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FW: Update on status of HIV/AIDS in Africa:

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  • Bell, Elizabeth
    fyi. some may be repetitive of what s been regularly posted on the listserve. those in/near wisc may be interested contacted aaron - an old rpcv from the
    Message 1 of 1 , Jun 29, 2000
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      fyi. some may be repetitive of what's been regularly posted on the
      listserve. those in/near wisc may be interested contacted aaron - an old
      rpcv from the drc/former zaire now working on hiv at cdc.

      > -----Original Message-----
      > From: Zee, Aaron
      > Sent: Thursday, June 29, 2000 9:11 AM
      > To: 'Lin Parsons (Zimbabwe)'; 'Kim Nichols (African Services Committee,
      > Inc.)'; 'Brad Barker'; 'paula loscocco'; 'peter f mcgivern'; 'Robert L
      > Reynolds'; 'Brad Barker'; 'Kathy Miner (GCP - RSPH - Emory)'; 'Kim Nichols
      > (African Services Committee, Inc.)'; 'laura shelby (nigeria)'; 'Maartin
      > Mol'; 'Tante Tap Zee'; 'Juliana & Michael'; 'paula loscocco'; 'Dan Frank';
      > Coggin, William; Coggin, William; 'Bonnie Kittle'; 'Charlie Walton';
      > 'Craig Martin'; 'Doane Perry (Friends of Uganda)'; 'Eliane Dogore';
      > 'Haitian Centers Council'; 'Hank Stephens'; 'Harry Goodall'; 'kate
      > winskell (Scenarios du Sahel - Dakar, SN)'; 'Kathy Miner (GCP - RSPH -
      > Emory)'; 'Keith Hackett'; 'Lin Parsons (Zimbabwe)'; 'Ross Thomson
      > (Northlake)'; 'SETZER, JIM'; 'Sandy Johnson'; 'Tante Tap Zee'; 'Tracy
      > Badsgard'; Bell, Elizabeth; Gittelman, David; Wechsler, Howell; Perry,
      > Sam; Cox, Ross; Qualls, Michael; McCray, Eugene; Bulterys, Marc; Do, Ann;
      > Naehr, Gerald; 002 APPLICATIONS SYS REPORTING; Alice Pope;
      > alice_pope@...; Badsgard, Tracy A.; bill coggin (new SA
      > address Y2K); Bill Gallo; Deymon Fleming; Emmanuel Puplampu (Ghana);
      > Parsons, M. Linwood; Tracy Badsgard; Anne Major; Anne Major (IETA2); Dawn
      > Broussard; dawn broussard (IETA2); Joseph Bronowski; Kerry Kenney; Kerry
      > Kenney (IETA2); Laura Shelby; Laura Shelby (IETA2); Mary Hayes; Mary
      > Hayes; Robert Kennedy (IETA2)
      > Cc: Martinez, Samuel A.
      > Subject: Update on status of HIV/AIDS in Africa:
      > In October I'm going to be facilitating a break-out session on the
      > HIV/AIDS situation in Africa at the State of Wisconson's annual public
      > health meeting. I've compiled a wealth of information specific to Africa
      > and put it into one document that you may find helpful/useful. If nothing
      > else, the shear impact of the epidemic will come screaming off the pages
      > and vibrate in your soul! I've basically just cut and pasted from the
      > National Prevention Information Network's prevention listserve all the
      > overviews of articles on Africa, dating back to late January 2000. While
      > certainly not exhaustive, it provides, I think, a "broad brushstroke" of
      > the gravity of the epidemic, and pertinent issues, on the African
      > continent. I intend to hand it out to the participants at the workshop in
      > Wisconsin in October. I've pasted the document for those of you who
      > cannot open files. There's also a file to open for those of you who want
      > to do so. Be well, all! Aaron
      > <<AfricanHIVInfo.wpd>>
      > "U.N. Warns of African AIDS Toll"
      > Washington Post (www.washingtonpost.com) (06/28/00) P. A1; Brown,
      > David
      > A new United Nations report warns that AIDS will kill up to
      > half of the young adults in some countries in southern Africa before
      > they reach middle age. AIDS has led to poor economic growth and
      > a decrease in life expectancy in sub-Saharan Africa, and the
      > effects will worsen in the coming years, according to Dr. Peter
      > Piot, director of UNAIDS. Last year, 2.8 million people died
      > from AIDS, and the report estimated there are now 34.3 million
      > people infected with HIV worldwide, including 1.3 million
      > children under the age of 15. The report showed mixed results on
      > the state of the global AIDS epidemic, citing both the
      > devastation in southern Africa but also progress in Senegal and
      > Uganda in fighting HIV and the increasing trend of condom use
      > among sexually active teenagers in some areas. South Africa, the
      > site of 13th International AIDS Conference next month, has about
      > 4.2 million people living with HIV--more than any other country.
      > The highest prevalence of infection is in Botswana, where 36
      > percent of adults have contracted HIV. Experts predict that AIDS
      > will take the lives of two-thirds of Botswanan 15-year-olds
      > before age 50, and they also forecast that in any nation where 15
      > percent of adults are now infected with HIV, at least 35 percent
      > of teenagers will eventually die from the disease. Some
      > encouraging news is that the number of pregnant teenagers with
      > HIV has decreased significantly in Lusaka, Zambia, and more young
      > Brazilian men are using condoms. In addition, the prevalence of
      > HIV in Uganda has dropped from 14 percent to 8 percent. Dr. Piot
      > noted that UNAIDS estimated that $1.6 billion to $2.6 billion is
      > needed to provide Africa with a "package" that would involve
      > limited use of with antiviral drugs to prevent mother-to-child
      > HIV transmission, and treatment of tuberculosis and other
      > infections.
      > "US Urges Strong Anti-AIDS Efforts After UN Report"
      > Reuters (www.reuters.com) (06/27/00)
      > The new United Nations report on AIDS has led Sandra Thurman,
      > head of the White House Office of National AIDS Policy, to call
      > for broader efforts to prevent HIV, especially in Africa. The
      > success of Uganda in reducing its infection rate could be used in
      > other nations, Thurman said. According to Thurman, leadership
      > can help end the stigma of AIDS and help disseminate HIV
      > prevention information, but cooperation from all sectors is
      > needed.
      > "Diseases Said Biggest World Disaster"
      > Minneapolis Star Tribune Online (www2.startribune.com)
      > (06/28/00); Leeman, Sue
      > A new report by the International Federation of Red Cross and
      > Red Crescent Societies indicates there were 13 million deaths from
      > preventable diseases in 1999. Increased public health services
      > could stop the number of deaths, as 160 times more people died
      > from AIDS, malaria, respiratory diseases, and diarrhea last year
      > than from natural disasters like earthquakes and cyclones. The
      > report noted the catastrophic effects of AIDS, which is now
      > taking the lives of 300 people an hour worldwide. According to
      > the report, health funding for developing nations from the
      > Organization for Economic Cooperation and Development fell to its
      > lowest level in seven years, and public spending on health in
      > poor nations averages only about 1 percent of gross domestic
      > product. Less spending on health worldwide has led to the
      > resurgence of once-controlled diseases like malaria and
      > tuberculosis. The report called for behavioral changes and
      > increased vaccinations against preventable diseases.
      > "Origins of HIV"
      > Science (www.sciencemag.org) (06/09/00) Vol. 288, No. 5472, P.
      > 1757; Hillis, David M.
      > The origins of HIV, and the date when simian immunodeficiency
      > viruses (SIVs) crossed over to humans are still being studied. A
      > recent study by B. Korber et al. used phylogenetic analysis to
      > estimate the year of HIV's origin. David M. Hillis of the School
      > of Biological Sciences at the University of Texas writes that by
      > the 1980s, when HIV was identified, widespread epidemics were
      > already taking place. It was known that HIV-1 came from
      > chimpanzees and viruses transmitted from sooty mangabeys were
      > called HIV-2. Korber calculated that the best estimate for
      > placing the common ancestry of HIV-1 M group is 1931. The
      > designation of the early 1930s reveals that the virus must have
      > been transmitted to humans before then, possibly in the 1800s or
      > early 1900s. It is also possible that the virus infected humans
      > around 1930 and rapidly began to spread. Another theory is that
      > multiple strains of HIV jumped from chimpanzees to humans around
      > the same time in the 1940s or 1950s. Korber's data seems to best
      > support the Transmission Early theory, Hillis writes. Under this
      > concept, the spread of the virus was slow, since HIV was present
      > in the 1930s but did AIDS did not become widespread until the
      > 1970s. Hillis also notes, "The epidemic exploded in the 1950s
      > and 1960s, coincident with the end of colonial rule in Africa,
      > several wars, the introduction of widespread vaccination programs
      > (with the deliberate or inadvertent reuse of needles), the growth
      > of large African cities, the sexual revolution, and increased
      > travel by humans to and from Africa."
      > "AIDS Devastates Africa, Destroys Human Dignity"
      > Reuters (www.reuters.com) (06/26/00); Swindells, Steven
      > AIDS has ruined 50 years of development in Africa, and Malawi is
      > one of many nations dealing with overcrowded hospital rooms and a
      > lack of medicine. AIDS has taken the lives of 12 million
      > Africans so far, and over 23 million in sub-Saharan Africa are
      > living with HIV. United Nations officials have called for a
      > Marshall plan to change sexual behavior and increase the use of
      > anti-AIDS drugs. According to some AIDS workers, a lack of
      > political leadership is also hurting Africa, as funding is often
      > spent on seminars and does not reach the ill.
      > "One in Four South African Men Admit Rape"
      > Reuters (www.reuters.com) (06/25/00)
      > A survey reported in South Africa's Sunday Times found that one
      > in four South African men questioned said they had committed rape
      > before age 18, while eight in 10 said they believed women were
      > responsible for sexual violence. Concern over South Africa's
      > high rate of rapes is warranted, as the number of rapes has risen
      > over five years. Police statistics show that the number of
      > reported rapes in the country increased from 109.8 per 100,000
      > people in 1994 to 119.1 in 100,000 last year. Of particular
      > concern with the high levels of rape is South Africa's AIDS
      > epidemic, as more than 4 million residents of the country are
      > thought to be infected with HIV
      > Ugandan Adults: Double-Blind, Randomised and Placebo Controlled
      > Trial"
      > Lancet (www.thelancet.com) (06/17/00) Vol. 355, No. 9221, P.
      > 2106; French, N.; Nakiyingi, J.; Carpenter, L. M.; et al.
      > A study of HIV-infected adults in Uganda by British and African
      > researchers attempted to determine if vaccination with 23-valent
      > pneumococcal polysaccharide vaccine is effective in preventing
      > complications like pneumonia or death among such patients. A
      > total of 1,392 HIV-1-infected adults enrolled in the study, 937
      > of them female. Of these adults, 697 received the vaccine and
      > 695 received a placebo. Results show the vaccine was well
      > tolerated. There were 34 instances of invasive pneumococcal
      > disease in 25 different subjects, with 29 of the cases among
      > patients who had received the vaccine; the other cases were in
      > individuals who had received a placebo. Five subjects had
      > recurrent invasive events. The pneumococcal vaccine offered no
      > protection to the adults studied, the researchers report.
      > Surprisingly, the rates of all-cause pneumonia were higher in the
      > group that received the vaccine. A total of 140 people died in
      > the first six months of the study, with 73 deaths due to wasting
      > syndrome and 61 due to cryptococcal disease. According to the
      > authors, immunization with the pneumococcal polysaccharide
      > vaccine for HIV patients was ineffective in this case and could
      > be detrimental to the health of such persons. The researchers
      > suggest that "the direct harmful effect of pneumococcal
      > polysaccharides is by destruction of polysaccharide-responsive
      > B-cell clones," and they conclude that overall, the vaccine
      > appears to have little public health value in sub-Saharan Africa.
      > **************************
      > "AIDS Is Moving into Rural Areas, U.N. Study Says"
      > New York Times (www.nytimes.com) (06/23/00) P. A11; McNeil Jr.,
      > Donald G.
      > A report from UNAIDS and the Food and Agricultural Organization
      > indicates that HIV is moving into rural areas of developing
      > countries. The shift may have disastrous effects, because while
      > sick city residents can sometimes obtain help from social
      > services or beg on the streets, the fatal illness of one adult in
      > a poor farm family can lead to the farm's collapse. "HIV hits
      > particularly the young adults, and they are the core of the labor
      > force, the keystone of the farm household," said Jacques du
      > Guerny, an AIDS expert at the Rome-based Food and Agricultural
      > Association. The report noted that, in turn, food production for
      > city residents may decline, and any crops that are planted may be
      > less labor-intensive and less nutritious. Areas particularly
      > hard hit are Africa, India, and some Caribbean nations. HIV is
      > spreading into rural regions as people migrate to cities or mines
      > for work, become infected, and return home for visits. The virus
      > is also being spread along trucking routes, where prostitution is
      > rampant. Cities are usually the focus of prevention efforts like
      > sex education and condom distribution, while customs that can
      > further HIV's spread, such as "cleansing" a widow via sex with a
      > relative of her dead husband, are more prevalent in rural areas.
      > The study offered no global estimate of urban-rural prevalence,
      > noting that rural HIV infections tend to be underreported or
      > misdiagnosed.
      > "Africa Debt Relief Needed to Tackle AIDS--WEF"
      > Reuters (www.reuters.com) (06/21/00); Isa, Mariam
      > The World Economic Forum (WEF) has released a report calling
      > for debt relief in Africa to allow its governments money for health
      > and AIDS programs. The 290-page report cited war, floods, and
      > disease outbreaks as threats to the African economy. AIDS is
      > expected to hurt foreign investment and strain government budgets
      > as overall profits decline. The report noted that debt relief
      > has been given to only a fraction of countries considered for it.
      > "Condom Use Among Botswana Youth Low"
      > PANA Wire Service (www.africanews.org/PANA) (06/21/00)
      > Margaret Mosojane, a community leader in Botswana, said Tuesday
      > that many youths in the country are not using condoms, despite
      > their efficacy in helping to prevent the spread of HIV. Mosojane
      > cited the high rate of teen pregnancy in Botswana as evidence of
      > unprotected sex among youths. One of the countries hardest hit
      > by the AIDS epidemic, Botswana is estimated to have an HIV
      > infection rate of about 25 percent.
      > "South Africans May Spurn Gift From Pfizer Inc."
      > Wall Street Journal (www.wsj.com) (06/21/00) P. B1; Waldholz,
      > Michael
      > Although the notion of philanthropy from drugs companies is
      > very appealing to southern African governments given their small
      > budgets, officials for the South Africa health ministry may well
      > refuse a gift from Pfizer of an AIDS-fighting medication because
      > of the restrictions--including a two-year limit of the donation,
      > the patients for whom the drug may be used, and how the drug's
      > action will be recorded--Pfizer has placed on the offer. While
      > Diflucan is the only effective therapy for the deadly
      > cryptococcal meningitis that affects many HIV patients in
      > sub-Saharan Africa, its daily costs of between $4.50 and $9 are
      > prohibitive for the South African government and most patients.
      > Patients' rights activists, including Doctors Without Borders,
      > have repeatedly asked Pfizer to lower the price of Diflucan, as
      > its cost in Thailand--where Pfizer's patents are not
      > enforceable--is just 60 cents per day, but Pfizer countered with
      > its restricted donation offer. Not surprisingly, Pfizer's
      > charity ends with its patent expiration at the end of 2002, and
      > while that means South African doctors would be able to then buy
      > cheaper generic versions of Diflucan, some officials are
      > suspicious that Pfizer's intention is to acclimate physicians
      > there to the free branded version, as the doctors would be
      > reluctant to switch to a generic formulation when the patent
      > expires.
      > "War Creates Explosive AIDS Situation in Central Africa"
      > PANA Wire Service (04/20/00); Masebu, Peter
      > Kadi Mwady Aimee, president of Congo's chapter of the Society
      > of African Women and AIDS, said wars in the central African region
      > will cause an explosion of AIDS, based on the rapes and
      > promiscuity being seen today. Aimee spoke at a meeting of
      > African anti-AIDS nongovernmental organizations (NGOs), where
      > Dr. Ibra Ndoye, of the Senegalese national AIDS Control Program,
      > called for more cooperation and better donors to help NGOs fight AIDS.
      > Also, Tati Isaac, a member of the Cameroonian Network of People
      > Living With HIV/AIDS, noted that although they were trying to
      > fight the AIDS epidemic, many NGOs had insufficient resources,
      > and he called on the international community to help Africa fight
      > back.
      > "Ugandans Use Over 60 Million Condoms"
      > Africa News Service (04/20/00); Ngatya, Kikonyogo; Musamali, A.G.
      > Ugandans use about 60 million condoms a year, a figure
      > expected to rise as awareness about sexually transmitted diseases
      > increases. The female condom is also being used more often, for
      > a total of about 1 million a year. Prof. John Rwomushana, head
      > of the health and research unit at the Uganda AIDS Commission,
      > noted that the country has an open policy to make the public,
      > particularly youths, aware of contraceptives. Rwomushana met
      > with a delegation of Indian officials this week that wanted to
      > learn more about Uganda's methods of fighting HIV.
      > "South African President Escalates AIDS Feud"
      > Washington Post (www.washingtonpost.com) (04/19/00) P. A1;
      > Gellman, Barton
      > South African President Thabo Mbeki believes his country should
      > be able to seek help from scientists who deny that HIV causes
      > AIDS, challenging the medical establishment and raising a heated
      > dispute. In a letter to President Clinton and other leaders,
      > Mbeki insisted that his country should meet with scientists who
      > hold other views on Africa's AIDS epidemic, noting that it "would
      > constitute a criminal betrayal of our responsibility to our own
      > people" to imitate foreign methods of treating the disease.
      > Around 4.2 million South Africans have HIV, and many officials
      > said they were shocked that Mbeki would continue the dispute and
      > maintain controversy over AIDS. The letter from Mbeki has not
      > reached the public, but Assistant Secretary of State Susan Rice
      > said much of it was logical and acknowledges the severity of the
      > AIDS problem in Africa, specifically in South Africa. Last week,
      > Sandra Thurman, head of the White House office of national AIDS
      > policy met in Atlanta with South African health minister Manto
      > Tshabalala-Msimang and Ambassador Makate Sisulu to discuss
      > Mbeki's letter. Thurman said they discussed "how important it is
      > to make sure we're spending most of our time and energy focused
      > on doing the things we know how to do to stop this epidemic."
      > "South Africa Has 4.2 Million People With HIV"
      > CNN Online (www.cnn.com) (04/18/00)
      > New statistics show that South Africa has 4.2 million people with
      > HIV, almost 10 percent of the population. The figures confirm
      > that the country has one of the highest HIV rates in the world.
      > The data, extrapolated from the 10th national antenatal HIV
      > survey, showed that 22 percent of tested pregnant women carry the
      > virus, with one in three testing positive in the province of
      > KwaZulu-Natal. South Africans in their 20s accounted for over
      > half of the HIV cases.
      > "World Trade Officials Pledging to Step Up Effort Against AIDS"
      > New York Times (www.nytimes.com) (04/18/00) P. A1; Kahn, Joseph;
      > Kifner, John
      > The world's top finance ministers and central bank governors at
      > the World Bank have promised to commit more money to fight AIDS
      > in developing countries. The news came as protests against the
      > World Bank continued in Washington on Monday and officials agreed
      > to quicken debt relief for developing nations. The officials
      > noted that AIDS is a poverty issue as well as a matter of public
      > health. The disease is spreading rapidly in Africa, India,
      > China, and the Caribbean, all of which are key World Bank clients.
      > James Wolfensohn, president of the World Bank, said the fight
      > against AIDS will intensify as part of the bank's goal to fight
      > poverty. "We will make sure that no sensible [AIDS] program is
      > stopped for lack of money," Wolfensohn said. The Development
      > Committee of the bank made AIDS lending the bank's top priority
      > and plans to help nations affected by the disease set up
      > prevention and treatment programs.
      > "Counting the Economic Cost of AIDS"
      > Financial Times (04/17/00) P. 6; Crooks, Ed
      > Grim figures on the HIV epidemic--including 2.6 million deaths
      > resulting from AIDS in 1999, at least 35 million people currently
      > infected with HIV, and 15,000 more contracting the virus every
      > day--were presented at the G7 finance ministers meeting at the
      > World Bank in Washington. Not only are individual tragedies more
      > widespread, but with 95 percent of all HIV cases occurring in
      > developing countries, the virus' social and economic costs are
      > devastating for nations struggling to treat infected people. The
      > spread of HIV has become large enough to become a major issue for
      > development policymakers at the International Monetary Fund and
      > the World Bank, who have found it difficult to convince finance
      > ministers that AIDS is a concern for nations as a whole, not just
      > health departments. While a number of AIDS treatments exist that
      > prolong the life of HIV patients and improve their health for a
      > longer period of time, few drug companies or nations have moved
      > to make the drugs affordable for poorer countries, although
      > Bristol-Myers Squibb, Pfizer, and Glaxo Wellcome have all
      > extended some HIV drugs to southern African nations at reduced
      > prices or for free.
      > "A World War on Disease"
      > Los Angeles Times Online (www.latimes.com) (04/17/00)
      > Dr. Nils Daulaire, head of the Global Health Council, said last
      > week that treatable infections are the leading cause of death
      > worldwide. An editorial in the Los Angeles Times notes that "the
      > history of AIDS, last year's outbreak of West Nile encephalitis
      > in New York, and the resurfacing of tuberculosis in parts of the
      > United States have shown that, in our global age, infectious
      > diseases are not contained by seas and continents." The editors
      > recommend that Congress pass a bipartisan bill by Reps. Sherrod
      > Brown (D-Ohio) and Constance A. Morella (R-Md.) that would give
      > $100 million to nations hardest hit by tuberculosis. Also, a
      > bill proposed by Sen. Patrick Leahy would double the $1 billion
      > the United States now spends on infectious disease programs in
      > poor countries. While the editors note that the overall sum will
      > be debated, they also suggest that the funds be given to programs
      > that have sharp oversight and culture-specific designs, noting
      > that fighting global disease is a "fiscal and national security
      > imperative."
      > "Mbeki Questions HIV Link to AIDS"
      > Washington Post (www.washingtonpost.com) (04/17/00) P. A15
      > South African President Thabo Mbeki upheld his decision to
      > question the link between HIV and AIDS, a move that has angered
      > many health activists. The president has ordered the Health
      > Ministry to establish a 20-person international panel to
      > investigate the matter, noting he is not convinced HIV is the
      > only virus that causes AIDS or deaths that have been attributed
      > to the disease. In discussing the panel, which will include
      > researchers who doubt that HIV causes AIDS, Mbeki explained: "The
      > reason we are doing all of this is to be able to respond
      > correctly to what is reported to be a major catastrophe on the
      > African continent." An estimated 1,700 South Africans are
      > infected with HIV daily.
      > "Soaring HIV/AIDS in Africa Worries UK Minister"
      > Africa News Service (04/12/00)
      > Clare Short, the British Minister for International Development
      > and Cooperation, asserted this week that unless aggressive steps
      > are taken to stem the spread of HIV in Africa, poverty reduction
      > and development efforts on the continent will not see any change.
      > Short noted that "HIV/AIDS is a desperate economic and
      > development tragedy and [is having a] grave effect on quality of
      > life." Furthermore, she said that no change in behavior is
      > likely if there is no frank talk about sex.
      > "Most Nations Fail to Supply Safe Blood, W.H.O. Finds"
      > New York Times (www.nytimes.com) (04/07/00) P. A6; Crossette,
      > Barbara
      > The World Health Organization (WHO) estimates that more than
      > two-thirds of the world's nations are not supplying safe blood to
      > their people, contributing significantly to the spread of HIV and
      > other diseases. The WHO and International Federation of Red
      > Cross and Red Crescent Societies are launching today, World
      > Health Day, a campaign to improve blood safety throughout the
      > world. According to a survey, the poorest countries are most at
      > risk and are frequently where diseases are spreading the most
      > rapidly. Many Third World countries pay donors for blood, and
      > Dr. David Brandling-Bennett, deputy director of the Pan American
      > Health Organization (PAHO), notes that "paid donors, it has been
      > demonstrated many, many times, are at a much higher risk of being
      > infected." PAHO's Dr. Jose Ramiro Cruz said that the Western
      > Hemisphere has the safest blood in the world, while other
      > regions--particularly South Asia and Africa--have much less safe
      > blood supplies. Because public health is a low priority in many
      > poor countries, blood testing is often not a primary focus.
      > "Health and humanitarian issues should be central in foreign
      > policies, not peripheral issues," said Dr. Kevin Cahill, the
      > president of the independent Center for International Health and
      > Cooperation.
      > "Agencies Urge Use of Affordable Drug for HIV in Africa"
      > New York Times (www.nytimes.com) (04/06/00) P. A1; McNeil, Donald
      > G.
      > The World Health Organization and UNAIDS have recommended that
      > Africans infected with HIV be given regular doses of a common
      > antibiotic known as trimethoprim-sulfamethoxazole, or
      > cotrimoxazole. The drug, also sold as Bactrim by Roche
      > Pharmaceuticals, is used in the United States to treat urinary
      > tract infections and bronchitis. The groups have preliminary
      > evidence that the drug could add years to the lives of Africans
      > and delay complications associated with AIDS. Preventive use of
      > the drug, which is already widely available in Africa for the
      > treatment of childhood pneumonia and bacterial diarrhea, could
      > cost between $8 and $17 a year per patient. The Clinton
      > administration has already committed at least $100 million to
      > fight AIDS abroad; it may also contribute millions to help
      > distribute Bactrim, although it has not yet determined how much
      > it will spend. Dr. Helene Gayle, director of the National Center
      > for HIV, STD, and TB Prevention at the Centers for Disease
      > Control and Prevention, notes that the drug is "cost-effective,
      > it's ready to roll, and it may become an important component of
      > the program." The long-term effects of the drug are still
      > unknown; but a one-year study in the Ivory Coast found that
      > Bactrim reduced death rates by 50 percent, while another study in
      > the same country revealed that the drug cut the number of serious
      > complications such as pneumonia and diarrhea by half.
      > "South Africa Halts Anti-AIDS Drug Trial"
      > Reuters (04/05/00); Lovell, Jeremy
      > South Africa has stopped further testing of the AIDS drug
      > nevirapine after five women died in a trial run by Triangle
      > Pharmaceuticals. The country's health minister, Mantombazana
      > Tshabalala-Msimang, noted that so far the death rate for
      > participants in the trial is 1 percent, with a liver toxicity
      > profile of 11 percent. Clinical trials in Uganda have shown that
      > nevirapine, which is made by Roxane Laboratories, can
      > successfully prevent mother-to-child HIV transmission. While
      > advocates cite the drug's apparent efficacy and low cost when
      > compared with AZT, Tshabalala-Msimang said the Ugandan research
      > was inconclusive in terms of potential long-term adverse
      > reactions.
      > "Three Million People With HIV in Ethiopia"
      > Reuters (04/05/00)
      > Over 3 million people in Ethiopia have HIV, which is 9.3 percent
      > of the country's sexually active population, according to a new
      > report. Eduard Sanders, program manager of the Ethio-Netherlands
      > AIDS Research Project, also warned that rural areas of
      > Ethiopia--where the majority of the population lives--may have
      > more infections than reported. Sanders noted that research on
      > so-called low-risk groups indicates that the rate of HIV
      > infection ranged from 7 percent to 23 percent in urban areas.
      > "Microsoft Foundation Fights AIDS in Africa"
      > Washington Times (www.washtimes.com) (04/05/00) P. A15
      > The Bill and Melinda Gates Foundation has donated $57 million
      > for AIDS programs in Botswana, Ghana, Uganda, and Tanzania. The
      > funds will be used to boost national campaigns to protect young
      > people under age 25 from HIV, the United Nations said. U.N.
      > Secretary-General Kofi Annan noted, "The contribution of the Bill
      > and Melinda Gates Foundation will save the lives of hundreds of
      > thousands of young men and women in Africa."
      > "Making a Better World With U.S. Money"
      > Washington Post (www.washingtonpost.com) (04/05/00) P. C15; Mann,
      > Judy
      > In a commentary, Washington Post columnist Judy Mann notes that
      > the latest Rand report on American attitudes shows that 59
      > percent of Americans favor international assistance for other
      > countries. According to the survey, Americans wanted the money
      > spent on such issues as children's health, the environment, and
      > helping women avoid unwanted pregnancies. Eighty percent
      > supported funding for voluntary family planning programs in other
      > nations. Another area that Mann notes requires U.S. assistance
      > is the spread of multidrug-resistant tuberculosis (TB), affecting
      > such countries as Russia, Denmark, Germany, and New Zealand. The
      > outbreaks of TB cost $2 billion according to the World Health
      > Organization (WHO), although TB can be cured for around $20 or
      > less per patient in developing countries. Treating TB that is
      > drug-resistant is 100 times more expensive, however, and less
      > effective. Arata Kochi, head of the WHO's Stop TB Initiative,
      > says wealthier countries must help others establish effective TB
      > control programs--an effort that will require millions of dollars
      > from donor countries. In conclusion, Mann points out that
      > "investing in TB programs now can save us from disastrous
      > epidemics tomorrow."
      > "Pfizer Plans to Provide Diflucan Drug at No Cost to South
      > African With AIDS"
      > Wall Street Journal (04/03/00) P. 43; Walholz, Michael
      > Pfizer's surprising initiative to provide Diflucan free of charge
      > to South African AIDS patients with cryptococcal meningitis may
      > lead to other drug manufacturers reducing drug prices or giving
      > drugs away in impoverished nations. Pfizer's decision comes
      > amidst advocacy efforts in several countries by Doctors Without
      > Borders and Treatment Action Campaign to get the company to
      > reduce the price of the drug. The majority of South Africans and
      > other Africans cannot afford the drug, which costs between $13
      > and $17 a day at retail, while generic versions of the drug sell
      > for $1.50 in Thailand. In addition to the expensive requirement
      > of dispensing Diflucan for the rest of a patient's life, Pfizer's
      > decision will likely bring pressure from other needy countries that
      > also want the drug.
      > "4,000 TB Cases Diagnosed in Swaziland"
      > PANA Wire Service (03/29/00)
      > Swaziland recorded more than 4,000 new cases of tuberculosis (TB)
      > last year, with 800 deaths from the disease. Health and Social
      > Welfare Minister Dr. Phetsile Dlamini noted that 58 percent of TB
      > patients are also infected with HIV, according to a 1998 study.
      > Many of the TB cases are among young people, Dlamini said. She
      > highlighted the need for effective treatment to stop the
      > transmission of the TB bacterium to others.
      > "Kenyans Using 10 Million Condoms Monthly"
      > PANA Wire Service (03/29/00); Okoko, Tervil
      > Increased awareness about HIV and AIDS has spurred greater use of
      > condoms in Kenya, according to health officials. At a recent
      > workshop, Meshack Ndolo, the head of the National AIDS and
      > Sexually Transmitted Diseases Control Program reported that
      > Kenyans are using 10 million condoms a month. Ndolo also said
      > the incidence of syphilis has dropped significantly in the past
      > decade, although many people are still contracting sexually
      > transmitted diseases, with about 120,000 cases being treated
      > every month. The official noted that the AIDS epidemic is taking
      > its toll on society, affecting the work force, raising medical
      > costs, and causing psychological trauma.
      > "Zambia's Kaunda to Become Peace, AIDS Activist"
      > Reuters (03/28/00); Esipisu, Manoah
      > Former Zambian President Kenneth Kaunda, who recently resigned as
      > head of the United National Independence Party, has announced his
      > intention to help fight the AIDS epidemic and work toward peace
      > in Africa. Statistics show that 25 percent to 30 percent of
      > Zambia's adult urban population has HIV or AIDS. Kaunda, who led
      > the nation for 27 years before losing the 1991 election, also
      > admitted for the first time that his son died of AIDS nearly 15
      > years ago, leaving him to raise his five grandchildren.
      > "Malawi: Donors Pledge 110 Million Dollars to Anti-AIDS Campaign"
      > Africa News Service (03/27/00); Tenthani, Raphael
      > Malawi has received $109.1 million in donations to help fight
      > AIDS, as a two-day meeting brought together government, AIDS
      > groups, and donor agencies. The latest plan in Malawi to fight
      > AIDS is the Strategic Framework for HIV/AIDS for 2000-2004, which
      > will emphasize civic education, particularly for the rural poor.
      > The donations came from several nations, including the United
      > States, the Netherlands, Norway, Canada, and Germany. At the
      > meeting, participants stressed the need to protect individuals
      > who were still HIV-free, while also supporting those already
      > infected.
      > "Lobola, AIDS and Africa"
      > Washington Post (www.washingtonpost.com) (03/27/00) P. A27;
      > Mathabane, Mark
      > A commentary in the Washington Post draws attention to the
      > practice of lobola, in which African girls are bought as wives
      > for a cash or livestock dowry. Author Mark Mathabane cites this
      > practice as one reason why AIDS affects more women than men in
      > South Africa, which has 4 million people carrying HIV. Lobola,
      > rape, and older men taking advantage of younger girls are the
      > reasons for the spread of HIV among young women. The tale of
      > Florah, the author's sister, highlights the need for change.
      > Florah's husband was repeatedly unfaithful to her and put her at
      > risk of infection with HIV and other sexually transmitted
      > diseases. Florah could not leave her husband because he could
      > ask for his money back and she was told leaving would disgrace
      > the family. The author notes that many women stay in such
      > situations and, even when faced with the threat of disease, do
      > not mention condoms. According to Mathabane, while additional
      > funding certainly is needed for vaccine research, prevention
      > campaigns, and education, such "measures will be effective only
      > if issues such as the oppression of women are vigorously
      > addressed."
      > "An Improbable Theory on AIDS Is Put to the Test"
      > New York Times (www.nytimes.com) (03/21/00) P. D1; Altman,
      > Lawrence K.
      > Three laboratories in the United States and Europe will start
      > testing soon samples of an experimental polio vaccine tested in
      > the Belgian Congo in the 1950s to determine if it was
      > accidentally made with chimpanzee tissues that could have
      > contained the ancestor of HIV. The Wistar Institute in
      > Philadelphia made the experimental vaccine and has kept drops of
      > it frozen since 1957. The tests follow the publication of a
      > theory in Edward Hooper's book, "The River," that an oral polio
      > vaccine in the Congo started the spread of HIV to humans;
      > however, scientists do not expect conclusive evidence proving or
      > disproving the theory. In part, this is because no one knows
      > whether the samples being tested are the same as the vaccine that
      > was actually administered in the Congo. The scientists will test
      > coded samples, the actual identities of which will only be known
      > to the independent lab and an independent committee of scientists
      > appointed by Wistar. The code will only be revealed after the
      > study is complete.
      > "South Africa in a Furor Over Advice About AIDS"
      > New York Times (www.nytimes.com) (03/19/00) P. A21; Swarns,
      > Rachel L.
      > South African President Thabo Mbeki recently consulted with two
      > American scientists who do not believe that HIV causes AIDS,
      > sparking concerns that already high HIV infection rates in the
      > country will continue to climb. Mbeki spoke with biochemist
      > David Rasnick and Charles Geshekter, a professor of African
      > history at California State University at Chico. Parks
      > Mankahlana, the president's spokesman, explained that Mbeki
      > wanted to speak to everyone and get all opinions. But Dr. Awa
      > Coll-Seck of the United Nations' Department of AIDS Policy in
      > Geneva fears that Mbeki's move could have dangerous results.
      > "People will reassure themselves, perhaps, that they can continue
      > risky behavior because HIV is not the real cause of AIDS,"
      > Coll-Seck said of the issue of whether there is a causal link
      > between HIV and AIDS. Most researchers and organizations,
      > including UNAIDS and the World Health Organization, believe the
      > relationship between the virus and AIDS has already been well
      > established. Rasnick and others claim that AIDS is caused by
      > malnutrition and recreational drug use.
      > "Zambia Steps Up Fight Against AIDS"
      > Reuters (03/16/00); Esipisu, Manoah
      > Zambia announced on Thursday the formation of a cabinet AIDS
      > council and a national secretariat to coordinate the fight
      > against the disease. Information Minister Newstead Zimba said
      > that 25 percent to 30 percent of adults in urban areas and up to
      > 15 percent of those in rural areas have HIV. The new council
      > will focus on HIV prevention and offer care to those already
      > infected. Zimba noted that HIV and AIDS have significantly
      > increased health spending in Zambia, which is expected to
      > increase from $3.4 million annually 10 years ago to $18.3 million
      > by 2004.
      > "AIDS Proves Deadlier Than War in Africa"
      > Washington Times (www.washtimes.com) (03/14/00) P. A15
      > United Nations Secretary-General Kofi Annan said Monday that AIDS
      > has taken the lives of more Africans in the past year than have
      > all the wars on the continent. Annan called on governments to
      > take action against the epidemic and noted, "We must end the
      > conspiracy of silence, the shame over this issue."
      > "New Vaccines for the Poor"
      > New York Times (www.nytimes.com) (03/14/00) P. A28
      > President Clinton's new budget includes a plan that would
      > encourage pharmaceutical companies to develop vaccines for poor
      > nations, note the editors of the New York Times. Millions of
      > people die every year from AIDS, malaria, and tuberculosis; the
      > majority of these individuals are poor and cannot pay for drug
      > treatments. Under Clinton's proposal, drug companies would
      > receive a targeted tax credit as an incentive for vaccine
      > research. The companies would be given one dollar of credit for
      > each dollar of sales of new vaccines they make to nonprofit
      > groups in poor nations. The plan should cost $1 billion for nine
      > years and would be restricted to new vaccines for malaria and
      > infectious diseases that kill over 1 million people a year.
      > "South Africa AIDS Activists Press Pfizer to Drop Prices"
      > Reuters (03/13/00); Sithole, Emelia
      > South African AIDS activists are calling on Pfizer to lower the
      > price of fluconazole, which helps prevent and treat thrush and
      > cryptococcal meningitis, two opportunistic infections linked to
      > HIV. According to the activists, the drug company has one week
      > to respond to the demand, or it could face industrial action and
      > lobbying from groups like ACT UP and Medecins Sans Frontieres.
      > The Treatment Action Campaign (TAC) also plans to urge the South
      > African government to allow imports of the drug and generic
      > versions to be sold as well. In South Africa, fluconazole is
      > sold under patent at a wholesale price of 57 rand per 200 mg
      > capsule to the private sector and 37 rand to public services;
      > however, TAC said that most public hospitals and workers could
      > not afford the daily dose of up to 400 mg, and it called on
      > Pfizer to lower the cost to less than four rand per 200 mg for
      > the public sector.
      > "New Vaccines for the Poor"
      > New York Times (www.nytimes.com) (03/14/00) P. A28
      > President Clinton's new budget includes a plan that would
      > encourage pharmaceutical companies to develop vaccines for poor
      > nations, note the editors of the New York Times. Millions of
      > people die every year from AIDS, malaria, and tuberculosis; the
      > majority of these individuals are poor and cannot pay for drug
      > treatments. Under Clinton's proposal, drug companies would
      > receive a targeted tax credit as an incentive for vaccine
      > research. The companies would be given one dollar of credit for
      > each dollar of sales of new vaccines they make to nonprofit
      > groups in poor nations. The plan should cost $1 billion for nine
      > years and would be restricted to new vaccines for malaria and
      > infectious diseases that kill over 1 million people a year.
      > "South Africa AIDS Activists Press Pfizer to Drop Prices"
      > Reuters (03/13/00); Sithole, Emelia
      > South African AIDS activists are calling on Pfizer to lower the
      > price of fluconazole, which helps prevent and treat thrush and
      > cryptococcal meningitis, two opportunistic infections linked to
      > HIV. According to the activists, the drug company has one week
      > to respond to the demand, or it could face industrial action and
      > lobbying from groups like ACT UP and Medecins Sans Frontieres.
      > The Treatment Action Campaign (TAC) also plans to urge the South
      > African government to allow imports of the drug and generic
      > versions to be sold as well. In South Africa, fluconazole is
      > sold under patent at a wholesale price of 57 rand per 200 mg
      > capsule to the private sector and 37 rand to public services;
      > however, TAC said that most public hospitals and workers could
      > not afford the daily dose of up to 400 mg, and it called on
      > Pfizer to lower the cost to less than four rand per 200 mg for
      > the public sector.
      > "Zambia: Incorporate AIDS Subject in Schools Curriculum"
      > Africa News Service (03/09/00)
      > In Zambia, UNAIDS country representative Dr. Kenneth Ofosu Barku
      > has suggested that students entering college in the country
      > should first pass a class about AIDS. At a workshop in Lusaka,
      > Barku said HIV should be a priority in the curriculum so Zambia
      > can successfully fight the epidemic. He noted, "HIV/AIDS is the
      > major problem which has led to all the development problems
      > because people could not get the formal education in the first
      > place regarding the disease."
      > "U.N. Peacekeepers Spreading AIDS, U.S. Says"
      > United Press International (03/08/00); Baker, Ashley
      > Some United Nations peacekeepers are "unintentionally" spreading
      > HIV in the countries they are trying to help, according to
      > Richard Holbrooke, the U.S. ambassador to the United Nations.
      > Holbrooke asserted, "As long as I am ambassador, the United
      > States will never again vote for a peacekeeping resolution that
      > does not require specific action by the (U.N.) to prevent AIDS
      > from spreading by or to peacekeepers." Lawmakers are trying to
      > gain support for a $100 million trust fund that, over the course
      > of five years, would be used to fight AIDS in sub-Saharan Africa,
      > India, and the former Soviet Union.
      > "AIDS Threatens to Kill 10 Percent of South African Miners"
      > PANA Wire Service (03/08/00); Mulenga, Mildred
      > New statistics show that 10 percent of South Africa's 500,000
      > mine workers could die from AIDS unless aggressive measures are
      > taken. According to Marlea Clarke, a researcher from the
      > University of Cape Town, AIDS-related deaths are increasing for
      > miners, who often visit commercial sex workers. Clarke reported
      > that more than three-quarters of the sex workers living in
      > informal settlements near some of the mines were infected with
      > HIV. Clarke, who reported her findings at the Regional Labor
      > Migration Seminar for Southern Africa, said that many of the
      > HIV-infected workers were also infected with tuberculosis.
      > "Ignorance Could Worsen South Africa AIDS Threat"
      > Reuters (03/01/00)
      > A survey by MarkData found that, in a sample of 2,200 South
      > Africans, between 55 percent and 65 percent of the population was
      > exposed to significant degree of risk for HIV infection because
      > of ignorance regarding the disease. An estimated 1,700 South
      > Africans are infected with HIV each day, and, according to the
      > report, 20 percent of the population studied was considered at
      > extreme risk for contracting the virus. Lack of safe sex and
      > other fallacies regarding HIV are fueling the crisis. Some of
      > the individuals surveyed thought AIDS was not necessarily fatal,
      > while others said they thought a cure was available.
      > "Zimbabwe's Sad Lack: Land to Bury AIDS Victims"
      > New York Times (www.nytimes.com) (03/01/00) P. A4; Cauvin, Henri
      > E.
      > In Zimbabwe, AIDS deaths are filling up cemeteries in record
      > time. The United Nations estimates that 25 percent of Zimbabwe's
      > 6 million adults are infected with HIV. The Granville cemetery
      > in Harare was built to last around 40 years, but the current rate
      > of deaths may fill it in less than half that time. Economic
      > problems have forced Zimbabweans into poverty, and the shortage
      > of burial space is only one problem faced because of AIDS. Every
      > day the gravediggers at Granville dig at least a dozen burial
      > plots, sometimes digging more than twice that number. A burial
      > costs around $14 for an adult and $8 for an infant, but many
      > cannot afford the costs for a site in a maintained area and are
      > buried near grass that is five feet high.
      > "AIDS Rising in Cameroon but Containable--World Bank"
      > Reuters (02/23/00)
      > World Bank official Serge Michailof reported Tuesday that HIV
      > infections are rapidly increasing in Cameroon, but could be
      > stemmed by quick action. A 1997 count estimated an HIV infection
      > rate of 4.9 percent, a rate which Michailof noted is still low
      > enough to be affected by aggressive actions. Michailof, the
      > bank's director of operations for Central Africa, said that
      > Cameroon has a chance to stop AIDS before it destroys the country
      > as a whole, and he offered the World Bank's assistance for the
      > effort.
      > "Over 20,000 TB Cases Reported Yearly in Angola"
      > PANA Wire Service (02/23/00)
      > Angola's health minister, Julia Hamukuaya, announced that over
      > 20,000 cases of tuberculosis (TB) occur each year in Angola, and
      > diseases like malaria, leprosy, AIDS are also plaguing the
      > country. Hamukuaya attributed the diseases' spread to the
      > nation's deteriorating military, political, and socio-economic
      > situation. Most TB patients receive no treatment due to
      > inadequate screening, and the disease will likely become the
      > chief cause of death among the active population in future years.
      > Hamukuaya also said that 157,000 cases of HIV were reported in
      > 1999.
      > "Two Die Daily of TB In Malawi"
      > PANA Wire Service (02/23/00)
      > New statistics from Malawi's National TB Control Program show
      > that an average of two people die daily in Malawi from
      > tuberculosis (TB). About 22,000 TB cases occur each year in
      > Malawi, with 8,000 deaths. The AIDS epidemic is part of the
      > reason for the increase in TB cases, as 66 of every 100 TB
      > patients in hospitals have HIV. The head of the TB Control
      > Program, Felix Salaniponi, estimated that there will be about
      > 29,000 TB cases in Malawi in five years, mostly among young
      > adults.
      > "Zimbabwe's AIDS War Gets New Blood"
      > Los Angeles Times Online (02/20/00)
      > In Zimbabwe, thousands of recent high school graduates are
      > pledging to donate blood 25 times as part of a campaign to reduce
      > HIV rates. The idea is based on the fact that HIV infection
      > rates among blood donors are low, and young graduates are part of
      > the most sexually active group. The Pledge 25 Club asks donors
      > to give blood every three or four months, for a total of 25
      > times, during their late teens and early 20s. The club, which
      > promotes abstinence and safe sex, was formed in 1994. Pledge 25
      > grows 20 percent a year, with about 3,000 regular members
      > currently. But officials note that despite the high rate of
      > enrollment at the beginning, most recruits drop out of the club,
      > often because they move to areas with no blood centers or,
      > perhaps, because they do not want to admit their HIV status.
      > Since the club began, the HIV infection rate among Zimbabwe's
      > 12,000 blood donors has dropped to 0.8 percent in 1999, compared
      > to 4 percent in 1993. Dr. Deogratias Barakamfitiye, a World
      > Health Organization representative, has encouraged other African
      > countries to start similar clubs.
      > "President Says U.S. Has Stake in Africa's Success"
      > Washington Post (02/18/00) P. A17; Mufson, Steven
      > During the first full day of a five-day conference organized by
      > the National Summit on Africa, President Clinton called on
      > Congress to help expand access to U.S. markets for African goods.
      > Clinton also noted the United States needs to better support
      > Africa in terms of disease control, debt relief, and conflict
      > resolution. Africa's problems, including the AIDS epidemic and
      > poverty, have been key topics of discussion the conference.
      > Clinton urged African countries to become more open culturally
      > and to lay aside differences in order to stem the spread of HIV.
      > He stressed the need for behavioral changes and highlighted the
      > plight of Africa's children, who are losing their parents and
      > families to AIDS.
      > "Africa Conference's Huge Task: Turning Interest Into Action"
      > Washington Post (02/17/00) P. A2; Fletcher, Michael A.; Mufson,
      > Steven
      > Rep. Alcee Hastings (D-Fla.) says that some African Americans in
      > his district have shown very little concern about Africa's many
      > problems because they have their own survival to carve out.
      > "[Some people in] my district are as interested in day-to-day
      > survival as the people in the Sudan are," he notes. Hastings, a
      > member of the House International Relations subcommittee on
      > Africa, is meeting with thousands of activists, business people,
      > and others for a conference in Washington to try to change
      > America's attitude towards Africa. Political leaders know they
      > face an immense task, since few people in America strongly
      > support specific African countries. The need for support for
      > Africa is great, as AIDS ravages the continent, diseases orphan
      > children by the thousands, and civil wars continue to rage.
      > "Botswana Launches Study of African Strain of HIV"
      > Reuters (02/15/00); Baxter, Barry
      > Botswana began on Tuesday a large study of the HIV-1C subtype, an
      > HIV strain particularly prevalent in Africa. Max Essex, head of
      > the Harvard AIDS Institute, is working with the government of
      > Botswana to study the strain, using an $18.2 million grant from
      > Bristol-Myers Squibb. Until now, HIV research has centered on
      > HIV-1B, which is found in mostly developed nations, while HIV-1C
      > is found throughout southern and east Africa and India.
      > Scientists in the joint program will research HIV-1C's ability to
      > resist treatment.
      > "98 Percent of TB Patients in Zambia Are HIV Positive"
      > Africa News Service (02/15/00); Hampande, Douglas
      > A 1999 country program review by the Danish Association for
      > International Cooperation has found that 98 percent of
      > tuberculosis patients in Zambia who are between the ages of
      > 20 and 40 are also infected with HIV. An estimated 19.7 percent
      > of all adults in the country are infected with HIV. HIV
      > prevalence in the African nation ranges from about 28 percent in
      > some urban centers to 13.6 percent in rural areas. Over 1.5
      > million Zambians are expected to die from AIDS in the next 15
      > years, according to the review.
      > "400,000 Take HIV/AIDS Test"
      > Africa News Service (02/15/00); Mucunguzi, Julius
      > The Director of AIDS Information Center in Uganda, Jane Harriet
      > Namwebya, said Monday that over 400,000 Ugandans have taken HIV
      > tests since the center opened in 1990. Namwebya noted, however,
      > that it is still a small number when an estimated 2 million
      > Ugandans are infected with HIV. Dr. Donna Kabatesi from the AIDS
      > Control Program of the Ministry of Health also said there should
      > be follow-up for people who test HIV-negative, to help encourage
      > them to stay free from the virus.
      > "Botswana Comes to Grips With AIDS"
      > Boston Globe Online (02/15/00) P. E2; Knox, Richard A.
      > In some parts of Botswana, half of all pregnant women are
      > infected with HIV, but after being offered a drug treatment to
      > minimize the transmission of the virus to their babies, less than
      > 50 percent of the women accepted. A fatalism associated with HIV
      > and AIDS in Africa prevents many from trying drug treatments,
      > when they are available. Only 200 people in Botswana have access
      > to antiviral drugs that are helping millions with HIV in wealthy
      > nations. In an effort to address that disparity, a new virology
      > lab funded with a $4.9 million grant from Bristol-Myers Squibb
      > will be dedicated today in the capital city of Gabarone. The
      > facility is the first attempt in an immense effort to bring AIDS
      > drugs and, hopefully, a vaccine to Africa. The lab will run 100
      > to 200 HIV tests a day, and will investigate the subtype of HIV
      > known as 1C, which is responsible for half of the world's HIV
      > infections, especially in Africa and India, according to Harvard
      > researchers. The clade C subtype has spread more rapidly in East
      > Africa than type B in North America, and scientists do not know
      > if it responds to treatment similar to the way other subtypes do.
      > Dr. Max Essex, a Harvard AIDS researcher, believes the clade C
      > virus is more easily transferred from mother to child and during
      > heterosexual intercourse than other types. The vaccines being
      > created to fight HIV-1B may not work on clade C, another reason
      > that research is needed on this subtype.
      > "Zambian Judge Advises Wives to Insist on Condoms"
      > Reuters (02/11/00)
      > Zambian High Court judge Ireen Mundia has advised women to make
      > their husbands wear condoms during sex if they suspect or know
      > that he is having intercourse with other women. Mundia, who made
      > her comments when presiding over a case in which a woman sued her
      > husband for cruelty and denial of sex, said the man should honor
      > his marital obligations but that the wife should also insist on
      > protection during intercourse. An estimated 20 percent of
      > Zambians between the ages of 19 and 49 have HIV or AIDS.
      > "UNICEF Chief Heads to Africa to Confront AIDS and Poverty"
      > Africa News Service (02/11/00)
      > UNICEF head Carol Bellamy has started a two-week, four-country
      > tour in Africa to address AIDS, poverty, children, and gender
      > discrimination. During her trip, Bellamy plans to meet with
      > national officials, visit rural education projects, and talk to
      > children and adolescents. The four nations she will visit are
      > South Africa, Namibia, Mozambique, and Burundi.
      > "State Survey: Montana"
      > Infectious Diseases in Children (01/00) Vol. 13, No. 1, P. 42
      > A survey of 400 parents and their teenage children in Montana
      > revealed that over 66 percent believe a recent multimedia
      > campaign promoting sexual abstinence will help them resist sexual
      > activity. The campaign was well-understood and led to teen
      > discussions with parents. About 90 percent of both parents and
      > teens said they want to see the ads continue.
      > "10 Million Orphans"
      > Newsweek (01/17/00) Vol. 135, No. 3, P. 42; Masland, Tom; Nordland,
      > Rod
      > In Kenya, 350,000 children have been orphaned by AIDS. By
      > year-end 2000, the global AIDS epidemic will have left 10.4
      > million children under the age of 15 without parents. According
      > to the Ugandan Women's Effort to Save Orphans, one of every four
      > families cares for an AIDS orphan in Uganda. The loss of parents
      > to AIDS makes children grow up fast, with the eldest frequently
      > dropping out of school to care for the others. Ethembeni House
      > in downtown Johannesburg has 38 orphans who are age five or
      > younger, and all have HIV. Almost all the children in such
      > houses have been orphaned by AIDS, not famine or neglect. Many
      > orphans become prostitutes, and some become child brides.
      > Orphans are more likely to drop out of school, because required
      > school fees are unaffordable when medical needs come first. AIDS
      > orphans, compared to children with parents, are also more likely
      > to be malnourished and to lack healthcare.
      > "Africa, the Thwarted Giant"
      > Wall Street Journal (02/08/00) P. A27; Berkley, Seth
      > In a letter to the editor, Seth Berkley, president of the
      > International AIDS Vaccine Initiative (IAVI), discusses the need
      > to provide AIDS drugs to Africa at affordable prices while still
      > enabling the drug firm to make a profit. Berkley explains that
      > IAVI has come up with an approach known as social venture
      > capitalism, which creates partnerships between pharmaceutical and
      > biotechnology companies and developing country scientists who
      > work in epidemic areas. He notes that in return for venture
      > capital and project management assistance, IAVI requests a
      > guarantee that any successful vaccine developed will be offered
      > to poor countries at a reasonable price.
      > "A New AIDS Mystery: Prostitutes Who Have Remained Immune"
      > New York Times (02/03/00) P. A17; Altman, Lawrence K.
      > A perplexing study of 1,900 prostitutes in Nairobi, Kenya, shows
      > that four women who were frequently exposed to HIV became
      > infected with the virus only after stopping to work as a
      > prostitute or taking a break of over two months. At the Seventh
      > Conference on Retroviruses and Opportunistic Infections,
      > researchers said they could not explain the phenomenon, but the
      > solution could aid in the development of a vaccine against AIDS.
      > Two-thirds of the women had HIV when the study began, and they
      > reported having sex with about five clients a day, using condoms
      > on four clients a day. A small number of the women have not
      > contracted HIV after some three years, and no correlation has
      > been determined between the women who did contract the virus
      > after stopping commercial sex and their use of condoms or sexual
      > habits. Dr. Anthony Fauci, director of the National Institute of
      > Allergy and Infectious Diseases, suggested two possible
      > explanations for the prostitutes' immunity: that people need
      > constant exposure to HIV to boost the immune system, or that
      > perhaps sperm stimulate a short immunologic reaction in women
      > that helps to protect them.
      > "Boxer Lobbies for Worldwide AIDS Help"
      > San Francisco Examiner Online (02/01/00) P. A4; Lelchuk, Ilene
      > Sen. Barbara Boxer (D-Calif.) has announced plans to introduce
      > the Global AIDS Prevention Act, which would give $2 billion over
      > the next five years for HIV prevention abroad, chiefly in Africa.
      > Boxer noted, "AIDS is decimating Africa the way that the plague
      > hit Europe in the 14th century. ... The African AIDS epidemic is
      > a global catastrophe that needs a global response." Boxer's
      > measure would increase funding for the U.S. Agency for
      > International Development's AIDS program and specifies that some
      > of the funds should be used for drugs that can prevent
      > mother-to-child HIV transmission.
      > "South African Industry Unites to Fight AIDS Crisis"
      > Reuters (02/01/00); Sithole, Emelia
      > The South African Business Council on HIV/AIDS plans to form an
      > AIDS council this month in an effort to fight the AIDS epidemic.
      > The council aims to create universal strategies on fighting the
      > disease in the workplace; experts predict that one in five South
      > African workers may have HIV by the year 2005. AIDS could also
      > prevent growth in the nation's economy, which is expected to
      > expand 3 percent this year. In a statement, the business council
      > noted that the epidemic has already taken its toll, with a loss
      > of skilled workers, more absenteeism, higher healthcare costs,
      > and higher labor turnover.
      > "AIDS Pandemic Grips Tanzania"
      > PANA Wire Service (01/26/00)
      > AIDS cases are on the rise in Tanzania, as prostitutes and
      > tourists contribute to the spread of HIV. The region reported
      > 2,287 AIDS cases last January, according the United Nations
      > Development Program. The Zanzibar AIDS Control Program noted
      > that HIV prevalence is increasing sharply in certain groups, and
      > AIDS is the leading cause of death among 15- to 59-year olds in
      > the Mbeya region. Risky behaviors like unsafe sex and drug abuse
      > are growing in mining and fishing towns, which are notorious for
      > prostitution. An estimated 242 new cases of HIV occur in
      > Tanzania each day. President Benjamin Mkapa has called on
      > churches, community leaders, and the private sector to help
      > prevent the spread of HIV.
      > "Embassy Row: Rebuilding South Africa"
      > Washington Times (01/24/00) P. A12; Morrison, James
      > The new U.S. ambassador to South Africa, Delano Lewis, said
      > Friday that he plans to help the country rebuild its economy and
      > also fight AIDS. "Among the many issues that confront South
      > Africa, three of my priority concerns as ambassador will be
      > education, economic development, and HIV/AIDS," explained Lewis.
      > "AIDS Changes Cancer Profile in Sub-Saharan Africa"
      > Reuters Health Information Services (01/20/00)
      > Two recent studies show that the AIDS epidemic has caused
      > increased incidence of cancer in sub-Saharan Africa, with trends
      > in Uganda and Zimbabwe showing more cases of Kaposi's sarcoma
      > (KS), squamous cell carcinomas of the conjunctiva, and
      > non-Hodgkin's lymphoma. Dr. D. Maxwell Parkin of the
      > International Agency for Research on Cancer in France found that
      > the incidence of KS in Uganda has increased significantly since
      > the 1960s and been stable since 1990s. Meanwhile, Dr. Eric
      > Chokunonga of Parirenyatwa Hospital in Harare found that KS rates
      > doubled in men and women from 1990 to 1995, and there was a
      > dramatic increase in squamous cell tumors of the conjunctiva.
      > The studies, both published in the journal AIDS
      > (1999;13:2563-2570, 2583-2590), reveal the primary HIV-related
      > cancers in Africa.
      > Aaron K. Zee
      > Project Officer
      > CAPNP branch, DHAP*
      > Centers For Disease Control and Prevention
      > 1600 Clifton Road, N.E.
      > Mailstop E-58
      > Atlanta, Georgia 30333
      > 404-639-5249
      > *Community Assistance, Planning, and National Partnerships Branch,
      > Division of HIV and AIDS Prevention
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