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Friday, June 6, 2003

POLITICS AND POLICY
========================================
1. Caribbean Leaders Ask Congress To Expand Global AIDS Initiative


ACROSS THE NATION
========================================
2. Number of HIV Infections Among Seattle-Area Men Who Have Sex With Men
Increases 40% From 2001 to 2002


GLOBAL CHALLENGES
========================================
3. Global Fund Signs Seven Grant Agreements With Indonesia, Philippines,
Western Pacific Islands

4. Canada's House of Commons Health Committee Calls for Increased Funding
for National HIV/AIDS Strategy


OPINION
========================================
5. Kaiser Daily HIV/AIDS Report Summarizes Opinion Pieces on Signing of
Global AIDS Bill, G8 Summit

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POLITICS AND POLICY


1. Caribbean Leaders Ask Congress To Expand Global AIDS Initiative

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http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18121

Caribbean leaders this week plan to send a proposal to Congress requesting
that 14 additional nations from the region be included in the five-year,
$15 billion global AIDS relief plan, the Hartford Courant reports (Hay
Brown, Hartford Courant, 6/5). Bush last week signed into law the bill
authorizing the money to fight AIDS in African nations and Haiti and Guyana
(Kaiser Daily HIV/AIDS Report, 5/30). While the nations said that they
welcome the aid, they said that a more broad-based approach is needed to
stop the spread of the disease. "Whatever happens in one specific corner
of the region will have an impact in other places," Rafael Mazin, acting
chief of the HIV/AIDS unit of the Pan American Health Organization, said,
adding that in order to be effective, HIV "needs to be prevented and
contained in all places." People in the region often travel to other
countries to seek out the best medical treatment, which has contributed to
the spread of the virus, according to the Courant. In addition, "[i]t's
very difficult to de-link the different countries. You have migration from
Haiti to the Dominican Republic, Haiti to the Bahamas, Guyana to the rest
of the Caribbean. Although we can target countries, it might be more
effective to look at the region as a whole," Edward Green, assistant
secretary-general of the Carribean Community and head of the Pan-Caribbean
Partnership to Fight AIDS, said.

Caribbean Region 'Overlooked'


The Caribbean, a region that according to the Courant has been "largely
overlooked by international donors," has the highest HIV prevalence outside
of sub-Saharan Africa. While Haiti, where more than one in 17 adults ages
15 to 49 are HIV-positive, and Guyana, where the HIV prevalence rate is
2.7%, are widely considered to be the worst hit by the epidemic, HIV
prevalence in nations such as the Bahamas, Belize, the Dominican Republic,
Suriname and Trinidad and Tobago are all more than 2%. "This is a regional
crisis in our own hemisphere," Sen. Christopher Dodd (D-Conn.), who has
supported the measure to expand the bill, said, adding, "It deserves to be
given the same serious attention that is being given to the HIV/AIDS
epidemic in sub-Saharan Africa. If we're not careful, we are going to lose
a generation of young people in the Caribbean" (Hartford Courant, 6/5).

ACROSS THE NATION


2. Number of HIV Infections Among Seattle-Area Men Who Have Sex With Men
Increases 40% From 2001 to 2002

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18122

The number of HIV infections diagnosed among Seattle-area men who have sex
with men who attended public health clinics increased 40% from 2001 to
2002, according to public health officials, the New York Times reports
(Preusch, New York Times, 6/5). For their analysis, public health
officials examined test results from HIV screenings conducted in public
health clinics beginning in 2000, according to the Seattle Times. Although
about 11% more HIV tests were given to MSM in 2002 versus the previous
year, the testing increase does not explain the jump in positive results,
Robert Wood, director of the HIV/AIDS Program of the Seattle and King
County Public Health Department, said. "It's the most dramatic increase
since the beginning of the [HIV/AIDS] epidemic," Wood said. If the trend
continues, officials predict that new infections could increase by another
60% in 2003. MSM represent approximately 85% of HIV/AIDS cases in King
County, according to the Times (King, Seattle Times, 6/4).

Destigmatize HIV Testing


Wood said that new life-prolonging treatment for HIV/AIDS, along with
"prevention burnout," has led MSM to resume risky sexual behavior,
according to the Seattle Post-Intelligencer. "AIDS is no longer as scary
as it used to be," Wood said, adding, "It's now viewed as a long-term
manageable disease. There's just not as much fear, which may be
contributing to the unsafe behavior" (Paulson, Seattle Post-Intelligencer,
6/4). Cases of other STDs, including syphilis, gonorrhea and chlamydia,
have been on the rise for three years in the area, and health officials
predicted that an increase in HIV cases would follow, according to the
Times. To encourage testing, the health department is using the rapid HIV
test, called OraQuick, which can produce results in 20 minutes. Health
officials and AIDS advocates say that all sexually active MSM need to be
tested for HIV, disclose their status to sexual partners and practice safe
sex, according to the Times. "We need to take HIV out of the closet," Jack
Johnston, program coordinator for Positive Power, a counseling group for
MSM, said, adding, "It's the responsibility of all guys who are sexually
active to be talking about it. And don't be afraid to talk about it if you
have it" (Seattle Times, 6/4).

GLOBAL CHALLENGES


3. Global Fund Signs Seven Grant Agreements With Indonesia, Philippines,
Western Pacific Islands

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http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18123

The Global Fund to Fight AIDS, Tuberculosis and Malaria yesterday signed
seven grant agreements totaling $33 million over two years to fight the
three diseases in Indonesia, the Philippines and several Western Pacific
island nations, the Associated Press reports. The money will boost
prevention and treatment programs in the region, focusing on rural and
indigenous populations. Indonesia will receive up to $15 million over two
years to improve AIDS education and care in four high prevalence areas and
to combat malaria in four eastern provinces. The Philippines, where the
burden of TB is the eigth highest in the world, will receive $3.4 million
for TB treatment programs and $7 million for malaria prevention and
treatment programs in rural areas (Fowler, Associated Press, 6/5). UNAIDS
estimates that 9,400 of the Philippines' 84 million inhabitants are
HIV-positive, which is only 0.1% of the adult population (Kaiser Daily
HIV/AIDS Report, 5/21). Several island states in the Western Pacific
region, where HIV/AIDS "is emerging as one of the biggest health
challenges," will receive $3 million to strengthen surveillance systems and
laboratory facilities, improve prevention and care and launch targeted
education programs among young people and other high-risk groups. Cook
Islands, Federated States of Micronesia, Fiji, Kiribati, Niue, Palau,
Samoa, Solomon Islands, Tonga, Tuvalu and Vanuatu are among the island
states included in the grant. Richard Feachem, executive director of the
Global Fund, called the grants "notable for their focus on remote rural and
indigenous populations," adding that the funds will enable the development
of "rapid diagnosis, quality care and effective prevention measures for
HIV/AIDS, TB and malaria in regions that up to now have had little or no
access to these services" (Global Fund release, 6/5).

4. Canada's House of Commons Health Committee Calls for Increased Funding
for National HIV/AIDS Strategy

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18124

The Canadian House of Commons Health Committee yesterday released a report
unanimously calling on the government to increase funding for the country's
national HIV/AIDS strategy, the Canadian Press reports. The country
currently has budgeted $42.2 million in annual funding for the program, but
the committee believes that amount is "inadequate," according to committee
member Rob Merrifield (Bueckert, Canadian Press, 6/4). The program's
funding has been "frozen" at that amount since the strategy's inception 11
years ago; however, the number of HIV-positive people in the country has
risen to more than 54,000, from fewer than 30,000 in 1992. During a health
committee hearing in March, HIV/AIDS advocates called for funding to be
increased to $85 million. A coalition of community groups, scientists and
patients focused on the disease's effect on the economy and the need to
invest in HIV/AIDS prevention (Kaiser Daily HIV/AIDS Report, 3/18). In the
report, the committee called for the government to more than double funding
for the national HIV/AIDS strategy to $100 million, the Canadian Press
reports (Bueckert, Canadian Press, 6/5). Merrifield added that the
committee was unable to reach a consensus on how the funds should be spent.
He said that only $3.9 million of the 2002 HIV/AIDS strategy budget went to
prevention, compared with $14.3 million when the program was first
established. "We're seeing a disproportionate amount going to treatment.
Let's see what we can do to prevent more individuals from being infected,"
Merrifield said, adding, "We're going to be recommending more dollars for
this because we have to get serious about attacking [HIV/AIDS]" (Canadian
Press, 6/4).

Needle Exchange for Prisoners Proposed


The report also supported a needle-exchange program for injection drug
users in federal prisons, the Canadian Press reports. The Canadian
Alliance political party in a dissenting report opposed the needle-exchange
program proposal, stating, "It would amount to an admission of defeat to
the disturbing reality of heightened drug use and abuse among inmates."
The party also called for a "somewhat smaller" funding increase to $85
million (Canadian Press, 6/5). The Alliance's report also called for an
increased focus on prevention and "measurable targets," such as a 50%
reduction in the number of new infections each year within five years,
according to the Canadian Press (Canadian Press, 6/4).

OPINION


5. Kaiser Daily HIV/AIDS Report Summarizes Opinion Pieces on Signing of
Global AIDS Bill, G8 Summit

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18125

A number of media outlets and organizations have commented on the bill (HR
1298), signed into law by President Bush last week, that authorizes $15
billion over five years to fight AIDS in Africa and the Caribbean. The
law, sponsored by Rep. Henry Hyde (R-Ill.), authorizes $3 billion a year
for five years to international HIV/AIDS programs, 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, 5/28). The amount actually
appropriated to the Global Fund may be less and is contingent upon the
contributions of other countries. Under the measure, the United States can
contribute up to $1 billion to the fund only if that amount totals no more
than one-third of the fund's total contributions. Therefore, in order for
the total $1 billion to be appropriated, other nations must contribute more
money (Kaiser Daily HIV/AIDS Report, 6/4). At the G8 summit in Evian,
France, this week, Bush used the bill as leverage to urge other nations to
allocate money for the fight against AIDS (Kaiser Daily HIV/AIDS Report,
6/2). The following are summaries of editorials, opinion pieces and press
releases related to the events:

Editorials


* Charleston Post and Courier: Congress will "not have discharged its duty
to help address the worldwide AIDS crisis until" it allocates the funds
authorized in the global AIDS bill, according to a Charleston Post and
Courier editorial. Bush is encouraging other countries to contribute
similarly to the fight against AIDS and other diseases, with the global
AIDS bill serving as a "fine example," the editorial says, concluding,
"Congress should give [the bill] the fullest backing" (Charleston Post and
Courier, 6/2).

* Columbus Dispatch: Bush should be "applauded" for his HIV/AIDS
initiative and for the legislation supporting it, which will "prevent many
millions of people from contracting AIDS, will help alleviate suffering of
many millions of victims and will save many millions of lives," according
to a Columbus Dispatch editorial. But Bush and the public must "keep the
pressure on Congress to keep its promise" of the funding that is authorized
in the AIDS bill during the appropriations process, the Dispatch says. The
editorial concludes, "[T]he most compelling reason for spending $15 billion
is that it's the right thing to do. ... It's a large investment, but it's
worth every penny" (Columbus Dispatch, 6/2).

* Economist: "The pot of money [for fighting AIDS] is getting larger, but
it is not becoming any easier to share out" due to inefficiency or
corruption in African governments, "ideological hang-ups" among donor
nations and a lack of "well-organized and functioning health system[s]" in
developing nations, an Economist editorial says. So while "extra cash is
always welcome ... there are doubts about whether it can be spent
efficiently," the Economist concludes (Economist, 6/7).

* Seattle Post-Intelligencer: Although the Bush administration deserves
"credit for asking France, Russia and other nations ... to step up spending
on AIDS ... every wealthy nation, including the United States, can and
should do more," according to a Seattle Post-Intelligencer editorial. "We
know what can be done when the world's nations focus enough attention --
and money -- on the quest to make AIDS a disease of the past. ... Now we
need to put AIDS (and, possibly malaria) on the list of diseases that ought
to be relegated to historical or theoretical," according to the
Post-Intelligencer. The editorial continues, "It won't matter what part of
the world designs the plan, or which nations spent the most money. It will
only matter how quickly the devastation caused by AIDS is eliminated as a
global threat." There is still "much work to be done" toward ending the
AIDS pandemic, but the "best solution is the rivalry of generosity," the
editorial concludes (Seattle Post-Intelligencer, 6/2).

* Syracuse Post-Standard: The $15 billion authorized in the global AIDS
bill is "a lot of money," but it still "fails to meet the demand" of
fighting HIV/AIDS throughout the world, according to a Syracuse
Post-Standard editorial. The editorial says that "far more could have been
approved to really halt the scourge that has killed more than 20 million
people." The Post-Standard concludes, "Here's hoping [the G8] portion
exceeds the example set" by the United States (Syracuse Post-Standard,
5/31).

* Virginian-Pilot: The president's AIDS initiative is indicative of
"compassionate conservatism at its effective best," and therefore Bush
should be "applauded," according to a Virginian-Pilot editorial. The
editorial says that critics should "curb [their] grumbling" because Bush
has "thrown down the gauntlet to other rich countries" to make similar
contributions. Although Bush has been criticized by some Democrats for his
funding recommendations and for trying to "fit such large amounts" into the
constraints of foreign aid spending limits, the initiative is still "wise
foreign policy, helping project an image abroad of a benevolent America
when resentment of our wealth and power is at an all-time high," the
editorial concludes (Virginian-Pilot, 6/2).


Opinion Pieces


* Mona Charen, Philadelphia Inquirer: Bush's global AIDS initiative
represents "the kind of humanitarian intervention that the wealthiest
nation on Earth should undertake," Charen, a syndicated columnist, writes
in a Philadelphia Inquirer opinion piece, adding, so "[w]hy hasn't
President Bush gotten more credit for this here at home?" The initiative
is "precisely the sort of generous, humanitarian, decent act liberals claim
to admire," Charen says, concluding, "But where is the applause?" (Charen,
Philadelphia Inquirer, 6/4).

* Murray Feshbach, New York Times: The United States must recognize that
"the difficulties Russia faces" in its AIDS epidemic "may be almost as
great" as the problems faced by those countries that are scheduled to
receive funding through the AIDS initiative, Feshbach, a senior scholar the
Woodrow Wilson International Center for Scholars, writes in a New York
Times opinion piece. Deterioration of Russia may "come with greater
consequences" than Africa since "[e]pidemics invite chaos ... [which is]
the last thing we want in a struggling democracy with huge arsenals of
nuclear, chemical and biological weapons," Feshbach says, concluding that
the world must donate more money to address the problem (Feshbach, New York
Times, 5/31).

* Kenneth Kaunda, Boston Globe: The success of the fight against AIDS will
depend on the ability of African nations to build their capacity to "wage
this war on their own behalf" and on the assistance provided by the
international community to accomplish this goal, Kaunda, former president
of Zambia, writes in a Boston Globe opinion piece. "Although I can't say
enough about Bush's leadership in pushing [the global AIDS] bill, it is
still not enough," Kaunda says, concluding, "My hope is that now that the
drama of the Group of Eight summit in Evian is history, the commitment of
Bush and his G8 counterparts to join us in the fight against the disease
will not become history as well" (Kaunda, Boston Globe, 6/6).

* Mikhail Margelov and Leo Hindrey, New York Times: "Eurasia is a new
epicenter of the AIDS pandemic," and the potential consequences of health
crises in this area "cannot [be] overestimat[ed]," Margelov, chair of the
Foreign Relations Committee of Russia's upper house of Parliament, and
Hindrey, chair of the Yankees Entertainment and Sports Network, write in a
New York Times letter to the editor. Margelov and Hindrey, who co-chair
the independent U.S.-Russia Working Group Against AIDS, say that their goal
is to "create a trans-Atlantic partnership, so countries can combine
resources, knowledge and political will to fight AIDS" (Margelov/Hindrey,
New York Times, 6/6).

* Lesley Reed, Seattle Times: "You cannot speak of AIDS without speaking
of the other diseases that plague poor nations [nor] without addressing the
failure of export-led growth and the black hole of debt," Reed, a writer
who traveled to Africa with a delegation of 36 American women to learn
about the epidemic, writes in a Seattle Times opinion piece. Bush must
therefore ensure that Congress allocates all of the funds promised in the
bill, push other nations to contribute to the Global Fund and cancel the
debts of developing countries, she concludes (Reed, Seattle Times, 5/30).

* Jeffrey Sachs, Taipei Times: "For the first time in history, the rich
are so rich and the poor so poor, that a tiny effort by the rich could end
massive suffering," costing less than 1% of the annual income of rich
countries, Jeffrey Sachs, director of the Columbia University Earth
Institute, writes in a Taipei Times opinion piece. G8 nations should
therefore work to raise food productivity and the availability of
education, sanitation and clean drinking water in developing countries and
"provide adequate financing for the Global Fund," Sachs concludes (Sachs,
Taipei Times, 6/3).

* Simon Wright, Financial Times: "While the story behind the Bush billions
for the fight against AIDS is not quite as generous as the United States
would like us to believe ... it is still a significant step forward,"
Wright, HIV campaign manager at ActionAid, a U.K.-based development agency,
writes in a Financial Times opinion piece. The possible $1 billion a year
for the Global Fund is "particularly important," as the fund is
"transparent and accountable and does not impose irrelevant conditions" on
aid, Wright says. The European Union can and should therefore match U.S.
contributions to the fund, Wright concludes (Wright, Financial Times, 6/5).

Press Releases


* International Association of Physicians in AIDS Care: In a statement,
the IAPAC expressed its "frustration" that the other G8 nations, with the
exception of France and the United Kingdom, are not meeting the goals set
by Bush for increasing international AIDS. "Either we will collectively
contribute to ending needless suffering, or we will wait and watch for
others to take this lead alone, increasing the risk that by inaction HIV
disease and the poverty that engenders it will consume tens of millions
more lives," IAPAC President and CEO Jose Zuniga said (IAPAC release, 6/5).

* Physicians for Human Rights: Stating that since the "Global Fund has a
proven record of funding what we know works in the fight against AIDS," PHR
expressed concern that Bush's goal of preventing seven million new HIV
infections will never be reached without the help of the fund, according to
a PHR release. "The Global Fund's proven comprehensive, integrated
approach can only work if European and other G8 donors match the U.S.
pledge," Holly Burkhalter, PHR U.S. policy director, said, concluding that
without such a response, "the Global Fund could face bankruptcy" (PHR
release, 5/30).

* STOPP International: "Celebrating the fact that this bill reserves a
third of its prevention funding for abstinence programs is like celebrating
the fact that condoms are effective 85% of the time," Ed Szymkowiak,
national director of STOPP International, a program of the American Life
League, said in a statement, referring to a provision in the bill that
allocates 33% of prevention funding to abstinence programs, leaving the
remainder for monogamy and condom programs. He added, "Despite the best
intentions of many pro-family legislators who wanted to steer this bill in
the right direction, it is simply not on par with the traditional family
values the administration claims to represent" (STOPP International
release, 5/28).

* World Bank: The World Bank "welcomes" the new initiative and "trust[s]
that the U.S. Congress will appropriate the funds authorized" by the law,
according to a World Bank release. "With three million people being killed
per year by AIDS, and 15,000 people each day becoming newly infected, we
salute this generous initiative by the United States to help stop the
deadly march of this terrible disease and safeguard the hard won
development gains of the last several decades," World Bank President James
Wolfensohn said (World Bank release, 5/28).

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