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The Washington Diplomat

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Israel Joins Fight Against AIDS in Africa

by Larry Luxner

For Africa to successfully fight the AIDS epidemic, its health authorities must dramatically improve sanitary conditions, tackle neglected tropical diseases and boost widespread immunization efforts — while promoting the circumcision of boys and men throughout the continent.

These are among the chief recommendations of Dr. Zvi Bentwich, who runs the Center for Emerging Diseases, Tropical Diseases and AIDS at Israel’s Ben-Gurion University of the Negev. Bentwich was in town to attend the XIX International AIDS Conference; his July 19 lecture at the Israeli Embassy attracted about 50 visitors.

Bentwich was introduced by one of Israel’s top experts on Africa, Noam Katz. A former ambassador to Nigeria and Ghana, Katz is now Israel’s Jerusalem-based minister of public diplomacy.

Photos: Ben-Gurion University
Susan Kovsky, a medical student at Ben-Gurion University of the Negev, second from left, is surrounded by colleagues as she examines a woman at a clinic in Ethiopia.

“Africans are very supportive of Israel, and they appreciate what we did in the past,” he said. “And they have lots of expectations of what Israel should do in the future.”

Almost immediately after independence in 1948, said Katz, the new Jewish state began forging relationships in Africa. In 1957 — even before most African nations won independence from their former European colonizers — Israel’s then-foreign minister, Golda Meir, launched Mashav, the Center for International Cooperation.

“That created a real impact on the lives of people who lived in those new states,” said Katz. But in 1974 — in the wake of the Arab oil embargo following the Yom Kippur War — most African states severed their relations with Israel, re-establishing ties only in the 1990s after the Oslo peace accords had been signed.

“They had expectations that Israel would come back [into Africa] in full force, as it had in the ’60s, but by then the Israeli economy had changed dramatically,” he said. “It was very difficult for us, as a government, to convince Israeli investors to go back to Africa.”

Nevertheless, said Katz, “We have many international cooperation projects that deal with some of the worst problems Africa is facing. Tens of thousands of Africans come to Israel for training in agriculture and rural development. AIDS is not only a medical problem; it’s a social problem and an economic problem. Many young people are HIV carriers; they will never mature to their roles in the economy.”

That’s where Bentwich comes in. A former flight surgeon in the Israel Defense Forces, he’s been to Ethiopia 22 times and is the founder of Israel’s largest AIDS clinic. Bentwich is also a consultant to the Bethesda-based National Institutes of Health (NIH).

“The challenges of AIDS changed my life,” said Bentwich. “It was a terrible disease, totally fatal, with social and human rights implications. Last but not least, it was a tremendous scientific challenge. As such, I created the first AIDS center in Israel, and then came the Ethiopian immigration.”

Bentwich noticed that between 70 percent to 80 percent of the Ethiopian immigrants arriving in Israel to start new lives there suffered from intestinal worms and parasites.

Nicolai Furmansky, a medical student at Ben-Gurion University of the Negev,
examines a malnourished Ethiopian child.

“Immunologists pay more attention to the host, while infectious disease specialists look more at the bug,” he explained. “Because I was an immunologist, I said maybe the fact they have so many other infections plays a role in HIV. Their immune system was screwed up. My conclusion: If you want to get better in Africa, eradicate these diseases.”

The most common of them are ascariasis (807 million sufferers worldwide); trichuriasis (604 million); hookworm (576 million); amebiasis (500 million); and schistosomiasis or bilzahria (200 million).

“It is part and parcel of poverty,” said Bentwich. “These diseases affect education, cognitive development, and cause social stigmatization. But Africa is very conservative and it takes a long time to accept new ideas. The best example is circumcision. It took 20 years from the time people said circumcision plays an important role in preventing HIV until the time it was adopted.”

The economic factor is crucial too, he said. In Africa, a “rapid impact package” of basic vaccinations costs 50 cents a year to administer, compared to $600 a year to treat full-blown AIDS. “It’s the most cost-effective intervention in the health field,” he said.

This is precisely why Bentwich established the NALA Foundation, an Israeli-based nonprofit that aims to eradicate neglected tropical diseases among Ethiopia’s 75 million inhabitants. The program involves de-worming, drug distribution, health education and improving water supply and sanitation — all of which has a tremendous trickle-down effect on the severity of HIV/AIDS.

“Of course we cannot treat everyone, but at least this can serve as a model for others to follow,” said Bentwich, whose program began in three Ethiopian locales: Addis Ababa, the Rift Valley and Mekelle. Initially reaching 10,000 people, NALA now reaches 1 million.

“Even if you don’t eradicate these diseases, you decrease the amount of parasites in the population. The immediate impact of giving out these medications is watching children flock around you and tell you they feel so much better. This is an award you don’t have to wait ages for.”

Bentwich said that when it comes to financing the fight against HIV, the picture in Africa has changed dramatically. Currently, 2 million Africans are now surviving thanks to antiretroviral drugs. The continent has seen a 25 percent drop in new HIV infections and a significant decline in AIDS-related deaths (though around 68 percent of all people around the world living with HIV reside in sub-Sahara Africa).

That decline could have been even more dramatic if not for the former president of South Africa, Thabo Mbeki, who throughout his 1999-2008 term in office argued that HIV doesn’t cause AIDS — poverty does. That’s like denying the Holocaust, argued Bentwich, who attributed such policies to the needless deaths of hundreds of thousands.

“Mbeki was terrible for South Africa. Because of his government, AIDS spread faster because he didn’t show leadership when he should have,” Bentwich said. “Fortunately, this has since been replaced by a very different policy.”

The Israeli researcher also had harsh words for U.S. and European opponents of circumcision, who claim the ancient procedure — practiced not only by Jews but also by Muslims and other groups — is cruel and barbaric. Bentwich cited three studies proving that circumcision prevents 70 percent of all HIV transmission in both males and females.

“If we had a vaccine that conferred such protection, we would consider that fantastic,” Bentwich said. “There’s no question in the scientific world that circumcision is almost a must from the public health perspective. However, due to cultural trends that are very fashionable in some societies, people have chosen to deny this — and I think this is totally unacceptable.”

About the Author

Larry Luxner is the news editor for The Washington Diplomat.




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