Bird flu could hobble Africa's AIDS fight-UN

By Andrew Quinn

DAR ES SALAAM, Feb 19 (Reuters) - Bird flu poses a major threat to Africa's fight against its AIDS epidemic, challenging overburdened healthcare systems and stretching economies already hit by the impact of HIV, the U.N.'s AIDS chief said.

UNAIDS Executive Director Peter Piot said a human outbreak of bird flu in Africa - where the deadly H5N1 strain of the virus was detected in poultry in Nigeria this month - could be a massive blow to the campaign to rein in AIDS.

"We are on very thin ice here," Piot told Reuters in Dar es Salaam, where he was on an inspection mission.

"AIDS has made a mess of Africa's health care systems, and none of the factors that created the AIDS disaster have gone away. But with bird flu, we could be looking at things getting worse in a matter of months, not decades."

Cases of H5N1 have been confirmed on four farms in the northern Nigerian states of Kano and Kaduna and in the central state of Plateau. There have been suspected outbreaks in at least five other states in the centre or north of the country.

No human bird flu case has been found in Africa so far. But detecting such a case will be difficult because mortality rates are high from other diseases and health services are almost non-existent in rural areas, where people are often buried without a medical check.

Officials are now increasingly worried the likelihood of human transmission could rise if the virus spreads to other countries in the region - many already suffering from widespread malnutrition, poverty and the effects of the world's worst HIV/AIDS pandemic.

"Africa is fragile, and this could really overburden its systems," Piot said.

"We have not seen a human outbreak yet. But if we do, the resources are going to have to come from somewhere. That is a real concern for everybody involved in development."

VIRAL INTERACTION

Piot said scientists were studying the possible interaction of bird flu and HIV, the virus which causes AIDS and which has already infected some 26 million people in sub-Saharan Africa.

While some theorise that those whose immune systems are weakened by HIV might die faster in a bird flu outbreak, others say that because bird flu overstimulates the immune response, HIV-positive people might not die themselves but instead become "supercarriers" that spread the virus.

Piot said precautionary measures such as poultry culls could spell disaster in their own right on a continent where many people survive on subsistence farming and keep chickens to feed their families.

"For many people in Africa, chicken is either the major source of protein or the major source of income. If we try to eliminate chickens it would be an economic catastrophe, and that has clear implications for AIDS," he said.

Piot - who has spent a decade at the helm of the U.N.'s AIDS effort - said he was encouraged by the rapid global response to the bird flu threat but that much more needed to be done both to organise an effective response.

"The first lesson from AIDS is to act early and not to wait until you've got a big problem," he said. "That's what happened with AIDS in Africa, and look at the impact now."