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



Tuesday, April 8, 2003

ACROSS THE NATION
========================================
1. New Orleans Awaits Stalled Federal Housing Funds for People Living With
HIV/AIDS

2. U.S. Teen AIDS Rates Increase as Successful Treatments Foster Feelings
of Invincibility


GLOBAL CHALLENGES
========================================
3. World Bank Loans Russia $150 Million For Five-Year National Plan To
Combat HIV/AIDS, Tuberculosis

4. Former President Clinton During Caribbean Tour Praises Bahamas' Efforts
To Fight AIDS


OPINION
========================================
5. House AIDS Bill Could Save Lives, 'Propel' United States to 'Forefront'
of AIDS Fight

6. Gates Foundation Grant for Microbicide Research 'Fills Void' Left by
Pharmaceutical Companies, Editorial Says

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

ACROSS THE NATION

1. New Orleans Awaits Stalled Federal Housing Funds for People Living With
HIV/AIDS

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17039

New Orleans' receipt of federal funds from the Housing and Urban
Development Department for people with HIV/AIDS has been delayed, causing
many low-income, HIV-positive individuals in the area to fall short on
paying bills and rent, the New Orleans Times-Picayune reports. HUD's
Housing Opportunities for People With AIDS program reimburses local
agencies for providing housing funding or services to people living with
HIV/AIDS. However, local officials this year have not yet received
authorization to spend money for the program because the measure approving
the federal money passed only last month, according to the Times-Picayune.
Ellen Lee, who runs the program in New Orleans, said that one-third of the
money arrived on Friday, but that amount will have to be distributed to
many organizations. "Until we get the funding, we can't get the money to
the local residents," Lee said. "It's driving me crazy," Lois Falk, a
housing counselor for Associated Catholic Charities, said, adding,
"Utilities are being turned off, and people are getting eviction notices."
The amount of funding is based only on an area's reported number of AIDS
cases, according to the Times-Picayune. Lee said that the number of AIDS
cases is shrinking due to treatment, while the number of HIV-positive
people continues to grow. New Orleans will receive almost $2.2 million
from the program this year, down 16% from last year's $2.6 million
allocation. Lee and colleagues will be providing emergency assistance
through their organizations' lines of credit to those people most in need
until the full amount of funding arrives. Local officials do not know when
the remainder of the money will be distributed (Pope, New Orleans
Times-Picayune, 4/5).

2. U.S. Teen AIDS Rates Increase as Successful Treatments Foster Feelings
of Invincibility

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17040

One-fourth of all new HIV cases in the United States occur in people under
age 21, a development that many observers attribute to the false sense of
security created by the success of antiretroviral drugs in treating the
disease and by feelings of invincibility leading to risky behaviors, the
Virginian-Pilot reports. Medical advances to prevent mother-to-child HIV
transmission have virtually eliminated prenatal cases, and people infected
in such a manner often live into their teens or 20s due to antiretroviral
treatment. The Norfolk, Va.-based Children's Hospital of The King's
Daughters estimates that it is treating at least twice the number of
HIV-positive teens that it treated 10 years ago. Many young people who
contracted HIV prenatally have had experience with an HIV-positive parent
who has died or had a serious illness as a result of the disease, which
often encourages teens to maintain the complicated AIDS drug regimen.
However, teens who do not have such a "touchstone" often have difficulty
adhering to treatment, a problem compounded by teens' tendency to lead
"chaotic lives. Shun authority. Keep secrets. And wear defiance like a
badge of courage," according to the Virginian-Pilot. Erratic adherence to
a drug regimen can be dangerous, as such behavior can prompt the
development of drug resistance, and each time resistance develops, a teen
must switch to a different antiretroviral regimen (Simpson,
Virginian-Pilot, 4/6).


GLOBAL CHALLENGES

3. World Bank Loans Russia $150 Million For Five-Year National Plan To
Combat HIV/AIDS, Tuberculosis

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17041

The World Bank on Thursday agreed to loan Russia $150 million to fund a
five-year national program to treat and prevent the spread of HIV/AIDS and
tuberculosis, the Moscow Times reports. Russia will use $50 million of the
loan to combat HIV/AIDS and $100 million for TB. The program is also
supported by $2.1 million from the World Health Organization and $134.1
million from the Russian government, which is a "considerable" spending
increase over current spending, according to the Times. The Russian
Healthcare Foundation, a nongovernmental organization whose supervisory
board is chaired by Russian Health Minister Yury Shevchenko, will implement
the program, according to the Times (Munro, Moscow Times, 4/7). The
program, called the Tuberculosis and AIDS Control Project, is the first
nationwide Russian effort to fight TB and HIV/AIDS, according to a World
Bank release. Russia has one of the world's fastest-growing HIV/AIDS
epidemics and is one of 22 "high-burden" TB countries. In addition, Russia
has a high rate of drug-resistant TB cases due to poor treatment of
ordinary cases, according to the World Bank (World Bank release, 4/7).
Russia has more than 230,000 documented HIV/AIDS cases, although the
country's Federal AIDS Center estimates that the actual number is closer to
one million, according to the Times. Although about 20,000 HIV-positive
individuals are in need of treatment, only 5,000 of them receive
medication, and approximately 30,000 Russians die of TB each year (Moscow
Times, 4/7).

Focus on Prisons


"The rapidly growing number of people infected with TB and HIV pose
daunting challenges to the country's social and economic development,"
Julian Schweitzer, World Bank country director for Russia, said, adding,
"This project is a sign of the government's commitment to starting a more
vigorous attack on these diseases" (World Bank release, 4/7). "Due to the
potential for (HIV/AIDS and TB to) spread beyond Russia, the situation has
been described as a time bomb or 'ebola with wings,'" the World Bank said.
The program will focus on prisons, where HIV infection and TB often occur
"side-by-side," according to Olusoji Adeyi, the World Bank's lead health
specialist for Europe and Central Asia, the Times reports. Russian
President Vladimir Putin has endorsed the national program. "We note that
our relationships with the bank are developing in the best possible way,"
Putin told World Bank President James Wolfensohn on Radio Mayak in November
2002, adding, "The initiatives that we are taking together are extremely
significant for us, for example, the fight against AIDS and TB" (Moscow
Times, 4/7).

More information on HIV/AIDS in Russia is available through
kaisernetwork.org's Issue Spotlight on the epidemic.

4. Former President Clinton During Caribbean Tour Praises Bahamas' Efforts
To Fight AIDS

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17042

Former President Clinton on Friday praised the Bahamas' efforts to stem
the spread of HIV, noting the country's success in reducing mother-to-child
transmission rates from 30% to 3%, the Associated Press reports. Clinton
-- who on Friday began a five-day tour of the Caribbean with stops in the
Bahamas, Puerto Rico, St. Kitts, the Dominican Republic and Haiti to speak
about AIDS and to meet with not-for-profit organizations and government
leaders -- speaking at a high school in the Bahamas, said, "No nation has
done more to try to face this problem in a brave and forthright way than
you have." After leaving office in January 2001, Clinton founded the
William J. Clinton Presidential Foundation HIV/AIDS Initiative, which
brings together experts to work in the Caribbean and Africa to expand
access to antiretroviral treatment (Associated Press, 4/4). The foundation
assisted the Bahamian government in creating a business plan that calls for
the provision of antiretroviral therapy for all HIV-positive people within
three years (Clinton Foundation release, 4/2). In addition, the foundation
successfully negotiated a deal with the 15-nation Caribbean Community and
pharmaceutical companies to lower the cost of antiretroviral drugs for
HIV-positive people in the region (Kaiser Daily HIV/AIDS Report, 2/5). In
the Bahamas, the cost of antiretroviral drugs dropped from $3,800 per
person per year to less than $500 per person annually (Clinton Foundation
release, 4/2). Clinton said that the success of the Bahamas could serve as
a model for other nations. "If you can reverse and defeat HIV/AIDS in the
Bahamas, if we can do it in the Caribbean, then we can do it in the places
where the numbers are bigger," he said (Associated Press, 4/4).


OPINION

5. House AIDS Bill Could Save Lives, 'Propel' United States to 'Forefront'
of AIDS Fight

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17043

The passage last week in the House International Relations Committee of a
bill (HR 1298) that addresses the global AIDS epidemic could represent a
"willingness" on the part of the United States to "invest in prevention,
treatment and care," a move that could "ultimately save lives," a
Minneapolis Star Tribune editorial says (Minneapolis Star Tribune, 4/7).
The committee approved 37-8 an amended bill that would authorize $15
billion over five years to fight global AIDS. 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 (Kaiser Daily HIV/AIDS Report,
4/3). The measure is a "leap" beyond the proposal originally offered by
President Bush in his State of the Union address, the Star Tribune says.
The House bill "should be embraced" because of its increased commitment to
the Global Fund, the "world's best hope for curbing AIDS," and because it
lacks the "antiabortion baggage that so often sandbags reproductive health
legislation," the editorial says (Minneapolis Star Tribune, 4/7). The bill
excludes language that would prohibit 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. The Bush administration had shown support for
extending the policy to HIV/AIDS efforts (Kaiser Daily HIV/AIDS Report,
4/7). If the House bill becomes law, the United States "at last will be
acting like the world leader it claims to be," the editorial says.
However, "[t]hat's quite a big if," the editorial states, concluding that
lawmakers should avoid any "unseemly and irrational ... obstructionism" and
"rally behind the House bill ... [to] propel the United States into the
forefront of the fight against AIDS" (Minneapolis Star Tribune, 4/7).

6. Gates Foundation Grant for Microbicide Research 'Fills Void' Left by
Pharmaceutical Companies, Editorial Says

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17044

A $60 million grant from the Bill & Melinda Gates Foundation to the
International Partnership for Microbicides is "helping to fill a void" left
by pharmaceutical companies that are unwilling to perform microbicide
research because of the products' lack of potential for "hefty profits," a
Louisville Courier-Journal editorial says (Louisville Courier-Journal,
4/6). The grant, announced last week, will be used to research the
possible use of microbicides to prevent HIV transmission. Microbicides
include a range of products such as gels, films, sponges and other products
that could help prevent the sexual transmission of HIV and other sexually
transmitted diseases (Kaiser Daily HIV/AIDS Report, 4/1). While
microbicide technology would be "crucial" to all women, the power of such
protection would be an "extraordinary blessing" to women in developing
nations, where religious and cultural traditions often do not afford women
the power to make their own sexual health decisions. The editorial
concludes that while many may call Bill Gates a "fierce, and sometimes
unfair, business competitor," such critics cannot deny that he and his wife
have been "generous benefactors of worthy causes at home and abroad.
Unlike some wealthy Americans, they do their economic class proud"
(Louisville Courier-Journal, 4/6).


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