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


Wednesday, February 4, 2004

ACROSS THE NATION
========================================
1. L.A. County Supervisors Order Health Officials To Strengthen
HIV, STD Prevention Programs in Bathhouses, Sex Clubs

GLOBAL CHALLENGES
========================================
2. Investing in Sexual, Reproductive Health Results in Medical
Benefits, Lives Saved, Report Says

3. South Africa To Receive $40M from United States To Combat
HIV/AIDS

4. Uganda Receives $37 Million in U.S. AIDS Funding, Plans To
Provide Antiretrovirals to Government Workers

DRUG ACCESS
========================================
5. Drug Shortages, Corruption Hindering Nigeria's Antiretroviral
Drug Program, Advocates Say

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

ACROSS THE NATION

1. L.A. County Supervisors Order Health Officials To Strengthen
HIV, STD Prevention Programs in Bathhouses, Sex Clubs

Access this story and related links online:
http://cme.kff.org/Key=1800.Cbr.C.D.GnyRjp

The Los Angeles County Board of Supervisors on Tuesday voted
unanimously to support a motion requiring county public health
officials to strengthen sexually transmitted disease prevention
efforts among men who have sex with men at bathhouses and sex
clubs, the AP/San Francisco Chronicle reports. The motion,
sponsored by County Supervisor Zev Yaroslavsky, requires the
county Department of Health Services and other workers within 90
days to recommend improvements for prevention programs and
guidelines for how the county and cities can coordinate
licensing and permitting for the clubs (AP/San Francisco
Chronicle, 2/3). The motion cited a study conducted in 2002,
which found that 11% of men at two Los Angeles area bathhouses
tested HIV-positive, compared with 5% of men who had been tested
at a public clinic or community-based testing center (AIDS
Healthcare Foundation release, 2/3). The high rate of HIV among
MSM in bathhouses "suggests that our HIV/AIDS and STD prevention
and treatment efforts must be strengthened to address the
environment in which high-risk sexual behavior occurs," the
motion said (AP/San Francisco Chronicle, 2/3). "Serious
infectious diseases continue to be transmitted at these venues
while we sit here today, while we wait for this report to be
compiled," Karen Mall, director of prevention and testing for
the AIDS Healthcare Foundation, said, adding, "I urge this body
to act quickly to develop a sound public health ordinance in
order to ensure clients have consistent, accessible prevention
and HIV and STD screening services in these venues" (AHF
release, 2/3).

Black AIDS Awareness Week

The Board of Supervisors on Tuesday also joined several U.S.
cities in proclaiming this week National Black HIV/AIDS
Awareness Week, Xinhua News Agency reports. In a motion
sponsored by Supervisor Yvonne Brathwaite Burke, the board
supported the week as a means of promoting HIV/AIDS awareness in
the black community. HIV/AIDS is the number one cause of death
among black men and women ages 25 to 44 in the United States,
and 23.5% of recently diagnosed HIV cases in Los Angeles were
among blacks. To commemorate the week, state offices,
businesses, churches and AIDS organizations are working together
to raise awareness about the disease, Xinhua News Agency
reports. "It is time for young people to get involved and do
something," Richard Hamilton, director of the event, said,
adding, "You can make a difference." Atlanta, Baltimore,
Chicago, Dallas, Detroit, Houston, Miami, New Orleans, New York
and Oakland, Calif., this week also are recognizing National
Black HIV/AIDS Awareness Week (Xinhua News Agency, 2/3).National
Black HIV/AIDS Awareness Day is Feb. 7 (Kaiser Daily HIV/AIDS
Report, 2/3).

GLOBAL CHALLENGES

2. Investing in Sexual, Reproductive Health Results in Medical
Benefits, Lives Saved, Report Says

Access this story and related links online:
http://cme.kff.org/Key=1800.Cbr.D.D.GfY6Yv

Investing in women's sexual and reproductive health services
results in "huge returns" in medical benefits and lives saved,
according to a report released on Tuesday by the Allan
Guttmacher Institute and UNFPA, Reuters reports. The report,
titled "Adding it Up: The Benefits of Sexual and Reproductive
Health Care," is the first of its kind to examine research on
the return on investment in sexual and reproductive health
programs from the previous 25 years, according to Reuters
(Reaney, Reuters, 2/3). The report focused on the societal and
individual impact of three "key" areas, including the
prevention, diagnosis and treatment of sexually transmitted
diseases, including HIV/AIDS; maternal health; and contraceptive
services and supplies to prevent unintended pregnancies (AGI
release, 2/3). Both the U.N. Millennium Development Goals set in
2000 and targets set at the 1994 International Conference on
Population and Development in Cairo, Egypt, aimed to provide
family planning options and education to prevent unwanted
pregnancies as a way to reduce world poverty and hunger and
improve women's rights in developing countries (Kaiser Daily
Reproductive Health Report, 1/15). The report found that in
2000, developed countries provided $2.6 billion for sexual and
reproductive health services, which is less than 50% of the
amount those countries pledged at the conference to be giving by
that time (Kirby, BBC News, 2/3). The report says that providing
reproductive and sexual health services for the 200 million
women throughout the world who need them would cost $3.9 billion
per year, according to Reuters. However, providing the services
could prevent annually 1.5 million maternal and infant deaths,
52 million unintended pregnancies and 505,000 children from
becoming orphans, the report says (Reuters, 2/3).

Recommendations

The report calls on developed countries to fulfill the pledges
made at the Cairo conference, the AP/Long Island Newsday reports
(Wardell, AP/Long Island Newsday, 2/3). The report says that
more than 75% of spending on reproductive and sexual health
services is currently provided by "individuals, governments and
nongovernmental organizations in developing countries," and
although "developing countries must continue investing ... it is
time for developed countries to live up to the pledges they made
at the 1994 conference" (BBC News, 2/3). AGI President Sharon
Camp said, "Governments are not recognizing the importance to
long-term development goals from investment in this area. We
have seen greater awareness of the need to address the AIDS
epidemic but that's only on[e] piece of the picture" (AP/Long
Island Newsday, 2/3). She added, "Our report makes it clear that
the global community can well afford to make the additional
investment needed to close the gap in sexual and reproductive
health." UNFPA Executive Director Dr. Thoraya Obaid said, "Money
invested in sexual and reproductive health services will be
repaid many times over." Camp also said, "We hope [the report]
will reach the Bush administration and also members of the U.S.
Congress who appropriate funds. We also hope it will reach
European donor governments. Even though they are doing better
than the United States in meeting their pledges, none of them
are where they committed to be in 1994" (Reuters, 2/3).

3. South Africa To Receive $40M from United States To Combat
HIV/AIDS

Access this story and related links online:
http://cme.kff.org/Key=1800.Cbr.F.D.Gg7f5s

U.S. Ambassador to South Africa Cameron Hume on Tuesday
announced that South Africa will receive an initial $40 million
from the United States to help combat HIV/AIDS,
BuaNews/AllAfrica.com reports (Freeman, BuaNews/AllAfrica.com,
2/3). The funds will be administered by the U.S. embassy, which
-- along with the South African government -- has already
identified some programs that will receive funding. According to
Hume, some funds have already been awarded, according to the
SAPA/Mail & Guardian (SAPA/Mail & Guardian, 2/3). The funding is
part of President Bush's five-year, $15 billion global AIDS
initiative, through which the administration hopes to prevent
seven million new HIV infections, treat two million HIV-positive
people with antiretroviral drugs and provide care for 10 million
HIV-positive adults and orphans (Xinhua News Agency, 2/3). Hume
said, "We are now at a point where we will be asking ourselves
what do we do, working with our South African partners, to
ensure that ... the aid is actually getting to individual South
Africans who need the help." He added, "Until we know there are
specific children being helped by these programs or until we
know that prevention efforts are getting to South Africans,
until we know that people who are sick are getting their
medicine, we cannot really say we have made any progress"
(SAPA/Mail & Guardian, 2/3). Hume also said that the South
African government has "given us clear guidelines on how to go
about using these funds so we stay in line with their own HIV
and AIDS program of action" (BuaNews/AllAfrica.com, 2/3).
According to Hume, fighting the epidemic will take more than
money, the SAPA/Mail & Guardian reports. "I don't think $40
million is the answer. Getting active with the kind of programs
we are able to fund will help us to find answers. Obviously,
money alone or programs alone aren't enough, but I think they
are a big help," Hume said (SAPA/Mail & Guardian, 2/3).

South Africa Cuts HIV/AIDS Budget

The South African government has cut by more than 66% its
HIV/AIDS budget for the current fiscal year, the Financial Times
reports. The government had allocated nearly $42.45 million for
its new antiretroviral drug program, but the treasury has
reduced funding to $12.8 million (Degli Innocenti/Lamont,
Financial Times, 2/3). The South African Cabinet in November
2003 approved a plan for a national HIV/AIDS treatment program,
including the distribution of free antiretroviral drugs through
service points in every health district within one year and in
every local municipality within five years. The program aims to
treat 1.2 million people -- or about 25% of the country's
HIV-positive population -- by 2008. About 25% of South Africa's
economically active individuals are HIV-positive, with about
five million total HIV cases in the country (Kaiser Daily
HIV/AIDS Report, 1/28). Joanne Collinge, a spokesperson for the
South African Department of Health, said that $12.9 million is
"adequate for the preparatory phase" of the rollout. The health
department said that any delay in funding has been based on a
need to "do things properly and thoroughly," according to the
Times. But AIDS advocacy groups, including the Treatment Action
Campaign, said that the delays stem from "completely
unjustifiable neglect," the Times reports. TAC Secretary Mark
Heywood said, "We seriously doubt the politicians' commitment to
make a success of the plan. Even the [$12.8 million] still
earmarked for ARVs have not yet been dispensed to the provinces"
(Financial Times, 2/3). Swazi Hlubi, lead coordinator of the
advocacy group AIDS Therapeutic Treatment Now-South Africa,
said, "This budget cut serves as the death knell for the
fleeting promise of widespread treatment access to life-saving
AIDS drugs that our government promised us here in South Africa"
(ATTN-SA release, 2/3). South African Minister of Finance Trevor
Manuel is set to unveil the country's annual budget on Feb. 18,
the Times reports (Financial Times, 2/3).

Businesses 'Slow' To React to HIV/AIDS

South African businesses have been "slow to respond" to the
HIV/AIDS epidemic, according to a final report released on
Tuesday by the South African Business Coalition on HIV & AIDS,
Reuters reports (Chege, Reuters, 2/3). SABCOHA and the South
African Bureau for Economic Research surveyed 1,006 South
African companies in October and November. According to
preliminary findings that were released in December,
approximately 30% of the firms reported higher labor turnover
rates, 27% had "lost experience and skills" and 24% amassed
recruitment and training costs because of the HIV/AIDS epidemic.
The survey -- which was conducted among the manufacturing,
retail, wholesale, motor trade and building and construction
sectors -- also found that HIV/AIDS has had a "smaller or less
noticeable" impact on the demand side of business, with less
than 10% of companies participating in the survey reporting a
negative impact on their sales (Kaiser Daily HIV/AIDS Report,
12/11/03). The report says, "It seems that HIV/AIDS has had a
larger or more noticeable impact on the production side of
business, with more than 30% of all firms reporting that
HIV/AIDS had reduced productivity or increased absenteeism."
SABCOHA spokesperson Leighton McDonald said that the survey
indicates that "HIV/AIDS is undoubtedly a bottom-line issue for
business." SABCOHA Chair Gaby Magomola said, "If we do not
tackle the issue of HIV/AIDS effectively, we will be failing our
duty as citizens of this world. HIV/AIDS will pose a
considerable economic impact if left unchecked" (Reuters, 2/3).

4. Uganda Receives $37 Million in U.S. AIDS Funding, Plans To
Provide Antiretrovirals to Government Workers

Access this story and related links online:
http://cme.kff.org/Key=1800.Cbr.G.D.Gl93cf

The U.S. embassy in Uganda on Monday announced that Uganda had
received $37 million in funding from the U.S. global AIDS
initiative, Agence France-Presse reports. That amount represents
half of what the country is expected to receive under the
initiative for fiscal year 2004, according to an embassy
statement (Agence France-Presse, 2/2). Funding for the first
installment of Bush's five-year, $15 billion global AIDS
initiative, which targets countries in Africa and the Caribbean,
is contained in an omnibus spending bill (HR 2673), which the
Senate passed last month. The bill, which combines seven of the
13 FY 2004 spending bills, includes $2.4 billion for
international AIDS, TB and malaria initiatives (Kaiser Daily
HIV/AIDS Report, 1/29). In Uganda, the funding will be used to
expand the country's existing HIV/AIDS programs, including the
provision antiretroviral drug treatment for 60,000 HIV-positive
people as well as care and support for an additional 300,000
HIV-positive people (Agence France-Presse, 2/2). An estimated
100,000 of the 1.2 million HIV-positive Ugandans are in need of
antiretroviral treatment but only 17,000 currently have access
to the drugs (Kaiser Daily HIV/AIDS Report, 12/19/03).

Government Employees To Receive Antiretrovirals

Ugandan Director General of Health Services Francis Omaswa on
Monday announced that HIV-positive government employees soon
will be able to access free antiretroviral drugs. The first
shipment of drugs, which will be distributed through all of the
country's district hospitals, will arrive this month, Omaswa
said. Teachers will be included in the program scheme but will
be required to request the antiretroviral drugs through the
Ministry of Education and Sports, Omaswa said (Jaramogi,
Monitor, 2/3). Ugandan Minister of Health Jim Muhwezi in
December 2003 announced that the country this month will use a
$3 million grant from the World Bank to begin providing free
antiretroviral drugs to HIV-positive people. In addition to the
$3 million World Bank grant, the country has received $54
million from the Global Fund to Fight AIDS, Tuberculosis and
Malaria, of which $9 million has been allocated for the
antiretroviral drug program. The country is expected to receive
an additional $62 million from the Global Fund to purchase the
drugs. The drug distribution program will make Uganda the second
country in Africa to provide free antiretroviral drugs,
according to Muhwezi (Kaiser Daily HIV/AIDS Report, 12/19/03).

Infants

At least 25,000 infants are born HIV-positive in Uganda each
year, according to a Ministry of Health official, Xinhua News
Agency reports. Dr. Alex Opio, assistant commissioner of
national disease control, cited the country's 30%
mother-to-child HIV transmission rate. Opio said that vertical
HIV transmission is the second leading cause of HIV transmission
in the country after sexual contact, Xinhua News Agency reports.
Although antiretroviral therapy can help reduce the risk of
mother-to-child transmission, the treatment should be
accompanied by a "comprehensive prenatal care package, modified
delivery practices and good infant feeding options," Opio said
(Xinhua News Agency, 2/2).

DRUG ACCESS

5. Drug Shortages, Corruption Hindering Nigeria's Antiretroviral
Drug Program, Advocates Say

Access this story and related links online:
http://cme.kff.org/Key=1800.Cbr.H.D.GRxXTz

AIDS Alliance Nigeria on Tuesday said that the country's plan
to provide discounted antiretroviral drugs has failed due to
corruption, repeated drug shortages and the dispensation of
expired drugs, the AP/Newport News Daily Press reports.
President Olusegun Obasanjo in 2002 launched the program, which
aimed to provide antiretroviral drugs to HIV-positive people at
25 government treatment centers for less than $1 a month, or
less than 1% of the market price. However, AIDS Alliance Nigeria
advocates said that government commitment to the program has
"flagged" and the treatment centers in July 2003 began handing
out expired drugs and rejecting patients, according to the
AP/Daily Press. In addition, advocates said that officials at
some of the centers began demanding bribes before dispensing the
medications. "A total of 14,730 people living with HIV/AIDS on
government-subsidized antiretroviral drugs may lose their lives
to expired drugs and erratic drug administration," Lt. Commodore
Nsikak Ekpe, an HIV-positive naval officer and president of AIDS
Alliance Nigeria, said. Health Minister Eyitayo Lambo was
unavailable for comment, but a senior Ministry of Health
official, who spoke on the condition of anonymity, said that the
antiretroviral program was "in crisis" but that additional drugs
had been ordered, according to the AP/Daily Press. In addition,
the official said that doctors had dispensed expired drugs
because of concerns that patients could develop drug resistance
if they took a break in their treatment. Ekpe said that doctors
had provided AIDS Alliance Nigeria with similar reasoning, but
he added, "[W]e're not impressed by that argument because when a
drug is expired, it's expired" (Mbachu, AP/Newport News Daily
Press, 2/3).

________________________________________

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