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

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*** WEBCAST: HIV/AIDS, TB, AND MALARIA ACT OF 2003***
View a full House International Relations
Committee markup of H.R.1298, the United
States Leadership Against HIV/AIDS, Tuberculosis,
and Malaria Act of 2003.
http://www.kaisernetwork.org/healthcast/internationalrelations/02apr03
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________________________________________



Thursday, April 3, 2003

POLITICS AND POLICY
========================================
1. House International Relations Committee Approves International AIDS
Bill, Amendments

2. New York Minority Legislative Caucus Calls on Pataki To Restore $12M in
AIDS Funding to State Budget

3. Public Advocate Blames New York City Health Department for Drop in AIDS
Funding


IN THE COURTS
========================================
4. Los Angeles HIV-Positive Prostitute Sentenced to 10 Years in Prison


GLOBAL CHALLENGES
========================================
5. Johannesburg Securities Exchange Considers Mandatory Corporate Reporting
of HIV/AIDS Cases Among Workers


OPINION
========================================
6. Bush Administration AIDS Initiative Must Take 'Concrete Steps' To
Protect Women, Young Girls, Opinion Piece Says

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

POLITICS AND POLICY

1. House International Relations Committee Approves International AIDS
Bill, Amendments

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=16969

The House International Relations Committee yesterday approved 37-8 an
amended bill (HR 1298) that would authorize $15 billion over five years to
fight global AIDS, the Washington Times reports (Fagan, Washington Times,
4/3). The bill, sponsored by Rep. Henry Hyde (R-Ill.), would allocate $3
billion a year for five years for HIV/AIDS, with up to $1 billion in fiscal
year 2004 going to the Global Fund to Fight AIDS, Tuberculosis and Malaria.
President Bush in his State of the Union address on Jan. 28 proposed
spending $15 billion over five years to fight HIV/AIDS in Africa and the
Caribbean. Bush's plan includes $10 billion in new money. Under the
initiative, new funds averaging an additional $2 billion per year would be
phased in gradually to supplement the $1 billion per year the government
now spends on AIDS; only $1 billion total would go to the Global Fund
(Kaiser Daily HIV/AIDS Report, 4/2). Hyde's bill endorses the "ABC"
approach of "abstinence, being faithful and, when appropriate, use
condoms," which has had success in lowering AIDS prevalence rates in Uganda
(Kaiser Daily HIV/AIDS Report, 4/1). But committee members rejected an
amendment sponsored by Rep. Joseph Pitts (R-Pa.) that would have provided
funding "priority" to programs promoting abstinence over those that focus
on condom use. Members instead approved 24-20 an amendment from Rep.
Barbara Lee (D-Calif.) that states that condom use is also a "priority
item." A second Pitts amendment that would have "explicitly permitted"
funding for faith-based groups -- even if they favor abstinence "at the
expense of condom use" -- was defeated 21-23 (MacFarland, CongressDaily
Markup Report, 4/2). The committee also approved an amendment by Rep. Dana
Rohrabacher (R-Calif.) that recommends that 10% of the funding go to help
orphans whose parents have died from AIDS-related causes (Abrams,
AP/Houston Chronicle, 4/3). In addition, the committee approved 24-22 an
amendment sponsored by Rep. Christopher Smith (R-N.J.) that would prohibit
funds from going to any group or organization that does not have a policy
"explicitly opposing prostitution and sex trafficking" (Abrams, AP/Fort
Worth Star-Telegram, 4/3). Other amendments include:

* A measure sponsored by Rep. Nick Smith (R-Mich.) that would have
authorized more funds for the later years of the five-year initiative
instead of the first years was defeated 15-25.

* A measure sponsored by Rep. Sherrod Brown (D-Ohio) that would require the
U.S. Agency for International Development to show more accountability for
its TB programs passed by voice vote.

* An amendment by Rep. Grace Napolitano (D-Calif.) that would give priority
to groups that already provide mother-to-child HIV transmission prevention
programs was approved by voice vote.

* An amendment by Rep. Howard Berman (D-Calif.) that would "recognize[e]
the importance" of the public-private partnership Medicines for Malaria in
developing new anti-malaria medicines was approved by voice vote.

* A measure sponsored by Rep. Jeff Flake (R-Ariz.) that would reduce the
amount of federal funding for the Global Fund by an amount equal to the
amount provided by the fund to governments on the State Department's
terrorism list was approved by voice vote. Money provided by the Global
Fund to nongovernmental organizations in such countries would not be
affected by the amendement.

* An amendment from Rep. Betty McCollum (D-Minn.) that would make
physician's assistants eligible to participate in a pilot program for the
placement of health care professionals in other countries "severely
affected" by HIV/AIDS, TB and malaria passed by voice vote (CongressDaily
Markup Report, 4/2).

* An amendment from Rep. JoAnn Davis (R-Va.) that would require an analysis
of HPV in sub-Saharan Africa and the "impact that condom usage has upon the
spread of HPV in sub-Saharan Africa" was approved unanimously, according to
Roland Foster, a senior staff member of the House Government Reform
criminal justice, drug policy and human resources subcommittee (Foster,
E-mail correspondence, 4/2).

Hyde, who opposes abortion rights, has avoided the abortion issue by
excluding language from the bill that prohibits federal funding from going
to health and family planning groups that perform or counsel on abortion.
The so-called "Mexico City" 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 (Kaiser Daily HIV/AIDS Report, 4/1). The Bush
administration had shown support for extending the policy to HIV/AIDS
efforts (Kaiser Daily HIV/AIDS Report, 3/18). Hyde said, "I am doing
everything humanly possible to separate abortion from this effort." Hyde
added that abortion is not addressed in the measure because it would "kill
the bill" (Sweet, Chicago Sun-Times, 4/3).

Reaction


White House spokesperson Scott McClellan said, "We're pleased that they're
moving forward with this important priority," adding that the
administration will work with lawmakers to pass a bill "that is consistent
with what the president proposed" (Abrams, AP/Boston Globe, 4/3). Some
critics of the measure have said that they disagree with channeling funds
through the Global Fund. A House aide said, "The Global Fund is
ineffective and bureaucratic." But Dr. Paul Zeitz, executive director of
the Global AIDS Alliance, defended the fund calling it "super-efficient"
(Cusack, The Hill, 4/1). Zeitz also said, "This is something everyone
ought to unite around. The bill approved [yesterday] takes the AIDS crisis
seriously, and it shows that a broad range of members of Congress favor a
pragmatic approach. Now it's up to Congress to see [that] this money is
actually provided so effective programs can do their work" (Cobb,
AllAfrica.com, 4/3). Michael Weinstein, president of the AIDS Healthcare
Foundation, said that the "swift" passage of the bill will "help to save
millions from the certainty of death by providing treatment and the money
to purchase life-sustaining AIDS drugs for Africa and the developing world"
(AHF release, 4/2). Jamie Drummond, executive director of Debt, AIDS,
Trade in Africa, said, "House leadership should move swiftly to schedule a
vote on the ... bill, to send a clear message to other rich countries that
they must join America in stepping up the struggle against AIDS in Africa,"
adding, "Many more steps need to be taken for the U.S. initiative to save
tens of millions of lives. AIDS supporters in the Senate ... will have to
guide authorizing legislation through the Senate" (DATA release, 4/2).
Mark Isaac, vice president of the Elizabeth Glaser Pediatric AIDS
Foundation, said that the bill's passage "sends a strong signal that we can
get a bipartisan global AIDS bill passed this year." He added that the
group is "very pleased" that the measure "puts a high priority on programs
to prevent [vertical HIV transmission] and includes provisions to provide
care and treatment programs for families" (EGPAF release, 4/2). Dr. Nils
Daulaire, president and CEO of the Global Health Council, said, "This is a
very solid bill to address a very serious problem. The levels are right,
the ramp-up is early, and we are especially heartened by the policy
language that calls for an integrated strategy of prevention, care and
treatment. ... We urge the full House and the full Senate to pass this
legislation quickly" (GHC release, 4/2). The bill could see action on the
House floor by next week (AllAfrica.com, 4/3).

A kaisernetwork.org HealthCast of the committee mark-up session is
available online.

2. New York Minority Legislative Caucus Calls on Pataki To Restore $12M in
AIDS Funding to State Budget

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=16970

Members of the New York state minority legislative caucus yesterday urged
Gov. George Pataki (R) to restore the nearly $12 million in funding for
AIDS prevention programs that was cut from his proposed budget and called
for an additional $96 million in funding for antiretroviral drugs, the
AP/Long Island Newsday reports. Pataki's budget currently allots $2.6
billion for AIDS funding in the state, a $288 million increase over the
last fiscal year, Kevin Quinn, spokesperson for the state Budget Division,
said. He added that 80% of the $2.6 billion is scheduled to be spent on
minorities. The proposed budget cuts $11.9 million from the New York State
Department of Health AIDS Institute, which provides AIDS prevention
education programs and legal, medical and housing services for people with
HIV/AIDS. The group urged the restoration of prevention funds, citing new
statistics that show that 90% of HIV-positive women in New York are black
or Hispanic. "This problem will continue to exist unless we make it a
priority to target those in need to fight this disease, and women of color
are most in need," Assembly member Roger Green (D), chair of the Black,
Puerto Rican and Hispanic Legislative Caucus, said, adding, "We don't want
this problem to be marginalized." More than one-fourth of the 56,000 AIDS
cases in the state are women, and of those women, 91% are minorities --
60.7% black and 30.1% Hispanic. In addition, AIDS cases among women in New
York state account for 25% of the total number of AIDS cases nationwide,
according to a 2001-2002 state report. The caucus also asked Pataki to
provide in the budget an additional $96 million for antiretroviral drugs to
be distributed through the state's AIDS Drug Assistance Program, an amount
the governor had originally proposed through the Health Care Reform Act
reauthorization bill. The program provides antiretroviral drugs and
medical services to 22,000 uninsured people living with AIDS. "No governor
has done more to combat AIDS and HIV than Gov. Pataki, and even in the face
of the largest budget gap in state history, he has proposed a budget that
has increased AIDS funding by $300 million," Quinn said (Adcox, AP/Long
Island Newsday, 4/2).

3. Public Advocate Blames New York City Health Department for Drop in AIDS
Funding

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=16971

Public Advocate Betsy Gotbaum on Monday called the New York City Health
Department's failure to submit AIDS funding applications on time
"reprehensible" and blamed the agency for a $14 million cut in federal AIDS
funds, the Long Island Newsday reports (Ramirez, Long Island Newsday, 4/2).
HHS awarded New York City 12% less than last year in federal Ryan White
CARE Act funds this year, the largest reduction nationwide. Although the
allocation of funds based on the number of AIDS cases in New York City
increased, the allocation of supplemental funds based on severity of need
decreased from $48 million last year to $32 million this year (Kaiser Daily
HIV/AIDS Report, 3/31). The department's "failure to demonstrate severe
need for a city with the highest number of AIDS cases in the country and
maintain supplemental funding is reprehensible," Gotbaum said, adding, "The
city's failure to simply submit required paperwork on time does not only
cost money, it costs lives." City Health Commissioner Thomas Frieden
denied that the city's application was at fault for the cuts. The HIV
Planning Council, the citywide panel that decides how to distribute Ryan
White funds, will meet today to discuss how to deal with the cuts. "The
city must do whatever it takes to find some money and avoid cuts for
services to people with AIDS," Terri Smith-Carona, a member of the
council's finance committee, said. Mayor Michael Bloomberg (R) on Sunday
said that the city will fight to restore the funds. "We have a commitment
to cut the number of AIDS infections by 50% by 2005. I want to meet that
commitment. We have plenty of people who are HIV-positive or have AIDS and
we've got to make sure that we take care of them," he said (Long Island
Newsday, 4/2).


IN THE COURTS

4. Los Angeles HIV-Positive Prostitute Sentenced to 10 Years in Prison

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=16972

Donnie Ray Bobo, who first learned that he was HIV-positive more than 10
years ago while in prison, on Tuesday was sentenced by a Los Angeles
Superior Court Judge to 10 years in prison for prostitution, the Los
Angeles Times reports. Bobo pleaded no contest to the felony prostitution
charge, marking his fifth prostitution conviction since he learned of his
HIV-positive status, according to the Times. Although prostitution is
usually a misdemeanor charge, someone can be charged with a felony if they
have previously tested positive for HIV. Judge John Doyle said that he
gave Bobo the 10-year sentence to "protect society." Doyle said, "[Bobo's]
background is grim, his prospects are even more grim, and his
characteristics are such that every time he gets out of prison, he gets
back on the street and renders someone else susceptible to the HIV virus."
Bella Dilworth, Bobo's lawyer, said that judges "overreact to a lot of
tragic things." Laurie Levenson, a Loyola Marymount University law
professor, said that the sentence was "harsh" but the circumstances were
"unique," adding, "They're almost treating it the same way as serious
assaults or an attempted-murder case." Levenson said that she is unsure of
what the results of the sentence will be due to the potential spread of HIV
in prison, according to the Times. "There are big question marks as to
whether this is the solution for dealing with people with HIV," Levenson
said (Bonilla, Los Angeles Times, 4/2).


GLOBAL CHALLENGES

5. Johannesburg Securities Exchange Considers Mandatory Corporate Reporting
of HIV/AIDS Cases Among Workers

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=16973

The Johannesburg Securities Exchange is considering requiring companies
listed on the exchange to include employee HIV/AIDS rates in their
financial reports, the Wall Street Journal reports. Russell Loubser,
president of the exchange, said that the requirement is currently under
discussion. "We are working with the South African Institute of Chartered
Accountants, listed companies and a range of other parties to see if it's
possible to have an accounting standard and some sort of reporting
requirements specifically related to HIV/AIDS," he said. The JSE ranks as
the 14th largest exchange by market capitalization and currently lists 462
companies (Wall Street Journal, 4/2). Approximately 30% of the companies
listed on the exchange already report HIV/AIDS statistics. A number of
banks, including Deutsche Bank and Dresdner Bank, have said that HIV/AIDS
statistics will have to be included in financial forecasting, stock
selection, asset allocation and risk underwriting (Kaiser Daily HIV/AIDS
Report, 3/25). Many people have been calling for the requirement under the
rationale that a company's financial health is tied into the health of its
workers (Wall Street Journal, 4/2). Labor-intensive industries, such as
mining, have been particularly hard hit by HIV/AIDS, and service industries
such as banking and food products may have to project slower growth in
coming years due to a declining consumer base (Kaiser Daily HIV/AIDS
Report, 3/25). The JSE last year conducted voluntary and anonymous staff
testing. Of 320 workers, 210 employees took the test, and four people were
found to be HIV-positive. "We wanted to go through the same sort of
process that other organizations will have to experience down the line,"
Loubser said (Wall Street Journal, 4/2).


OPINION

6. Bush Administration AIDS Initiative Must Take 'Concrete Steps' To
Protect Women, Young Girls, Opinion Piece Says

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=16974

The United States "can take concrete steps to tackle widespread [HIV]
transmission among women and girls by making their protection a priority"
in President Bush's new AIDS initiative, Janet Fleischman, Human Rights
Watch Washington director for Africa and chair of the Working Group on
Women and Girls of the HIV/AIDS Task Force established by the Center for
Strategic and International Studies, writes in an International Herald
Tribune opinion piece (Fleischman, International Herald Tribune, 4/2).
President Bush in his State of the Union address on Jan. 28 proposed
spending $15 billion over five years to fight HIV/AIDS in Africa and the
Caribbean (Kaiser Daily HIV/AIDS Report, 4/2). In many parts of Africa,
HIV is more prevalent among teenage girls than among boys because the AIDS
epidemic "is being fueled by the abuse and subordination of young women,"
Fleischman states. She says that sexual violence and coercion; men
choosing increasingly younger women as sex partners; the growing number of
AIDS orphans; the sex trade; and a lack of action by legal authorities all
contribute to high HIV rates among women. Therefore, Fleischman states
that an "integrated response is needed." She says that the response should
include expanding social services, strengthening property and inheritance
rights, investigating and prosecuting sexual violence and coercion and
"dramatically expand[ing] treatment possibilities" to keep young girls'
parents alive longer. Such actions "are not very costly compared to many
other elements of AIDS programs," Fleischman says, concluding that if plans
for the Bush administration's initiative do not include such measures to
protect the rights of women and young girls, "it will be impossible to curb
the AIDS epidemic" (International Herald Tribune, 4/2).


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