In der größten politischen Wochenzeitung "Rai" wird in Tanzania wird unter dem obigen Link über den Skandal um die CD4 Maschinen berichtet.

http://www.newhabari.com/rai/habari.php?id=507&section=habari

For the Kiswahili speaking audience the link might be checked, Rai talks about the case of the CD4 machines and the the Ministry of Health.

Die Kiswahili Wissenden könne sich selbst ein Bild machen.

Bis zum gewaltsamen Schluss der CTC Klinik in Bulongwa durch die ELCT, der auch zum Tode von Patienten geführt hat, waren in Bulongwa CYFLOW Counter erfolgreich im Einsatz und die Tests wurde innerhalb weniger Stunden erledigt, sodass die Patienten am selben Tag wieder den weiten Fußweg nach hause beginnen konnten.
Kinder können heutzutage nicht mehr im vorher gegeben Standard betreut werden können. Das ist besonders traurig.
Die korruptions-, diebstahlsförderenden und mitfinanzierenden Missionswerke: Mission Centrum EINE Welt (die ehemalige "Bayrische Mission" in Neuendettelsau ist in dieser neuen Konstruktion aufgegangen), NMZ (nordelbisches Missionszentrum in Hamburg) und KPS (Kircheprovinz Sachsen in Magdeburg) haben die Menschenrechtsverletzungen der Diözese schweigend geduldet und in einigen Fällen ideologisch durch unterstützende Gerüchte und aktiv in die Welt gesetzte Unwahrheiten gefördert ("Ausländer fordern, dass der Bischof zurücktritt").

Die sterbenden AIDS Kranken sind den Werken kein Wort wert und die Menschenrechtsverletzungen auch nicht.

Das gilt auch für den Österreichischen Evangelischen Bischof Michael Bünker, den Bayrischen Ladesbischof Friedrich und die Bischöfe der ELCT in Tanzania. Für Sie zählt offensichtlich "die Kirche" und der Schaden den es abzuwende gilt und nicht die schutzbefohlenen Menschen. Für Sie zählt der eigenen Geldbeutel und das Spendengeschäft und nicht Wahrheit und Gerechtigkeit. Es zählt Macht und nicht Achtung.
Es bleibt der Job dieser Bischöfe auf die Fehler der anderen in der Gesellschaft aufmerksam zu machen, aber die Kriminalität in der eigenen Religionsgemeinschaft unter den Tisch zu kehren.

The CD4 counting and human rights abuses in ELCT and MoH, a twins fact?

Today, the following letter reached my desk:


"1. In 2002, the CD4 test price has been USD 40 in average (BD FACSCount monopol). Due to introduction of the CyFlow technique (and later on other techiques) and the consequently gained competition, Becton Dickinson reduced the price to USD 15-20 per test after having lost the monopoles in many countries.

2. After constructive discussions with PS Mwaffisi and Professor Göhde at the International AIDS conference, the MoH of Tanzania requested a CyFlow for evaluation at Muhimbili (MUCHS).

3. A CyFlow SL unit (which works in the same way like the CYFLOW Counter) was shipped to Tanzania according to the agreement this was done free of any cost for Tanzania.

4. Hundreds of tests and reagents have been shipped free of cost for supporting the evaluation.

5. After shipping the goods, officials from Muhimbili and MoH delayed the evaluation for many months. This fact has been evidenced and documented in detail.

6. Communication from Professor Göhde to the PS at the MoH was obvously actively blocked by several MoH officials, so that letters, mails and fax messages never reached the addressees at the MoH.

7. For this reason, a direct communication line, which designates a fair partnership and evaluation process, from MoH and Muhimbili (MUCHS) to Germany was dead for many months.
8. All offers by the PARTEC company to supporting Muhimbili (MUCHS) stayed unanswered.

9. In November 2005, Muhimbili announced that it had released an evaluation report to PARTEC. The letter was not presenting a comprehesive scientific report and contains many false information. A publication in an international journal or any publication of methodes and particular results was refused or not done by MUCHS up to date.

10. In presence of an attoreny of law PARTEC has proven - by investigating the harddisk from the returned CyFlow unit - that the evaluation was obviously either sabotaged and manipulated on purpose or done by staff who had no idea at all about running even a simple flow cytometer. Subsequently Muhimbili officials issued a false report contradicting all the internastionally published ressearch done on the Cyflow.

11. Circulating reports in the media mention that Muhimbili Professors could have been bribed by an Indian business man (Mr. Bharat Rajan) who exclusively distributes BD FACSCount instruments and reagents in Tanzania and many other equipments for the treatmetn of HIV/AIDS.

12. There is obviously a well done report from a Tanzanian patriote and scientist circulating, which also gives hints about the involvement of EHT/WHO.

13. During the entire course, the MoH was in complete possess of the copies from all existing clinical validations and international studies which entirely turned out successfully for the CyFlow in the US, Europe, Africa and Asia.

14. Following the proof of theft of donor money by the hospital and the bishops office and announced protests by a patients group and Jackson Mbogela, the South Central Diocese closed down the CTC in Bulongwa by force form one minute to the other for several days. Consequently the CyFlow units were not working again as the trained staff was locked out.
Later on, the MoH personally took a BD FACSCount unit to Bulongwa. This FACSCount is said not to operate regularilly: There are reports by PIUMA ("pima uishi kwa matumaini" - local self helped group) members, that blood has been withdrawn but results were not given out frequently (this can easily be checked at the patients cards).
Anyway, during the time the CYFLOW was running at Bulongwa CTC all the CD4 tests were provided within few hours and on the same day the patient reached the clinic (you know about the walking distances in Makete?).
In joint hands, ELCT and the MoH initiated the impairment of CD4 counting services for the patients in Bulongwa. This probably lead to the loss of lives within the patients cared by Bulongwa CTC.
Compared to Ikonda Hosptiatl which is still using CYFLOW units (up to date) the death toll was rising in Bulongwa, after the impairment of the CTC services through the violant action of the South Central Diocese under support of MoH and the former PM, who also was contacted and visited Bulongwa and heared the grieviances of the villagers.

15. Now the same Minister of Helath is announcing an import stop for the CyFlow. At the same time it is said by sources from Tanzania, that many of the FACSCount units are not functioning properly.

16. Effectively, the Minister therefore by governmental ruling through import stop is promoting a CD4 testing method, which offers CD4 tests at cost of USD 5 -20 instead of USD 2-3. He is promoting the use of CD4 equipments which are obviously in many times failing to function in typical Tanzanian clinics and labs in the rural setting all over the world. As a medical professor and ressearch person he discredits a competitive method by ignoring all scientific facts and documented evidences.

17. Furthermore, the Minister directly excludes all Tanzanian children from controlled best qualtiy state of the art antiretroviral treatment when promoting other machines and banning CyFlow.

How can a Minister of Health look into the face of any Tanzanian Citizen as honourable Minister while he actively excludes children from best available and internationally demanded quality of controlled treatment ? Excluding children from best available services is bad, because "dealing" with children's lives also kills the future of Tanzania and human beings who deserve our special care and love.

It is indeed very sad to see that some individuals are obviously playing witht the minister and are much more interested in promoting costly products (which obviously have proven to fail in resource-poor settings in many times) because affordable products do not leave any room for detouring money into private pockets.
A USD 15-20 priced single patient test can feed many systems and people, a USD 2-3 test cannot do more than to support as many patients as possible without allowing that money is being diverted into different pockets or increased shareholder values and profits.

Only fair competition works!"


Im Übrigen bin ich der Meinung, dass die für Korruptionsfinazierung und fehlende Rechenschaftslegung zuständigen Missionssekretäre in Europa zurücktreten müssen und die Finanzgebarung auch der kirchlichen Entwicklungshilfe in Europa und Tansania vollkommen offengelegt werden muss und für Diebstähle, Korruption und Spendengeldermisswirtschaft Verantwortliche in Tansania und in anderen Ländern zur Rechenschaft gezogen werden müssen.

In September 2006 the following link http://pdf.usaid.gov/pdf_docs/PNADG265.pdf led to a CD4 MACHINE LOGISTIC FACT SHEET of USAID describing the BD's (Becton Dickinson) FACSCount CD4 Counter.

The sheet for example says that the FACSCount cannot do a cd4% ("cd4 percent") value, which is especially important for the treament of children. It gives out a lot of interesting and accurate information about the FACSCount:

The complete FACT SHEET for the FACS COUNT is still available, for example under the following link:

http://www.phishare.org/files/4365_CD4MACHINE_FACTSHEET_FACS.pdf

Nowadays, the above mentioned link http://pdf.usaid.gov/pdf_docs/PNADG265.pdf does not any longer lead to the FACT SHEET of the BD gadget. Instead the same link leads to the USAID FACT SHEET for GUAVA EASYCD4 Counter which is producet by another US Company supported by the Clinton foundation.

It stays to ask, whether there are links of these Companies (BD and GUAVA) with the Clinton foundation or PEPFAR, which are serving other purposes than to help the PLWHA by the best and most affordable equipments in the world.

It is a somehow "normal" - a well known process - that interests of certain companies and national players are protected by the concerend national donors and supporters (mainly US and Europe), but it should not lead to unfair market protection. This is a part of the international "aid" business.

An e-mail from PARTEC from 18th of March 2008 the says:

"...on 30th November 2007 a so called "CD4 working group teleconference" was jointly (!!!) organized by WHO/EHT (Dr. Gaby Vercauteren) and BD (Mrs. Renuka Gadde)

During this phone conference, I openly asked the manufacturers active in CD4 counting to submit a clear commitment to the field and to the patients and patient programmes by openly publishing the instrument and test prices in the internet, at the company websites and the product brochures in order to secure transparent pricing which would be a significant advantage for all sides, especially for the MoH programmes and patients. This is what Partec already is doing since start in the CD4 field.
BD replied that "because the company is public and has shareholders and because of agreements with Clinton Foundation and PEPFAR, BD will never make pricing public!" (this was the exact wording and there was a special hard expression on the word "never")."

I am asking myself why all the companies dealing with "AID(S)" are so reluctant to untangle the web of prices?

Partec has publicly announced to sell CD4 test for as low as 2 US$ in the same qualitiy and for the same price worldwide. As far as I know this has happened up to now.

Friends, can we calculate how much "AID(S)" money has been dumped? Let us compare only the costs for cd4 Tests sold by BD under the Clinton agreement for 4 or 5 US$ plus all the other tests for up to more than 50 US$ and compare if we calculate 2 US$ each for all the tests sold worldwide?

What would be the difference and where does this revenue end up?

The quality of the test result is acceptable for all machines! The price, the handling, the time consumed, the support... makes the difference.

It seems money is not the problem for Tanzania and other countries, there seems to be an abundance of cash here. Why the hell are so many still not on treatment and dying? I think the donors should consider to stop all their "AID".

I will tell you why: The burden of AIDS is connected to CORRUPTION and MARKET MONOPOLIZATION. The whole story is about making money and not about helping the poor or PLWHA, the revenue of BD for example is increasing and the shareholders might be happy. But: Transparecny is not there!

Transparency is also lacking in the mission and church business, therfore:

Im Übrigen bin ich der Meinung, dass die zuständigen Missionssekretäre in Europa zurücktreten müssen und die Finanzgebarung in Europa und Tansania vollkommen offengelegt werden muss und Verantwortliche in Tansania und in anderen Ländern zur Rechenschaft gezogen werden müssen.

The following article was published in October 2006 in the

"viennese ethnomedicine newsletter"

INSTITUTE FOR THE HISTORY OF MEDICINE, MEDICAL UNIVERSITY OF VIENNAquondam ACADEMIA CAESAREO - REGIA IOSEPHINA 1785
department of ethnomedicine (volume IX number 1).

ISSN 1681-553XA

A Case Behind the International AID(S) Business:Corruption Siphons AIDS Money

Dr. Rainer Brandl

The artist John Kilaka reflects on the mounting evidence of procurement scandals at the ministry of Health in Tanzania which allegedly granted a single supplier with exclusive rights to provide HIV/AIDS laboratory equipment for National AIDS Control Programmes. This led to a broad public discussion with several front-pages in the national Kiswahili and English Press.

Kilaka shows through his painting that market monopolization and corruption are directly connected to the suffering of the people at the grass roots. Institutionalized human greed is interfering with the immediate needs of the downtrodden in the villages. These needs are: Bestand affordable technologies and effective use of funds allocated for serving the health of the masses.

The cry for life is opposed by international industries striving for market control and corrupt local elites struggling for financial gains.During the last decade antiretroviral drugs (“AIDS drugs”) have turned HIV/AIDS into a chronic disease as opposed to what once was regarded as a death sentence. Nevertheless, still only a minority of roughly one in six Africans who are in urgent need for treatment have access to these life saving drugs by December 2005 (UNAIDS 2006). At present many countries say that they want to scale up treatment and prevention rapidly leading to full access.The realization of the human right for treatment was again demanded by People Living with HIV/AIDS at the XVI International AIDS Conference (International Aids Conference 2006). Therefore a lot of equipments and tests are procured and the door for manipulation and corruption seems to be wide open.

The piece of Tinga Tinga art deals with the procurement irregularities concerning special laboratory devices – the so called CD4 counters – and John Kilaka specifically chooses one of themost dramatic cases within the procurement scandals. The issue was discussed and documentedfor several weeks in the country’s English (The Citizen No. 511, This Day No. 174, No. 104) and Kiswahili (Rai No. 666, No. 667) press. The daily Tanzanian newspaper This Day (No. 174) reported on its front-page:

“A Dar es Salaam businessman with exclusive rights to supply HIV test kits – at hiked prices – is behaving like a gagged man against press probes, This Day can reveal. Mr. Bharat Rajan, CEO of Biocare Health Products Limited, is currently directing all questions to the Ministry of Health as if it were part of his outfit. Mr. Rajan’s firm currently supplies almost every equipment and reagents from a global fund to fight Aids, Tuberculosis and Malaria to the Ministry of Health and Social Welfare at fictitiously high prices … … investigations by This Day have established that Rajan’s Biocare has supplied the ministry with chemistry analyzers, hematology analyzers and FACS Count cd4 count machines which are said to be costly because they use expensive reagents.”

CD4 counters are special flow cytometers and used all over the world as “gold standard” to determine the immune-status of HIV/AIDS patients by counting CD4 positive blood cells (also called T-helper lymphocytes). CD4 positive cells represent the backbone of the immune-system. The number of these cells slowly decreases in the HIV infected individual. To know the CD4 count of somebody who is HIV infected is an essential help in determining when to start and to monitor life saving treatment by antiretroviral drugs. The brown box in Kilaka’s painting with the letters “FACS” on it symbolizes a FACS Count (Fluorescence activated cell sorting) which is the brand name of Becton Dickinson’s CD4 counter (BD Biosciences, USA) and obviously the favorite machine of the Ministry of Health of Tanzania. (Private Health Laboratory Board, August 2006; Rai No. 671; This Day No. 174).Compared to more recently developed CD4 counters on the market, the FACS Count was originally designed for the use in the highly sophisticated environment of clean laboratories in industrialized nations and not for the dusty health centre or outreach program in a developing country in order to closely serve the needy rural population. The FACS Count lacks an additional feature – the CD4 % of total lymphocytes necessary for the proper treatment of children below the age of 7 years (USAID 2006). This is especially important as the proportion of – due to mother-to-child-transmission – infected children is very high in the resource limited rural African setting with its matured and generalized HIV epidemics and the determination of the CD4% is also requested by the guidelines of the National AIDS Control Programme of Tanzania and by the World Health Organization (WHO 2006).

Although the lowest found list price of the FACS Count (USAID 2006) with 27.000 US$ is comparable to other products on the market; it was reported from different countries that the over the shelf prices were sometimes up to 4 times higher (Partec personal communication 2005, 2006). It is general knowledge that higher prices are found especially after decisions leading to market domination of a single product or after adding additional costs for freight, localdistribution, warranty, service contracts or installation and training. The FACS Count is a closed system, which means that only the pre-packed original reagents of the manufacturer can be used for this type of machine, which practically eliminates competition in the field of reagents for this technique and therefore national treatment programmes and Ministries of Health would depend on only one supplier. As internationally often the case, the price of reagents and other consumables are very differentdepending on the market share, the level of regional competition, and the local price policy of companies. In some cases the prices for reagents are reportedly 3-25 times higher than those of other manufacturers or the announced minimum price. The Clinton Foundation says that its negotiations with manufacturers like Becton Dickinson have brought the test down to 5 dollars (Carter 2004), but currently in Zimbabwe the cost for one of Becton Dickinson’s CD4 count is US$56 and is revised upward quarterly according to a scientific peerreviewed publication of the University of Zimbabwe and Stanford University (Zijenah et al. 2006).

In John Kilaka’s painting “The FACS Count” bundled money is falling down at an umbrella which covers the people in the villages. Seated in the umbrella are fat men eating good food and counting money which is channeled into their own pockets. Their pecuniary wealth seems to be financed through artificially high prices and cooperation contracts with local distributors (This Day No. 174) who are excluding other competitive high quality products from the national market. International funds and the country’s tax funded budget are feeding some of the politicians, civil servants and so called experts, who eat rich meals and enjoy high quality life, while the rural, uniformed and poverty-stricken men, women and their children under the umbrella are cut off from their constitutional and human rights for proper health care, they are starving and they have no shelter. The smaller brown box on the table of the desperately weeping villagers with the letters “CYFLOW” on it, symbolizes a “CyFlow” which is the brand name of Partec’s CD4 counter, developed and manufactured especially for the use in resource limited settings, while the same key technology is also in use for other applications in the US, Europe, Japan and the rest of the world (see Partec homepage). The well working laboratory equipment is lying idle on the table as its use is blocked. The villagers cannot understand the rationale behind this as already they were perfectly served by the equipment (Partec personal communication 2005, 2006). The CyFlow has many advantages and therefore studies from different authors published in world’s renowned scientific journals and from most reputable scientific groups – including co-operations with Boston Harvard School of Health (Imade et al. 2005), Stanford University (Zijenah 2006), and Center of Disease Control – CDC (Pattanapanyasat et al. 2005) as well as organizations like Doctors without Borders MSF (Fryland et al. 2006) propose the use of this product as one of the solutions to scale up life saving antiretroviral treatment in resource limited settings. A conclusion of a very recent study says: “Although the purchasing price of FACS Count and Cyflow counter are comparable (US$ 30 000 - 50 000), the FACS Count reagents are more expensive than those for the Cyflow. The Cyflow counter also has a high throughput and as many as 200 specimens can be run per day, making it ideal for use in Zimbabwe, a country with one of the highest prevalence of HIV globally. In conclusion, the Cyflow counter is as accurate as the FACS Count in enumerating absolute CD4+ T lymphocytes in the range 1-1200 cells/μL. Cyflow cytometry is relatively affordable, easy to use technology that is useful not only in identifying HIV seropositive individuals who require ART but also for monitoring immunologic responses to ART.” (Zijenah 2006).

A CyFlow CD4 counter can run on a car battery or a solar panel and because of its robustness and portability it can be operated in a rural health centre or in a car by one trained person and its handling is rather simple. Mobile laboratories are already successfully used in Nigeria (Gede Foundation), in Benin (“action pro humanity”/government) and in Lesotho (UNDP). One CD4 test costs worldwide always the same and is at present the least expensive with only 1,75 Euro (2,5 Euro including cd4% per test) and according to the manufacturer in the year 2006 approximately 1.1 million CD4 tests will be distributed worldwide. According to the manufacturer exactly 346 Partec CyFlow devices have been placed in more than 30 African and 10 Asian countries within the past 3,5 years” (Partec personal communication 2005, 2006). Nigeria has decided to use the CyFlow as a national reference method and placed already more than 100 CyFlow units. Partec CD4 counters were mainly ordered by small programmes of local and international NGOs and faith based hospitals but also by some UN programmes (UNICEF, WHO, UNDP). The cost for the Cyflow-SL3 which can directly do the additional feature of CD4% (in order to facilitate treatment of children below 7 years of age) is worldwide always the same with 20.850 Euro and therefore even a bit less than the lowest international price found for a FACS Count (which is lacking to do a direct CD4% of total lymphocytes and therefore cannot directly serve the HIV positive children). This over-the-counter price includes a starter kit containing several hundreds of tests, consumables, an uninterruptible power supply, and at least a one year warranty. Accordinbg to Partec, compared to the FACS Count, the cost for service contracts and consumables are offered at starting prices three times lower than reported for the BD FACS Count. In December 2005 a price guarantee of 10 years was offered to the Ministry of Health in Tanzania (Partec personal communication 2005, 2006). However, numerous letters and offers from the company to co-operate with the national programmes and to develop even better and less expensive ways of CD4 counting never got any response. Instead of answering theses letters, the official Tanzania prohibited the import and use of the CyFlow (Rai No. 671, Private Health Laboratory board 2006) saying that its technical performance is poor and the test results are unreliable, following findings of a research which was reportedly done by Muhimbili University of Health.

For unknown reasons this research was never published and requests to present the methods and data were never answered.

The former Minister of Health recently said in a media interview (Rai No. 674) that she had advised her civil servants and university professors last year to purchase various types of machines in order to make the country more independent and to keep the competition going. This advice was ignored by the new Minister of Health who repeatedly in public used the argument of bad technical performance of the CyFlow. He says that his statements are based on the unpublished findings of the Muhimbili University, which contradict more than 30 publications and findings of multi-centre studies confirming the accuracy of the CyFlow (e.g. Cassens et al. 2004).

Media reports say that some of the civil servants and university employees leading investigations in order to decide about registrations of health products in Tanzania have close ties with businessmen dealing with the import of such products (This Day No. 174). The practical result of the malady is that a lot of money is spent for overpriced unreliable equipment which is not working very well in the resource limited rural setting and very few CD4 counts are done subsequently keeping people away from life saving treatment. John Kilaka vividly pictures an ancient game:

The “haves” are eating and the “have nots” are dying!

References

BD Biosciences, San Jose, CA 95131-180, USA, http://www.bdbiosciences.com/

Carter M. (2004) Clinton Foundation secures cut price CD4 and viral load tests for resource limited countries. www.aidsmap.com/en/news/A62F59CF-0590-4FE9-AAD4-E6253B5BF027.asp

Cassens U. et al. (2004): Simplified volumetric flow cytometry allows feasible and accurate determination of CD4 T lymphocytes in immunodeficient patients worldwide. In: Antiviral Therapy 9: 395-405

Fryland et al. (2006) The Partec CyFlow Counter® could provide an option for CD4+ T-cell monitoring in the context of scaling-up antiretroviral treatment at the district level in Malawi. In: Transactions of the Royal Society of Tropical Medicine and Hygiene 100, 10: 980-985

Imade G.E. et al. (2005) Comparison of a New, Affordable Flow Cytometric Method and the Manual Magnetic Bead Technique for CD4 T-Lymphocyte Counting in a Northern Nigerian Setting. In: Clinical and Diagnostic Laboratory Immunology 12, 1: 224-227

International Aids Conference (2006) Closing session of the XVI international AIDS conference, Toronto 2006 – Statement of Activists – PLWHA (http://www.kaisernetwork.org/)

Pattanapanyasat et al. (2005) Evaluation of a New Single-Parameter Volumetric Flow Cytometer (CyFlowgreen) for Enumeration of Absolute CD4+ T Lymphocytes in Human Immunodeficiency Virus Type 1-Infected Thai Patients. In: Clinical and Diagnostic Laboratory Immunology 12, 12: 1416-1424.

Partec GmbH, D-48161 Münster, Germany, http://www.partec.com/

Private Health Laboratory Board of the Ministry of Health (2006) Letter of the Registrar from 21st August 2006, Ref No HC49/421/VOL.V/26.

Rai (Tanzania) 671 August 17-23, 2006, Statement explaining the decision of the ministry by citing the contradicting findings of the ministry of health

Rai (Tanzania) 674, September 7-13, 2006, Corruption Saga in the Ministry of health

Rai (Tanzania) 666, July 13-19, 2006, Mvutano mkali waibuka Wizara ya afya, front page

Rai (Tanzania) 667, July 20-26, 2006, Mafarisayo Wizara ya Afya na fedha za ‘migodi’ ya ukimwi, front page

The Citizen (Tanzania) 511, May 4, 2006, It’s hell over Aids kits, front page

This Day (Tanzania) 104, June 24, 2006, Trouble brews at home over HIV testing kit, front page.

This Day (Tanzania), 105, June 26, 2006

This Day (Tanzania), 174, September 14, 2006, Supplier of suspect HIV/AIDS kits shuts up on media, front page

UNAIDS (2006) Report on the global AIDS epidemic 2006. Joint United Nations Programme on HIV/AIDS (UNAIDS) http://www.unaids.org/en/HIV_data/2006GlobalReport/default.asp

USAID (2006) CD4 machine logistics fact sheets. http://pdf.usaid.gov/pdf_docs/PNADG265.pdf (nowadays this link leads to another producer of CD4 Counters, GUAVA but the FACSCount data sheet is still available at http://www.phishare.org/files/4365_CD4MACHINE_FACTSHEET_FACS.pdf it is a unfortunate policy to change information under the same link in a way like this!)

WHO (2006) Antiretroviral therapy of HIV infection in infants and children in resource-limited settings: towards universal access. Recommendations for a public health approach. Department of HIV/AIDS, Geneva, Switzerland. http://www.who.int/hiv/pub/guidelines/WHOpaediatric.pdf

Zijenah, L.S. et al. (2006) Affordable flow cytometry for enumeration of absolute CD4+ T-lymphocytes to identify subtype C HIV-1 infected adults requiring antiretroviral therapy (ART) and monitoring response to ART in a resource-limited setting. In: Journal of Translational Medicine 2006, 4, 33.

Elisabeth und Wema bei einem Tratsch mit Jakaya Kikwete in Ikonda Ende 2005

http://www.elisabethzenz.blogspot.com/

Schreibt Elisabeth was sich so in Bulongwa und mit PIUMA tut. Die Korrupten an den Spendentöpfen, die wehren sich und machen PIUMA das Leben oft schwer. PIUMA setzt selbst Konsequenzen!

FOR THE BOOKS OF many NGOs, FBOs and MISSIONs who collect money for the "poor" in Africa. The poor are providing the Do-gooders and criminal local and international Elites a job instead of being helped by them.
Fact is: TANZANIA is very rich and its children and sick ones should not serve as a reason to collect funds, which do not work for their benefit for most of the times!
There are also many criminals occupying church and NGO offices. If the ressources of the country would be used properly, it will lead to the situation that decisions will be made by Tanzanians and for the benfit of all of them.
Which HIV-Test or which CD4 counter should be bought will be decided by their well working corruption free institutions. No WHO/EHT "experts" who are in many times not working for the good of the poor would be needed any longer.

TANZANIA will even save a lot of money (and use it for schools, hospitals, roads, water supply, pensions, whatever...), dependency is expensive!

http://www.thisday.co.tz/News/3671.html

"FINN’S FACTS: We have many criminals occupying public office

Finnigan Wa Simbeye

MARIE Shaba, the former chairperson of Tanzania Association of Non Governmental Organizations (TANGO) and interim chairperson of Non State Actors (NSAs) task force group, once stood up her ground and disputed the fact that Tanzania is a poor country. It was during the trademark World Bank monthly breakfast talks last year and the subject was mining.

’’We are not poor, are we?’’

Shaba wondered while sitting next to former World Bank (WB) Country Director for Tanzania and Uganda, Judy O’Connor.

’’We are not a poor country, the term is often used by donors to weaken our bargaining position but honestly we are a very rich country,’’ she argued.

The WB country director, a very humble, soft spoken Irish national, nodded in approval and agreed that indeed Tanzania is not a poor country.Imagine if we can be able to collect half of what is being siphoned out of this country by the so-called foreign investors and our brainwashed thieving politicians and bureaucrats who inflate prices of property bought by the government, the record high 152m/- per day being paid by the Treasury to Dowans Holdings as capacity charge and the 133bn/- Bank of Tanzania’s external payment arrears account looting?"


Im Übrigen bin ich der Meinung, dass die zuständigen Missionssekretäre in Europa zurücktreten müssen und die Finanzgebarung in Europa und Tansania vollkommen offengelegt werden muss und Verantwortliche in Tansania und in anderen Ländern zur Rechenschaft gezogen werden müssen.

CYFLOW CD4 Counter leading at a CD4 Workshop of WHO in Jakarta!

MoH in Tanzania repeatedly gives out embarrassing statments contradicting the international ressearch community.

Partec's chief scientist Dr. Volker Ost in a respectful talk with the former MoH (2005) : Hon. Anna Abdallah

According to a report submitted by chief scientist from PARTEC Germany - Dr. Volker Ost - the Cyflow counter is leading in performance and excellence. (see original PARTEC statement at the end of this article)
It is said in press articles from Tanzania, the sitting MoH has banned the CYFLOW machines from TANZANIA for reasons of poor performance.

This repeatedly published statement of the current Minister of Health contradicts the huge majority of the scientific papers and field reports published in international scientific journals.

It is astonishing that obviously some WHO "experts" (who are co-chairing meetings with BD representatives) and the MoH of Tanzania who is a Professor of medicine himself are obviousyl not able to do state of the art literature ressearches. Any docotrate student in the world is able to perform this exercise. http://www.pubmed.com/ is only one of the sources used by the international ressearch community and every medical students. Where are the publications underlinig the statements of the MoH of Tanzania?

Currently PARTEC CD4 counters are used all over the world in more than 60 countries including the USA (!), almost all European Countries, Canada, China, India, Nigeria, Malawi, Sudan and Japan.

EVEN SOME WHO DEPARTMENTS REPEATEDLY ORDERED CD4 COUNTER FROM PARTEC. It stays to aks the question why WHO is obviously not able to speak with one voice.

Best Technologies worldwide in the same quality and for the same price of less than 3 US$ per test including cd4% for children!

Among the many International research institutes which have evaluated the CyFlow and the Partec absolute counting method very successfully with excellent performance or are using the CyFlow with best success in their programmes are for example:

• Harvard School for Public Health, Boston, USA
• Institute of Human Virology, University of Baltimore, Maryland, USA
• PEPFAR Programmes in Nigeria
• AIDS Prevention Initiative Nigeria (APIN)
• Cheikh Anta Diop University, Dakar, Senegal
• MSF Malawi, MSF Belgium, MSF France
• Laboratory of Immunology, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium
• Croix-Rouge Française, Paris, France
• Laboratoire d’Immunologie Hopital Pitiè Salpetriere, Paris, France
• Institute of Immunology, Dept. of Biomedical Sciences, University of Modena and Reggio Emilia, Italy
• Spallanzani Hospital, Rome, Italy
• Servizio d’Immunologia Istituto Pascale Hospital, Naples, Italy
• Infectious Diseases Clinic San Raffaele Hospital, Milano, Italy
• Institute of Immunology, Robert-Rössle-Klinik Berlin, Germany
• Institute of Laboratory and Transfusion Medicine, University Hospital Bad Oeynhausen, Germany
• Institute of Immunology and Transfusion Medicine, University Hospital Lübeck, Germany
• Department of Internal Medicine, University Hospital Münster, Germany
• Institute of Transfusion Medicine, University Hospital Münster, Germany
• Institute of Radiation Biology, University Hospital Münster, Germany
• California Department of Health Services, Richmond (CA), USA
• Noguchi Memorial Institute, Accra, Ghana
• Université de Ougadougou, UFR/SVT, Burkina Faso
• Hopital General de Douala, Cameroon
• Hopital Laquintinie de Douala, Douala, Cameroon
• Programme des Recherche Santé, Faculté des Sciences, University of Douala, Cameroon
• Hopital La Pette, Marua, Cameroon and MSF Younde, Cameroon
• Centre Hospitalier Kigali (CHK) / Projet RWA21, Lux Development, Kigali, Rwanda
• many more...


From the Partec's press statement:

"21.12.2007

Dr. Volker Ost +49 2534 8008 - 0

Report from WHO / MoH CD4 Counting Workshop in Jakarta, 17-19 December 2007
WHO / MoH CD4 COUNTING WORKSHOP REPORT (17-19 DEC, JAKARTA, INDONESIA)

The Ministry of Health in Jakarta/Indonesia and the regional WHO office organized a CD4 counting training workshop for lab technicians from December 17 to 19, 2007.

Three manufacturers have participated at the workshop: BD, Guava and
Partec. The workshop was attended by 27 lab technicians and doctors as
well as officials from MoH and WHO.

The workshop started on Monday morning, December 17 in the Dharmais Hospital in Jakarta. Following the opening ceremony Dr. Agus and Dr. Martha gave lectures about the background of CD4/CD4% counting and the technologies in use. Advantages of single platform and dual platform techniques were presented and discussed. Important issues were quality control and quality assurance. According to Dr. Agus there will be ring trials started soon with the support from Dr. Kovit in Bangkok who will provide the reference material.

An WHO consultant arrived in the afternoon to have a round table discussion with company representatives. He had to find out for what reason the deliveries for BD CD4 reagents for BD instruments in Indonesia were delayed.

It was pointed out in the discussion that Partec and its local representive company Europ Continents Indonesia have a threefold strategy for in-time deliveries: (1) local stock in Jakarta for immediate deliveries, (2) minimum 12 to 13 months shelf life time for reagents, i. e. 12 months shelf life time at customer site and (3) partial deliveries of reagents as agreed with the purchaser.

Later during the day, the three companies had the chance to introduce their technological concepts and diagnostic products for HIV monitoring by CD4 absolute counting for adult patients and CD4% counting for pediatric patients to the assembly.

On Tuesday the workshop started with three groups at the three different instruments from BD, Guava and Partec. Three groups with each 9 lab technicians and doctors were built. When the groups arrived at the Partec site, they were introduced into the CyFlow instrument and sample
preparation. The sample preparation is very easy and quickly done. The nine samples of the group members were incubating simultaneously (15 minutes) and were run by each of them one after the other. There is no time restriction when running samples after sample preparation.
The result data were immediately noted and further questions were answered and discussed. All three groups came and left in time. The timing problem in the evening arose from the fact that sample preparation took very long time at the Guava and BD instrument or for further reasons, all which have not occured at the group using the Partec CyFlow technique where sample preparation was utmost quick and easy.

The BD instrument had to be carried from the hospital room to the meeting room in order to finish samples even late while the other people were already discussion data.

After concluding the sample runs, the results have been evaluated and reported (mean value and coefficient of variation). Each group had a speaker who presented the data and gave comments about instrument operation and sample handling:


GROUP 1
--------------
CyFlow FACSCount Guava
mean 413 428 420
CV 5.1% 14% 7.7%


GROUP 2
--------------
CyFlow FACSCount Guava
mean 348 389 331
CV 5.5% 7.6% 19%


GROUP 3
--------------
CyFlow FACSCount Guava
mean 687 DNF 705
CV 8.9% DNF 18.8%

(DNF = did not finish)

All three groups gained the best CVs using the Partec CyFlow technique.

Furthermore, the participants were very much impressed about the absolutely easy and rapid blood preparation protocol featured by the CyFlow method.

In comparison to the 15 minutes protocol using the CyFlow technique, the preparation with the Guava and the BD FACSCount required at least 75 minutes (e.g. for Guava 60 minutes alone for the incubation). The significant difference in preparation time and preparation complexity for the different CD4 counting techniques was noticed by the lab technicians.

The result processing worked successfully for any sample on the CyFlow, but not all samples could be run with the BD FACSCount and the Guava. It was discussed that larger CV values from the Guava instrument may arise from the small blood sample volume (10µl, only).
The overall summary was therefore very advantageous to the favour of the CyFlow method. Participants liked the simplicity. The organizers asked why CD4 counting can be so easy when using the CyFlow technique.

Furthermore, the situation was discussed that BD is not able to deliver reagents in time to the Indonesian treatment programme. It happened repeatedly that CD4 test kits from BD arrived only after months while the shelf life was already expired.

On Wednesday morning with the closing ceremony all officials thanked the particants and the company members for their work.

Compiled by:
Dr. Volker Ost

Senior Scientist"

http://www.afrika.info/aktuell_detail.php?N_ID=575&kp=news

2007-11-29


Journalist aus Tansania in Salzburg

Packender Gastvortrag an der UniversitätSalzburg.

Im Rahmen der Lehrveranstaltung „Medien in Afrika“ von Dr. Martin Sturmer am Fachbereich Kommunikationswissenschaft der Universität Salzburg war am 22. Oktober der tansanische Journalist Muhingo Rweyemamu zu Gast. Rweyemamu, der auf Einladung des Evangelischen Arbeitskreises für Weltmission (EAWM) nach Österreich gekommen war, ist Chefredakteur der größten Wochenzeitung des Landes Rai (Meinung). Vor allem durch seinen Kampf gegen die Korruption zählt Rweyemamu zu den populärsten Journalisten in seinem Heimland.

Permanentes Schwimmen gegen den Strom

„Journalismus in Afrika ist ein permanentes Schwimmen gegen den Strom.“ Mit diesen Worten eröffnete Rweyemamu seinen Vortrag vor 40 Studierenden. „Die meisten afrikanischen Länder haben vor zwei Jahrzehnten begonnen, Mehrparteiensysteme zu installieren“, so der Journalist weiter, „aber viele Machthaber benehmen sich so, als würden sie noch immer alleine regieren. In meinem Heimatland sehen Regierungsbeamte in Journalisten Freunde, wenn sie positiv über sie berichten. Aber sie sehen Feinde in ihnen, wenn sie Missstände aufdecken.“ Rweyemamu war im letzten Jahr selbst von der Polizei in Gewahrsam genommen worden, als er einen Straßenbauskandal aufdeckte, in den ein Minister verwickelt war.

Acht Journalisten in Somalia ermordet

Dabei hat sich die Situation für Journalisten durch die Wahl von Präsidenten Jakaya Kikwete Ende 2005 entscheidend verbessert. Die drakonische Pressegesetzgebung aus dem Jahr 1976, die die Einstellung eines Printmediums jederzeit ermöglicht, ist seit Kikwetes Amtsantritt nicht mehr exekutiert worden. Anders stellt sich die Situation freilich in anderen afrikanischen Staaten dar. In Somalia seien im laufenden Jahr bereits acht Journalisten ermordet worden, so Rweyemamu, in Burundi würden immer wieder Medienleute von der Bildfläche verschinden. Der wohl wesentlichste Unterschied zwischen afrikanischen und europäischen Mediensystemen sei, dass Journalisten in fast allen afrikanischen Staaten ihre Quellen preisgeben müssten. Dadurch wird die Informationsbeschaffung erschwert.

Presse führt den Kampf gegen Korruption an

Muhingo Rweyemamu hat sich seine ersten journalistischen Sporen als Reporter während des Genozids in Ruanda im Jahr 1994 verdient. Trotz der Gefahren, die sein Beruf für sich bringt, ist er leidenschaftlicher Journalist und hat ein hohes Amt in der Regierung von Präsident Kikwete ausgeschlagen. „Medien müssen versuchen, das Leiden der armen Bevölkerungsschichten zu verringern“, lautet sein journalistisches Credo. „In meinem Heimatland spielt die Presse die Hauptrolle im Kampf gegen die Korruption. Wir üben Druck auf die Regierung aus, damit diese handeln muss.“

Bischof unterschlägt Geld

Ein trauriges Beispiel aus jüngster Zeit sei der Fall der AIDS/HIV-Klinik Bulongwa im Bezirk Makete, wo große Summen an Hilfsgeldern vom dortigen Bischof unterschlagen worden sind. Deshalb müssten auch Journalisten in Europa wachsam sein, meinte Rweyemamu in Richtung der Studierenden. „Was ich von Euch Nachwuchsjournalisten erwarte, dass ihr die Organisationen in Europa zur Verantwortlichkeit ermahnt. Damit die Gelder auch dort ankommen, wofür sie gespendet worden sind. “

Rückfragehinweis
Dr. Martin Sturmer +43 662 450627
ms@afrika.info

http://www.cd4counter.blogspot.com/

A voice from TANZANIA!


"ELCT Bishop should start to cleanse his churches since charity starts at home. There are people working in churches pretending to be holy, always pretending to give greetings like ``BWANA YESU ASIFIWE`` however they embezzle the offerings from their believers. I was shocked to meet a friend of mine, who was an accountant in a private firm and was sacked for stealing the company`s money, now employed as a treasurer in one of the big ELCT Church. As I know, one could confess, however, the way I see this man lifestyle and behaviour, there is no change. Bishop Malasusa has a big homework to cleanse his churches. Do not just employ people in churches because they are brought by ``Mzee wa Usharika``. Be careful.

Jema"

I hope the day will come when people can speak out loud and free of fear or wrong respect in front of all the worng-doers. "Heshima" is a word which should be used in front of people who deserve it, because their moral and ethics are higher than others and because they lead by example.

In that regard I demand the mission secreatries from Europe, who are responsible for educating corrupt elites in Africa, to resign. They were and are pouring money into the open greedy arms of corrupt and criminals through systems without control and accountability.

So many faces and stories of poor orphans and the dying sick are used on the advertisment boards of church NGOs in Europe and well meaning church goers donate billions every year for the poor in Africa.
Anyway, there is no transparency which can make one trust that the money reaches the target group. Missionaries are flying up and down and discuss within their corrupt groups. This is not a matter of religion, nationalism, "developed" or "developing" - it is a question of honesty and truth.

Presiding Bishop of the Lutheran Church in Tanzania Rt. Rev. Malasusa is washing his dirty hands with his tears.


The Secretary of EAWM a Lutheran Austrian Development Association writes the following statement in reply to a newspaper article published today in Tanznia. The article follows the statement of the EAWM secretary.

"As general secretary of an Austrian church NGO, who terminated collaboration with ELCT in 2006, I can only smile about the words of the Presiding Bishop of ELCT. There is the problem of systemic corruption in ELCT. A short look at the website of the Lutheran Mission Co-operation (www.lmc.or.tz) will show that a lot of programmes and projects are pending and mission financial statements or sufficient reports.From my own experiece I know, that the former ELCT SCD Bishop Shadrack Manyiewa was responsible (there are independent audit reports !) for the embezzlement of minimum EUR 280.000 Euros (= 420.000.000 TSH) and he has to face NO legal action.Parts of ELCT leadership and some northern partners from Germany are knowing very well that there is a network of nepotism, systemic corruption and abuse of human rights in ELCT - when Rt. Rev.Malasusa is now bemoaning, he is either very naive or he tries to wash his dirty hands with his tears !Gottfried MernyiVienna, Austria

"The original article is published at:

http://www.ippmedia.com/ipp/guardian/2008/03/11/110129.html

Cleric bemoans grand corruption 2008-03-11 10:09:30

By Judica Tarimo, just back from Zanzibar

The Head of Evangelical Lutheran Church of Tanzania (ELCT), Bishop Alex Malasusa, has expressed disappointment over high-profile graft and massive embezzlement of national resources by few people at the expense of millions of poor Tanzanians.The bishop made the remarks on Sunday at a fund-raising function for construction of the ELCT mission branch at Mwanakwerekwe Parish in Zanzibar.``I am really disappointed by these people. They embezzle public funds while millions of Tanzanians are suffering from hunger and lack of basic needs,`` he said.According to the cleric, the majority of Tanzanians are facing critical socio-economic problems-lack of reliable transport, food, clean water, quality health services and other essentials services because of financial constraints triggered by massive mcorruption and embezzlement of funds by a greedy few.He urged those involved to fear God, change their behaviour and work honestly and diligently for the benefit of all.``These people must be concerned with the welfare of majority of Tanzanians rather than enriching themselves and their families. They need to put the interest of the nation ahead and not abuse public office,`` said Bishop Malasusa.The fund raising attracted clerics from ELCT and other church denominations, believers from different sects, ordinary people and prominent personalities including IPP Executive Chairman Reginald Mengi and Managing Director and owner of Dar Express Bus Services Company Ltd, Yudica Mremi.A total of 65m/-, being pledges and cash money, was collected during the occasion.The church had targeted to raise a total 50m/- for the envisaged project. Mengi and Mremi were among the contributors.Addressing the congregation, Mengi appealed to religious leaders to advise people who wanted to confess for squandering public funds to return the stolen money first.``When these people come to you to confess, you should tell them to return the money. Before accepting their confession, you need to ask them `have you returned the money`? said Mengi.He said clerics and religious leaders generally, were better positioned to enlighten corrupt leaders who had siphoned public resources and funds to return the money.``If this money is returned, the church will be relieved of extra responsibility of engaging in public services delivery such as education, health, and other social and economic development engagements,`` he said.Mengi also appealed to church goers and other Tanzanians to cultivate the culture of giving to others as a gesture of thanking God who created the wealth and money possessed by today�s people.``Always ask yourself why me. You are eating while others are suffering from hunger. Why me? You are dressing while others have no clothes.Why me? You are physically fit while others are disabled. Why me? So, you have to thank God who gave you by giving to the have-nots,`` he said.

SOURCE: Guardian

Am 16. Juni 2007 schreiben die Salzburger Nachrichten in Ihrer Wochenendbeilage:

"Geld hilft nicht

Miliarden fließen. Das Elend bleibt.

Verplichtung und Gewissensberuhigung, aber auch Fluch und Hindernis: Jährlich fließen Unsummen in die Entwicklungsländer.
Entwickelt haben sich nur die wenigsten derart finanzierten Gesellschaften - von den korrupten Eliten abgesehen.
Entwicklungshilfe nimmt das Geld von den Armen der reichen Länder und gibt es den Reichen der armen Länder. Sagt ein Sprichwort."

Ich denke, das ist sehr richtig und ich denke, dass die kleinen "armen" Geber von den reichen Eliten in Staat, Kirche und NGOs in Afrika Rechenschaft fordern sollten. Die wirklich Armen werden durch Entwicklungshilfegelder vielfach nur noch zusätzlich frustriert. Spenden heißt Verantwortung! Irgendeinem Missionswerk oder einem Bischof in Afrika zu glauben, das ist zu wenig und kann im schlimmsten Fall auch Menschen töten.

Im Übrigen bin ich - was Makete und Tansania betrifft - der Meinung, dass die zuständigen Missionssekretäre in Europa zurücktreten müssen und die Finanzgebarung in Europa und Tansania vollkommen offengelegt werden muss und Verantwortliche in Tansania und in anderen Ländern zur Rechenschaft gezogen werden müssen.