Garlic No Substitute for ARVs

PRETORIA, SOUTH AFRICA--Injecting scientific rigor into the intense debate over health policy in South Africa, the nation's most influential science academy issued a report today warning that consuming certain foods and supplements--although possibly helpful in maintaining overall health--are no substitute for drug therapies prescribed to fight the nation's HIV/AIDS and tuberculosis (TB) epidemics.

The study by a 15-member panel named by the Academy of Science of South Africa came in the wake of renewed controversy about the policies of the health minister, Manto Tshabalala-Msimang, who has angered AIDS activists by contending that foods such as beets and garlic could help slow the progression of the disease. The report complained that public debates over these kinds of approaches "have caused confusion within communities and among health care workers." Meanwhile, the report said, certain political leaders have exacerbated the confusion by expressing concern "about potential toxicities of ARVs [antiretroviral drugs] while simultaneously promoting alternative nutritional therapies for benefit or cure of HIV."

"We're not aware of any scientifically credible study that has identified a specific food or food supplement as being an effective alternative to appropriate medications," the academy panel's chair, hematologist Barry Mendelow, told ScienceNOW. He said the U.S. National Academies had advised the South African academy on conducting the study, intended to be similar to a National Research Council report. The panel included immunologists, biochemists, physicians, nutritionists, and epidemiologists.

Although the study states that healthier eating habits help protect against what it called South Africa's third epidemic--malnutrition--Mendelow said the panel considered nutrition as a "supportive treatment" that cannot replace drug therapy against HIV/AIDS and TB. Nevertheless, the report recommends more research into the impacts of nutrition on disease, including further investigation of studies indicating that the gastrointestinal tract is "a major anatomical front line" in the pathogenesis of HIV.

Nutritionist Esté Vorster, director of the Africa Unit for Transdisciplinary Health Research at North-West University in Potchefstroom, South Africa, agrees that diet is no substitute for effective drugs. Still, she points out that malnutrition is widespread in South Africa and, for that reason, "we should have a well-integrated public health and individual medical approach in addressing malnutrition problems associated with HIV/AIDS and active TB."

Shortly after the academy's report was released, South Africa's main opposition party, the Democratic Alliance, cited the study in calling on President Thabo Mbeki to fire the health minister. The South African Department of Health was not commenting on the report as of press time.

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