AIDS Treatment News Issue #371, September 21, 2001
phone 800-TREAT-1-2, or 215-546-3776

Contents

** September 11: What Happens Now?
The terrorist attack will likely set back control of an epidemic
that kills 8,000 people every day.

** Tuberculosis: Guidelines Changed for Latent TB Treatment
Experts urge caution with a two-drug regimen after cases of severe
liver injury, including some fatalities.

** HIV/HCV Coinfection: One-Day Conference October 11 in
Washington
The Forum for Collaborative HIV Research will hold a one-day forum
on research needs in HIV/hepatitis C coinfection

** AmfAR Announces Research Grants: Letters of Intent Due October
23
The American Foundation for AIDS Research will fund research on
new viral targets, including use of combinatorial libraries.

** ICAAC Postponed to December 16-19; "Salvage" Workshop Also
Postponed
Two medical conferences were postponed because of concerns about
air travel.

** ADAP Funding Crisis: Talking Points
Patients in a growing number of states are not getting needed
medicines due to underfunding of the AIDS Drug Assistance Program
by Congress and some states.

** U.S., Switzerland Oppose Developing-Country Proposal on Access
to Medicines
A proposal by 52 developing countries to make sure that trade
rules do not prevent access to medications has been opposed by
five rich countries, led by the U.S. and Switzerland.

** AIDS TREATMENT NEWS Publication Schedule
We published only one issue instead of two in August, and again in
September.

** Malawi Plan to Control AIDS Epidemic: Interview with David
Scondras, Search for a Cure
Malawi has developed a model plan to control the epidemic --
including treatment of persons already infected.


***** September 11: What Happens Now?

by John S. James

Several major AIDS organizations in Manhattan were in the disaster
area near the World Trade Center. It appears that everyone in
those offices got out alive, although some lost friends or
relatives. The long-term consequences for the global fight against
AIDS, tuberculosis, malaria, and other major infectious diseases
remain unknown but ominous.

Every day HIV infection alone kills more people than died at the
World Trade Center and other terrorist attacks on September 11
(AIDS EPIDEMIC UPDATE: DECEMBER 2000 by UNAIDS estimated 3 million
deaths in 2000 -- over 8200 per day -- and the numbers have risen
since then). But even on September 10 the prospects for worldwide
response did not look good. The epidemic did get media attention
during the previous year. But it was becoming clear that the U.S.
and other rich countries did not have the political will to pay
more than a fraction of the cost of a serious program for
controlling the disease. (The total cost would be about $10
billion per year from the entire world -- about $2 billion from
the U.S. if the cost were shared in proportion to the size of each
country's economy). The problem wasn't lack of money; in just one
week after the September 11 attack, the U.S. had found and signed
into law $40 billion -- money no one had thought about, let alone
proposed, just seven days before.

We still believe as we did on September 10 that ultimately there
is enough interest and good will in the U.S. to support a
proportional contribution to the money and leadership of an
effective worldwide AIDS and infectious epidemic program. The
central problem is that nobody has found an effective strategy for
dealing with the three fundamental political divisions that have
always blocked an effective response to the epidemic.

1. The international pharmaceutical industry is more interested in
protecting its patent rights than in controlling the epidemic.
Some companies cut prices to some poor countries by 80 to 90
percent when they had to, but then largely washed their hands of
the global problem, leaving prices that will largely remain unused
(except for prevention of mother-to-infant transmission) because
they are still so far beyond reach. There is no plan that
pharmaceutical companies, medical professionals, and activists can
get behind enthusiastically and bring to Congress, international
agencies, foundations, and other decision makers (as they can with
the AIDS Drug Assistance Program for funding treatment for U.S.
patients).

Industry so far has tried to lead an unworkable campaign to
preserve drug patents everywhere, with piecemeal charity for some
poor countries -- negotiated between each country and company,
revocable any time, and with secret political quid pro quo. What
could work instead is to preserve drug patents in rich countries
while relaxing them in poor ones where there is no significant
market anyway, then pushing for global funding for systematic bulk
purchases, which can and should be profitable to the patent
holders (we want them with us when going to funders). Countries
neither rich nor poor will need a mixed system. This approach
could greatly relieve the global access problem -- and end
industry's horrible public relations from people dying because
they cannot pay impossibly high prices for needed medications.
Events are already moving in this direction, but with industry
impeding this solution instead of helping to lead it (for example,
see "U.S., Switzerland Oppose Developing-Country Proposal on
Access to Medicines," in this issue).

2. Also critically important is the conflict around sexuality
throughout the world, and the resulting stigma around AIDS. A
great many individuals and institutions have so much invested in
saying "No!" that they find it difficult to pivot emotionally and
be helpful to someone infected through sex or drugs, or to support
measures to make behavior they oppose less dangerous. As a result,
it is hard to mobilize consistent support for rational, can-do
responses to this worldwide health emergency.

3. In addition, the HIV epidemic increasingly affects mostly the
poor, whose life and death interests are usually not taken
seriously. This problem increases with the growing inequality in
the modern world.

All this was in place on September 10, and still is. No one can
predict what will happen now. Some concerns:

* A major war now will further divert money, attention, and other
resources away from other issues, including health, education, and
development. With no clear enemy, there could be a permanent war
against terrorism, not seeking victory but rather building a
constituency for continuing conflict, like the drug war. It could
become a race to the bottom among governments and terrorists, each
trying to outdo the others in death and destruction.

* The harm to the U.S. economy from the attacks will result in
fewer resources for health programs of all sorts.

* Wars always result in curtailment of civil liberties. Over the
years AIDS activists have relied heavily on direct action
(demonstrations, often including civil disobedience) to get AIDS
onto the table of decision makers, when otherwise it would not
have been. Our impression since September 11 is that while most
demonstrations have been called off, more people are coming to
activist meetings than ever before because they need to talk with
others about what has happened and what it means. But there is
much concern about what kinds of activism will or will not be
allowed in the future -- especially in view of the major efforts
to make big changes in laws in days, with little or no chance for
public discussion or input (for fact sheets and other information,
see: //www.aclu.org; for recent Web links, see
http://www.indymedia.org -- especially the 'IMC News Blast' or
other edited summaries on that site).

Yet there has also been more solidarity among Americans in the
week and a half since the disaster -- from willingness to help
those affected, to expressions of patriotism, to activism for
peace, to people being less isolated from each other in everyday
life.

No one can predict what will happen. There is no U.S. precedent
for the attack of September 11 -- and few attacks in any country
with so many killed and so little warning. We can only do our best
work each day.


***** Tuberculosis: Guidelines Changed for Latent TB Treatment

The U.S. Centers for Disease Control and the American Thoracic
Society have issued new guidelines calling for more caution in
using the two-month regimen of rifampin and pyrazinamide. The
change resulted from reports of 21 cases of severe liver injury
with the two-drug regimen. Five of these patients died, and 16
recovered.

The new guidelines were published in the August 31, 2001 MMWR
(MORBIDITY AND MORTALITY WEEKLY REPORT), volume 50, number 34,
pages 733-735. We cannot summarize them because there are many
special cases. For most patients, especially those who are HIV-
negative, the older nine-month regimen of isoniazid (INH) should
be used. The persons with HIV, the guidelines include the
following:

"Available data do not suggest excessive risk for severe hepatitis
associated with RIF-PZA treatment among HIV-infected persons. In a
large multinational trial, HIV-infected patients treated with RIF-
PZA had lower rates of serum aminotransferarase (AT) elevations
than those given INH alone. The RIF-PZA regimen also was well
tolerated when given twice weekly to HIV-infected persons in
Zambia and Haiti. However, experience from trials may not
translate to all clinical practice settings, and it may be prudent
to use 9 months of daily INH for treatment of HIV-infected persons
with LBTI [latent TB infection] when completion of treatment can
be assured."

The August 31 MMWR is available at
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5034a1.htm


***** HIV/HCV Coinfection: One-Day Conference October 11 in
Washington

The Forum for Collaborative HIV Research is sponsoring a one-day
meeting on HIV and hepatitis C coinfection on October 11 in
Washington D.C. "Speakers will focus on the pathogenesis,
prevalence, and treatment of coinfection with the goal of
highlighting what we do and do not know to identify the need for
additional research efforts and facilitate progress in research on
HCV/HIV coinfection."

For more information, see http://www.hivforum.org


***** AmfAR Announces Research Grants: Letters of Intent Due
October 23

The American Foundation for AIDS Research has announced targeted
research grants up to $75,000, fellowships, and travel grants, for
studies of new viral and cellular targets for anti-HIV agents,
including use of combinatorial libraries. The letter of intent is
due 5 p.m. October 23, 2001.

More information and application forms are available at
http://www.amfar.org


***** ICAAC Postponed to December 16-19; "Salvage" Workshop Also
Postponed

Due to the recent terrorist attack and concerns about air travel,
the 41st Interscience Conference on Antimicrobial Agents and
Chemotherapy (ICAAC), originally scheduled for September 22-25 in
Chicago, has been postponed until December 16-19; it will be held
at the McCormick Place in Chicago. This conference focuses
primarily on new antibiotics, and also has a strong HIV/AIDS
track. For more information, see the conference Web site at
http://www.icaac.org

Also, the International HIV Workshop on Management of Treatment-
Experienced Patients, which had been scheduled for September 19-21
in Chicago, has been postponed. For more information, see
http://conferences.intmedpress.com/mtep/


***** ADAP Funding Crisis: Talking Points

The AIDS Drug Assistance Program (ADAP) is running out of money in
increasing numbers of states; already hundreds of people who
cannot pay for drugs through insurance or out of pocket are not
getting the medicines they need. The ADAP Working Group is an
industry-activist coalition to seek funding for this program,
which is administered separately by each state. On September 20
the Glaxo Wellcome representative to the ADAP Working Group
circulated the following talking points -- facts about ADAP as of
September 2001 -- to use for supporting this program, in Congress
or elsewhere:

* The AIDS Drug Assistance Programs (ADAPs), funded primarily
under Title II of the Ryan White Care Act, are in trouble across
the nation.

* ADAP programs around the country provide needed medications to
treat HIV disease to low-income and underinsured individuals
living with HIV/AIDS.

* Last year, a $130 million increase was requested to fund ADAP
programs in fiscal year 2001. Congress appropriated only $61
million for a total funding level of $589 million in federal
funding for fiscal year 2001, approximately $87 million less than
needed.

* We are now seeing the impact of this shortage on states,
particularly in the South. Nine state ADAPs have already closed
[to new patients] including: Alabama, Arkansas, Georgia, Indiana,
Kentucky, Maine, Montana, and South Dakota.

* Prior to the end of this fiscal year, 7 more states may cap
enrollment or institute other program restrictions including:
Idaho, Florida, Missouri, Nevada, Oregon, Rhode Island, and West
Virginia.

* Currently, there are over 600 people on waiting lists. As the
funding crisis grows, this number will increase.

* The number of clients served nationwide by state ADAPs has more
than doubled between 1996 and 2000, with ADAPs serving
approximately 70,000 clients a month.

* Recent reports of declining death rates and decreasing HIV-
related morbidity point directly to the importance and cost
savings of access to antiretroviral treatment and treatment
advances using combination therapies.

* In all parts of the United States, new HIV infections are
disproportionately affecting communities of color, rural
populations, inner city communities and women of color.

* The ADAP program is effective and accessible, providing the gift
of life to people across the country. The very success of HIV
disease treatments continues to increase the need for ADAP.

* There have been several congressional delegation letters
expressing the need for fiscal year 2002 increased appropriations
of $120 million for ADAP. We urge your careful consideration of
those requests.

* We join with our colleagues in speaking for patients across the
country that this increase would ensure that those enrolled in
ADAP treatment programs will not be cut off from these essential
treatments and necessary therapies will be available for those
identified by nationwide HIV outreach programs this year.

For additional information, see the ADAP Working Group site,
http://www.aidsinfonyc.org/awg/


***** U.S., Switzerland Oppose Developing-Country Proposal on
Access to Medicines

by John S. James

At a September 19 meeting in Geneva, Switzerland on access to
medicines, 52 developing countries asked the members of the WTO
(World Trade Organization) to agree that rules on international
patent protection (known as TRIPS) be interpreted in ways that
allow governments to ensure access to affordable medicines; they
were not asking for changes in the wording of TRIPS itself. The
United States and Switzerland, supported by Japan, Australia, and
Canada, opposed their proposal. The European Union did not support
either side and sought a negotiated solution; Norway was the only
rich country that sided with the developing countries. The
U.S./Swiss position "echoed the well-rehearsed views of the
international pharmaceutical companies," according to a press
release issued jointly by Doctors Without Borders, Oxfam, and
Third World Network.

The September 19 meeting was to prepare for the World Trade
Organization's fourth Ministerial Conference, scheduled for Doha,
Qatar, November 9-13, 2001.

For more information, see:

MSF (Doctors Without Borders -- Campaign for Access to Essential
Medicines):
http://www.accessmed-msf.org/index.asp

IFPMA (International Federation of Pharmaceutical Manufacturers
Associations):
http://www.ifpma.org/


***** AIDS TREATMENT NEWS Publication Schedule

AIDS TREATMENT NEWS usually is published twice a month, on the
first and third Friday. Because we have been behind schedule
recently, we are publishing only one issue in August and one in
September.


***** Malawi Plan to Control AIDS Epidemic: Interview with David
Scondras, Search for a Cure

by John S. James

In May 2001, when David Scondras was in Malawi, the headlines on
the May 19-20 WEEKEND NATION newspaper read, "Few on the AIDS
drugs; Babies May Be Saved; No Hope for the Poor." Almost the
whole front page was devoted to the epidemic.

Scondras was there working with health experts from Malawi and the
U.S. trying to change that picture -- by developing a plan to
control the epidemic in Malawi, a plan that could become a model
for other countries if it succeeds. While the number one goal is
to reduce HIV transmission, this plan will also include medical
treatment for those who need it -- and extensive operations
research to make sure that the program is working effectively.
This September, officials from Malawi are coming to Boston for
meetings to finalize the plan and begin steps toward
implementation. [The meeting was postponed after the September 11
terrorist attacks, but is still scheduled for September, with a
smaller delegation from Malawi.]

AIDS TREATMENT NEWS asked David Scondras to explain this project
to our readers. The interview took place on August 27, 2001.

ATN: Tell us what is happening now.

SCONDRAS: This will be the second trip that people from Malawi are
making to the United States to get help. Experts and officials,
including those responsible for Malawi's five-year plan to control
AIDS, are coming to Boston to, among other things, meet with
Jeffrey Sachs and others at Harvard's Center for International
Development. They will continue a process begun several months ago
in a previous trip, of having their countrywide plan reviewed by a
group of scientists that Search for a Cure pulled together, and
brought to Malawi as well as to Boston. Then, with the blessing of
the scientific community that is reviewing the plan, they will
seek funding from at least three different sources to implement
that countrywide plan as soon as humanly possible.

On this trip, Search for a Cure and Harvard are hosting them in
Boston for about a week.

ATN: How did this project develop?

SCONDRAS: Two years ago when I first went to Malawi, the president
of the country was on television and radio, explaining that there
were some medicines that could help this disease, but
unfortunately no one could afford them in Malawi, so they were
going to have to do without them. This entire picture changed when
we met with the Vice President and explained how these drugs work.
When it became clear that lowering viral load with these drugs
might help reduce transmission, it became obvious that these drugs
were a necessary part of the prevention program, not just help for
people who are sick. In that context people became much more
determined to see that there was access to them.

Finally, when CIPLA (a drug manufacturer in India) and other
generic producers offered generic drugs that were much, much less
expensive, there was an increase in morale in Malawi. And when the
Global AIDS Fund was announced, that morale reached the point that
the vice president of Malawi accepted an invitation from Search
for a Cure to come to the United States, and went to Harvard with
me and met with Jeffrey Sachs and put this whole program in
motion.

Malawi is determined to do a countrywide treatment program that
will stop the epidemic -- that's the objective. This will be one
of the tools.

ATN: Tell us about the country.

SCONDRAS: Malawi is a small country in sub-Saharan Africa, one
third of which is a giant lake. About 70% of the population of ten
million is small farmers. It has two big cities, Lilongwe and
Blantyre. It is one of the poorest countries in Africa, with a per
capita income in U.S. dollars around $250 per year. It has three
main Bantu languages; a major one is called Chichewa. English is a
second language for most people who are educated, because Malawi
was an English colony.

It is a very new democracy; it emerged from a struggle to end a
dictatorship only six years ago. The dictator had refused to allow
the word "AIDS" to be used. The first thing the new government did
was launch a prevention program across the country, with the
President singing anti-AIDS and behavior change songs on
television with schoolchildren -- to try to get people to
understand that AIDS is a crisis and people had to change their
behavior.

Development experts and economists came in to try to get the
country going after the dictatorship ended. But they quickly
realized that this country has about five years left to live.
Malawi has ten million people, over one million HIV-infected. It
has about 400,000 orphans who do not have HIV but whose parents
are dead as a result of the epidemic. Up to a point, extended
families and relatives can absorb orphans. But the ability to
sustain life is being stretched to its limits, as members of the
extended families are now dying, as workers are dying and
productivity is collapsing. The vice president compares the
situation to an earthquake or other natural catastrophe, and asks
why is the world so willing to help a country when there is a
sudden disaster like an earthquake, but so slow when there is a
crisis of equal magnitude that takes time to develop.

There has been a change. Malawi went from hopeless resignation to
a sense of aggressive optimism. They decided they are going to
live, and going to fight to live. This year Vice President Justin
Malewezi said:

"Malawi has not been spared this worldwide epidemic. Sixteen
percent of the population aged between 15 and 49 are HIV positive.
These people are commonly called People Living with HIV/AIDS.
However, these are not the only people living with the disease.
Every day we are burying our children, our sisters and brothers,
our workmates, our neighbors, our leaders, our teachers, doctors
and other professionals. In the suffering and death of our
brothers and sisters we face grief beyond words, sorrow beyond
tears. We will not stand by and watch while our people are dying."

A study by Hamoidi and Sachs looked at how the epidemic affects
individuals and families:

"To take an individual case, a husband and father of young
children, who earns a market income and who becomes HIV infected.
He is likely to face years of declining market income due to
absenteeism from work and reduced productivity before suffering a
premature death. Household income will be diverted to pay for
medical care, he is likely to sell assets and borrow at very high
interest rates to get minimal access to palliative care. Upon his
death, funeral costs will absorb savings from the extended family
while his children may be sent away to live with relatives and
their future education will be severely compromised. Tragically
this scenario is repeated in Malawi every day."

SCONDRAS: Malawi's plan [from which the above quotes are taken] is
a direct call for help, in human terms that are unmistakable and
explicit. If we don't respond to it, then there's something wrong
with us. We cannot say we didn't know about it.

ATN: Once the plan is ready, where does it go for funding?

SCONDRAS: Malawi already had a large and well-funded tuberculosis
program, using directly observed therapy (DOT), with community
workers who give medicine to individuals. Tuberculosis had been
almost wiped out -- but AIDS brought it back. So the DOT people
are willing to finance part of the program, as it affects their
ability to control tuberculosis. (A recent South African study of
people with HIV who use antiretrovirals vs. those who do not shows
a dramatic difference of five times more tuberculosis among those
who do not use the HIV drugs. So one can argue correctly that the
antiretroviral program is an effective tuberculosis program, as
70% of tuberculosis patients in Malawi are co-infected with HIV.)
The tuberculosis program is funded by the English contribution to
the European Community.

Malawi will have a DOT program for its HIV drugs, along the line
of what Dr. Paul Farmer has done on a smaller scale in Haiti. But
here it will be expanded to the whole country.

A second source of potential funding will be a request from the
Global AIDS Fund. The World Bank will be asked to change the
payments that Malawi is presently making on its debt, which are
considerable, and returning them to Malawi as grants targeted
specifically for this AIDS program.

In addition, Malawi is asking for a start-up grant from the World
Bank -- which has been directed to make 50% of its future
investments in developing countries in the form of grants instead
of loans. Incidentally the Bush Administration is supportive of
this shift from loans to grants.

There is also an effort to organize an international concert to
ask for support from the world community.

And in the U.S. Congress, Congresswoman Barbara Lee (D.,
California) is leading an effort to contribute an additional $150
million immediately to treatment.

ATN: How would Malawi purchase the drugs?

Malawi could use the International Dispensary Association (the
IDA) as a vehicle for drug purchases. The IDA (http://www.ida.nl/)
is a nonprofit organization based in Holland that has had a
terrific reputation over the years for being the purchaser of the
most inexpensive essential drugs for poor countries. They have
decided to add HIV drugs to their list. They don't just buy the
drug on behalf of the country; they also test the drugs on an
ongoing basis to maintain their quality. Clearly for small
developing countries, it is essential to have a dependable buyer
who will get you the best price and guarantee the quality of the
product. Malawi may choose to use the IDA for their HIV drugs,
especially since they already use it for their tuberculosis drugs.

Besides funding, other support is from volunteers who are helping
this effort and not getting paid, among them being quite a few
U.S. scientists, including Peter Salk, M.D., from the Jonas Salk
Foundation, and Robert Redfield, M.D., from the Institute of Human
Virology, and people from the U.S. Public Health Service.

Several of pharmaceutical companies are also going to try to help.

ATN: How is the AIDS program in Malawi organized?

SCONDRAS: Over a year and a half ago we helped put together a
meeting in Malawi, under the leadership of UNAIDS, which helped
create the Technical Working Group, a kind of committee with the
sanction of the cabinet of Malawi. This committee was given the
responsibility of developing a plan to use antiretrovirals in
Malawi, and overseeing its implementation. It is the only
committee I know of its kind that includes foreigners on it.

The Technical Working Group includes all the major stakeholders in
Malawi working with HIV, including the private hospitals and so
forth. That organization is headed by the director of the AIDS
program in Malawi. This is the organization that, if you are going
to do anything with HIV in Malawi, you have to get approval from.
Last week the Cabinet of Malawi gave the approval for moving
forward.

ATN: Is there any opposition?

SCONDRAS: The government of Malawi is fighting hard for this plan,
but not everyone is supportive. There is a lot of skepticism. Part
of the donor community has been trying to get Malawi to not do
this plan, still saying it's unrealistic, you should do prevention
only. Malawi is going forward anyway, because it does not see any
choice. Malawi knows that even a perfect vaccine tomorrow would be
too late to save the country. And besides that it would be immoral
not to try to save those already infected. This struggle has not
been made public, but people have a right to know about it.

ATN: What about foundation funding?

SCONDRAS: We will be seeking a planning grant to help finish
putting the program together.

Malawi wants to prove that you can stop an epidemic, and that
antiretrovirals can be part of that program, that it can be done.
But the first target for this program is reduction in transmission
of HIV.

ATN: Tell our readers about the research plans.

SCONDRAS: The plan itself makes a compromise between the demands
of science and the demands of the economy, ethics, and politics.
The scientific community wants to make sure through research on
the ground that the choice of medicines is correct, that the
delivery system is actually working, and so forth -- and that the
type of therapy used is the right one, and wants to see which
types of therapy might be better. Should we use interrupted
therapy? Does nutrition have a role? What about use of immune-
based therapies? You can imagine how many questions scientists
have. But it would take years to answer them all. Meanwhile the
country would collapse.

So Malawi is starting the program by basically enrolling everyone
into a best-guess approach -- using community-based directly
observed therapy that can be taken once a day. But many people, in
fact the majority, will be involved in a set of interlocking
clinical trials, which the scientists refer to as operations
research. These trials will test the different regimens and
different styles of delivering them, to find out which work
better. And as they learn what is best, they will phase out
certain treatments and switch people to others.

Malawi will maintain the research component, so that Malawi will
not only be a country that tries to stop the AIDS epidemic, but
also will become the world's largest clinical-trial system, to
find out the best way to reduce HIV transmission and improve on
existing therapies across the world. For example, studies could
test microbicides and see if they can reduce the rate of spread,
or test vaccines. The research component, the ability to track
data, analyze it, and feed it back to the working group and have
the government make decisions about what to do, has to be much
more advanced and larger than you would expect for a treatment
program. The advantage is that this research will help everyone in
the world, including people in the United States.

ATN: Could you summarize what's happening now?

SCONDRAS: In a few months Malawi will make history -- as its
leaders present this ambitious, countrywide program for stopping
AIDS in an African country to funders at the World Bank and the
Global AIDS Fund.

Malawi will not survive unless this program succeeds. Today a
million people are infected, there are 400,000 orphans, and the
whole country has only ten million people. If this plan works in
one of the poorest countries, then it can work elsewhere and will
become a beacon of hope for Africa and the rest of the world.

This effort has been put together by a team of volunteers
including some of the best medical minds in the world, students
from Harvard Business School, politicians, ministers, people with
HIV, people of good will from all walks of life, working together
with leaders from Malawi. It is possible because activists from
around the world have pushed for a worldwide AIDS fund, and for
reduced prices of antiretrovirals. Malawi will come to the United
States to work with some of this country's finest experts and
activists, all committed to finishing the design of the program
and finding the funds to put it into operation now.

Anyone interested in helping is welcome to call or write us and
join this effort. Many of us feel that one measure of our
civilization will be how the rich nations and people of the Earth
behaved during the most devastating epidemic in the history of the
world.

[For more information about the Malawi program, contact David
Scondras or Dede Ketover at Search for a Cure, 617-536-2474, or
email them at hope@...]

***** AIDS TREATMENT NEWS

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ISSN # 1052-4207

Copyright 2001 by John S. James. Permission granted for
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John S. James
AIDS Treatment News
http://www.aidsnews.org