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Trying To Treat Africa

Administrative adjustments prevent drugs from reaching African HIV patients in time

“These have the goal of ensuring that Harvard is in the best position to meet the expectations of the U.S. government and to serve Africans suffering with AIDS,” Hyman wrote in an e-mail last Friday. “These new arrangements also recognize Professor Kanki’s role as the programmatic leader of this effort.”

FUNDING DELAY

The five months it took to restructure the administrative aspects of the grant—from March until the first infusion of cash at the end of July 2004—had serious consequences for the African clinics and their patients, according to researchers.

Professor John Idoko, chair of infectious diseases at Jos University Teaching Hospital in Jos, Nigeria and head of one of SPH’s Nigerian clinics, criticized the University for the delay in 2004.

He said it came while at least 1,000 AIDS-infected patients were on a waiting list for anti-retroviral drugs that were supposed to be purchased by Harvard with PEPFAR funds.

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But the funding for those drugs was not released by the University until the end of last July, Idoko told The Crimson in April, and up to 400 patients died while waiting for them.

John Longbrake, a spokesman for Summers, said at the time that the University believed the delays were necessary in order to lay the groundwork for optimal treatment.

“We believe strongly that our early attention to this program will allow us to maximize these funds in order to treat more people and save more lives,” his statement read.

The delay also meant that in-country partners in Nigeria—including doctors, nurses, counselors, and community health workers—went without pay from Harvard for five months, according to Idoko.

Max Essex, chair of the department of immunology and infectious diseases and of the Harvard AIDS Institute, said that some of the initial delays were likely not necessary.

“Obviously it hasn’t been well coordinated, and I do believe that until recently there was a lack of understanding of the extent of expertise available in the SPH for such work in developing countries,” Essex said last Friday.

TAKE TWO

Funding for the second year of the program, which officially began April 1, was also delayed until last week. The University is supposed to “draw down,” or accept a portion of the PEPFAR money, at least once every quarter—or risk defaulting and losing the grant, according to Program Director for Nigeria and SPH Adjunct Professor of Infectious Disease Robert Murphy.

Reached in Nigeria last Friday, Murphy said that there was a danger that Harvard would lose the grant if it did not draw down soon. Murphy said Friday that the University had yet to accept the funding.

But Hyman said last Sunday that the funds for the second year had been accepted “sometime in the past week,” although Murphy was unaware of this.

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