used in SADC countries as immune boosters and available over the counter are Aloe vera, African potato (Hypoxis sp.), and cancer bush (Sutherlandia frutensis).

• Basic scientific research and clinical trials have been completed and reported on several herbs from the SADC region; hypoxis, sutherlandia, aloe, spinach, boabab tree, pumpkin seeds, algae, and others. Several trials are ongoing. Most research is being done in South Africa, Zimbabwe, and Botswana.

• Regulatory processes for traditional products are still evolving in SADC countries.

• Several SADC countries have specific guidelines and/or programs concerning nutrition and food supplements for “HIV-positive” and AIDS individuals.

• Currently, 30,000 people take anti-retrovirals in Africa, and UNAIDS expects to have 3 million on these medications by 2005.

5.5. The role of nutrition in improving the health of people living with HIV/AIDS.

Main presentation. “Nutritional therapy for the treatment and prevention of AIDS: Scientific bases” Roberto Giraldo, New York. Addressed the scientific bases of nutritional immunology, nutritional deficiencies and HIV/AIDS, nutritional deficiencies and the progression of HIV-positive individuals to AIDS, nutritional deficiencies and the “transmission” of HIV/AIDS, reactivity on tests for HIV in sub-Saharan Africa not explained by sexual or vertical transmission, oxidative stress and HIV/AIDS, nutritional and antioxidant deficiencies in the pathogenesis of AIDS, and nutritional and antioxidant therapy for the prevention and treatment of AIDS. The main objective of this presentation was to demolish the myth that HIV=AIDS=DEATH and to describe the scientific bases and international experiences which support the view that AIDS can easily be prevented and healed by alternative measures which are effective, nontoxic, and inexpensive.

A week before the meeting, several newspapers attacked the Minister of Health, Dr. Manto Tshabalala-Msimang, and the Government of South Africa for inviting an AIDS dissident to speak on nutrition and AIDS before the SADC Ministers of Health.

The full text of my presentation and documents on the controversy surrounding my invitation are available at: <www.robertogiraldo.com>

Discussant. Dr. Marinus Gotink from UNICEF was asked to react to my presentation. However, he was very supportive of the views addressed in my paper. He described with kind words my presentation, the paper supporting it, and the scientific bases that I offered. He also commented on the scientific information contained in my website.

Some facts mentioned in this session:

• Micronutrient/antioxidant supplements and immune boosters that are being used in the treatment and prevention of AIDS include: vitamin A and carotenoids, vitamin C, vitamin E, selenium, n-acetyl cisteine, l-gluthamin, zinc, cooper, manganese, alphalipoic acid, coenzyme Q 10, B-complex vitamins, and flavonoids.

• Antioxidant and immune booster foods and herbs that are being used in the treatment and prevention of AIDS include: sutherlandia (Sutherlandia frutenscens), African potato (Hypoxis sp), garlic, spiruline, aloe vera, astragalus, echinacea, turmeric, licorice, golden seal, ginkgo biloba, grape fruit seeds, rosemary, sage, oat, olives, cloves, grapes, papaya, mango, kiwi, pineapple, avocado, bananas, broccoli, cauliflower, beets, cabbage, cayenne, cinnamon, sprouts, and yogurt.
  

5.6. The role of traditional therapies in improving the health of people living with HIV/AIDS. Mr. Motswaledi. A young South African scientist explained in detail the basic scientific research that is ongoing in various universities, studying the medicinal plants used in treating AIDS in the SADC region.

5.7. Regulations guiding the use of food supplements and herbs to improve the health of people living with HIV/AIDS in SADC member states. Motlalepula Matsabisa, Ph.D, Manager of Indigenous Knowledge Systems (Health), The Medical Research Council, South Africa.

5.8. Programs for effective responses: Integrating nutrition/food supplements in the National Health Systems and the collaboration of modern medicine with traditional systems. Ms. Boitshepo Giyose, Coordinator of Food and Nutrition of the Commonwealth Regional Health Community Secretariat for East, Central and Southern Africa. Arusha, Tanzania. And Wilbald Lorri, Ph.D. Managing Director of Tanzania Food and Nutrition Centre. Dar es Salaam, Tanzania.

Testimonies:

5.9. Ernest Saila, “HIV-positive” individual. He and his wife have both rejected anti-retrovirals for a decade and are enjoying perfect health, thanks to nutrition, food supplements, and immune booster herbs. He has an “HIV-negative” daughter and his wife used vitamin A during pregnancy. Mr. Saila is the HIV/AIDS & STD Directorate, Chief Community Liaison Officer: Care, Counselling & Support, Department of Health of South Africa.

5.10. Dr. P Adams. Explained that, in contrast to Mr. Saila, he is “healthy” thanks to the use of anti-retrovirals. He was saddened to find at this meeting that only 30,000 people in Africa are currently taking anti-retrovirals and that UNAIDS expects to have “only” 3 million Africans on anti-retrovirals by year 2005.

5.11. Ms. Tina Van der Maas, nurse and naturopathic therapist from Cape Town, described her very positive experiences preventing and healing AIDS, using natural means and African foods and supplements, since 1989 at the Human Responsibility & Health Educational Services organization. Attendees were delighted with this very informative presentation. She described her experience with garlic, lemon, olive oil, pumpkin seeds, and several African products for “HIV-positive” individuals and patients with AIDS.

6. RECOMMENDATIONS.

• There is agreement within the SADC member states that nutritional supplements have a crucial role in the fight against AIDS. All member states should invest in nutrition programs. Fortification, vitamin supplementation, and production and consumption of macro and micronutrients.

• SADC countries should strengthen the advocacy of nutrition programs and the necessary resources. The programs should extend to all, not only to people with AIDS or at risk for it.

• SADC member states should ensure that nutrition programs are fully integrated into the national health systems.

• In view of the intersectoral nature of nutrition, National Coordination Units for Nutrition should be established.

• SADC countries should finalize the development of policy guidelines and protocols detailing the implementation of nutrition programs for people with AIDS or at risk for it, and for everyone else.

• SADC countries should give priority to research on nutrition.

• Establish mechanisms of coordinating research and sharing information in the SADC region. Focus on indigenous foods and traditional herbal therapies.

• Establish national laboratories that could serve as testing and quality assurance sites for products.

• Establish centers of research excellence to determine safety, efficacy, and quality of traditional herbs and nutritional supplements.

• Strengthen regulations of herbal products to ensure safety and efficacy.

• SADC countries should make firm commitments to the implementation of the WHO resolution for collaboration with traditional healers.

• Establish mechanisms that will serve to protect traditional healing practices and prevent exploitation of their products and knowledge.

• Establish regional networks and databases to ensure that information on registered products and clinical studies are shared.

• Harmonize regulation in the SADC region to ensure quality products within the region that can compete globally.

• Strengthen the capacity of the region to regulate and market herbal therapies internationally.

• SADC countries should support a monitoring system for nutrition to ensure that the region's capacity for effective emergency preparedness is strengthened, among other things.

• Collaboration between modern and traditional health systems needs to be strengthened.

7. OFFICIAL REPORT.

I will report as soon as the official documentation of the meeting is finalized and made public.

Roberto A. Giraldo
www.RobertoGiraldo.com