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).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: http://www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. (c) 2004 Advisory Board Company and Kaiser Family
Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at
http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or
unsubscribe.
Questions about your email subscription? Contact us at
subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family
Foundation. For access to the Foundation's policy research,
analyses, reports and fact sheets, and media partnerships, visit
the Foundation's main website at http://www.kff.org .

-Message-Id: <20040204072753.BF54.4360-1800@...>

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

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*** LIVE WEBCAST: THE BUDGET FY05 ***
"Ask the Experts," a live webcast today at 2pm ET,
will feature a panel of experts answering questions
about President Bush's budget. Email questions to
ask@... or call 888-KAISER8 during the program.
http://cme.kff.org/Key=1785.Cbt.C.D.CpTPXP
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
________________________________________


Tuesday, February 3, 2004

POLITICS AND POLICY
========================================
1. Bush's FY 2005 Budget Proposal Requests $2.8B for
International AIDS, TB, Malaria Programs

GLOBAL CHALLENGES
========================================
2. UNAIDS, Actress Emma Thompson, Other Prominent Women Launch
Global Coalition on Women and AIDS

ACROSS THE NATION
========================================
3. Some California Prison Inmates Oppose Integration With
HIV-Positive Inmates

4. Owensboro, Ky., Churches Hold HIV/AIDS Awareness Event

PUBLIC HEALTH & EDUCATION
========================================
5. NPR's 'Tavis Smiley Show' Interviews Black AIDS Advocates
About National Black HIV/AIDS Awareness Day Feb. 7

6. Christian Science Monitor Examines U.S.-Style Summer Camps
for Children Affected by HIV/AIDS in Africa

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

POLITICS AND POLICY

1. Bush's FY 2005 Budget Proposal Requests $2.8B for
International AIDS, TB, Malaria Programs

Access this story and related links online:
http://cme.kff.org/Key=1785.Cbt.D.D.Cxl4nD

  President Bush on Monday submitted his $2.4 trillion fiscal
year 2005 budget proposal, including funding for international
and domestic HIV/AIDS programs, Reuters reports (Entous/Bohan,
Reuters, 2/2). The proposal requests $2.8 billion for
international HIV/AIDS, tuberculosis and malaria programs, USA
Today reports (Benedetto et al, USA Today, 2/3). That amount
includes $1.45 billion for the new State Department Office of
the Global AIDS Coordinator, headed by Randall Tobias (Marquis,
New York Times, 2/3). Under the proposed budget, the U.S.
contribution to the Global Fund to Fight AIDS, Tuberculosis and
Malaria would be reduced from nearly $550 million in FY 2004 to
$200 million in FY 2005. For FY 2004, Congress approved $2.4
billion for international AIDS, TB and malaria programs, $400
million more than Bush had requested (Kaiser Daily HIV/AIDS
Report, 1/29). The FY 2005 proposal also includes $2.5 billion
-- a "big chunk of ... new money" -- for the Millennium
Challenge Account, an assistance program for developing nations
that encourages democracy and development through economic aid,
according to the Washington Post (Kessler, Washington Post,
2/3).

Reaction

With a FY 2005 request of $2.8 billion for global AIDS programs,
more than $9 billion must be committed to the AIDS relief plan
over the next three years to meet Bush's promise of $15 billion
over five years, which he made during his 2003 State of the
Union address, according to USA Today. However, the
administration said that the funding request is "right on track"
to meet the five-year, $15 billion goal, according to USA Today.
AIDS advocates said that Bush should "put up all the money he
promised," USA Today reports (USA Today, 2/3). Jamie Drummond,
executive director of the debt, AIDS and trade advocacy group
DATA, said that Bush's FY 2005 budget request "aggressively
supports exciting new bilateral initiatives on AIDS and poverty.
But it reduces funding for the multilateral Global Fund to Fight
AIDS by more than half -- down to the level of France's
contribution. DATA will work with the administration and
Congress to fully fund the Global Fund, as well as the bilateral
AIDS program and the Millennium Challenge, without cuts to other
live-saving programs" (DATA release, 2/2). The International
Association of Physicians in AIDS Care said in a statement that
Bush and Congress should "shore up funding" for AIDS, TB and
malaria programs. Although both the FY 2004 and FY 2005 budgets
include "significant increases" from FY 2003 spending levels,
"the request still does not meet the tremendous global need,"
according to the release. IAPAC President and CEO Jose Zuniga
said that if the administration has concerns about the Global
Fund, "they are better to articulate them, and to work with the
global community to find remedies, as opposed to hastily
withdrawing support from this promising institution" (IAPAC
release, 2/2).

Domestic Funding

Except for "meager" increases for the Ryan White CARE Act AIDS
Drug Assistance Program and the Minority HIV/AIDS Initiative,
the FY 2005 budget proposal "continues to underfund the domestic
and global" effort to combat HIV/AIDS, the AIDS Foundation of
Chicago said in a statement. According to AFC, the FY 2005
budget includes a $35 million increase for ADAP, bringing the
program's total appropriation to $783 million for the fiscal
year. However, that amount is $284 million short of projected
needs, according to AFC. "Thousands of HIV-positive people will
be denied access to care, which will simply worsen our nation's
AIDS crisis," AFC Associate Director David Munar said. AFC
Executive Director Mark Ishaug asked, "How can we possibly
reduce the 40,000 infections each year in this country without a
greater financial commitment to proven prevention programs?"
(AIDS Foundation of Chicago release, 2/2). AIDS Healthcare
Foundation President Michael Weinstein said that the ADAP
funding included in the FY 2005 budget proposal is "insufficient
to address waiting lists, capped enrollments, and other
restrictions in 15 states and increased costs and utilization in
others," adding, "We call on Congress to appropriate enough
funding to ensure that poor people with HIV will have the
medications they need to stay alive" (AHF release, 2/2).

Prevention

"Americans living with HIV want and need more from the
president," AIDS Action Executive Director Marsha Martin said,
adding that budget increases for HIV/AIDS programs "have to be
significant, not merely symbolic of his compassion" (AIDS Action
release, 2/2). According to a statement from the Human Rights
Campaign, the proposal requests $696 million for HIV/AIDS
prevention programs under CDC for FY 2005, representing a
"slight increase" of $1 million over FY 2004 spending but $4
million less than FY 2003 levels. "We are extremely disappointed
that President Bush has proposed spending $4 million less than
our nation did two years ago on critical HIV/AIDS prevention
programs," HRC President Cheryl Jacques said, adding, "With
approximately 40,000 new infections each year in our nation, we
cannot go backward in our commitment to preventing new HIV/AIDS
infections. ... We must strengthen the entire range of federal
HIV/AIDS programs" (HRC release, 2/2). AIDS Project Los Angeles
Executive Director Craig Thompson said, "We understand the
enormous demands on this budget, especially for increases in
funding for national security. But protecting the country
against AIDS is also part of national security." He added, "The
administration is scaling back on domestic AIDS funding just as
the epidemic may be showing signs of resurgence" (APLA release,
2/2).

Abstinence Funding Doubles

The FY 2005 budget proposal also includes $270 million for
abstinence education programs, Reuters reports (Kenen, Reuters,
2/2). During his State of the Union speech last month, Bush
called for the doubling of federal funding for abstinence
programs to fight sexually transmitted diseases. Bush said, "To
encourage right choices, we must be willing to confront the
dangers young people face -- even when they're difficult to talk
about. Each year, about three million teenagers contract
sexually transmitted diseases that can harm them, or kill them,
or prevent them from ever becoming parents. In my budget, I
propose a grassroots campaign to help inform families about
these medical risks. We will double federal funding for
abstinence programs, so schools can teach this fact of life:
Abstinence for young people is the only certain way to avoid
sexually transmitted diseases." He added, "Decisions children
now make can affect their health and character for the rest of
their lives. All of us -- parents and schools and government --
must work together to counter the negative influence of the
culture and to send the right messages to our children" (Kaiser
Daily HIV/AIDS Report, 1/21). The FY 2005 budget also includes
funding for initiatives to promote "healthy marriages" (Reuters,
2/2).

  NPR's "Morning Edition" on Tuesday reported on Bush's FY 2005
budget proposal, including funding for HIV/AIDS and Medicare.
The segment includes comments from David Moore, board member for
the Coalition for Health Funding and president of the
Association of American Medical Colleges; Rep. John Spratt Jr.
(D-S.C.); and HHS Secretary Tommy Thompson (Rovner, "Morning
Edition," NPR, 2/3). The complete segment is available online in
RealPlayer.

GLOBAL CHALLENGES

2. UNAIDS, Actress Emma Thompson, Other Prominent Women Launch
Global Coalition on Women and AIDS

Access this story and related links online:
http://cme.kff.org/Key=1785.Cbt.F.D.DHpb5V

  British actress Emma Thompson, UNAIDS Executive Director Peter
Piot and former Irish President Mary Robinson on Monday launched
the Global Coalition on Women and AIDS to raise awareness and
increase HIV/AIDS education among women in developing countries,
the PA News/Scotsman reports (Moss, PA News/Scotsman, 2/2). The
coalition will bring together advocates, government
representatives, celebrities and community workers to eradicate
violence against women, expand their access to education,
strengthen their inheritance and property rights and ensure fair
access to HIV prevention and care services (Piot/Thompson, BBC
News, 2/2). Women represent about half of all HIV-positive
people worldwide. In sub-Saharan Africa, women represent 58% of
HIV-positive people, and young women ages 15 to 24 are 2.5 times
more likely to be infected than young men. Women's increased
vulnerability to HIV is primarily due to "inadequate knowledge,
... insufficient access to HIV prevention services, inability to
negotiate safer sex, and a lack of female-controlled HIV
prevention methods, such as microbicides," according to a
coalition press release (Global Coalition on Women and AIDS
release, 2/2). In addition, women are more vulnerable to HIV
because the virus is more easily transmitted from men to women
and because women generally have sex earlier and with older
partners, according to Reuters (Reaney, Reuters, 2/2).

Reaction

"We have to put this power into the hands of women. It is not
that I want to exclude men in tackling this ... but we do have
to place emphasis on women having jurisdiction over their own
bodies," Thompson said. "All too often, HIV prevention is
failing women and girls. Because of their lack of social and
economic power, many women and girls are unable to negotiate
relationships based on abstinence, faithfulness and use of
condoms," Piot said (PA News/Scotsman, 2/2). He added that women
"are infected by their only sexual partner, their husband or
their regular boyfriend. Marriage doesn't protect against HIV"
(Boseley, Guardian, 2/3). Piot said, "It is precisely to address
these inequalities and reduce women's vulnerability to HIV that
the coalition has been created." Robinson said, "This is the
black plague of this century and it is particularly affecting
women. This coalition must make a difference" (PA News/Scotsman,
2/2). The coalition will be operated by a steering committee of
28 people involved with AIDS initiatives, including Musimbi
Kanyoro, secretary-general of the World Young Women Christian
Association in Kenya; Justice Edwin Cameron from South Africa;
Asma Jahangir, a lawyer and special rapporteur of the U.N.
Commission on Human Rights in Pakistan; Marta Suplicy, mayor of
Sao Paulo, Brazil; and Iman Bibars, chair of the Association for
the Development and Enhancement of Women in Cairo (Suri, Inter
Press Service, 2/2).

ACROSS THE NATION

3. Some California Prison Inmates Oppose Integration With
HIV-Positive Inmates

Access this story and related links online:
http://cme.kff.org/Key=1785.Cbt.G.D.DCpn8P

  Some inmates at the California Institution for Men in Chino,
Calif., are opposed to a desegregation proposal that would move
them into a housing unit with HIV-positive inmates, the
Riverside Press-Enterprise reports. Prison officials say that
the move, which is scheduled to take place this month, is
necessary to save money and prevent overcrowding, according to
the Press-Enterprise. Officials say that the Del Norte building,
which was built in the 1980s specifically to house HIV-positive
inmates, now has available space because the number of
HIV-positive inmates has declined. Prison official Sgt. Arioma
Sams said that the prison's east yard permanent work crew is
opposed to the move but added that they "already coexist in the
yard" with HIV-positive inmates, attending classes and visiting
hours together, the Press-Enterprise reports. A letter sent to
the Press-Enterprise claiming to be from the inmates said that
HIV-positive and HIV-negative inmates working together and
living together are "two very separate ideas" and expressed
concerns about HIV exposure and exposure to hepatitis and
tuberculosis. California Department of Corrections spokesperson
Terry Thornton said that the general populations of several of
the state's 32 other prisons integrate HIV-positive inmates,
adding that her department supports HIV/AIDS testing and
education because of high-risk behavior among some inmates,
according to the Press-Enterprise. She added, "Many inmates
don't know if they are HIV-positive or not." According to the
corrections department, 1.4% of the state's 160,000 inmates were
HIV-positive in 2002, the Press-Enterprise reports (Frith,
Riverside Press-Enterprise, 1/30).

4. Owensboro, Ky., Churches Hold HIV/AIDS Awareness Event

Access this story and related links online:
http://cme.kff.org/Key=1785.Cbt.H.D.Cd499N

  Several churches in Owensboro, Ky., on Sunday held an HIV/AIDS
awareness event targeting the city's black and Hispanic
residents, the Owensboro Messenger-Inquirer reports. The event,
which was held at the Cedar Street Missionary Baptist Church,
was coordinated by the churches and local and state AIDS
advocates. Walter McClain, a disease intervention specialist
with the state Department for Public Health, said that because
"people turn to churches for support and guidance, the church
[is] a good place to talk to the community about AIDS,"
according to the Messenger-Inquirer. Most new HIV infections in
the state occur among black and Hispanic women between the ages
of 23 and 35, according to Nick Sauer, a program manager for the
Owensboro Area HIV/AIDS Task Force. Blacks represented 29% of
the total number of AIDS cases in the state as of June 2003.
"The main focus of this is just to start making people aware,"
Task Force President Robbie Stone said, adding, "It mainly goes
untalked about" (Mayse, Owensboro Messenger-Inquirer, 2/2).

PUBLIC HEALTH & EDUCATION

5. NPR's 'Tavis Smiley Show' Interviews Black AIDS Advocates
About National Black HIV/AIDS Awareness Day Feb. 7

Access this story and related links online:
http://cme.kff.org/Key=1785.Cbt.J.D.Chyp3r

  NPR's "Tavis Smiley Show" on Monday included an interview with
Erylene Piper-Mandy, executive director of the Center for Cross
Cultural Competence, and Phill Wilson, executive director of the
Black AIDS Institute, in anticipation of National Black HIV/AIDS
Awareness Day on Feb. 7. According to Smiley, health and human
service agencies nationwide this week are participating in
activities related to HIV/AIDS awareness as part of a "count
down" to Saturday. In 2002, blacks accounted for 13% of the U.S.
population but 42% of HIV diagnoses, according to NPR. In
addition, black U.S. residents are nine times more likely to be
HIV-positive than white U.S. residents, NPR reports. According
to Wilson, HIV/AIDS is "still a difficult thing for black folks
to talk about" and discussion of the issue "consistently is
framed by other folks." Wilson said, "Unless and until we
develop the infrastructure and capacity to talk about AIDS in a
way that resonates with us, we're not going to solve this
problem. And that is one of the reasons why National Black AIDS
Awareness Day is so important -- it's about black folks talking
about an issue that is killing us in a language that we
understand." Piper-Mandy agreed that "African people have to
begin to look at solutions for HIV/AIDS themselves." Wilson and
Piper-Mandy also discussed the debate between allocating
resources to research and development into HIV/AIDS treatments
and vaccines versus spending funding on HIV/AIDS education,
prevention and testing, as well as whether there is a
"systematic lack of attention" to black health issues. Wilson
also discussed the Rap-It-Up/BASS Black AIDS Short Subject Film
Competition, a contest awarding $25,000 to black short film
makers aimed at increasing HIV/AIDS awareness within black
communities and sponsored by BAI, BET and the Kaiser Family
Foundation (Smiley, "Tavis Smiley Show," NPR, 2/2).

  The complete segment is available online in RealPlayer.

6. Christian Science Monitor Examines U.S.-Style Summer Camps
for Children Affected by HIV/AIDS in Africa

Access this story and related links online:
http://cme.kff.org/Key=1785.Cbt.K.D.Cj6dLq

  The Christian Science Monitor on Tuesday examined how
U.S.-style summer camps are helping some South African children
affected by HIV/AIDS escape their "difficult lives in the hard
world of South Africa's townships and squatter camps." Aid
organizations are bringing the camps, which are modeled after
U.S. summer camps for "sick or troubled" children, to South
Africa, Zimbabwe and Malawi, the Monitor reports. While allowing
the children to "just be kids" through activities such as soccer
and arts and crafts, the camps also aim to provide daily
life-skills training through classes on AIDS prevention and
respect. Thabanga Mpanza, a 15-year-old boy who attended the
Sizanani camp outside of Johannesburg, said, "We're just taking
part to see where it can take us. Because most of our friends
are committing themselves into crime and doing things that they
are not supposed to be doing -- so we just wanted to get off the
streets" (Itano, Christian Science Monitor, 2/3).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: http://www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. (c) 2004 Advisory Board Company and Kaiser Family
Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at
http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or
unsubscribe.
Questions about your email subscription? Contact us at
subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family
Foundation. For access to the Foundation's policy research,
analyses, reports and fact sheets, and media partnerships, visit
the Foundation's main website at http://www.kff.org .

-Message-Id: <20040203100315.BFF1.4362-1785@...>

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

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*** LIVE WEBCAST: THE BUDGET FY05 ***
"Ask the Experts," a live webcast Tues. at 2pm ET,
will feature a panel of experts answering questions
about President Bush's budget. Email questions to
ask@... or call 888-KAISER8 during the program.
http://cme.kff.org/Key=1765.Cby.C.D.MKg16H
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
________________________________________


Monday, February 2, 2004

GLOBAL CHALLENGES
========================================
1. Global Fund Suspends Funding to HIV/AIDS Programs in Ukraine,
Citing Poor Management, Other Concerns

2. Nearly Half of Patients in South African Public Hospitals
HIV-Positive, 'Secret' Report Says

3. South African Archbishop Lobbies U.S. Officials for Help
Combating HIV/AIDS

ACROSS THE NATION
========================================
4. Cirque du Soleil Offers To Rehire HIV-Positive Gymnast Fired
Because of Perceived Threat to Others

5. AIDS Advocates Stage Protest Following Death of HIV-Positive
Man Sentenced to 25 Years for Biting Prison Guard

PUBLIC HEALTH & EDUCATION
========================================
6. Viacom, Kaiser Family Foundation Launch Second Year of KNOW
HIV/AIDS Campaign With Super Bowl Ad

OPINION
========================================
7. Washington Post Editorial Gave President Bush's Emergency
AIDS Plan Unmerited Credit, Letter to Editor Says

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

GLOBAL CHALLENGES

1. Global Fund Suspends Funding to HIV/AIDS Programs in Ukraine,
Citing Poor Management, Other Concerns

Access this story and related links online:
http://cme.kff.org/Key=1765.Cby.D.D.Lv5wWw

  The Global Fund to Fight AIDS, Tuberculosis and Malaria on
Friday announced that it has suspended approximately $6.7
million in payments on grants to three Ukrainian HIV/AIDS
organizations because of concerns that they are poorly managed
and behind schedule in meeting their goals, the Washington Post
reports. The Global Fund has approved a total of $25 million in
two-year grants for Ukrainian programs. The three primary
recipients -- for which grants were suspended -- include a
Ukraine health ministry program to increase the number of people
on antiretroviral therapy from fewer than 60 people to about
4,000 people over two years; a public education program on AIDS
prevention organized by the Ukrainian Fund to Fight HIV
Infection and AIDS; and prevention programs for injection drug
users, prostitutes, soldiers and other high-risk groups run by
several small organizations under the management of the United
Nations Development Programme. So far, the Global Fund has
disbursed $7.5 million, but the programs have spent only about
$740,000, according to Global Fund spokesperson Jon Liden
(Brown, Washington Post, 1/31).

Analysis Shows Problems

Over the past three weeks, the Global Fund's secretariat has
carried out a comprehensive analysis of the programs' operations
and determined that "Ukraine is significantly behind in its
objectives on containing AIDS and providing medical assistance
for people who live with the virus," according to a Global Fund
statement (Interfax-Ukraine, 1/31). "We do not believe the
programs can be successful if we stay with the current
structure," Global Fund Executive Director Richard Feachem said,
adding, "Yet we do not wish to stop Global Fund funds from
flowing. ... The issue, therefore, is to secure operations in
the short term to ensure that in the medium term, we are able to
get the program back on track" (Global Fund release, 1/30). The
Global Fund plans to ask a "reliable organization" to assume
control over the AIDS programs for "several months," the
Ukranian News reports (Ukrainian News, 1/31). In addition, the
fund plans to bring in outside experts to reorganize local
management of the programs, according to the Post (Washington
Post, 1/31). The programs are expected to be turned over to the
Global Fund within the next few months while the Ukrainian
government works on improving the implementation process,
management and supervision. The Global Fund said that it would
take "decisive measures" to ensure that the programs' goals are
achieved within two years, Interfax-Ukraine reports
(Interfax-Ukraine, 1/31). The Global Fund -- which finances 225
disease prevention and treatment programs in 121 countries --
has never before stopped financing to one of its programs, the
Post reports (Washington Post, 1/31).

2. Nearly Half of Patients in South African Public Hospitals
HIV-Positive, 'Secret' Report Says

Access this story and related links online:
http://cme.kff.org/Key=1765.Cby.F.D.Lt05Vp

  Nearly 50% of all patients in South African public hospitals
were HIV-positive in 2002, according to a "secret" report
completed for the Department of Health, the Saturday
Star/Independent Online reports. The 175-page report, titled
"The Impact of HIV/AIDS on the Health Sector," was based on a
2002 study led by Dr. Olive Shisana, executive director of the
Human Sciences Research Council's program on the social aspects
of HIV/AIDS. Researchers found that AIDS patients have begun to
"crow[d] out" other South African patients from hospitals, as
46% of the patients in public hospitals have HIV infection.
Researchers also found that people living with HIV/AIDS tended
to have longer hospital stays, with an average of 13.7 days,
compared with an average of 8.2 days for HIV-negative patients.
The report says, "The finding that almost half of the patients
admitted to hospital are HIV-infected demonstrates the massive
increase in the burden placed on health care facilities"
(Terreblanche, Saturday Star/Independent Online, 1/30). The
report called for the government to train more nurses because up
to 16% of health care workers are expected to die from
AIDS-related complications between 2002 and 2007, the
SAPA/News24.com reports. The report also said that because of
the HIV/AIDS epidemic, "almost half the usual number of beds
were no longer available to other patients." The report, which
has been "kept under wraps," was leaked to the Saturday Star,
according to the SAPA/News24.com (SAPA/News24.com, 1/31).

Democratic Alliance, TAC Respond

The Democratic Alliance political party called for the
government to make public the contents of the report, the South
African Press Association reports. DA spokesperson Mike Waters
said in a statement on Sunday, "It is time Health Minister Manto
Tshabalala-Msimang realized concealing the findings of the
[report] will not make the problem go away." He added that the
impact of the epidemic on the South African health care system
is directly linked to the health minister's "inability to manage
the crisis properly," saying, "The economic and human costs of
the ruling party's slipshod handling of the pandemic are
immeasurable" (South African Press Association, 2/1). The South
African AIDS advocacy group Treatment Action Campaign on Sunday
after the report was leaked called again on the government to
implement its plan to provide antiretroviral drugs to people
living with HIV/AIDS in the country, Reuters/AlertNet reports
(Reuters/AlertNet, 2/1). The program, which was approved in
November 2003, 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). TAC National
Director Nathan Geffen said that although the group has not seen
the report, the figures leaked are "not ... surprising." He
added, "What this means is that there is no excuse for the
government to continue delaying the rollout of the
antiretroviral treatment program. That program is essential to
stem the growth of the burden on the public health system"
(Reuters AlertNet, 2/1).

Washington Times Editorial

"Many observers, especially from large multilateral
organizations, believe that there is a direct relationship
between success and spending when it comes to AIDS," a
Washington Times editorial says. However, some countries,
including Uganda, have "achieved great success" in fighting
AIDS, proving that "much can be done with little," the editorial
says. Although wealthy nations should "do their part to combat
AIDS" and President Bush should "start using political capital"
to get the five-year, $15 billion global AIDS initiative "on
track," African countries "must also be taken to task,"
according to the Times. TAC -- "[o]ne of the world's most
influential advocacy groups for combating HIV/AIDS" -- "deserves
credit for doing so" in South Africa, the editorial says,
concluding, "The governments of AIDS-afflicted countries should
be rewarded for progress and held to account for failures"
(Washington Times, 2/2).

3. South African Archbishop Lobbies U.S. Officials for Help
Combating HIV/AIDS

Access this story and related links online:
http://cme.kff.org/Key=1765.Cby.G.D.Lq8Qbx

  South African Archbishop Njongonkulu Ndungane last week met
with U.S. government and corporate officials in Washington,
D.C., to lobby for assistance in fighting HIV/AIDS in South
Africa, the Washington Post reports. Ndungane met with HHS
Secretary Tommy Thompson, National Security Adviser Condoleezza
Rice and other officials to advocate for debt relief and "full
funding" of President Bush's five-year, $15 billion global AIDS
initiative, according to the Post. Responding to criticism by
some AIDS advocates that Bush's upcoming budget would cut by
two-thirds U.S. contributions to the Global Fund to Fight AIDS,
Tuberculosis and Malaria, Ndungane said, "It is up to the
American public to challenge whatever discrepancies are there."
He added that South Africa is "appreciative of any help given to
alleviate the global pandemic before us." According to the Post,
Ndungane is the only leader in the African Episcopal Church who
has publicly supported the U.S. Episcopal Church after it voted
in August 2003 to ordain an openly gay bishop and to recognize
same-sex couples. Eight other African Anglican provinces have
cut ties with the U.S. chapter. Ndungane has said that
differences of opinion over homosexuality should not take
precedent over the "life and death issues before us" (Cooperman,
Washington Post, 2/1).

ACROSS THE NATION

4. Cirque du Soleil Offers To Rehire HIV-Positive Gymnast Fired
Because of Perceived Threat to Others

Access this story and related links online:
http://cme.kff.org/Key=1765.Cby.H.D.LbhRww

  Cirque du Soleil on Friday said that it will offer to rehire an
HIV-positive gymnast who was fired in spring 2003 because of
concerns that his HIV-positive status could endanger other
performers, the Los Angeles Times reports (Romney, Los Angeles
Times, 1/31). Matthew Cusick said that he disclosed his
HIV-positive status to Cirque shortly after his July 2002
hiring, underwent several medical evaluations and was found to
be in good health and considered fully able to perform with the
company. However, shortly before he was to begin performing in
the company's Las Vegas show "Mystere," Cirque sent him a letter
terminating his employment and stating that his HIV-positive
status "will likely pose a direct threat of harm to others,
particularly in the case of future injury" (Kaiser Daily
HIV/AIDS Report, 12/19/03). However, Cirque spokesperson
Renee-Claude Menard on Friday said that the company now believes
that Cusick's HIV-positive status would present "minimal" risk
to other performers and audience members and that "there are no
restrictions now for anyone with HIV at Cirque." Cirque's
decision to reinstate Cusick comes in response to the Equal
Employment Opportunity Commission's proposal for mediation in
the case, the Times reports (Los Angeles Times, 1/31).

'Too Soon To Say'

In July 2003, the Lambda Legal Defense and Education Fund filed
a federal discrimination complaint with the Equal Employment
Opportunity Commission against Cirque on Cusick's behalf (Kaiser
Daily HIV/AIDS Report, 12/19/03). EEOC on Thursday issued a
proposal for mediation, and Cirque du Soleil plans to offer to
reinstate the gymnast during mediation talks. Menard said, "Any
job opening at the Cirque is now available for [Cusick]"
(Donnelly, Montreal Gazette, 1/31). Cusick said it is "too soon
to say" if he would accept Cirque's offer of reinstatement
because he had heard of the offer only through a news release
and had not been contacted directly, the AP/San Diego
Union-Tribune reports (Leff, AP/San Diego Union-Tribune, 1/31).
Hayley Gorenberg, attorney for Cusick, said she believes Cirque
should also pay Cusick damages (Los Angeles Times, 1/31).

Separate Investigation Into Alleged Job Discrimination

Meanwhile, the San Francisco Human Rights Commission has begun a
separate probe into whether Cirque violated city codes that
prohibit job discrimination based on HIV status, the San
Francisco Chronicle reports. Cirque has leased property owned by
the Port of San Francisco and must comply with the codes
(Marech, San Francisco Chronicle, 1/31). Larry Brinkin, lead
negotiator with the commission's HIV division, said Cirque
officials last month met with commission officials to discuss
the alleged discrimination. Brinkin said Cirque Vice President
Marc Gagnon on Tuesday is expected to return to San Francisco to
begin writing an anti-discrimination policy (Los Angeles Times,
1/31). Brinkin said the commission will not end its
investigation until Cirque has stated "clearly and strongly that
in San Francisco all positions in Cirque du Soleil are open to
anyone qualified regardless of ... HIV status" (San Francisco
Chronicle, 1/31).

5. AIDS Advocates Stage Protest Following Death of HIV-Positive
Man Sentenced to 25 Years for Biting Prison Guard

Access this story and related links online:
http://cme.kff.org/Key=1765.Cby.J.D.L4z2WN

  AIDS advocates on Thursday chanted and staged a mock funeral at
the home of a retired judge to protest the 1990 sentencing of an
HIV-positive inmate, who died in prison in November 2003, the
Philadelphia Inquirer reports. About 75 people from ACT
UP/Philadelphia placed a black casket and flowers in the yard of
retired Superior Court Judge John Mariano, who in 1990 sentenced
inmate Gregory Smith to 25 years in prison for biting Camden
County Sheriff's Officer Albert Waddington. According to
Waddington's testimony, Smith -- who had been serving a
five-year sentence at the Camden County Jail for robbery -- bit
Waddington three times on the hand, spat on him and shouted,
"Now die, you pig. Die from what I have." Although there is no
evidence that HIV can be transmitted through saliva, an appeals
court upheld Smith's conviction saying that it was Smith's
intent to transmit HIV by biting the guard. Smith, who denied
biting the guard, died Nov. 10, 2003, at the Northern State
Prison in Newark, N.J. Members of ACT UP/Philadelphia said that
Smith had been an "openly homosexual AIDS activist" while
serving at the Camden County Jail and that the biting charges
stemmed from "AIDS hysteria," according to the Inquirer. Dan
Murphy, a spokesperson for ACT UP/Philadelphia, said that the
demonstrators on Thursday were also demanding better medical
care for HIV-positive inmates in the New Jersey prison system
(Gambardello, Philadelphia Inquirer, 1/30).

PUBLIC HEALTH & EDUCATION

6. Viacom, Kaiser Family Foundation Launch Second Year of KNOW
HIV/AIDS Campaign With Super Bowl Ad

Access this story and related links online:
http://cme.kff.org/Key=1765.Cby.K.D.L6hDY8

  The Kaiser Family Foundation and Viacom on Sunday during the
pre-game show of Super Bowl XXXVIII aired an HIV/AIDS public
service announcement to kick off the second year of the "KNOW
HIV/AIDS" awareness campaign, which the groups first launched in
January 2003 (Kaiser Family Foundation/KNOW HIV/AIDS release,
1/27). The campaign is aimed at raising HIV/AIDS awareness
through PSAs, television and radio programming and free print
and online content. The campaign -- which includes media
placements valued at more than $130 million in 2004 -- is
targeted at both the general population and groups hardest hit
by HIV/AIDS, such as people under age 25, minorities, women and
men who have sex with men. In 2003, the initiative created 49
television, radio and outdoor ads. The 2004 campaign will
include 40 targeted ads -- including some of the 49 ads created
for last year's campaign -- that will run across Viacom's
broadcast networks CBS and UPN; cable networks MTV, BET, VH1,
CMT: Country Music Television, TV Land, Nickelodeon, Nick at
Nite, Showtime, Spike TV and Comedy Central; 185 Infinity
Broadcasting radio stations; and billboards, buses and bus
shelter advertising. In addition, MTV, MTV International,
Nickelodeon, BET, VH1, Showtime, Sundance Channel and Infinity
Broadcasting are planning to air special HIV/AIDS-related
programming throughout the year (Kaiser Daily HIV/AIDS Report,
1/12).

'Lives Thrown Away'

The ad opens with the image of a dumpster in an alley. A
voiceover says, "Twenty million young lives thrown away. That's
how many could contract HIV in the next few years. But it
doesn't have to be like that." The dumpster opens and young
people climb out as the voiceover adds, "HIV is preventable,"
directing viewers to the KNOW HIV/AIDS Web site,
knowhivaids.org. The PSA ends with "thousands" of young people
climbing out of the dumpster (Kaiser Family Foundation/KNOW
HIV/AIDS release, 1/27). A Kaiser Family Foundation survey found
that 44% of adults in the United States either recognized the
KNOW HIV/AIDS brand or had seen at least one of the campaign's
ads (Viacom/Kaiser Family Foundation release, 1/12).

* The PSA is available online online.

* The Sundance Channel, which is owned by Viacom, on Monday will
air four HIV/AIDS-related documentaries, including "The Gift,"
"It's My Life," "Mother to Child," and "14 Million Dreams" (KNOW
HIV/AIDS Web site, 2/2).

OPINION

7. Washington Post Editorial Gave President Bush's Emergency
AIDS Plan Unmerited Credit, Letter to Editor Says

Access this story and related links online:
http://cme.kff.org/Key=1765.Cby.L.D.LdvG6c

  A Jan. 22 Washington Post editorial "correctly noted President
Bush's failure to provide an update" in his State of the Union
address on emergency AIDS funding, but it improperly "credited
the president for the latest spending increase," David Bryden,
communications director for the Global AIDS Alliance, writes in
a Post letter to the editor (Bryden, Washington Post, 2/1). The
Post editorial stated that the Bush administration has been
"ramping up its effort in a serious way," noting that
AIDS-related spending has increased five-fold during Bush's
term. The Post also said the Bush administration's requirement
that one-third of AIDS spending be used to fund abstinence
programs is "pronounced but not outrageous" and that it "makes
sense to give a large slice of the money" to agencies other than
the Global Fund to Fight AIDS, Tuberculosis and Malaria (Kaiser
Daily HIV/AIDS Report, 1/22). Bryden responds that Bush "fought
emergency spending" on AIDS and that the total amount spent on
AIDS, TB and malaria in fiscal year 2004 will total $2.4 billion
only "because members of Mr. Bush's own party ignored his
opposition." As a result, one year after Bush announced his
global AIDS initiative, "only a tiny fraction of the two million
people the president promised would receive life-saving
medications" actually have received them. "The question is not
whether the United States is spending more than in previous
years to fight AIDS; it is whether we are providing a fair
contribution to a global effort," Bryden says, concluding that
the United States is "not on track to provide even ... a
'bare-bones' response" to the AIDS pandemic (Washington Post,
2/1).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: http://www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. (c) 2004 Advisory Board Company and Kaiser Family
Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at
http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or
unsubscribe.
Questions about your email subscription? Contact us at
subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family
Foundation. For access to the Foundation's policy research,
analyses, reports and fact sheets, and media partnerships, visit
the Foundation's main website at http://www.kff.org .

-Message-Id: <20040202075930.C097.4366-1765@...>

New System Quickly Tracks HIV Prevalence
http://health.yahoo.com/search/healthnews?lb=s&p=id%3a42268

Yahoo!   My Yahoo!   Mail
	Sign In New User? Sign Up
				Health Home - Help

Yahoo! Health Search  All Yahoo! Health Health Centers Encyclopedia Drug Index Health News Ask the Expert Clinical Trials Alternative Medicine  for

Quicklinks:     Health Centers        Encyclopedia        Drug Index

Health > Health News > HealthDay

News by Source   News Main Page   ACS News Center   Acurian   Associated Press HealthDay   KidsHealth.org   Reuters  Health Resources  •  Ask the Doctor  •  Community  Yahoo! Resources  •  Ask Y!: Health and Wellness  •  Books: Health and Wellness  •  News: Health  •  Shopping: Health and Personal Care  Yahoo! Community  •  Chat: Health  •  Groups: Health  •  Message Boards: Health

HealthDay All HealthDay News New System Quickly Tracks HIV Prevalence June 9, 2003 09:50:08 AM PDT , HealthDay   By Randy Dotinga HealthDay Reporter   THURSDAY, May 22 (HealthDayNews) -- Armed with new testing technology, federal health officials are creating early-warning systems to quickly sound the alarm if HIV cases suddenly start to increase in a community. Until now, it has been impossible for health departments to track the ups and downs of the AIDS epidemic until months or years after infections occurred. The newest generation of tests, however, lets officials figure out whether patients were recently infected with HIV, the virus that causes AIDS. "This allows us to focus on where the epidemic is moving today," says Dr. Gary Goldbaum, a chronic disease and injury control officer with the public health department in Seattle and its surrounding county. The region tested the early-warning system before its nationwide rollout, which is beginning this year. The federal government hopes to bring the testing technology to 35 cities and regions by next year at an estimated annual cost of $12 million, says Dr. Matthew McKenna, chief of the HIV incidence and case surveillance branch of the U.S. Centers for Disease Control and Prevention. Currently, the system is in place in Seattle, Colorado and New Jersey. In those places, blood that tests positive for HIV undergoes a second test. "It tells within a pretty good degree of accuracy whether somebody has been infected within the past six months," McKenna says. If the number of recent infections is increasing in a "hot spot," local health officials could focus prevention efforts there, he explains. "It also allows you to evaluate the effectiveness of your interventions. If [an increase in cases] doesn't go away, you know you need to do something else." For most of the AIDS epidemic, state health departments tracked only the number of patients with AIDS itself. Privacy concerns played a major role in preventing officials from keeping tabs on people infected with the virus. But health officials had no idea when the AIDS patients were infected because it typically took six to seven years for the disease to develop, McKenna says: "It's like looking at a star. You're looking years back because it takes so long for the light to get here." Now, 49 states keep track of HIV-positive patients, either by name or through systems that protect the privacy of the patients. (The one holdout is Georgia, but McKenna says it may soon join the others.) Even with tracking of HIV cases, however, it's still hard to figure out if a rise in numbers is because of a worsening epidemic or simply the result of more testing in a community, McKenna says. That's where the new testing system comes in. More information To learn more about HIV/AIDS and treatments, visit the U.S. Centers for Disease Control and Prevention or the National Institute of Allergy and Infectious Diseases.   Email this Article | Printer-friendly format Archived Stories by Date: Jan 31, 2004 Jan 30, 2004 Jan 29, 2004 Jan 28, 2004 Jan 27, 2004 Jan 26, 2004 Jan 25, 2004 Jan 24, 2004 Jan 23, 2004 Jan 22, 2004 Jan 21, 2004 Jan 20, 2004 Jan 19, 2004 Jan 18, 2004 Jan 17, 2004 Jan 16, 2004 Jan 15, 2004 Jan 14, 2004 Jan 13, 2004 Jan 12, 2004 Jan 11, 2004 Jan 10, 2004 Jan 09, 2004 Jan 08, 2004 Jan 07, 2004 Jan 06, 2004 Jan 05, 2004 Jan 04, 2004 Jan 03, 2004 Jan 02, 2004 Jan 01, 2004 Dec 31, 2003 Dec 30, 2003 Dec 29, 2003 Dec 28, 2003 Dec 27, 2003 Dec 26, 2003 Dec 25, 2003 Dec 24, 2003 Dec 23, 2003 Dec 22, 2003 Dec 21, 2003 Dec 20, 2003 Dec 19, 2003 Dec 18, 2003 Dec 17, 2003 Dec 16, 2003 Dec 15, 2003 Dec 14, 2003 Dec 13, 2003 Dec 12, 2003 Dec 11, 2003 Dec 10, 2003 Dec 09, 2003 Dec 08, 2003 Dec 07, 2003 Dec 06, 2003 Dec 05, 2003 Dec 04, 2003 Dec 03, 2003 Dec 02, 2003 Dec 01, 2003 Nov 30, 2003 Nov 29, 2003 Nov 28, 2003 Nov 27, 2003 Nov 26, 2003 Nov 25, 2003 Nov 24, 2003 Nov 23, 2003 Nov 22, 2003 Nov 21, 2003 Nov 20, 2003 Nov 19, 2003 Nov 18, 2003 Nov 17, 2003 Nov 16, 2003 Nov 15, 2003 Nov 14, 2003 Nov 13, 2003 Nov 12, 2003 Nov 11, 2003 Nov 10, 2003 Nov 09, 2003 Nov 08, 2003 Nov 07, 2003 Nov 06, 2003 Nov 05, 2003 Nov 04, 2003 Nov 03, 2003 Nov 02, 2003 Nov 01, 2003 Oct 31, 2003 Oct 30, 2003 Oct 29, 2003 Oct 28, 2003 Oct 27, 2003 Oct 26, 2003 Oct 25, 2003 Oct 24, 2003 Oct 23, 2003 Oct 22, 2003 Oct 21, 2003 Oct 20, 2003 Oct 19, 2003 Oct 18, 2003 Oct 17, 2003 Oct 16, 2003 Oct 15, 2003 Oct 14, 2003 Oct 13, 2003 Oct 12, 2003 Oct 11, 2003 Oct 10, 2003 Oct 09, 2003 Oct 08, 2003 Oct 07, 2003 Oct 06, 2003 Oct 05, 2003 Oct 04, 2003 Oct 03, 2003 Oct 02, 2003 Oct 01, 2003 Sep 30, 2003 Sep 29, 2003 Sep 28, 2003 Sep 27, 2003 Sep 26, 2003 Sep 25, 2003 Sep 24, 2003 Sep 23, 2003 Sep 22, 2003 Sep 21, 2003 Sep 20, 2003 Sep 19, 2003 Sep 18, 2003 Sep 17, 2003 Sep 16, 2003 Sep 15, 2003 Sep 14, 2003 Sep 13, 2003 Sep 12, 2003 Sep 11, 2003 Sep 10, 2003 Sep 09, 2003 Sep 08, 2003 Sep 07, 2003 Sep 06, 2003 Sep 05, 2003 Sep 04, 2003 Sep 03, 2003 Sep 02, 2003 Sep 01, 2003 Aug 31, 2003 Aug 30, 2003 Aug 29, 2003 Aug 28, 2003 Aug 27, 2003 Aug 26, 2003 Aug 25, 2003 Aug 24, 2003 Aug 23, 2003 Aug 22, 2003 Aug 19, 2003 Aug 18, 2003 Aug 17, 2003 Aug 16, 2003 Aug 15, 2003 Aug 14, 2003 Aug 13, 2003 Aug 12, 2003 Aug 11, 2003 Aug 10, 2003 Aug 09, 2003 Aug 08, 2003 Aug 07, 2003 Aug 06, 2003 Aug 05, 2003 Aug 04, 2003 Aug 03, 2003 Aug 02, 2003 Aug 01, 2003 Jul 31, 2003 Jul 30, 2003 Jul 29, 2003 Jul 28, 2003 Jul 27, 2003 Jul 26, 2003 Jul 25, 2003 Jul 24, 2003 Jul 23, 2003 Jul 22, 2003 Jul 21, 2003 Jul 20, 2003 Jul 19, 2003 Jul 18, 2003 Jul 17, 2003 Jul 16, 2003 Jul 15, 2003 Jul 14, 2003 Jul 13, 2003 Jul 12, 2003 Jul 11, 2003 Jul 10, 2003 Jul 09, 2003 Jul 08, 2003 Jul 07, 2003 Jul 06, 2003 Jul 05, 2003 Jul 04, 2003 Jul 03, 2003 Jul 02, 2003 Jul 01, 2003 Jun 30, 2003 Jun 29, 2003 Jun 28, 2003 Jun 27, 2003 Jun 26, 2003 Jun 25, 2003 Jun 24, 2003 Jun 23, 2003 Jun 22, 2003 Jun 21, 2003 Jun 20, 2003 Jun 19, 2003 Jun 18, 2003 Jun 17, 2003 Jun 16, 2003 Jun 15, 2003 Jun 14, 2003 Jun 13, 2003 Jun 12, 2003 Jun 11, 2003 Jun 10, 2003 Jun 09, 2003 May 01, 2003 Apr 28, 2003 Apr 04, 2003 Feb 26, 2003 All Health News All HealthDay News

ADVERTISEMENT

---

Copyright © 2004 HealthDay All Rights Reserved. Copyright © 2004 Yahoo! Inc. All Rights Reserved. Terms of Service - Copyright Policy - Privacy Policy - Ad Feedback This site does not provide medical or any other health care advice, diagnosis or treatment. The site and its services, including the information above, are for informational purposes only and are not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health professional before starting any new treatment or making any changes to existing treatment. Do not delay seeking or disregard medical advice based on information on this site. Medical information changes rapidly and while Yahoo! and its content providers make efforts to update the content on the site, some information may be out of date. No health information on Yahoo! , including information about herbal therapies and other dietary supplements, is regulated or evaluated by the Food and Drug Administration and therefore the information should not be used to diagnose, treat, cure or prevent any disease without the supervision of a medical doctor.

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

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*** LIVE WEBCAST: THE BUDGET FY05 ***
"Ask the Experts," a live webcast next Tues. at 2pm ET,
will feature a panel of experts answering questions
about President Bush's budget. Email questions to
ask@... or call 888-KAISER8 during the program.
http://cme.kff.org/Key=1749.CcD.C.D.L2Ktz9
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
________________________________________


Friday, January 30, 2004

POLITICS AND POLICY
========================================
1. U.S. Government Expected To Announce Next Week Plans for
Spending $2.4B for AIDS, TB, Malaria Initiatives, Powell Says

2. NIH Director Zerhouni Defends AIDS, Sexual Health Research in
Letter to Senate, House Members

GLOBAL CHALLENGES
========================================
3. British Health Department Launches Hepatitis C Testing
Campaign

4. Croatian Conference of Bishops Says HIV/AIDS Education
Program Conflicts With 'Christian Morality'

DRUG ACCESS
========================================
5. Vatican Condemns Drug Companies for Profiting From AIDS Drug
Sales, Setting High Prices in Developing Countries

6. Not-for-Profit Company Requests Federal Trade Commission
Investigation Into Abbott's Price Increase of AIDS Drug

ACROSS THE NATION
========================================
7. Boston Mayor Supports Measure That Would Decriminalize Sale
of Hypodermic Needles Without Doctor's Prescription

8. San Francisco Chronicle Profiles New Advocacy Group AIDS
Housing Alliance

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

POLITICS AND POLICY

1. U.S. Government Expected To Announce Next Week Plans for
Spending $2.4B for AIDS, TB, Malaria Initiatives, Powell Says

Access this story and related links online:
http://cme.kff.org/Key=1749.CcD.D.D.LPN8qY

  The U.S. government is expected to announce next week how it
plans to spend $2.4 billion for international AIDS, tuberculosis
and malaria programs in fiscal year 2004, Secretary of State
Colin Powell said during a press briefing on Thursday, Agence
France-Presse reports (Agence France-Presse, 1/29). Funding for
the first installment of President Bush's five-year, $15 billion
global AIDS initiative is contained in an omnibus spending bill
(HR 2673), which the Senate passed late last week. House-Senate
conferees in November 2003 agreed to increase FY 2004 federal
spending on international AIDS, TB and malaria initiatives to
$2.4 billion, $400 million more than the Bush administration had
requested. Although the measure (HR 1298) supporting the global
AIDS initiative authorizes $3 billion for the first year of the
program, the Bush administration requested only $2 billion for
FY 2004. Bush said that his administration requested less than
$3 billion in order to give the program time to "ramp up"
(Kaiser Daily HIV/AIDS Report, 1/29). "You will see that it will
be a significant commitment of funds: new funds for new programs
as well as a continuation of our efforts with our bilateral
programs and our support of the [Global Fund to Fight AIDS,
Tuberculosis and Malaria]," Powell said, adding, "[S]o the
president has a strong commitment to HIV/AIDS, and when you see
how the money is going to be flowing out rather quickly in the
near future, the commitment the president has made will be quite
evident, and I think the American people will be proud of what
we are doing" (State Department release, 1/29). According to
Agence France-Presse, Bush administration officials said that
the announcement on how the FY 2004 AIDS money will be spent
likely will be made on Tuesday, one day after Bush is expected
to present his FY 2005 budget (Agence France-Presse, 1/29).
According to White House officials, Bush will request $2.7
billion for AIDS, TB and malaria programs in his FY 2005 budget
proposal (Kaiser Daily HIV/AIDS Report, 1/29).

2. NIH Director Zerhouni Defends AIDS, Sexual Health Research in
Letter to Senate, House Members

Access this story and related links online:
http://cme.kff.org/Key=1749.CcD.F.D.LNBy2j

  NIH Director Elias Zerhouni this week sent a letter to House
and Senate members defending his agency's funding of research
related to sexual health, including AIDS, the New York Times
reports (Grady, New York Times, 1/30). Conservative House
members have questioned at least 10 NIH research grants,
including grants for studies on emergency contraception, Asian
sex workers in San Francisco and women's response to
pornography. At an Oct. 2, 2003, hearing on the grants, Rep.
Michael Ferguson (R-N.J.) asked NIH for information about the
public benefit of the 10 studies. Zerhouni's staff contacted the
House Energy and Commerce Committee, which co-sponsored the
hearing, to obtain the list of studies about which Ferguson
wanted further information. Instead of sending the list of 10
studies, a committee staff member sent a different, longer list.
That list, which includes more than 200 grants representing $100
million in funding, was prepared by the Traditional Values
Coalition, which says it represents 43,000 churches nationwide.
Zerhouni ordered his staff to review approximately 190 of the
studies (Kaiser Daily HIV/AIDS Report, 1/13). NIH staff were
required to review the grants to determine whether the projects
"were relevant to the public health needs of our country," used
methodology that was "scientifically and ethically appropriate,"
had been "properly reviewed and funded by NIH" and received
funding that was proportional "relative to the burden of
sexually related diseases as compared to other diseases" (Letter
text, 1/26).

Findings

Zerhouni wrote in the letter that although such research is
"distasteful to some," the studies are important to public
health, according to the AP/Atlanta Journal-Constitution.
"Clearly, this has to be considered as one of our highest
priorities in light of the enormous suffering and costs of
illnesses associated with sexual behavior," he said (Sherman,
AP/Atlanta Journal-Constitution, 1/30). Zerhouni noted that
there are 15 million new cases of sexually transmitted diseases
each year in the United States and said that "[u]nhealthy human
behaviors," including risky sexual practices, "have been
estimated to be the proximal cause of over half of the disease
burden in our country" (New York Times, 1/30). Zerhouni said
that NIH is "initiating discussions ... to ensure that this
research is better presented to the public so that they may
understand the relevance of this research to public health and
that it is prioritized appropriately" (Stacy McCain, Washington
Times, 1/30). Enclosed with the letter was a summary of NIH's
findings on the projects, including detailed reviews of several
grants (Letter text, 1/26).

Reaction

Rep. Henry Waxman (D-Calif.), who in fall 2003 criticized NIH
and HHS Secretary Tommy Thompson for questioning researchers
about their work, praised Zerhouni, saying, "I urge my
colleagues in Congress and Secretary Thompson to respect Dr.
Zerhouni's decision and disavow irresponsible attacks on
science" (AP/Atlanta Journal-Constitution, 1/30). Rep. Mark
Souder (R-Ind.) called Zerhouni's defense of the projects "an
unbelievable rationalization," adding, "Do I need a Ph.D. to
understand why it is a sensible prioritization to spend hundreds
of thousands of research dollars to pay women to watch porn,
while countless Americans are suffering from dehabilitating
diseases with no cures?" (Washington Times, 1/30).

GLOBAL CHALLENGES

3. British Health Department Launches Hepatitis C Testing
Campaign

Access this story and related links online:
http://cme.kff.org/Key=1749.CcD.G.D.LKLgNS

  The British Department of Health on Wednesday announced a new
campaign to encourage people to be tested for hepatitis C,
APM/Reuters Health reports. A health department spokesperson
said that the agency likely will publish an action plan soon,
according to APM/Reuters Health. The campaign will encourage
testing among high-risk groups, including injection drug users.
If a person tests positive for hepatitis C, the patient would
then be offered treatment and counseled about the risks of
alcohol consumption, which can contribute further to liver
damage caused by the disease. The plan includes a hepatitis C
awareness campaign targeting the public and health care
professionals. The initiative will "be centrally funded and
sustained over a number of years," the spokesperson said.
Officials believe that there are currently 500,000 people living
with hepatitis C in the United Kingdom, but most of them do not
know they are infected, according to APM/Reuters Health
(APM/Reuters Health, 1/28).

4. Croatian Conference of Bishops Says HIV/AIDS Education
Program Conflicts With 'Christian Morality'

Access this story and related links online:
http://cme.kff.org/Key=1749.CcD.H.D.KvPxvb

  A high school education program that includes HIV/AIDS
prevention messages promoting safer sex is "explicitly against
the Christian morality," the Croatian Conference of Bishops said
in a statement, Agence France-Presse reports. The program,
titled "Youth Educating Youth About AIDS -- MEMOAIDS," is taught
by teachers and peer educators through optional workshops in
high schools. The sessions focus on HIV/AIDS prevention and
condom use to help prevent the spread of sexually transmitted
diseases (Agence France-Presse, 1/28). The statement, which the
bishops released after they discussed the issue at a meeting on
Monday, said that the program is "unacceptable" and "held under
the pretext that it aims to protect adolescents from AIDS." The
bishops also said that parents were not asked for permission for
their children to participate in the program, adding that
"student and teacher believers are forced to participate in the
program, which goes against Christian morality, against their
conscience" (Vukic, Associated Press, 1/28). The bishops also
expressed concern that "[u]nder the pretext of protection of
adolescents against AIDS, a technique on how to use preventive
means is actually being practiced." The bishops did not make
recommendations for an alternative HIV/AIDS prevention program,
Agence France-Presse reports (Agence France-Presse, 1/28). The
bishops also did not call for the program to be stopped, and it
is unknown if the statement will affect the future of the
program, according to the Associated Press. Although there are
fewer than 150 registered HIV/AIDS cases in the country, health
officials recently have increased their awareness efforts, the
Associated Press reports (Associated Press, 1/28). Approximately
88% of the country's 4.4 million people are Catholic (Agence
France-Presse, 1/28).

DRUG ACCESS

5. Vatican Condemns Drug Companies for Profiting From AIDS Drug
Sales, Setting High Prices in Developing Countries

Access this story and related links online:
http://cme.kff.org/Key=1749.CcD.J.D.Kn2tY4

  The Vatican on Thursday condemned pharmaceutical companies for
making large profits from the sale of antiretroviral drugs in
developed countries while pricing the drugs at costs that are
unaffordable for millions of HIV-positive people in sub-Saharan
Africa, AFP/Yahoo! News reports (AFP/Yahoo! News, 1/29).
Archbishop Paul Cordes, president of the Vatican's charity
organization, said that the Vatican has undertaken several
public and private initiatives to pressure drug companies to
lower antiretroviral prices for developing countries, according
to Reuters (Reuters, 1/29). "This is a moral issue which shows
the lack of social conscience by these capitalistic enterprises,
which could easily save the lives of the 25 million sub-Saharan
Africans who are HIV-positive and otherwise doomed," Father
Angelo D'Agostino, a Jesuit priest who runs an AIDS orphanage in
Nairobi, Kenya, said, according to Agence France-Presse. Pope
John Paul II on Thursday in his Lenton message urged the world
community "not to close its eyes" to millions of people living
with HIV/AIDS in developing countries, particularly the
approximately 2.5 million HIV-positive children (Barnett, Agence
France-Presse, 1/29). "These children are dying because they
don't have the medicines," Cordes said (ANSA, 1/29). The World
Health Organization estimates that there are approximately 11
million AIDS orphans in Africa, according to Agence
France-Presse. The pope said that the Vatican would establish a
foundation to oversee the construction of an AIDS orphan village
near Nairobi, where the Kenyan government has donated land for
such a purpose (Agence France-Presse, 1/29).

6. Not-for-Profit Company Requests Federal Trade Commission
Investigation Into Abbott's Price Increase of AIDS Drug

Access this story and related links online:
http://cme.kff.org/Key=1749.CcD.K.D.KqL5xS

  Not-for-profit company Essential Innovations on Thursday filed
a complaint with the Federal Trade Commission calling for an
investigation into whether pharmaceutical company Abbott
Laboratories raised the price of its antiretroviral drug Norvir
in order to drive market share toward Kaletra, another of the
company's antiretroviral drugs, Reuters reports (Richwine,
Reuters, 1/29). Abbott last month increased the wholesale price
of Norvir -- which is known generically as ritonavir -- from $54
per month to $265 per month (Kaiser Daily HIV/AIDS Report,
12/19/03). Norvir is primarily used as a booster for other
protease inhibitors, such as Bristol-Myers Squibb's Reyataz and
Merck's Crixivan. Kaletra is a combination drug that includes
Norvir and another protease inhibitor. The price increase made
two-drug antiretroviral combinations including Norvir cost
between $12,254 and $16,933 annually, compared with $8,599 a
year for Kaletra, according to the complaint. The complaint
alleges that the Norvir price increase is "anti-competitive"
because it will make the Norvir combinations more expensive,
thereby shifting prescriptions toward Kaletra. "A main effect of
the price increase will be to raise the price of competing
products to shift market share to its combination product
Kaletra," James Love, a consumer advocate who this month founded
Essential Innovations, wrote in the complaint. Abbott
spokesperson Ann Fahey-Widman said, "That's simply not the case.
This action is specific to Norvir. It does not affect Kaletra,"
adding, "This pricing action supports our ability to continue
research and development" (Reuters, 1/29).

Patent Override

Essential Innovations on Thursday also was expected to ask HHS
Secretary Tommy Thompson to override Abbott's patent on Norvir
and grant licenses for generic production of the drug. The
company said that Thompson, under the 1980 Bayh-Dole Act, can
provide licenses to other pharmaceutical companies "when needed
for public health or because the patent holder has failed to
make the product available on reasonable terms," according to
Reuters. Essential Innovations was expected to file a complaint
claiming that Abbott set "abusive prices on government-funded
medicines," according to a statement posted on the Web site of
the Consumer Project on Technology. Fahey-Widman said the
petition was "completely without merit and contains gross
misinformation." She added that the company is allowing public
assistance programs to purchase the drug at the old price and
that patients lacking public or private insurance can obtain the
drug at no cost. In addition, the only government funding the
company received in relation to its development of Norvir was a
$3 million grant in 1988 for "very early discovery work" into
the company's entire HIV program, Fahey-Widman said. Even if all
of the funding went toward the development of Norvir, the $3
million would represent less than 1% of total spending by Abbott
and the government on the drug's development, she said.
Representatives for Thompson were not immediately available for
comment, according to Reuters (Richwine, Reuters, 1/29).

ACROSS THE NATION

7. Boston Mayor Supports Measure That Would Decriminalize Sale
of Hypodermic Needles Without Doctor's Prescription

Access this story and related links online:
http://cme.kff.org/Key=1749.CcD.L.D.Kx9jw2

  Boston Mayor Thomas Menino (D) on Wednesday called for the
Massachusetts Legislature to approve a bill (H 1087) that would
allow the city's pharmacies to sell hypodermic needles without a
prescription to injection drug users, which could help curb the
spread of HIV, the Boston Herald reports (Silberman, Boston
Herald, 1/29). Currently, Massachusetts is one of five states --
including California, Delaware, New Jersey and Pennsylvania --
that require a prescription to buy needles (Kaiser Daily
HIV/AIDS Report, 12/5/03). Under Massachusetts law, state
residents, with the exception of certain health professionals,
cannot possess hypodermic needles without a prescription.
However, the state Legislature in 1993 amended the law to allow
state participants in pilot needle-exchange programs in Boston,
Cambridge, Northampton and Provincetown to possess hypodermic
needles. In addition, the state Supreme Judicial Court in
December 2002 unanimously ruled that state residents who receive
hypodermic needles through one of the state's four
needle-exchange programs may not be arrested for possession of
the needles in communities without such programs (Kaiser Daily
HIV/AIDS Report, 12/9/02). Menino said that the measure would
help to "preven[t] the spread of AIDS. We've known that for
years." Lawmakers who oppose the measure said that it could lead
to increases in drug use, according to the Herald. However,
public health advocates said that there has not been a trend of
an increase in drug use when allowing the sale of needles
without a prescription, the Herald reports. Jean Flatley
McGuire, a Northeastern University public health professor and
former director of the state's HIV/AIDS bureau, said, "We know
that clean needles work. We have to use them in the fight
[against HIV/AIDS]" (Boston Herald, 1/29).

8. San Francisco Chronicle Profiles New Advocacy Group AIDS
Housing Alliance

Access this story and related links online:
http://cme.kff.org/Key=1749.CcD.M.D.LC9653

  The San Francisco Chronicle on Thursday profiled the AIDS
Housing Alliance, a new organization that aims to connect
HIV-positive people to landlords and roommates who are friendly
to HIV-positive people. Although San Francisco offers affordable
housing units to HIV-positive people, waiting lists are long and
the turnover rate is slow because antiretroviral drugs have
allowed patients to live longer. No organizations currently
exist in the private sector to link landlords and HIV-positive
tenants or to refer potential roommates to each other, according
to AHA founder Brian Basinger. The new alliance will link
landlords, tenants and roommates through listings that
interested parties can peruse at an office donated by the
Housing Rights Committee of San Francisco or at monthly
functions that Basinger calls "speed dating for roommates."
Although most city landlords know that open discrimination on
the basis of HIV status is illegal and "wouldn't fly," they
often use economic or disability discrimination to reject
prospective tenants who are HIV-positive, according to Christian
Irizarry, a case manager at Catholic Charities. An estimated 750
of the fair housing complaints filed with the San Francisco
Human Rights Commission each year come from HIV-positive people,
according to Compliance Officer Ed Ilumin. In addition, about
33% of the 1,500 cases handled each year by the AIDS Legal
Referral Panel are related to housing discrimination, panel
Director Bill Hirsh said. "It's the next generation of evolving
services needed for people living with HIV," John Crapo, an
adviser to the new alliance, said, adding, "Initially,
organizations were set up for the crisis and ... dying times.
Now, the issues are longevity: How do we live?" (Marech, San
Francisco Chronicle, 1/29).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: http://www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. (c) 2004 Advisory Board Company and Kaiser Family
Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at
http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or
unsubscribe.
Questions about your email subscription? Contact us at
subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family
Foundation. For access to the Foundation's policy research,
analyses, reports and fact sheets, and media partnerships, visit
the Foundation's main website at http://www.kff.org .

-Message-Id: <20040130133203.BFE2.4370-1749@...>

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


Thursday, January 29, 2004

POLITICS AND POLICY
========================================
1. Bush To Release FY 2005 Budget Proposal With
Lower-Than-Expected Contribution to Global Fund

GLOBAL CHALLENGES
========================================
2. Haiti's AIDS Epidemic Persists Despite Prevention, Treatment
Advances

3. Former Secretary of State Madeleine Albright Praises Romanian
HIV/AIDS Programs

4. New Zealand Government To Decline Entry to Immigrants With
Costly, Contagious Diseases, Including HIV, TB

PUBLIC HEALTH & EDUCATION
========================================
5. HIV Prevalence Lower Among Black Tar Heroin Users Compared
With White Powder Users, Study Says

MEDIA & SOCIETY
========================================
6. One World Beat Global Music Festival To Benefit Group
Providing Treatment for Children Living With HIV/AIDS

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

POLITICS AND POLICY

1. Bush To Release FY 2005 Budget Proposal With
Lower-Than-Expected Contribution to Global Fund

Access this story and related links online:
http://cme.kff.org/Key=1725.CcG.C.D.sgYmM

  President Bush on Monday is scheduled to release his fiscal
year 2005 budget, which will include a lower-than-expected
contribution to the Global Fund to Fight AIDS, Tuberculosis and
Malaria, Reuters/Yahoo! News reports (Reuters/Yahoo! News,
1/28). Under the proposed budget, the U.S. contribution to the
Global Fund would be reduced from $550 million in FY 2004 to
$200 million in FY 2005, according to congressional officials
who have been briefed on the budget proposal, the New York Times
reports (Becker, New York Times, 1/29). Funding for the first
installment of Bush's five-year, $15 billion global AIDS
initiative is contained in an omnibus spending bill (HR 2673),
which the Senate passed late last week. The bill, which combines
seven of the 13 FY 2004 spending bills, includes $2.4 billion
for international AIDS, TB and malaria initiatives. House-Senate
conferees in November 2003 agreed to increase FY 2004 federal
spending on international AIDS, TB and malaria initiatives to
$2.4 billion, $400 million more than the Bush administration had
requested. Although the measure (HR 1298) supporting the global
AIDS initiative authorizes $3 billion for the first year of the
program, the Bush administration requested only $2 billion for
FY 2004. Bush said that his administration requested less than
$3 billion in order to give the program time to "ramp up"
(Kaiser Daily HIV/AIDS Report, 1/28). Overall, AIDS, TB and
malaria funding in the FY 2005 budget proposal would total
almost $2.7 billion, including a funding increase for bilateral
programs -- from $1.9 billion to $2.5 billion. However, the
total amount is less than the $3 billion that AIDS advocates
expected after Bush announced the initiative in his 2003 State
of the Union address, according to the Times.

Reaction

Patrick Cronin, former assistant administrator at USAID, said,
"I would love to see the administration match the figures
outlined in the president's speech. But for all of our
quibbling, this is a serious commitment and these figures are
still very good." Global Fund Executive Director Richard Feachem
said in a telephone interview from Geneva that the United States
is the fund's single largest contributor, according to the
Times. He added, "The United States is a very generous
supporter, and I do not believe it will diminish its
contributions and will fully support the excellent work we are
doing in 121 countries" (New York Times, 1/29). Jamie Drummond,
executive director of the debt, AIDS and trade advocacy group
DATA, said that the administration is "robbing Peter to pay
Paul," and he cautioned that a reduction in funding could weaken
the Global Fund's support of programs "already in place," in
addition to new grants, according to Reuters/Yahoo! News. A
White House spokesperson said that Bush is not "backing away"
from his pledge to support the Global Fund. He said that the
fund is "an important part of the president's plan and there
will be a steady and sustained commitment" to it (Reuters/Yahoo!
News, 1/28).

GLOBAL CHALLENGES

2. Haiti's AIDS Epidemic Persists Despite Prevention, Treatment
Advances

Access this story and related links online:
http://cme.kff.org/Key=1725.CcG.D.D.zzF2B

  The Los Angeles Times on Thursday examined Haiti's AIDS
epidemic, which "rages on" despite advances in education and
treatment. More than 100 Haitians die each day from AIDS-related
illnesses, and the country is home to 90% of the HIV/AIDS
patients living in the Caribbean, the Times reports. Although
the incidence of new HIV cases has declined over the past two
years, "breaking the vicious cycle of poverty that propels the
AIDS epidemic is ... a herculean task," and efforts to expand
antiretroviral drug programs have become "enmeshed in the bitter
and divisive political crisis" affecting the country, leading
foreign aid programs to give money to nongovernmental
organizations instead of the "dysfunctional government," the
Times reports. Dr. Paul Farmer, a physician and anthropologist
who has worked in Haiti for more than 20 years, said that the
public health community has slowed the implementation of
antiretroviral drug programs, arguing that limited funds should
be spent instead on improving health care infrastructure. Some
people say that antiretroviral drugs cannot be used effectively
in countries such as Haiti because of a lack of intrastructure
and the risk of developing resistance, Farmer said, adding that
"we can use these drugs, and we have to use them. It's the job
of a doctor to take care of the sick." In 1998, Farmer
established an antiretroviral drug program in Haiti, which he
says now treats 2,000 HIV-positive people and has "reinvigorated
prevention efforts" and "reduced the stigma" of AIDS in rural
areas, according to the Times. However, some AIDS patients
continue to be turned away for treatment at clinics and
hospitals because of the stigma surrounding the disease. Such
incidents are driving advocacy groups in the country to
establish a network of specialized AIDS clinics throughout
Haiti, according to the Times (Williams, Los Angeles Times,
1/29).

3. Former Secretary of State Madeleine Albright Praises Romanian
HIV/AIDS Programs

Access this story and related links online:
http://cme.kff.org/Key=1725.CcG.F.D.w5V8S

  Former Secretary of State Madeleine Albright on Wednesday at an
international symposium in Bucharest, Romania, lauded Romania's
efforts to combat HIV/AIDS, saying that HIV-positive people in
the country receive medical treatment that is "in line with
international standards," Rompres reports. At the symposium,
titled "Public-Private Partnership for Increasing Access to
HIV/AIDS Treatment," Albright said she had observed health
professionals committed to fighting the disease at the Dr. Matei
Bals Institute of Infectious Diseases in Bucharest and she was
heartened by the country's response to the epidemic (Rompres,
1/28). "For about seven years, Romania is trying to fight AIDS
in many ways, it is a success story," Albright said, adding, "I
could even say that pediatric AIDS is not a problem anymore in
Romania. From this point of view, this country is an example"
(Agence France-Presse, 1/28). The symposium was sponsored by the
Romanian government and the pharmaceutical company Merck. Merck
President Per Wold-Olsen said that public-private partnerships
are important for fighting HIV/AIDS in countries such as Romania
and praised the Romanian government's efforts to support such
partnerships. Wold-Olson said that while many Central and
Eastern European countries are in a state of denial over the
HIV/AIDS epidemic, Romania is making progress in fighting the
disease. U.S. Ambassador to Romania Michael Guest said that
Merck and other large pharmaceutical companies -- including
Abbott Laboratories, Pfizer and GlaxoSmithKline -- are working
with the Romanian government to provide low-cost antiretroviral
drugs to the country's HIV-positive residents (Rompres, 1/28).

4. New Zealand Government To Decline Entry to Immigrants With
Costly, Contagious Diseases, Including HIV, TB

Access this story and related links online:
http://cme.kff.org/Key=1725.CcG.G.D.vvc6M

  The New Zealand government on Wednesday announced that it will
ban people from migrating to the country if they test positive
for diseases or conditions that could be contagious or costly to
treat, such as HIV or tuberculosis, the Associated Press
reports. Currently, people coming into the country are asked to
self-report a range of illnesses, but they are not tested for
most of them. Immigration Minister Lianne Dalziel said that the
government later this year will require potential immigrants to
be tested in their home countries for conditions such as TB,
HIV, hepatitis B and "significant" kidney disease, according to
the Associated Press. Beginning in March, foreign students
wishing to stay in New Zealand for more than six months will be
required to undergo testing, and the screening policy will apply
in mid-2004 to visitors or workers wishing to stay longer than
one year, Dalziel said. New Zealand's free public health system
spends millions of dollars each year treating Pacific Islanders
who have illnesses such as advanced heart and kidney disease and
are unable to access or afford treatment in their home
countries, according to the Associated Press (Lilley, Associated
Press, 1/28). A review of the existing screening system, which
has been in place for more than one year, "clearly" identified a
need for improvement to protect the public against contagious
diseases, the NZPA/New Zealand Herald reports (NZPA/New Zealand
Herald, 1/28). Dalziel said, "A country is entitled in
determining whether people are eligible for residence or not to
undertake ... a cost-benefit analysis." The new screening policy
will require a change in the nation's law, and the initiative is
expected to receive widespread support from legislators, the
Associated Press reports (Associated Press, 1/28).

PUBLIC HEALTH & EDUCATION

5. HIV Prevalence Lower Among Black Tar Heroin Users Compared
With White Powder Users, Study Says

Access this story and related links online:
http://cme.kff.org/Key=1725.CcG.H.D.CZqQMh

  The prevalence of HIV among injection drug users in cities
where the use of black tar heroin is common is lower than the
prevalence among IDUs in cities where the white powder form of
heroin is prevalent, according to a study conducted by
University of California-San Francisco researchers and published
in a recent issue of the journal Substance Use & Misuse, UCSF
Today reports. Researchers compared Drug Enforcement
Administration data on the predominant types of heroin used in
20 U.S. cities between 1990 and 1993. White powder heroin is
more common in East Coast cities, while black tar heroin is used
more often in cities west of the Mississippi River. Researchers
then compared that data with estimates of HIV prevalence during
the same time frame among injection drug users and gay men in
the same cities. Based on ethnographic, clinical,
epidemiological and laboratory data, the researchers found
several reasons why the risk of HIV transmission is lower among
IDUs who use black tar heroin versus the powder form. Black tar
heroin -- which is a "dark, gummy, resinous substance" -- must
be heated to 165 degrees, which is sufficient to kill HIV,
before it is injected, according to UCSF Today. In addition,
injecting black tar heroin can cause venous sclerosis, which is
a hardening of the veins and can lead to the loss of veins for
injection sites. Therefore, black tar heroin users are likely to
move quickly from intravenous injection to either subcutaneous
or intramuscular injections, which previous studies have
demonstrated are less efficient for HIV transmission. Black tar
heroin also clogs syringes, leading IDUs to frequently rinse or
dispose of their syringes. The rinsing of syringes could reduce
the residual amount of blood and HIV left in them after
injecting, according to the study.

Implications

Philippe Bourgois, a study co-author and chair of the UCSF
Department of Anthropology, History and Social Medicine, said,
"In California, injectors are constantly complaining that their
needles clog. They almost always rinse their syringes
immediately after shooting up in order to keep them from
jamming. The grounds of shooting encampments and the walls of
shooting galleries are wet from the water that they squirt
through their used needles. This is not the case in New York,
where white powder heroin does not 'gum up' needles." Dr. Daniel
Ciccarone, assistant professor in the UCSF Departments of Family
and Community Medicine and Anthropology, History and Social
Medicine and lead author of the study, said, "In the early
1990s, about 40% of IDUs in New York City were HIV-infected,
while only about 4% of IDUs in Los Angeles were infected with
HIV. Yet in both cities, about 25% of gay men were HIV-infected.
The solution to this discrepancy is found in the distribution
and use of black tar heroin and is due to its unique chemical
properties." Ciccarone added, "This data is valuable to public
health authorities. Consider that if powder heroin were to
become more widely available on the West Coast, public health
agencies would need to prepare for the possibility that
currently successful interventions to prevent HIV transmission
among IDUs may lose much of their effectiveness" (Sheehy, UCSF
Today, 1/27).

MEDIA & SOCIETY

6. One World Beat Global Music Festival To Benefit Group
Providing Treatment for Children Living With HIV/AIDS

Access this story and related links online:
http://cme.kff.org/Key=1725.CcG.J.D.CQlfyS

  The Second Annual One World Beat Global Music Festival, which
is scheduled for March 19 through March 21 at sites around the
world, will benefit Keep a Child Alive, a new initiative
established by Artists Against AIDS Worldwide, the Pak Tribune
reports. The initiative's goal is to provide antiretroviral
drugs to children living with HIV/AIDS in developing countries.
Leigh Blake, co-founder and executive director of Keep a Child
Alive, said, "As the HIV/AIDS epidemic continues to spread
throughout the world, many people and especially children in
developing nations are dying because they cannot afford the
medicine that will keep them alive. ... This event will help
bring much needed awareness of the global AIDS epidemic and its
effect on families as well as financial support for those who
need it desperately." The festival will feature performances of
many different music genres in many countries around the world
(Pak Tribune, 1/28).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: http://www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. (c) 2004 Advisory Board Company and Kaiser Family
Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at
http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or
unsubscribe.
Questions about your email subscription? Contact us at
subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family
Foundation. For access to the Foundation's policy research,
analyses, reports and fact sheets, and media partnerships, visit
the Foundation's main website at http://www.kff.org .

-Message-Id: <20040129080031.BFB6.4372-1725@...>

HRSA Develops Costing Tool for HIV Providers:  The HRSA HIV/AIDS Bureau in
conjunction with the Center for Health Services Financing and Managed Care
developed software to assists providers with determining how much it costs
to provide services to their patients with HIV/AIDS, known as the Technical
Assisting Costing Tool (TACT).  TACT was developed to help Ryan White
grantees and other safety-net providers negotiate billing and reimbursement
rates with managed care organizations and other third-party payors by
identifying service costs based on basic patient information, types of
services provided and expenses by category of service.

Details and the software (an Excel file) are available online at
www.hrsa.gov/tact.  Ryan White grantees and subgrantees may participate in a
webcast on Wednesday, February 25 from 12:00 pm to 2:00 pm (Central) to
learn more about how to use the TACT software.  Details, including online
registration, are available at http://www.hrsa.gov/tact/webcast.htm.

Source: HIV Quality Care E-News via Jackie Goff

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


Wednesday, January 28, 2004

ELECTION 2004
========================================
1. AIDSVote.org Releases Results of Presidential Candidate
Survey on AIDS-Related Policy Issues

POLITICS AND POLICY
========================================
2. Newsweek Web Exclusive Examines Bush's Global AIDS Initiative

GLOBAL CHALLENGES
========================================
3. TAC Criticizes South African Government for Delay in
Antiretroviral Drug Distribution

4. Sierra Leone Government Ministers To Undergo HIV Testing To
Break Down Stigma, Vice President Says

IN THE COURTS
========================================
5. Libyan Trial of Health Care Workers Who Allegedly Infected
Children With HIV May End Soon

PUBLIC HEALTH & EDUCATION
========================================
6. Public Service Announcements Featuring Animated Condoms
Airing Up to 20 Times Daily on South African Television

MEDIA & SOCIETY
========================================
7. Singer Dionne Warwick Receives Award From U.S. Government
Recognizing Work in Fight Against AIDS

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

ELECTION 2004

1. AIDSVote.org Releases Results of Presidential Candidate
Survey on AIDS-Related Policy Issues

Access this story and related links online:
http://cme.kff.org/Key=1716.CcS.C.D.FjN46W

  AIDSVote.org, an organization founded in 2003 to educate
candidates and the public on AIDS issues, last week posted the
results of a survey of 2004 presidential candidates,
Gay.com/PlanetOut.com reports. President Bush, who is running
for re-election, and Democratic presidential candidate Rev. Al
Sharpton were the only candidates who did not respond to the
survey, which was based on a model presidential platform
endorsed by AIDS advocacy organizations. All of the six
Democratic candidates who responded -- Sens. John Edwards
(N.C.), John Kerry (Mass.) and Joe Lieberman (Conn.), Rep.
Dennis Kucinich (Ohio), retired Army Gen. Wesley Clark and
former Vermont Gov. Howard Dean -- indicated support for an
increase in federal funding for the Ryan White CARE Act and
favored changing the federal government's ban on funding for
needle-exchange programs. All six respondents also indicated
that they opposed financial incentives to encourage
abstinence-only sex education programs and would lift the
funding bans imposed by the so-called "Mexico City" policy
(Lisotta, Gay.com/PlanetOut.com, 1/27). The policy, which is
also known as the "global gag rule," bars U.S. money from
international groups that support abortion through direct
services, counseling or lobbying activities (Kaiser Daily
HIV/AIDS Report, 12/2/03). In addition, all of the candidates
indicated support for efforts to overturn a law barring
HIV-positive foreigners from entering the country (AIDSVote.org
release, 1/22).

Question on NIH Research

The only issue included in the survey upon which the candidates
disagreed was federal investigations of peer-reviewed research
projects funded by NIH. The question refers to a controversial
investigation of research projects, including HIV and
sex-related research, that were considered "politically
sensitive," Gay.com/PlanetOut.com reports
(Gay.com/PlanetOut.com, 1/27). In what many said was a mix-up, a
congressional staff member in October 2003 requested that NIH
give information on a list of more than 200 grants representing
more than $100 million in funding instead of a shorter list of
10 grants that conservative House members had questioned for
several months. The longer list was prepared by the Traditional
Values Coalition, which says it represents 43,000 churches
nationwide. As a result of the longer list being sent, NIH began
calling researchers whose grants were on the list as part of a
report for Congress on broad categories of grants (Kaiser Daily
HIV/AIDS Report, 10/30/03). In the survey, AIDSVote.org asked
whether the candidates would support "the investigation of
approved, peer-reviewed research projects" conducted through
NIH. Edwards, Kerry, Lieberman and Kucinich said "yes," while
Clark and Dean said "no."

Response

Michael Kink of Housing Works in New York said, "The candidates'
responses illustrate their understanding of the critical
leadership role the White House must play in the fight against
AIDS," adding, "We hope this information will help the
electorate understand that critical role as well." AIDSVote.org
supporters and organizers were in New Hampshire on Monday in
advance of Tuesday's primary in an effort to draw attention to
the international AIDS crisis and domestic AIDS issues
(Gay.com/PlanetOut.com, 1/27).

POLITICS AND POLICY

2. Newsweek Web Exclusive Examines Bush's Global AIDS Initiative

Access this story and related links online:
http://cme.kff.org/Key=1716.CcS.D.D.F9z3P7

  Although President Bush's announcement of a five-year, $15
billion global AIDS initiative in his 2003 State of the Union
address "surprised and delighted" many AIDS advocates, the
president made no mention of AIDS in his State of the Union
address this year, which "came as little surprise" to critics of
the administration, Newsweek reports in a Web exclusive. The
emergency AIDS relief plan, which was meant to be a "bold
display of American generosity," could turn into a "public
relations disaster for Bush," according to Newsweek. The U.S.
Treasury has not disbursed any of the money Bush pledged last
year, and the administration's office of the Global AIDS
Coordinator continues to operate with few staff of its own.
Congress holds "[p]art of the blame for the hold-up," as an
omnibus spending bill (HR 2673) containing the first installment
of funding for the initiative was stalled until the Senate
passed it late last week, according to Newsweek (McLure,
Newsweek, 1/27). The bill, which combines seven of the 13 fiscal
year 2004 spending bills, includes $2.4 billion for
international AIDS, tuberculosis and malaria initiatives.
House-Senate conferees in November 2003 agreed to increase FY
2004 federal spending on international AIDS, TB and malaria
initiatives to $2.4 billion, $400 million more than the Bush
administration had requested. Although the measure (HR 1298)
supporting the global AIDS initiative authorizes $3 billion for
the first year of the program, the Bush administration requested
only $2 billion. Bush said that his administration requested
less than $3 billion in order to give the program time to "ramp
up" (Kaiser Daily HIV/AIDS Report, 1/23).

'Too Unilateral'

AIDS advocates have criticized the plan for "being too
unilateral" and fear that funneling money through U.S. aid
agencies instead of more multilateral organizations such as the
Global Fund to Fight AIDS, Tuberculosis and Malaria may
"imperil" the fund, Newsweek reports. Advocates say that the
administration wants to "g[o] it alone" so it would not have to
share credit with other countries for saving lives and so it
could fund only programs that fit its socially conservative
agenda, according to Newsweek. Paul Zeitz of the Global AIDS
Alliance said that although African nations could absorb more
money, USAID and other U.S. government agencies do not have the
capacity to disburse large amounts of funding. However, the
Global Fund, which has been in operation for 18 months, is able
to distribute large sums of money, according to Newsweek. By
disbursing money through U.S. aid agencies, the administration
could build a "parallel bureaucracy" that would compete with the
Global Fund, which -- with limited support from the United
States -- may have trouble attracting large contributions from
European nations and Japan, Newsweek reports. The Bush
administration proposed giving less than 7% of its overall AIDS
funding to the Global Fund, but Congress -- including
Republicans -- voted to almost triple the administration's
request and provide $550 million to the fund this year.

Presidential Campaign

Although Bush's plan is "hampered by unilateralism and
ideology," some critics say that the administration "must be
lauded for proposing such a bold initiative," which is "vastly
more ambitious" than any plan put forth by the Clinton
administration, according to Newsweek. During the 2004
presidential campaign, Bush's Democratic opponents are "unlikely
to gain much traction" on AIDS policy, which is not a top
priority for most voters, Newsweek reports. In addition,
Democrats in Congress share some of the blame for stalling
funding for the global AIDS initiative. However, "the president
could do more to halt the erosion of good-will generated by last
year's promise," Newsweek reports (Newsweek, 1/27).

GLOBAL CHALLENGES

3. TAC Criticizes South African Government for Delay in
Antiretroviral Drug Distribution

Access this story and related links online:
http://cme.kff.org/Key=1716.CcS.F.D.FfZRLJ

  The South African AIDS advocacy group Treatment Action Campaign
on Tuesday following a meeting of the group's executive board
criticized the government for its delay in providing
antiretroviral drugs to people living with HIV/AIDS in the
country, Reuters reports (Reuters, 1/27). 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, 12/17/03). TAC said that
the program is "inadequate" and "lacks political commitment,"
according to SABC News. Mark Heywood of TAC said, "We are
concerned that the plan originally allocates [nearly $38.4
million] for the end of this financial year and has been cut to
[almost $12.8 million]," adding that TAC believes that the $12.8
million has not been disbursed to provincial governments (SABC
News, 1/27). "It is unjustifiable, not acceptable, that in
almost February 2004 [the provision of antiretroviral drugs] is
not happening ... anywhere outside the Western Cape province,"
Heywood said (Reuters, 1/27). South Africa's Department of
Health did not respond to requests for comment, the Cape Times
reports.

Obtaining Antiretrovirals

Although TAC applauded the government for "biting the bullet" in
announcing a national antiretroviral program, the group said
that the government must move to implement the program
(Smetherham, Cape Times, 1/28). Heywood said that by not signing
a tender for the provision of antiretroviral drugs, the
government was guilty of "neglect," which "should not keep
hospitals and clinics from prescribing these antiretrovirals to
patients. The provinces' own budgets provide for the acquisition
of the medicine." He added, "We cannot sit back and watch people
die while doctors are actually ready to prescribe the medicine"
(Bremmer, News 24.com, 1/28). However, Health Minister Manto
Tshabalala-Msimang said that the government has established a
task team to investigate the pricing and amount of drugs needed.
"We are now placing tenders on antiretrovirals but ... we
[can]not just rely on one supplier -- we have got to have a
number of suppliers so that we actually always have
antiretrovirals in stock," she said (SABC News, 1/28).

Health System 'Decay'

  TAC also announced plans to hold a "people's health conference"
prior to the upcoming national elections to help create plans
for national, provincial and local campaigns to improve health
care services, according to the Times (Cape Times, 1/28). The
conference tentatively is scheduled for March or April before
the general election, for which the government has yet to
announce a date (Reuters, 1/27). "We believe that the health
system is in a state of serious decay, and is not meeting
government's constitutional obligation to provide quality health
care to as many people as possible," Heywood said, adding that
"the election is an opportunity to question the largest
political party about what has been delivered in health care,
and in HIV/AIDS particularly" (Cape Times, 1/28).

4. Sierra Leone Government Ministers To Undergo HIV Testing To
Break Down Stigma, Vice President Says

Access this story and related links online:
http://cme.kff.org/Key=1716.CcS.G.D.FfzNnR

  Sierra Leone Vice President Solomon Berewa on Monday said that
all of the country's government ministers and their deputies are
scheduled to undergo HIV testing to try to break down some of
the stigma attached to the disease, IRIB News reports. Speaking
to reporters following Sierra Leone's sixth development
partnership conference, Berewa said that the tests would be
conducted "soon." Berewa added, "I shall select a day for this.
... This is a practical way for us to show leadership." Berewa
said that he would also encourage the country's lawmakers to
undergo public HIV testing. Last week, the National AIDS
Commission called for journalists to undergo testing. According
to UNAIDS statistics, as of the end of 2001, 170,000
HIV-positive people lived in Sierra Leone, which has a
population of 5.7 million people. Approximately 42,000 children
in Sierra Leone have lost one or both parents to AIDS-related
causes, according to IRIB News (IRIB News, 1/27).

IN THE COURTS

5. Libyan Trial of Health Care Workers Who Allegedly Infected
Children With HIV May End Soon

Access this story and related links online:
http://cme.kff.org/Key=1716.CcS.H.D.FtrNPc

  The Libyan trial of six Bulgarian health care workers charged
with deliberately infecting 400 children with HIV through
contaminated blood products may end soon, BBC News reports.
Libyan leader Moammar Kadafi has accused the workers of taking
orders from the CIA and the Israeli secret service Mossad to
kill Libyan children in order to destabilize the country,
according to BBC News (Wood, BBC News, 1/26). However, some
European governments and human rights groups say that the Libyan
Health Ministry failed to screen blood products adequately and
allowed poor sterilization practices at Al Fateh Children's
Hospital in Benghazi, where the children were infected. The
health care workers have been detained in Libya since early
1999. A civil prosecutor in September 2003 requested about $10
million in compensation for the families of each HIV-positive
child. The trial was suspended in December 2003 to await an
opinion by a group of Libyan doctors (Kaiser Daily HIV/AIDS
Report, 1/5). AIDS and infectious disease experts, including HIV
co-discoverer Luc Montagnier, have testified for both the
defense and prosecution.

Seeking Acceptance?

According to BBC News, "[h]opes are high" that Libya will
release the health care workers as early as next month in an
attempt to end the country's isolation from the international
community. Western diplomats have said that the health care
workers were accused of spreading HIV because Libyan authorities
needed someone to blame for the "tragedy," which has caused
"outrage" in the country, BBC News reports (BBC News, 1/26).
Kadafi has promised Western diplomats that he will intervene,
but his decision is expected to have political implications. If
he accepts the European opinion that the epidemic was caused by
Libya's health system, he likely will win the support of Europe
but will be forced to accept blame in his home country, a move
that could cost more than $4 billion if Libya provides the
requested compensation (Kaiser Daily HIV/AIDS Report, 1/15).
However, the outcome of the trial also could be seen by many "as
a test of just how serious Libya is about ending its long, and
sometimes rather paranoid, isolation," according to BBC News
(BBC News, 1/26). The court is expected to announce the verdicts
at a hearing on Feb. 9, according to Bulgarian News Digest
(Bulgarian News Digest, 1/27).

PUBLIC HEALTH & EDUCATION

6. Public Service Announcements Featuring Animated Condoms
Airing Up to 20 Times Daily on South African Television

Access this story and related links online:
http://cme.kff.org/Key=1716.CcS.J.D.GDrR9p

  Public service announcements featuring three "jive-talking,
gaffe-prone condoms" that were produced and designed by a group
of volunteers from various Ottawa, Canada, production companies
are airing up to 20 times a day on South African television, the
Ottawa Citizen reports. The "Three Amigos" -- Shaft, Stretch and
Dick -- are a trio of animated condoms whose 15- to 60-second
adventures have gained "minor cult status" in South Africa,
according to the Citizen. Ottawa film and TV producer Firdaus
Kharas has shipped 14 of the cartoon PSAs to the South African
Broadcasting Company and is working on six more episodes. In one
episode, the condoms are strapped into a spaceship, as a female
voice is performing an "increasingly breathless" countdown "that
ends with a fizzle," the Citizen reports. "No condom, no
blastoff," a voiceover says. Jill Kruger, deputy director of the
Centre for HIV/AIDS Networking in South Africa, said, "I
anticipate that the Three Amigos will popularize condoms and
lead to increased use, which is vitally important in the fight
against HIV infection." Kharas is searching for funding to
reformat and mass produce the PSAs in multiple languages and
formats for free distribution worldwide. Ethiopia's minister of
health recently requested copies of the cartoons in several
tribal languages, according to the Citizen. The Canadian
International Development Agency is currently considering
providing funding for the project, the Citizen reports
(Atherton, Ottawa Citizen, 1/26).

MEDIA & SOCIETY

7. Singer Dionne Warwick Receives Award From U.S. Government
Recognizing Work in Fight Against AIDS

Access this story and related links online:
http://cme.kff.org/Key=1716.CcS.K.D.FypW18

  Singer Dionne Warwick on Tuesday in Singapore received an award
from the U.S. government in recognition of her work to raise
funds for HIV/AIDS research, the AAP/NEWS.com.au reports. U.S.
Ambassador to Singapore Frank Lavin presented Warwick with the
American Citizen Honor Award to recognize her 20-year
involvement in humanitarian efforts against the epidemic.
Warwick -- a five-time Grammy winner who is in Singapore for a
concert scheduled for Thursday -- said that education is the
most important tool in the fight against the disease, according
to the AAP/NEWS.com.au. "We have to make people aware, not just
through writing but also verbally and through demonstrations,"
Warwick said. She added that she felt overwhelmed with the
recognition. "I am doing what I feel comes naturally," she said,
adding, "When you receive an accolade you feel that your work is
being accepted ... but this is overwhelming." In 1985, Warwick
worked with producer Burt Bacharach and singers Gladys Knight,
Stevie Wonder and Elton John to record "That's What Friends Are
For." The profits of the song were donated to the American
Foundation for AIDS Research. In 1990, Warwick and other artists
raised more than $2.5 million dollars for AIDS organizations at
a benefit at New York City's Radio City Music Hall
(AAP/NEWS.com.au, 1/27).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: http://www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. (c) 2004 Advisory Board Company and Kaiser Family
Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at
http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or
unsubscribe.
Questions about your email subscription? Contact us at
subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family
Foundation. For access to the Foundation's policy research,
analyses, reports and fact sheets, and media partnerships, visit
the Foundation's main website at http://www.kff.org .

-Message-Id: <20040128085345.C061.4382-1716@...>

Dear Interested Party:

Kaisernetwork.org, the Kaiser Family Foundation's health policy news and
information website, introduces a new online resource that provides easy access
to the candidates' positions on critical health policy issues, as well as
election-related news and analysis.

Access the Election 2004 Issue Spotlight at
http://www.kaisernetwork.org/spotlight/election2004 .  Features include:
-- Candidate profiles, including issue statements, speeches, audio/video
interviews and transcripts, news coverage, and additional resources on all major
candidates.
-- A searchable archive of public opinion questions on health issues related to
the election.
-- A reference library of election websites and publications.
-- Multimedia resources, including webcasts of interviews, discussions, and
debates.
-- Election-related health news headlines.

The Election 2004 Issue Spotlight will be updated regularly to include new
information and developments throughout the campaign cycle.

If you have any questions about this or any of the Foundation's resources,
please call 202/347-5270 or send an email to webmaster@....


*****************************************************************
To subscribe, unsubscribe or make changes to your profile, go to
http://www.kff.org/register/

If you know anyone who would be interested in this alert, please pass it on.

The Henry J. Kaiser Family Foundation and kaisernetwork.org -- on the web at
www.kff.org and www.kaisernetwork.org
*****************************************************************









-Message-Id: <20040127122351.C8C0.27290-1703@...>

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


Tuesday, January 27, 2004

GLOBAL CHALLENGES
========================================
1. United States To Provide $66M to Zambia This Year for Fight
Against HIV/AIDS, U.S. Ambassador Says

2. U.N. Special Envoy for HIV/AIDS in Africa Says Celebrity
Important Component of Fighting African AIDS Epidemic

DRUG ACCESS
========================================
3. Fifteen State ADAPs Have Waiting Lists, Access Restrictions,
NASTAD Says

ACROSS THE NATION
========================================
4. Idaho, 11 Other States Receive HUD Grants for HIV/AIDS
Programs

5. Philadelphia AIDS Forum Attendees Focus on Inmate Care

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

GLOBAL CHALLENGES

1. United States To Provide $66M to Zambia This Year for Fight
Against HIV/AIDS, U.S. Ambassador Says

Access this story and related links online:
http://cme.kff.org/Key=1692.CcV.C.D.r6W3j

  The United States is expected to give $66 million to Zambia
this year to help the country fight its HIV/AIDS epidemic, one
of the worst in the world, according to U.S. Ambassador to
Zambia Martin Brennan, Reuters reports. Approximately one in
five people in Zambia is HIV-positive, and more than 800,000
children are orphans because of the epidemic, according to
Reuters. The money, which is part of President Bush's five-year,
$15 billion global AIDS initiative, will be used to purchase
antiretroviral drugs and train doctors and nurses to administer
the medications. "We are (going) to work with Zambians to
educate people about AIDS, to enable those infected with HIV to
have access to treatment," Brennan said, adding, "We want to
reach 200,000 Zambians in the next two years." He said that 55%
of the money would be used to buy antiretroviral drugs, which
would be distributed free-of-charge to HIV/AIDS patients who
cannot afford them. Currently, about 8,000 Zambians receive free
treatment under a government-sponsored program that was supposed
to reach 100,000 people.

Brand Name vs. Generic

Critics of the global AIDS initiative said that most of the
money would go to Western pharmaceutical companies to purchase
name-brand drugs instead of toward the purchase of locally
produced generic antiretroviral drugs. However, U.S. Embassy
Public Affairs Officer James Greene said, "The (U.S.) government
is currently working out guidelines and a mechanism for buying
the AIDS drugs. ... We will only know after two to three weeks
where the drugs will be bought." Brennan said that Zambia will
receive about $15 million in the next few weeks, with the
balance expected to be made available by July. He added that
Zambia's allocation of funding would increase in 2005 if the
country could show that the initial funds were well-spent,
according to Reuters (Shacinda, Reuters, 1/26).

2. U.N. Special Envoy for HIV/AIDS in Africa Says Celebrity
Important Component of Fighting African AIDS Epidemic

Access this story and related links online:
http://cme.kff.org/Key=1692.CcV.D.D.yqvFG

  U.N. Special Envoy for HIV/AIDS in Africa Stephen Lewis on
Sunday said that celebrity attention could be an integral part
of combating the African AIDS epidemic, the Canadian Press
reports. Lewis -- who was in Saskatoon, Saskatchewan, for a
weekend symposium -- said during an interview that "celebrity
attention," including Oprah Winfrey's recent trip to Zambia,
could help "kickstart the search for a cure" to HIV/AIDS,
according to the Canadian Press (Canadian Press, 1/26). Winfrey
in December 2003 traveled to Zambia to learn more about AIDS
orphans. Winfrey was encouraged to take her two-day trip to
Zambia after discussions with Lewis and former South African
President Nelson Mandela. In Zambia, approximately one in five
people is HIV-positive and one in three children is an orphan
(Kaiser Daily HIV/AIDS Report, 12/17/03). While in the country,
Winfrey visited clinics in the capital city Lusaka that provide
care to HIV-positive pregnant women, including the provision of
antiretroviral drugs to prevent mother-to-child HIV transmission
(Kaiser Daily HIV/AIDS Report, 12/5/03). Lewis said, "To go to a
country as poor as Zambia, struggling as hard as Zambia, was ...
quite a jolt and reinforced [Winfrey's] determination to do
something." In addition to Winfrey, Irish rock star Bono,
Microsoft CEO Bill Gates and former President Bill Clinton have
made "major" contributions to the fight against HIV/AIDS, the
Canadian Press reports. Lewis said that although more
high-profile figures are using their positions to raise HIV/AIDS
awareness, "[i]t should be major politicians in major countries
who are the voice, supporting what Africa wants to do" (Canadian
Press, 1/26).

DRUG ACCESS

3. Fifteen State ADAPs Have Waiting Lists, Access Restrictions,
NASTAD Says

Access this story and related links online:
http://cme.kff.org/Key=1692.CcV.F.D.xkBm9

  Fifteen states as of this month have waiting lists or access
restrictions on their AIDS Drug Assistance Programs, according
to the latest "ADAP Watch" released on Thursday by the National
Alliance of State and Territorial AIDS Directors, according to a
NASTAD press release (NASTAD release, 1/22). ADAPs -- which are
funded with both state and federal funds -- provide
HIV/AIDS-related medications to low-income, uninsured and
underinsured HIV-positive individuals(Kaiser Daily HIV/AIDS
Report, 1/13). According to the "ADAP Watch," Alabama, Alaska,
Arkansas, Colorado, Idaho, Indiana, Kentucky, Montana, North
Carolina, Oklahoma, Oregon, South Dakota, Washington, West
Virginia and Wyoming have waiting lists and/or access
restrictions. Currently, 791 people are on waiting lists for
enrollment in ADAP programs. According to NASTAD, Alabama,
Alaska and New Hampshire are anticipating new or additional
restrictions in fiscal year 2003, which ends March 31, 2004 for
ADAPs. Alabama, Montana, New Hampshire, New Mexico, Oklahoma,
South Carolina and Texas also are expecting new restrictions in
FY 2004, according to the "ADAP Watch" (NASTAD release, 1/22).

ACROSS THE NATION

4. Idaho, 11 Other States Receive HUD Grants for HIV/AIDS
Programs

Access this story and related links online:
http://cme.kff.org/Key=1692.CcV.G.D.tsl00

  The U.S. Department of Housing and Urban Development has
awarded a $1.3 million grant to the Idaho Housing and Finance
Association to fund a program for people living with HIV/AIDS,
AP/KTVB.com reports. The IHFA program during the last three
years has helped 178 HIV-positive people obtain long-term
housing, provided other services to 216 people living with
HIV/AIDS and helped 18 families receive both housing and other
services (AP/KTVB.com, 1/25). The funds will go to seven service
providers throughout Idaho. IHFA Vice President Julie Williams
said, "We look forward to using these valuable funds to assist
key service providers in securing permanent housing for their
clients." According to the Associated Press, Idaho is one of 12
states to receive the funding (Associated Press, 1/25). For
example, Our House -- Portland, Oregon's only residential care
facility with 24-hour specialized nursing care for AIDS patients
-- received a three-year $1.3 million HUD grant, which will
allow the facility to expand to care for 14 patients, the
Oregonian reports. Our House will also use the funds to offer
rental assistance to patients who do not live in the facility
and strengthen "onsite care," including nursing, social work and
occupational therapy, for patients who do not require 24-hour
care "but cannot live totally independently," according to the
Oregonian (Colburn, Oregonian, 1/23).

5. Philadelphia AIDS Forum Attendees Focus on Inmate Care

Access this story and related links online:
http://cme.kff.org/Key=1692.CcV.H.D.CY91GG

  Approximately 500 people in Philadelphia on Saturday attended
the sixth annual AIDS Care in the Minority Community Luncheon
and Forum, which focused on the issue of health care for inmates
with infectious diseases, the Philadelphia Inquirer reports. The
forum, sponsored by the AIDS service group Philadelphia FIGHT,
also honored health care providers who treat prisoners with
infectious diseases, such as HIV/AIDS. According to Leon King,
acting commissioner of the Philadelphia Prison System, providing
health care for HIV-positive inmates is an issue that is
"important beyond prison walls," according to the Inquirer. He
added, "[W]hen people leave the prison system they go back into
the neighborhoods." AIDS prevalence among prisoners is five
times the rate in the general population, the Inquirer reports.
King added that the PPS currently is seeking accreditation from
the National Commission on Correctional Health Care, which
mandates prisons to train staff on privacy issues and ensure
inmate access to "good" health care, according to the Inquirer
(Schiavo, Philadelphia Inquirer, 1/25).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: http://www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. (c) 2004 Advisory Board Company and Kaiser Family
Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at
http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or
unsubscribe.
Questions about your email subscription? Contact us at
subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family
Foundation. For access to the Foundation's policy research,
analyses, reports and fact sheets, and media partnerships, visit
the Foundation's main website at http://www.kff.org .

-Message-Id: <20040127083743.C0BF.4384-1692@...>

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


Monday, January 26, 2004

GLOBAL CHALLENGES
========================================
1. Ghana Begins Antiretroviral Treatment Distribution

2. Montreal Hospital Begins HIV Testing Thousands of Child
Patients Operated on by HIV-Positive Surgeon

IN THE COURTS
========================================
3. Creator of AIDS Memorial Quilt Can Keep Health Insurance
Despite Lawsuit, Names Project Foundation Says

ACROSS THE NATION
========================================
4. New York Times Examines HIV/AIDS Crisis in Westchester
County, N.Y.

OPINION
========================================
5. Humanitarian, Political Consequences Result From U.S. Funding
Delay for Global AIDS Initiative, Editorial Says

6. Wall Street Journal Claims About WHO, Global Fund Treatment
Guidelines 'Wrong,' Letter to Editor Says

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

GLOBAL CHALLENGES

1. Ghana Begins Antiretroviral Treatment Distribution

Access this story and related links online:
http://cme.kff.org/Key=1669.CcZ.C.D.KV0fp7

  Ghana earlier this month began providing antiretroviral
treatment to some HIV-positive people living in the country,
Reuters reports. Sekyi Amoah, director-general of the Ghana AIDS
Commission, said, "We started providing free antiretroviral
drugs to patients in four hospitals around the country this
month. Our target is to have 6,000 people on the drugs each year
over the next two years." The antiretroviral drugs are partially
subsidized through a $15 million grant from the Global Fund to
Fight AIDS, Tuberculosis and Malaria, which also will help fund
refurbishment of the country's hospital and laboratory
facilities, in addition to counseling and testing for the next
two years. Nii Akwei Addo, AIDS program director for the
country's Ministry of Health, said that the Global Fund's grant
will cover 2,000 people a year and that the government "will be
responsible for the remaining 4,000 patients." Of the 19 million
people in Ghana, 3.4% are HIV-positive, and 200 people become
infected daily, according to Reuters. Only 1% of people living
with HIV/AIDS in Ghana will have access to antiretroviral
treatment, Reuters reports. Amoah said, "That may not sound like
a lot of people, but it's not everyone who has HIV who needs to
be put on antiretrovirals." Addo added that the country's
attorney general's office is considering whether it would be
feasible to produce generic antiretrovirals locally without
breaking World Trade Organization intellectual property rules,
Reuters reports. He said, "Once the legal issues have been
cleared, we'll include that possibility in our options"
(Sakyi-Addo, Reuters, 1/22).

2. Montreal Hospital Begins HIV Testing Thousands of Child
Patients Operated on by HIV-Positive Surgeon

Access this story and related links online:
http://cme.kff.org/Key=1669.CcZ.D.D.KGWpj8

  A Montreal children's hospital by Saturday had already tested
400 former child patients and scheduled testing for 500 more who
were operated on between 1990 and 2003 by a now-deceased surgeon
whom the hospital administration recently learned was
HIV-positive, the CP/Ottawa Citizen reports. Thus far, no
children have tested HIV-positive (CP/Ottawa Citizen, 1/25). The
hospital plans to contact and test more than 2,600 former
patients, according to Reuters/New York Times (Reuters/New York
Times, 1/23). Although the Sainte-Justine Children's Hospital
has "insisted" that all young patients operated on by Dr. Maria
Di Lorenzo be contacted and informed that Di Lorenzo -- who died
on Aug. 16, 2003 -- was HIV-positive, hospital officials said
the chance that any children contracted HIV from operations is
"extremely small," according to Toronto's Globe and Mail
(Picard/Peritz, Globe and Mail, 1/23). Di Lorenzo in 1991
informed her immediate supervisor of her HIV-positive status and
a committee was formed to determine what medical work she could
do, according to the AP/Fort Lauderdale Sun-Sentinel. However,
the hospital had no "written follow-ups" on Di Lorenzo after
1996 (AP/Fort Lauderdale Sun-Sentinel, 1/22). Although Di
Lorenzo's immediate supervisor was aware of her HIV status, the
hospital administration said that it was unaware of the doctor's
HIV status until a "few weeks ago" and that Di Lorenzo continued
to operate on patients until her death in 2003, according to the
Toronto Star (Cernetig, Toronto Star, 1/23). The hospital on
Wednesday sent 700 letters to patients who were operated on by
Di Lorenzo and said they would contact all other potentially
affected patients in coming days (Carroll, CanWest News
Service/National Post, 1/23). As of Saturday, a call center
established at the hospital had received 7,200 phone calls from
the public and families of former patients, according to the
CP/Citizen (CP/Ottawa Citizen, 1/25). Official investigations by
both the hospital and public health authorities have been
initiated, but the Canadian Medical Association said that health
care workers do not have an "explicit obligation" to tell
patients about their HIV status, according to the Globe and
Mail. The Quebec College of Physicians is preparing a more
detailed set of guidelines for HIV-positive doctors (Globe and
Mail, 1/23).

Reaction

The hospital's announcement "went off like a rocket" in
Montreal, "flooding the hospital's switchboard with calls from
people wondering if they or their children had been infected
[with HIV]," according to the Star. Hubert Tanguay-Labrosse, who
had his appendix removed by Di Lorenzo, said he is not concerned
about his potential exposure to HIV, adding, "It doesn't bother
me really because there is only a very small chance that I have
[HIV]. Between then and now, I had more chance of being in a car
accident than getting AIDS" (Toronto Star, 1/23). Manon
Lariviere, the mother of a child who underwent surgery at the
hospital, said she is "angry and really worried," but she added
that she was "grateful" to Di Lorenzo because the doctor "saved
my son's life" (Globe and Mail, 1/23). Dr. Lucie Poitras,
director of professional services at the hospital, said, "Of the
thousands of surgeries conducted every day in the western world
since the appearance of HIV more than 20 years ago, only two
situations where patients were contaminated by HIV-positive
physicians have been recorded to date, and no affected children
have been reported" (Reuters, 1/22).

IN THE COURTS

3. Creator of AIDS Memorial Quilt Can Keep Health Insurance
Despite Lawsuit, Names Project Foundation Says

Access this story and related links online:
http://cme.kff.org/Key=1669.CcZ.F.D.KNDLYY

  The Atlanta-based foundation that owns the AIDS Memorial Quilt
on Thursday said that the HIV-positive gay-rights advocate who
created the quilt and is suing the foundation for wrongful
firing can retain his health benefits even though he is no
longer employed by the foundation, the San Francisco Chronicle
reports (Williams, San Francisco Chronicle, 1/23). Cleve Jones,
who created the AIDS Memorial Quilt and has served as the
quilt's spokesperson for 15 years, on Tuesday filed a lawsuit in
San Francisco Superior Court claiming that the Names Project
Foundation fired him because he encouraged a plan to take the
quilt on a nationwide, election-year tour ending with a display
on the National Mall in Washington, D.C. In the suit, Jones also
alleges that the foundation did not keep its promise to reopen a
quilt project office in San Francisco, where the quilt was first
sewn and where the foundation was located until 2001. According
to Jones, the foundation said that it did not have enough
funding for the national quilt tour -- which would include voter
registration for HIV-positive people -- and expressed concern
that the quilt's first display in eight years would be connected
to a national political campaign. Although Jones raised more
than $1 million for the project, the foundation on Dec. 31,
2003, fired him from his $41,500 per year job. In addition,
Jones said that the foundation threatened to end his health
insurance, which it had promised to provide until his death
(Kaiser Daily HIV/AIDS Report, 1/22). Foundation Board President
Edward Gatta said that Jones was not fired but that the
foundation's board suspended his salary at the end of 2003
because Jones had refused to meet with officials during the last
three months of the year to discuss changes in his role with the
foundation, according to the Los Angeles Times (Hollis, Los
Angeles Times, 1/25).

Reaction

Gatta said that he is "disappointed and saddened" by the dispute
with Jones, adding that he is "willing to work for a positive
resolution," according to the Chronicle. Gatta said that Jones
would be allowed to keep his health benefits, which cover the
antiretroviral drugs that Jones said would cost him $22,000 per
year without insurance (San Francisco Chronicle, 1/23). In
addition, the foundation has authorized a display of portions of
the quilt "as a kickoff effort to bring the quilt in its
entirety to the National Mall within two to five years," a
foundation press release said. The foundation is also launching
a fundraising effort to open a display and visitors center in
San Francisco and to underwrite the cost of a Names Project
workshop, the Times reports. Jones said, "The real story isn't
me. The real story is the [AIDS] pandemic is worse than ever and
this potent weapon (the quilt) is being rendered impotent and
irrelevant" by the actions of the foundation (Los Angeles Times,
1/25).

ACROSS THE NATION

4. New York Times Examines HIV/AIDS Crisis in Westchester
County, N.Y.

Access this story and related links online:
http://cme.kff.org/Key=1669.CcZ.G.D.KM2PG3

  The New York Times on Sunday examined the prevalence of
HIV/AIDS in Westchester County, N.Y., which county health
commissioner Dr. Joshua Lipsman calls Westchester's "most
challenging health crisis." Westchester has more people living
with HIV and AIDS than any other county in the state, excluding
New York City, with approximately 2,000 people living with AIDS
and about 3,000 people living with HIV, according to Lipsman.
Prevalence among the county's African-American and Latino
populations is of particular concern, the Times reports. While
14.2% of the county's total population is African-American,
African Americans account for 51% of AIDS cases in the county.
In addition, Latinos, which comprise 15.6% of the population,
account for 19% of AIDS cases. Lipsman said, "If you look at the
most likely person in Westchester to be getting an HIV
infection, she is going to be a heterosexual African-American
woman between the ages of 30 and 50 and living in one of
Westchester's cities. There are very few other medical problems
in which we can identify so clearly the targeted population." He
added, "There is no other disease that is so disproportionately
impacting people of color as [HIV/AIDS] is."

Outreach Actions

HIV/AIDS advocates say that outreach and education programs are
necessary because "there remains a widespread misconception"
that antiretroviral drugs offer a "cure for AIDS, or that living
with the diseases is just not that big a deal," the Times
reports. Jeffrey Kraus, executive director of the Hudson Valley
regional agency AIDS Related Community Service, said, "Because
there's a viable treatment that's keeping a lot of people alive
and healthy, people think that 'Gee, this isn't so bad; it's
treatable. I can live with it.' [But t]hat's a dire mistake."
Larry Hilton, executive director of HIV/AIDS programs for the
Urban League and co-chair of the Westchester AIDS Council, said
that the council is exploring new ways of addressing HIV/AIDS
prevention among the hardest-hit populations in the county,
according to the Times. He said that one possible way to target
African Americans is through faith-based initiatives, as
religious leaders could be a "powerful force in AIDS
prevention," the Times reports. Kraus and other HIV/AIDS
advocates also say that needle exchange programs could help curb
the spread of the disease in the Hudson Valley region, where 38%
of cases are attributed to injection drug use (Stone Lombardi,
New York Times, 1/25).

OPINION

5. Humanitarian, Political Consequences Result From U.S. Funding
Delay for Global AIDS Initiative, Editorial Says

Access this story and related links online:
http://cme.kff.org/Key=1669.CcZ.H.D.K4MnDs

  Although the "quickest and most effective way to put U.S.
dollars to work" in the fight against the HIV/AIDS epidemic
would be to give money to the Global Fund to Fight AIDS,
Tuberculosis and Malaria, President Bush seems "intent on
setting up his own war on AIDS," which could mean "more delays"
while the government establishes a program, a Newark Star-Ledger
editorial says. Although Bush announced the five-year, $15
million global AIDS initiative during his 2003 State of the
Union address, the government has yet to "write the check."
According to the Star-Ledger, the funding "should have been
handled as a stand-alone emergency appropriation," instead of
being folded into the omnibus spending bill, which is "filled
with pork-barrel measures and last-minute controversy." Even
though action is being taken on the spending bill, there "will
still be many ways to keep from spending what the administration
does not want to spend," the Star-Ledger says, adding that the
United States has been "pushing trade policies and patent
protectionism that work against efforts to provide cheap generic
anti-AIDS medication to those countries that need it." The
editorial concludes, "We are still waiting for a sign that the
president ... is serious about the war on AIDS," adding that the
wealthiest countries in the world "cannot afford the
humanitarian and political consequences of its current politics
and lethargy" (Newark Star-Ledger, 1/24).

6. Wall Street Journal Claims About WHO, Global Fund Treatment
Guidelines 'Wrong,' Letter to Editor Says

Access this story and related links online:
http://cme.kff.org/Key=1669.CcZ.J.D.K5Tf6v

  The Wall Street Journal in a Jan. 21 editorial on the malaria
treatment program run by the Global Fund to Fight AIDS,
Tuberculosis and Malaria and the World Health Organization made
"numerous errors," Jack Chow, assistant director of AIDS,
tuberculosis and malaria at WHO, and Richard Feachem, executive
director of the Global Fund, write in a Journal letter to the
editor. The editorial referred to an article in the Lancet,
which claimed that WHO and the Global Fund recommended and
financed the purchase of ineffective malaria drugs. However, the
Global Fund -- with WHO guidance -- is "financing one of the
fastest shifts to new and better treatment regimens ever
implemented in the developing world," Chow and Feachem say.
Although such drugs changes usually take "five to 15 years," the
Global Fund and WHO are already helping countries in Africa
switch to the "new, more effective artemisinin-based combination
therapy," according to Chow and Feachem (Chow/Feachem, Wall
Street Journal, 1/26). The editorial also claimed that the
Global Fund and WHO "frown on patent law and would rather employ
off-patent medicines or cheap knockoffs," even though the "whole
purpose of the Global Fund is to pay for the more expensive
treatments that poor countries can't afford" (Kaiser Daily
HIV/AIDS Report, 1/21). That assertion is "wrong," Chow and
Feachem say, adding that the organizations have a
"straightforward policy regarding [their] recommendations on
which medicines to use: It matters most that medicines are safe,
effective and affordable, rather than who manufactures them"
(Wall Street Journal, 1/26).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: http://www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. (c) 2004 Advisory Board Company and Kaiser Family
Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at
http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or
unsubscribe.
Questions about your email subscription? Contact us at
subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family
Foundation. For access to the Foundation's policy research,
analyses, reports and fact sheets, and media partnerships, visit
the Foundation's main website at http://www.kff.org .

-Message-Id: <20040126083855.C19B.4388-1669@...>

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


Friday, January 23, 2004

POLITICS AND POLICY
========================================
1. Senate Passes Omnibus Spending Bill, Including Funding for
Global AIDS Initiative

SCIENCE & MEDICINE
========================================
2. Researchers Retract Key Finding in Study of HIV-Positive
Long-Term Survivors Published 16 Months Ago

3. Only 10% of Patients Referred for HIV Testing by Emergency
Rooms Undergo Test, Study Says

PUBLIC HEALTH & EDUCATION
========================================
4. Public Health Officials Consider Legal Action To Force AOL,
Web Sites To Warn MSM About Syphilis Outbreaks

GLOBAL CHALLENGES
========================================
5. German Auto Makers in South Africa Fund Own HIV/AIDS Programs

OPINION
========================================
6. Medical Examination, Including Possibly HIV Testing, Part of
Seminary Application Process, Opinion Piece Says

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

POLITICS AND POLICY

1. Senate Passes Omnibus Spending Bill, Including Funding for
Global AIDS Initiative

Access this story and related links online:
http://cme.kff.org/Key=1655.CcZ.C.D.K2VNKK

  The Senate on Thursday voted 65-28 to approve an omnibus
spending bill (HR 2673), which includes $2.4 billion for
international AIDS, tuberculosis and malaria initiatives, the
Washington Post reports (Dewar, Washington Post, 1/23). The
House last month approved the bill, which combines seven of the
13 annual fiscal year 2004 spending bills. House-Senate
conferees in November 2003 agreed to increase FY 2004 federal
spending on international AIDS, TB and malaria initiatives to
$2.4 billion, $400 million more than the Bush administration had
requested. Although the measure (HR 1298) supporting the
five-year, $15 billion global AIDS initiative authorizes $3
billion for the first year of the program, the Bush
administration requested only $2 billion. Bush said that his
administration requested less than $3 billion in order to give
the program time to "ramp up." The omnibus spending bill also
includes $1 billion for the Millennium Challenge Account, an
assistance program for developing nations that encourages
democracy and development through economic aid (Kaiser Daily
Reproductive Health Report, 1/21). Senate Democrats had earlier
blocked the bill, citing objections to provisions on overtime
pay rules, country-of-origin food labeling and other issues but
on Thursday "conceded" that they could not sustain the
filibuster, according to the Post. In a procedural vote, most
Republicans were joined by 16 Democrats in a 61-32 vote to end
debate on the measure. Bush is expected to sign the measure
soon, the Post reports (Washington Post, 1/23).

Reaction

Bush on Thursday said that the spending bill "fulfills important
commitments, like AIDS relief," adding, "I look forward to
signing this bill into law" (Singer, Chicago Tribune, 1/23).
Kate Carr, president and CEO of the Elizabeth Glaser Pediatric
AIDS Foundation, said the bill's passage was an "historic goa[l]
outlined by President Bush and Congress" for fighting the
HIV/AIDS pandemic, adding, "We now urge the president to sign
this legislation as soon as possible so that we can move these
resources into the field quickly and get about the business of
saving lives" (EGPAF release, 1/22). The spending bill, which
also includes funding for state AIDS Drug Assistance Programs,
is "critical for the provision of life-saving HIV/AIDS
treatments and supportive services to low-income Americans,"
Loretta Davis-Satterla, chair of the National Alliance of State
And Territorial AIDS Directors, said, adding, "Unfortunately the
spending bill cuts domestic HIV care and prevention programs.
These cuts to domestic HIV/AIDS programs will only increase the
challenges facing states in meeting the needs of the increasing
number of Americans infected with and at risk for HIV/AIDS"
(NASTAD release, 1/22). Sen. Robert Byrd (D-W.Va.) on Wednesday
called the measure a "Frankenstein of a bill," and Sen. John
McCain (R-Ariz.) urged Bush to veto the bill, saying that it
contained $11 billion in "pork-barrel" spending, according to
the Los Angeles Times (Simon, Los Angeles Times, 1/23). Senate
Majority Leader Bill Frist (R-Tenn.) said, "There are provisions
in this bill that I would have preferred be different," but he
added, "It is time to move on. The country demands that we
complete action on this bill" (Godfrey, Dow Jones Newswires,
1/22).

SCIENCE & MEDICINE

2. Researchers Retract Key Finding in Study of HIV-Positive
Long-Term Survivors Published 16 Months Ago

Access this story and related links online:
http://cme.kff.org/Key=1655.CcZ.D.D.KfLb4X

  Dr. David Ho of the Aaron Diamond AIDS Research Center in New
York and colleagues in the Jan. 23 issue of the journal Science
retracted the key finding of a study of HIV-positive long-term
survivors that identified a family of proteins that block HIV
replications, the San Francisco Chronicle reports (Russell, San
Francisco Chronicle, 1/23). The researchers in September 2002
published a study in the journal Science in which they announced
that they had identified a family of three proteins present in
HIV-positive long-term non-progressors that block HIV
replication and could reveal a new way to combat the disease.
The proteins, called alpha-defensins -- which are found in white
blood cells called neutrophils that attack bacteria and
parasites and not viruses like HIV -- were first discovered in
1985 and function as natural "antibiotics." Ho's team reported
that they found alpha-defensins in CD8+ T cells, a type of
immune cell in which alpha-defensins had previously not been
identified. Dr. Jay Levy of the University of California-San
Francisco was the first researcher to reveal that CD8 cells
exhibited a protective antiviral factor, which he called CAF, in
some people with HIV. Between 1% and 5% of people with HIV can
live untreated with the disease for 10 to 15 years or more
without developing AIDS-like symptoms due to an unknown immune
response in their body, which researchers have been attempting
to identify for years. In a quest to find CAF, which Levy has
not been able to identify, Ho and colleagues drew CD8 cells from
three long-term non-progressors. The cells were cultured, and
then HIV and CD4+ T cells -- HIV's main target -- were added to
the cultures. HIV was unable to infect the CD4 cells in the
presence of the cultured CD8 cells. The researchers then added
antibodies against the three defensins to cultures, essentially
inactivating them. When HIV and CD4 cells were added, the cells
were "easily" infected, the researchers reported. The
researchers performed other tests, including washing the CD8
cells over a new kind of protein chip developed by Ciphergen
Biosystems of Fremont, Calif., to prove that the defensins were
present. The chips were then read by a mass spectrometer to
determine their weight, and the alpha-defensins were identified
(Kaiser Daily HIV/AIDS Report, 9/27/02).

Retraction

Ho and colleagues in a letter to Science titled "Retraction of
an Interpretation," wrote that the antiviral factor they had
identified did not come from the white blood cells donated by
healthy HIV-positive participants, according to the Chronicle.
Instead, the researchers said that the factor likely came from a
protein produced by a "mixture of blood cells routinely used in
the laboratory to make CD8 cells mature," the Chronicle reports
(San Francisco Chronicle, 1/23). The retraction comes after two
studies -- one led by Levy, who is also editor-in-chief of the
journal AIDS, and one by Dr. Mary Klotman, chief of Mount Sinai
School of Medicine's infectious diseases division -- that found
defensins could not be found in CD8 cultures, the New York Times
reports. But Ho and study co-author Dr. Linqi Zhang said that
they identified the error "on their own," according to the Times
(Pollack, New York Times, 1/23). Levy said, "The paper confused
the field and led many to believe that alpha defensins were CD8
antiviral factors. ... But it's good that they took the
initiative to write the retraction." He added that his
laboratory will continue working to identify "the exact
character and composition of the elusive [antiviral] factor,"
according to the Wall Street Journal (Chase, Wall Street
Journal, 1/23). In the letter, the researchers added that they
were not retracting the entire article, only the finding that
defensins originated from CD8s, saying, "All of our conclusions,
except for one, were valid" (San Francisco Chronicle, 1/23).

3. Only 10% of Patients Referred for HIV Testing by Emergency
Rooms Undergo Test, Study Says

Access this story and related links online:
http://cme.kff.org/Key=1655.CcZ.F.D.KgSFqQ

  Only about 10% of people referred for HIV testing by emergency
room personnel ever go to clinics to obtain the testing,
according to a study published in the January issue of the
Journal of Acquired Immune Deficiency Syndromes, Reuters Health
reports. Emergency room doctors are in a "unique position" to
target undiagnosed HIV infection, because undiagnosed HIV
infection is common among low-income patients, "the same
patients who commonly seek care in public hospital [emergency
rooms]," Dr. Roger Lewis of Harbor-UCLA Medical Center said
(Reuters Health, 1/21). Lewis and colleagues collected data from
586 referrals made by an urban emergency department for
outpatient HIV testing. Of the 586 referrals, 494 patients met
the inclusion criteria for the study. Only 56 of the 494
patients went to the clinic and completed pretest counseling. Of
these, 51 tested HIV-negative, four tested HIV-positive and one
refused to be tested. The researchers concluded that the
referral system was ineffective at identifying unrecognized HIV
infection (Coil et al., Journal of Acquired Immune Deficiency
Syndromes, 1/1). The researchers suggested that rapid HIV
testing, which could be conducted at the hospital, may increase
detection of previously undiagnosed HIV infection. In addition,
the researchers are conducting a follow-up study to determine
whether financial incentives improve compliance with outpatient
HIV testing referrals. Lewis said that new approaches to the
problem are important because "a large proportion of at-risk
patients delay testing or fail to get tested, even when they are
referred for HIV testing, and thus miss an opportunity to learn
their status, protect others and to potentially benefit from
[antiretroviral drugs]" (Reuters Health, 1/21).

PUBLIC HEALTH & EDUCATION

4. Public Health Officials Consider Legal Action To Force AOL,
Web Sites To Warn MSM About Syphilis Outbreaks

Access this story and related links online:
http://cme.kff.org/Key=1655.CcZ.G.D.KlTtTg

  Public health officials are considering filing a lawsuit to
force Internet service provider America Online and some Web
sites to warn members about outbreaks of sexually transmitted
diseases among the men who have sex with men who use their
services to find sex partners, Wired News reports. A report
released last month found that 44% of recently diagnosed
syphilis cases in San Francisco were linked to the Internet,
compared with 13% in 2000. Similar statistics are not available
for HIV/AIDS because the disease has a longer incubation period,
but many men diagnosed with syphilis are HIV-positive, Wired
News reports. Health officials more than two years ago began
requesting that some Web sites warn users about STDs after they
detected an increase in syphilis cases nationwide (Dotinga,
Wired News, 1/22). In 1999, when San Francisco officials traced
a rise in the number of syphilis cases to seven men who had used
an AOL chat room to meet partners, Dr. Jeffrey Klausner, head of
the city's STD control division, tried to use the Internet to
alert potential partners to the risk and urge them to be tested.
He asked AOL to post syphilis warnings in its San Francisco chat
rooms but was turned down. Instead, the company offered his
staff free AOL accounts so they could log in and disseminate
information about the diseases. According to Klausner, fewer
than half of the seven men's partners were notified and tested,
illustrating difficulties of practicing prevention and partner
notification with people who meet over the Internet. Many
Internet encounters are often anonymous, with partners only
knowing each other by their screen names, which can change
daily, and many Internet service providers will not release the
names of customers without a court order (Kaiser Daily HIV/AIDS
Report, 7/26/02).

Legal Action?

Klausner said that he would like managers of chat rooms to
inform members about syphilis outbreaks connected to specific
chat rooms, according to Wired News. However, Klausner said he
would be content with other sexual health education measures.
Some Web sites currently post links, messages and banner
advertisements about safer sex, and other sites offer discounted
advertising for safer sex messages. AOL still provides free
accounts for safer-sex counselors and last year briefly posted
public service announcements. However, the company now refuses
to post announcements or banner ads in private chat rooms. AOL
spokesperson Andrew Weinstein said that the company lacks the
technical ability to place ads targeting specific chat rooms. In
addition, Weinstein says that AOL wishes to protect users'
privacy, adding, "I don't think any of our members would want to
track who goes into what chat rooms." Deb Levine, executive
director of Internet Sexuality Information Services, said that
AOL should target users with free banner ads, according to Wired
News. Klausner said that public health officials may be able to
sue AOL under the same laws that require alcohol companies to
put warning labels on their bottles. However, Charles Tobin, a
media attorney, said that there is "no legal mechanism to force
an industry like the Internet to post any kind of message" and
that Web sites are not responsible for monitoring the content of
their chat rooms. In addition, even if health advocates are
successful in forcing Web sites to cooperate, it is unclear
whether such prevention efforts are effective, Wired News
reports. Links to outside Web sites can be ignored and safer-sex
counselors in chat rooms are reportedly kicked out by other
users on a "regular basis," according to Wired News (Wired News,
1/22).

GLOBAL CHALLENGES

5. German Auto Makers in South Africa Fund Own HIV/AIDS Programs

Access this story and related links online:
http://cme.kff.org/Key=1655.CcZ.H.D.KRk455

  German auto makers with assembly plants in South Africa are
spending "big money" on antiretroviral drugs, treatment and
education to combat HIV/AIDS among their workforces, Reuters
reports. The companies' efforts are expected to be highlighted
during German Chancellor Gerhard Schroeder's visit to the
country on Thursday. According to Reuters, car maker
DaimlerChrysler South Africa spends approximately $420,000 each
year to offer antiretroviral treatment to its HIV-positive
employees, who make up an estimated 9% of the company's total
workforce. Mike Folan, human resources manager for DCSA, said,
"We decided on giving antiretroviral drugs to our employees
because of the government's policy at the time. It (the
government) wasn't providing antiretroviral therapy." He added,
"The management board of DCSA gave a guarantee to people who
were retrenched from the company that they and any of their
family members registered on the program will continue to have
benefits for two years and hopefully the government's program
will be in place." An estimated 6% of Volkswagen South Africa's
employees are HIV-positive, and the company operates a program
similar to DCSA's with an annual budget of about $420,000.
Gustav Meyer of the Department of Trade and Industry said,
"Several of the motor vehicle assemblers in South Africa have
indicated a willingness to increase the outreach of these
programs. We are aiming to rollout the HIV/AIDS programs by the
vehicle assemblers to the supplier base as well as the
community. This will maximize the impact of efforts against
HIV/AIDS" (Mutikani, Reuters, 1/22).

OPINION

6. Medical Examination, Including Possibly HIV Testing, Part of
Seminary Application Process, Opinion Piece Says

Access this story and related links online:
http://cme.kff.org/Key=1655.CcZ.J.D.KY2QTV

  The question of whether a new policy requiring that men who are
applying to the Grand Seminaire de Montreal to become Roman
Catholic priests undergo HIV testing "may be a good idea or bad
idea ... is not altogether that important" because the "drama of
the priestly vocation cannot be reduced to medical tests and
wrongheaded human rights questions," Father Raymond de Souza, a
co-chaplain of Newman House, the Roman Catholic mission at
Queen's University in Ontario, Canada, writes in a National Post
opinion piece. When accepting a new priest into his diocese, a
bishop takes on responsibility -- sometimes including health
insurance -- for the priest for the remainder of his life, de
Souza says, adding, "Whether a diocese should devote the
considerable resources necessary for priestly formation to a man
who has a serious disease is at least a valid question."
Therefore, it is "standard procedure" for dioceses and
seminaries to require medical examinations, including tests for
HIV and other diseases, he says. De Souza notes that a coalition
of Canadian AIDS groups last week asked the Quebec Human Rights
Commission to investigate the new policy, saying that requiring
an HIV test may constitute a human rights violation. However,
"[t]here is serious confusion here," de Souza writes, adding,
"There is not a human right to be a priest." He continues, "We
have it on the highest authority that ... many are called, but
few are chosen. No one has a right to be chosen. It is entirely
a gratuitous act of God's mercy." De Souza concludes, "HIV is an
important matter of health. More important are matters of faith"
(de Souza, National Post, 1/21).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: http://www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. (c) 2004 Advisory Board Company and Kaiser Family
Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at
http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or
unsubscribe.
Questions about your email subscription? Contact us at
subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family
Foundation. For access to the Foundation's policy research,
analyses, reports and fact sheets, and media partnerships, visit
the Foundation's main website at http://www.kff.org .

-Message-Id: <20040123074422.C08C.4388-1655@...>

*******************************************
TEXAS HIV/STD E-UPDATE
Information from the Bureau of HIV and STD Prevention,
Texas Department of Health
*******************************************

SPECIAL ISSUE
-Public Meetings Scheduled on Organziational Changes in Health


PUBLIC MEETINGS SCHEDULED ON ORGANIZATIONAL CHANGES IN HEALTH

The Health and Human Services Commission (HHSC) is conducting public
hearings throughout the state on proposed organizational changes that
combine the Texas Department of Health (TDH) with three other state
agencies; Texas Commission on Alcohol and Drug Abuse, Texas Health Care
Information Council, and the mental health community services and state
hospitals under the Department of Mental Health and Mental Retardation to
form the Department of State Health Services (DSHS).

A schedule of these public hearings is below*:

HARLINGEN
Thursday, January 29, 2004, 5-7pm (comment time will be extended to 8pm if
needed)
Valley Baptist Medical Center
Woodward Conference Room
2101 Pease St.
Contact: Carol Cornelison, 956-423-0130 or
Carol.Cornelison@....
ADA assistance: Redge Westbrook, 512-458-7627, 888-388-6332 or TDD
877-432-7232

ARLINGTON
Friday, January 30, 2004, 5-7pm (comment time will be extended to 8pm if
needed)
Bob Duncan Community Center
2800 S. Center St. (inside Vandergriff Park)
Contact: Jan Havins, 817-264-4503 or Jan Havins@....
ADA assistance: Redge Westbrook, 512-458-7627, 888-388-6332 or TDD
877-432-7232

AUSTIN
Tuesday, February 3, 2004, 3-5pm (comment time will be extended to 7pm if
needed)
Texas Department of Human Services
Winters Building, Board Room
701 West 51st St.
Contact: Barrett Markland, 512-438-5419 or Barrett.Markland@...
ADA assistance: Redge Westbrook 512-458-7627, 888-388-6332 or TDD
877-432-7232

HOUSTON
Wednesday, February 4, 2004, 5-7pm (comment time will be extended to 8pm if
needed)
Hornberger Conference Center
Texas Medical Center
2151 W. Holcombe Blvd.
Planning contact: Greta Etnyre, 713-767-3029 or Greta.Etnyre@...
ADA assistance: Redge Westbrook 512-458-7627, 888-388-6332 or TDD
877-432-7232

EL PASO
Thursday, February 5, 2004, 5-7pm (comment time will be extended to 8pm if
needed)
El Paso Community College
Administrative Building
9050 Viscount Blvd.
Planning contact: Kaye Moore, 915-834-7752 or kaye.moore@...
ADA assistance: Redge Westbrook 512-458-7627, 888-388-6332 or TDD
877-432-7232

*People with disabilities planning to attend these meetings who need
auxiliary aids or services should contact the person listed for the location
they are planning to attend at least two business days in advance of the
meeting so that appropriate arrangements can be made.

For background information and the proposed organizational chart go to:
www.hhsc.state.tx.us/Consolidation/News/dshs_org/Structure.html

Or, contact TDH External Relations at (512) 458-7400 for more information.


***************************************
The Texas HIV/STD E-Update mailing list is maintained by the Bureau of HIV
and STD Prevention, Texas Department of Health. To subscribe to or remove
your name from the mailing list, send a message to dan.warr@....

***************************************
TDH Electronic Publication Number E13-11720
***************************************

Texas HIV/STD E-Update
Greg Beets, Editor
Texas Department of Health
HIV/STD Health Resources Division
1100 West 49th Street
Austin, Texas 78756-3199
Phone: 512-490-2500, ext. 2671
Fax: 512-490-2538
E-mail: greg.beets@...

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


Thursday, January 22, 2004

POLITICS AND POLICY
========================================
1. Kentucky House Approves Bill That Would Require State To
Identify HIV Patients by Name

ACROSS THE NATION
========================================
2. Construction of Los Angeles AIDS Memorial To Begin Soon

GLOBAL CHALLENGES
========================================
3. World Economic Forum Global Health Initiative Releases First
Report on Business Leaders' Perceptions of, Responses to AIDS

4. South African Companies Using Managed-Care Plans To Control
Health Care Costs in Country With 20% AIDS Prevalence

5. German Chancellor Gerhard Schroeder To Discuss South Africa's
Response to AIDS With President Mbeki

DRUG ACCESS
========================================
6. AIDS Advocates Upset With South African Government Over
Delays in Roll-Out of Antiretroviral Treatment Program

7. South African National Defence Force Launches Clinic for Army
Personnel, Families

IN THE COURTS
========================================
8. Creator of AIDS Memorial Quilt Files Suit Against Names
Project Foundation

OPINION
========================================
9. Some Criticisms of Bush's Global AIDS Initiative
'Misconceived,' While One Is 'Telling,' Editorial Says

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

POLITICS AND POLICY

1. Kentucky House Approves Bill That Would Require State To
Identify HIV Patients by Name

Access this story and related links online:
http://cme.kff.org/Key=1635.Cc1.C.D.FV92jZ

  The Kentucky House on Tuesday approved 95-0 a bill (HB 82) that
would require doctors to report HIV patients by name to state
health officials, the Associated Press reports (Schreiner,
Associated Press, 1/21). The state previously reported
HIV-positive individuals using special codes, but the CDC
prefers to track HIV-positive people by name. Currently, 38
states track HIV-positive patients by name, which helps them in
obtaining federal AIDS funding. The bill, sponsored by Rep. Tom
Burch (D), would require the state's database to identify HIV
patients by name, but reports to the CDC would continue to
include code numbers (Kaiser Daily HIV/AIDS Report, 1/20). The
bill next moves to the state Senate for consideration, the
Associated Press reports (Associated Press, 1/21).

ACROSS THE NATION

2. Construction of Los Angeles AIDS Memorial To Begin Soon

Access this story and related links online:
http://cme.kff.org/Key=1635.Cc1.D.D.F3Ffjn

  Construction on a controversial AIDS monument in Los Angeles'
Lincoln Park is set to begin soon, according to a press release
from The Wall -- Las Memorias Project (The Wall -- Las Memorias
Project release, 1/20). The memorial commemorates Latinos and
non-Latinos who have died of AIDS-related illnesses and will
include a rose garden, benches, a walking path, a sculpture and
eight wall panels upon which the names of people who have died
will be listed (Kaiser Daily HIV/AIDS Report, 8/29/03). The
design also calls for six of the panels to be murals, according
to the release. Construction on the monument was scheduled to
begin in December 2003 but was delayed because the Los Angeles
City Attorney's office called for the removal of a mural panel
that some people believed depicted the Virgin of Guadalupe. The
panel was considered "religious in nature" and therefore not
appropriate for the publicly funded project, according to the
release. The removed panel will be purchased with private funds
raised by the project and is expected to become part of a
touring AIDS awareness and education project, according to
Richard Zaldivar, executive director and founder of the project.
He added, "While we are disappointed that this one panel will be
removed, we will respect the opinion of the city attorney. We
know that our message of compassion, hope and understanding for
our community continues with the construction of the AIDS
monument (The Wall -- Las Memorias Project, 1/20).

Opposition

Several groups have opposed construction of the monument, saying
that it will attract gay men "who will hold hands in public" and
others have criticized the monument as "pagan" because it is in
the shape of the Aztec god Quetzalcoatl, according to the
release (The Wall -- Las Memorias Project release, 1/20). Some
opponents of the monument in March allegedly shouted anti-gay
statements at a project meeting and distributed fliers stating,
"Latino gay men [have] been covertly trying to make a monument
to themselves." The flier was signed by the Coalition to Save
Lincoln Park, but the people distributing the flier did not know
who was responsible for the material or who was involved in the
coalition (Kaiser Daily HIV/AIDS Report, 8/29/03).

GLOBAL CHALLENGES

3. World Economic Forum Global Health Initiative Releases First
Report on Business Leaders' Perceptions of, Responses to AIDS

Access this story and related links online:
http://cme.kff.org/Key=1635.Cc1.F.D.F1x5Gz

  The World Economic Forum Global Health Initiative on Wednesday
at its 2004 Annual Meeting in Davos, Switzerland, released its
2003-2004 report, which is the first global survey of business
leaders on their perceptions of and responses to HIV/AIDS,
according to a GHI release. GHI, which collaborated with UNAIDS
and the Harvard School of Public Health to survey 7,789 business
leaders in 103 economic markets, found that 47% of firms felt
that HIV/AIDS was impacting their businesses. In addition, the
report, titled "Business and HIV/AIDS: Who Me?," found that most
business leaders make lower estimates of HIV prevalance rates
among their workers than country-level UNAIDS estimates of adult
HIV prevalence. The survey found that 16% of firms provide
information about the risk of HIV infection to employees; 5%
said that they provide antiretroviral drugs for all HIV-positive
staff members; and less than 6% of firms have formal HIV
policies. The report concludes that most companies are "not
particularly active" in addressing HIV/AIDS, have been making
HIV/AIDS policy decisions based on "fairly patchy assessment of
the risks they face" and "seem to favor a broad social response"
to the epidemic, according to the GHI release. The report
recommends that information be generated and distributed on
workforce HIV/AIDS prevalence, the impact of the epidemic on
businesses with differing prevalence levels and the cost
effectiveness of business-sponsored prevention programs. In
addition, the report recommends that business coalitions and
public-private partnerships continue to join in the fight
against HIV/AIDS (GHI release, 1/21).

4. South African Companies Using Managed-Care Plans To Control
Health Care Costs in Country With 20% AIDS Prevalence

Access this story and related links online:
http://cme.kff.org/Key=1635.Cc1.G.D.FXxpMc

  South African companies have begun using managed-care plans to
control health care costs for HIV-positive employees, a move
considered "revolutionary" in a country with a 20% HIV/AIDS
prevalence rate, the Wall Street Journal Europe reports.
Managed-care plans, which aim to constrain costs by managing how
patients use health care services, help firms keep HIV-positive
employees productive and working longer, according to the
Journal Europe. Alexander Forbes, a South African
employee-benefits consulting firm, has established a program
with a unit of the United States Agency for International
Development that has enrolled 20,000 South African workers in
managed-care plans, according to the Journal Europe. Alexander
Forbes uses a model called Direct AIDS Intervention in which
companies and insurance firms determine long-term costs for
insuring HIV-positive workers rather than insuring against the
"day-to-day risk" of illness, the Journal Europe reports. Under
DAI, employers and insurance companies determine the amount it
will cost to cover HIV-positive employees for 10 years, and a
separate fund is established to cover those costs. Companies
encourage employees to be tested for HIV, and those employees
who test HIV-positive are immediately given antiretroviral drug
regimens, enabling employees to work longer and continue paying
into the company's health insurance plan, according to the
Journal Europe. An Alexander Forbes cost-benefit analysis
determined that by using DAI companies can save $16,737 by
keeping an employee on the job for seven years longer than
without the program and avoiding absenteeism costs. By
continuing to use the current health care coverage system,
Alexander Forbes determined that companies would have to pay
about $42,194 in health costs for an HIV-positive employee over
12 years.

'Hurdles' to Managed Care

There are several "hurdles" to establishing a managed-care
system in South Africa, including changing the way companies and
employees think about health insurance and HIV/AIDS, according
to the Journal Europe. About 30% of South African workers
currently are covered by employer-provided health plans, and
many HIV-positive employees do not disclose their HIV status so
they do not lose their health coverage. In addition, companies
will have to be more "transparent" about HIV/AIDS-related risks
before managed-care plans become more accepted, according to the
Journal Europe. According to Markinor, a South African
market-research company, about one-third of 130 South African
companies surveyed in 2003 had established a budget to address
HIV/AIDS, and about 45% of the companies had a "fully
documented" HIV/AIDS policy, according to the Journal Europe.
Some South African companies that currently quantify
HIV/AIDS-related risks and costs include AngloGold, Impala
Platinum Holdings and Gold Fields (Spicer, Wall Street Journal
Europe, 1/22).

5. German Chancellor Gerhard Schroeder To Discuss South Africa's
Response to AIDS With President Mbeki

Access this story and related links online:
http://cme.kff.org/Key=1635.Cc1.H.D.FKnsbR

  German Chancellor Gerhard Schroeder plans to discuss South
Africa's response to the HIV/AIDS epidemic during a meeting with
President Thabo Mbeki this week, a senior German official said
on Tuesday, Agence France-Presse reports. Schroeder is expected
to arrive in South Africa late Wednesday for the longest leg of
his four-nation tour of Africa, which has included stops in
Kenya, Ethiopia and Ghana. "In face-to-face talks, the
chancellor will undoubtedly ask President Mbeki about his policy
on ... HIV/AIDS," the unnamed official said (Cornish, Agence
France-Presse, 1/20). In addition, a "high-profile" delegation
of officials from the Nelson Mandela Foundation is expected to
meet with Schroeder on Thursday, the South African Press
Association reports. Dr. Olive Shisana of South Africa's Human
Sciences Research Council is scheduled to present information on
the threats that HIV/AIDS poses to political and economic
stability in Southern Africa. Foundation CEO John Samuel is
expected to give a presentation on the importance of the private
sector in fighting HIV/AIDS. Mandela is on vacation in Mauritius
and will not be attending the session, according to SAPA (South
African Press Association, 1/21).

DRUG ACCESS

6. AIDS Advocates Upset With South African Government Over
Delays in Roll-Out of Antiretroviral Treatment Program

Access this story and related links online:
http://cme.kff.org/Key=1635.Cc1.J.D.FDHqHY

  AIDS advocates are "heading for confrontation" with the South
African government over delays in the roll-out of the country's
national HIV/AIDS treatment program, the Financial Times
reports. Advocates had expected drug distribution to commence
within weeks of the health minister's approval of the program,
but treatment may not be available in state hospitals until
April, the Times reports (Degli Innocenti/Reed, Financial Times,
1/21). The South African Cabinet in November approved the
treatment program, which includes 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
(Kaiser Daily HIV/AIDS Report, 12/17/03). However, a team
responsible for negotiating drug procurement contracts with
pharmaceutical companies has not yet convened and does not plan
to request proposals until Feb. 1. The team then must review the
proposals before purchasing the drugs, the Times reports. "It
will be a slow and cumbersome process, but with good reason. We
must play by the rules and ensure our choice is beyond
reproach," Dr. Humphrey Zokufa, the team's coordinator, said.
Mark Heywood, secretary of the Treatment Action Campaign, said,
"The request for proposals could have been done six months ago.
It is a totally unwarranted delay, with the result that it could
be months before any antiretrovirals get to hospitals." Sharon
Ekambaram of the AIDS Consortium said that provincial
governments have been working to implement the program and are
"ready to go," adding, "Once again, national government is
hampering their efforts" (Financial Times, 1/21).

  The Times on Tuesday examined other challenges that South
Africa may encounter in implementing the drug program (Degli
Innocenti/Reed, Financial Times, 1/21). The complete article is
available online.

Program Could Become 'Model' for Developing World, Editorial
Says

Although "belated," South Africa's national antiretroviral drug
program "can show the way" throughout Africa and the developing
world and could solve one of the "great inequalities" of our
time, a Financial Times editorial says. Making the program
successful will be "no simple task," and the difficulties
involved in establishing "training, facilities and public
awareness ... should not be underestimated," the editorial says.
However, South Africa is on the "front line in the battle to
overcome" the "injustice" of limited access to antiretroviral
drugs in developing countries and has a "greater capacity than
anywhere else in the continent to mobilize people and
resources," the editorial says, concluding, "If [South Africa]
does this quickly and well it will become the model for others
to follow" (Financial Times, 1/22).

7. South African National Defence Force Launches Clinic for Army
Personnel, Families

Access this story and related links online:
http://cme.kff.org/Key=1635.Cc1.K.D.FDf6lZ

  The South African National Defence Force on Tuesday opened the
country's first clinic where army personnel and their families
can obtain HIV/AIDS testing and treatment, VOANews.com reports.
The clinic is the first of six testing and treatment centers
that the military plans to establish throughout the country as
part of Project Phidisa, which means "to heal" in Tswane
(Robertson, VOANews.com, 1/20). Staff at the clinic plan to
conduct clinical research into the most appropriate and
effective medical treatment to combat HIV, Xinhua News Agency
reports (Xinhua News Agency, 1/20). The military primarily will
be in charge of the project but will receive assistance from
local academic and research institutions, as well as from the
U.S. Department of Defense and NIH (VOANews.com, 1/20). South
African Deputy Minister of Defence Nozizwe Madlala-Routledge
said that the success of the program depends on the
participation of army personnel. "This clinic can achieve its
set objectives only if those members and their families
voluntarily enroll and participate fully in the project,"
Madlala-Routledge said (Xinhua News Agency, 1/20).

IN THE COURTS

8. Creator of AIDS Memorial Quilt Files Suit Against Names
Project Foundation

Access this story and related links online:
http://cme.kff.org/Key=1635.Cc1.L.D.DqpFYn

  The gay-rights advocate who created the AIDS Memorial Quilt and
has served as the quilt's spokesperson for 15 years on Tuesday
filed a lawsuit in San Francisco Superior Court claiming that
the Atlanta-based Names Project Foundation fired him because he
encouraged a plan to take the quilt on a nationwide,
election-year tour ending with a display in October on the
National Mall in Washington, D.C., the San Francisco Chronicle
reports. In the suit, Cleve Jones also alleges that the
foundation did not keep its promise to reopen a quilt project
office in San Francisco, where the quilt was first sewn and
where the foundation was located until 2001. According to Jones,
the foundation said that it did not have enough funding for the
national quilt tour -- which would include voter registration
for HIV-positive people -- and expressed concern that the
quilt's first display in eight years would be connected to a
national political campaign. When Jones offered to raise money
for the project, foundation Board President Edward Gatta and
Executive Director Julie Rhoad encouraged him to raise the $3
million needed for the project, Jones said. In order to apply
for grants to help subsidize the tour, Jones asked Gatta and
Rhoad for the foundation's current financial information,
including annual reports or the annual audits mandated by the
foundation's bylaws, but Gatta and Rhoad refused to grant the
request, the Chronicle reports. In September 2003, Jones -- who
had raised more than $1 million for the project -- wrote a
letter to the project's 15-member board detailing his concerns
about Gatta and Rhoad and requesting "to be given new powers" so
that the quilt could go on tour. However, "relations
deteriorated," and the foundation on Dec. 31, 2003, fired Jones
from his $41,500 per year job, the Chronicle reports. In
addition, Jones -- who is HIV-positive -- said that the
foundation threatened to end his health insurance, which it had
promised to provide until his death.

Jones Wants Quilt To Tour

The lawsuit, which names Gatta and Rhoad as defendants, asks the
court to put the Names Project Foundation in receivership, which
would allow the quilt -- which is currently stored in a Georgia
warehouse -- to be returned to San Francisco and displayed.
Jones said, "We need to use the quilt to fight AIDS, and you do
that by displaying the quilt in as many venues as possible"
because the quilt -- which lists the names of 40,000 people who
have died from AIDS-related complications -- "works where dry
statistics and parental admonitions fail." He added, "I want the
quilt to be used to fight AIDS, and if this board doesn't know
how to do that, I'm quite capable of doing it myself." The Names
Project Foundation's attorney told employees not to discuss
Jones or the lawsuit, according to an unnamed staff member who
answered the phone when the Chronicle attempted to contact the
foundation (Williams, San Francisco Chronicle, 1/21).

OPINION

9. Some Criticisms of Bush's Global AIDS Initiative
'Misconceived,' While One Is 'Telling,' Editorial Says

Access this story and related links online:
http://cme.kff.org/Key=1635.Cc1.M.D.Dtf3Sp

  Although Bush's global AIDS initiative "went unmentioned"
during his State of the Union address on Tuesday, his
administration has been "ramping up its effort in a serious
way," as AIDS-related spending has increased fivefold since Bush
took office, a Washington Post editorial says. "Of the four
criticisms often directed against the administration's efforts,
two are misconceived, one is premature and only one is really
telling," according to the editorial. First, the belief that
fighting AIDS through faith-based groups is ineffective is
"misconceived" because "shunning" the religious organizations
that operate a large percentage of the medical and social
services in developing countries "would be wrong," the editorial
says. Second, objections about a provision in the bill requiring
funding for abstinence education are misguided because such
funding accounts for one-third of the total AIDS prevention
funding, or 7% of the total U.S. international AIDS effort,
which means that the abstinence focus is "pronounced but not
outrageous," the Post says. Third, claims that the Bush
administration is "biased against cheap, non-patented 'generic'
medicines," are "premature" because officials insist that the
plan will involve generic drugs, "provided they prove safe," the
editorial says. The only "telling complaint" about Bush's plan
is the claim that his program is "unilateralist," creating new
programs instead of going through the already-established Global
Fund to Fight AIDS, Tuberculosis and Malaria, the Post says,
concluding that while the global AIDS initiative is in its early
stages, "it makes sense to give a large slice of the money to
other agencies ... that have a longer track record" (Washington
Post, 1/22).

Absence of AIDS Discussion 'Conspicuous,' Editorial Says

The absence of discussion of the global AIDS initiative from
Bush's State of the Union address on Tuesday was "conspicuous,"
a Houston Chronicle editorial says. Although it was "one of the
centerpieces" of last year's address, both mention of the pledge
and the money itself "has been largely missing in action," the
editorial says. Bush last year made a "bold AIDS proposal," but
has since "disappointed many by underfunding the pledge," the
editorial says. The "shortfall" in Bush's funding requests is
"important" because the initiative targets only 14 countries,
"leaving out dozens of countries in great need, including
populous 'next wave' nations such as India," according to
RESULTS Legislative Director Joanne Carter, the editorial says.
The "shortfall" will cause a "ripple effect" because other
nations follow the lead of the United States, the editorial
concludes (Houston Chronicle, 1/21).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: http://www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. (c) 2004 Advisory Board Company and Kaiser Family
Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at
http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or
unsubscribe.
Questions about your email subscription? Contact us at
subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family
Foundation. For access to the Foundation's policy research,
analyses, reports and fact sheets, and media partnerships, visit
the Foundation's main website at http://www.kff.org .

-Message-Id: <20040122082731.BFE7.4390-1635@...>

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


Wednesday, January 21, 2004

POLITICS AND POLICY
========================================
1. Bush's State of the Union Calls for Doubling of Abstinence
Program Funding, Does Not Specifically Mention AIDS

2. Senate Democrats Block Omnibus Spending Bill, Including
Funding for Global AIDS Initiative

ACROSS THE NATION
========================================
3. HIV-Positive Male Inmates in Alabama Prison Allowed to Attend
Educational, Vocational Programs

PUBLIC HEALTH & EDUCATION
========================================
4. Durex Stops Making Condoms With Nonoxynol-9 Due to Possible
Increased Risk of HIV Transmission

5. AIDS Foundation of Chicago Launches New AIDS Awareness Ad
Campaign

GLOBAL CHALLENGES
========================================
6. WHO To Expand Collaboration Between National HIV, TB Programs
To Reduce Number of Coinfection Cases

7. U.N. Special Envoy Lewis Calls for Canada to Double Funding
for AIDS Vaccine Research

DRUG ACCESS
========================================
8. Cost of AIDS Drugs Forcing Families To Choose Which Members
To Treat, Advocates at World Social Forum Say

SCIENCE & MEDICINE
========================================
9. Three Top VaxGen Officials Leaving Company To Start
Not-for-Profit AIDS Vaccine Foundation

OPINION
========================================
10. Opinion Piece, Editorial React To Lancet Article on WHO,
Global Fund and Malaria Treatment

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

POLITICS AND POLICY

1. Bush's State of the Union Calls for Doubling of Abstinence
Program Funding, Does Not Specifically Mention AIDS

Access this story and related links online:
http://cme.kff.org/Key=1619.Cc5.C.D.GGLwqj

  President Bush during his State of the Union address on Tuesday
night called for the doubling of federal funding for abstinence
programs to fight sexually transmitted diseases but did not
specifically mention HIV/AIDS, the San Francisco Chronicle
reports (Sandalow, San Francisco Chronicle, 1/21). Bush said,
"To encourage right choices, we must be willing to confront the
dangers young people face -- even when they're difficult to talk
about. Each year, about three million teenagers contract
sexually transmitted diseases that can harm them, or kill them,
or prevent them from ever becoming parents. In my budget, I
propose a grassroots campaign to help inform families about
these medical risks. We will double federal funding for
abstinence programs, so schools can teach this fact of life:
Abstinence for young people is the only certain way to avoid
sexually transmitted diseases." He added, "Decisions children
now make can affect their health and character for the rest of
their lives. All of us -- parents and schools and government --
must work together to counter the negative influence of the
culture and to send the right messages to our children" (State
of the Union text, 1/20). According to the Washington Post,
Bush's proposal would increase abstinence program funding from
$80 million a year to more than $270 million in 2005
(Goldstein/Weisman, Washington Post, 1/21).

Reaction

International Association of Physicians in AIDS Care President
and CEO Jose Zuniga said, "[W]e appreciate concern for
preventing the spread of sexually transmitted diseases and HIV,
but we fear that an overemphasis on abstinence as the only
method of prevention could be dangerous," adding, "The
grassroots efforts for which the president called should reflect
the full scope of what we know about preventing sexually
transmitted diseases. Abstinence is one part of the equation,
but so too are condoms and safer sex education." Although IAPAC
lauded Bush's attention to the country's health care system,
Zuniga said that plans mentioned in the address and during the
preceeding week may not "be far-reaching enough to bring
treatment to the thousands of patients living with HIV who will
go without the life-sustaining drugs they need" (IAPAC release,
1/20). AIDS Healthcare Foundation President Michael Weinstein
said, "There is simply no scientific basis for abstinence-only
programs as a substitute for quality sex education in preventing
HIV or other sexually transmitted diseases. America will pay a
terrible price for turning HIV prevention over to the Christian
Right as the president seems to want to do" (AHF release, 1/20).
James Dobson, founder and chair of Focus on the Family, said, "I
am ... pleased that President Bush has unashamedly endorsed
abstinence education and programs as the single best way to
prevent our children from paying the awful price that sexually
transmitted diseases extract from those who are sexually active
outside the bounds of marriage. Our children need to hear the
life-giving message that abstinence before marriage and monogamy
after marriage are the safest and most rewarding expressions of
intimate love" (Focus on the Family release, 1/20).

One Year Later

AIDS Action said in a statement, "If our goal is to give every
young person the information and tools to remain STD-free and
HIV-negative, then our nation must speak frankly and honestly
about what will keep our society socially and physically
healthy." AIDS Action Executive Director Marsha Martin said that
Tuesday's speech "was a missed opportunity to continue the great
work President Bush began last year, and to speak only about
abstinence and not other scientifically accepted public health
interventions for young people (and their adult parents) is a
costly omission -- not just in dollars but also in lives" (AIDS
Action release, 1/20). Physicians for Human Rights called on
Bush to increase funding for his global AIDS initiative, which
he unveiled during last year's State of the Union address (PHR
release, 1/20). In 2003, Bush announced the Emergency Plan for
AIDS Relief -- also known as the global AIDS initiative -- which
is a five-year, $15 billion program focused on HIV/AIDS
prevention and care in some African and Caribbean nations
(Kaiser Daily HIV/AIDS Report, 1/20). PHR U.S. Policy Director
Holly Burkhalter said, "Three million people have died since the
last State of the Union address. We can't afford to lose any
more time on the extraordinary commitment that the President
made last January. President Bush needs billions every year to
bring life to the AIDS-stricken African continent, leaving no
vulnerable person behind" (PHR release, 1/20).

  The health policy portion of the president's State of the Union
address, including his call to double abstinence funding, is
available online from kaisernetwork.org.

2. Senate Democrats Block Omnibus Spending Bill, Including
Funding for Global AIDS Initiative

Access this story and related links online:
http://cme.kff.org/Key=1619.Cc5.D.D.FwjfMw

  Senate Democrats on Tuesday blocked passage of an omnibus
spending bill, which includes $2.4 billion for international
AIDS, tuberculosis and malaria initiatives, the Washington Times
reports (Fagan, Washington Times, 1/21). The 48-45 Senate vote
fell short of the 60 votes needed to end debate on the bill and
force a final vote, according to the AP/Philadelphia Inquirer
(Fram, AP/Philadelphia Inquirer, 1/21). The House last month
approved the spending bill, which combines seven of the 13
annual fiscal year 2004 spending bills. House-Senate conferees
in November 2003 agreed to increase FY 2004 federal spending on
international AIDS, TB and malaria initiatives to $2.4 billion,
$400 million more than the Bush administration had requested.
Although the measure (HR 1298) supporting the five-year, $15
billion global AIDS initiative authorizes $3 billion for the
first year of the program, the Bush administration requested
only $2 billion. Bush said that his administration requested
less than $3 billion in order to give the program time to "ramp
up." The omnibus spending bill also includes $1 billion for the
Millennium Challenge Account, an assistance program for
developing nations that encourages democracy and development
through economic aid (Kaiser Daily HIV/AIDS Report, 1/20). The
government is currently operating under last year's spending
levels through a continuing resolution that is set to expire on
Jan. 31, according to the Los Angeles Times (Hook, Los Angeles
Times, 1/21). If the bill continues to be blocked, the "only
option" would be to adopt a continuing resolution extending the
FY 2003 funding levels through the remainder of the current
fiscal year, which ends on Sept. 30, according to Senate
Majority Leader Bill Frist (R-Tenn.), the Washington Times
reports (Washington Times, 1/21).

'Empty Threat'

Delaying the bill's passage is "mostly an empty threat,"
according to the New York Times. Senate Minority Leader Tom
Daschle (D-S.D.) on Tuesday said that he expects Congress to
pass the measure by the end of this month (Gay Stolberg, New
York Times, 1/21). Senate Democrats say they are blocking the
bill so that they can "fix" provisions on overtime pay rules,
country-of-origin food labeling and other issues, according to
the Washington Post (Dewar, Washington Post, 1/21). "Our desire
isn't to kill this bill," Daschle said, adding, "Our desire is
to give them a chance to fix it" (New York Times, 1/21).
President Bush on Tuesday called on Congress to pass the
spending bill, saying, "Today, a minority in the Senate denied a
vote on a spending bill that is four months overdue, and that
fulfills important commitments," including "commitments ... to
Africans suffering from AIDS" (Washington Times, 1/21). Frist
urged Congress to quickly pass the bill, adding, "To defeat the
omnibus will ... put at risk millions of lives for those who
suffer from AIDS overseas" (Lerman, Newport News Daily Press,
1/20).

ACROSS THE NATION

3. HIV-Positive Male Inmates in Alabama Prison Allowed to Attend
Educational, Vocational Programs

Access this story and related links online:
http://cme.kff.org/Key=1619.Cc5.F.D.GBN9LN

  About 200 HIV-positive male inmates at the Athens, Ala.,
Limestone Correctional Facility on Monday were permitted to
attend educational and vocational programs, bringing to an end
the state's practice of segregating HIV-positive prisoners from
other inmates, the Birmingham News reports (Crowder, Birmingham
News, 1/20). Alabama had been the only state to adhere to a
policy of total segregation of HIV-positive prisoners. In a
report issued in September, the Alabama Governor's HIV
Commission for Children, Youth and Adults said that the state's
policy of excluding inmates from such programs "simply on the
basis of HIV status, has no public health or correctional
justification." The report recommended that the state's
HIV-positive inmates be allowed to participate in all of the
educational, vocational and community-based programs available
to other inmates (Kaiser Daily HIV/AIDS Report, 9/24/03).
However, the change in policy does not apply to HIV-positive
female inmates, who remain segregated and unable to participate
in classes at the Tutwiler Correctional Facility, the AP/Biloxi
Sun-Herald reports. Margaret Winter, associate director of the
American Civil Liberties Union's National Prison Project, and
advocates from AIDS Alabama have called for Prison Commissioner
Donal Campbell to change the policy at Tutwiler as well,
according to the AP/Sun-Herald (AP/Biloxi Sun-Herald, 1/20).
Winter said, "Since 1987, prisoners with HIV/AIDS in Alabama
have fought to receive the same opportunities to learn and
rehabilitate themselves as other prisoners. Today male prisoners
with HIV are closer to equality in Alabama then they have ever
been before" (Birmingham News, 1/20).

Lawsuit

Medical care and conditions at Limestone, which houses all of
the state's HIV-positive male inmates, have been at the center
of a class-action lawsuit, Leatherwood et al. v. Campbell, filed
in 2002, the AP/Sun-Herald reports (AP/Biloxi Sun-Herald, 1/20).
The Atlanta-based Southern Center for Human Rights in August
2003 released a report on the medical treatment and living
conditions of the 300-person HIV unit at Limestone as part of
the lawsuit, which was filed in U.S. District Court for the
Northern District of Alabama by the center against the Alabama
Department of Corrections and Birmingham-based NaphCare, the
prison system's medical contractor. The 125-page report, written
by Dr. Stephen Tabet, an infectious disease expert, provides a
detailed case summary of the deaths of 38 HIV-positive inmates
between 1999 and 2002 and concludes that the unit's medical care
system is substandard. Tabet in the report says that nearly all
of the 38 deaths he investigated were "preceded by a failure to
provide proper medical care or treatment" and all of the deaths
were caused by "preventable illnesses." In October 2003, all of
the facility's 237 inmates were moved into new two-person units,
which prisoners' lawyers said was a victory in reducing the
spread of infectious diseases. HIV-positive inmates previously
were housed in a converted warehouse. However, many other
problems remain, including a lack of access to antiretroviral
drugs, the lawyers said (Kaiser Daily HIV/AIDS Report,
10/27/03). Limestone's medical staff has said that medical care
has improved, but the lawsuit remains unsettled, the
AP/Sun-Herald reports. Attorneys for the inmates lauded the
state's policy change, saying it was "long overdue," and called
for more improvements, according to the AP/Sun-Herald. Gretchen
Rohr, an attorney with Atlanta-based firm Holland and Knight,
which is working with the Southern Center for Human Rights on
the case, said, "They want to appear they've put their best foot
forward before they're in front of a federal judge" (AP/Biloxi
Sun-Herald, 1/20).

PUBLIC HEALTH & EDUCATION

4. Durex Stops Making Condoms With Nonoxynol-9 Due to Possible
Increased Risk of HIV Transmission

Access this story and related links online:
http://cme.kff.org/Key=1619.Cc5.G.D.GCxMlC

  SSL International, the maker of Durex condoms, has stopped
producing condoms containing the spermicide nonoxynol-9, which
in recent studies has shown that it may increase the risk of HIV
transmission, BBC News reports (BBC News, 1/20). Nonoxynol-9
works as a vaginal contraceptive by damaging the cell membranes
of sperm, and some laboratory evidence has shown that the
spermicide damages the cell walls of some organisms that cause
sexually transmitted diseases and is active against some
bacteria and viruses. According to data presented in January
2003, nonoxynol-9's membrane-damaging effect can also harm the
cell lining of the vagina and cervix, possibly increasing the
risk of STD and HIV transmission in women who use the spermicide
(Kaiser Daily HIV/AIDS Report, 8/29/03). The World Health
Organization, UNAIDS and the CDC have raised concerns about the
use of the spermicide in condoms. In a statement, SSL said that
it "is anticipating a material reduction in demand for
spermicidally lubricated condoms following a recent WHO report
which questioned the level of additional protection provided by
such condoms when compared to non-spermicidally lubricated
condoms. In light of this, SSL decided to discontinue using the
spermicide N-9 in our condom manufacturing process." Keith
Winestein of the U.K. National AIDS Trust said, "This is a very
welcome decision. A raft of agencies and organzations agree that
N-9 is harmful and it needs to be removed from any products that
might put the consumer at risk" (BBC News, 1/20). Several other
companies, including Johnson & Johnson, which makes K-Y
lubricant jelly, and Mayer, which makes the Kimono brand of
condom, have stopped manufacturing condoms with nonoxynol-9
(Kaiser Daily HIV/AIDS Report, 8/29/03).

5. AIDS Foundation of Chicago Launches New AIDS Awareness Ad
Campaign

Access this story and related links online:
http://cme.kff.org/Key=1619.Cc5.H.D.F6sgrc

  The AIDS Foundation of Chicago on Tuesday launched a new
HIV/AIDS public awareness campaign aimed at increasing attention
to the epidemic, according to an AIDS Foundation of Chicago
release. The campaign, titled "AIDS: A Tragic Trend," was
developed for no charge by the Chicago Creative Partnership. The
three ads feature models wearing clothing, shoes and other
accessories with the word "AIDS" on the label, and the tagline
"When will it go out of style?" appears on all of the ads. The
aim is to "remind viewers that the AIDS crisis, like fashion, is
still a current issue," according to the release. The ads are
located throughout the city in bus shelters, select bus lines,
entertainment establishments such as bars and in community
newspapers throughout Chicago. AFC Executive Director Mark
Ishaug said, "Too many people mistakenly and tragically believe
that AIDS is under control and not their problem. The campaign
is an effort to break that myth and encourage everyone to
respond to the AIDS epidemic in our community." Shawna Delaney
Ross, an account planner for the Chicago Creative Partnership,
said, "Because of the growing complacency about the epidemic, we
felt that the best way to renew attention to AIDS was with a
bold statement. The fashion motif lures in viewers and then
provides a serious, unanticipated message that we hope will
catch them off guard and get them thinking" (AIDS Foundation of
Chicago release, 1/20). The ads can be viewed online.

GLOBAL CHALLENGES

6. WHO To Expand Collaboration Between National HIV, TB Programs
To Reduce Number of Coinfection Cases

Access this story and related links online:
http://cme.kff.org/Key=1619.Cc5.J.D.FgxFzf

  The World Health Organization on Wednesday announced plans to
fight the growing problem of HIV and tuberculosis coinfection,
AFP/Yahoo! News reports (AFP/Yahoo! News, 1/20). HIV weakens the
immune system, making HIV-positive people more susceptible to
TB. If active TB goes untreated in HIV-positive people, most
will die within one year, according to the Wall Street Journal.
HIV/TB coinfection is a problem especially in Africa, where 70%
of the world's coinfected people live. As many as half of all
HIV-positive people in Africa have TB, and up to 80% of TB
patients have HIV. The new plan will encourage an expansion of
voluntary HIV testing and counseling in TB programs in the hopes
of identifying more than 500,000 coinfected people for
antiretroviral treatment by 2006 (Naik, Wall Street Journal,
1/21). In addition, the plan encourages the development of TB
screening and testing programs at HIV clinics and service points
(AFP/Yahoo! News, 1/20). WHO plans to provide primarily
technical assistance to countries participating in the program
but hopes to persuade bilateral donors and groups such as the
Global Fund to Fight AIDS, Tuberculosis and Malaria to fund the
treatments needed for the initiative.

'Three-by-Five' Goal

The new plan is part of WHO's larger goal of treating three
million HIV-positive people with antiretroviral drugs by 2005
(Wall Street Journal, 1/21). WHO Director-General Jong-Wook Lee
in September during a U.N. General Assembly special session on
HIV/AIDS announced WHO's commitment to the "three-by-five" plan
and declared the lack of access to antiretroviral drugs a global
health emergency. WHO's $5.5 billion plan calls for training
100,000 health care workers, refocusing 10,000 clinics in
developing countries to treat HIV/AIDS and using some common
antiretroviral drug combinations. However, the plan does not
provide the drugs or subsidize their cost (Kaiser Daily HIV/AIDS
Report, 12/8/03). The launch of the new HIV/TB initiative,
titled the "Interim Policy on Collaborative TB/HIV Activities,"
coincides with the fourth round call for grant proposals from
the Global Fund. The WHO initiative will "enhance" proposals
that address HIV/TB coinfection, according to a WHO release (WHO
release, 1/21).

7. U.N. Special Envoy Lewis Calls for Canada to Double Funding
for AIDS Vaccine Research

Access this story and related links online:
http://cme.kff.org/Key=1619.Cc5.K.D.FdDnkW

  U.N. Special Envoy for HIV/AIDS in Africa Stephen Lewis in a
recent speech to the Toronto Rotary Club called on Canada to
double its investment in HIV/AIDS vaccine research and triple
its funding for tuberculosis and malaria research, which would
bring the country's total contribution to $100 million, the
Toronto Star reports. Lewis, who is Canadian, said it is a
"travesty" that while HIV/AIDS patients in developed countries
have access to antiretroviral drugs, treatment for people living
with HIV/AIDS in developing countries -- especially in Africa
and Asia -- is "out of reach" because the drugs are too
expensive, according to the Star. Lewis said, "Only a vaccine
will end this pandemic. Until then, we'll forever be counting
the bodies." Lewis added that 2004 could be a "breakthrough
year" in the fight against HIV/AIDS because pharmaceutical
companies, governments and private citizens have the "interest,
will and resources" to take action, the Star reports. Lewis said
that it could be possible to meet the World Health
Organization's goal of providing antiretroviral therapy to three
million HIV/AIDS patients by 2005 as long as drug makers
continue to lower their prices on the drugs, according to the
Star.

Canadian Legislation

Lewis cited a recent measure introduced in Canada's Legislature
that would make it easier for generic drug manufacturers to
produce antiretroviral drugs (Palmer, Toronto Star, 1/19).
Former Canadian Prime Minister Jean Chretien in November
introduced in the House of Commons legislation that would amend
the country's patent laws to allow drug makers to manufacture
and export generic drugs -- including antiretroviral drugs -- to
developing countries. If passed, the bill would allow the
government to amend a WHO list of essential medicines to include
other drugs that are patented in Canada. Under the measure,
about 50 countries would be eligible to receive generic drugs at
a fraction of the prices charged in Canada. One official said
that the legislation uses the same language as a November 2001
World Trade Organization statement on patented medications
(Kaiser Daily HIV/AIDS Report, 11/7/03). "We've been marking
time until now. Suddenly there's some sense that things are
changing," Lewis said, adding, "This is the year it will come if
it's going to come at all." The international arm of the Rotary
Club is less than two years away from finishing a campaign to
eradicate polio worldwide, and the Toronto chapter of the
organization appears to be pushing for the group to next target
HIV/AIDS for eradication (Toronto Star, 1/19).

DRUG ACCESS

8. Cost of AIDS Drugs Forcing Families To Choose Which Members
To Treat, Advocates at World Social Forum Say

Access this story and related links online:
http://cme.kff.org/Key=1619.Cc5.L.D.FrBpTw

  The high cost of antiretroviral drugs in developing countries
has forced some families with more than one HIV-positive person
to decide which family members should receive treatment and
which should not, advocates at the World Social Forum said on
Tuesday, the Associated Press reports. About 100,000 advocates,
aid workers, academics and trade unionists on the fifth day of
the forum attended seminars and workshops on HIV/AIDS. The
anti-globalization forum is being held in Asia for the first
time and is meant to be a counterpoint to the World Economic
Forum, which begins on Wednesday. AIDS advocates said that
although the price of antiretroviral drugs has dropped, more
needs to be done, according to the Associated Press. "People
with a steady income can afford these drugs," Alice Wynne
Willson of ActionAid said, adding, "But unless the AIDS drugs
are bought by governments and made available through health care
systems, it will be impossible for the poor to afford" (Talwar
Badam, Associated Press, 1/20).

SCIENCE & MEDICINE

9. Three Top VaxGen Officials Leaving Company To Start
Not-for-Profit AIDS Vaccine Foundation

Access this story and related links online:
http://cme.kff.org/Key=1619.Cc5.M.D.Fq1QXF

  Brisbane, Calif.-based biotechnology company VaxGen on Tuesday
announced that three upper-level officials are leaving the
company to form a not-for-profit AIDS vaccine foundation,
Reuters reports. The company said that President Donald Francis
and Senior Vice President for Research and Development Phillip
Berman will leave the company on Feb. 1. According to a company
statement, Francis and Berman are also stepping down from the
VaxGen's board of directors, but both will continue to work with
the company as consultants. Senior Vice President for Finance
and Administration Carter Lee is also stepping down, but he will
remain with the company to oversee VaxGen's 2003 financial
statements, according to Reuters (Reuters, 1/20). The news comes
after the company failed to "push through" FDA approval of its
AIDS vaccine, the Wall Street Journal reports (Wall Street
Journal, 1/21). VaxGen in November announced that late-stage
clinical trials of its AIDS vaccine AIDSVAX failed because the
vaccine did not affect HIV infection rates among participants.
The trial, the first HIV vaccine efficacy trial ever held in a
developing nation, involved nearly 2,500 injection drug users in
Thailand. VaxGen said that the vaccine failed to meet its
primary endpoint of preventing HIV infection and also failed to
meet the secondary endpoint of slowing disease progression among
participants who received the vaccine but later became
HIV-positive (Kaiser Daily HIV/AIDS Report, 11/13/03). Francis
said, "Developing an effective HIV vaccine is an expensive and
lengthy process fraught with immense scientific challenges. But
given our experience with HIV and the lessons we have learned
during the many years we have spent in vaccine development,
[Berman, Lee] and I believe that we can make an important
contribution to the field." He added that the new foundation's
goal will be to focus on producing HIV vaccine candidates for
developing countries, "where the disease takes a
disproportionate toll on human life" (Reuters, 1/20).

OPINION

10. Opinion Piece, Editorial React To Lancet Article on WHO,
Global Fund and Malaria Treatment

Access this story and related links online:
http://cme.kff.org/Key=1619.Cc5.N.D.FkVlFk

  If the Global Fund to Fight AIDS, Tuberculosis and Malaria
cannot "get it right" in its policy on malaria drugs, as
suggested by a recent article in the Lancet, "one wonders if it
can sustain decent AIDS treatment," Richard Tren, director of
Africa Fighting Malaria, and Roger Bate, a visiting fellow at
the American Enterprise Institute, write in a Washington Times
opinion piece. The authors of the Lancet article -- a "who's who
of the malaria research world" -- attribute rising malaria rates
to the World Health Organization's "policy failure[s]" and to
the Global Fund's funding the purchase of "ineffective drugs,"
Tren and Bate say. Although both WHO and the Global Fund seem
"loathe to buy patented drugs, whether for malaria control or
AIDS ... buying off-patent drugs that don't work is
unacceptable," Tren and Bate say. In addition, "AIDS activists
and Democrats" who criticize Bush for his "miserly funding" of
WHO and the Global Fund should concede that Bush is "right to
retain control" of foreign aid because it is "far from certain"
that the agencies "can be trusted," Tren and Bate say,
concluding that Bush and African health ministers should "take
the health bureaucrats" of WHO and the Global Fund "to task"
over their "negligent [malaria] policies" (Tren/Bate, Washington
Times, 1/19).

Bush Administration Should 'Reconsider' Funding

The Bush administration should "reconsider" allocating money
from the global AIDS initiative to the Global Fund, "given how
it has bungled the malaria epidemic," a Wall Street Journal
editorial says. It is "well known" that "activist groups" like
the Global Fund and WHO "frown on patent law and would rather
employ off-patent medicines or cheap knockoffs," even though the
"whole purpose of the Global Fund is to pay for the more
expensive treatments that poor countries can't afford," the
editorial says. Because the United States "fund[s] the world's
drug research ... it makes little sense for us to give money to
anti-patent organizations that would undermine the property laws
and protections that lead to new and better therapies," the
editorial says. Therefore, the Bush administration should
consider attaching a "requirement" to Global Fund contributions
stating "that the money not be used on patent-breaking
medications -- let alone ineffective off-patent treatments," the
editorial says, adding, "Better still, the U.S. could encourage
more public-private partnerships," such as a partnership between
the Bill & Melinda Gates Foundation and drug maker Merck, which
has funded antiretroviral treatment in Botswana. The editorial
concludes, "Mr. Bush has every right to demand that
organizations like the Global Fund do better with U.S. tax
dollars or do without them" (Wall Street Journal, 1/21).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: http://www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. (c) 2004 Advisory Board Company and Kaiser Family
Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at
http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or
unsubscribe.
Questions about your email subscription? Contact us at
subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family
Foundation. For access to the Foundation's policy research,
analyses, reports and fact sheets, and media partnerships, visit
the Foundation's main website at http://www.kff.org .

-Message-Id: <20040121082028.C05E.4394-1619@...>

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


Tuesday, January 20, 2004

POLITICS AND POLICY
========================================
1. President Bush's FY 2005 Budget Expected To Include $38M in
Additional Funds To Fight AIDS Domestically

2. Senate Democrats Could Block Omnibus Spending Bill, Including
Funding for Global AIDS Initiative

3. Irish Rock Star Bono Says Advocates Should Use Nonviolent
Activism To Pressure Governments To Fight AIDS

4. Kentucky House Committee Approves Bill That Would Require
State To Identify HIV Patients by Name

DRUG ACCESS
========================================
5. Bristol-Myers Squibb Returns Patent for Antiretroviral Drug
to Thailand; Group Agrees To Drop Lawsuits Over Patent Rights

6. Brazil's National STD/AIDS Programme Announces Largest Drug
Price Reduction Deals in Five Years

SCIENCE & MEDICINE
========================================
7. Wall Street Journal Examines Law Enforcement Officials'
Efforts To Curb Black Market Sales of Serostim

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

POLITICS AND POLICY

1. President Bush's FY 2005 Budget Expected To Include $38M in
Additional Funds To Fight AIDS Domestically

Access this story and related links online:
http://cme.kff.org/Key=1608.Cc9.C.D.GTKQH4

  HHS Secretary Tommy Thompson on Friday announced that President
Bush's fiscal year 2005 budget proposal will contain $38 million
in additional funds to help fight the spread of HIV/AIDS in the
United States and help HIV-positive people obtain medication for
treatment, the Washington Post reports. The AIDS Drug Assistance
Program, a federal program that helps states pay for
antiretroviral drugs for HIV-positive people who cannot afford
them, would receive $35 million, while $3 million would go to
the HIV/AIDS in Minority Communities Fund, according to the Post
(Goldstein, Washington Post, 1/17). The budget request, which is
expected to be released early next month, will include a total
of $784 million for ADAP programs, allowing the program to serve
100,000 people a month in FY 2005, up from 93,800 a month in FY
2004, according to an HHS release (HHS release, 1/16). However,
state and federal ADAP officials estimate that the program will
need an additional $215 million in funding for FY 2004 to cover
the cost of treating current and new patients. Congress has
proposed a $35 million increase for 2004. At that funding level,
13 states have closed enrollment to new patients, leaving more
than 700 patients on waiting lists for drugs. The number could
grow to 7,000 this year if no additional funding is secured,
according to the ADAP Working Group, which helps advocate for
more ADAP funding (Kaiser Daily HIV/AIDS Report, 1/13). Although
administration officials announced the increases as "good news,"
the 4.7% increase in ADAP funding would be the smallest annual
expansion of the program since Bush took office, the Post
reports. However, one administration official said that the
increases for the two programs would be one of the largest among
other social programs, according to the Post.

International vs. Domestic

Thompson said that the $3 million dollar expansion of the
HIV/AIDS in Minority Communities Fund is part of the
administration's effort to improve the health of several
minority groups. The fund, which was created in 1999, has
contained $50 million every year since then (Washington Post,
1/17). "Minority communities are disproportionately affected by
the HIV/AIDS epidemic," Thompson said, adding, "We must be as
flexible as possible in our treatment, research and prevention
of HIV/AIDS to ensure that we are directing our energy and
resources to the communities that are most seriously impacted by
the disease." Under Bush, overall federal spending on HIV/AIDS
has increased 28%, from $14.2 billion in FY 2001 to $18.2
billion in FY 2004, according to the release. In his State of
the Union address last year, Bush announced the Emergency Plan
for AIDS Relief -- also known as the Global AIDS Initiative --
which is a five-year, $15 billion program focused on HIV/AIDS
prevention and care in some African and Caribbean nations (HHS
release, 1/16). According to the Post, the proposed increase in
funds "is an effort to counteract criticism" from AIDS advocates
who complained that Bush did not devote equal attention to the
disease domestically when he announced his Global AIDS
Initiative. Ronald Johnson, board chair for AIDS Action, an
umbrella organization for several local AIDS groups, commended
the Global AIDS Initiative but said, "We also have to recognize
that the domestic agenda should not be shortchanged." He added
that the proposed increases are "so well below what is needed."
Administration officials on Friday would not say whether Bush
plans to highlight the AIDS funding in his State of the Union
address on Tuesday or whether it will only appear in the budget
request, according to the Post (Washington Post, 1/17).

2. Senate Democrats Could Block Omnibus Spending Bill, Including
Funding for Global AIDS Initiative

Access this story and related links online:
http://cme.kff.org/Key=1608.Cc9.D.D.G13w9B

  Senate Democrats on Tuesday could block passage of a "massive"
omnibus spending bill, which includes $2.4 billion for
international AIDS, tuberculosis and malaria initiatives, the
Washington Times reports (Fagan, Washington Times, 1/20). The
House last month approved the spending bill, which combines
seven of the 13 annual fiscal year 2004 spending bills.
House-Senate conferees in November 2003 agreed to increase FY
2004 federal spending on international AIDS, TB and malaria
initiatives to $2.4 billion, $400 million more than the Bush
administration had requested. Although the measure (HR 1298)
supporting the five-year, $15 billion global AIDS initiative
authorizes $3 billion for the first year of the program, the
Bush administration requested only $2 billion. Bush said that
his administration requested less than $3 billion in order to
give the program time to "ramp up." The omnibus spending bill
also includes $1 billion for the Millennium Challenge Account,
an assistance program for developing nations that encourages
democracy and development through economic aid. If the bill is
blocked, most of the government will have to operate under a
temporary resolution, which funds most government offices at FY
2003 funding levels (Kaiser Daily HIV/AIDS Report, 12/10/03).

Procedural Vote

Senate Minority Leader Tom Daschle (D-S.D.) on Friday said that
there is "strong support" among Democrats to block a final vote
on the spending bill, according to the Times. Democrats would
like the bill to include provisions requiring country-of-origin
labeling on certain food products and object to provisions on
media-ownership rules and overtime-pay. However, House
Republican leaders last week warned that changing the bill and
sending it back to the House "is not an option," according to
the Times. Senate Republicans will need to gain 60 votes in a
procedural move on Tuesday to end debate on the spending bill
and force a final vote. If Republicans succeed in securing the
60 votes, the Senate probably will pass the measure on Tuesday
(Washington Times, 1/20). However, it appears likely that
Democrats will block the spending bill, a move that could
"alienate key Democratic constituents, such as AIDS activists,"
according to Roll Call. Republicans are "threaten[ing]" to pass
a year-long continuing resolution to maintain FY 2003 funding
levels for agencies covered in the bill if the Democrats
continue to block the measure, according to Roll Call
(Bolton/Earle, Roll Call, 1/20). Senate Democrats and
Republicans on Tuesday are scheduled to meet separately with
their caucuses to determine their voting strategies (Fram,
AP/Las Vegas Sun, 1/19).

3. Irish Rock Star Bono Says Advocates Should Use Nonviolent
Activism To Pressure Governments To Fight AIDS

Access this story and related links online:
http://cme.kff.org/Key=1608.Cc9.F.D.G97G99

  Irish rock star and AIDS advocate Bono on Saturday at the King
Center in Atlanta where he received the "Salute to Greatness"
award said that the nonviolent activism of Rev. Martin Luther
King Jr. should be used to pressure governments and corporations
in developed countries to help fight HIV/AIDS in Africa and aid
"the poorest of the poor," the Atlanta Journal-Constitution
reports. Bono, who co-founded the debt, AIDS and trade advocacy
group DATA, said that HIV/AIDS is "not a cause. It's an
emergency." He added that there will be "plenty of protestors"
at the G8 summit on Sea Island, Ga., in June. Bono said, "The
G8, the richest countries in the world, are coming to Georgia
this summer for their big hoo-ha. And you know, I think they
came to the right state, because I met some pretty energetic
people and they've got something they want to say. And they are
going. (The G8) can be on an island if they want, but these
people can swim." According to the Journal-Constitution, the
meeting is being held on Sea Island in part because it is a
"secure and remote location"; previous meetings of the G8 --
which includes the United States, Britain, Canada, Italy,
France, Russia, Germany and Japan -- have been disrupted by
protesters. Earlier Saturday, Bono met at the King Center with
AIDS advocates, including Coretta Scott King, King's widow; Rep.
John Lewis (D-Ga.); and actor Chris Tucker, a co-founder of
DATA. Sandra Thurman, president of the International AIDS Trust
and head of the Office of National AIDS Policy under former
President Clinton, said, "It's important that people get the
opportunity to understand how the epidemic in Atlanta and the
U.S. is part of the larger global pandemic," adding, "We need
people like Bono to call attention to the fact that ordinary
people can make a difference" (McWhiter/Poole, Atlanta
Journal-Constitution, 1/18).

4. Kentucky House Committee Approves Bill That Would Require
State To Identify HIV Patients by Name

Access this story and related links online:
http://cme.kff.org/Key=1608.Cc9.G.D.G570DM

  The Kentucky House Health and Welfare Committee on Thursday
approved without dissent a bill (HB 82) that would require the
state to identify HIV patients by name to state health
officials, the Louisville Courier-Journal reports. The state
previously reported HIV-positive individuals using special
codes, but the CDC prefers to track HIV-positive people by name.
Currently, 38 states track HIV-positive patients by name, which
gives them "an edge" in obtaining federal AIDS funding, State
Public Health Commissioner Dr. Rice Leach said during a hearing
on the bill, according to the Courier-Journal (Louisville
Courier-Journal, 1/16). The bill, sponsored by Rep. Tom Burch
(D), would require the state's database to identify HIV patients
by name, but reports to the CDC would continue to include code
numbers, the Associated Press reports. Krista Wood, executive
director of the Heartland Clinic, previously opposed the measure
because of concerns over a "vast database and confidentiality
leaks," but she changed her mind due to the financial
implications of losing federal funding, according to the
Associated Press. Leach said that the policy change would make
the state "more competitive" in obtaining federal funding for
HIV/AIDS care and support programs, the Associated Press
reports. Robbie Stone, head of the Owensboro Area HIV/AIDS Task
Force, said that for every person living with AIDS in Kentucky,
there are seven people living with HIV who are unreported to
state officials, according to the Associated Press (Schreiner,
Associated Press, 1/15).

DRUG ACCESS

5. Bristol-Myers Squibb Returns Patent for Antiretroviral Drug
to Thailand; Group Agrees To Drop Lawsuits Over Patent Rights

Access this story and related links online:
http://cme.kff.org/Key=1608.Cc9.H.D.GqFl77

  U.S. pharmaceutical company Bristol-Myers Squibb on Friday
reached an agreement with the Thai Network of People Living with
HIV/AIDS, the AIDS Access Foundation and the Foundation for
Consumers at the Central Intellectual Property Rights and
International Trade Court to return its patent for the
antiretroviral drug didanosine to Thailand, the Bangkok Post
reports (Bhatiasevi, Bangkok Post, 1/17). Under the agreement,
BMS agreed to return the patent for the drug -- which BMS sells
as Videx -- to the country's Department of Intellectual
Properties, which granted the patent in January 1998. In
exchange, the Foundation for Consumers and three HIV-positive
people agreed to settle a legal suit filed against the drug
maker in 2002, the Nation reports (Sakboon, Nation, 1/17).
Thailand's Government Pharmaceutical Organization in the lawsuit
alleges that BMS' entire patent on Videx is invalid because the
drug is "merely a combination of an antacid and the active
ingredient didanosine," for which BMS does not hold a patent.
The company developed Videx after licensing didanosine from NIH
but maintains that Videx is patentable because the antacid
improves the drug's effectiveness (Kaiser Daily HIV/AIDS Report,
10/10/02). The suit followed a ruling in another case that
removed BMS' exclusive right to market didanosine in Thailand.
The court ruled that part of BMS' patent on the drug was invalid
and the company had the exclusive right to produce didanosine
only in doses from five milligrams to 100 milligrams, while
other drug companies could produce the drug in higher doses.
BMS, in its original patent application filed in July 1992,
asked that its patent be extended to cover a "range of 5 mg to
100 mg per unit of use." In 1997, BMS amended its patent and
omitted the dosage restriction (Kaiser Daily HIV/AIDS Report,
10/2/02).

Reaction

Kamol Uppakaew, chair of the Network of People Living with
HIV/AIDS, said, "It is good news, but [it] came with a lot of
hard work." GPO Director Thongchai Thavichachart lauded the
agreement and said that the GPO would "immediately" begin
production of didanosine, according to the Post. He added,
"We've been waiting for a long time. Last year, we had to return
the raw materials we ordered for manufacturing the tablets
because the court case was still pending. But now the medicine
should be available within a month's time" (Bangkok Post, 1/17).
"This did not happen because the drug company wants to be kind
to people living with HIV/AIDS in Thailand," AIDS Access
Foundation Director Nimit Tien-udom said, adding, "It is the
result of our fight to improve access to medicine" (Nation,
1/17). He added, "This was an important result, and we think
this case serves as an example for other countries of the world"
(AFP/Yahoo! News, 1/17).

6. Brazil's National STD/AIDS Programme Announces Largest Drug
Price Reduction Deals in Five Years

Access this story and related links online:
http://cme.kff.org/Key=1608.Cc9.J.D.Gt7vcf

  Brazil's National STD/AIDS Programme on Thursday announced that
it has received the largest price reductions on antiretroviral
drugs in five years, Reuters reports. The deal will save the
country's treatment program $107 million this year and allow
20,000 new patients to obtain treatment through the program in
2004, according to Reuters. The country negotiated deals with
drug makers, including Roche, Gilead and Abbott Laboratories,
generating discounts of between 10% and 76% for the five most
expensive antiretroviral medications. The discounts brought the
total cost of the national AIDS program to $180 million for 2004
and the cost per patient to $1,200, Reuters reports. With the
addition of 20,000 new patients this year, the program will
provide treatment to a total of 148,500 HIV-positive people
(Bugge, Reuters, 1/15). Brazil's AIDS program, which is
considered to be one of the most progressive in the world,
manufactures and distributes generic versions of antiretroviral
drugs, ignoring patents issued before 1997 when Brazil signed an
intellectual property law in order to join the World Trade
Organization (Kaiser Daily HIV/AIDS Report, 12/11/03).
Approximately 600,000 Brazilians are HIV-positive, but more than
65% are unaware of their HIV status (Kaiser Daily HIV/AIDS
Report, 11/17/03). Health Minister Humberto Costa said, "These
were hard negotiations, but the result was very positive,"
adding that the "important thing is that with the savings we
have made we are guaranteeing the continuation of the program
and ensuring that every Brazilian that needs treatment for AIDS
receives adequate treatment" (Reuters, 1/15).

Efavirenz, Nelfinavir

Although the Brazilian government was able to negotiate a deal
in which the program could obtain Merck's antiretroviral drug
efavirenz at a cost of $1.58 per patient per day -- a 25%
reduction agreed to in November -- the government is seeking to
"make the drug even cheaper," Inter Press Service reports. The
government is hoping to obtain a voluntary license to produce
the drug in a state-run laboratory in Rio de Janeiro, according
to Inter Press Service. Joao Sanches, Merck's local
communications director, said that the proposal "is one
possibility." But a similar proposal made to Roche, which
manufactures the antiretroviral drug nelfinavir, is not as
promising, according to Inter Press Service. Roche said that it
has already cut the price of the drug by 72%. But Brazilian
officials have said that they might implement compulsory
licensing, allowing other drug makers to produce nelfinavir.
Alexandre Grangeiro, director of Brazil's AIDS program, said,
"It is relatively little, because drug production by a state-run
lab would allow an additional 30% discount, even paying 4% for
patent rights." According to Inter Press Service, even with the
deep discounts, pharmaceutical companies still benefit by
participating in the national program because it "assure[s]
sales without having to spend money on advertising or
distribution" (Osava, Inter Press Service, 1/15).

SCIENCE & MEDICINE

7. Wall Street Journal Examines Law Enforcement Officials'
Efforts To Curb Black Market Sales of Serostim

Access this story and related links online:
http://cme.kff.org/Key=1608.Cc9.K.D.GvHcdx

  The Wall Street Journal on Monday examined U.S. law enforcement
officials' efforts to curb black-market sales of an AIDS
medication "that has found an underground recreational use as a
bodybuilding drug." Serostim, which is a growth hormone, is
prescribed to HIV-positive patients to treat AIDS-related
wasting. However, some bodybuilders use the injectable drug to
"pump up their muscles," according to the Journal. Serostim,
unlike anabolic steroids, is undetectable by sports groups'
blood tests. A 12-week supply of the drug, which is manufactured
by Geneva-based Serono Laboratories, costs about $21,000. Many
AIDS patients receive the drug through the state-federal
Medicaid program, which includes the medication in its drug
formularies. However, some patients use little or none of the
drug, instead selling it on the black market for up to $2,000
for a week's supply. Police have broken up illegal Serostim
sales rings in California, New York, Hawaii and New Jersey. In
addition to authorities' efforts to stop illegal sales of the
drug, Medicaid programs and Serono have taken steps to fight the
problem (Windham, Wall Street Journal, 1/19). Federal and state
officials involved in investigating the sales rings are looking
for evidence of possible improper sales, improper billing of
state Medicaid programs and improper financial incentives to
encourage doctors and pharmacists to prescribe the drug. Sales
of Serostim have fallen from $125 million in 2001 to $95 million
in 2002 (Kaiser Daily HIV/AIDS Report, 9/23/03). According to
Serono, about 5,000 HIV-positive people in the United States
currently take Serostim (Wall Street Journal, 1/19).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: http://www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. (c) 2004 Advisory Board Company and Kaiser Family
Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at
http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or
unsubscribe.
Questions about your email subscription? Contact us at
subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family
Foundation. For access to the Foundation's policy research,
analyses, reports and fact sheets, and media partnerships, visit
the Foundation's main website at http://www.kff.org .

-Message-Id: <20040120074411.C040.4398-1608@...>

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

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*** WEBCAST: GLOBAL MEDIA AIDS INITIATIVE***
United Nations Secretary-General Kofi Annan hosts a
roundtable meeting of media leaders to discuss ways in
which the media can contribute to the fight against
AIDS.
http://cme.kff.org/Key=1580.Cc9.C.D.F83C7w
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
________________________________________


Friday, January 16, 2004

SPECIAL NOTICE
========================================
1. Kaiser Daily Reports Will Not Publish Monday, Jan. 19

PUBLIC HEALTH & EDUCATION
========================================
2. U.N. Secretary-General Annan Launches Global Media AIDS
Initiative To Educate Public About HIV/AIDS

GLOBAL CHALLENGES
========================================
3. Canadian AIDS Groups Ask Human Rights Commission To
Investigate Catholic Church Policy Requiring HIV Testing

4. TAC To Launch Campaign Targeting Inequities Between South
Africa's Public, Private Health Systems

5. Zambian HIV/AIDS Advocate Calls Attention to AIDS Orphans,
Truck Drivers During Visit to England

SCIENCE & MEDICINE
========================================
6. Group of Scientists Questions Value, Cost of Federally Funded
AIDS Vaccine Trial in Thailand

7. Chiron Begins Human Clinical Trials of Combination of Two HIV
Vaccines

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

SPECIAL NOTICE

1. Kaiser Daily Reports Will Not Publish Monday, Jan. 19

Access this story and related links online:
http://cme.kff.org/Key=1580.Cc9.D.D.Fm1x3H

  The Kaiser Daily HIV/AIDS Report will not publish Monday, Jan.
19, in observance of the Martin Luther King Jr. holiday. The
report resumes publishing Tuesday, Jan. 20.

PUBLIC HEALTH & EDUCATION

2. U.N. Secretary-General Annan Launches Global Media AIDS
Initiative To Educate Public About HIV/AIDS

Access this story and related links online:
http://cme.kff.org/Key=1580.Cc9.F.D.Fn7tkF

  Leading executives from 22 media companies on Thursday at a
meeting with U.N. Secretary-General Kofi Annan in New York City
pledged to use their companies' influence to educate the
worldwide public about HIV/AIDS, the Financial Times reports
(Thal Larsen, Financial Times, 1/16). After a three-hour
meeting, the executives signed a declaration promising "to
expand public knowledge and understanding about HIV/AIDS"
through their companies' practices (Arieff, Reuters, 1/15). The
idea of the Global Media AIDS Initiative, an alliance between
the United Nations and the media, was generated through a
partnership between UNAIDS and the Kaiser Family Foundation,
with financial support from the Bill & Melinda Gates Foundation.
The meeting was organized to explore how the media can draw
attention to the epidemic and create long-lasting public
education campaigns. UNAIDS estimates that two-thirds of the 45
million new HIV infections projected to occur worldwide over the
next 10 years could be averted through greater access to
effective prevention and public education efforts
(U.N./UNAIDS/Kaiser Family Foundation/Gates Foundation release,
1/15). Recent studies show that more than half of young adults
ages 15 to 24 in 40 countries do not know how HIV is
transmitted. A study conducted in 21 African countries found
that 60% of girls have at least one major misconception about
HIV/AIDS or have not heard of the disease (Lauria, Boston Globe,
1/16).

Specifics

Most of the companies pledged to use public service
announcements, expanded news coverage and documentaries to
educate the public about the AIDS epidemic. Many participants
agreed to weave AIDS-related stories into entertainment
programs, recruit other media outlets to join the campaign and
provide their campaign materials free-of-charge to other
broadcast outlets (McNamara, AP/Yahoo! News, 1/15). Specific
company commitments include:

* Gazprom-Media: Gazprom CEO Alexander Dybal said that the
Russian company's television and radio stations will use PSAs
and popular programs to disseminate education messages and will
train staff to better cover HIV/AIDS (Boston Globe, 1/16).

* BBC: BBC's World Service Trust plans to work with with local
media and government launch an HIV/AIDS education campaign in
eight African countries (AP/Yahoo! News, 1/15).

* Black Entertainment Television: Robert Johnson, founder and
CEO of BET, is working with African-American celebrities and
athletes to produce AIDS programs that the company will share
with media outlets in sub-Saharan Africa at no cost (Boston
Globe, 1/16).

Other participating companies include Broadcasting Organizations
of Nigeria, China Central TV, Brazil's Globo International, NHK
Japan Broadcasting Corp., Time Warner, France's TV5, Lebanese
Broadcasting Corp. International, South African Broadcasting
Corp. and Spain's Radio Television Espanola (Reuters, 1/15).

Viacom

Viacom, which owns CBS, UPN, MTV, BET and several other cable
channels, will commit $200 million in air time to its HIV/AIDS
education campaign in 2004, AP/Yahoo! News reports (AP/Yahoo!
News, 1/15). The $200 million is in addition to the $380 million
that the company has already spent on AIDS-related programming,
according to the Globe (Boston Globe, 1/16). The Kaiser Family
Foundation and Viacom on Feb. 1 during the pre-game show of the
Super Bowl plan to air an HIV/AIDS public service announcement
that will kick off the second year of the "KNOW HIV/AIDS"
awareness campaign, which Viacom and the Kaiser Family
Foundation launched in January 2003 (Kaiser Daily HIV/AIDS
Report, 1/12). In addition, MTV plans to convene a "creative
summit" to discuss methods of informing young people about
HIV/AIDS, MTV International President Bill Roedy said (Financial
Times, 1/16).

Reaction

Annan said, "As leaders of the media, you have the power and the
reach to disseminate the information people need to protect
themselves from HIV/AIDS. Silence is death. As broadcasters, you
can bring the disease out of the shadows and get people talking
about it in an open, informed way" (Boston Globe, 1/16). "The
commitments made by the media organizations [at the forum] are
one of the most important collective contributions to the fight
against AIDS to date," UNAIDS Executive Director Peter Piot
said, adding, "By harnessing the media's unparalleled ability to
communicate with billions of people around the world, we can now
provide more people than ever with vital life-saving information
on AIDS." Kaiser Family Foundation President and CEO Drew Altman
said, "For more than a decade, the Kaiser Family Foundation has
worked with media companies in the U.S. and globally to include
HIV/AIDS public education messages into their programming that
will resonate especially with young people and those who are
most at risk," adding, "The new Global AIDS Media Initiative
signals a new and expanded commitment by media leaders that will
reach millions more people with public health information"
(U.N./UNAIDS/Kaiser Family Foundation/Gates Foundation release,
1/15). Bill Gates, who delivered the keynote address at the
meeting, told the industry executives, "You are joining into
something where there is very much positive momentum, but we're
not even doing half of what should be done. The challenge for
all of you is to think about how to raise visibility" (Reuters,
1/15).

* Webcasts of the Global Media AIDS Initiative meeting, Gates'
keynote address and press conference announcing the intiative
are available online from kaisernetwork.org.

GLOBAL CHALLENGES

3. Canadian AIDS Groups Ask Human Rights Commission To
Investigate Catholic Church Policy Requiring HIV Testing

Access this story and related links online:
http://cme.kff.org/Key=1580.Cc9.G.D.Fs9qSh

  A coalition of Canadian AIDS groups has asked the Quebec Human
Rights Commission to investigate a new Roman Catholic Church
policy requiring all men who apply to the Grand Seminaire de
Montreal to become priests to take an HIV test, saying that the
policy promotes discrimination in the workplace, the CP/Toronto
Globe and Mail reports (CP/Toronto Globe and Mail, 1/16). In
announcing the new policy, which is set to begin this fall, Rev.
Marcel Demers of the Grand Seminaire de Montreal said that a
positive HIV test may indicate that an applicant could be a man
who has sex with men. HIV-positive applicants will be asked how
they were infected, and if they say that they were infected by
having sex with a man, the seminary "will try to see what really
is the person's calling," Demers said. Demers added that MSM
would not be automatically refused admittance to the seminary
but said that their chances for acceptance would be "slim"
(Kaiser Daily HIV/AIDS Report, 1/12). The new policy is a
"public slap in the face to all Quebeckers living with HIV," the
Quebec Coalition of Community-Based Organizations Fighting AIDS
and the Canadian HIV/AIDS Legal Network wrote in a letter to the
commission. "We are seriously concerned about a possible
increase of discriminatory practices against people living with
HIV should the commission decide not to investigate," the letter
said (CP/Toronto Globe and Mail, 1/16).

Sexual Orientation vs. Health Status

Quebec Human Rights Commission spokesperson Ginette L'Heureux
said that discrimination on the basis of sexual orientation may
be protected under an exclusion clause in the charter but only
if the church claimed to be using HIV testing to exclude MSM for
reasons of religious belief. However, the exclusion clause would
not apply if the church is testing applicants only to determine
their health status, she said, the Montreal Gazette reports.
Montreal Archbishop Jean-Claude Turcotte on Monday said that the
church's decision to require applicants to undergo HIV testing
was meant solely to determine the health of the applicant and
not his sexual orientation, which could conflict with Quebec's
Charter of Human Rights and Freedoms. Turcotte said that the
seminary's decision to require HIV testing has "nothing to do
with trying to determine" sexual orientation, according to the
Gazette. The commission this week plans to examine whether to
launch an investigation of the seminary's policy, L'Heureux said
(Parkes, Montreal Gazette, 1/14).

4. TAC To Launch Campaign Targeting Inequities Between South
Africa's Public, Private Health Systems

Access this story and related links online:
http://cme.kff.org/Key=1580.Cc9.H.D.GGVKcd

  The South African AIDS advocacy group Treatment Action
Campaign, which has been nominated for the 2004 Nobel Peace
Prize, on Wednesday announced plans for a new campaign in its
battle for universal AIDS treatment that would target inequities
between the country's public and private health care systems,
Reuters reports. South Africa's health care system has retained
its apartheid-era structure of "elite" private hospitals, which
primarily care for wealthy whites, and public hospitals, which
are overburdened in their attempts to care for the majority of
blacks, Mark Heywood of TAC said. In its campaign, TAC plans to
target private hospitals, which it says are "too expensive," and
push for a "people's health service for a people's
antiretroviral program," Heywood said. Private laboratories,
which charge up to $140 for an HIV test, would be targeted
through lawsuits and protests, as would drug companies that try
to stop domestic generic drug makers from producing
antiretrovirals, Heywood said, adding that the details of the
campaign will be settled by TAC's national committee later this
month, according to Reuters. Heywood also said that TAC will
criticize the government if it does not work more quickly to
rollout a national antiretroviral drug program. "The
announcement was August 2003 ... [and] it is now January 2004
and almost no facilities yet have access to the medicines,"
Heywood said, adding, "We don't feel there is enough urgency,
enough political leadership or determination behind this plan"
(Harding, Reuters, 1/14). The South African government's
national HIV/AIDS plan aims to treat 1.2 million people -- or
about 25% of the country's HIV-positive population -- by 2008
(Kaiser Daily HIV/AIDS Report, 12/11/03).

Plan To Cut Drug Prices

Health Minister Manto Tshabalala-Msimang on Thursday announced
draft regulations aimed at lowering consumer drug prices, making
medicine more affordable for millions of South Africans, Reuters
reports. The rules, which will undergo a three-month period of
review and public comment, would require drug makers and
importers to set drug prices at no more than 50% of current
listed prices, according to Reuters. "We are well aware that our
primary goal of affordable medicine for all is served through a
healthy manufacturing, wholesale and retail industry,"
Tshabalala-Msimang said in a statement, adding, "We have no wish
to undermine this industry, only to make it fully accountable to
the interests of the consumer." The rules, which are set to go
into effect in May, would apply to all drugs sold in South
Africa, excluding drugs that the government purchases for public
sector health care. South Africa's increasingly tough stance on
drug pricing has touched off concern among some large
pharmaceutical companies, Reuters reports. Industry officials on
Thursday said that they have expressed their concern to the
government and were studying the new regulations, according to
Reuters (Quinn, Reuters, 1/15).

5. Zambian HIV/AIDS Advocate Calls Attention to AIDS Orphans,
Truck Drivers During Visit to England

Access this story and related links online:
http://cme.kff.org/Key=1580.Cc9.J.D.GNB2BT

  Princess Kasune Zulu, an HIV-positive international AIDS
advocate from Zambia, on Thursday spoke at the Cambridge
Theological Federation in Cambridge, England, about the
"realities of AIDS in her increasingly benighted continent,"
London's Daily Telegraph reports. Zulu, who became an AIDS
orphan at age 14 and now hosts a radio program in Zambia
dedicated to helping listeners with HIV/AIDS address problems in
their lives, last week wrote a letter to the Daily Telegraph
calling attention to Africa's AIDS orphans. During her talk in
Cambridge, Zulu described how she has dressed up as a sex worker
to "test the willpower" of Africa's long-distance truck drivers,
a population that has been identified as "key carriers" of HIV,
according to the Telegraph (Woods, Daily Telegraph, 1/15). Zulu
said, "We are late in tackling the AIDS epidemic, but we can
stop it," adding that a "key to turning things around" is
educating and empowering women because "not enough of them have
their own home or a job which would help them assert themselves"
(Taylor, Guardian, 1/15). Zulu said, "AIDS knows no borders; it
doesn't respect titles or differentiate between color or creed.
It's not just an African problem, it is a world problem and we
need to make sure that this generation of AIDS orphans doesn't
get infected" (Daily Telegraph, 1/15). Zulu on Monday is
scheduled to speak -- alongside the British Secretary of State
for Development Hillary Benn -- at an AIDS conference at the
House of Commons. Zulu also hopes to meet with Prime Minister
Tony Blair during her visit, the Guardian reports (Guardian,
1/15).

SCIENCE & MEDICINE

6. Group of Scientists Questions Value, Cost of Federally Funded
AIDS Vaccine Trial in Thailand

Access this story and related links online:
http://cme.kff.org/Key=1580.Cc9.K.D.GM04hm

  A group of 22 prominent AIDS researchers in the Jan. 16 issue
of Science magazine question a multimillion-dollar federally
funded program to test two AIDS vaccines in Thailand because of
the study's high cost and the recent failure of one vaccine in
two other large-scale trials, the San Francisco Chronicle
reports (Russell, San Francisco Chronicle, 1/16). The study is
testing Brisbane, Calif.-based biotechnology company VaxGen's
AIDS vaccine AIDSVAX in conjunction with Aventis Pasteur's ALVAC
among 16,000 HIV-negative volunteers from Thailand's Rayong and
Chon Buri provinces. In the five-year trial, AIDSVAX is used as
a booster for the ALVAC vaccine (Kaiser Daily HIV/AIDS Report,
11/13/03). The researchers -- including Dr. Robert Gallo, who
co-discovered HIV and heads the Institute for Human Virology in
Baltimore; Dr. Ronald Desrosiers of Harvard Medical School; Dr.
Douglas Richman of the University of California-San Diego; and
Dr. Mike McCune of the Gladstone Institute for Virology and
Immunology in San Francisco -- say that the $119 million study
should be halted because of the results of two previous
VaxGen-sponsored studies, which found that the vaccine was not
effective in producing a sufficient immune response, according
to the Chronicle (San Francisco Chronicle, 1/16).

Reasoning

According to the researchers, Phase I and Phase II clinical
trials have shown that AIDSVAX and ALVAC used separately are
ineffective, and there is "no persuasive data to suggest that
the combination" of the two vaccines could "induce a better
cellular or humoral responses than either component can alone."
The scientists write, "We seriously question whether it is
sensible now to conduct a third trial that, in our opinion, is
no more likely to generate a meaningful level of protection
against infection or disease." The scientists conclude, "Society
expects the scientific community to develop a vaccine to counter
the AIDS pandemic, but there are adverse consequences to
conducting large-scale trials of inadequate HIV-1 vaccines"
(Burton et al., Science, 1/16). Desrosiers said, "Basically, you
have two things that don't work and two things nobody has
enthusiasm for, and now you're going to spend $119 million to
put them together? We just can't go on testing unpromising
products. It wastes limited resources." Mario Stevenson, a
co-author and director of the Center for AIDS Research at the
University of Massachusetts Medical School, said that the
authors also are concerned that if too many vaccines are tested
and fail, the citizens and governments of the nations hosting
the trials may become wary of scientific studies. "We're really
concerned this will create a backlash that will inhibit the
ability to get more effective (vaccine) candidates into trials
and that will discourage participants from wanting to
participate in trials," Stevenson said (Smith, Boston Globe,
1/16). Dennis Burton, a co-author of the Science critique and an
AIDS researcher at Scripps Research Institute in La Jolla,
Calif., said, "Everything I've seen about the Thai trial
suggests that it doesn't have a prayer" (Nesmith, Cox
News/Atlanta Journal-Constitution, 1/16).

Reaction

Officials at NIH said that completing the study could hold some
benefits, the Boston Globe reports. NIAID Division of AIDS
Director of Vaccine Research Peggy Johnston said, "As long as
the vaccine is safe and is not going to do any harm to people,
what's the harm of doing the trial and getting the data to
determine if the vaccine works or doesn't work? There's an
urgent need out there for an AIDS vaccine. We can't sit here and
debate" (Boston Globe, 1/16). VaxGen spokesperson Kesinee Yip
said that a large-scale study "would be a valuable source of new
information that could be useful for the field of HIV vaccine
research" (Jacobs, San Jose Mercury News, 1/16). "I don't think
this is a waste of time," Prasert Thongcharoen, chair of the
Thai National AIDS Commission's subcommittee on HIV Vaccine
Development, said, noting that Thailand is one of the few
countries in which the E-type strain of HIV is present. "Who
will do that trial for us if we don't do it?" he asked (Noikorn,
Associated Press, 1/16).

Other Groups React

New York-based Treatment Action Group said in a statement, "[I]t
would be a far better policy to prioritize the development and
testing of these newer and more potent vaccines rather than
waste human and financial resources ... on a trial that is
extremely unlikely to lead to an effective and licensable AIDS
vaccine" (TAG release, 1/15). However, the AIDS Vaccine Advocacy
Coalition disagreed, saying, "Cancellation of the trial at this
point would send a message to other countries and vaccine
developers that the U.S. government has not kept its
commitment." Wayne Koff, senior vice president of the
International AIDS Vaccine Initiative, said, "Since this really
is early in the start of the trial it makes sense to give
careful consideration to what the authors are proposing. There
may be ways to improve it. People amend clinical trials all the
time." NIH officials said in a statement that they "strongly
disagree" with the critique authors, adding that they plan to
draft a formal rebuttal that they expect will be published in
Science (San Francisco Chronicle, 1/16).

7. Chiron Begins Human Clinical Trials of Combination of Two HIV
Vaccines

Access this story and related links online:
http://cme.kff.org/Key=1580.Cc9.L.D.GDGjQR

  Emeryville, Calif.-based biotechnology company Chiron on
Thursday announced that it will begin human clinical trials of
its experimental HIV vaccine, Bloomberg News/Los Angeles Times
reports. Chiron, working with the HIV Vaccine Trials Network, a
research effort supported by NIH, will administer the two-part
injectable vaccine to 168 HIV-negative participants in the
United States to determine if the vaccine is safe and if it
strengthens the immune system (Bloomberg News/Los Angeles Times,
1/16). The trial first will be conducted at sites in St. Louis,
Seattle and Nashville, Tenn., and later will be expanded to
other HVTN sites, according to a Chiron release (Chiron release,
1/15). Over two years, participants will receive an injection of
a DNA vaccine, which is based on the theory that two proteins
from the DNA will prime the immune system for possible HIV
infection. Participants will next receive an injection of a
protein -- not DNA -- that will serve as a "booster" to the
first injection, according to the Contra Costa Times. If the
trial proves the two-step injection vaccine effective, Chiron
plans to conduct a larger trial that would include hundreds of
volunteers. Jorge Flores, head of the vaccine branch of NIAID's
Division of AIDS, said, "We'll learn something, and that will
help in designing vaccine for the next round (of trials)"
(Silber, Contra Costa Times, 1/16).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: http://www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. (c) 2004 Advisory Board Company and Kaiser Family
Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at
http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or
unsubscribe.
Questions about your email subscription? Contact us at
subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family
Foundation. For access to the Foundation's policy research,
analyses, reports and fact sheets, and media partnerships, visit
the Foundation's main website at http://www.kff.org .

-Message-Id: <20040116083615.C09A.4398-1580@...>

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

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***LIVE WEBCAST TODAY: GLOBAL MEDIA AIDS INITIATIVE***
United Nations Secretary-General Kofi Annan hosts a
roundtable meeting of media leaders to discuss ways in
which the media can contribute to the fight against
AIDS. View a LIVE webcast of a press conference
with the media leaders today. For more details, visit
http://cme.kff.org/Key=1568.Cc9.C.D.NqvxcP
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
________________________________________


Thursday, January 15, 2004

POLITICS AND POLICY
========================================
1. HHS Secretary Thompson Hired Openly Gay Former Rep. Gunderson
To 'Reassess Domestic AIDS Strategy,' POZ Reports

2. Massachusetts Legislature Considers Measure Allowing
Exception in Confidentiality of HIV Test Results

GLOBAL CHALLENGES
========================================
3. Clinton Foundation Deal Will Reduce Price of Viral Load, CD4+
Tests for Developing Countries by as Much as 80%

4. UNAIDS Urges Caution Over Kenya Study Findings That HIV
Prevalence Rates Are Overestimated

5. Group Therapy Can Help Treat Depression Among HIV/AIDS
Patients, Uganda Study Says

6. Turkish Police Identify HIV-Positive Sex Worker on Television

7. China's HIV/AIDS Response Should Be Similar to SARS Response,
Experts Say

IN THE COURTS
========================================
8. European Union Calls for Libya To Drop Charges Against Health
Care Workers Who Allegedly Infected Children With HIV

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

POLITICS AND POLICY

1. HHS Secretary Thompson Hired Openly Gay Former Rep. Gunderson
To 'Reassess Domestic AIDS Strategy,' POZ Reports

Access this story and related links online:
http://cme.kff.org/Key=1568.Cc9.D.D.NbygZ9

  HHS Secretary Tommy Thompson last year hired openly gay former
Rep. Steve Gunderson (R-Wis.) to "reassess domestic AIDS
strategy -- and do a little burned-bridge repair," according to
POZ magazine, The Hill reports (DuFour/Eisele, The Hill, 1/14).
After a "string of Republican AIDS bungles" -- including the
administration's plans to close the White House Office of
National AIDS Policy, multiple audits of the San Francisco-based
Stop AIDS Project and the potential "censorship" of prevention
programs and federally funded research -- Thompson "much less
publicly" brought in Gunderson, who left Congress in 1996 after
16 years in office, according to POZ. Gunderson held meetings
between HHS staff members and AIDS advocates, POZ reports. The
meetings "culminated in a high-powered, closed-door" meeting in
early September, during which leaders of a dozen large AIDS
organizations voiced their concerns about the CDC's new HIV/AIDS
prevention initiative with several government leaders, including
Thompson, NIAID Director Anthony Fauci and CDC Director Julie
Gerberding, according to POZ (Kaplan, POZ, January 2004). The
CDC in April announced a new HIV/AIDS prevention strategy that
will shift funding distribution away from community groups that
provide education aimed at reducing unsafe sexual and drug-use
behaviors in people who have not contracted HIV. According to
the strategy, the government will invest most heavily in
initiatives that focus on identifying HIV-positive people who
are unaware of their status, which could jeopardize
approximately $90 million in annual federal funding for
community groups (Kaiser Daily HIV/AIDS Report, 12/16/03). HHS
spokesperson Tony Jewell said that the meetings served as
"outreach to better explain what it is we're doing," adding that
Thompson "is always interested in hearing how things can be done
better" (POZ, January 2004).

2. Massachusetts Legislature Considers Measure Allowing
Exception in Confidentiality of HIV Test Results

Access this story and related links online:
http://cme.kff.org/Key=1568.Cc9.F.D.NjfkbG

  The Massachusetts General Assembly's Joint Committee on Health
Care last week held a hearing on a bill (SB 647) that would
allow public health or safety officials who are exposed to a
person's bodily fluid while working to learn whether the person
is HIV-positive, the Providence Journal reports. Current state
law requires hospitals and clinics to keep a patient's HIV
status confidential. The bill, sponsored by state Sen. Michael
Morrissey (D), would create an exception that would allow
firefighters, police officers, emergency medical technicians and
medical personnel who are scratched, bitten or pricked with a
hypodermic needle while on duty to file a petition requesting to
learn the patient's HIV status. Under the bill, the hospital or
clinic performing the testing would not be liable for releasing
test results. Some people at the hearing said that the bill
would encroach on patient confidentiality, while others
testified that the safety of medical workers should "trump"
doctor-patient confidentiality, according to the Journal. Mary
Ellen Jepsen, a nurse practitioner, called on legislators to
vote against the bill, saying that it sends a "negative message"
and that the risk of contracting HIV while caring for patients
is "negligible." However, Roberta Wright, a registered nurse,
said that she had to take up to 16 medications after
accidentally being pricked by a needle used on a patient who
refused HIV testing. She said that the incident was "above and
beyond" her duties as a nurse. The state Department of Public
Health has no position on the legislation, according to the
Journal.

Other HIV/AIDS Policy Changes

The committee also is debating a bill (SB 545) that would
require the state Department of Public Health and the Executive
Office of Public Safety to develop guidelines for education and
training requirements for all health care providers and HIV/AIDS
counselors. Supporters say the measure will cut health care
costs by helping workers recognize the disease in its early
stages, according to the Journal (Stickgold, Providence Journal,
1/14). In addition, the Department of Public Health has offered
to help school districts in the state develop formal policies to
deal with HIV/AIDS in schools. The Swansea school district,
which local health services director Maureen Bushell said "wrote
the book" on school AIDS policy, has not adopted a formal
written policy. The Swansea School Committee in 1985 became the
first district in the United States to voluntarily allow an
HIV-positive child to continue to attend school. Bushell said
that the district has been complying with state guidelines and
recommendations, guaranteeing confidentiality for HIV-positive
students and training workers to properly handle and dispose of
bodily fluids, according to the Journal. Bushell said she is
leaning toward asking district administrators to recommend that
the Swansea School Committee adopt state guidelines as formal
district policy, according to the Journal (Reynolds, Providence
Journal, 1/14).

GLOBAL CHALLENGES

3. Clinton Foundation Deal Will Reduce Price of Viral Load, CD4+
Tests for Developing Countries by as Much as 80%

Access this story and related links online:
http://cme.kff.org/Key=1568.Cc9.G.D.NjJC8Y

  As expected, former President Bill Clinton on Wednesday at a
press conference in New York announced a deal between the
William J. Clinton Presidential Foundation and five medical
technology companies -- Beckman Coulter, Becton, Dickinson &
Co., Roche Molecular Diagnostics, Bayer HealthCare and
bioMerieux -- that will cut the prices of viral load and CD4+ T
cell diagnostic tests in developing nations by as much as 80%,
Reuters/Washington Post reports (Reuters/Washington Post, 1/15).
Although HIV diagnostics have not received the same media
attention as antiretroviral drugs, they are a significant part
of the cost of HIV/AIDS treatment and limited funding has lead
doctors in some developing nations to stop administering viral
load tests and to make limited use of CD4+ tests. The tests --
which are standard in the United States -- help doctors
determine when to begin administering antiretroviral drugs and
whether the drugs are working (Kaiser Daily HIV/AIDS Report,
1/14). Under the new agreements, the cost of CD4+ tests will
drop from $8 to $10 per test to $3 to $5 per test, BD Chair and
CEO Edward Ludwig said. Roche Molecular Diagnostics Vice
President Robin Toft would not discuss in detail the price
agreement on the more expensive viral load test but said that
the price would be 20% lower than what the company is currently
charging developing nations (Dugger, New York Times, 1/15). The
companies will not require up-front payment for the expensive
testing equipment and will delay payment collection until the
system is in place and staff are trained, according to the
Associated Press (Dobnik, Associated Press, 1/14).

Expanded Treatment Access

Ira Magaziner, a long-time Clinton aide and head of the
foundation's AIDS initiative, and a team of management
consultants and AIDS experts visited the companies'
manufacturing plants to help them develop ways to cut costs. The
foundation used a similar tactic in October to secure a deal
with Ranbaxy Laboratories, Cipla, Matrix Laboratories and Aspen
Pharmacare that reduced the prices of commonly used three-drug
antiretroviral regimens to 38 cents per patient per day, down
from the already discounted price of 55 cents per patient per
day (Kaiser Daily HIV/AIDS Report, 1/14). The new agreement,
combined with the October agreement, will cut the cost of
treating an HIV-positive person from $800 a year to $250 a year
in the 13 developing nations where the foundation is operating,
Clinton said (New York Times, 1/15). The foundation expects that
the deal will allow five million more HIV-positive people to
access treatment by 2008 (AFP/Yahoo! News, 1/14). South Africa
will be the first to benefit from the plan and within two months
is expected to finalize a deal that could save the country
almost $300 million over the next five years, Lynn Margherio,
executive vice president of the foundation's HIV/AIDS
Initiative, said. Mozambique, the Bahamas, Tanzania and Rwanda
are expected to be the next countries to benefit from the deal,
according to Reuters/Post (Reuters/Washington Post, 1/15). The
foundation is receiving private funding for its treatment
project and has received pledges from several developed
countries -- including Canada, Ireland, Norway and Sweden -- to
contribute directly to programs in specific developing countries
(Associated Press, 1/14).

Reaction

Company executives attending the press conference said that they
planned to make up for lower profit margins with higher sales
volume, the AP/Long Island Newsday reports (Dobnik, AP/Long
Island Newsday, 1/14). "We are systematically changing the
economics of AIDS treatment," Clinton said, adding that the
companies had done an "astonishing service" by agreeing to the
deal (Barber, Financial Times, 1/15). "By pushing down the price
of HIV/AIDS medicine and laboratory tests, we are ramping up the
ability of developing countries to treat millions of people, and
to do so with the kind of quality of care that people with AIDS
in the developed world usually receive," Clinton said
(AFP/Yahoo! News, 1/14). Richard Feachem, executive director of
the Global Fund to Fight AIDS, Tuberculosis and Malaria, said
that the Clinton Foundation "has made a major contribution to
the fight against HIV/AIDS" (New York Times, 1/15).

4. UNAIDS Urges Caution Over Kenya Study Findings That HIV
Prevalence Rates Are Overestimated

Access this story and related links online:
http://cme.kff.org/Key=1568.Cc9.H.D.PBhvFt

  UNAIDS on Tuesday urged caution in interpreting a recent study
that implied that Kenya's HIV prevalence rate has decreased or
is overestimated, Agence France-Presse reports (Agence
France-Presse, 1/13). Researchers administering the Kenyan
survey, which was funded by the CDC, interviewed 8,561 Kenyan
men and women to collect health information. In addition, 70% of
the participants agreed to have blood samples taken for HIV
testing. Researchers found that 6.7% of Kenyans are
HIV-positive, compared with a previous estimate of 9.4% by the
country's Ministry of Health. Among the CDC study participants,
8.7% of the women tested HIV-positive, compared with 4.5% of the
men (Kaiser Daily HIV/AIDS Report, 1/9). UNAIDS in a statement
said that the study should not be interpreted as a sign that the
severity of Kenya's epidemic has been overestimated. Although
the statement said that UNAIDS "welcome[s]" household studies,
it questioned the dramatic differences in prevalence rates
between men and women, Agence France-Presse reports. "Nowhere in
any country in the world do you see a twofold difference between
men and women in the population," Catherine Hankins, chief
scientific adviser at UNAIDS, said, adding, "When you look at
the prevalence among men, that just hits you right in the face
-- there's something wrong there." Hankins said that the gender
difference could be accounted for by the fact that 30% of the
people surveyed refused to be tested for HIV. Many of the people
who refused testing could be men who engage in risky sexual
behavior and fear the stigma of testing HIV-positive, Hankins
said.

Testing Techniques

Hankins said that similar surveys from four other African
countries had been taken into account last year when the
organization published its update on AIDS data. UNAIDS' own
techniques in determining HIV prevalence, which rely on prenatal
testing centers, have been a matter of debate among AIDS
specialists, according to Agence France-Presse (Agence
France-Presse, 1/13). The United Nations and the World Health
Organization base their estimates of HIV and AIDS prevalence in
Africa on anonymous screening of pregnant women in clinics, the
results of which are extrapolated to an area's entire
population. However, some experts say that estimates based on
HIV prevalence among pregnant women are flawed because the women
tested are all sexually active and have likely not used condoms.
In addition, most of the data are taken from urban clinics where
HIV rates are higher than in rural areas (Kaiser Daily HIV/AIDS
Report, 1/9). The new survey estimates that 1.4 million adults
in Kenya are HIV-positive; the 2002 UNAIDS estimate said that
more than three million HIV-positive people live in the country,
according to the Boston Globe. "More than one million people who
are HIV-positive is a serious problem," Anthony MBewu, executive
director of research for the South Africa Medical Research
Council, said, adding, "Three million is a serious problem.
Which number is correct, I don't know. But either way, it's
serious" (Donnelly, Boston Globe, 1/15).

5. Group Therapy Can Help Treat Depression Among HIV/AIDS
Patients, Uganda Study Says

Access this story and related links online:
http://cme.kff.org/Key=1568.Cc9.J.D.PCqG5Q

  People living with HIV/AIDS in Uganda who also have major
depression have benefited from group therapy sessions, according
to a study conducted by counselors from World Vision and
researchers from Johns Hopkins University and Columbia
University, the New York Times reports. Counselors conducted
therapy studies with 15 groups of patients, separated into
groups of 12 according to gender. They did not allow patients
who "entertained active thoughts" of suicide to participate in
the study, but many participants said that they had thought
about suicide at some point, according to the Times.
Participants attended one 90-minute session each week for four
months. Following the sessions, researchers found that 6.5% of
group therapy participants still had major depression, compared
with 54.7% of participants in the control group who did not
participate in therapy, the Times reports. Many of the people
who participated in the therapy sessions have continued to meet,
and some have used their groups to start business ventures
together, according to the Times. Paul Bolton of the Boston
University School of Public Health, who led the study during his
tenure at JHU, said, "So much attention is being paid to AIDS,
but so little is being done about the mental health aspects of
the disease. Depression devastates people's ability to function"
(Lacey, New York Times, 1/15).

6. Turkish Police Identify HIV-Positive Sex Worker on Television

Access this story and related links online:
http://cme.kff.org/Key=1568.Cc9.K.D.PHpmCv

  Turkish police during a recent televised news conference
identified a Ukrainian sex worker who tested HIV-positive after
her arrest and encouraged all individuals who had had sexual
contact with the woman to get tested for the disease, the
Chicago Tribune reports. The woman, Oksana Topor, was arrested
for solicitation in Erzurum, Turkey, and given a medical exam
that included an HIV test. After learning her HIV status, Topor
gave police a notebook that listed the times and dates of 1,300
sexual encounters she had during the three months that she was
in Erzurum. However, the notebook did not include patrons'
names. In the days following the news conference, approximately
800 men went to two local hospitals to be tested for HIV,
according to the Tribune. Health authorities say that it will be
months before it is known whether a large number of men were
infected by having sex with Topor, but officials believe that
"at least a fraction" will test HIV-positive. "None of these men
has tested positive at this point, but that is not surprising,"
Dr. Selcuk Bozhalil, director of the Numune Hospital, which has
tested 150 men, said, adding, "HIV transmission from a woman to
a man is relatively difficult. And it is too soon to be seeing
positive tests." Bozhalil said that the hospital has asked the
men to return for repeat HIV testing every two months, adding
that he believes many of the men will be retested "because they
are scared." Bozhalil said, "Worst-case scenario: Months from
now, we may see an infection rate of 10%. I hope not." Turkey's
health ministry has recorded about 1,600 HIV/AIDS cases in the
country, which has a population of 70 million, according to the
Tribune.

Rights Violation

Erzurum police routinely arrest foreign sex workers and give
them sexually transmitted disease tests before deporting them;
however, Topor was the first arrested sex worker to test
HIV-positive, according to the Tribune. Turkish human rights
workers have criticized the decision to have Topor appear on
television, and the Interior Ministry has opened an
investigation. "You could have protected both" public health and
Topor, Demet Gural, director of the Human Resource Development
Foundation, said, adding, "Erzurum is one of the most
fundamentalist cities in Turkey. People were shocked. Then
officials reacted without thinking through the consequences.
They panicked." However, some residents were willing to "set
aside" Topor's right to privacy to help stop the spread of HIV
in the community, and some people called for a second TV
broadcast showing Topor, according to the Tribune. "The human
rights of one person sometimes end where another's begin,"
Sadullah Kara, chair of Erzurum's bar association, said. Erzurum
Police Chief Tahsin Demir said, "I am unhappy with the criticism
(we have) received," adding, "I feel so sad about this case.
Despite the authority the law has given the police in this
situation, I would prefer not to do it again." The regional
governor's office endorsed the police department's decision to
show Topor on television, basing its decision on a 1996 Interior
Ministry resolution requiring foreign sex workers who test
positive for STDs to be "exposed to the public by the press,"
according to the Tribune. "We did this for the public good,
although some have taken a different stance," Mustafa Malay, the
regional governor, said, adding, "If there were a better way of
handling this difficult situation, I would like to know."
According to the Interior Ministry, the 1996 resolution that
required exposing foreign sex workers was canceled in 1999, and
Turkey now requires protection for medical patients' privacy
(Collins, Chicago Tribune, 1/14).

7. China's HIV/AIDS Response Should Be Similar to SARS Response,
Experts Say

Access this story and related links online:
http://cme.kff.org/Key=1568.Cc9.L.D.PQQwG1

  Although China's "belated awakening" to the HIV/AIDS epidemic,
sparked by its response to the recent SARS outbreak, is
"encouraging," more is needed to combat the disease in the large
country, according to experts who attended a conference in
Washington, D.C., on Tuesday, U.N. Wire reports. The conference
was sponsored by the Asia Society, the U.S.-China AIDS
Foundation and the Woodrow Wilson International Center for
Scholars. UNAIDS Executive Director Peter Piot said that the
Chinese government's announcement of a "five-point plan" at the
beginning of the U.N. General Assembly in September 2003 was a
"good start," but he added that the government's "tardy
recognition" of the epidemic is "not enough" without a "quick
and forceful" response similar to its efforts in spring 2003 to
combat SARS, according to U.N. Wire (Hukill, U.N. Wire, 1/13).
Last year during a symposium on HIV/AIDS and SARS at Tsinghua
University in Beijing, Piot said that disease tracking and
reporting systems used during China's SARS outbreak could be
applied to the AIDS epidemic (Kaiser Daily HIV/AIDS Report,
11/10/03).

Accurate Data

Piot also said that because of the country's large population
and land mass as well as its "cultural variations," national
statistics on HIV/AIDS are inaccurate and officials should focus
on "provinces, at communities." Bates Gill of the Center for
Strategic and International Studies said, "We can go to Beijing
and hear the right words, but we all know the real challenge is
implementing the policy created in Beijing at the provincial
levels" (U.N. Wire, 1/13). The Chinese government estimates that
there are 840,000 HIV-positive people in the country and that
80,000 have AIDS; however, some experts believe that those
figures are an underestimate. The United Nations estimates that
there are at least one million HIV-positive people in China and
the number could grow to 20 million people by 2010 (Kaiser Daily
HIV/AIDS Report, 12/15/03).

IN THE COURTS

8. European Union Calls for Libya To Drop Charges Against Health
Care Workers Who Allegedly Infected Children With HIV

Access this story and related links online:
http://cme.kff.org/Key=1568.Cc9.M.D.PRxfhd

  The European Union has called on Libya to end the trial of six
Bulgarian health care workers charged with deliberately
infecting several hundred children with HIV through contaminated
blood products, according to the Bulgarian Ambassador to Libya
Zdravko Velev, the Bulgarian News Network reports (Bulgarian
News Network, 1/13) More than 400 children in Libya contracted
HIV in 1997 and 1998 in what some Libyan groups say was a
conspiracy to experiment with HIV on children. However, some
European governments and human rights groups say that the Libyan
Health Ministry failed to screen blood products adequately and
allowed poor sterilization practices at Al Fateh Children's
Hospital, where the children were infected. The health care
workers have been detained in Libya since early 1999. A civil
prosecutor in September 2003 requested about $10 million in
compensation for the families of each HIV-positive child. The
trial was suspended in December 2003 to await an opinion by a
group of Libyan doctors (Kaiser Daily HIV/AIDS Report, 1/12).
Velev said in an interview with Bulgarian state radio that the
British and Dutch ambassadors delivered a note to Libyan Prime
Minister Shukri Ghanim requesting that the charges be dropped
because they are "unsubstantiated" and that the workers be
released, the Associated Press reports (Associated Press, 1/13).

Implications

The health care workers have pleaded not guilty, and
international HIV/AIDS experts Dr. Luc Montagnier and Vittorio
Collizzi have testified that the outbreak stemmed from poor
infection control practices at the hospital in 1997 -- more than
one year before the health care workers began working there, the
Bulgarian News Network reports. However, a court-appointed
commission comprised of Libyan doctors disagreed with Montagnier
and Collizzi, claiming instead that the Bulgarians intentionally
infected the children through blood transfusions. The court is
scheduled to hold another hearing in the case on Jan. 26,
according to the Bulgarian News Network (Bulgarian News Network,
1/13). Libyan leader Moammar Kadafi has promised Western
diplomats that he will intervene, but his decision is expected
to have political implications. If he accepts the European
opinion that the epidemic was caused by Libya's health system,
he likely will win the support of Europe but will be forced to
accept blame in his home country, a move that could cost more
than $4 billion if Libya provides the requested compensation
(Kaiser Daily HIV/AIDS Report, 1/12).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: http://www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. (c) 2004 Advisory Board Company and Kaiser Family
Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at
http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or
unsubscribe.
Questions about your email subscription? Contact us at
subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family
Foundation. For access to the Foundation's policy research,
analyses, reports and fact sheets, and media partnerships, visit
the Foundation's main website at http://www.kff.org .

-Message-Id: <20040115072609.C13A.4398-1568@...>

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

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*** LIVE WEBCAST: GLOBAL MEDIA AIDS INITIATIVE ***
United Nations Secretary-General Kofi Annan hosts a
roundtable meeting of media leaders to discuss ways in
which the media can contribute to the fight against
AIDS. View a LIVE webcast of a press conference with
the media leaders on Thursday, January 15. For more
details, visit http://cme.kff.org/Key=1544.Ccd.C.D.M54hBL
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
________________________________________


Wednesday, January 14, 2004

POLITICS AND POLICY
========================================
1. Leaders Attending Summit of Americas Sign Declaration
Expressing Concern Over HIV/AIDS Epidemic

2. Coalition of Evangelical Groups Calls on Bush To Propose
Increase in Funding To Combat AIDS, TB, Malaria

GLOBAL CHALLENGES
========================================
3. Clinton Foundation To Announce Deal Reducing Price of Viral
Load, CD4+ Tests for Developing Countries

4. Global Fund Calls for Fourth Round of Grant Funding Proposals

5. Catholic Cardinal Backs Use of Condoms in Preventing HIV
Transmission

6. India's Roman Catholic Bishops Call for Mandatory HIV Testing
Before Marriage

MEDIA & SOCIETY
========================================
7. South Africa's National Press Club Names Achmat, TAC 2003
'Newsmakers of the Year'

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

POLITICS AND POLICY

1. Leaders Attending Summit of Americas Sign Declaration
Expressing Concern Over HIV/AIDS Epidemic

Access this story and related links online:
http://cme.kff.org/Key=1544.Ccd.D.D.MTjxCM

  Leaders of 34 nations at the Special Summit of the Americas on
Tuesday expressed concern about the AIDS epidemic and agreed to
take steps to fight the disease, Xinhua News Agency reports. In
the Declaration of Nuevo Leon, which the nations signed at the
end of the summit, leaders expressed concern about the spread of
the disease in certain countries and the danger the epidemic
poses to security. "We recognize that in order to combat the
HIV/AIDS pandemic we must intensify our prevention, care and
treatment efforts within the Hemisphere," the declaration said,
adding, "We recognize that to confront the challenge posed by
the HIV/AIDS pandemic, it is necessary to continue increasing
global cooperation efforts." HIV prevalence in the region among
people ages 15-49 is estimated to be about 0.5%. However,
underreporting is common, and researchers predict that Latin
America is likely to have 30% more AIDS cases and 40% more HIV
cases than current statistics show (Xinhua News Agency, 1/13).
President Bush at the summit called for a concerted effort to
stop the spread of HIV, saying that countries need to admit that
the disease poses a problem and focus on education and
prevention efforts, the AP/WLOX.com reports (AP/WLOX.com, 1/13).
In addition, Bush urged leaders of developed nations to
contribute money to efforts to fight HIV/AIDS or use "bargaining
power [to] work on behalf of those who suffer" from the disease
to secure antiretroviral drugs at a "reasonable cost" (Speech
text, 1/13). The leaders made a commitment to provide
antiretroviral therapy to all who need the drugs, with a focus
on treating at least 600,000 HIV-positive people by 2005,
according to a White House fact sheet (White House fact sheet,
1/13).

2. Coalition of Evangelical Groups Calls on Bush To Propose
Increase in Funding To Combat AIDS, TB, Malaria

Access this story and related links online:
http://cme.kff.org/Key=1544.Ccd.F.D.MQQjvK

  A coalition of evangelical Christian groups on Tuesday called
for President Bush to propose during his Jan. 20 State of the
Union address increasing fiscal year 2005 funding for the global
AIDS, tuberculosis and malaria initiative to $3.6 billion, the
San Francisco Chronicle reports. During his 2003 State of the
Union speech, Bush announced a five-year, $15 billion initiative
to fight HIV/AIDS, tuberculosis and malaria in some sub-Saharan
African and Caribbean nations (Epstein, San Francisco Chronicle,
1/14). According to sources involved in the budget process, Bush
plans to request in his FY 2005 budget proposal $2.7 billion for
international HIV/AIDS, tuberculosis and malaria initiatives.
However, White House sources have declined to comment on the
funding request, saying that no final decisions have been made.
Bush's proposed FY 2005 budget is expected to be sent to
Congress on Feb. 2 (Kaiser Daily HIV/AIDS Report, 1/7). The
House on Dec. 8 approved in the FY 2004 omnibus spending bill
$2.4 billion for spending on the three diseases. However, the
Senate failed to vote on the bill before its winter recess.
Senate Majority Leader Bill Frist (R-Tenn.) has scheduled a vote
on the bill for Jan. 20, when the Senate reconvenes (Kaiser
Daily HIV/AIDS Report, 12/12/03). Although the measure (HR 1298)
supporting the global AIDS initiative authorizes $3 billion for
the first year of the program, the Bush administration requested
only $2 billion. Bush said that his administration requested
less than $3 billion in order to give the program time to "ramp
up" (Kaiser Daily HIV/AIDS Report, 12/10/03). According to AIDS
advocates, Congress has authorized up to $3.6 billion for AIDS,
TB and malaria programs in FY 2005 (Kaiser Daily HIV/AIDS
Report, 1/7).

Reaction

Serge Duss, director of public policy for World Vision, said,
"We urge the president to agree to $3.6 billion for his 2005
fiscal year budget. It is absolutely necessary to keep the plan
on target." Rev. Richard Cizik, vice president for public
affairs at the National Association of Evangelicals, said, "I'm
not directly challenging the administration's arguments, but if
we give the money, there are groups to do the work who will do
it very effectively." He added, "The evangelical community in
America is not the Republican Party at prayer. We will hold both
political parties accountable, and that includes President
Bush." Global AIDS Alliance Executive Director Paul Zeitz said,
"We strongly think this program should be front-loaded. You
don't delay funding when you're fighting an epidemic. ... The
question is what are the needs? The president's plan isn't
meeting up to that standard." Office of Management and Budget
spokesperson Chet Kolton said, "We will ramp up spending. All
sober observers of the situation recognize that some
infrastructure needs to be developed for the effective use of
these funds. You can't just write a check for $15 billion" (San
Francisco Chronicle, 1/14).

* A fact sheet, titled "U.S. Government Funding for HIV/AIDS in
Resource Poor Settings," is available online from the Kaiser
Family Foundation. The fact sheet examines federal funding for
the global HIV/AIDS epidemic, with a primary emphasis on funding
activities that benefit resource poor countries.

GLOBAL CHALLENGES

3. Clinton Foundation To Announce Deal Reducing Price of Viral
Load, CD4+ Tests for Developing Countries

Access this story and related links online:
http://cme.kff.org/Key=1544.Ccd.G.D.MN5XF3

  The William J. Clinton Presidential Foundation on Wednesday
plans to announce a deal with Beckman Coulter, Becton, Dickinson
& Co., Roche Diagnostics, Bayer HealthCare and bioMerieux that
will cut the prices of viral load and CD4+ T cell diagnostic
tests in developing nations, the Wall Street Journal reports.
Although HIV diagnostics have failed to receive the same media
attention as antiretroviral drugs, they are a "big part" of the
cost of HIV/AIDS treatment, according to the Journal. The prices
of the tests are prohibitively expensive in some developing
nations, leading doctors to stop administering viral load tests
and making limited use of CD4+ tests. The tests -- which are
standard in the United States -- help doctors determine when to
begin administering antiretroviral drugs and whether the drugs
are working. Under the new deal, the companies will offer
developing countries special pricing on a package including the
tests, the machines for running them, training, maintenance and
repair of the machines, chemical reagents and other supplies.
The countries will receive the equipment without any
downpayments and will instead "pay as they go" using a per-test
fee, according to the Journal. Per-test charges for the CD4+
tests will range from $3 to $5, down from an average price in
some African nations of $8 to $10. In one South African clinic,
the test costs $15. However, the companies say that the nature
of the package deal makes such comparisons misleading. For
example, the vast majority of Becton Dickinson's African
customers purchase the test kits separately from the expensive
machines used to process them, the company said. Under the
agreement, the pricing of the viral load tests is confidential.

Sustainability

In order to ensure the sustainability of the program, the
Clinton Foundation priced the tests at a level that would allow
the companies to make a "modest profit," according to the
Journal. The companies see the proposed program as a "market
maker," offering predictability and high demand, the Journal
reports. Ira Magaziner, a long-time Clinton aide and head of the
foundation's AIDS initiative, and a team of management
consultants and AIDS experts visited the companies'
manufacturing plants and helped the companies develop ways to
cut costs (Schoofs, Wall Street Journal, 1/14). The foundation
used a similar tactic last year to secure a deal with Ranbaxy
Laboratories, Cipla, Matrix Laboratories and Aspen Pharmacare
that reduced the prices of commonly used three-drug
antiretroviral regimens to 38 cents per patient per day, down
from the already discounted price of 55 cents per patient per
day; the lowest available price of the same three-drug regimen
using brand-name antiretrovirals is $1.54 per patient per day
(Kaiser Daily HIV/AIDS Report, 11/21/03). The diagnostic tests
price cuts will be available immediately in countries that the
Clinton Foundation is currently working with, including South
Africa, Tanzania, Mozambique, Rwanda, Haiti, the Dominican
Republic and several other nations in the Caribbean. Magaziner
said that the foundation hopes to expand the deal to as many
nations as possible (Wall Street Journal, 1/14).

4. Global Fund Calls for Fourth Round of Grant Funding Proposals

Access this story and related links online:
http://cme.kff.org/Key=1544.Ccd.H.D.Mh1LPs

  The Global Fund to Fight AIDS, Tuberculosis and Malaria on
Saturday called for a fourth round of grant funding proposals,
according to a Global Fund release. The fund has already
committed $2.1 billion over two years to 224 programs in more
than 120 countries to fight the three diseases. Grants from the
Global Fund likely will serve as the "main opportunity to
finance the massive expansion of services needed" to fulfill the
World Health Organization's goal of providing antiretroviral
treatment to three million HIV-positive people by 2005,
according to the release. The fund is also calling for the
fourth round of funding proposals to include "ambitious,
large-scale" projects aimed at fighting malaria. Global Fund
Executive Director Richard Feachem said, "A number of countries
are now ready to conduct a major offensive against malaria. We
have effective tools to prevent and treat malaria. We need to
spread these tools to as many countries and people as possible."
HHS Secretary Tommy Thompson, who serves as chair of the Global
Fund board, said, "We are looking for proposals of the highest
quality, particularly from partnerships that include the private
sector and local non-governmental organizations, to meet the
greatest challenge of our times -- turning back the tide of
these three pandemics." The deadline for proposal submissions is
April 5. The proposals will be considered by an independent
Technical Review Panel, comprised of health and development
experts. Proposals approved by the panel will then be considered
by the Global Fund's board, which is scheduled to meet at the
end of June, according to the release (Global Fund release,
1/10).

* A fact sheet, titled "Global Funding for HIV/AIDS in Resource
Poor Settings," is available online from the Kaiser Family
Foundation. The fact sheet presents data on the range of
resources currently directed to address the HIV/AIDS epidemic in
resource poor settings, including bilateral, multilateral, and
private sector support, as well as domestic funding by affected
country governments.

5. Catholic Cardinal Backs Use of Condoms in Preventing HIV
Transmission

Access this story and related links online:
http://cme.kff.org/Key=1544.Ccd.J.D.M7YFQl

  Belgian Cardinal Godfried Danneels, a leading candidate to
succeed Pope John Paul II, on Sunday in an interview with the
Dutch Catholic broadcaster RKK said that in certain
circumstances condoms should be used to prevent the spread of
HIV, London's Guardian reports. Danneels said he preferred
abstinence as a means of HIV prevention but added that if an
HIV-positive person had sex without a condom, they would be
guilty of a contravention of the sixth commandment -- "thou
shalt not kill" (Hooper/Osborn, Guardian, 1/13). Danneels said,
"When someone is HIV-positive and his partner says 'I want to
have (sexual) relations with you,' then he doesn't have to do
it. But if he does, he has to use a condom. Otherwise he will
commit a sin" (Associated Press, 1/12). He added, "Protecting
oneself against sickness or death is an act of prevention.
Morally, it cannot be judged on the same level as when a condom
is used to reduce the number of births" (Agence France-Presse,
1/12). The Vatican has not issued a definitive statement on the
use of condoms in specific situations to prevent the
transmission of HIV, but most Vatican officials who have spoken
on the issue are against condom use, Reuters reports (Reuters,
1/12). Danneels' statement clashes with statements made by
Cardinal Alfonso Lopez Trujillo that were aired last year on a
BBC1 program (Guardian, 1/13). Trujillo, president of the
Vatican's Pontifical Council for the Family, said in an episode
of BBC1's "Panorama" program, titled "Sex and the Holy City,"
which aired on Oct. 12, 2003, "The AIDS virus is roughly 450
times smaller than the spermatozoon. The spermatozoon can easily
pass through the 'net' that is formed by the condom. These
margins of uncertainty ... should represent an obligation on the
part of the health ministries and all these campaigns to act in
the same way as they do with regard to cigarettes, which they
state to be a danger" (Kaiser Daily HIV/AIDS Report, 11/11/03).

6. India's Roman Catholic Bishops Call for Mandatory HIV Testing
Before Marriage

Access this story and related links online:
http://cme.kff.org/Key=1544.Ccd.K.D.MbRHBc

  India's Roman Catholic bishops have called for national
legislation requiring couples to undergo HIV testing before
obtaining marriage licenses in an effort to prevent HIV
transmission, the AP/News24.com reports. The country's 149
bishops on Monday at the annual meeting of the Catholic Bishops
Conference of India discussed how the church should reorganize
its health outreach program to address HIV/AIDS (AP/News24.com,
1/13). Bishop Yoohanan Chrysostom said that the church plans to
annul marriages in which a partner deceives another partner
about his or her HIV status before getting married
(NewIndPress.com, 1/13). "But the efforts of the church would be
strengthened only if appropriate legislation is enacted by the
government," a statement released by the conference on Monday
said. Chrysostom added that mandatory HIV testing would "put
fear into the minds of young adults" about contracting HIV,
according to the AP/News24.com. The treatment of HIV/AIDS is a
"major mission" for the church's 4,745 hospitals and clinics in
India. In addition, the church runs 39 hospitals that
exclusively treat HIV/AIDS patients (AP/News24.com, 1/13).

Gay Advocacy Groups Form 'Manas'

At least 10 gay advocacy groups in India have formed a platform
called "Manas," which is Hindi for "thought," in order to fight
HIV/AIDS among gay men and women and street children, the
Associated Press reports. The campaign will first target
Kolkata, which has an estimated 200,000 street children. "Sex
happens among street children at a very early age, making them a
medium-risk group [for contracting HIV]. So we have decided to
involve them in our initiative," Saurav Banerjee of the Prajak
voluntary group said. In addition, the group will focus on
"spreading awareness and providing support and counseling" to
gay men and women, according to Amitava Sarkar, of People Like
Us. Homosexuality is banned in India under a law first enacted
while the country was under British rule. Manas members called
on the government to withdraw the law, the Associated Press
reports. "Homosexuality is practiced clandestinely and it will
remain so if the government continues to consider gays and
lesbians criminals. And this will not help fight AIDS among
homosexuals," Sarkar said. The campaign is funded by the
Government of West Bengal, which agreed to finance the program
because it does not specifically target gays, Suresh Kumar, an
official with the West Bengal state AIDS Cell, said, according
to the Associated Press (Banerjee, Associated Press, 1/13).

* Additional information on HIV/AIDS in India is available
online as part of kaisernetwork.org's Issue Spotlight on
HIV/AIDS.

* Also available online is a kaisernetwork.org video feature on
HIV/AIDS in India. The report -- prepared by Fred de Sam Lazaro,
a correspondent for the NewsHour with Jim Lehrer -- includes
interviews with people who are on frontlines of India's efforts.

MEDIA & SOCIETY

7. South Africa's National Press Club Names Achmat, TAC 2003
'Newsmakers of the Year'

Access this story and related links online:
http://cme.kff.org/Key=1544.Ccd.L.D.MknD0W

  South Africa's National Press Club on Tuesday named South
African HIV/AIDS advocate Zackie Achmat and the Treatment Action
Campaign its 2003 "Newsmakers of the Year," Reuters/AlertNet
reports (Reuters/AlertNet, 1/13). Achmat five years ago
co-founded TAC, the country's largest AIDS treatment advocacy
group, and pressed the South African government to provide
antiretroviral drugs to the public by refusing to take
antiretroviral drugs from 1998 until August 30, 2003, when the
South African government pledged to announce a plan to provide
universal access to the drugs (Kaiser Daily HIV/AIDS Report,
11/24/03). According to the National Press Club, Achmat and TAC
presented legal and moral arguments to help persuade the
government to provide antiretroviral therapy to people living
with HIV/AIDS in South Africa. "This victory raised hope for
millions of AIDS sufferers to finally gain access to drugs that
could prolong their lives," the National Press Club said in a
statement. Achmat and TAC have also been nominated for the 2004
Nobel Peace Prize, and Achmat was named one of 35 "heroes of
2003" by Time magazine, Reuters/AlertNet reports
(Reuters/AlertNet, 1/13).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: http://www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. (c) 2004 Advisory Board Company and Kaiser Family
Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at
http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or
unsubscribe.
Questions about your email subscription? Contact us at
subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family
Foundation. For access to the Foundation's policy research,
analyses, reports and fact sheets, and media partnerships, visit
the Foundation's main website at http://www.kff.org .

-Message-Id: <20040114073007.BF35.4401-1544@...>

FDA approved a labeling supplement on January 12, 2004 for Crixivan (Indinavir Sulfate) Capsules, resulting in the following changes:

Revisions to the Package Insert (Drug Label)

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


Tuesday, January 13, 2004

POLITICS AND POLICY
========================================
1. NIH Director Zerhouni To Send Letter to Lawmakers Defending
Agency's Funding of AIDS, Sexual Health Research

ACROSS THE NATION
========================================
2. California Gov. Schwarzenegger's Budget Would Cap ADAP
Enrollment, Cut AIDS Spending by 2%

DRUG ACCESS
========================================
3. Increased Number of Low-Income HIV-Positive People, High
Price of Fuzeon Creating Care 'Rationing'

PUBLIC HEALTH & EDUCATION
========================================
4. California State Legislators Expected To Reintroduce Bill To
Legalize Over-the-Counter Hypodermic Needle Sales

5. Illinois Hypodermic Needle Access Program Awaiting
Publication of Required Literature

6. New York Times Examines Debate Over Access to Clean Needles,
AIDS Epidemic in New Jersey

MEDIA & SOCIETY
========================================
7. Merck Senior Vice President of Vaccine Research Leaving To
Join International AIDS Vaccine Initiative

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

POLITICS AND POLICY

1. NIH Director Zerhouni To Send Letter to Lawmakers Defending
Agency's Funding of AIDS, Sexual Health Research

Access this story and related links online:
http://cme.kff.org/Key=1529.Ccg.C.D.GmqJgQ

  NIH Director Elias Zerhouni this week plans to send a letter to
the Senate Health, Education, Labor and Pensions Committee and
the House Energy and Commerce Committee "resolutely" defending
the agency's funding for "dozens" of research studies on
HIV/AIDS, sexual behavior and addiction, USA Today reports
(Sternberg, USA Today, 1/13). Conservative House members have
questioned at least 10 NIH research grants, including grants for
studies on emergency contraception, Asian sex workers in San
Francisco and women's response to pornography. At an Oct. 2,
2003, hearing on the grants, Rep. Michael Ferguson (R-N.J.)
asked NIH for information about the public benefit of the 10
studies. Zerhouni's staff contacted the House Energy and
Commerce Committee, which co-sponsored the hearing, to obtain
the list of studies about which Ferguson wanted further
information. Instead of sending the list of 10 studies, a
committee staff member sent a different, longer list. That list,
which includes more than 200 grants representing $100 million in
funding, was prepared by the Traditional Values Coalition, which
says it represents 43,000 churches nationwide (Kaiser Daily
HIV/AIDS Report, 10/30/03).

'Major' Public Health Issues?

Zerhouni ordered his staff to review approximately 190 studies,
including research on the sexual habits of older men, drug use
among California sex workers, sexual identity among Native
Americans and sexual arousal in women, and determined that the
research represented "major" public health issues that should
receive scientific attention, according to USA Today. TVC
Director Andrea Lafferty said, "We're not opposed to research.
But research dollars are scarce. Choices have to be made. Are we
going to research finding a cure for juvenile diabetes or the
sex lives of Mexican workers before and after they come over the
border?" Zerhouni responded in an interview with USA Today,
"There is no American that doesn't deserve research to alleviate
their suffering, no matter where they are or whatever ethnic
group they come from." He added, "When you look at the impact of
sexually transmitted diseases, you're talking about HIV/AIDS and
many others that affect millions of people and their
reproductive lives." Zerhouni also voiced his support for the
method by which the NIH determines funding levels, saying,
"Independent peer review is the cornerstone of science in
America" (USA Today, 1/13).

ACROSS THE NATION

2. California Gov. Schwarzenegger's Budget Would Cap ADAP
Enrollment, Cut AIDS Spending by 2%

Access this story and related links online:
http://cme.kff.org/Key=1529.Ccg.D.D.Gd41yH

  California Gov. Arnold Schwarzenegger (R) on Friday proposed
his $99.1 billion fiscal year 2004-2005 budget, which includes a
2% cut in funding for HIV/AIDS prevention and treatment
programs, the Contra Costa Times reports (LaMar/Hannah, Contra
Costa Times, 1/10). The budget also includes a provision that
would cap enrollment for the state's AIDS Drug Assistance
Program, the San Jose Mercury News reports (Feder Ostrov, San
Jose Mercury News, 1/10). ADAPs -- which are state-managed,
federally funded programs -- provide HIV treatment to
low-income, uninsured and underinsured HIV-positive individuals
(Kaiser Daily HIV/AIDS Report, 11/26/03). California's ADAP
needs an additional $45 million for FY 2004-2005 to cover
increased enrollment, the cost of additional drugs for current
enrollees and increased drug prices. However, Schwarzenegger's
budget did not include any increased funding; the budget instead
would cap enrollment in the program at the current 23,900
enrollees. The move would cause more than 1,400 HIV-positive
people in California to go without antiretroviral drugs and
would reduce benefits for existing enrollees, according to a San
Francisco AIDS Foundation release (San Francisco AIDS Foundation
release, 1/9). In addition, the budget would cut Medi-Cal
reimbursements by 10%, in addition to a 5% cut adopted last
year, the San Francisco Chronicle reports (Seligman/DelVecchio,
San Francisco Chronicle, 1/10). These cuts could force many
providers to stop treating HIV-positive Medi-Cal patients,
according to the release (SFAF release, 1/9).

Reaction

"The state's fiscal crisis may require sacrifices all around,
but limiting access to ADAP could cost people with HIV/AIDS
their health and ultimately their lives," AIDS Project Los
Angeles Executive Director Craig Thompson said, adding, "It is
simply not cost effective in the short or long term to cap
enrollment in this program" (AIDS Project Los Angeles release,
1/9). "Every person who cannot access these lifesaving
medications will become increasingly sick, and the cost of their
acute health care will add to the financial burdens affecting
the state," SFAF Director of State and Local Affairs Dana Van
Gorder said (SFAF release, 1/9). Ellen LaPointe, executive
director of Project Inform, said, "The governor knows that to
truly serve low-income Californians with HIV, he needs to
increase ADAP funding by approximately $45 million in this
budget. ... It is disappointing that the governor has not only
chosen to ignore this, but has gone further to propose
additional cuts. We believe this recommendation is shortsighted,
and disregards the needs of thousands who are depending on the
governor for their continued well-being" (Project Inform
release, 1/9). The AIDS Healthcare Foundation has enacted
measures in its 12 AIDS clinics in the state that have generated
more than $2 million in drug cost savings on just 800 patients,
according to an AHF release. AHF President Michael Weinstein
said that the "savings potential is enormous" if these
techniques are applied to the nearly 24,000 people who are
enrolled in the state's ADAP. AHF has proposed cost-saving
measures that would prohibit monthly refills less than 27 days
from the last refill, eliminate automatic refills, allow
prescriptions to be written for a maximum of three months of
refills and access federal drug pricing programs to reduce the
costs of drugs. "We found pharmacies needlessly refill expensive
prescriptions far too often after doctors have changed patient
treatment. Too many medications are wasted. The solution is to
fix these problems -- not cut off new patients," Weinstein said
(AHF release, 1/9).

DRUG ACCESS

3. Increased Number of Low-Income HIV-Positive People, High
Price of Fuzeon Creating Care 'Rationing'

Access this story and related links online:
http://cme.kff.org/Key=1529.Ccg.F.D.GhtsLz

  As HIV/AIDS increasingly affects low-income populations in the
United States, expensive antiretroviral drugs such as Roche's
Fuzeon are starting to create a "rationing" of HIV care "rarely"
seen in the country, the Wall Street Journal reports. State and
federal AIDS Drug Assistance Program officials estimate that the
program will need an additional $215 million in funding for
fiscal year 2004 to cover the cost of treating current and new
patients. However, Congress has proposed only a $35 million
increase. As a result, 13 states have closed enrollment to new
patients, leaving more than 700 patients on waiting lists for
drugs. The number could grow to 7,000 this year if no additional
funding is secured, according to the ADAP Working Group, which
helps advocate for more ADAP funding. State resources have also
been strained by the high price of Fuzeon, which costs roughly
$20,000 per year per patient -- three times as much as most
antiretroviral drugs (Fuhrmans, Wall Street Journal, 1/13).
Fuzeon, which is in a new class of drugs called fusion
inhibitors, is designed for HIV/AIDS patients who have failed to
respond to other medications (Kaiser Daily HIV/AIDS Report,
1/7).

Rationing

Some states have decided not to cover Fuzeon because of its high
cost. North Carolina's ADAP chose to purchase Fuzeon for a
limited number of patients, knowing that for each new Fuzeon
patient it took on, it would have to put two or three other new
patients on a waiting list for less-expensive antiretroviral
treatments. Roche conducts its own Fuzeon assistance program but
refuses to disclose how many people receive the free treatment.
The company recently announced that it would not provide
medication to any ADAP-eligible patients in states where the
program does not cover Fuzeon or has placed limits on how many
patients receive the drug. However, Roche said it will continue
to enroll patients in states with waiting lists provided that
Fuzeon is covered by ADAP and the program agrees to take over
coverage of the drug when it has sufficient funds(Wall Street
Journal, 1/13).

PUBLIC HEALTH & EDUCATION

4. California State Legislators Expected To Reintroduce Bill To
Legalize Over-the-Counter Hypodermic Needle Sales

Access this story and related links online:
http://cme.kff.org/Key=1529.Ccg.G.D.GkbYgL

  California state legislators are soon expected to reintroduce a
bill that would allow pharmacies across the state to sell
hypodermic needles over-the-counter, a move some health
officials believe will curb the spread of HIV and other
bloodborne disease among injection drug users, the Los Angeles
Times reports (Costello, Los Angeles Times, 1/12). Former
California Gov. Gray Davis (D) in October 2003 vetoed a similar
bill (SB 774), which would have allowed pharmacies to sell up to
30 hypodermic syringes to an adult without a prescription. The
measure, sponsored by Sen. John Vasconcellos (D), aimed to
reduce the incidence of needle sharing among drug users, which
contributes to the spread of HIV, hepatitis C and other
diseases. California law currently requires a prescription to
purchase syringes, except when used to inject adrenaline or
insulin (Kaiser Daily HIV/AIDS Report, 10/14/03).

Needle-Exchange Programs

Although a 1999 law allows local governments to set up
needle-exchange programs, fewer than 25% of counties have acted
to initiate programs, making some health officials concerned
that HIV and hepatitis rates among injection drug users will
continue to climb, the Times reports. According to the state
Office of AIDS, 14 cities and counties in the state have set up
legal needle-exchange programs (Los Angeles Times, 1/12).
However, some locally approved needle-exchange programs in
California are facing routine interference from police,
according to a Human Rights Watch report released in September
2003 (Kaiser Daily HIV/AIDS Report, 9/10/03). The "majority" of
California municipalities do not have legal needle-exchange
programs and have to "rely on a patchwork of illegal underground
exchanges," according to the Times. Over the last 10 years,
"several dozen" volunteers at illegal needle exchanges have been
arrested, but most were not convicted because they were able to
convince judges and juries that they "had no choice but to break
the law," according to the Times. However, some judges are now
ruling that illegal needle-exchange volunteers can no longer use
such a defense.

Reaction

Ricky Blumenthal, a health researcher at RAND Corp., said, "I
hope we don't wait until the cow has left the barn and rates
climb back up dramatically among addicts to realize that what we
have now isn't working." Many law enforcement agencies
"vehemently" oppose allowing over-the-counter hypodermic needle
sales, saying that the current policy of allowing individual
municipalities to operate needle exchanges is "sufficient,"
according to the Times. John Lovell, a lobbyist who represents
the California Narcotic Officers' Association, said that
allowing needles to be sold over-the-counter "would lead to an
unregulated, unfettered mess that we wouldn't be able to change
once it starts" (Los Angeles Times, 1/12).

5. Illinois Hypodermic Needle Access Program Awaiting
Publication of Required Literature

Access this story and related links online:
http://cme.kff.org/Key=1529.Ccg.H.D.GQbrBn

  A six-month-old Illinois program that allows anyone age 18 and
older to purchase hypodermic needles without a prescription from
a pharmacist still lacks the educational materials that
pharmacists are required to hand out during sales transactions,
the St. Louis Post-Dispatch reports (Skalski, St. Louis
Post-Dispatch, 1/10). Illinois Gov. Rod Blagojevich (D) in July
2003 signed into law a bill allowing individuals to purchase up
to 20 needles at a time from a pharmacy. The pharmacy is
required to offer the buyer educational materials on drug
treatment and safe needle disposal. The Illinois Department of
Public Health will pay for the educational brochures, which will
cost approximately $100,000 in the first year (Kaiser Daily
HIV/AIDS Report, 7/29/03). The health department last month
hired the AIDS Foundation of Chicago to make recommendations
about what information to include in the literature. The
foundation has until March 1 to make its recommendations, and
the health department then will develop the materials and take
bids for printing them. Some pharmacists are not selling needles
and syringes without a doctor's prescription because they
currently do not have the literature for patrons that is
required by the law.

Spreading the Word

Mike Patton, executive director of the Illinois Pharmacists
Association, said that more pharmacists might offer
over-the-counter needles once they have the required educational
materials. "It's impossible for a pharmacy to comply with the
law when the literature isn't even there," he said. Health
department spokesperson Tom Schafer said that the delay in
distributing the materials is not hindering AIDS prevention
efforts. "The fact that (drug users) actually show up at a
pharmacy actually requesting clean needles underscores the fact
that they already know how important it is to have clean needles
to protect their health," Schafer added. Karen Reitan, director
of state affairs for AFC, said that drug users are starting to
spread the word that clean needles are available in some
pharmacies. Schafer said that it will take at least another year
to determine whether the number of HIV/AIDS cases related to
injection drug use have decreased. Although opponents of the law
said that over-the-counter needle sales would increase the
number of discarded needles found in public places, the Chicago
Department of Public Health has not seen an increase in
complaints related to discarded needles, according to the
Post-Dispatch (St. Louis Post-Dispatch, 1/10).

6. New York Times Examines Debate Over Access to Clean Needles,
AIDS Epidemic in New Jersey

Access this story and related links online:
http://cme.kff.org/Key=1529.Ccg.J.D.GZbSHg

  The New York Times on Sunday profiled the political debate in
New Jersey over proposed legislation that would decriminalize
the purchase and possession of needles in an attempt to reduce
the spread of hepatitis C and HIV through injection drug use
(Sullivan, New York Times, 1/11). A recent report released by
the New Jersey Drug Policy Project-Drug Policy Alliance found
that approximately 46% of reported HIV cases in New Jersey are
related to injection drug use. Sharing contaminated needles to
inject drugs is the leading cause of both HIV and hepatitis C
infections in New Jersey, according to the report. New Jersey
ranks fifth in HIV prevalence in the United States, and the
state has the third-highest pediatric AIDS prevalence and the
highest percentage of HIV-positive women in the country,
according to the report (Kaiser Daily HIV/AIDS Report, 12/5/03).
Although injection drug use has become the primary source of new
HIV/AIDS cases in the state, New Jersey is one of only a few
remaining states that requires a prescription in order to
purchase needles, the Times reports. State Health Commissioner
Clifton Lacy and Gov. James McGreevey (D) have called for the
legalization of programs that would provide drug users access to
clean needles, saying that the issue is "no longer a matter of
condoning or condemning drug abuse but an urgent health
problem," according to the Times.

Previous Legislative Attempts

Only one bill calling for needle-exchange programs has made it
out of the state Senate Health, Human Services and Seniors
Committee, and no proposed legislation has made it to the floor
for a vote, the Times reports (New York Times, 1/11). New Jersey
state Sen. Joseph Vitale (D) in December withdrew from
consideration a bill (S 2794) that would have allowed the sale
and possession of needles without a prescription (Kaiser Daily
HIV/AIDS Report, 12/5/03). The bill was "sidetracked by internal
legislative conflict" but may be reintroduced in the next
legislative session, according to the Times. "When you talk
about why things are the way they are in New Jersey, part of it
is no one has had the guts on a state political level to stand
up and say we have a public health crisis," Rosanne Scotti,
director of the New Jersey Drug Policy Project, said, adding
that the state is "decades behind the curve" because of its high
AIDS prevalence rate and because it is one of only two states
that does not provide some sort of access to clean needles.

Debate

State Sen. Ronald Rice (D), who has been one of the strongest
opponents of needle access programs over the last decade, said
that allowing such legislation would do little to help stem the
spread of HIV. He added that the programs "encourag[e] people to
go out and do something that is illegal." Rice said, "The key to
addressing the HIV problem is ... to put more money into
prevention and education, into treatment facilities and into
research." The New Jersey State Association of Chiefs of Police
also opposes needle access legislation. However, state Sen.
Robert Singer (R), who co-sponsored the bill in the last
legislative session, said that such programs make sense from a
financial standpoint and would save the state hundreds of
thousands of dollars it spends each year on health care for poor
HIV/AIDS patients. "The belief that if you make it accessible,
people are going to run out, buy needles and become drug addicts
is ludicrous," Singer said (New York Times, 1/11).

MEDIA & SOCIETY

7. Merck Senior Vice President of Vaccine Research Leaving To
Join International AIDS Vaccine Initiative

Access this story and related links online:
http://cme.kff.org/Key=1529.Ccg.K.D.GWlGww

  Merck Senior Vice President of Vaccine Research Emilio Emini
has announced that he is leaving the Whitehouse Station,
N.J.-based drug maker to head research at the not-for-profit
International AIDS Vaccine Initiative, the Newark Star-Ledger
reports (Silverman, Newark Star-Ledger, 1/13). Emini, who began
the antiviral drug program at Merck, will begin his tenure at
the New York City-based IAVI on March 1, the Wall Street Journal
reports (Chase, Wall Street Journal, 1/13). Emini said, "The
primary driver in my decision is to put 100% of my time in AIDS
research. It's the biggest infectious disease problem in the
world and there is much to be done" (Newark Star-Ledger, 1/13).
Although some HIV/AIDS vaccine advocates say that Emini's move
could "be a shot in the arm for collaborative vaccine
development," others are concerned about the effect Emini's
departure could have on the progress of Merck's HIV vaccine
research, according to the Journal. However, Merck spokesperson
Janet Skidmore said, "Our commitment to the [AIDS vaccine]
program remains intact" (Wall Street Journal, 1/13). Huntly
Collins, director of scientific communication at the AIDS
Vaccine Advocacy Coalition, said, "[W]e trust that Emini's
departure does not signal any diminution of Merck's commitment
to funding research and development. As long as Merck and IAVI
move forward aggressively, the move may strengthen overall
efforts to find a vaccine." IAVI CEO Seth Berkley said, "We've
proven we can take vaccines from a conceptual framework into
trials. But hiring [Emini] signifies a level of maturity for us"
(Newark Star-Ledger, 1/13).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: http://www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. (c) 2004 Advisory Board Company and Kaiser Family
Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at
http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or
unsubscribe.
Questions about your email subscription? Contact us at
subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family
Foundation. For access to the Foundation's policy research,
analyses, reports and fact sheets, and media partnerships, visit
the Foundation's main website at http://www.kff.org .

-Message-Id: <20040113073852.BFF8.4403-1529@...>

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


Monday, January 12, 2004

PUBLIC HEALTH & EDUCATION
========================================
1. New York City Health Workers Say Crystal Meth Use Helping To
Spread HIV Among Men Who Have Sex With Men

GLOBAL CHALLENGES
========================================
2. Canadian Catholic Seminary To Screen Applicants for HIV

3. Number of Mother-to-Child HIV Transmission Cases Increasing
in Thailand, Data Show

MEDIA & SOCIETY
========================================
4. HIV/AIDS Ad To Air Before Super Bowl, Launches Second Year of
Kaiser Family Foundation, Viacom Awareness Campaign

5. Los Angeles Times Examines 'Phenomenon' of Men Who Want To Be
HIV-Positive, Documentary Film 'The Gift'

IN THE COURTS
========================================
6. New York Times Examines Ongoing Case of Health Care Workers
Accused of Intentionally Infecting Libyan Children With HIV

OPINION
========================================
7. Food Is 'First Line of Defense' Against HIV/AIDS in
Developing Countries, Opinion Piece Says

8. United States Should Not Deport HIV-Positive Immigrants,
Opinion Piece Says

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

PUBLIC HEALTH & EDUCATION

1. New York City Health Workers Say Crystal Meth Use Helping To
Spread HIV Among Men Who Have Sex With Men

Access this story and related links online:
http://cme.kff.org/Key=1516.Ccj.C.D.KGKHc6

  Methamphetamine use among men who have sex with men has fueled
a "sharp increase" in the number of new syphilis cases and could
lead to a "resurgence" of HIV infection, according to New York
City health officials, the New York Times reports. New York City
HIV/AIDS specialist Dr. Howard Grossman said that more than 50%
of men who tested HIV-positive in his private practice said that
methamphetamine use led to the risky behavior that led to their
HIV infections, according to the Times. "This drug is destroying
our community," Grossman said, adding, "It just seems to be
getting worse and worse, and no one is doing anything about it."
Methamphetamine, also known as crystal meth or crystal, "erases
inhibitions and spurs sex marathons with multiple partners,"
health officials say. The New York City Department of Health and
Mental Hygiene does not track methamphetamine use among
individuals newly infected with HIV, but the city's poison
control center received approximately 48 methamphetamine
overdose reports in 2002 and 2003, compared with no such reports
during the previous two years, according to the Times. New York
City Health Commissioner Dr. Thomas Frieden said that a survey
showed that HIV-positive men are twice as likely to use
methamphetamine as HIV-negative men, adding that men who use
methamphetamine are less likely to wear condoms during anal
intercourse, according to the Times. "We're seeing a general
increase in risky sexual behavior, and we're concerned," Frieden
said. The Callen-Lorde Community Health Center, the city's
largest private clinic for lesbians and gays, reported that
two-thirds of individuals who tested HIV-positive since June
2003 said that methamphetamine use was a factor in their
infection, according to the Times.

Addiction, Treatment

Methamphetamine is a highly addictive drug that users often
initially snort, then smoke and eventually inject when their
tolerance for the drug increases, according to the Times.
According to Dr. Antonio Urbina, a researcher at St. Vincent
Catholic Medical Centers who studies methamphetamine's impact on
neurological function, the drug can compromise immune function
and interfere with antiretroviral drugs. "If you're
HIV-positive, crystal is a disaster," Urbina said. In New York
City, methamphetamine use is "largely confined to gay white men
in Manhattan" but likely will spread to the wider community of
MSM and the general population, according to the Times. Although
health care workers say that methamphetamine use among MSM is an
"emerging crisis," New York public health officials and private
organizations that serve MSM in the city have not done much to
address the problem, according to the Times. In San Francisco,
the city plans to spend $425,000 for methamphetamine treatment
and education. There is no "silver bullet" to treat
methamphetamine addiction, and there are about two dozen 12-step
meetings held each week around New York City for individuals who
want to stop using the drug. In 1999, there were no such
meetings for methamphetamine addicts in the city, according to
the Times. Peter Staley, a "driving force" behind the AIDS
advocacy group ACT UP, has spent $6,000 of his own funds to
place "provocative" ads on phone booths in New York City to
"demonize" methamphetamine, the Times reports. One ad says,
"Huge Sale, Buy Crystal, Get HIV Free!" Staley, who is a
recovering methamphetamine user, said, "My goal is to get the
drug the reputation it deserves," adding, "My fear is that young
gay men think it's the latest party drug. I want crystal to get
the stigma that heroin has. It is not glamorous, it is not
alluring" (Jacobs, New York Times, 1/12).

GLOBAL CHALLENGES

2. Canadian Catholic Seminary To Screen Applicants for HIV

Access this story and related links online:
http://cme.kff.org/Key=1516.Ccj.D.D.KStrzX

  The Grand Seminaire de Montreal, a Catholic seminary, this fall
will begin requiring all men who apply to study to become
priests to take an HIV test, the Montreal Gazette reports. The
Rev. Marcel Demers said that a positive HIV test will "sound an
alarm bell" that an applicant could be a man who has sex with
men, according to the Gazette. HIV-positive applicants will be
asked how they were infected, and if they say that they were
infected by having sex with a man, the seminary "will try to see
what really is the person's calling," Demers said. Demers added
that MSM would not be "automatically refused" admittance to the
seminary, but he said that their chances for acceptance would be
"slim," according to the Gazette. "It's not that Jesus wanted
homophobia," Demers said, adding, "But we also realize that this
profile doesn't lend itself as well to what we require of a
priest." Demers added that the church believes MSM "have a
harder time" remaining celibate than men who do not.

Violation of Human Rights?

Robert Rousseau, executive director of the AIDS advocacy group
Action Sero-Zero, said that the seminary's requirement that
applicants take an HIV test could violate the Quebec Charter of
Rights and Freedoms, according to the Gazette. "They'd do well
to first update their knowledge of sexual orientation," Rousseau
said (Parkes, Montreal Gazette, 1/10). Ginette L'Heureux, a
spokesperson for the Quebec Human Rights Commission, said that
the church could be exempt from the charter because the charter
makes some exception for religious and charitable organizations
(Canadian Press, 1/10). Seminaries in Vancouver and Edmonton
also require HIV tests for applicants and U.S. seminaries have
required HIV testing for more than 10 years, according to the
Gazette. Bill Ryan, a spokesperson for the United States
Conference of Catholic Bishops, said that he is "virtually
certain" that all U.S. dioceses require an HIV test. St.
Augustine's Seminary of Toronto, Canada's largest seminary, does
not require applicants to take an HIV test, the Gazette reports
(Montreal Gazette, 1/10).

Zimbabwe Pentecostal Churches Require HIV Test for Pastors

In related news, the Pentecostal Assemblies of Zimbabwe, a group
of 150 Zimbabwean churches, on Jan. 1 began requiring HIV tests
for all of its pastors, marriage officers and couples seeking
marriage, Religion News/Charlotte Observer reports. Clergy who
test HIV-positive "presumably" would be allowed to continue
working, and all who are tested will receive certification,
according to Religion News/Observer. Marriage officers who do
not have certificates will not be allowed to conduct weddings.
"Although this might sound rather controversial, discriminatory
and infringing on individuals' rights, we felt that the only way
we could effectively fight this pandemic was through adoption of
more pragmatic and practical measures," Bishop Trevor Managa
said. He added, "Church leaders who daily preach to and counsel
church members on various issues, including HIV/AIDS, have to
set the pace and lead by example and avoid the notion of 'do as
I say, and not as I do.'" Other African church leaders have
"voiced support" for the testing, according to Religion
News/Observer. Rev. Mvume Dandala said, "I think it is important
for [HIV-positive people] to come out into the open and for us
all as a church to learn how to handle one another in a
responsible way" said (Religion News/Charlotte Observer, 1/10).

3. Number of Mother-to-Child HIV Transmission Cases Increasing
in Thailand, Data Show

Access this story and related links online:
http://cme.kff.org/Key=1516.Ccj.F.D.KXYbvG

  The number of cases of mother-to-child HIV transmission in
Thailand has increased to 60,000, according to data released on
Thursday, Xinhua News Agency reports. The data, collected by the
Department of Non-Formal Education and presented by Mahidol
University's Faculty of Medicine Deputy Professor Sunee
Lakampan, also show that there are 100,000 AIDS orphans in the
country (Xinhua News Agency, 1/8). Sunee estimated that there
could be approximately 200,000 HIV-positive children in the
country by 2005, an increase of between 5,000 to 8,000 cases per
year, according to the Thai News Service (Thai News Service,
1/9). Sunee said that the "current situation of poverty, disease
and lack of opportunity" for children in the country is a
"vicious cycle," according to Xinhua News Agency (Xinhua News
Agency, 1/8).

MEDIA & SOCIETY

4. HIV/AIDS Ad To Air Before Super Bowl, Launches Second Year of
Kaiser Family Foundation, Viacom Awareness Campaign

Access this story and related links online:
http://cme.kff.org/Key=1516.Ccj.G.D.KZHsVl

  The Kaiser Family Foundation and Viacom on Feb. 1 during the
pre-game show of the Super Bowl are set to air an HIV/AIDS
public service announcement, USA Today reports. The ad will kick
off the second year of the "KNOW HIV/AIDS" awareness campaign,
which Viacom and Kaiser launched in January 2003 (Kornblum, USA
Today, 1/12). The campaign is aimed at raising HIV/AIDS
awareness through PSAs, television and radio programming and
free print and online content. The campaign, which includes
media placements valued at more than $130 million in 2004, is
targeted at both the general population and groups hardest hit
by HIV/AIDS, such as people under age 25, minorities, women and
men who have sex with men. In 2003, the initiative created 49
television, radio and outdoor ads. The 2004 campaign will
include 40 targeted ads -- including some of the 49 ads created
for last year's campaign -- that will run across Viacom's
broadcast networks CBS and UPN; cable networks MTV, BET, VH1,
CMT: Country Music Television, TV Land, Nickelodeon, Nick at
Nite, Showtime, Spike TV and Comedy Central; 185 Infinity
Broadcasting radio stations; and billboards, buses and bus
shelter advertising. In addition, MTV, MTV International,
Nickelodeon, BET, VH1, Showtime, Sundance Channel and Infinity
Broadcasting are planning to air special HIV/AIDS-related
programming throughout the year (Viacom/Kaiser Family Foundation
release, 1/12). The pre-Super Bowl ad shows young people coming
out of a trash bin with a voice saying that 20 million young
people are expected to contract HIV, but "it doesn't have to be
like that. HIV is preventable." The ad directs viewers to
knowhivaids.org, the campaign's Web site, which has had 6.5
million visitors in the past year, and to 866-344-5669, a
toll-free hotline, which 336,000 people called last year to ask
questions about HIV/AIDS (USA Today, 1/12). A Kaiser Family
Foundation survey found that 44% of adults in the United States
either recognized the "KNOW HIV/AIDS" brand or had seen at least
one of the campaign's ads (Viacom/Kaiser Family Foundation
release, 1/12).

5. Los Angeles Times Examines 'Phenomenon' of Men Who Want To Be
HIV-Positive, Documentary Film 'The Gift'

Access this story and related links online:
http://cme.kff.org/Key=1516.Ccj.H.D.KbNG8k

  The Los Angeles Times on Sunday examined the "phenomenon" of
"bug chasing" -- when HIV-negative men seek out HIV infection --
and "The Gift," a documentary film by Los Angeles-based
filmmaker Louise Hogarth that derives its title from the term
"gift givers," or HIV-positive men who purposefully try to
transmit HIV to willing partners. Since the film premiered at
the Berlin Film Festival in February 2003, "audiences have
viewed 'The Gift' with a mixture of horror and fascination,"
according to the Times. Although the movie is being released "at
a time when AIDS in the U.S. has receded from public attention,"
some critics say that the film's view is too limited and that it
could create "a new wave of homophobia," similar to the
discrimination gays faced in the early 1980s when AIDS first
emerged, according to the Times. However, Hogarth said, "My
documentary is about the large numbers of people who don't care
if they get infected with HIV. ... The infection rate is
exploding, just exploding." The film is scheduled to be shown on
the Sundance Channel on Feb. 2 (Welkos, Los Angeles Times,
1/11).

IN THE COURTS

6. New York Times Examines Ongoing Case of Health Care Workers
Accused of Intentionally Infecting Libyan Children With HIV

Access this story and related links online:
http://cme.kff.org/Key=1516.Ccj.J.D.KlRdk7

  The New York Times on Sunday examined the ongoing trial of one
Palestinian and six Bulgarian health care workers who are
accused of intentionally infecting hundreds of children with
HIV. More than 400 children in Libya contracted HIV in 1997 and
1998 in what some Libyan groups say was a conspiracy to
experiment with HIV on children, the Times reports. However,
some European governments and human rights groups say that the
Libyan Health Ministry "failed to screen blood products
adequately and allowed poor sterilization practices by the staff
of Al Fateh Children's Hospital," where the children were
infected (Tyler, New York Times, 1/11). The seven health care
workers, including two physicians and five nurses, have been
detained in Libya since early 1999 on charges that they
deliberately infected children with HIV through contaminated
blood products. A civil prosecutor in September 2003 requested
about $10 million in compensation for the families of each
HIV-positive child (Kaiser Daily HIV/AIDS Report, 9/10/03). The
trial was suspended in December 2003 to await a judgment by a
group of Libyan doctors. Libyan leader Moammar Kadafi has
promised Western diplomats that he will intervene, but his
decision will have political implications, the Times reports. If
he accepts the European opinion that the epidemic was caused by
Libya's health system, he will win the support of Europe but
will be forced to accept blame at home, a move that could cost
more than $4 billion if Libya provides the requested
compensation, according to the Times (New York Times, 1/11).

OPINION

7. Food Is 'First Line of Defense' Against HIV/AIDS in
Developing Countries, Opinion Piece Says

Access this story and related links online:
http://cme.kff.org/Key=1516.Ccj.K.D.KhYjf6

  Food is the "first line of defense" against HIV/AIDS in
resource-poor settings, and it is "imperative" for developed
nations to "at least ensure" that people in developing countries
receive sufficient food, James Morris, executive director of the
World Food Programme, writes in a Washington Times opinion
piece. Because there "simply isn't enough financial aid
available right now" to provide antiretroviral drugs for all of
the people living with HIV/AIDS in developing countries, it is
important to find other ways to keep HIV-positive people "alive
and productive," Morris says. "As a first minimum step," the
international community must ensure that HIV-positive people
receive basic nutrition, which will enable them "to survive and
care for their families as long as possible," Morris says. In
addition, improved nutrition can prevent mother-to-child HIV
transmission as well as reduce the "likelihood that [people]
will resort to high-risk survival strategies -- such as
exchanging sex for food or cash," Morris writes. The
"cataclysmic confluence" of hunger and AIDS can only be overcome
by starting with the "basics," Morris says, adding that the
international community "cannot allow the shortage or absence of
drugs to become a reason for doing nothing" (Morris, Washington
Times, 1/12).

8. United States Should Not Deport HIV-Positive Immigrants,
Opinion Piece Says

Access this story and related links online:
http://cme.kff.org/Key=1516.Ccj.L.D.K7qmdf

  The United States should reverse its policy of deporting
HIV-positive immigrants and should allow HIV-positive
individuals to visit the country, columnist Jonathan Rauch
writes in his National Journal column. The policy of barring
HIV-positive immigrants was initiated by the Public Health
Service in 1987, "when fear of AIDS was at its peak" and
HIV/AIDS was "effectively untreatable," Rauch notes. As
treatment for HIV/AIDS became available, public health officials
began to think that the policy -- which Congress wrote into law
in 1993 -- "merely drove the disease underground" and was
"ineffective, if not counterproductive," according to Rauch.
Immigrants are not required to take an HIV test for entry into
the United States but are required to be tested when applying
for a "green card," or permanent resident status, he says.
Immigrants who test HIV-positive are deported "whether or not
they are sick" and even if they became infected in the United
States, making the policy "about kicking people out, not keeping
them out," according to Rauch. Congress bars immigrants "deemed
likely to become a 'public charge'" regardless of their disease;
however, HIV-positive individuals are the only people who are
deported even if they can demonstrate that they can "keep
themselves off the welfare rolls," Rauch says. Barring all
HIV-positive immigrants is "discrimination, pure and simple,"
and "singling out" HIV-positive immigrants for deportation will
only create stigma against people living with the disease, Rauch
says. The international committee of the Presidential Advisory
Council on HIV and AIDS favors lifting the ban and will seek
full council approval for opposing the policy in March,
according to Rauch. If the commission votes to endorse lifting
the measure, Bush will then have to decide whether to "take the
case to Congress, where being seen as soft on AIDS is never
popular," Rauch concludes (Rauch, National Journal, 1/10).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: http://www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. (c) 2004 Advisory Board Company and Kaiser Family
Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at
http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or
unsubscribe.
Questions about your email subscription? Contact us at
subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family
Foundation. For access to the Foundation's policy research,
analyses, reports and fact sheets, and media partnerships, visit
the Foundation's main website at http://www.kff.org .

-Message-Id: <20040112073754.BFC7.4405-1516@...>

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


Friday, January 9, 2004

GLOBAL CHALLENGES
========================================
1. African AIDS Epidemic May Have Been Overestimated, Kenyan
Government Report Says

2. Mumbai, India, Police Dept. Mandates HIV Testing, Creates
AIDS Awareness Program After 450 Officers Test HIV-Positive

3. Researchers Recommend 'Safer Breastfeeding' To Minimize
Vertical HIV Transmission

4. Kenyan Orphanage, Government Reach Agreement Over Admittance
of HIV-Positive Orphans to Primary Schools

PUBLIC HEALTH & EDUCATION
========================================
5. New York City Schools' AIDS Education Not in Compliance With
Statewide Mandate, Report Says

6. Riverside County, Calif., Board of Supervisors Approves
Health Dept. Funding for Programs To Combat Syphilis Epidemic

7. San Antonio Express-News Profiles AIDS Outreach Group
Targeting Latinas, Families

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

GLOBAL CHALLENGES

1. African AIDS Epidemic May Have Been Overestimated, Kenyan
Government Report Says

Access this story and related links online:
http://cme.kff.org/Key=1492.Ccp.C.D.QjX2h

  Africa's HIV/AIDS epidemic may be "grossly overestimated,"
according to preliminary findings of the Kenya Demographic and
Health Survey, the Daily Telegraph/National Post reports. The
findings could lead the United Nations and other groups to
"rethink the way it measures AIDS in Africa," according to the
Telegraph/Post. Researchers administering the Kenyan survey,
which is funded by the CDC, interviewed 8,561 Kenyan men and
women to collect health information, 70% of whom also agreed to
have blood samples taken for HIV testing. Researchers found that
6.7% of Kenyans are HIV-positive, compared with a previous
estimate of 9.4% by the country's Ministry of Health
(Blomfield/LaGuardia, Daily Telegraph/National Post, 1/9). Among
study participants, 8.7% of women were HIV-positive, compared
with 4.5% of men, BBC News reports. In addition, HIV prevalence
rates ranged from 1% in Kenya's North Eastern province to 14% in
Nyanza province (BBC News, 1/9). Also, only 13% of women and 14%
of men in the country are estimated to know their HIV status,
the Telegraph/Post reports (Daily Telegraph/National Post, 1/9).

Further Results, Other Studies

Kenneth Chebet, director of Kenya's National AIDS and Sexually
Transmitted Diseases Programme, said that the findings indicate
that the number HIV-positive people in Kenya has declined 40%
over the last four years. Chebet attributed such a decline to
AIDS awareness campaigns and deaths from AIDS-related
complications (Agence France-Presse, 1/8). Dr. Kevin DeCock, the
CDC's Kenya director, said, "The number of HIV-infected people
in Kenya ... is lower than previously estimated" (Daily
Telegraph/National Post, 1/9). He added, "This is based on ...
better, more accurate measurements" (Xinhua News Agency, 1/9).
Previous surveys conducted in Mali, Zambia and South Africa have
also "hinted" that the HIV/AIDS epidemic in Africa may not be as
widespread as previously believed, according to the
Telegraph/Post (Daily Telegraph/National Post, 1/9). Other
countries, including Cameroon and Tanzania, which have estimated
HIV prevalence rates of 12% and 8%, respectively, are planning
to conduct population-based surveys to determine their "true"
HIV prevalence, BBC News reports (BBC News, 1/9).

Different Methods

The United Nations and the World Health Organization base their
estimates of HIV and AIDS prevalence in Africa on anonymous
screening of pregnant women in clinics, the results of which are
extrapolated to an area's entire population, the Telegraph/Post
reports. The results therefore do not include "all known cases
of HIV" because they rely primarily on blood tests from prenatal
clinics, according to the Telegraph/Post. According to UNAIDS,
studies have indicated HIV prevalence among pregnant women is
the "best approximation of prevalence in the adult population,"
the Telegraph/Post reports. However, some experts say that
estimates based on HIV prevalence among pregnant women are
"inherently flawed" because the women tested are all sexually
active and have likely not used condoms. In addition, most of
the data are taken from urban clinics where HIV rates are higher
than in rural areas, according to the Telegraph/Post. But the
United Nations says that studies similar to the Kenyan survey
risk underestimating HIV prevalence because many participants
are reluctant to answer questions or are absent. In the Kenya
study, 30% of eligible participants refused to give blood
samples for HIV testing, the Telegraph/Post reports. Although
the most recent UNAIDS report found lower overall HIV/AIDS
prevalence estimates than the previous year, the report stated
that "the number of people living with HIV/AIDS continues to
increase in several regions, most markedly in sub-Saharan
Africa, with southern Africa registering the highest
prevalence." The preliminary results of the Kenyan study
estimate that there are 22 million people living with HIV/AIDS
in Africa, and a more detailed report scheduled for release in
May is expected to support those findings, according to the
Telegraph/Post (Daily Telegraph/National Post, 1/9).

2. Mumbai, India, Police Dept. Mandates HIV Testing, Creates
AIDS Awareness Program After 450 Officers Test HIV-Positive

Access this story and related links online:
http://cme.kff.org/Key=1492.Ccp.D.D.CmQ8W

  The Mumbai, India, police department has decided to make it
mandatory for all of its 38,000 constables, officers and
inspectors to undergo HIV testing every six months after
discovering that hundreds of the city's police officers are
HIV-positive, the Times of India reports (Times of India, 1/8).
About 450 male police officers have tested HIV-positive,
according to Prem Kishan Jain, joint police commissioner for
administration. However, the number is preliminary, and medical
data have not yet been compiled for much of the police force.
Jain said that the department is also attempting to determine
how the police had been infected, adding that most of the men
who tested HIV-positive were low-level constables who are not
well-educated. It is well-known that some Mumbai police officers
are customers of the city's sex workers, according to Agence
France-Presse (Agence France-Presse, 1/7). The police department
plans to build a database of the HIV status of its employees and
implement an AIDS awareness program at the 83 police stations
and 12 crime branch units in the city. More than 800 police
officers have been trained to participate in the program. In
addition, the Mumbai District AIDS Control Society plans to
conduct a sample survey to determine the HIV/AIDS incidence
among police personnel and to set up a voluntary testing and
counseling center at the Nagpada police hospital (Times of
India, 1/9). India has at least 4.58 million HIV-positive
people, and a study released last year warned that the problem
could grow if the government did not act to prevent the spread
of the disease (Agence France-Presse, 1/7).

3. Researchers Recommend 'Safer Breastfeeding' To Minimize
Vertical HIV Transmission

Access this story and related links online:
http://cme.kff.org/Key=1492.Ccp.F.D.K3XFb

  Several researchers have suggested that HIV-positive mothers in
Africa should practice "safer breastfeeding" to minimize the
risk of transmitting HIV while passing on the benefits of
breastfeeding to their infants, the Toronto Globe and Mail
reports. Breastfeeding passes antibodies on to infants,
contributes to cognitive development and is safer than using
formula, which is expensive and must be mixed with water, which
could be contaminated in some parts of Africa. However, 50% of
HIV-positive children in sub-Saharan Africa were infected
through the breastmilk of their HIV-positive mothers, according
to the Globe and Mail. After assessing the relative risks of HIV
transmission through breastfeeding and contracting a disease
through contaminated water, researchers have suggested that
women practice "exclusive breastfeeding and abrupt weaning," in
which an infant is given nothing but breastmilk for the first
six months and then is abruptly cut off, the Globe and Mail
reports. Researchers are unsure why this reduces the risk of HIV
transmission but speculate that water, small amounts of porridge
and cooking oil that are often given to infants irritate the
lining of the intestines, increasing the chances that an
infant's body will absorb HIV from breastmilk.

Support Needed

Women must receive support from counselors and the community to
effectively practice safer breastfeeding because women can end
up with breast diseases like mastitis and infants can become
frustrated, leading to malnourishment, according to Katherin
Semrau, project coordinator for the Zambia Exclusive
Breastfeeding Study. In addition, women must be taught proper
breastfeeding techniques to reduce the risk of cracked nipples
and other problems that may increase the chances of HIV
transmission, the Globe and Mail reports. Hoosen Coovadia, a
professor of HIV/AIDS at the Nelson Mandela School of Medicine
at the University of KwaZulu-Natal, found that women who adhere
to the recommendations and receive proper support may have as
low as a 6% chance of passing HIV on to their infants. "You
can't just say, 'Don't breastfeed.' That's a death sentence for
many babies. Fine, they won't get HIV, but they will die of
diarrhea," Jean Humphrey, head of Zvitambo, a research project
on HIV and breastfeeding in Zimbabwe, said, adding, "Safer
breastfeeding is now the only real choice" (Nolen, Toronto Globe
and Mail, 1/6).

4. Kenyan Orphanage, Government Reach Agreement Over Admittance
of HIV-Positive Orphans to Primary Schools

Access this story and related links online:
http://cme.kff.org/Key=1492.Ccp.G.D.Hlrh7

  A Kenyan orphanage for HIV-positive children on Thursday
announced that it had reached a deal with the government and
local authorities to ensure that the orphans could attend local
primary schools, Reuters AlertNet reports (Reuters AlertNet,
1/8). Rev. Angelo D'Agostino, founder of the Nyumbani Home --
the oldest and largest AIDS orphanage in the country -- said
that five Nairobi-area primary schools previously had refused to
admit children from the orphanage despite a law providing for
free primary education for all Kenyan children. D'Agostino said
that the schools have made excuses for not admitting the
children, often claiming that they are too full and do not have
room for them. Nyumbani on Wednesday sought a court order
against the Ministry of Education, Science and Technology and
the attorney general's office to force state schools to admit
HIV-positive children, Nyumbani attorney Ababu Namwamba said. A
Kenyan judge on Wednesday ordered the Kenyan government and
Nyumbani to develop an agreement within one day that would
enable the children to be admitted to local schools (Kaiser
Daily HIV/AIDS Report, 1/8). "It is a consensus agreed on
between the government, the directorate of [Nairobi] education
and ourselves as the applicants," Namwamba said. He added that
details of the agreement would be released on Friday, according
to Reuters AlertNet. Ministry of Education officials were not
available for comment (Reuters AlertNet, 1/8).

PUBLIC HEALTH & EDUCATION

5. New York City Schools' AIDS Education Not in Compliance With
Statewide Mandate, Report Says

Access this story and related links online:
http://cme.kff.org/Key=1492.Ccp.H.D.1dsCR

  New York City schools have violated state mandates on HIV/AIDS
education, according to a report released on Wednesday by the
New York AIDS Coalition, the AP/Long Island Newsday reports. The
report, titled "A Call for Reform: Strengthening HIV/AIDS
Education in New York City's Public Schools," found that the
schools have failed to meet guidelines requiring students in
grades six through 12 to receive six HIV/AIDS lessons per year
and guidelines requiring students in kindergarten through grade
five to receive five AIDS-related lessons per year. In addition,
the report said that health resource sites in city high schools
and AIDS education seminars for parents are not in full
compliance with state rules. The report recommends that the
school system update its HIV/AIDS lessons, employ well-trained
personnel to teach the lessons and improve oversight and
evaluation procedures to better ensure compliance, according to
the AP/Newsday. "Examining the stipulations of the mandate one
by one reveals that the school system is not in full
compliance," the report said, adding, "These grave inadequacies
exist in the face of increasing HIV infections among youth."
Department of Education spokesperson Eileen Murphy said that
"teaching New York City students about HIV/AIDS and its
prevention is critical. ... We are working continually to
improve and update our HIV curriculum to make it as current and
user-friendly as possible" (Gray, AP/Long Island Newsday, 1/8).

6. Riverside County, Calif., Board of Supervisors Approves
Health Dept. Funding for Programs To Combat Syphilis Epidemic

Access this story and related links online:
http://cme.kff.org/Key=1492.Ccp.J.D.2lydq

  The Riverside County, Calif., Board of Supervisors on Tuesday
approved a measure that would allocate $103,000 from the state
Department of Health Services for syphilis outreach and
education to help fight the county's burgeoning epidemic, the
Riverside Press-Enterprise reports (Riverside Press-Enterprise,
1/7). In the county, 75 new syphilis cases were reported in the
first nine months of 2003, compared with 17 new cases during the
same period in 2001. In addition, the total number of reported
early syphilis cases is expected to reach 92 for all of 2003,
Dr. Gary Feldman, Riverside County health director, said,
according to the Press-Enterprise. He added, "That really
represents an epidemic" (Coronado, Riverside Press-Enterprise,
1/6). Of the $103,00 in funding, approximately $75,000 would go
to the Desert AIDS Project for community outreach and education
programs, including establishing a syphilis elimination task
force, the Press-Enterprise reports (Riverside Press-Enterprise,
1/7). The task force will focus on a community-wide media
campaign and preventive outreach measures to encourage condom
use (Riverside Press-Enterprise, 1/6). The remaining $28,000
would go to laboratory equipment, supplies and testing,
according to the Press-Enterprise (Riverside Press-Enterprise,
1/7).

7. San Antonio Express-News Profiles AIDS Outreach Group
Targeting Latinas, Families

Access this story and related links online:
http://cme.kff.org/Key=1492.Ccp.K.D.5cHvr

  The San Antonio Express-News on Wednesday profiled Mujeres
Unidas Contra el SIDA -- or Women United Against AIDS -- a
not-for-profit group founded in 1994 to target Latinas who are
HIV-positive or are otherwise affected by HIV/AIDS. Mujeres
Unidas offers support groups for women and their families,
programs for children and information about HIV prevention and
about staying healthy after contracting the disease. In 2002,
the group started the Madrinas -- or Godmothers -- program in
which newly diagnosed HIV-positive women are teamed up with
other women who are either HIV-positive or have family members
who are HIV-positive. The women are required to contact one
another twice a month, but many of the women are in more
frequent contact, according to the Express-News. "It's sort of
like your buddy system," Yolanda Rodriguez-Escobar, executive
director of the program, said. The group, which has
not-for-profit status, operates primarily on grassroots
fundraising, in addition to a three-year $50,000 grant from
Pfizer and a one-year, $40,000 grant from the Levi Strauss
Foundation (Davila, San Antonio Express-News, 1/7).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: http://www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. (c) 2004 Advisory Board Company and Kaiser Family
Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at
http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or
unsubscribe.
Questions about your email subscription? Contact us at
subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family
Foundation. For access to the Foundation's policy research,
analyses, reports and fact sheets, and media partnerships, visit
the Foundation's main website at http://www.kff.org .

-Message-Id: <20040109074423.BF9F.4410-1492@...>

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


Thursday, January 8, 2004

POLITICS AND POLICY
========================================
1. Nebraska Senate Bill Would Make Knowingly Exposing Sexual
Partner To HIV Felony Assault

ACROSS THE NATION
========================================
2. Debate Over MSM Sexual Behavior, HIV Exposes 'Cultural
Divide' Among Seattle-Area Gay Men

3. Minnesota Syphilis Rate Continues To Increase; State Health
Department Calls for More Screening, Testing

SCIENCE & MEDICINE
========================================
4. Synthetic Sea Snail Venom Eases Pain in AIDS, Cancer
Patients, Study Says

GLOBAL CHALLENGES
========================================
5. Kenyan Orphanage Seeks Court Order To Force Schools To Admit
HIV-Positive Children

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

POLITICS AND POLICY

1. Nebraska Senate Bill Would Make Knowingly Exposing Sexual
Partner To HIV Felony Assault

Access this story and related links online:
http://cme.kff.org/Key=1453.Ccw.C.D.LQwNms

  HIV-positive people who knowingly engage in sexual activities
without revealing their HIV status to their partners could be
charged with felony assault under a bill (LB 872) introduced on
Wednesday by Nebraska state Sen. Lowen Kruse, the Omaha
World-Herald reports (Stoddard/Reed, Omaha World-Herald, 1/7).
The bill would also make it a crime for an HIV-positive person
to donate blood, sperm, organs or other tissue "except as deemed
necessary for medical or scientific research." In addition, the
measure would allow for the prosecution of HIV-positive people
for knowingly sharing needles with another person without
informing them of their HIV status. People who violate the
conditions in the bill could be charged with a felony punishable
by 20 years in prison and a $25,000 fine, according to the
Associated Press. Kruse said that he worked with the advocacy
group Lambda Legal Defense and Education Fund to ensure that the
bill did not target men who have sex with men or women who have
sex with women, adding, "We do not want to hammer anybody --
it's not related to a particular population." More than half of
all states have laws relating to HIV exposure or transmission,
according to the National Conference of State Legislatures. In
addition, at least 20 states have specific laws against
intentionally infecting a sexual partner with HIV, the
Associated Press reports (O'Hanlon, Associated Press, 1/8).

ACROSS THE NATION

2. Debate Over MSM Sexual Behavior, HIV Exposes 'Cultural
Divide' Among Seattle-Area Gay Men

Access this story and related links online:
http://cme.kff.org/Key=1453.Ccw.D.D.L2jpzr

  Debate over the expectations that men who have sex with men
have about sexual behavior and the spread of HIV in King County,
Wash., has "expos[ed] a cultural divide" among MSM in the area,
the Seattle Times reports. The number of newly reported HIV
cases among MSM in the county increased 35% from 2001 to 2002
and could have risen an additional 16% in 2003, according to the
Times. Some MSM say that it is unfair to condemn men who engage
in risky sexual activity without considering the causes of such
behavior, while other MSM say that making excuses for such
behavior is fueling the spread of HIV, according to the Times
(Eskenazi, Seattle Times, 1/6). A manifesto issued in October
2003 by public health workers and gay community leaders said
that MSM need to take more responsibility and make greater
efforts to stop the spread of HIV. The document, titled "A
Community Manifesto: A New Response to HIV and STDs," calls on
MSM to be accountable to themselves, their sex partners and
their community, calling unprotected sex outside of a monogamous
relationship unacceptable (Kaiser Daily HIV/AIDS Report,
10/9/03). However, some MSM, as well as the Gay City Health
Project, one of Seattle's largest gay health organizations, said
that the manifesto makes moral judgments about sex between MSM,
according to the Times. Gay City says that it is more important
to nurture men's self-esteem, which will inspire them to make
healthier choices.

Funding and Bathhouse Event

However, Gay City could be "paying the price" for its
philosophy, the Times reports. The group this year lost its bid
for public HIV prevention funding for the first time in nine
years. In addition, Gay City -- after being pressured by County
Executive Ron Sims -- canceled its annual workshop on HIV
prevention, which was to be held in a bathhouse, where some men
have anonymous sex with other men, sometimes without a condom.
Dr. Alonzo Plough, director of public health for Seattle and
King Counties, said that the event "implicitly normalized"
anonymous and unprotected sex, according to the Times. "Part of
nurturing self-esteem is saying, 'Hey, being gay is great,'"
Fred Swanson, executive director of Gay City, said, adding, "We
don't plan events worrying about whether they are acceptable
dinner conversation for a 64-year-old straight man in Bellevue."
Dan Savage, a nationally syndicated sex columnist who helped
found Gay City before becoming critical of the organization,
said, "There are some lost gay men out there who want and need
guidelines on what is expected of them, so they go searching and
are told, 'Everything goes, and the more reckless you are, the
gayer you are.' ... Gay men today don't need AIDS organizations
saying, 'Go for it!'" (Seattle Times, 1/6).

3. Minnesota Syphilis Rate Continues To Increase; State Health
Department Calls for More Screening, Testing

Access this story and related links online:
http://cme.kff.org/Key=1453.Ccw.F.D.LTjknX

  Minnesota Department of Health officials on Tuesday called for
an increase in efforts to screen and test people for the
sexually transmitted disease syphilis, after a preliminary
review of the state's 2003 health statistics showed that the
state's syphilis rate is increasing at a "steady and alarming"
rate, the St. Paul Pioneer Press reports. According to the
preliminary data, 74 cases of early syphilis infections were
reported in the first nine months of 2003, compared with 60 new
cases during the same period in 2002. Of the 74 new syphilis
cases in 2003, 69 -- or 93% -- occurred in men and 54 were among
men who have sex with men. The statistics also indicate that the
majority of new syphilis cases in 2002 and 2003 occurred in the
Minneapolis/St. Paul metropolitan region. A recent CDC report
found that Minneapolis had the 12th highest syphilis rate among
major U.S. cities in 2002, up from 30th in 2000, according to
the Pioneer Press. State epidemiologist Dr. Harry Hull said that
one of the concerns about the rise in the number of new syphilis
cases is the increased risk of HIV transmission, adding, "Part
of the problem that we are seeing here is that, with all the
effective treatments we now have, HIV doesn't seem as
threatening as it once was" (Majeski, St. Paul Pioneer Press,
1/7).

Two-Pronged Approach

Department officials said that the state needs to "take two
steps" to fight the syphilis outbreak: encourage health
providers to increase syphilis screenings and encourage more
people to seek testing if they have had unprotected sex,
including oral sex, the AP/Minneapolis Star Tribune reports
(AP/Minneapolis Star Tribune, 1/6). Hull said, "Doctors need to
be taking sexual histories of their patients and testing those
who are involved in high-risk sexual practices. The hallmark of
the disease is a lesion on your genitals. But it's painless, so
if you don't look, you won't see it and you'll spread the
disease to others." Hull added, "We are continuing to see new
cases of syphilis, and that's extremely worrisome. It's a
totally preventable disease. If you practice safe sex, you
shouldn't get it. If you do, it can be treated and you shouldn't
be spreading it to anyone else. Some people are not taking the
safe sex warning seriously" (St. Paul Pioneer Press, 1/7).

SCIENCE & MEDICINE

4. Synthetic Sea Snail Venom Eases Pain in AIDS, Cancer
Patients, Study Says

Access this story and related links online:
http://cme.kff.org/Key=1453.Ccw.G.D.LYjm5n

  Ziconotide, a synthetic form of sea snail venom manufactured by
Elan Pharmaceuticals, can ease pain in patients with AIDS or
cancer for whom other painkillers, such as morphine, have not
been beneficial, according to a study published in the Jan. 7
issue of the Journal of the American Medical Association, the
AP/Florida Times-Union reports (Tanner, AP/Florida Times-Union,
1/6). Dr. Peter Staats of the Division of Pain Medicine at Johns
Hopkins University School of Medicine and colleagues gave either
ziconotide or a placebo to 111 patients ages 24 to 85 who had
cancer or AIDS and a mean Visual Analog Scale of Pain Intensity
(VASPI) score of 50 mm or greater (Staats et al., Journal of the
American Medical Association, 1/7). The medication was
administered for 10 days through a small, battery-operated pump
implanted in the patients' abdomens that delivered continuous
doses of the medication into the fluid surrounding the spinal
cord.

Results

Approximately 53% of patients receiving ziconotide experienced
moderate to complete pain relief, compared with 18% of patients
randomized to the placebo group (AP/Florida Times-Union, 1/6).
In addition, some patients in the ziconotide group were able to
reduce their use of other pain medications while receiving the
medication, while some patients in the placebo group had to
increase their use of other painkillers (Rauscher, Reuters
Health, 1/6). Although 22 ziconotide patients, compared with
four in the placebo group, experienced serious side effects,
study author Dr. David Ellis, medical director at Elan, said
that subsequent research showed that starting patients on lower
doses of ziconotide reduces their risk of serious side effects
(AP/Florida Times-Union, 1/6). The FDA is currently reviewing
ziconotide, which is being developed by California-based Neurex,
according to Reuters Health (Reuters Health, 1/6). The study was
co-funded by Elan and Medtronic, the company that manufactures
the pumps that delivers the medication (AP/Florida Times-Union,
1/6).

GLOBAL CHALLENGES

5. Kenyan Orphanage Seeks Court Order To Force Schools To Admit
HIV-Positive Children

Access this story and related links online:
http://cme.kff.org/Key=1453.Ccw.H.D.LFRwXh

  A Kenyan judge on Wednesday ordered the Kenyan government and
Nyumbani Home -- the oldest and largest AIDS orphanage in the
country -- to develop an agreement that would allow HIV-positive
children from the orphanage to be admitted to area primary
schools, the AP/Yahoo! News reports (Tomlinson, AP/Yahoo! News,
1/7). Nyumbani on Wednesday sought a court order against the
Ministry of Education, Science and Technology and the attorney
general's office to force state schools to admit HIV-positive
children, Nyumbani attorney Ababu Namwamba said (England,
Associated Press, 1/6). In addition to allowing the children
admittance to the schools, the lawsuit seeks an official
government declaration that it is discriminatory for schools to
refuse to admit a child on the basis of HIV status (Reuters,
1/7). Rev. Angelo D'Agostino, founder of the orphanage, said
that five Nairobi-area primary schools have refused to admit
children from the orphanage despite a law providing for free
primary education for all Kenyan children. Karega Mutahi, a
senior education ministry official, said that the law allows for
"equitable and nondiscriminatory access to education" for all
children, including those who are HIV-positive. D'Agostino said
that the schools have made excuses for not admitting the
children, often claiming that they are too full and do not have
room for them. D'Agostino said he does not blame the government
for the problem but rather the teachers and parents of children
attending the schools, adding, "What we are hoping to do is
educate the public that the government is against this
discrimination, too. There's a lot of ignorance" (Associated
Press, 1/6).

Meeting Planned for Thursday

Namwamba, the Ministry of Education, the Nairobi City
Directorate of Education and the Attorney General's office were
scheduled to meet on Thursday to try to resolve the matter,
according to the AP/Long Island Newsday. According to Namwamba,
the court has given the parties one day to work out a deal. "Our
demand is simple: we want these children to be in class,"
Namwamba said, adding, "If we don't get this, we'll be back in
court on Friday" (Tomlinson, AP/Long Island Newsday, 1/7).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: http://www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for
kaisernetwork.org, a free service of The Henry J. Kaiser Family
Foundation. (c) 2004 Advisory Board Company and Kaiser Family
Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at
http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or
unsubscribe.
Questions about your email subscription? Contact us at
subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family
Foundation. For access to the Foundation's policy research,
analyses, reports and fact sheets, and media partnerships, visit
the Foundation's main website at http://www.kff.org .

-Message-Id: <20040108074233.BFBA.4416-1453@...>

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



Wednesday, January 7, 2004

POLITICS AND POLICY
========================================
1. Bush To Request $2.7B For FY 2005 AIDS Spending, Sources Say


ACROSS THE NATION
========================================
2. Florida Senate Committee Approves Bill That Would Require
HIV Testing for Almost All Newborns

3. Florida Public Health Goals for AIDS Prevention Not Met,
Audit Says


SCIENCE & MEDICINE
========================================
4. Roche, Trimeris Halt Clinical Trials of New Fusion Inhibitor
T-1249

5. FDA Approves Antiretroviral Drug Combination of Roche's
Invirase, Abbott's Norvir

6. Presence of Steady Partner May Slow HIV Progression, Delay
Death, Study Says


GLOBAL CHALLENGES
========================================
7. Atlanta Journal-Constitution Examines 'Unlikely Alliance'
of Traditional Healers, Modern Doctors in Fight Against HIV/AIDS
in Africa


OPINION
========================================
8. Japan's Increased Global Fund Contribution Boosts U.S. Funding,
Editorial Says

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


POLITICS AND POLICY


1. Bush To Request $2.7B For FY 2005 AIDS Spending, Sources Say

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21545

  President Bush plans to request $2.7 billion for HIV/AIDS spending
for fiscal year 2005, sources involved in the budget process said
on Tuesday, Reuters reports.  White House sources declined to comment
on the AIDS funding levels, saying that no final decisions have been
made. However, if the $2.7 billion amount is approved, it would
represent an increase over the $2.4 billion expected to be appropriated
by Congress for AIDS for FY 2004.  Despite the projected increase,
some AIDS advocates hope Bush will request at least $3 billion in
the 2005 budget.  According to AIDS advocates, Congress has
authorized up to $3.6 billion for AIDS in 2005, Reuters reports.
Administration officials have said that the president has held back
his support for providing $3 billion per year for AIDS because of
concerns that there is not sufficient infrastructure in place to
spend the money, adding, "President Bush made the largest single
upfront commitment in history for an international health initiative
involving a specific disease and his budgets are going to continue
to reflect that commitment."  However, advocates say that more money
is needed immediately to confront the epidemic.  "In the face of
that kind of an emergency, we've got to front-load the funding to
respond.  It is not something that we should be scaling up slowly.
I don't think ($2.7 billion) is an adequate response," Joanne Carter,
legislative director of the advocacy group RESULTS, said.
Bush's proposed FY 2005 budget is expected to be sent to Congress on
Feb. 2, according to Reuters (Entous, Reuters, 1/6).

ACROSS THE NATION


2. Florida Senate Committee Approves Bill That Would Require
HIV Testing for Almost All Newborns

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21546

  The Florida Senate Health, Aging and Long-Term Care Committee on
Tuesday approved a bill (SB 144) that would require HIV testing for
nearly all infants born in the state, the AP/Lakeland Ledger reports.
Senators on Tuesday amended the bill, which was sponsored by Sen. Evelyn
Lynn (R), to allow women to opt out of testing for their newborns for
religious reasons, but some lawmakers said that all parents should be
allowed to waive testing.  Current state law calls for pregnant women
to be offered HIV testing twice during their pregnancy and to receive
HIV testing counseling, but HIV testing of pregnant women is not mandatory.
Approximately 205,000 infants were born in Florida in 2002, about 20
of whom were born HIV-positive, according to state health officials.
However, Lynn said that estimates of the number of HIV-positive infants
born in the state are "useless" because not all infants are tested,
the AP/Ledger reports.  Several lawmakers who voted in support of the
legislation said that they would push for changes to the bill that
would allow HIV testing of newborns to be optional, according to the
AP/Ledger.  Sen. Durell Peaden (R), chair of the Senate Health
Appropriations Subcommittee, which will also consider the measure,
said that he will work with Lynn to address some of the concerns about
the bill.  Currently, only Connecticut and New York have mandatory HIV
testing for newborns, according to the AP/Ledger (AP/Lakeland Ledger, 1/6).

3. Florida Public Health Goals for AIDS Prevention Not Met,
Audit Says

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21547

  Florida is falling short on several public health goals, including
reducing the number of new AIDS cases and reducing the state's
infant mortality rate, according to an audit by the state Legislature's
Office of Program Policy Analysis and Government Accountability,
the Fort Myers News-Press reports (Fort Myers News-Press, 1/6).
The Legislature had set a goal of limiting the number of new AIDS
cases to 30 per 100,000 Florida residents in 2003, but there were
approximately 31 new AIDS cases per 100,000 people last year in the
state, according to the audit, the New York Times reports (Barnes,
New York Times, 1/6).  In addition, the rates of chlamydia and
vaccine-preventable disease in 2003 were higher than the standards
set by the legislature.  However, OPPAGA auditors noted that the state
has improved in several infectious disease measurements, including
"drastically" reducing case rates for AIDS, tuberculosis, gonorrhea and
syphilis over the past 10 years, according to the AP/Sarasota Herald-Tribune
(Royse, AP/Sarasota Herald-Tribune, 1/5).

SCIENCE & MEDICINE


4. Roche, Trimeris Halt Clinical Trials of New Fusion Inhibitor T-1249

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21548

  Swiss drug maker Roche and U.S. biotechnology company Trimeris on
Monday announced that they have halted clinical trials of their
experimental antiretroviral drug T-1249, Reuters reports.  The two
companies developed a similar antiretroviral drug called Fuzeon, which
received FDA approval in March 2003 (Pierson/Berkrot, Reuters, 1/6).
Fuzeon, which is in a new class of drugs called fusion inhibitors,
has encountered resistance from doctors and patients because of its
high cost and injection delivery method. The drug costs about $20,000
per patient per year -- double the price of the next most expensive
HIV treatments currently on the market. The drug is designed for
HIV/AIDS patients who have failed to respond to other medications
(Kaiser Daily HIV/AIDS Report, 10/17/03).  Roche and Trimeris said
that trials of T-1249, which the FDA had agreed to "fast-track" after
later trials were completed, were stopped because of problems in the
drug's formulation (Reuters, 1/6).  "We didn't feel confident we
could reproduce it at a large scale," Roche said, according to the
Financial Times (Firn, Financial Times, 1/7).  However, the companies
did not describe the problems, Reuters reports.  The companies said
that they are still committed to developing fusion inhibitors and
signed an agreement to continue research on such drugs, according
to Reuters (Reuters, 1/6).  In addition, the companies are researching
ways to reduce the number of times Fuzeon must be injected from twice
a day to once a week or once a month, according to the Raleigh
News & Observer (Vollmer, Raleigh News & Observer, 1/6).

5. FDA Approves Antiretroviral Drug Combination of Roche's Invirase,
Abbott's Norvir

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21549

  Swiss drug maker Roche on Tuesday announced that the FDA has
approved the company's protease inhibitor Invirase for use in
combination with Abbott Laboratories' Norvir -- which is known
generically as ritonavir -- for the treatment of HIV, Reuters
reports.  In research studies, Roche found that 1,000 mg of
Invirase used in combination with 100 mg of Norvir boosted the
level of Invirase in a patient's bloodstream compared with using
Invirase alone (Reuters, 1/6).  Roche also found that using 1,000
mg of Invirase and 100 mg of Norvir together produced similar
results to using 1,200 mg of Roche's antiretroviral drug Fortovase
with 100 mg of Norvir.  However, using Invirase instead of Fortovase
cuts dosage from three times a day to twice a day.  In addition,
Invirase does not require refrigeration and produces fewer
gastrointestinal side effects than Fortovase (Dow Jones News
Service, 1/6).  Roche is currently developing a 500 mg formulation
of Invirase and expects to submit it for FDA review in 2004, the
company said (AFX News, 1/7).

6. Presence of Steady Partner May Slow HIV Progression,
Delay Death, Study Says

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21550

  HIV-positive people who have a steady partner may experience
slower progression from HIV to AIDS and may postpone death,
compared with HIV-positive people without a steady partner,
according to a study published in the Jan. 3 issue of BMJ, Reuters
Health reports.  Dr. Heiner Bucher of the University Hospital of
Basel in Switzerland and colleagues beginning in 1993 enrolled
in the study 3,736 HIV-positive people who were on an antiretroviral
drug regimen (McCook, Reuters Health, 1/5).  Every six months,
the researchers asked the participants whether they had had sex
with a stable partner over the six-month period.  Beginning in
April 2000, the researchers asked the participants two separate
questions: whether they had a stable partner and whether they
had sex with a stable partner (Young et al., BMJ, 1/3).  About
80% of study participants reported being in a stable relationship
at least once during the study.  Approximately half of study
participants were followed for more than 3.5 years.  The researchers
found that participants with stable partners were less likely to
receive an AIDS diagnosis or die over the study period and were
more likely to experience an increase in CD4+ T cells (Reuters
Health, 1/5).  The researchers said that they "can only speculate"
about why a stable relationship is associated with a slower rate
of disease progression, adding that HIV-positive people may get
help with drug adherence from stable partners or may be less likely
to experience depression, a risk factor in many other chronic
diseases (BMJ, 1/3).  Based on the findings, Bucher recommends
that doctors ask their HIV-positive patients whether they are in
a stable relationship and ask the patients who are not in a
relationship whether they need help with their treatment regimen
or are experiencing depression (Reuters Health, 1/5).

GLOBAL CHALLENGES


7. Atlanta Journal-Constitution Examines 'Unlikely Alliance' of
Traditional Healers, Modern Doctors in Fight Against HIV/AIDS
in Africa

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21551

  The Atlanta Journal-Constitution on Wednesday examined the
"unlikely alliance" in Africa between traditional healers and
"practitioners of modern medicine" in the fight against HIV/AIDS.
According to Dr. Virginia Davis Floyd, a visiting scholar at Spelman
College, 85% of people in sub-Saharan Africa receive part or all
of their health care and health education from traditional healers.
She said, "Most people in Africa don't have access to primary
health care. ... Since we don't have doctors or nurses in many
of these places, the only primary provider is the traditional
healer."  Therefore traditional healers are now "being courted
as the first line of defense against" HIV/AIDS, according to the
Journal-Constitution (Poole, Atlanta Journal-Constitution, 1/7).
The full article is available online.

OPINION


8. Japan's Increased Global Fund Contribution Boosts U.S. Funding,
Editorial Says

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21552

  Japan's announcement that it will increase its donation to the
Global Fund to Fight AIDS, Tuberculosis and Malaria in 2004 is
"important" because "every increase from a donor nation also
increases the U.S. contribution to the Global Fund" under current
U.S. law, a Seattle Post-Intelligencer editorial says
(Seattle Post-Intelligencer, 1/5).  Japanese Prime Minister Junichiro
Koizumi in December announced that Japan would increase its
2004 funding to the Global Fund from a planned contribution of
$40 million to $100 million. The announcement brings the total
Japanese contribution to the fund between 2002 and 2004 to $260
million, with $80 million pledged for 2003. The Global Fund
currently has $3 billion in pledges through 2004 and another
$1.9 billion pledged for 2005 to 2008. The Global Fund has
pledged $2.1 billion over two years to 224 programs to combat
HIV/AIDS, tuberculosis and malaria in more than 120 countries
(Kaiser Daily HIV/AIDS Report, 12/16/03).  The editorial says
that Japan is "demonstrating that the Global Fund ... is an
excellent international vehicle for distributing money to the
countries fighting these terrible diseases" (Seattle
Post-Intelligencer, 1/5).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org,
a free service of The Henry J. Kaiser Family Foundation. (c) 2004
Advisory Board Company and Kaiser Family Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily
HIV/AIDS Report, please contact Larry Levitt, Kaiser Family
Foundation vice president, editor-in-chief, kaisernetwork.org;
Jill Braden Balderas, Editor, kaisernetwork.org; Regina Davis,
Senior Web Producer, HealthCast; Tina Murrow, Online Production
Manager, HealthCast;  Alyson Browett, editor, Kaiser Daily HIV/AIDS
Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org,
please contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or unsubscribe.
Questions about your email subscription?  Contact us at subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family Foundation.
For access to the Foundation's policy research, analyses, reports
and fact sheets, and media partnerships, visit the Foundation's
main website at www.kff.org .

-Message-Id: <20040107072745.BFDC.4423-1435@...>

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



Tuesday, January 6, 2004

GLOBAL CHALLENGES
========================================
1. Gates Foundation To Grant $17M to University of Manitoba
To Expand HIV/AIDS Programs in India

2. Houston Chronicle Examines Baylor University Doctor's
Efforts To Fight Global HIV/AIDS


ACROSS THE NATION
========================================
3. West Hollywood, Calif., Assisted Living Complex for
HIV-Positive People Plans To Hire Additional Staff


PUBLIC HEALTH & EDUCATION
========================================
4. Doctor Uses Kama Sutra To Help Sex Workers in India Fight
Spread of HIV/AIDS


OPINION
========================================
5. Developed Nations Must Share Knowledge of Fighting HIV/AIDS
With Developing Nations, Editorial Says

6. Improving Health Infrastructure, Sanitation Key in Fighting
HIV/AIDS, Other Pandemics, Editorial Says

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


GLOBAL CHALLENGES


1. Gates Foundation To Grant $17M to University of Manitoba
To Expand HIV/AIDS Programs in India

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21530

  The Bill & Melinda Gates Foundation on Tuesday is expected to award
the University of Manitoba in Canada a $17 million grant to expand
its HIV/AIDS programs in India, the Toronto Globe and Mail reports
(Smith, Globe and Mail, 1/6).  The university has been working with
approximately 10% of the population in the Indian province of Karnataka
with a grant from the Canadian Economic Development Agency (Martin,
Winnipeg Free Press, 1/6).  The funds will go to a collaborative
project between the university and the government of Karnataka, where
500,000 of its 55 million people -- about 1.7% of the province's
population -- are living with HIV/AIDS (Agrell, National Post, 1/6).
According to the Press Trust of India, the Transport Corporation of
India Foundation and Population Services International will share an
additional $8 million Gates grant as project partners with the
University of Manitoba, the Free Press reports.  The groups would
work in collaboration with the Karnataka State Aids Prevention Society
to offer HIV prevention programs to high-risk populations, according
to the Free Press.  With the grant, the university and its partners
will provide HIV/AIDS counseling and testing, behavior-change communication
campaigns, condom promotion and improved diagnosis and treatment of
sexually transmitted diseases, according to the Press Trust of India,
the Free Press reports.

Reaction

Dr. John O'Neil, head of community health sciences at the University
of Manitoba, said, "We try to come up with innovative ways to respond
to the epidemic.  What Gates recognized is it's an evidence-based
approach we are taking, and secondarily, that we were evaluating what
we were doing very carefully, to measure the impact of what we were
doing" (Winnipeg Free Press, 1/6).  Helene Gayle, Gates Foundation
director of HIV, tuberculosis and reproductive health, said that the
foundation is "very pleased to support the University of Manitoba's
efforts to fight HIV/AIDS in India."  Stephen Moses, University of
Manitoba professor of community health sciences, medical microbiology
and medicine, who will lead the program along with associate professor
James Blanchard, said, "We've learned from our experiences in Kenya
and elsewhere that the most effective approach to HIV/AIDS prevention
is to focus on the most vulnerable groups, and empower these people
to improve their own health and the health of their communities"
(National Post, 1/6).

Additional information on HIV/AIDS in India is available online as
part of kaisernetwork.org's Issue Spotlight on HIV/AIDS.

Also available online is a kaisernetwork.org video feature on
HIV/AIDS in India. The report -- prepared by Fred de Sam Lazaro,
a correspondent for the NewsHour with Jim Lehrer -- includes
interviews with people who are on frontlines of India's efforts.

2. Houston Chronicle Examines Baylor University Doctor's
Efforts To Fight Global HIV/AIDS

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21531

  The Houston Chronicle on Sunday examined a Baylor University
physician's efforts to combat the HIV/AIDS pandemic.  Dr. Mark
Kline, a pediatric HIV/AIDS specialist, and colleagues at Baylor
since 1996 have made a "dramatic difference" in the lives of
HIV-positive children in Romania by providing antiretroviral drugs
for them, the Chronicle reports.  In the city of Constanta, Romania,
the number of HIV-positive children hospitalized daily has dropped
from 30 patients to four, and the yearly AIDS-related death rate
has fallen from 20% four years ago to 3% today.  Kline, who directs
Baylor's International Pediatric AIDS Initiative, hopes to duplicate
the success of the Romanian clinic in Gaborone, Botswana, where Baylor
opened a clinic in summer 2003.  The university plans to open a third
clinic in Mexico City, the Chronicle reports.  Pharmaceutical company
Bristol-Myers Squibb, which has supplied funding for the Baylor
clinics, announced on Dec. 3 that it also will fund a second African
clinic (Hopper, Houston Chronicle, 1/4).

ACROSS THE NATION

3. West Hollywood, Calif., Assisted Living Complex for
HIV-Positive People Plans To Hire Additional Staff

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21532

  A West Hollywood, Calif., apartment complex for HIV-positive people
plans to hire additional staff after a report by a New York
consulting firm concluded that although the majority of tenants
at the complex are well-served, the complex should hire more staff
and better inform residents of the services it offers, the Los
Angeles Times reports (Lin, Los Angeles Times, 1/6).  Managers of the
$6.5 million Palm View Apartments, which opened in 1998, are responsible
for monitoring residents' social service needs, but the tenants
live independently.  The city of West Hollywood ordered an investigation
of apartment management after four residents complained that tenant
Kevin McDaniel was "virtually abandoned" by managers of the complex
when his health began to fail about a year ago, according to the Times.
Lee Myers, resident services coordinator of the 40-unit building,
said that she checked on McDaniel weekly and suggested that he see a
doctor, adding that she called him every other day in the two weeks
preceding his March 2003 hospitalization.  However, McDaniel said
that he does not recall any attention from Myers.  The report offered
20 recommendations to the West Hollywood Community Housing Corp.,
which operates the apartments.  The West Hollywood City Council in
September gave the company 90 days to respond to the report and develop
a plan of action.  However, the company on Dec. 1 asked for an
additional 30 days, the Times reports (Lin, Los Angeles Times, 1/5).
The city council on Monday approved 4-1 a 19-page response from the
company, which included plans to hire an additional staff member, who
will spend one afternoon and one morning per week at Palm View.  The
company will also institute new protocols for when a tenant's health
appears to be failing, which would allow tenants to sign an agreement
allowing management to intervene if a resident becomes seriously ill,
according to the Times (Los Angeles Times, 1/6).

PUBLIC HEALTH & EDUCATION

4. Doctor Uses Kama Sutra To Help Sex Workers in India Fight
Spread of HIV/AIDS

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21533

  Dr. Sachchidananda Sarkar, head of the government's anti-AIDS
program in India's West Bengal state, uses the Kama Sutra, an
ancient Indian text, to encourage sex workers in Kolkata to "make
the most of foreplay" and try to satisfy customers with little or
no intercourse, which Sarkar said can reduce the risk of accidents
and injuries that can spread HIV, the Los Angeles Times reports.
In addition, Sarkar said that a client who is seduced with the
traditional entertainment outlined in the Kama Sutra, including
herbal oil massages or poetry reading, is less likely to resist
a sex worker's request to use a condom.  Sarkar has enrolled about
20 sex workers in a free, six-month course on the techniques,
during which sex workers meet twice a week in local brothels.
More than half of the sex workers in some cities in the two Indian
states most affected by HIV/AIDS -- Tamil Nadu and Maharashtra --
are HIV-positive, and the epidemic is moving from high-risk groups
to the general population, according to the United Nations.  Dr.
Kenneth Wind-Andersen, head of the UNAIDS program in India, said that
although UNAIDS wants more evidence of the effectiveness of Sarkar's
techniques, they are "worth a try -- and a thorough assessment,"
according to the Times.  However, some public health experts call
the idea that the Kama Sutra can make sex safer "wishful thinking,"
adding that the theory fails to address the realities of Kolkata
brothels, according to the Times.  "If it did, only song and dance
would be going on there," Mrinal Kanti Dutta, program director of
one of Kolkata's largest AIDS prevention projects, said.  "I am
making a compromise with the culture, science and technology and
condom use -- holistically, so that they get the most benefits,"
Sarkar said, adding, "It's a difficult job for me, but I'm trying"
(Watson, Los Angeles Times, 1/6).

Additional information on HIV/AIDS in India is available online as
part of kaisernetwork.org's Issue Spotlight on HIV/AIDS.

Also available online is a kaisernetwork.org video feature on HIV/AIDS
in India. The report -- prepared by Fred de Sam Lazaro, a correspondent
for the NewsHour with Jim Lehrer -- includes interviews with people
who are on frontlines of India's efforts.

OPINION


5. Developed Nations Must Share Knowledge of Fighting HIV/AIDS
With Developing Nations, Editorial Says

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21534

  Although it is important for developed nations to offer developing
nations funding and the "promise of ongoing medical research" on
HIV/AIDS vaccines and treatments, it is equally important for
developed countries to "shar[e] the experience and tactics they
have learned while grappling with AIDS for more than two decades,"
a Chicago Tribune editorial says.  For example, "[o]ne lesson learned
in the U.S. and applicable in the developing world is to engage the
people most vulnerable to the disease," such as Hispanic men who
have sex with men in the United States, the Tribune says.  In addition,
"[s]trong and effective government" involvement in fighting the
disease has been shown to "trigge[r] a chain of other favorable
events," removing stigma and encouraging people to get tested, the
editorial says, concluding, "It's up to the developed and developing
worlds to join forces to fight one of the most formidable challenges
in human history" (Chicago Tribune, 1/5).

6. Improving Health Infrastructure, Sanitation Key in Fighting HIV/AIDS,
Other Pandemics, Editorial Says

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21535

"If the United States and other wealthy nations did more to help
provide basic health care and sanitation around the world, they wouldn't
have to work so hard to combat pandemics such as AIDS and tragic
rates of infant mortality," a Detroit Free Press editorial says.
It is important for developed nations to work to improve basic health
care throughout the world by setting aside money and putting pressure
on leaders of developing countries to invest in their health systems,
"even if it's not as sexy as the disease of the week," the editorial
says.  In addition, it is important to focus on "population control,
as much as some extremists hate to admit it," the editorial says.
The world's health problems may seem "insurmountable," but it will
"hel[p] to start at the beginning, with healthy moms, healthy babies
and a healthy medical system," the Free Press concludes (Detroit Free
Press, 1/3).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: www.kaisernetwork.org/email

The Kaiser Daily Health Policy Report is published for kaisernetwork.org,
a free service of The Henry J. Kaiser Family Foundation. (c) 2004 Advisory
Board Company and Kaiser Family Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily HIV/AIDS
Report, please contact Larry Levitt, Kaiser Family Foundation vice president,
editor-in-chief, kaisernetwork.org; Jill Braden Balderas, Editor,
kaisernetwork.org; Regina Davis, Senior Web Producer, HealthCast;
Tina Murrow, Online Production Manager, HealthCast;  Alyson Browett, editor,
Kaiser Daily HIV/AIDS Report; or Susannah Hunter, associate editor,
at dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org, please
contact us at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or unsubscribe.
Questions about your email subscription?  Contact us at subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family Foundation.
For access to the Foundation's policy research, analyses, reports and
fact sheets, and media partnerships, visit the Foundation's main website
at www.kff.org .

-Message-Id: <20040106073031.BEDD.4425-1420@...>

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



Monday, January 5, 2004

SCIENCE & MEDICINE
========================================
1. Vertical HIV Transmission Rate Down in U.S.; Majority of Cases Associated
With Lack of Prenatal Care, CDC Report Says

2. FDA Approves Trinity Biotech Rapid HIV Test for Use With Blood Serum, Plasma,
Whole Blood


ACROSS THE NATION
========================================
3. Los Angeles Times Profiles Cirque Du Soleil Gymnast Allegedly Fired Over HIV
Status


GLOBAL CHALLENGES
========================================
4. Long Island Newsday Chronicles Progress in Fight Against AIDS in 2003


5. New York Times Profiles Plight of AIDS Orphans in Southern Africa


6. Japanese Patient Infected With HIV Through Blood Transfusion After New
Screening System Implemented


MEDIA & SOCIETY
========================================
7. Maclean's Magazine Names U.N. Special Envoy for HIV/AIDS in Africa Stephen
Lewis Canadian of the Year


OPINION
========================================
8. Bush 'On Track, On Time' To Meet Pledge To Fight Global HIV/AIDS, Tobias Says
in WSJ Letter to Editor

9. Bush Administration Has 'Essentially Abandoned' Plan To Fight AIDS in Asia,
Letter to Editor Says

10. International AIDS Programs Must Address 'Cross-Generational' Sex, Opinion
Piece Says


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

SCIENCE & MEDICINE


1. Vertical HIV Transmission Rate Down in U.S.; Majority of Cases Associated
With Lack of Prenatal Care, CDC Report Says

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21503

  Although the percentage of HIV-positive women who give birth to HIV-positive
infants has declined "dramatically" in developed nations due largely to the use
of antiretroviral drugs, a lack of prenatal care increases a woman's likelihood
that she will transmit the virus to her infant, according to a study published
in the Jan. 2 issue of the CDC's Morbidity and Mortality Weekly Report, Reuters
Health reports.  Researchers from the CDC assessed compliance with the U.S.
Public Health Service guidelines recommending universal prenatal HIV counseling,
voluntary HIV testing and provision of antiretroviral drugs to HIV-positive
pregnant women and their newborns at Grady Memorial Hospital in Atlanta between
1997 and 2000.  Of the 253 infants born to HIV-positive women at the hospital
during the time period, 17 were HIV-positive, according to the researchers. 
Between 1999 and 2000, nine HIV-positive infants were born at Grady Memorial. 
Of those infants, six were born to women who did not receive any prenatal care
and three were born to women who received some prenatal care but for whom the
antiretroviral drug regimen or timing was not optimal.  During the same time
period, no cases of vertical transmission were identified among HIV-positive
women who received adequate prenatal counseling, HIV testing and antiretroviral
drugs.  During the four-year study period, the vertical HIV transmission rate
ranged from 3% to 10% (Reuters Health, 12/31/03).  Before the introduction of
antiretroviral drugs, approximately 25% of all infants born to HIV-positive
women were born infected, according to Dr. Mary Glenn Fowler, who oversees CDC's
perinatal HIV research.

Focus on Prenatal Care, Drug Regimen Adherence


Fowler said, "We know that if we get women into prenatal care, get them properly
tested and start them early on antiretrovirals, we can reduce the [vertical HIV]
transmission rate to about 2%," adding, "This study shows the failures, those
who slipped through, and the numbers are reflective of what we see nationally"
(Guthrie, Atlanta Journal-Constitution, 1/2). The CDC researchers concluded,
"For pregnant women who receive prenatal care and know their HIV status,
prevention programs should focus on promoting adherence to recommended treatment
regimens and administering (AIDS drugs) during pregnancy.  Efforts to reduce
(mother-to-infant) HIV transmission should continue to focus on increasing
prenatal care rates and prenatal HIV testing, particularly in areas where missed
opportunities for prevention of perinatal HIV transmission persist" (Reuters
Health, 12/31/03).

2. FDA Approves Trinity Biotech Rapid HIV Test for Use With Blood Serum, Plasma,
Whole Blood

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21504

  The FDA has approved Dublin, Ireland-based Trinity Biotech PLC's Uni-Gold
Recombigen rapid HIV test, the first rapid-test product approved for use in
detecting HIV in blood serum, plasma and whole blood, according to Trinity, Dow
Jones/Wall Street Journal reports. The test, which offers results within 10
minutes and will cost doctors and hospitals $10 per test, detected 100% of
HIV-positive specimens and returned 99.7% accurate results for HIV-negative
specimens in Trinity-sponsored trials involving more than 9,000 patient samples,
according to Dow Jones/Journal.  Trinity President Brendan Farrell said that the
Uni-Gold test is "every bit as accurate as lab-based tests," which can take days
or weeks to return results, Dow Jones/Journal reports. Trinity plans to market
the test to government programs, physicians and hospitals for testing patients
and health care workers who may be exposed to HIV through accidental needle
sticks, Dow Jones/Journal reports.  Farrell said that the hospital market is
"not being met at the moment," adding, "There are over 800,000 needlestick
injuries per year in U.S. hospitals.  They need to know urgently if that patient
was infected with HIV." Trinity hopes to sell 400,000 to 500,000 tests in the
United States in 2004.  The company plans to target CDC programs, which could be
a potential $30 million market for the company, and the approximately 200,000
pregnant women who are considered at "high risk" for mother-to-child HIV
transmission, Dow Jones/Journal reports.  Farrell said the test is already sold
in Africa and Asia and is approved for use in the World Health Organization's
HIV testing program in Africa.

Competition for OraQuick Test


Trinity's test is expected to "compete directly" with Bethlehem, Pa.-based
OraSure Technologies' OraQuick rapid HIV test, according to Dow Jones/Journal
(Middleton, Dow Jones/Wall Street Journal, 12/30/03).  OraSure in October 2003
announced that it is seeking pre-market FDA approval for its test for use in
detecting HIV in saliva or plasma.  In September, the agency approved the
OraQuick HIV test for expanded use in hospitals using blood drawn intravenously
and stored in a tube. The test previously could be used only with blood obtained
from a finger prick (Kaiser Daily HIV/AIDS Report, 10/1/03).  In February 2003,
President Bush announced a plan to expand the availability of the OraQuick rapid
test, which offers results that are 99.6% accurate within 20 minutes, to more
than 100,000 doctors' offices and public health clinics nationwide (Kaiser Daily
HIV/AIDS Report, 10/30/03).

ACROSS THE NATION


3. Los Angeles Times Profiles Cirque Du Soleil Gymnast Allegedly Fired Over HIV
Status

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21505

  The Los Angeles Times on Monday profiled Matthew Cusick, an HIV-positive
gymnast who was allegedly fired from Cirque du Soleil after disclosing his HIV
status (Romney, Los Angeles Times, 1/5).  Cusick said that he disclosed his
HIV-positive status to Cirque shortly after his July 2002 hiring and underwent
several medical evaluations and was found to be in good health and considered
fully able to perform with the company. However, shortly before he was to begin
performing in the company's Las Vegas show "Mystere," Cirque sent him a letter
terminating his employment and stating that his HIV-positive status "will likely
pose a direct threat of harm to others, particularly in the case of future
injury" (Kaiser Daily HIV/AIDS Report, 12/19/03).  The San Francisco Human
Rights Commission is investigating the case, and a federal discrimination
complaint filed on Cusick's behalf by the Lambda Legal Defense and Education
Fund is pending with the U.S. Equal Employment Opportunities Commission's Los
Angeles District Office (Los Angeles Times, 1/5).

GLOBAL CHALLENGES


4. Long Island Newsday Chronicles Progress in Fight Against AIDS in 2003


Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21506

  After more than two decades since the first HIV cases appeared, governments and
international agencies in 2003 took "bold steps" to provide treatment for people
in developing nations, Long Island Newsday reports.  The escalation of treatment
programs was due in part to the efforts of the William J. Clinton Presidential
Foundation HIV/AIDS Initiative, which secured a deal with generic drug
manufacturers that will reduce the cost of commonly used three-drug regimens to
less than $200 per patient annually.  In addition, President Bush last year
announced a five-year, $15 billion program to fight AIDS in 14 developing
countries.  Although Congress has not yet allocated the funds, the State
Department is taking applications for companies, nongovernmental organizations
and others to manage drug delivery and prevention programs and say they plan to
have the program operating by the spring (Garrett, Long Island Newsday,
12/28/2003).  The complete article is available online.

Media Coverage


The following are summaries of recent broadcast features on HIV/AIDS:

* NPR's "All Things Considered" on Jan. 1 profiled the HIV/AIDS prevention
program at the Church of Our Lady of Africa in Kampala, Uganda (Wilson, "All
Things Considered," NPR, 1/1).  The complete segment is available online in
RealPlayer.

* NPR's "Morning Edition" on Dec. 29 profiled a pilot antiretroviral drug
distribution program in Lusikisiki, South Africa, which could serve as a model
for the country's national HIV/AIDS treatment program.  The segment includes
comments from Dr. Herman Reuter, a physician with Medecins Sans Frontieres who
established the program (Beaubien, "Morning Edition," 12/29/03).  The complete
segment is available online in RealPlayer.

* NPR's "Talk of the Nation" on Dec. 31 examined HIV/AIDS in Africa as a U.S.
foreign policy challenge for 2004.  The segment includes comments from Global
AIDS Alliance Executive Director Paul Zeitz (Conan, "Talk of the Nation," NPR,
12/31/03). The complete segment is available online in RealPlayer.

* NPR's "Tavis Smiley Show" on Jan. 2 featured an interview with Judith
Auerbach, vice president of public policy for the American Foundation for AIDS
Research.  Auerbach discusses new research on methods to prevent HIV/AIDS,
including vaccines and prescribing antiretroviral drugs for HIV-negative
individuals (Cox, "Tavis Smiley Show," NPR, 1/2).  The complete segment is
available online in RealPlayer.

* PRI's "The World" on Dec. 31 interviewed Medecins San Frontieres-USA Executive
Director Nicolas de Torrente about the group's list of the 10 most underreported
humanitarian stories of 2003.  According to de Torrente, HIV/AIDS did not make
the list in 2003 because of increased attention to the pandemic (Mullins, "The
World," PRI, 12/31/03). The complete segment is available online in Windows
Media.

5. New York Times Profiles Plight of AIDS Orphans in Southern Africa


Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21507

  The New York Times on Dec. 24 profiled the plight of AIDS orphans in
sub-Saharan Africa, where 11 million children under age 15 have lost at least
one parent to AIDS, according to UNICEF's "State of the World's Children 2004"
report, which was released last month.  The social implications of the region's
large number of orphans are "enormous" because orphans are more likely than
other children to drop out of school, be malnourished, be homeless, be exploited
by adults, engage in sex work or criminal activity and contract HIV, according
to the Times.  Although African social traditions expect relatives to care for
orphans, AIDS has "pushed so many families to the brink" that many have been
forced to turn relatives away, the Times reports.  In addition, governments have
done little to address the problem -- only six of the 40 sub-Saharan African
countries have plans in place to deal with orphans, according to the Times
(LaFraniere, New York Times, 12/24).

* NPR's "Morning Edition" on Dec. 31 reported on the UNICEF report.  The segment
includes comments from UNICEF Executive Director Carol Bellamy (Beaubien,
"Morning Edition," NPR, 12/31/03).  The complete segment is available online in
RealPlayer.

* PBS' "NewsHour with Jim Lehrer" on Dec. 30 reported on the UNICEF report and
orphans and grandmothers affected by HIV/AIDS in Kenya.  The segment includes
comments from Bellamy and Sister Mary Philip, assistant director of the
international agency Help Age (Hagler, "NewsHour with Jim Lehrer," PBS,
12/30/03).  The complete transcript of the segment is available online.  The
complete segment also is available online in RealPlayer.

6. Japanese Patient Infected With HIV Through Blood Transfusion After New
Screening System Implemented

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21508

  The Ministry of Health, Labour and Welfare last week announced that a Japanese
patient has been infected with HIV through a blood transfusion after blood
tainted with the virus slipped through the Japan Red Cross's new screening
system, the AP/Las Vegas Sun reports.  The infection represents the first time
since the country established its new blood screening program in 1999 that
anyone in the country has been infected with HIV from a blood transfusion,
Health Ministry spokesperson Kazunari Tanaka said. The infection was discovered
after a blood donor tested positive for the virus on Nov. 16, 2003, and said
that he had previously given blood.  Although the donor's blood had been tested
before his first donation in May 2003, antibodies for the virus were not
detected, according to Tanaka. Blood from the donor's May donation was
incorporated into three blood units, one of which was used in the Japanese
patient's transfusion.  The other two units had not been used, indicating that
no further infections could result from the tainted blood donation, Tanaka said.
It is the second time that HIV-tainted blood has passed through the Japan Red
Cross detection system, but the first time did not result in any infections,
according to the AP/Sun (Mizoguchi, AP/Las Vegas Sun, 12/29/03).

MEDIA & SOCIETY


7. Maclean's Magazine Names U.N. Special Envoy for HIV/AIDS in Africa Stephen
Lewis Canadian of the Year

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21509

  Maclean's magazine has named U.N. Special Envoy for HIV/AIDS in Africa Stephen
Lewis its inaugural Canadian of the Year for his "vision, perseverance and above
all his passion" in fighting AIDS.  Lewis has "devoted his energy, optimism and,
occasionally, white-hot anger, to prodding the world to action" in fighting the
disease, Maclean's says, adding that instead of getting "frustrated and
disheartened" by Western countries' complacency about the disease, Lewis
"decided to turn his despair and anger to advantage."  Lewis said, "I'm still at
the end of my rope. ... But what is my emotional disarray compared to the hell
that is happening?  I'm in a great rage now, as I understand how many lives we
have lost.  But I don't want to leave until I see a breakthrough" (Gatehouse,
Maclean's, 12/29). The complete article is available online.

OPINION


8. Bush 'On Track, On Time' To Meet Pledge To Fight Global HIV/AIDS, Tobias Says
in WSJ Letter to Editor

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21510

  Although the Wall Street Journal in a Dec. 10 article reported that the Bush
administration is "stepping back" from its "highly publicized pledge to spend
huge sums" to combat the HIV/AIDS pandemic, President Bush remains "on track and
on time to meet his historic commitment" to fight HIV/AIDS, Randall Tobias, head
of the new State Department Office of the Global AIDS Coordinator, writes in a
Wall Street Journal letter to the editor (Tobias, Wall Street Journal, 1/5). 
The Journal reported on Dec. 10 that the Bush administration told cabinet
departments that the administration's fiscal year 2005 spending proposal will
include "relatively small" funding increases for HIV/AIDS programs and the
Millennium Challenge Account, an assistance program for developing nations that
encourages democracy and development through economic assistance.  The proposal
will include $2.5 billion in new funds for the Millennium Challenge Account and
$1.1 billion in additional funds for global HIV/AIDS programs, according to
individuals familiar with Bush's proposal.  Those amounts -- along with the
funds yet to be approved in the FY 2004 spending bill -- account for 18% of the
$30 billion in spending increases the White House promised would take place by
2008 (Kaiser Daily HIV/AIDS Report, 12/10/03).  Tobias says that the Journal
"overlooked a key element" of the president's proposal, adding that the
"[c]apacity to provide treatment must be expanded in concert with funding
increases for treatment itself in order for these resources to be used
effectively."  According to Tobias, funding levels should be increased over
time, "with more funds available in the later years of the initiative as
capacity to provide treatment increases."  The administration will "move
quickly" to implement programs when Congress approves the FY 2004 omnibus
spending bill, and as infrastructure is built, "we will reach increasing numbers
of people each year in this unprecedented effort to prevent and treat a
devastating disease," Tobias concludes (Wall Street Journal, 1/5).

9. Bush Administration Has 'Essentially Abandoned' Plan To Fight AIDS in Asia,
Letter to Editor Says

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21511

  Ellen Nakashima in a Washington Post article on Dec. 13 "described in moving
terms how orphans [in Thailand] fear abandonment," Paul Zeitz, executive
director of the Global AIDS Alliance, writes in a Post letter to the editor
(Zeitz, Washington Post, 12/25/03). Nakashima in the article profiled Thailand's
efforts to care for more than 300,000 children -- both HIV-positive and
HIV-negative -- who have lost their parents due to AIDS-related death (Kaiser
Daily HIV/AIDS Report, 12/15/03).  However, Zeitz says that the Bush
administration has "essentially abandoned Thailand and many other countries as
they confront" the AIDS epidemic.  Zeitz says that no Asian countries were
included in the administration's five-year, $15 billion global AIDS initiative. 
"This deplorable situation is made worse by the low level of U.S. support" for
the Global Fund to Fight AIDS, Tuberculosis and Malaria, which supports Thailand
and 120 other countries, Zeitz says, adding that Bush has proposed cutting the
U.S. contribution from $550 million in 2004 to $200 million in 2005.  Zeitz
concludes, "We owe it to the orphaned children to look seriously at this issue
and start comparing our efforts to the global scale of the crisis, not to what
has or has not been done in the past in one or another region" (Washington Post,
12/25/03).

10. International AIDS Programs Must Address 'Cross-Generational' Sex, Opinion
Piece Says


Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=21512

  Cross-generational sex, in which older married men seek young girls for sex,
has become a "new cultural norm" in parts of sub-Saharan Africa and represents a
"deeply troubling" trend in a region where young girls are up to six times as
likely as boys their age to be HIV-positive, Edward Green, research scientist at
Harvard School of Public Health and a member of the Presidential Advisory
Council on HIV and AIDS, and John Berman, senior director of Population Services
International's international AIDSMARK HIV prevention program, write in a
Washington Times opinion piece.  It is "past time" for government leaders to
address the problem, and President Bush should include the issue as a "central
component" of his global AIDS initiative "no matter how uncomfortable the idea
makes some people," Green and Berman say.  Efforts to combat the problem must
include communication campaigns that emphasize "abstinence (for youth) and
faithfulness to one partner (for everyone else)," as well as programs that
address the "social norms that perpetuate cross-generational sex," Green and
Berman say.  In addition, governments need to enact and enforce stricter legal
penalties against statutory rape and sex with minors, Green and Berman conclude
(Green/Berman, Washington Times, 12/28/03).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: www.kaisernetwork.org/email

The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free
service of The Henry J. Kaiser Family Foundation. ? 2004 Advisory Board Company
and Kaiser Family Foundation. All rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily HIV/AIDS Report,
please contact Larry Levitt, Kaiser Family Foundation vice president,
editor-in-chief, kaisernetwork.org; Jill Braden Balderas, Editor,
kaisernetwork.org; Regina Davis, Senior Web Producer, HealthCast; Tina Murrow,
Online Production Manager, HealthCast;  Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
For questions and further information about kaisernetwork.org, please contact us
at info@... or at 202-347-5270.
-------------------------------------------------------
Manage Your Email Subscription at http://www.kaisernetwork.org/email .
Login to update your profile, add or modify subscriptions, or unsubscribe.
Questions about your email subscription?  Contact us at subscriptions@... .
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family Foundation.  For access
to the Foundation's policy research, analyses, reports and fact sheets, and
media partnerships, visit the Foundation's main website at www.kff.org .


-Message-Id: <20040105090738.C07C.4430-1398@...>

Use of Uni-Gold Recombigen HIV is restricted to clinical laboratory professionals in facilities having an adequate quality assurance program. The test is not approved to screen donors of blood, plasma, cells or tissues, or for home use.

Uni-Gold Recombigen HIV provides results in 10 minutes.  It was approved by the FDA on the basis of clinical trial results demonstrating test sensitivity of 100% and specificity of over 99.7%.

Test subjects must receive the "Subject Information Leaflet" prior to specimen collection, and appropriate counseling when test results are provided.

Positive test results require confirmation.  The test is suitable for use in appropriate multi-test algorithms designed for the statistical validation of rapid HIV test results.

Product labeling will be available in the coming weeks at http://www.fda.gov/cber/products/testkits.htm