KAISER DAILY HIV/AIDS REPORT
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*** SPOTLIGHT: HIV/AIDS EPIDEMIC IN SOUTH AFRICA***
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Wednesday, July 2, 2003

SPECIAL NOTICE
========================================
1. Kaiser Daily Reports Will Not Publish Friday, July 4


POLITICS AND POLICY
========================================
2. Bush To Name Former Eli Lilly CEO as Head of Global AIDS Initiative


DRUG ACCESS
========================================
3. Pharmaceutical Industry 'Recasting Its Position' in WTO Talks Over
Importation, Access to Generic Drugs


ACROSS THE NATION
========================================
4. Federal Government Approves EVMS, Norfolk, Va., Contract Regarding
Administration of Ryan White Funds


GLOBAL CHALLENGES
========================================
5. Kenya Needs $70M Annually To Assist Children Affected by HIV/AIDS,
UNICEF Says


SCIENCE & MEDICINE
========================================
6. VaxGen May Pull Funding From Thai HIV Vaccine Trial Before Data Complete


MEDIA & SOCIETY
========================================
7. MTV To Broadcast Nelson Mandela Birthday Special, Including Discussion
of HIV/AIDS, Other Issues

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

SPECIAL NOTICE


1. Kaiser Daily Reports Will Not Publish Friday, July 4

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18586

The Kaiser Daily HIV/AIDS Report will not publish Friday, July 4, in
observance of Independence Day. The report will resume publishing Monday,
July 7.


POLITICS AND POLICY


2. Bush To Name Former Eli Lilly CEO as Head of Global AIDS Initiative

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18587

President Bush is scheduled this morning to name former chair and CEO of
pharmaceutical company Eli Lilly Randall Tobias to head a new State
Department office assigned to oversee the global AIDS initiative, according
to unnamed government and outside sources, the Washington Post reports
(Goldstein/Brown, Washington Post, 7/2). The expected announcement comes
less than a week before Bush is scheduled to visit five African nations --
Senegal, South Africa, Botswana, Uganda and Nigeria -- to promote economic
development and the fight against HIV/AIDS, including the five-year, $15
billion AIDS initiative (HR 1298), which authorizes $3 billion a year over
five years for HIV/AIDS programs in Africa and the Caribbean, 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, 6/27). U.S.
officials from several government departments and agencies have been
working since February to develop a global AIDS bureau in the State
Department to oversee the initiative, but work has been delayed by the lack
of a coordinator, the Boston Globe reports (Donnelly, Boston Globe, 7/2).
As the "global AIDS czar," Tobias would work under the secretary of state,
and he would be able to distribute funds directly to nongovernmental
organizations and transfer funds between government agencies, according to
the Indianapolis Star (Indianapolis Star, 7/2). The position will carry
the rank of ambassador (Reuters, 7/1). Joseph O'Neill, head of the White
House Office of National AIDS Policy, is also expected to take a position
in the new State Department office (Washington Post, 7/2).

Reaction


While the move surprised some AIDS advocates and officials who had expected
a "higher-profile" person to be appointed to the post, U.S. officials said
that the Bush administration was drawn to Tobias's business record (Boston
Globe, 7/2). Paul Zeitz, executive director of the Global AIDS Alliance,
on Tuesday applauded "the idea of bringing someone from a business
background" to work on the initiative but questioned Tobias' knowledge of
both AIDS and Africa (Indianapolis Star, 7/2). Zeitz predicted that Tobias
could face opposition in Congress due to his connection to Eli Lilly.
"We're seriously concerned that there is a potential conflict of interest
here. Is he going to give up his stock? How are we going to ensure he's
not looking out for his buddies in the pharmaceutical industry," Zeitz
said, adding that he thinks Tobias may be more inclined to purchase
patented antiretroviral drugs over cheaper generic versions (Reuters, 7/1).
Sandra Thurman, president of the International AIDS Trust and director of
the White House Office of National AIDS Policy during the Clinton
administration, called the selection of Tobias "good news," adding that he
is a person of "tremendous stature and management acumen" (Washington Post,
7/2). An associate of Tobias who asked not to be identified said, "He
doesn't want to have any comment until after the Senate confirmation has
been completed." Senate confirmation could take up to two months, according
to the Globe (Boston Globe, 7/2).

WAMU's "Kojo Nnamdi Show" yesterday discussed President Bush's upcoming
trip to Africa with Charlie Cobb, senior writer and diplomatic
correspondent for AllAfrica.com, and J. Stephen Morrison, director of the
Africa Program at the Center for Strategic and International Studies
(Nnamdi, "The Kojo Nnamdi Show," WAMU, 7/1). The full program is available
online in RealPlayer. In addition, National Security Council Director for
African Affairs Dr. Jendayi Frazer will answer questions today at 2:30 p.m.
ET in the online interactive forum "Ask the White House." A transcript of
the chat will be available online after the discussion.

DRUG ACCESS


3. Pharmaceutical Industry 'Recasting Its Position' in WTO Talks Over
Importation, Access to Generic Drugs

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18588

The pharmaceutical industry is "recasting its position" in World Trade
Organization talks over the importation of generic drugs to developing
countries by considering compromises on the scope of diseases covered by
the agreement, Knight Ridder/Washington Times reports (Sparshott, Knight
Ridder/Washington Times, 7/1). WTO talks over generic drug access have
been stalled since members missed a Dec. 31, 2002, deadline to reach an
agreement. U.S. negotiators in February refused to sign a deal under the
Doha declaration to allow developing nations to override patent protections
to produce or import generic versions of drugs to combat public health
epidemics, including HIV/AIDS, unless wording was included to specify which
diseases constitute a public health epidemic. The United States said that
without such a list, developing nations could use patent overrides to
produce generic versions of any patented drug, including drugs that are not
used to fight public health epidemics. However, the United States last
month made a concession by dropping its demand that the agreement apply
only to a specified list of diseases (Kaiser Daily HIV/AIDS Report, 6/23).

Reaching Compromise


An unnamed U.S. trade official said that the pharmaceutical industry is
also exploring ways to reach a compromise. The companies are considering
compromises that would expand the scope of the diseases as well as which
countries would be able to receive the drug waivers and the conditions that
will constitute the public health crisis status needed to obtain the
waivers, according to Mark Grayson, spokesperson for Pharmaceutical
Research and Manufacturers of America. Although the companies have been
"having a lot of conversations" with U.S. Trade Representative Robert
Zoellick, Grayson said, "This has been a difficult problem, so I don't mean
to suggest that it's on its way to imminent solution" (Knight
Ridder/Washington Times, 7/1). U.N. Secretary-General Kofi Annan on Monday
at the opening of the U.N. Economic and Social Council called for countries
to show great flexibility in negotiations and to reach a compromise before
the September WTO ministerial meeting in Cancun, Mexico (Millar, Agence
France-Presse, 6/30).

ACROSS THE NATION


4. Federal Government Approves EVMS, Norfolk, Va., Contract Regarding
Administration of Ryan White Funds

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18589

The federal government on Friday approved a contract between the city of
Norfolk, Va., and the Eastern Virginia Medical School regarding the
administration of Ryan White CARE Act funds, and officials hope that the
new agreement will allow the school to reopen its regional HIV/AIDS
clinics, the Virginian-Pilot reports (Minium, Virginian-Pilot, 7/1). EVMS
and Norfolk officials early last month announced that they had reached a
tentative agreement to reopen six of the seven clinics in the region that
serve approximately 400 patients. A contract dispute between the parties
regarding billing practices resulted in the revocation of the clinics' Ryan
White funds on April 11. EVMS clinics were using a billing method in which
doctors received a set fee for each patient, a practice that is reportedly
not allowed under federal government regulations. As a result, the clinics
lost their Ryan White money and had to cease operations (Kaiser Daily
HIV/AIDS Report, 6/3). City Manager Regina Williams on Friday signed the
contract and EVMS spokesperson Doug Gardner said that EVMS officials were
expected to review and sign the contract yesterday. Federal officials took
three weeks longer than originally stated to approve the contract
(Virginian-Pilot, 7/1).

Clinics To Reopen 'Soon'


Over the past four years, Norfolk has failed to spend an average of $1
million per year from Title I Ryan White funds, and an estimated 900 local
residents living with HIV are not receiving care. Only two metropolitan
areas out of the 51 that received funds under Title I spent a smaller
percentage of their funding in the fiscal year that ended Feb. 28, 2002,
than Norfolk. AIDS advocates have accused the city of making the
administration of Ryan White funding more complicated than it needs to be
(Kaiser Daily HIV/AIDS Report, 6/3). Tommy Bennett, a member of the Ryan
White planning council that advises the city on AIDS treatment priorities,
said, "There has been no shortage of funds, which makes you wonder why they
would jeopardize lives [by closing the clinics]." He added that "the good
news is that the clinics will reopen soon, and people will begin receiving
care that could prolong their lives." Gardner said that he was not sure
when the clinics would reopen but added that he hoped it would be soon
(Virginian-Pilot, 7/1).

GLOBAL CHALLENGES


5. Kenya Needs $70M Annually To Assist Children Affected by HIV/AIDS,
UNICEF Says

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18590

Kenya needs about $70 million annually to assist approximately 1.2 million
Kenyan children who are affected by the HIV/AIDS epidemic, a UNICEF
official said Monday, Agence France-Presse reports. Nicholas Alipui,
UNICEF representative to Kenya, said that the problem of AIDS orphans could
not be tackled without the support of government and international aid
organizations. "An annual subsidy of $60 per child would amount to $72
million a year for fostering households where a parent is dying of AIDS, to
provide for children's needs and welfare, including sending them to
school," Alipui said. Following the introduction of free, compulsory
primary education in January by the ruling National Rainbow Coalition, 20%
more orphans are enrolled in basic education classes, meaning that an
additional one million children are enrolled in school, according to Agence
France-Presse. Alipui said, "We advocate for official resources from the
government budget for Kenya's orphans and channeling funds from
international relief programs, including food aid directly to communities
and households with the heaviest burden of orphans." He added that
although some orphans' extended families were able to manage their care,
"it is unrealistic to assume that the children can escape from stigma,
poverty and death without massive direct official support from the
government and other stakeholders." UNICEF estimates that by 2010, 2.2
million orphans will live in Kenya (Agence France-Presse, 6/30).

SCIENCE & MEDICINE


6. VaxGen May Pull Funding From Thai HIV Vaccine Trial Before Data Complete

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18591

Biotechnology company VaxGen has said that it may withdraw funding from a
study of its AIDS vaccine that is currently underway in Thailand, which
could lead to a "loss of invaluable data," Thailand's Nation reports. The
Thai trial of the AIDSVAX vaccine has enrolled more than 2,500 volunteers,
and VaxGen plans to announce results from the study later this year
(Nation, 7/2). VaxGen in late February announced that AIDSVAX reduced the
rate of new HIV infections by 3.8% among people who received the vaccine in
another clinical trial, compared with participants who received a placebo
injection. However, the company said that the vaccine was effective among
African Americans, Asians and other non-white, non-Hispanic volunteers. In
a subgroup of 498 non-white, non-Hispanic volunteers, the vaccine appeared
to provide protection in the range of 30% to 84%. According to the company,
the analysis had less than a 1% chance of being random chance, making it
statistically significant (Kaiser Daily HIV/AIDS Report, 6/12). VaxGen has
not yet confirmed that it is pulling its funding of the Thai study,
according to the Nation. Dr. Kajit Choopanya, principal investigator of
the trial, said that the company is split between employees who want to
pull out and scientists who say that the company must fund the study
through its final analysis. According to the Nation, VaxGen is acting
"entirely on commercial grounds" in making its decision. Several U.S.
government agencies and the Bill & Melinda Gates Foundation could step in
and provide funding to keep the trial running, the Nation reports.

'Far Reaching Effects'


Peggy Johnston, director of the vaccine and prevention research program at
the National Institute of Allergy and Infectious Diseases, said that losing
VaxGen's funding for the study could have "far reaching effects" (Nation,
7/2). She added, "Imagine going to a developing country again and asking
them to roll up their sleeves for an efficacy trial if we didn't finish
this one." Johnston said that VaxGen's board of directors has said they
are "not interested" in finishing the trial. However, she added that the
"staff, having put blood, sweat and tears into the trial, are very
interested in completing it. We are in discussions now to decide what
[VaxGen] will need to complete the trial." Johnston said, "From a
scientific perspective, it would be a tremendous loss not to complete the
trial and analyze the data" (Boseley, Guardian, 7/1). VaxGen insisted that
it was not pulling out of the trial "but simply did not have the money to
analyze all the data," the Nation reports. Lance Ignon, VaxGen's vice
president of corporate communications, said, "The financial markets sent a
loud and clear signal to us thorough the decline in our stock value and
through conversations with members of the financial community. Their
unambiguous response was, please do not spend more money than is necessary
on your trials." Gregg Gonsalves, director of treatment and prevention
advocacy at Gay Men's Health Crisis in New York, said, "Based on the poor
results from their trial in the United States, I think they made a rational
decision" to end funding for the Thai trial. "They've been hyping this
vaccine for many years based on dubious data, but at some point, all the
hype in the world can't salvage a product that doesn't work," he said.
AIDSVAX is one of two vaccines set to be studied among 16,000 participants
in another trial in Thailand scheduled to begin in October, the Nation
reports (Nation, 7/2).

MEDIA & SOCIETY


7. MTV To Broadcast Nelson Mandela Birthday Special, Including Discussion
of HIV/AIDS, Other Issues

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18592

MTV, owned by Viacom, later this month is scheduled to air a one-hour
special broadcast, including discussions of HIV/AIDS and other issues, to
mark former South African President Nelson Mandela's 85th birthday, Reuters
reports (Reynolds, Reuters, 6/30). The program, to be hosted by singer
Beyonce Knowles and produced in association with the Nelson Mandela
Foundation, UNAIDS, World Bank, the Kaiser Family Foundation and Family
Health International's YouthNet, will premiere on MTV at 8 p.m. ET on July
18 as part of the "Fight for Your Rights: Protect Yourself" sexual health
awareness campaign. The show will be available for free to third-party
broadcasters throughout the world, and many have already signed on to air
the special, including CCTV (China), Doordarshan (India), SABC (South
Africa), TV Africa (pan-African network) and Network Ten (Australia). In
addition, for the second year in a row the European Broadcasting Union will
distribute the campaign's programming free via satellite to its 71 member
broadcasters in 52 countries in Europe, North Africa and the Middle East.
The program is expected to be viewed by more than two billion young people.
Mandela said, "It is important to talk openly about subjects like HIV/AIDS,
war, political leadership and religion so that young people can make
informed decisions about these issues, and to understand that they have the
most vital role to play in helping to shape the future. It has been a
pleasure meeting the young people participating in MTV's program because,
ultimately, it is their lives and futures we are all celebrating" (MTV
release, 7/1). Viacom and the Kaiser Family Foundation are partners in
the KNOW HIV/AIDS campaign, which is aimed at raising HIV/AIDS awareness
through public service announcements, television and radio programming and
free print and online content (Kaiser Daily HIV/AIDS Report, 6/26).

________________________________________

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