[Congressional Record (Bound Edition), Volume 147 (2001), Part 13]
[Extensions of Remarks]
[Pages 18400-18401]
[From the U.S. Government Publishing Office, www.gpo.gov]



    DR. EDWARD AYENSU ON THE BENEFITS OF MASS HIV/AIDS TESTING AND 
                 COUNSELING FOR VULNERABLE POPULATIONS

                                 ______
                                 

                           HON. JIM McDERMOTT

                             of washington

                    in the house of representatives

                        Tuesday, October 2, 2001

  Mr. McDERMOTT. Mr. Speaker, I would like to include the following 
statement in the official Record. I have the highest regard for Dr. 
Ayensu, and would like to commend this body's attention to his work. As 
Dr. Ayensu has rightly stated, the lack of surveillance is a 
significant problem in the struggle against HIV/AIDS in Africa. If we 
are to truly overcome this disease, we must heed people like Dr. 
Ayensu. I hope that my colleagues find his work as beneficial as I 
have.

  The Benefits of Mass HIV/AIDS Testing and Counseling for Vulnerable 
                              Populations

       My name is Edward S. Ayensu. I am President of the Pan 
     African Union for Science and Technology, Chairman of the 
     Council for Scientific and Industrial Research of Ghana, 
     Member of the Independent Inspection Panel of the World Bank 
     and formerly a Director and Senior Scientist at the 
     Smithsonian Institution in Washington D.C.
       The fearsome prospect that HIV/AIDS can inadvertently be 
     transmitted to any one of us--regardless of our social and 
     economic standing--requires that decision makers the world 
     over should make a political commitment to help halt this, 
     the most formidable plague of all time.
       As an African whose continent is experiencing untold levels 
     of human suffering because of AIDS, I would like to offer an 
     observation which is based on extensive field experience. 
     Many people are dying needlessly in Africa and in other 
     developing countries because a large percentage of people in 
     these societies have no means of knowing their HIV-status. 
     Knowledge of one's HIV status provides a powerful stimulus 
     towards self-protection. For those who test HIV-negative, the 
     realization that they are yet to be attacked by the virus 
     results in a strong determination to remain forever free of 
     the disease through the accepted means of self-protection. 
     For individuals who test positive, there is generated a 
     powerful restraint on infecting others. The net outcome is a 
     dramatic check in HIV-spread.
       Based on our current knowledge of the disease, it is 
     evident that early diagnosis of the infection has enormous 
     benefits for both HIV-negative and HIV-positive individuals. 
     A key line of defense against the rapid spread

[[Page 18401]]

     of the disease accordingly is to ensure that everybody in a 
     vulnerable community is tested as soon as possible--certainly 
     long before the disease begins to break down the immune 
     system and the external manifestation of its dreadful effects 
     set in.
       It is therefore absolutely essential that we employ the 
     best and the most efficient and practical ultra rapid test 
     kits available today to undertake a mass Shielded Testing and 
     Counseling Program. Most of the currently available tests for 
     HIV are laboratory based and unsuitable for mass testing in 
     the field where the required infrastructure may not be 
     available. However, most of the available rapid tests are not 
     suitable partly because of an unacceptably high percentage of 
     false positives and negatives, and also because of the need 
     for unwieldy logistical support services such as 
     refrigeration.
       First and foremost the assay must be for blood, serum or 
     plasma and must be stable at temperatures ranging from 
     -20 deg.C to +45 deg.C. This is particularly important 
     because the high HIV prone areas are in pan tropical regions 
     of the world and in countries where the rural communities do 
     not have refrigeration facilities for tests that require it. 
     The test has to be fool proof in its performance with built-
     in controls to avoid misinterpretations. It must be designed 
     not to produce false-positive and false-negative results. The 
     sensitivity and specificity must be 100 per cent. It must be 
     suitable for mass testing (e.g. up to 1000 people per day 
     with a team of four persons administering the test and 
     serving as counselors). It must be a test that is suitable 
     for clinics, doctors' offices and rural areas where medical 
     infrastructure does not exist. The cost must be lower than 
     the costs for laboratory tests. Finally, it must enable the 
     use of simple pictorial instructions so that uninstructed 
     persons can perform it.
       For HIV-positive individuals, the heightened awareness of 
     the possible onset of opportunistic diseases enables the 
     latter to be quickly addressed. It further enables the 
     individual to assume a new lifestyle (including good 
     nutritional habits and sufficient exercise) and to take 
     medication that reduces the viral load in the blood. The 
     knowledge of being diagnosed HIV positive will enable the 
     individual to avoid transmitting the virus to others. It will 
     also help the person to develop long-term plans for his or 
     her future and dependents.
       The problem of arresting the rapid spread of HIV/AIDS is by 
     no means confined to the developing countries. There are, 
     however, highly vulnerable communities (sometimes enclaves) 
     in the developed countries, where the HIV/AIDS transmission 
     is largely heterosexual, and the communities in question are 
     relatively speaking, socially deprived or disadvantaged.
       It is therefore necessary that the current spread of the 
     disease be viewed as a universal problem, which knows no 
     boundary and requires the collective effort of us all to 
     contain it.

     

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