------------------------------------------------------------------------------ EAST AFRICAN MEDICAL JOURNAL EDITORIAL PANEL EDITOR-IN-CHEIF: KASILI, E.G., MB, ChB, (E.A.) MD, (Nbi) MRCP, RCPS (Glasg), FRC Path, (Nairobi) EDITORS: LORE, W., MD. ChB, (EA), MRCP (UK), FICA (USA). FRCP (Edin), FRCP, RCPS (Glasg), FRCP (Lond) (Nairobi) REES, P.H. OBE, MD (Amsterdam), FRCP (Lond, Edin) (Nairobi) MEMBERS: BENNETT, F.J., MB, ChB, DPH, FFCM (Nairobi) CHINTU, C., MD, LMCC, DABP, FRCP(C) (Lusaka) KUNG'U, A., MB, ChB, FRC Path (Nairobi) KYALWAZI, S., MB, ChB, FRCS (Edin) (Kampala) KYAMBI, J.M., MD (Heidelberg), FAChir (Giessen), FAChir (Paed) (Cologne) (Nairobi) MAKENE, W.J. MB, CHB, FRCP (Lond) (Dar es Salaam) MATI, J.K.G., MB, ChB, MD, FRCOG (Nairobi) MENGECH, arap H.N.K, MB, ChB (Nbi), DPM (Edin), MRC Psych (UK) (Nairobi) McLARTY, D.G., MD, FRCP (Dar es Salaam) MUGAMBI, B., MB, ChB (EA), PhD (Lond), Dip Cardiol (Rome) (Nairobi) ODUORI, M.L., MB, ChB, DCH, FRCP (Edin) (Nairobi) OJWANG, S.B.O., MD, MMED, OG, Dip Gyn Oncol (Nairobi) OKELLO, G.B.A., MD, FRCP, MBBS, MRCP, DTM&H, Cbiol, MlBiol (Lond), FAAS (Nairobi) OWOR, R., MD, FRC Path (Kampala) EDITORIAL ASSISTANTS: SYLVANUS R. ORIEDI (Nairobi) ROSEMARY W. KINYUA (MRS) (Nairobi) RATE The East African Medical Journal is published monthly Subscriptions in Kenya: KSh. 750/-(Students KSh, 250/-) Overseas and all other countries subscriptions are KSh. 2400/-- US$120 or UK$85 annually Plus airmail postage. A cheque or postal order for the amount will ensure your getting a copy each month. Bankers: Kenya Commercial Bank, Moi Avenue, P.O. Box 30081, Nairobi Articles are available on request through The Genuine Article, Institute for Scientific Information, 3501 Market Street, Philadelphia Pennsylvania, 19104, USA. Subscriptions to be addressed to: The Editor-in-Chief The East African Medical Journal P.O. Box 41632, Tel. 724711/726073 Nairobi, Kenya ------------------------------------------------------------------------------ EDITORIAL THE AIDS SITUATION AND ITS CONTAINMENT It is hardly ten years since Acquired Immune Deficiency Syndrome (AIDS) was first described. In this relatively short period of time, AIDS had claimed lives of thousands of people mainly in the prime of their productivity. Countless have been orphaned by the scourge. Similarly, many others may be left in due course if the pestilence continues to pursue its aggressive course on humankind. Ever since AIDS was attributed to human immunodeficiency virus (HIV), a retrovirus, the scientific community has vigorously pursued attempts aimed at containing the disease and curbing the wastage accruing from the loss of human lives. Efforts at various research institutions have not been entirely fruitless in yielding dividends although realization of achievements has been rather slow despite painstaking labour and capital outlay. So far, no definite development has obviated the need for continued research into a lasting remedy. To date, the most promising therapeutic agent in the effort to slow down deaths attributed to AIDS has been idovudine (formerly azidothymidine, AZT). Zidovudine, however, suffers two handicaps which have hampered its widespread use. The first one is associated with its toxicity manifesting as bone marrow depression and its propensity to cause anorexia which is unfortunately a major symptoms in AIDS, and which, coupled with diarrhea, accounts to a large extent for the wasting that is a classical feature of the disease. The second problem associated with zidovudine is the cost which is relatively high and can only be afforded by a small fraction of patients. However, these limitations should not impede the use of the drug if the cose:risk benefit ratio favors it. DDI is yet another compound which is undergoing evaluation as a therapeutic agent in the management of HIV infection. It is, however, too early to make any decisive statement regarding this compound at the moment. A recent development in the war against this dreaded disease is the development and use of KEMRON (low-dose oral interferon) as a therapeutic modality. A statment issued by Dr Lobe Monekosso, the Africa Regional Director of World Health Organization, during the Forty Third World Health Assembly meeting held in Geneva in the presence of senior World Health Organization officials summarizes the status quo on this compound... "The recently concluded WHO Collaborative Study has revealed that there is something immensely valuable in KEMRON, irrespective of whatever the entire world thinks". Dr. Monekosso therefore recommended a forward looking collaborative study to finalize the clinical use of this compound. To this effect, Dr Monekosso recommended that an urgent meeting of the five AFRO region multicentre researchers be held in Geneva as soon as possible as the world was waiting anxiously to be informed about KEMRON. The World looks forward to the promises accruing from the results obtained from evaluation of KEMRON in the management of AIDS, and the Ministry of Health and the entire Kenyan community wished KEMRI and her collaborators success in this endeavor. PROFESSOR JOSEPH OLIECH, FRCH, MBS DIRECTOR OF MEDICAL SERVIES, MINISTRY OF HEALTH, KENYA GOVERNMENT ------------------------------------------------------------------------------ East African Medical Journal (Special Supplement) Vol 67 No. 7 July 1990 EFFICACY OF ORAL KEMRON (LOW DOSE ORAL INTERFERON ALPHA) IN THE MANAGEMENT OF ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS) D.K. koech, PhD, and A.O. Obel, MD, PhD. Kenya Research Institute, P.O. Box 54840, Nairobi, Kenya. EFFICACY OF KEMROM (LOW DOSE ORAL NATURAL HUMAN INTERFERON ALPHA) IN THE MANGEMENT OF HIV-1 INFECTION AND ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS) D.K. KOECH and A.O. OBEL SUMMARY One hundred and ninety nine symptomatic and 5 asymptomatic patients seropositive for the human immunodeficiency virus type 1 (HIV-1) were treated with KEMRON, a natural human interferon alpha (nHIF-alpha) stabilized in a complex polysacchariche carrier. Treatment was given for at least 10 weeks at a daily oral dosage of approximately 2.0 IU of nHIF-alpha per kg body weight. Karnofsky performance score increased from an average of 60.5 on entry into the study to 100 by the 10th week after treatment. Similarly, common clinical complaints associated with HIV-1 infection rapidly reduced per patient from an average of 3.8 to 0.05 and 0 by week 8 and 10 of treatment. Eighteen of the patients serodeconverted by both ELISA and western blot assays during the study period. These observations suggest that KEMRON used as recommended is beneficial in HIV-1 seropositive individuals. INTRODUCTION Acquired immune deficiency syndrome (AIDS) is associated with opportunistic and other infections resulting from the depletion of those T lymphocytes bearing CD4 markers due to progressive infection and destruction of those cells by HIV virus. T lymphocytes bearing CD4 markers are critical in various immunologic reactions. Depletion of these cells from circulation also causes a decline in CD4:CD8 T lymphocyte ratio as well as energy to those antigens that normally elicit DTH reactions. In addition, there is defective CD4+ T lymphocyte function leading to decreased interleukin-2 and -gamma and -alpha interferon production. Monocytopenia is another recognized feature leading to selective locomotor and phagocytic defect. There is also decreased natural killer (NK) cell activity. All these defects lead to profound immunodeficiency associated with HIV infection. Human interferon alpha (HuIFN-alpha) belongs to a family of leukocyte-derived glycoproteins with some immunomodulatory, antiinflammatory and antiviral properties. It has been used in clinical management of hairy cell leukemia, condyloma acuminata and in AIDS associated Kaposi's sarcoma (1-3). These reports have employed parenteral use of high doses of IFN-alpha (between 10 and 35 million units per day). High doses of parenteral administration of interferon alpha, either recombinant or natural, have been associated with undesirable side effects such as chills, fever, myalgia, anorexia, nausea, fatigue, malaise, bone marrow depression, reversible cardia dysfunction and headache (4-6). Most of these side effects are characteristic features or symptoms associated with acquired immune deficiency syndrome (AIDS); hence, parenteral use of high doses of IFN-alpha is contraindicated in AIDS. Low dose (HuIF-alpha) has been found to be efficacious in feline leukemia when administered orally (7-9). In addition, it is non-toxic. Use of low dose recombinant HuIFN-alpha is currently being evaluated in an ongoing clinical study involving HIV-1 seropositive patients (10-11). Recent report by Koech et al. (12) has revealed the use of oral natural Human Interferon alpha (nHulFN-alpha) in 40 HIV-1 seropositive individuals causes an increase in of the levels of lymphocytes bearing CD$ markers as well as alleviation of symptoms commonly associated with AIDS. In some cases, serodeconversion by both ELISA and Western Blot assays was reported. These observations necessitated doing an expanded confirmatory study on AIDS patients with similar clinical background through the assessment of response to therapy by symptomatology and serologic assays. MATERIALS AND METHODS Patients: The patients selected into the study were HIV-1 positive by both EISA and Western Blot assays. They also satisfied the clinical criteria for AIDS related complex (ARC) and AIDS as given by CDC, WHO/GPA and the National AIDS Committee, Kenya, as well as having consented to the study. The exclusion criteria was on the basis of refusal to consent to participate in the study, pregnant women and children. The patients were also assessed on the basis of Karnofsky performance score (KPS) (13) of 20 and above. The patients were followed up every two weeks until they were asymptomatic (up to 10 weeks) and every month thereafter. There were 204 patients recruited into the study, 127 males and 77 females aged between 15-56, the majority falling within 20-40 year-range (Fig 1). Their weights ranged from 30 to 87 kg on admission. Blood testing and serology: Complete hemogram was performed using a standard automatic counter (coulter Electronics) and white cell differential was also done, but manually. Serologic testing for HIV-1 was achieved using the standard WHO approved ELISA antiglobulin test kit (Organon). Similarly, Western Blot assays were done using approved diagnostic kit (DuPont). These parameters were reassessed every two weeks as above. Clinical scoring: Prior to treatment, patients registered an average of 3.8 complaints consisting of fatigue, weakness, appetite and weight loss, prolonged diarrhea (salmonellosis), headache, fever, oral thrush (oral and esophageal candidiasis), skin rash, lymphadenopathy and respiratory tract infections as major clinical complaints. clinical examination and (KPS) were assessed by the same investigator, and the initial KPS ranged from 20 to 90 (mean 60.5). Treatment: KEMRON was used throughout the study. Each dose contained 150 IU of nHulFN-alpha (Hayashibara Biochemical Laboratories, Okayama, Japan) stabilized in a patented complex anhydrous polysaccharide carrier. The active ingredient was produced through a patented technology involving the stimulation of lymphoblastiod cell line with HVJ (Sendai) virus(14). It is a mixture of subspecies in specific proportions as 2-alpha, 7-alpha and 8-alpha subtypes and are of glycoproteins with molecular weights ranging from 13,000-21,000. It was purified by monoclonal antibody technique to a specific activity of 2*10^8 IU/mg. One dose was given daily, placed in the mouth and allowed to dissolve in the saliva for 2-3 minutes, massaging gently with the tongue to facilitate ease of dissolution and effective mucosal contact. The saliva was retained in the mouth for a further 2 minutes before swallowing. No food or liquid was consumed 30 minutes before and after medication. The treatment was continued on a daily basis for 6 months, evaluating both clinical improvement and serology every two weeks during the first 2 months of treatment and every 4 weeks thereafter. RESULTS The number of clinical complaints on entry in to the study was an average of 3.8 and declined to 1.0 by week 2 and further to 0.5 and 0.02 by week 4 and 6 respectively. By week 8, there was an average of 0.05 complaints per patient and by week 10, there was no patient with any definable clinical complaint (Table 1). In the majority of the patients, opportunistic infections (such as oral candidiasis) cleared with 2 weeks of treatment. These observations are summarized in Table 2. One hundred and forty two patients had significant weight loss on entry into the study. By the end of week 6, they had gained 52.8kg (range 2-15kg). There were 21 patients with significantly reduced hemoglobin levels. At the end of 8 weeks of treatment, their hemoglobin levels had reached normal levels and had increased by 1.8+-0.9 gl/dl (range 0.4 - 6.0 gl/dl). Similarly, 25 patients who had significantly low erythrocyte values on admission attained normal levels by week 8 of treatment. There was an increase of 0.9+-0.4*10^6 cells/ml (range 0.5-1.9*10^6 cells/ml). No of patient studied reported any undesirable side effect resulting from the use of KEMRON. The only side effect registered was increased appetite, which persisted throughout KEMRON medication. DISCUSSION The results indicate that KEMRON, used at dosages around 2.0 IU/kg body weight is capable of alleviating symptoms commonly associated with AIDS, hence, therapeutic effect of KEMRON in the management of this disease is significant. Opportunistic and other associated infections and symptoms resolved without further treatment suggesting that the use of KEMRON leads to a generalized improvement in the modulation of the patient's immune system. This view is supported by our earlier observations that circulating T lymphocytes bearing CD4+ markers increased in number(12). It is clear from these studies that most of the symptoms associated with AIDS are eliminated within 4 weeks of KEMRON medication leading to dramatic improvement of the patient. Most opportunistic infections are cleared within 2 weeks of treatment. Besides an increase in the absolute levels of CD4+ T lymphocytes, there is a corresponding increase in the levels of platelets, erythrocytes and hemoglobin. There is up to 10% serodeconversion by both ELISA and Western Blot assays during the period of KEMRON medication. This observation may suggest that in those patients who serodeconvert, antibodies to HIV virus have an extremely short half-life. It is also probable that anti-HIV antibody-producing cells may require constant stimulation to produce antibodies to HIV virus. These viral fractions and their corresponding antibodies are those routinely recognized by Western Blot and ELISA assays respectively. This observation is an important consideration in strategic planning for vaccine development. The p24 antigenemia was not assessed. The mechanism by which KEMRON acts on HIV-1 seropositive individuals is not known, and its fate when given orally is equally unknown. However, it is believed that modulation of the host immune response plays an important role. The active ingredient and the complex polysaccharide carrier to KEMRON may provide a concentration gradient for the transmucosal nHulFN-alpha to activate the immune system. This could be effectively achieved by the nHulFN-alpha binding onto specific mucosal receptors and the surrounding lymphatic tissue in the mouth and pharynx, thus triggering a cascade of immune response that acts systemically. Increased appetite is suggestive of central nervous system (probably pituitary-hypothalamus axis) effect similar to those of endorphine peptides. These observations call for further studies on the mechanism of KEMRON. ACKNOWLEDGEMENTS We thank Alex Wamachi, Charity Maingi, Rukia Kibaya, Francis Mbugua, David Libodo, Joseph Muita, Magdalene Kinyanjui, James Mwaniki and Geoffrey Gitau for technical assistance. We also thank Hayashibara biochemical Laboratories for the supply of natural human interferon alpha and Dr. Joseph M. Cummins of Amarillo Cell Culture for continued support and constructive criticisms. This paper was published with the permission from the Director, Kenya Medical Research Institute. Figure 1: Age distribution of patients with HIV infections and AIDS Number 0 10 20 30 40 50 60 70 80 90 100 |.....|.....|.....|.....|.....|.....|.....|.....|.....|.....| 11-20 XXXXXXXXXXXXX 19 Age 21-30 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 86 Range 31-40 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 72 (years) 41-50 XXXXXXXXXXXXX 20 51-60 XXXXX 7 Table 1: Karnofsky performance score (KPS) on patients on Kemron medication KPS Number of patients at Week 0 2 4 6 8 10 --- --------------------------- 10 0 0 0 0 0 0 20 18 2 1 0 0 0 30 13 3 1 0 0 0 40 21 9 1 1 0 0 50 26 10 5 1 0 0 60 15 17 6 1 0 0 70 26 29 8 0 0 0 80 36 30 5 2 2 0 90 44 71 67 11 3 0 100 5 33 110 188 199 204 Table 2: Observations during KEMRON medication (N = 200)* Characteristic Week 0 2 4 6 8 10 -------------------------------------------------------------------- A. Clinical 1. Fatigue/Weakness 131 38 24 3 1 0 2. Appetite or weight loss 142 20 7 2 1 0 3. Diarrhea (Salmonellosis) 101 27 10 4 1 0 4. Fever 96 18 11 7 0 0 5. Lymphadenopathy 41 21 11 7 2 0 6. Oral and esophageal candidiasis 93 21 5 2 0 0 7. Other infections (Pneumonia etc) 92 31 10 4 0 0 8. Skin rash 65 17 12 5 0 0 B. Serological 1. ELISA positive 200 196 191 188 186 186 negative - 4 9 16 18 18 2. W.B. positive 200 196 191 188 186 186 negative - 4 9 16 18 18 -------------------------------------------------------------------- * 125 males, 75 females REFERENCES 1. Interferon for treatment of hairy cell leukemia. _Med_Lett_Drugs_Ther. 28:18, 1986. 2. Altman, L. FDA approves first drug for an AIDS-related cancer. _New_ _York_Times_, November 3, p.31, 1988. 3. Ronel, S. Press release, Interferon Sciences, Inc. _New_Brunswick_, _New_Jersey_. October 10, 1989. 4. Bottomly, J.M. and Toy, J.L. Clinical side effects and toxicities of interferon. In: R.K. Oldham, N.B. Finter (eds). _Interferon_4_, Elsevier, North Holland, p.155, 1985. 5. Quesada, J.R., Talpaz, M., Rios, A., Kurzrock, r. and Gutterman, J.V. Clinical toxicity of interferons in cancer patients: a review. _J_Clin_ _Oncol_. 4:234, 1986. 6. Deyton, L.R., Walker, R.E., Kovacs, J.A. et al. Reversible cardiac dysfunctions associated with interferon alpha therapy in AIDS patients with Kaposi's sarcoma. _New_Engl_J_Med_. 321:1246, 1989. 7. Steed, V.P. Improved survival of four cats infected with feline leukemia virus after oral administration of interferon. _Feline_ _Practice_ 17:24, 1987. 8. Tompkins, M.B. and Cummins, J.M. Response of Felv-induced nonregenerative anemia to oral administration of a bovine interferon-containing preparation. _Feline_Practice_. 12:6, 1982. 9. Cummins, J.M., Tompkins, M.B., Olsen, R.G. et al. Oral use of human alpha interferon in cats. _J_Biol_Res_Mod_. 7:513, 1988. 10. Hutchinson, V. and Cummins, J.M. Oral interferon in an AIDS patient. _Lancet_ 2:1530, 1987. 11. Weight, S.E., Fagan, P., Blackburn, C. et al. Low dose oral interferon prophylaxis and therapy of HIV-1 seropositive individuals and contacts. Controlled study in progress in Amarillo, Texas, 1988-1989. 12. Koech, d.K. and Obel, A.O., Minowada, J., Hutchinson, V.A. and Cummins, J.M. Low dose oral alpha-interferon therapy for patients seropositive for human immunodeficiency virus type-1 (HIV-1). _Mol_Biotherapy_. 2:91, 1990. 13. Yates, J.W., Charmers, B. and McKegney, F.P. Evaluation of patients with advanced cancer using the Karnofsky performance status. _Cancer_. 45:2220, 1990. 14. Fakuda, S., Audo, S., Sanou, O. et al. Simultaneous production of natural human tumor necrosis factor and interferon from BALL-1 cells stimulated by NVJ. _Lymphokine_Res_ 7(2):175, 1988. ------------------------------------------------------------------------------ Title: KENYA: A TRIAL FIELD IN THE RACE AGAINST AIDS. 4 hits. ------------------------------------------------------------------------------- KENYA: A TRIAL FIELD IN THE RACE AGAINST AIDS AN INTER PRESS SERVICE FEATURE by Horace Awori NAIROBI, JUL 10 (IPS) -- Kenyans infected with AIDS are up in arms with their government for blocking a drug which they claim could have a positive therapeutic effect. "It is we who are suffering and dying and it's we who have tried this medicine. And we are testifying that it produces good results," a spokesperson for the Kenya Know AIDS Society told the country's minister of health, Mwai Kibaki. The society groups aids patients in this east African country where the Acquired Immune Deficiency Syndrome has created situations that are becoming difficult to handle, particularly for persons already afflicted by the scourge. The patients' appeal follows a government ban on a new, but controversial drug, 'Immunex' brought into Kenya for management of AIDS instead of another drug, 'Kemron, which has been hard to come by in local hospitals. Government maintains it will not allow 'Immunex' to be administered to AIDS patients until the Australian drug has been clinically tested and registered. But the government ban came weeks after the drug was imported into the country, distributed to pharmacies and prescribed for AIDS sufferers. The patients affirmed that AIDS symptoms disappeared within three weeks of application of 'Immunex.' Kenya's own interferon drug, Kemron, which was approved in 1989 for AIDS management is still under evaluation. 'Immunex' is reportedly produced by Encarich Development Limited of Victoria, Australia. "I would hate to be in Mwai Kibaki's shoes," a private medical practitioner here, Samuel Indiek, told IPS, "the cry of the AIDS sufferers is heart-rending but how far should the system bend its laws to allow any new discovery to be freely available in the pharmacies without trials?" A consultant psychiatrist who declined to be identified described the situation as "very tricky." "Just as the drug companies are out to make money fast and to test their medicines in poor countries, so are the AIDS sufferers desperately willing to try anything for a cure," he said. According to the psychiatrist, there are the dangers of society being blackmailed emotionally by the sufferers and the drug companies exploiting the plight of the patients. Referring to the Kenya Know AIDS Society's assertion that by holding back 'Immunex' the government wanted AIDS victims to die quickly, the psychiatrist said that was tantamount to emotional blackmail though understandable from those who see no hope of recovery. The World Health Organization estimates that between 500,000 and one million people around the world will die of AIDS-related diseases by the year 2000. Another 40 million will be carrying the Human Immunodeficiency Virus that leads to AIDS. According to medical sources here, the appearance of the 'Immunex' drug in Kenya is the work of those who initially worked with the Kenya Medical Research Institute (KEMRI), Amarillocell Culture Company (ACC) of Texas and Heyashibara Biomeclinical Laboratories of Japan. The three institutions were collaborators on Kemron. But shortly after the launch of Kemron, Kemri, ACC and its local distributing subsidiary, innovative therapeutics limited, were entangled in a dispute over ownership and distribution rights for the drug. Unconfirmed reports had it that a former worker of the ACC was behind the production of 'Immunex' by an Australian firm, Encarich Development Limited. ACC was reportedly pushing for a ban on 'Immunex' distribution and has threatened legal action against the drug manufacturers for infringement of patent rights. ------------------------------------------------------------------------------ THE CAPITOL SPOTLIGHT Washington's award winning newspaper Thursday, September 20, 1990 Volume 36 Number 47 COVER-UP Say African scientists cure for AIDS ignored by white press Black health officials have charged that white racism is to blame for the lack of publicity about a Kenyan drug hailed as an inexpensive cure for AIDS. Kenyan President Daniel Moi announced earlier this summer that a cure for acquired immune deficiency syndrome had been found - a drug called Kemron that is marketed by the Kenyan government. As a result of the drug, nearly 1300 HIV positive AIDS patients have had death threatening symptoms disappear and reclassified as HIV negative. "This is the first victory over AIDS and it's coming out of Africa, yet you haven't heard anything about it," said Gary Byrd, a New York radio talk show host who led a fact- finding mission to Kenya, where the above results have been documented. Byrd learned of the miraculous treatment from a series of articles in the New York Native, a gay publication. He then assembled a team of video and print journalists and a medical research team, headed by Dr. Barbara Justice, to travel to Kenya to find out firsthand if the claims were true. The fact-finding team conducted interviews, toured the state-of-the art medical facilities and were convinced that the findings were legitimate. Upon their return to New York, Byrd, host of the popular talk show "The Global Black Experience" On WLIB-AM, held a press conference at the world famous Apollo Theater. The Apollo press conference was jam-packed with medical personnel, community residents and representatives from various professions, but media representatives were few and far between. Outside of coverage in the Amsterdam News, and various appearances on local Black talk shows, the announcement went largely ignored. Dr. Justice also took an AIDS patient, Cedric Sandifford, who is well known to the New York community. It was his son who was killed in the infamous Howard Beach incident. Sandifford was dying from AIDS, which he contracted through IV drug use. "When we left New York, Cedric could barely keep up. Today he is responding to the treatment and it looks like he will be okay." Dr. Justice said. Black health officials contend that white-dominated news organizations did not publicize the drug because of a racially based distrust of African science, The New York Times reported. They also charged that the drug was played down because it posed competition for expensive AIDS medications offered by the white medical establishment. "I don't know how this works but there's nothing else that holds a candle to it," said Ronald Woodroof, of Dallas, Tx. He said after 122 days on the drug, he feels better than even before he had AIDS. ------------------------------------------------------------------------------