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Thursday, July 17, 2003

2ND IAS CONFERENCE ON HIV PATHOGENESIS AND TREATMENT
========================================
1. Global Fund Meeting Ends With No New Pledges; French President Heckled
by AIDS Advocates at Close of Conference


POLITICS AND POLICY
========================================
2. House Committee Approves $1.43B in Global AIDS Funding for FY 2004;
Rejects Amendment To Add Additional $1B


GLOBAL CHALLENGES
========================================
3. PBS' 'NewsHour' Examines Brazil's 'Bold' HIV/AIDS Prevention Efforts


ACROSS THE NATION
========================================
4. Fired HIV-Positive Gymnast Files Discrimination Complaint Against Cirque
du Soleil

5. National Council of La Raza Conference Addresses AIDS Among Latinos


MEDIA & SOCIETY
========================================
6. NPR's 'Tavis Smiley Show' Interviews AIDS Advocate Who Uses R&B Music To
Promote HIV Testing


OPINION
========================================
7. Bush, Congress Must Resolve 'Philosophical Differences' Over AIDS
Funding, BusinessWeek Analysis Says

8. Providing Treatment to HIV-Positive People Must be Strategy Included in
Fight Against AIDS, Editorial Says


SPECIAL NOTICE
========================================
9. CORRECTION

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

2ND IAS CONFERENCE ON HIV PATHOGENESIS AND TREATMENT


1. Global Fund Meeting Ends With No New Pledges; French President Heckled
by AIDS Advocates at Close of Conference

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18856

A meeting of supporters of the Global Fund to Fight AIDS, Tuberculosis and
Malaria ended yesterday in Paris with "little progress toward easing a cash
crisis" and with AIDS advocates calling for supporters to make "concrete
commitments" to the fund, the New York Times reports (Tagliabue, New York
Times, 7/17). The meeting's conclusion coincided with the end of the
four-day International AIDS Society 2nd Conference on HIV Pathogenesis and
Treatment. The Global Fund has pledges totaling $4.7 billion through 2008.
The fund needs $3 billion to cover grants through the end of 2004. The
Global Fund board in June agreed at a meeting in Geneva that it would limit
disbursements for the third round of grants -- which are under review and
scheduled to be awarded in October -- to the amount of funds currently
available based on the proposals' merits. The fund has received more than
200 proposals from 85 countries requesting a total of $2 billion over two
years, and about half of those proposals will likely be recommended to the
board for approval (Kaiser Daily HIV/AIDS Report, 7/16).

No New Pledges


Although French President Jacques Chirac and British Prime Minister Tony
Blair had called on other European leaders to pledge up to $1 billion
during the meeting, it ended with "no major pledges of new funds," Reuters
reports (Hirschler/Sithole, Reuters, 7/16). HHS Secretary and Global Fund
Chair Tommy Thompson said he hoped the fund would have the money it needs
by October (New York Times, 7/17). Baroness Amos, the United Kingdom's
international development secretary, said that Britain might consider
donating new money in October but first wanted to see "more evidence of the
effectiveness" of the Global Fund's programs, according to the Financial
Times. She added, "If there is still a shortfall in October, I would be
surprised if some imaginative ways to cover it are not found" (Dyer,
Financial Times, 7/17).

Gates Foundation


During the meeting, officials from the Bill & Melinda Gates Foundation
announced that it "immediately" would provide in full its $100 million
donation to the Global Fund (New York Times, 7/17). The Gates Foundation
originally had said that it would give $50 million as a first installment
to the fund and donate the remaining $50 million over 10 years. Dr. Helene
Gayle, the Gates Foundation's HIV, TB and Reproductive Health Program
director, said that the timing change was intended to boost confidence in
the Global Fund and to engender further contributions, according to the
Times. She added that more public funds "will be more likely as confidence
in the fund grows."

Demonstrations


Some advocates for making antiretroviral medicines widely available to
developing countries yesterday staged protests at the closing of the
meetings, criticizing Global Fund supporters for "failing to produce
concrete commitments," the Times reports (New York Times, 7/17).
Protesters chanting "Shame!" interrupted Chirac's speech for five minutes
during the joint closing session of the meetings, Reuters reports. Other
advocates demonstrated outside wearing Bush, Blair and Chirac masks and
carrying shovels and 16 body bags meant to represent the 16,000 people
worldwide who die from illnesses related to AIDS, TB and malaria. After
resuming his speech, Chirac said, "I wish, today, to issue a solemn appeal.
An appeal to governments of donor countries all over the world to show more
generosity, despite budgetary difficulties."

Reaction


European Commission President Romano Prodi said he is still "very keen" on
increasing Europe's contribution to the fund to $1.1 billion annually but
added that the European Union was "mov[ing] slowly." He said, "Sometimes
we are like the tortoise in the fable, advancing one step at a time. But
like the tortoise we get there in the end." Global Fund Executive Director
Richard Feachem said, "Over the months ahead we have to make further steps
forward. The aim is to rise to the cruising altitude [of] $7 billion a
year to be achieved by 2007 and to get to that cruising altitude it's is
important to keep up the pace." Irish rock star Bono -- founder of DATA,
an AIDS, debt relief and trade advocacy group - said, "The world's richest
countries talk a lot about the emergency of AIDS. But you don't fight a
raging forest fire with incrementally bigger watering cans. You call the
fire brigade to fight the crisis and stop it raging out of control"
(Reuters, 7/16).

Conference Session Webcasts Available


As the official IAS conference webcaster, kaisernetwork.org provides access
to webcasts for all six of the conference plenary sessions, as well as
other selected sessions and resources related to the conference. More
information on the conference webcasts is available online at
http://www.kaisernetwork.org/paris2003.

A webcast of the Global Fund meeting will be available at 3 p.m. ET today.

POLITICS AND POLICY


2. House Committee Approves $1.43B in Global AIDS Funding for FY 2004;
Rejects Amendment To Add Additional $1B

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18857

The House Appropriations Committee yesterday approved a fiscal year 2004
$17.1 billion foreign aid spending bill including $1.43 billion to fight
AIDS and other infectious diseases, the AP/Las Vegas Sun reports. The
House so far has approved $2 billion for AIDS in FY 2004, an increase of
about $500 million over FY 2003 spending (Holland, AP/Las Vegas Sun, 7/16).
The full House on July 10 approved a bill (HB 6470) to provide funding for
labor, education and health programs, including $644 million for foreign
AIDS research and prevention and $155 million for combating other
infectious diseases, such as tuberculosis. The money will go to fund the
five-year, $15 billion AIDS initiative (HR 1298), which Bush signed into
law in May. The initiative seeks to prevent seven million new HIV
infections, provide care for 10 million people living with the disease and
provide treatment to two million HIV-positive people. The House
Appropriations foreign operations subcommittee last week restructured the
AIDS plan, reducing funds controlled by a newly appointed AIDS coordinator
and increasing the U.S. contribution to the Global Fund to Fight AIDS,
Tuberculosis and Malaria (Kaiser Daily HIV/AIDS Report, 7/11).

Amendments Defeated


The committee voted 33-28 along party lines to reject an amendment proposed
by Rep. Nita Lowey (D-N.Y.), the ranking Democrat on the House
Appropriations Foreign Aid subcommittee, that would have added $1 billion
in emergency spending for AIDS to the bill. "The president has raised the
expectations that we will supply billions of dollars in aid in the coming
years and specifically $3 billion next year," Lowey said, adding that Bush
and top aides had "repeatedly left the distinct impression that Congress --
not the president -- is to blame for not providing the full $3 billion"
(Reuters, 7/16). The committee by a vote of 28-27 also defeated an
amendment by Rep. Carolyn Kilpatrick (D-Mich.) that would have shifted $500
million from the Millennium Challenge Account, an assistance program for
developing nations that seeks to encourage economic development, to the
AIDS initiative (Hess, CongressDaily, 7/16). The Senate last week passed a
nonbinding "sense of Congress" resolution calling for $3 billion to be
appropriated in FY 2004 to fight AIDS overseas, even if the amount exceeded
the ceiling mandated in Congress's annual budget resolution (Kaiser Daily
HIV/AIDS Report, 7/11). Mark Isaac, vice president of the Elizabeth Glaser
Pediatric AIDS Foundation, said that the committee's "failure to provide
full funding is a setback, but it will not weaken the resolve of those
fighting to ensure we make good on our promises and get about the business
of saving lives" (EGPAF release, 7/16).

Bush Administration Supports $2B


Rep. Jim Kolbe (R-Ariz.), chair of the Appropriations Subcommittee on
Foreign Operations, defended the $2 billion in appropriations, saying
procedures for programs are still being formulated, so there is no need to
"overspend," according to the AP/Sun (AP/Las Vegas Sun, 7/16). The
subcommittee last week approved increasing the U.S. contribution to the
Global Fund from $200 million to $400 million, an amount that the House
Appropriations Committee approved yesterday, according to a Global AIDS
Alliance press release (GAA release, 7/16). The committee approved the
increase despite a letter sent yesterday to Kolbe from Joe O'Neill,
director of the White House National Office of AIDS Policy, which states
that the Bush administration "strong[ly] supports" its $2 billion FY 2004
request for "all" international HIV/AIDS, TB and malaria activities,
"including $200 million for the Global Fund." In the letter, O'Neill said
that the amount "is a solid first step" in funding the president's
five-year, $15 billion global AIDS initiative. He added that efforts to
fight HIV/AIDS "need to be coordinated, deliberate and should scale-up in
stages to efficiently and effectively create the necessary training,
technology and infrastructure base needed to ensure the long-term success
of this initiative" (Letter text, 7/16). Kolbe said that $2 billion will
be sufficient to start the initiative, adding that he expects Congress to
appropriate the full $15 billion over the life of the program, Reuters
reports (Allen, Reuters, 7/16). GAA Executive Director Paul Zeitz said
that it was "an outrage" that President Bush -- rather than "accept[ing]
the increase for the Global Fund" -- "had to actively discourage increased
spending ... at a time when the Global Fund is facing a massive shortfall"
(GAA release, 7/16).

GLOBAL CHALLENGES


3. PBS' 'NewsHour' Examines Brazil's 'Bold' HIV/AIDS Prevention Efforts

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18858

In the second of a two-part series, PBS' "NewsHour with Jim Lehrer"
yesterday examined Brazil's "concerted campaign" to prevent the spread of
HIV with a "bold course" that emphasizes safe sex and condom use. The
program targets high-risk groups -- including sex workers, men who have sex
with men and injection drug users -- and includes efforts such as
commercials "frank in their display" of sexuality and condom use, free
condom distribution and needle-exchange programs. Dr. Artur Kalichman, who
coordinates the program for sexually transmitted disease and AIDS in the
Brazilian state of Sao Paolo, said that a short-lived focus on abstinence
in the early 1980s failed to slow the spread of HIV in the country.
According to PBS, although Brazil is a "deeply religious" country where
most citizens describe themselves as Roman Catholic and the church has
occasionally protested the government's HIV prevention messages as
"promoting promiscuity," the government has "pressed ahead anyway."
Brazil's Health Minister Dr. Humberto Costa said, "We say to religion
groups: Okay, you have your idea, but we are only thinking about health.
For this reason, we respect your opinion, but we are going this way:
Telling to the people to use condoms, telling to the people to practice
safe sex, and I think this is the best way." The segment also includes
comments from Gabriela Silva Leite, a retired sex worker who runs the
organization Prostitution Civil Rights and Health, and Rosemeire Munhoz, an
official with Brazil's national AIDS program (Dentzer, "NewsHour with Jim
Lehrer," PBS, 7/16). The full transcript of the segment is available
online. In addition, the full segment is available online in RealPlayer.
Expanded PBS coverage of Brazil's fight against HIV/AIDS is also available
online.

A kaisernetwork.org interview with Dr. Paulo Teixeira, director of Brazil's
National STD/AIDS Programme of Brazil's Ministry of Health, is available
online.

Additional information on AIDS in Brazil is available online through
kaisernetwork.org's Issue Spotlight on AIDS.

ACROSS THE NATION


4. Fired HIV-Positive Gymnast Files Discrimination Complaint Against Cirque
du Soleil

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18859

The Lambda Legal Defense and Education Fund on Tuesday filed a federal
discrimination complaint against Montreal-based Cirque du Soleil on behalf
of gymnast Matthew Cusick, who claims that he was fired from the troupe
because of his HIV-positive status, the Chicago Tribune reports (Jones,
Chicago Tribune, 7/16). Cusick said that he disclosed his status to the
company shortly after being hired in July 2002. He underwent several
medical evaluations and was found to be "in excellent health and considered
fully able to perform with the circus troupe," according to the AP/San
Francisco Chronicle. Shortly before he was to begin performing in the
company's Las Vegas show "Mystere," Cirque sent him a letter terminating
his employment because his HIV-positive status "will likely pose a direct
threat of harm to others, particularly in the case of future injury."
Cusick's attorney, Hayley Gorenberg, said that Cusick was denied the job
"not because of sound science or rational concern for other employees but
because of unfounded fear" (AP/San Francisco Chronicle, 7/15). "This is a
legal matter," Renee-Claude Menard, a spokesperson for Cirque, said,
adding, "We will have no comment until it follows its due course" (Chicago
Tribune, 7/16).

5. National Council of La Raza Conference Addresses AIDS Among Latinos

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18860

The National Council of La Raza on Tuesday in Austin, Texas, concluded its
Annual Conference, one of the largest Latino conferences in the United
States, with discussions of health issues affecting the Latino community,
including HIV/AIDS, the Austin American-Statesman reports. Advocates,
health workers and educators who attended the session discussed ways of
stemming HIV transmission among Latinos in the United States. In 2001,
27.5% of HIV-positive people in Texas were Latino, according to state
Department of Health statistics. Felipe Rocha, a field operations manager
with the Texas Department of Health's Bureau of HIV and STD Prevention,
said that many Latinos face "unique barriers" in accessing health care,
including language and cultural differences, regional shortages of doctors
and a lack of health insurance (Powell/Barrios, Austin American-Statesman,
7/16).

MEDIA & SOCIETY


6. NPR's 'Tavis Smiley Show' Interviews AIDS Advocate Who Uses R&B Music To
Promote HIV Testing

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18861

NPR's "Tavis Smiley Show" yesterday included an interview with AIDS
advocate Tony Wafford, whose consulting firm began an HIV prevention
campaign that uses R&B music to promote HIV testing among African
Americans. The campaign, which is titled "Fighting HIV through R&B" and is
operated in partnership with drug maker Pfizer/Agouron, provides free R&B
concert tickets for individuals who are tested for HIV and return to get
their results. Counseling, pamphlets and videos on HIV/AIDS are also
available through the campaign (Smiley, "Tavis Smiley Show," NPR, 7/16).
The campaign's 2003 "Fighting HIV through R&B" concert tour -- which is
scheduled to travel to nine cities nationwide beginning tomorrow in
Raleigh, N.C. -- will include performances by the O'Jays, the Four Tops,
the Temptations and the Whispers (Pfizer/Agouron Web site, 7/16). Wafford
said that he decided to get involved in fighting HIV/AIDS when he learned
that 64% of newly reported HIV infections are among African-American women
and that HIV/AIDS is the number one killer of African-American men and
women ages 22 to 45. Wafford said that entertainment and celebrities "move
our people, and certainly music more than anything," adding that by
associating music with HIV testing, "people forg[e]t about the negative
stigma attached to HIV/AIDS, [and] the fear factor [is] gone completely."
Wafford said the campaign has tested 8,000 people nationwide over the last
two years ("Tavis Smiley Show," NPR, 7/16).

The full segment is available online in RealPlayer.

OPINION


7. Bush, Congress Must Resolve 'Philosophical Differences' Over AIDS
Funding, BusinessWeek Analysis Says

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18862

While the media coverage of Bush's trip to Africa would make one think
that his "laudable humanitarian effort" to address AIDS in Africa had
already been undercut by the House, "White House spinmeisters failed to
point out" that the House slightly increased the amount Bush had requested
for AIDS programs in his fiscal year 2004 budget and "sharply increased"
the U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and
Malaria, according to a BusinessWeek news analysis. Bush and Congress have
"philosophical difference[s]" over how AIDS money would best be spent --
whether through bilateral programs run by U.S. agencies or through the
multilateral Global Fund, according to the analysis. In theory, the
bilateral approach will allow the U.S. to better control AIDS funding and
more easily disperse the money to "favored" African governments, according
to BusinessWeek. In Congress, however, there is widespread bipartisan
support for supporting the Global Fund, which could make use of the funds
more quickly than new U.S. programs that could take more than a year before
they would be fully operational. "Yet, while Washington debates how to
administer its health programs, more Africans are dying of AIDS each day.
And with new infection rates continuing to rise, the death toll promises to
become much higher. The world will be watching to see whether Bush is
willing to back up his rhetoric with sufficient money," BusinessWeek
concludes (Engardio, BusinessWeek, 7/15).

8. Providing Treatment to HIV-Positive People Must be Strategy Included in
Fight Against AIDS, Editorial Says

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18863

The "grim notion" that allowing people with HIV/AIDS to die without
treatment is less expensive than an "all-out" HIV prevention campaign
"happens to be entirely wrong," a Minneapolis Star Tribune editorial says.
According to economists who spoke this week at the International AIDS
Society's 2nd Conference on HIV Pathogenesis and Treatment, the "least
effective way to contain HIV is to ignore those already carrying [the
virus]," the editorial says. AIDS "wrecks societies" and "leaves kids
parentless, crops unplanted, incomes unearned, students untaught; it tears
communities apart," according to the Star Tribune. With antiretroviral
drug prices dropping, treating HIV-positive people "will be cheaper in the
long run than letting people die," according to several economists, who
said that the evidence supporting the findings is "indisputable," the
editorial says. However, "AIDS cannot be fought successfully without
shoring up developing countries' capacity to sustain themselves," according
to the editorial. That means working to keep people alive and healthy for
as long as possible so that they can help to raise children and hold
society together, the Star Tribune says, concluding, "It's a matter of
saving lives now in order to save more lives -- and more money -- later.
Who will challenge the logic, or the humanity, of doing so?" (Minneapolis
Star Tribune, 7/16).

SPECIAL NOTICE


9. CORRECTION

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18864

The Kaiser Daily HIV/AIDS Report on July 11 mistakenly reported facts
related to the issue of mandatory HIV testing for asylum seekers in the
United Kingdom. The Daily Report, using information reported in an earlier
edition, incorrectly reported as fact arguments put forth by supporters of
mandatory testing. An updated and corrected version of the story appears
below:

U.K. Should Not Implement Mandatory HIV Testing for Asylum Seekers,
Parliamentary Report Says

Mandatory HIV testing for asylum seekers upon entry to the United Kingdom
would violate the country's human rights obligations and could deter those
already in the country from undergoing HIV testing, according to a report
released on July 10 by the All-Party Parliamentary Group on AIDS, Reuters
reports. The 175-member group launched an investigation in response to
concerns that the government was not properly consulting refugee groups in
its probe of the public health risks posed by immigrants (Reuters, 7/9).
Member of Parliament Neil Gerrard, chair of the All-Party Parliamentary
Group on AIDS and the All-Party Parliamentary Group on Refugees, said, "We
feel that the current government position on asylum seekers and migrants
with HIV has been largely developed in response to reports based on fear
and stigma rather than factual evidence." After hearing testimony and
taking written submissions from a range of stakeholders, the group
concluded that the current immigration system does not provide adequate
access to treatment for HIV-positive people and that the government cannot
deny individuals entry into the country on the basis of poor health. The
group recommended that the government:

* improve access to HIV testing and treatment in order to prevent further
HIV transmission;

* not implement mandatory HIV testing for immigrants "with the aim of
exclusion on the basis of an HIV-positive test result";

* not detain people with communicable diseases, including HIV/AIDS, for
immigration purposes if care cannot be provided;

* develop and implement best practice guidelines on HIV-positive asylum
seekers; and

* work toward finalizing the World Trade Organization Doha declaration in
order to increase resources to develop health infrastructure in developing
countries and increase support of initiatives such as the Global Fund to
Fight AIDS, Tuberculosis and Malaria (Report summary, 7/10)

"It was felt that the U.K. government cannot look to exclude individuals on
the basis of poor health," Gerrard said, adding, "Instead, we should be
looking to address the factors which push people to migrate in developing
countries: poverty, access to health care, conflict, the impact of
environmental adversity and social exclusion" (BBC News, 7/10). The report
notes that under the European convention on human rights, asylum seekers
cannot legally be denied entry to a country on the basis of an HIV-positive
test result. Other immigrants to the United Kingdom are just as likely as
asylum seekers to be HIV-positive; therefore, immigration officials would
have to test all of the country's 12 million visitors each year if the
policy were to be anything but "blatantly discriminatory," the report says,
according to London's Guardian. The report also warns that singling out
HIV-positive people could discourage people already in the country from
getting tested. According to officials, two-thirds of HIV-positive people
in the country have not been diagnosed (Boseley/Travis, Guardian, 7/10).
The government responded that it will not rule out mandatory medical
testing for asylum seekers on arrival in the country, according to Home
Office Minister Beverly Hughes, who added, "What concerns me is the
underlying assumption that anybody with a significant illness -- as an
asylum seeker or a migrant -- should automatically get treatment in London"
(BBC News, 7/10).

________________________________________

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