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Dr Edward C. Green

Senior Research Scientist in the School of Public Health, Center for Population and Development Studies, Harvard University

Alternative and Complementary Medicine at the 1998 World AIDS Conference

Journal of Alternative and Complementary Medicine, Vol.4(3) 1998, pp 349-351.

While the general tone of the 12th World AIDS Conference held in Geneva was somber, due to increasing failure rates of combinations of antiretroviral drugs, the mood was very different for those interested in, or using, alternative and complementary therapies.

A number of scientific papers were presented demonstrating the value of herbal and other "unorthodox" treatments for HIV-related syndromes, and for HIV itself. For example, controlled studies of Chinese and Thai phytomedicines both showed inhibition of HIV, increased immune function, enhanced CD4 cell counts, and increased survival rates of those tested as HIV-positive (abstracts are available for all such papers).

It was hard not to encounter long-term survivors of HIV/AIDS at the conference; one needed to look no further than a special symposium convened for them. Long-term survivors are those living with the HIV virus for 10 or more years. What impressed me most about the conference was the number of these survivors that have been relying on indigenous (or "traditional") medicines and therapies (if they were from developing countries), or on alternative and complementary medicines and therapies if they were from so-called developed countries.

There seemed to be fewer PWAs (persons with AIDS) from poor, developing countries, no doubt because of the prohibitive expense of flying to Europe and paying the hefty conference registration fee. But there were some, and there were also many healthy PWAs from developed countries who have been living with HIV for 10-18 years. We can use PWAs' own definition of healthy: feeling generally well and energetic, and having no symptoms of AIDS. Some men and women had relatively high CD4 levels and low viral loads. Others had less desirable test values, but most seemed not to let themselves become very concerned with such test results. Some were aware that Kary Mullis, Nobel-prize winning biochemist and inventor of the PCR test used to measure "viral load" of HIV, has repeatedly criticized the use of his invention as an accurate measure of the amount of HIV circulating in the body.

At least a dozen survivors I chanced to meet have chosen not to take conventional antiretroviral drugs of any sort, singly or in "combo cocktails." Instead, they rely on a range of other therapies, including herbs, nutrition, yoga, acupuncture, exercise regimens, homeopathy, massage, and movement therapy, among others. A number (but not all) had stopped smoking and drinking alcohol and had opted for generally healthy lifestyles. Many were of the opinion that their greatest strength was simply not believing that an HIV diagnosis means a death sentence. They had positive attitudes and faith in the future.

Since I was in Geneva to participate in a symposium on alternative and complementary medicine, and I met some of these healthy long-term survivors in connection with this symposium, there was no doubt a bias in favor of my encountering PWAs who favor indigenous or alternative therapies. But I met about half of those I spoke with through chance encounters. Many of the total felt that their numbers were not reflected in official medical statistics since they do not participate in clinical trials and many do not even consult conventional doctors. They virtually all felt that the unconventional therapies they were following, through self-treatment and consulting alternative practitioners, were not adequately reflected by the single two-and-a-half hour Community Symposium (which means not on the "scientific track") that was allotted by the conference organizers. Its title was Alternative and Traditional Healing Practices, and it was co-chaired by Kaiya Montaocean and Xevi Garcia Flores. Others not living with HIV but conducting research in a variety of areas considered unconventional agreed with this assessment, as did many other delegates who have themselves found value in unconventional therapies.

As a result of the foregoing and the "Alternative" symposium itself, the following Declaration was developed and officially presented to:

The Global Network of People Living with HIV/AIDS (GNP+)
The International AIDS Society (IAS)
The International Council of AIDS Service Organizations (ICASO)
The International Community of Women Living with HIV/AIDS (ICW)
The Joint United Nations Programme on HIV/AIDS (UNAIDS)
The Government of the Republique et Canton de Geneve

Declaration on Traditional, Alternative and Complementary Medicine

Recognizing that in developing countries (the "south"):

• Some 90% of people rely on indigenous, natural medicine either through self-treatment or treatment by traditional medical practitioners;
  
• Natural medicines have been found to be effective in the treatment of some of the opportunistic infections associated with HIV,
  
• Pharmaceutical drugs, especially antiretrovirals are beyond the reach of most of the world's poor;
  
• A number of pilot projects and ongoing health programs have shown that traditional medical practitioners can collaborate with biomedical personnel to help prevent the spread of HIV and STIs (by promoting partner reduction, safer sex, condoms, sterilization of razor blades, etc)
  
• Traditional healers are in a unique position to provide individualized and home-based care and counseling and holistic treatment for HIV+ and AIDS patients;

Recognizing that in industrialized countries (the "north"):

• Often 50% or more of populations (e.g., in the USA, Germany, Australia) use some form of "alternative or complementary medicine" such as medicinal herbs, nutritional therapy, homeopathy, acupuncture, chiropractic, massage, dance or movement therapy,
  
• Individuals with HIV and AIDS often rely on such alternative medicines to relieve suffering associated with either the disease or the symptoms of antiretroviral treatment,
  
• Some living with HIV/AIDS, including long-term survivors, rely exclusively on alternative therapies, either because of drug resistance, drug failure, or personal choice;

And recognizing that traditional, alternative and complementary medicine receive small fraction of 1% of global health funds with less than half of that targeted to HIV/AIDS, in spite of the fact that a majority of people living with HIV use traditional or “alternative,” complementary medicines,

1. We resolve the role of natural medicines and traditional medical practitioners, as well as alternative and complementary medicines, be acknowledged in AIDS prevention and treatment, and therefore this health sector should be allocated an equitable share of AIDS research, treatment and prevention resources.
   
2. We resolve that venues and tracks be set aside at regional and international AIDS conferences for the exchange of ideas and experiences related to traditional and alternative therapies, and that regional and global networks be supported.

The natural, Alternative, Traditional and Complementary Medicines (NATC) Caucus of the International AIDS Society (IAS) will be responsible for follow-up on the response to this Declaration, and for promoting these resolutions.

The Declaration was accepted for publication in the official conference report.

Incidentally, there was so much interest in the Symposium on Alternative and Traditional Healing Practices that participants requested, and were granted, a conference room the following day for a continuation of discussions begun earlier. Some 40 people showed up and stayed for another 3 hours, during which plans were discussed for more and larger alternative medicine symposia to be held in Durban, South Africa, the World AIDS Conference site for the year 2000.

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