KAISER DAILY HIV/AIDS REPORT
A service of kaisernetwork.org
http://www.kaisernetwork.org/dailyreports/hiv

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*** WEBCAST: GLOBAL HIV/AIDS***
View webcasts of select sessions from the
Center for Strategic and International
Studies Task Force on HIV/AIDS meeting.
http://www.kaisernetwork.org/healthcast/csis/feb03
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
________________________________________



Monday, March 3, 2003

POLITICS AND POLICY
========================================
1. More Than 130 AIDS, Family Planning Groups Sign Letter To Bush Denouncing
Use of 'Mexico City' Policy in New AIDS Initiative


PUBLIC HEALTH & EDUCATION
========================================
2. Religious Groups Participate in Black Church 'Week of Prayer for the Healing
of AIDS'


GLOBAL CHALLENGES
========================================
3. Asian Businesses Must Address HIV/AIDS, Global Business Coalition on
HIV/AIDS Says


DRUG ACCESS
========================================
4. Texas Board of Health Will Not Revise Eligibility Requirements for State
AIDS Drug Assistance Program


SCIENCE & MEDICINE
========================================
5. Los Angeles Times Examines AIDS Vaccine Research After Announcement That
AIDSVAX Failed To Reduce HIV Infection Rate


MEDIA & SOCIETY
========================================
6. New York City's WNBC Interviews U.N. Special Envoy for HIV/AIDS in Africa
Stephen Lewis


OPINION
========================================
7. New York Times Features Opinion Pieces on Domestic, Global HIV/AIDS Funding,
Other Issues

8. HIV/AIDS Researchers Should See VaxGen Announcement as 'Challenge' Not
'Defeat,' Editorial Says

9. Political Economy, Political Anthropology Must Have Place in Debate Over
AIDS in South Africa, Opinion Piece Says

****************************************


POLITICS AND POLICY

1. More Than 130 AIDS, Family Planning Groups Sign Letter To Bush Denouncing
Use of 'Mexico City' Policy in New AIDS Initiative

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=16322

More than 130 nongovernmental organizations on Feb. 26 sent a letter to
President Bush asking him to abandon plans to make organizations that wish to
receive federal AIDS funding comply with the so-called "Mexico City" policy,
which prohibits federal aid from going to groups that fund or promote abortion,
the Washington Times reports (Carter, Washington Times, 3/3). In the letter,
the groups cite the WHO Global Sector Strategy for HIV/AIDS, which says that
existing family planning programs "provide a clear entry point for the delivery
of HIV/AIDS interventions." The groups state that integrated family planning
and AIDS counseling programs are the "best approach to improving public health"
and provide "a source of information and resources free from the stigma
frequently associated with stand-alone HIV prevention programs." The letter
calls on Bush to "eliminate barriers to effective programs not erect new ones"
(Letter text, 2/26). The policy -- which was originally implemented by
President Reagan at a population conference in Mexico City in 1984, removed by
President Clinton and reinstated by Bush on the first day of his presidency --
"bars U.S. money from international groups that support abortion, even with
their own money, through direct services, counseling or lobbying activities."
Under the new policy, outlined by a senior Bush administration official in a
memo to the State Department, social services groups that deal with abortion
services would have to "administer AIDS programs separately from family
planning" in order to receive funds from the administration's new AIDS
initiative (Kaiser Daily Reproductive Health Report, 2/26). Paula Dobriansky,
undersecretary of state for global affairs, last week at a forum on AIDS in
Africa at the Center for Strategic and International Studies said, "Can anyone
apply? Yes. They can apply [for funding] even if they are noncompliant with
Mexico City. The money is intended for programs relevant to HIV. They cannot
use the money for abortion-related activities." However, many groups argue that
it is impossible to "compartmentalize" HIV/AIDS counseling from reproductive
health counseling, according to the Times (Washington Times, 3/3).

NPR's "All Things Considered" on Friday reported on the Bush administration's
application of the Mexico City policy to HIV/AIDS funding. The segment includes
comments from Jodi Jacobson, executive director of the Center for Health and
Gender Equity, and Connie Mackey, executive director for government affairs at
the Family Research Council (Wilson, "All Things Considered," NPR, 2/28). The
full segment is available in RealPlayer online.


PUBLIC HEALTH & EDUCATION

2. Religious Groups Participate in Black Church 'Week of Prayer for the Healing
of AIDS'

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=16323

The 14th Annual Black Church Week of Prayer for the Healing of AIDS, which
seeks to mobilize the black religious community to become involved in fighting
the disease through prayer, music, plays, speeches and discussions, started
yesterday, the Kansas City Star reports (Klein, Kansas City Star, 3/1). The
Week of Prayer is sponsored by The Balm in Gilead, a not-for-profit group that
seeks to stem the spread of HIV/AIDS in the black community by encouraging
churches and faith-based groups to provide education and support networks for
all people living with and affected by the disease (The Balm in Gilead release,
2/7). "There's a feeling of apathy in the African-American community, a feeling
of invulnerability. We're trying to make people understand that everyone's at
risk," Rev. David Gilmore, vice chair of the Black Church Week of Prayer in St.
Louis, said. AIDS is the leading cause of death for black women ages 25 to 34
and for black men ages 35 to 44. Blacks accounted for nearly half of all new
AIDS cases in 2001, according to statistics from the CDC (Kansas City Star,
3/1). Pernessa Seele, founder and CEO of The Balm in Gilead, developed the
prayer week 14 years ago after her work as an immunologist at a Harlem hospital
exposed her to a trend of many HIV-positive blacks being abandoned by their
families and churches. "One of the reasons the church didn't get involved was
because of its theological stance on homosexuality. When people said it was a
gay white man's disease, the church said that's not us," Rev. Alberta Ware,
director of church and community mobilization for The Balm in Gilead, said
(Gutierrez-Mier, Fort Worth Star-Telegram, 3/1). Since 1989, involvement in The
Balm in Gilead has grown from 50 Harlem churches to more than 10,000 churches
nationwide (Dyer, Pittsburgh Post-Gazette, 3/1).


GLOBAL CHALLENGES

3. Asian Businesses Must Address HIV/AIDS, Global Business Coalition on
HIV/AIDS Says

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=16324

Businesses in Asia have "not done nearly enough" to combat the spread of
HIV/AIDS in the region, members of the Global Business Coalition on HIV/AIDS
said on Friday at a media briefing on the eve of the Williamsburg Conference, a
gathering of Asian and American leaders in Bangkok, Thailand's Nation reports.
"The HIV problem here is the tip of the iceberg, especially in the workplace"
and "only 10% of what [businesses] should have done has been done," GBC
President and CEO Richard Holbrooke, former U.S. ambassador to the United
Nations, said (Khwankhom, Nation, 3/1). Asia has an estimated 7.2 million
people living with HIV/AIDS, according to U.N. statistics (Peck, Associated
Press, 2/28). The majority of those cases are among people of working age
(Nation, 3/1). Holbrooke said that the epidemic is "too big a problem for
governments alone," adding that businesses must help by educating their
employees on HIV/AIDS, providing free HIV/AIDS testing and treatment and
encouraging other companies to take similar measures (Associated Press, 2/28).
The GBC released a new briefing paper advising companies on how to address the
stigma surrounding HIV/AIDS and workplace discrimination. Bill Black,
co-founder of the Asian Business Coalition on AIDS and the Business Coalition on
AIDS in Singapore, said, "AIDS is a management issue that needs to be handled
just as any other business issue. With commitment and collaboration, companies
can educate their workers and extend awareness to the communities in which they
operate" (GBC release, 2/28).


DRUG ACCESS

4. Texas Board of Health Will Not Revise Eligibility Requirements for State
AIDS Drug Assistance Program

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=16325

HIV-positive individuals and AIDS advocates on Thursday "gained a small but
significant victory" when the Texas Board of Health tabled a proposal to
restructure eligibility requirements for the state's AIDS Drug Assistance
Program, the Houston Chronicle reports. Instead, the board directed the health
department to find other ways to save money and report back in June
(Villafranca, Houston Chronicle, 2/27). Currently, the Texas HIV Medication
Program allows about 12,500 low-income HIV-positive Texans to buy prescription
drugs at a greatly reduced cost. Health department officials expect a $34
million shortfall in the program's budget over the next two-year cycle; the
program's annual budget is $58 million. As a result, health department officials
had proposed revised eligibility requirements under which people earning more
than 140% of the federal poverty level, or $12,400 annually, would no longer be
eligible for the program. Current requirements allow beneficiaries who earn up
to 200% of the poverty level, or $17,720 annually, to participate in the
program. If they had been approved, the new requirements would have effectively
cut 2,500 people from the program's rolls by August 2005 and kept up to 50 new
applicants from qualifying each month (Kaiser Daily HIV/AIDS Report, 1/21).

Legislature Should Address Funding, Advocates Say


The health department received 800 letters opposing the changes, as AIDS
advocates said that the new requirements would have made it "much more
difficult" for HIV-positive patients to obtain antiretroviral drugs, according
to the Fort Worth Star-Telegram. "We heard a resounding 'don't want to go
there' from the public," Sharilyn Stanley, associate commissioner for disease
control and prevention, said, adding, "We clearly have to make some changes in
the program to live within the dollars that we have currently allocated."
Stanley said that the health department may consider implementing copayments,
temporarily halting new enrollments, tightening medical criteria for admission
or asking cities that receive federal AIDS funding to help the state pay for the
program. "If there are not new dollars appropriated, then we have to change the
program and that will mean that we can't continue to enroll everyone who wants
to access the program," she said (Kirsch, Fort Worth Star-Telegram, 2/28).
"It's kind of a mixed victory," Tracy Wilson of the Houston-based AIDS Coalition
of Texas Now, said, adding that her group wants the Legislature to decide how
much money the HIV drug program should receive (Houston Chronicle, 2/27).
Health Commissioner Eduardo Sanchez has also said that it will be up to the
Legislature to allocate money to the program to keep it running. According to
the Associated Press, the health department has asked for more funding for the
program in the coming two-year budget cycle. Rep. Garnet Coleman (D), who
supports the ADAP program, commended Sanchez and the board for their decision.
"The future of this program now rests with the Legislature," he said (Shannon,
Associated Press, 2/27).


SCIENCE & MEDICINE

5. Los Angeles Times Examines AIDS Vaccine Research After Announcement That
AIDSVAX Failed To Reduce HIV Infection Rate

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=16326

Following the announcement last week that Brisbane, Calif.-based VaxGen's
AIDSVAX vaccine failed to reduce the HIV infection rate among participants in
Phase III human trials, "researchers and advocates are not giving up," the Los
Angeles Times reports. According to the Times, 19 other AIDS vaccines that use
different strategies are currently in human clinical trials and other vaccines
"remain in the pipeline, keeping alive the hope that at least one will someday
tame the global spread" of HIV. However, researchers warn that "large-scale
progress isn't expected any time soon," the Times reports (Allen, Los Angeles
Times, 3/3). The complete article is available online.


MEDIA & SOCIETY

6. New York City's WNBC Interviews U.N. Special Envoy for HIV/AIDS in Africa
Stephen Lewis

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=16327

New York City television station WNBC's "Gabe Pressman's NEWS FORUM" yesterday
interviewed U.N. Special Envoy for HIV/AIDS in Africa Stephen Lewis. Lewis said
that drug companies and African nations have worked to reduce the cost of
HIV/AIDS drugs to $300 per person per year and that if the "donor nations were
to give the resources, which they've promised, but never delivered on, we could
make a huge difference to the pandemic and ... prolong and save lives." Lewis
said that President Bush's plan to increase funding for HIV/AIDS in Africa will
"make a real difference" in fighting the disease, but he added that the Global
Fund to Fight AIDS, Tuberculosis and Malaria needs "a good deal more" than
Bush's pledge. Lewis also talked about how HIV/AIDS has "fractur[ed] and
dismember[ed]" African societies and could cause an increase in terrorism. In
addition, he addressed how a war with Iraq could "diminis[h]" the United States'
response to HIV/AIDS in Africa (Pressman, "Gabe Pressman's NEWS FORUM," WNBC,
3/2). A transcript of the interview is available online.


OPINION

7. New York Times Features Opinion Pieces on Domestic, Global HIV/AIDS Funding,
Other Issues

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=16328

The New York Times on Saturday featured a series of opinion pieces, titled
"The New AIDS Fight," on funding for anti-HIV/AIDS efforts both domestically and
internationally. The following summarizes those pieces:

* "A Plan as Simple as ABC" by Edward Green, a medical anthropologist at the
Harvard School of Public Health and author of the forthcoming book "Rethinking
AIDS Prevention": The United States must go "beyond the fruitless battle
between the abstinence and condom camps" and develop a "balanced approach" to
fighting HIV/AIDS, Green says. Green explores how the abstinence-based approach
of "ABC" -- abstain, be faithful and use condoms if those options fail -- was
successful in preventing the spread of the epidemic in Uganda. However, because
the approach has been "embraced" by U.S. conservatives, many AIDS groups are
"reluctant" to believe it works, Green says. He cites a 2002 United Nations
study, which found that the "majority of Africans" cite behavior change and
"becoming monogamous" as their first-line response to the epidemic, as opposed
to condom use. Green concludes that AIDS advocates should "recogniz[e] that
Africa and the West have different types of epidemics" and support programs that
utilize the ABC technique (Green, New York Times, 2/1).

* "Protect Women, Stop a Disease" by Kati Marton, a member of the board of the
International Women's Health Coalition and author of "Hidden Power:
Presidential Marriages That Shaped Our Recent History": An effective AIDS
program must empower women to "defend themselves against men who are infecting
and abandoning them," and the Bush administration's policy in these areas has
been "worse than disappointing," Marton says. "[S]exual coercion, violence
against women, child marriage, polygamy and the widespread belief that having
sex with a virgin will cure AIDS" have combined to make girls in sub-Saharan
Africa four to seven times more likely than boys to be become infected, she
adds. Marton states that administration policies, such as prohibiting any group
that receives funds from performing or discussing abortions and opposition to
condom distribution, have prevented organizations that are "already well
positioned to provide women with [a] full range of [health] services" from
taking action. Congress should authorize the president's proposed funds for
international AIDS initiatives "only if girls' and women's needs are central,"
Marton concludes (Marton, New York Times, 2/1).

* "Don't Forget This Infectious Killer" by Ponsiano Ocama, a specialist medical
officer at Makerere University Teaching Hospital in Kampala, Uganda, and
William Lee, professor of internal medicine at the University of Texas
Southwestern Medical Center-Dallas: It is "foolish" to treat HIV "without at
the same time" diagnosing and treating hepatitis B and C, Ocama and Lee say.
Four hundred million people worldwide have hepatitis B, 10 times the number of
people with AIDS, they add. Inexpensive and reliable tests must be made widely
available in Africa to stop the spread of the disease, they conclude (Ocama/Lee,
New York Times, 2/1).

* "Generic Drugs Can Make the Money Last" by Mamphela Ramphele, a managing
director at the World Bank, and Nicholas Stern, the chief economist of the World
Bank: American leadership in helping developing nations get better access to
drugs to fight public health epidemics such as HIV/AIDS "would be a fitting
complement to President Bush's generous pledge" of increased HIV/AIDS funding,
Ramphele and Stern write. Because developing nations represent only 1% of the
global pharmaceuticals market, "allowing [the countries] to import generics
would hardly erode incentives for Western conglomerates" to conduct new
research. The authors conclude that while an agreement on generics "would not
solve these countries' health problems ... continued legal access to generics
for the poorest countries is vital to improving their health care systems"
(Ramphele/Stern, New York Times, 2/1).

* "Race, Sex and Stigmas" by Tricia Rose, author of the forthcoming book
"Longing to Tell: Black Women Talk about Sexuality and Intimacy" and a professor
of American studies at the University of California-Santa Cruz: Although black
women make up less than 15% of the U.S. female population, they represented 64%
of all new AIDS cases among U.S. women in 2001, Rose says. Despite these
statistics, "it is difficult to find any public [AIDS education] campaign that
focuses specifically on ... black women," she adds. Rose states that a social
and cultural legacy of "distorted notions" about black women's sexuality has led
many black women to "retrea[t] into silence" and "neglect to adopt" safe sex
practices. Any program that seeks to lower AIDS rates among this population
must also address "the racial legacies of sexual stigma and the silences they
have produced" to "make room for a new cultural language on sexuality that will
help us navigate this crisis," she concludes (Rose, New York Times, 2/1).

* "Waging a Global Battle More Efficiently" by Paul Zeitz, executive director of
the Global AIDS Alliance: While the president's pledge to increase HIV/AIDS
funding is "encouraging [and] even historic," the plan "fails to make use of the
most efficient way to distribute the money," which is through the Global Fund to
Fight AIDS, Tuberculosis and Malaria, Zeitz says. Even if Congress quickly
approves the president's initiative, the bureaucracy through which the funds
must pass will prevent African nations from experiencing the effect of the money
"for almost two years," he writes. He states that in contrast, the Global Fund
"can deliver assistance in a matter of months [and] has strong safeguards to
ensure the proper use of funds and spends only 3% on administrative overhead."
In addition to directing money towards the fund, the United States should
augment the AIDS initiative with programs that would provide "better access to
clean water and good nutrition" and "mandat[e] debt cancellation," Zeitz
concludes (Zeitz, New York Times, 2/1).
8. HIV/AIDS Researchers Should See VaxGen Announcement as 'Challenge' Not
'Defeat,' Editorial Says

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=16329

HIV/AIDS advocates should not be "defeated" by the results of VaxGen's AIDSVAX
trial but should instead consider the results a "challenge" to continue with
similar research, an Atlanta Journal-Constitution editorial says (Atlanta
Journal-Constitution, 2/28). Last week, Brisbane, Calif.-based biotech firm
VaxGen, the makers of AIDSVAX, the first AIDS vaccine to be tested in a Phase
III clinical trial, announced that the vaccine failed to protect the overall
study population from HIV infection. However, VaxGen also said that the
vaccine, which mimics the protein gp120 in an attempt to stimulate antibody
production, was effective among African Americans, Asians and other non-white,
non-Hispanic volunteers. VaxGen said that in a subgroup of 498 non-white,
non-Hispanic volunteers the vaccine "appeared to provide protection in the range
of 30% to 84%" (Kaiser Daily HIV/AIDS Report, 2/27). Those findings are
"intriguing enough to justify further investigation," the editorial continues.
The editorial concludes that prevention and education "only go so far" in
efforts to curb the spread of HIV, adding, "Wealthy nations, including [the
Bush] administration, must help by committing more resources to researchers
instead of offering just a Band-Aid" (Atlanta Journal-Constitution, 2/28).

9. Political Economy, Political Anthropology Must Have Place in Debate Over
AIDS in South Africa, Opinion Piece Says

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=16330

The July 2002 ruling by the South African Constitutional Court that the
government must provide nevirapine to HIV-positive pregnant women and the
October cabinet statement supporting wider availability of antiretroviral drugs
"may have finally ushered in a new era" in the debate over AIDS in South Africa,
Didier Fassin, director of the Centre de Recherche sur les Enjeux Contemporains
en Sante Publique at the University of Paris, and Helen Schneider, director of
the Center for Health Policy at the School of Public Health at the University of
Witwatersrand, write in an "Education and debate" piece in the March 1 issue of
BMJ. "It should now be possible to discuss the reality of AIDS in South Africa
without reducing the argument to simple dualisms (such as being for or against a
viral cause of AIDS, for or against the president)," they write. The authors
propose an approach for discussion of the epidemic in South Africa that involves
political economy and political anthropology. Fassin and Schneider state that
three social factors -- social inequalities, mobility and sexual violence --
"seem to place South Africa at a higher risk of HIV." Further, the authors
state that these three factors are "partly the legacy of centuries of colonial
exploitation and racial segregation, culminating in the institution of apartheid
in the second half of the 20th century."

A 'Resource for Democracy'


However, Fassin and Schneider write that a political economy of AIDS cannot
altogether explain the suspicion in South Africa of science and orthodox
beliefs; history shows that a "racialization" of issues and a "theme of
conspiracy against Africans" have contributed to the "somewhat contradictory
notion that the AIDS epidemic and its treatments are part of a plot to eradicate
the black population." The authors write, "The marks of apartheid are still
deeply inscribed in the bodies and minds of the people who had to suffer under
it ... and the country's AIDS crisis manifests the legacy of the politics of the
past." They state that limiting the explanation of HIV to poverty is "certainly
an oversimplification" and that the factors of inequality, mobility and violence
must be considered in constructing public health policies. In addition,
focusing only on behavior change or treatment would be overlooking such social
factors, they write. Fasin and Schneider conclude, "In South Africa, AIDS is
not just a tragic and dramatic phenomenon: through the mobilization of
activists as well as lay people and through the fight for social justice it has
also come to be a resource for democracy" (Fasin/Schneider, BMJ, 3/1).



________________________________________


-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a service
of The Henry J. Kaiser Family Foundation, by The Advisory Board Company. © 2003
by The Advisory Board and Kaiser Family Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily HIV/AIDS Report,
please contact Larry Levitt, Kaiser Family Foundation vice president,
editor-in-chief, kaisernetwork.org; Joshua Perin, editor-in-chief, Daily
Reports; Alyson Browett, editor, Kaiser Daily HIV/AIDS Report; or Susannah
Hunter, associate editor, at dailyreports@....
-------------------------------------------------------
kaisernetwork.org Contacts:
Marla Bolotsky, Vice President; Director, Online Information
Robin Sidel, Senior Outreach Associate
Dana Greil, Online Coordinator
For questions and further information about kaisernetwork.org, please contact us
at info@... or at 202-347-5270.
--------------------------------------------------------
Manage Your Email Subscription at http://www.kaisernetwork.org/email .
SUBSCRIBE by choosing "Create a new subscription."
CHANGE your subscription by logging in and choosing "Update your Report
Preferences."
UNSUBSCRIBE by logging in and choosing "Please delete my profile."
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family Foundation. For access
to the Foundation's policy research, analyses, reports and fact sheets, and
media partnerships, visit the Foundation's main website at www.kff.org.