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AIDS in Africa

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  • Bell, Elizabeth
    Advances and Research Directions in the Prevention of Mother-to-Child HIV-1 Transmission Lancet (www.thelancet.com) (06/24/00) Vol. 355, No. 9222, P. 2237;
    Message 1 of 29 , Jul 3, 2000
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      "Advances and Research Directions in the Prevention of
      Mother-to-Child HIV-1 Transmission"
      Lancet (www.thelancet.com) (06/24/00) Vol. 355, No. 9222, P.
      2237; Mofenson, Lynne M.; McIntyre, James A.
      Mother-to-child transmission of HIV remains a problem in many
      developing nations, as 90 percent of children infected with HIV
      live in sub-Saharan Africa. The drug zidovudine has shown to be
      effective in reducing perinatal HIV transmission; however,
      developing nations have found the regimen required too expensive
      and complex. These nations also have problems with implementing
      less-expensive, short antiretroviral treatments, due to
      inadequate healthcare, lack of testing programs, and limited
      resources. Breast feeding is also an issue. Non-antiretroviral
      treatments for poor countries are a possibility. Strategies
      researchers are investigating include cleansing the infant and
      mother's birth canal with a virucide, giving nutritional
      supplements, and subclinical chorioamnionitis treatment.
      Caesarean delivery has also shown to significantly reduce the
      risk of perinatal HIV transmission. Countries that cannot afford
      short-course antiviral regimens need continued funding to end
      perinatal infections. Developed countries like the United States
      have had success in reducing transmission of HIV to babies by
      using short-course antiretroviral therapy.

      "Evidence Overwhelming HIV Causes AIDS--Doctors"
      Reuters (www.reuters.com) (07/01/00); Reaney, Patricia
      More than 5,000 scientists, doctors, and medical experts have
      signed the Durban Declaration, which asserts that there is
      significant evidence that HIV causes AIDS. The declaration has
      been made to end controversy in South Africa over the HIV-AIDS
      link. South African President Thabo Mbeki has fueled the
      controversy by asking dissident scientist Peter Duesberg to be on
      a presidential panel charged with investigating the disease.
      Those who signed the declaration wrote that by denying the cause
      of AIDS, countless people will die and vaccine research and
      prevention efforts will be hampered.

      "Writing the Bill for Global AIDS"
      New York Times (www.nytimes.com) (07/02/00) P. 1; McNeil Jr.,
      Donald G.
      A global survey by UNAIDS estimates that more than a third
      of 15-year-olds living in Africa and other severely affected
      countries will die from AIDS. In the United States, AIDS therapy
      focuses on treatment with anti-AIDS drugs. In Africa, India, and
      Haiti, however, funding must focus on prevention instead of
      treatment--which is virtually unaffordable. Third-world nations
      need education and more basic rights to start fighting AIDS with
      drugs, which can cost roughly $12,000 a year per person in the
      United States. Condoms and clean needles will not help most
      Africans, many of whom cannot read and do not use condoms, often
      due to stigma. UNAIDS believes $2 billion is necessary to help
      sub-Saharan Africans prevent HIV infections. This money would be
      used for basic steps--free condoms, blood screening, and
      counseling. There is no money left over for AIDS drugs; funding
      would first go toward cheap antibiotics like Bactrim and
      tuberculosis drugs. With 30 million of the 34 million
      HIV-infected people in the world living on less than $2 a day,
      prevention becomes a priority. Economist Alan Whiteside, who
      studies AIDS in South Africa, would spend $1 billion on educating
      the poor, empowering women, and caring for orphans. It is simply
      not possible to treat all current HIV infections in Africa and
      Asia, where resources are low and clean water and food are hard
      to find.

      "African Children Face AIDS-Blighted Future"
      Reuters (www.reuters.com) (07/02/00); Sithole, Emelia
      In Africa, when family members die of AIDS, it is the children
      who must take over; and often, the eldest child must quit school
      and work to care for the family, or even beg for food. Children
      who are orphaned by AIDS--a total of 13.2 million worldwide, 95
      percent of which live in sub-Saharan Africa--may be sent to
      grandparents or they may turn to the streets. UNICEF states that
      one-sixth of Zambia's orphans are under the age of five and must
      grow up alone, often infected with HIV. Children who live with
      HIV also suffer from discrimination, trauma, and abandonment; and
      without a multi-country commitment to end the epidemic, UNICEF
      warns that the situation will worsen.
    • Bell, Elizabeth
      Free of Apartheid, Divided by Disease Washington Post (www.washingtonpost.com) (07/06/00) P. A1; Jeter, Jon In 1993, the African National Congress (ANC)
      Message 2 of 29 , Jul 10, 2000
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        "Free of Apartheid, Divided by Disease"
        Washington Post (www.washingtonpost.com) (07/06/00) P. A1; Jeter,
        In 1993, the African National Congress (ANC) called 50 public
        health experts to a conference in South Africa to form a plan to
        fight AIDS. With the end of apartheid in sight, South Africa had
        hopes for setting a standard in Africa for AIDS prevention.
        However, the AIDS panel did not discuss economic problems that
        help the spread of AIDS, avoiding the issues that most affect the
        spread of the virus. Seven years later, South Africa has failed
        to form a successful plan against AIDS. The country's HIV rate
        has grown to 25 percent of adults. The racial caste system of
        apartheid looms over any attempt to slow AIDS, as blacks continue
        to distrust whites and internal problems hamper AIDS activism.
        The ANC closed clinics run by white doctors because blacks were
        fearful after years of abuse by whites. Morna Cornell, director
        of the AIDS Consortium, calls apartheid a main reason for the
        AIDS program failure. Even so, South Africa is the more prepared
        than any other nation on the continent for the epidemic. In
        1989, the ANC knew of AIDS in surrounding countries, and when
        exiles were allowed to return in 1990, they brought AIDS with
        them. The National Party treated the disease as a stigma for
        the oversexualized black male. Nkosazana Zuma, appointed later
        as the country's first black health minister, led an advisory
        panel that created an AIDS plan for the use of $64 million for
        education, media campaigns, free condoms, and support programs.
        Just $15 million was allocated for the AIDS campaign, and civil
        servants were unprepared to enforce the strategy. Quarraisha
        Abdool Karim, the first national AIDS director of South Africa,
        found that her staff knew nothing of HIV and HIV prevention.
        These HIV programs were abandoned by most communities. In 1997,
        word came that the AIDS advisory panel was dissolved. HIV was
        rarely mentioned by top officials, with President Nelson Mandela
        mentioning it first in late 1997 in Switzerland for the World
        Health Organization. This lack of attention by cabinet ministers
        fueled the denial of an epidemic. While the government has given
        out 140 million condoms, only 10 percent of South Africans
        recently polled said they used one during their last sexual
        encounter. The country's HIV prevalence rate, once less than 1
        percent in 1990, has reached 19.94 percent today. The upcoming
        international AIDS conference in Durban will bring to light these
        problems for the first time on African ground.

        "Africa Can't Just Take a Pill for AIDS"
        New York Times (www.nytimes.com) (07/06/00) P. A27; Goldyn,
        Lawrence Goldyn, a doctor who treats HIV-positive patients,
        writes in an editorial that South African President Thabo Mbeki
        has frustrated AIDS researchers with his decision not to promote
        the use of the drug AZT and his consideration that HIV may not
        cause AIDS. However, in light of the country's poor
        infrastructure, these decisions are rational. South Africa lacks
        the resources and pharmaceuticals to treat its growing
        HIV-infected population. Cocktail drugs cost up to $15,000 a
        year, not affordable for most, and unavailable without the
        social, economic, and medical structures needed to administer
        drug therapies. The complicated treatments for HIV require full
        adherence and stability, and getting South Africans to follow a
        drug schedule could be impossible, based on the past failure of
        tuberculosis treatments. Transmission of HIV to newborns is also
        an issue, but in a country where breast-feeding is the only
        option, the infection rate is 30 percent for infants born to an
        infected mother. The best solution is an AIDS vaccine, but
        without research funds that turn profits, it is years away.
        Mbeki is right to say that the Western way of fighting AIDS will
        not transfer to Africa.

        "Little Hope on Horizon at AIDS Conference"
        Reuters (www.reuters.com) (07/06/00); Fox, Maggie
        The July AIDS conference in Durban, South Africa, bringing
        together 11,000 doctors and activists, will offer no
        breakthroughs for new AIDS treatments, according to Dr. Salim
        Abdool-Karim, leader of the HIV/AIDS Research Unit and chair of
        the 13th International AIDS conference. AIDS continues to spread
        quickly among young people, with 34.3 million people infected
        with HIV worldwide. The conference will include thoughts from
        dissident scientists who do not believe HIV causes AIDS. Talk of
        an AIDS vaccine will continue, but no trial results have shown
        great promise, even in the arena of microbicides.

        "AIDS Poses Huge Threat to African Security"
        Reuters (www.reuters.com) (07/06/00); Stoddard, Ed
        Gareth Newham, a researcher at the Centre for the Study of
        Violence and Reconciliation in South Africa, has found that crime
        and conflict will worsen on the African continent due to the
        rising number of AIDS orphans. South Africa has one of the
        highest violent crime levels in the world, and with so many
        youths left without parents, they will turn to crime to survive.
        AIDS will also lead to joblessness, a major factor in high crime
        rates. Analysts predict that orphaned children will form roving
        gangs as food supplies dwindle due to a reduced workforce.

        "AIDS Groups Plan Drug March at South Africa Conference"
        Reuters (www.reuters.com) (07/05/00); Sithole, Emelia
        The Treatment Action Campaign (TAC), a South African AIDS groups
        coalition, announced on Wednesday that hundreds of people will
        march at a global conference on AIDS that is scheduled to be held
        in South Africa on Sunday. The groups will emphasize the need
        for cheaper drugs to fight AIDS, especially in Africa, where the
        disease has reached epidemic proportions. The organizers said
        that offers from drugs companies, including Pfizer's proposal to
        donate diflucan to South African AIDS patients and a drug company
        coalition pitch to reduce AIDS medication prices for poorer
        nations, are much too restrictive to be of any help to the
        continent. The group, which has threatened legal action against
        Pfizer and the South African government if little or nothing is
        done, is demanding that the U.N. programme on AIDS and the
        Southern African Development Community create a plan for
        affordable AIDS drugs by December, that HIV suppressor drugs be
        made available to pregnant women, and that Pfizer immediately
        reduce the price for diflucan.

        "Treating AIDS (Letter)"
        New York Times (www.nytimes.com) (07/06/00) P. A24; Tanguy,
        A letter to the editor from Joelle Tanguy, executive director
        of Doctors Without Borders in the United States, states that AIDS
        treatments must be a priority, with millions of lives at stake.
        Education and prevention programs must be balanced with drug
        therapies to reach patients in Africa and elsewhere.
        Opportunistic infections can be treated, if access to drugs is
        available and affordable. Long-term strategies for cheaper drugs
        is one solution.
      • Bell, Elizabeth
        *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** Is AIDS
        Message 3 of 29 , Jul 10, 2000
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          "Is AIDS in Africa a Distinct Disease?"
          Science (www.sciencemag.org) (06/23/00) Vol. 288, No. 5474, P.
          2153; Cohen, Jon
          AIDS in Africa varies from AIDS in the Western world by more than
          a few reasons. South African President Thabo Mbeki has
          questioned if HIV causes AIDS, raising the issue of how the virus
          is mainly spread there by heterosexual sex. HIV has moved
          quickly through Africa, which has several strains throughout the
          continent. Researchers are not sure what causes these
          differences, and if they find out, better treatment strategies
          could be determined. Tuberculosis is the number one AIDS-related
          disease in Africa and is the largest killer of patients. In the
          United States, TB is rare for AIDS patients, but pneumocystis
          carinii pneumonia (PCP) is quite common in HIV-infected people.
          Africans have antibodies to the protozoa for PCP and chiefly
          remain unaffected. James Whitworth of the U.K. Medical Research
          Council believes PCP may be under-diagnosed in Africa, and he
          does not believe that HIV progresses more quickly in Africa.
          Studies from Nairobi show that sex workers develop AIDS about
          five years after HIV infection, but pregnant Nairobi women
          developed it much slower, similar to the United States' rate of
          an average 10 years before AIDS develops. Whitworth's own study
          in Uganda revealed that after eight years of HIV infection, 40
          percent of the people studied had AIDS. HIV has spread so
          rapidly in Africa that researchers have looked to the effects of
          untreated sexually transmitted diseases and overall lack of
          healthcare for answers. They also wonder if Africans are more
          vulnerable to HIV and if the strains in Africa are more
          infectious. Mario Clerici of Milan and Matthew Lukwiya of Lacor
          Hospital compared the immune systems of people living in Gulu,
          Uganda, or Milan. The researchers found that the immune systems
          of those people living in Africa, including those of Italian
          descent, were more active, due to the exposure to more diseases.
          This suggests that regional location may play a role in HIV's
          ability to target CD4 cells.


          "Disease Spread Faster Than the Word"
          Washington Post (www.washingtonpost.com) (07/07/00) P. A1; Vick,
          Andrecus Miruka of Masogo, Kenya, first heard mention of AIDS in
          1990. Once he learned all he could about the disease, he spread
          the knowledge around his community. Staying informed is the only
          way many Africans can fight AIDS, but information about AIDS took
          four years to travel just three miles in Masogo. The Luo, one of
          Kenya's largest tribes, has an HIV infection rate believed to be
          around 70 percent. The people in Masogo know they are isolated
          and were slow to understand AIDS, which is sometimes known as
          chira, an illness caused by breaking traditions. Miruka shared
          his knowledge of AIDS with people mostly at funerals. A British
          agency called Futures Group International works with Kenya's
          Ministry of Health to train volunteers to be community health
          workers. These workers stress the need to end wife-sharing of a
          widow and to use condoms. The Ministry of Health, which relies
          on foreign aid, has few resources or means to reach the people.
          Rural Africans do not talk about sex, and the conservative nature
          of their lives has added to the stigma associated with AIDS.
          Many do not know the risk factors of AIDS since sex is rarely
          discussed in detail. Miruka's son Bernard learned about the risk
          factors for AIDS but kept them private because of others' belief
          in chira and their unwillingness to discuss sex. The silence in
          Kenya, compounded with other risk factors, led to increased
          potential for sexually transmitted diseases. However, the Luo
          people did not believe HIV was present until AIDS developed.
          When people started dying in late 1999 and this year, the public
          burials brought long-needed attention to the epidemic. As more
          people became informed, more questions rose about how to prevent
          infections. Some prostitutes thought that by offering anal sex
          they were safe from AIDS. One success story has been Uganda,
          which has reduced its rate of new HIV infections. The health
          minister in Masogo learned about AIDS in September 1998 and
          trains health workers now. However, Kenyan schools do not teach
          about AIDS, and if so, it is only a brief mention. Sex education
          traditionally takes place in the home, but the message of condom
          use is not reaching young males. Men like Eric Owino, age 23,
          say condoms are not reliable and that women oppose using them.
          Kenya still has a long way to go to educate the people about STDs
          and prophylactics.

          "A Call for Fair Access to Future AIDS Vaccine"
          New York Times (www.nytimes.com) (07/07/00) P. A9; Altman,
          Lawrence K.
          The International AIDS Vaccine Initiative, a research consortium
          funded by government and private grants, announced that steps to
          offer simultaneous access to an AIDS vaccine to rich and poor
          countries should be created now, even though a vaccine to prevent
          AIDS is still many years away. Vaccine Initiative President Seth
          Berkley suggested that steps be taken now in order to avoid
          problems similar to those caused by the limited availability of
          HIV drugs in sub-Saharan countries and delays seen in the
          eradication of diseases like polio in developing countries. Two
          vaccines--Aventis Pasteur's Alvac canary pox vaccine and a
          vaccine that integrates both the Alvac vaccine and one prepared
          from a molecular component of the surface of HIV--are currently
          in phase II clinical trials, while VaxGen's vaccine has entered
          phase III trials, although data from that trial are not expected
          until 2002 at the earliest. Biotech concern Chiron is also
          working on a vaccine.

          "South Africa HIV Testing Plans Undermine Prevention"
          Reuters (www.reuters.com) (07/06/00); Sithole, Emelia
          South African AIDS activists oppose their president's decision
          for a panel to study the experimental HIV ELISA test, claiming
          that it will hamper efforts to stop the spread of AIDS. Mark
          Heywood, head of the AIDS Law Project, believes the presidential
          advisory panel is sending confusing messages by focusing
          attention outside of the need for HIV screening. Heywood
          emphasized that a large problem in South Africa is that few
          people are tested for HIV, and the new studies will undermine
          awareness efforts. Morna Cornell, director of the AIDS
          Consortium, called research into the ELISA test a waste of time.

          "AIDS in Angola Means Stigma, Death"
          Reuters (www.reuters.com) (07/06/00); McClelland, Colin
          In Angola, a country plagued by civil war since the 1960s, AIDS
          means death, according to Dr. Marilia Afonso of the Josina Machel
          Hospital in Luanda. Afonso can treat patients only for
          opportunistic infections like tuberculosis, candida and herpes.
          Antiviral drugs for HIV are too expensive, and the majority of
          the 13 million Angolans live in poverty. In this country, AIDS
          carries such a stigma that few will acknowledge and seek
          treatment for the disease, making it a much quicker fatal
          infection than for those who treat their illness.

          "Bristol-Myers Finds Pledging AIDS Aid Is Easier Than Giving It"
          Wall Street Journal (07/07/00) P. A1; Waldholz, Michael
          Bristol-Myers Squibb's 1999 announcement of a five-year $100
          million donation to Botswana and four other African countries
          appeared at the time to be a much-needed boost to the ailing
          nations in their losing battle against HIV and AIDS, but
          activists and African humanitarian workers in the region are
          discovering that the funding is not easy to use because of
          restrictions and regulations put in the way seemingly at random
          by Bristol-Myers. Bristol-Myers executives' complaints that the
          difficulties are frustrating to them demonstrates the cultural
          differences between Western corporations and African nations,
          where Bristol-Myers has little understanding and less experience
          and is working at odds with the region's AIDS goal of preventing
          future illness, not treating those already very ill.
          Bristol-Myers was surprised in the early stages of the
          philanthropy by the low quality of grant proposals, but activists
          note that writing skills are reserved for the elite few in
          Africa, and those interested in helping the poor and sick often
          have little formal education and less experience with the
          bureaucratic processes common to Western organizations, as grant
          competition is unknown in Africa. The drugs company placed the
          restrictions on its donations, such as requiring strict record
          maintenance, denying the purchase of furniture or the rental of
          office space, and limiting the hiring of multiple employees, to
          prevent notoriously corrupt African governments from using the
          funding for purposes other than AIDS relief; however, these
          restrictions have essentially prevented small nonprofit
          organizations in Botswana from performing the relief work despite
          donations as large as $400,000.

          "AIDS Counseling for Peacekeepers Urged"
          Washington Post (www.washingtonpost.com) (07/07/00) P. A18;
          Lynch, Colum
          The United States has proposed a measure to the U.N. Security
          Council that urges all United Nations peacekeepers to counsel
          troops on sexually transmitted diseases and to track AIDS among
          soldiers. The resolution reiterates the fact that AIDS is
          considered a threat to security and peace in Africa and abroad.
          U.S. Ambassador to the United Nations Richard Holbrooke said the
          measure has support but no vote is pending. The resolution does
          not call for mandatory HIV testing due to its cost. However,
          AIDS prevention training would be given to 35,000 peacekeepers
          worldwide. Holbrooke realized that U.N. peacekeepers may be at
          risk for AIDS when in 1992 he saw Cambodian soldiers visiting
          brothels at night. David Wimhurst, a spokesman for the United
          Nations, said there is no AIDS crisis among the peacekeepers and
          that condoms had been given to soldiers in Sierra Leone.

          "Pfizer Plans to Start Free-Diflucan Project in South Africa in
          Wall Street Journal (www.wsj.com) (07/06/00) P. B12
          Pfizer has announced that it will initiate its program to offer
          supplies of cryptococcal meningitis drug Diflucan at no charge to
          South African patients with AIDS this fall. Pfizer belives that
          up to 100,000 cases of crytococcal meningitis, a brain infection
          that occurs in roughly one in 10 patients with AIDS, causing
          death, can be treated under the program. Although South African
          health ministry officials stated in June that they may ignore the
          offer considering that the program included too many
          restrictions, South African Minister of Health Manto
          Tshabalala-Msimang has expressed her complete support of the
          program. Pfizer intends to expand the program to other areas,
          including Asia, Latin American, and other parts of Africa.
        • Bell, Elizabeth
          there are not many true heroes in this world, but jonathan mann was one. bless him. **************************************************************** GENERAL
          Message 4 of 29 , Jul 10, 2000
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            there are not many true heroes in this world, but jonathan mann was one.

            bless him.

            GENERAL MEDIA

            "World Shunned Signs of the Coming Plague"
            Washington Post (www.washingtonpost.com) (07/05/00) P. A1;
            Gellman, Barton
            A CIA document called Interagency Intelligence Memorandum
            91-10005 entitled "The Global AIDS Disaster" predicted in 1991
            the AIDS epidemic seen today. The report was largely ignored and
            seen with indifference, according to author Kenneth Brown. This
            year, the Clinton administration, Congress, and the United
            Nations have recommitted to fighting AIDS, stating that the total
            effects of the epidemic are finally known. The World Health
            Organization (WHO) had predicted a death toll of tens of millions
            in 1990, yet few groups reacted to the warning. William Foege,
            director of the Centers for Disease Control and Prevention (CDC)
            until 1983, stated that the United States spent $3 billion a year
            on healthcare in the early 1980s, but AIDS was left out of any
            funding. New cases of HIV have not peaked, as the death toll
            doubles each year in many African countries. Sandra Thurman,
            director of the White House Office of National AIDS Policy,
            stated that "we are at the beginning of a pandemic, not the
            middle, not the end." Yet the 1991 CIA report shed light on what
            was to come in the epidemic. Since HIV was named, the virus has
            infected 53 million and AIDS has reversed economic and social
            growth in many areas worldwide. Some members of the National
            Intelligence Council did not see AIDS as a threat to any nations
            outside of Africa, and even felt that the illness would allow
            soldiers to advance more easily in those countries affected by
            it. There was little response to the CIA document for years, and
            a budget for AIDS control of $124.5 million that was created that
            year not increase for seven years, a period during which over 17
            million people contracted HIV. Jonathan Mann was a researcher who
            went to Kinshasa to study the HIV cases. He was tireless in
            attempting to persuade officials that AIDS was a monumental
            problem. However, WHO director Halfdan Mahler wanted to focus on
            what he considered were more important diseases at the time.
            Mann continued to argue that AIDS had several important factors
            associated with it--poverty, oppression, and social violence,
            requiring non-medical solutions. Mahler became convinced of the
            seriousness of the pandemic and made Mann director of a special
            program on AIDS. When Mahler was replaced by Hiroshi Nakajima,
            Mann was cited for spending too much time on a few cases and his
            resources were cut. A dispute over quotes by Nakajima in an
            interview led to the loss of Mann's budget requests and quitting.
            For years, the CDC and U.S. Agency for International Development
            did not pay for AIDS tests abroad, so millions did not know they
            were HIV-positive. USAID did not want to create mandatory
            funding for AIDS programs. Once drug therapies like AZT
            developed in the mid-1990s, hope was restored and increased
            funding was discussed among wealthy nations like the United
            States. A joint U.N. AIDS program was finally created in 1996,
            but cosponsors argued over loans and spending for months. In
            1999, AIDS became the leading killer in Africa, a fact never
            mentioned in the 1999 World Health Report. This year brought
            increased attention to AIDS after it was declared a national
            security threat in the United States. Today the Clinton
            administration has granted $200 million to global AIDS
            prevention, as African governments must address sex, injection
            drug use, and taboos that create a stigma against AIDS patients.
            Plans are underway for a multibillion-dollar program for southern
            Africa to educate, counsel, and help treat patients with sexually
            transmitted diseases besides AIDS.

            "South Africa AIDS Panel to Validate HIV Tests"
            Reuters (www.reuters.com) (07/04/00); Sithole, Emelia
            International experts meeting with South Africa President
            Thabo Mbeki will conduct studies on the reliability of the ELISA
            HIV test. Harvey Bialy of the Autonomous National University of
            Mexico is a member of the group, along with Helene Gayle of the
            Centers for Disease Control and Prevention. A report by UNAIDS
            has raised questions about the accuracy of the HIV tests. The
            team of three scientists will focus on the ELISA and on helping
            South Africa gather reliable data to use for prevention planning.
          • Bell, Elizabeth
            *************************************************************** PEER-REVIEWED JOURNALS ***************************************************************
            Message 5 of 29 , Jul 11, 2000
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              "Preventing Infections With Today's Tools"
              Science (www.sciencemag.org) (06/23/00) Vol. 288, No. 5474, P.
              2161; Cohen, Jon
              Without an AIDS vaccine, Africa must rely on other HIV prevention
              methods. Frank Plummer of the University of Manitoba's research
              program in Kenya recommends six interventions, including bottle
              feeding babies and male circumcision. However, implementing
              these behaviors and educating the public is difficult, and has
              been slow. Plummer's team has worked with sex workers in Nairobi
              to show that intervention can help the most at-risk groups. A
              1991 study by Plummer and colleagues found that peer education,
              HIV testing, counseling, and sexually transmitted disease (STD)
              treatments can prevent up to 10,000 new HIV cases a year.
              Stephen Moses and Plummer also discovered that male circumcision
              lowers the risk of HIV, but cultural differences keeps many from
              choosing the option. Two conflicting studies address the
              relationship between sexually transmitted diseases and the risk
              of HIV. A 1995 study from Tanzania found that people treated for
              STDs had fewer HIV infections. However, a Ugandan study found no
              relationship between STD treatment and HIV rates. Scientists
              agree that treating STDs is necessary for good health, but more
              active preventions are needed to stop HIV.

              "Africa Boosts AIDS Vaccine R&D"
              Science (www.sciencemag.org) (06/23/00) Vol. 288, No. 5474, P.
              2165; Cohen, Jon
              In Hlabisa, in the Kwazulu-Natal Province of Africa, almost 40
              percent of pregnant women have HIV; just 10 years ago, none
              tested positive. Hlabisa has become a prime spot to test HIV
              vaccines, including those in development by the International
              AIDS Vaccine Initiative (IAVI), led by Seth Berkley. IAVI has
              granted $4.5 million for the next three years to test vaccines in
              South Africa, Kenya, and Uganda. Ethical standards require that
              testing these vaccines is conducted with volunteers who
              understand the risks and how to avoid infection. This is
              difficult in a poorly educated land that has low-income citizens.
              Guidelines for AIDS vaccine tests mandate that testers not take
              advantage of vulnerable populations. The Council for
              International Organizations of Medical Sciences (CIOMS) calls for
              "equitable distribution" of a successful vaccine at an affordable
              price. Peggy Johnston of the NIH's AIDS vaccine program believes
              these requirements will not be enough to allow community access
              to a vaccine. Researchers have not yet found a perfect vaccine,
              but even a 60 percent effective vaccine will save twice as many
              lives if created today rather than in a few years. A study of
              sex workers outside Nairobi, Kenya, has led to some startling
              results. They show that certain prostitutes who are repeatedly
              exposed to HIV have no sign of infection. A woman named Agnes
              Monifa has sex up to 10 times a day and remains uninfected,
              perhaps due to her white blood cells' power. Discouraging news
              came near the end of the trial when 10 of the 80 uninfected sex
              workers contracted HIV after stopping sexual behavior. This
              means that natural immunity may be caused by repeated stimulation
              from HIV, a difficult behavior to copy in a vaccine. A vaccine
              is needed to treat strains other than subtype B, which is common
              in Europe and the United States. Seth Berkley knows that a
              vaccine would be embraced by the people of Hlabisa if only one
              can reach final testing phases.

              GENERAL MEDIA

              "AIDS in Africa Is Reshaping Whole Populations, Study Says"
              USA Today (www.usatoday.com) (07/11/00) P. 1A; Sternberg, Steve
              A new report from the U.S. Census Bureau indicates that the AIDS
              epidemic will significantly affect life expectancy in Africa over
              the coming years. By the year 2010, study author Karen Stanecki
              concluded, life expectancy will be 29 in Botswana, 30 in
              Swaziland, and 33 in Namibia and Zimbabwe. Life expectancy would
              have been about 70 without AIDS. Stanecki also noted there would
              negative population growth in Botswana, South Africa, and
              Zimbabwe, versus 2 percent to 3 percent population growth in each
              of those nations without AIDS. The study suggested that AIDS
              will affect entire populations, take the lives of whole
              communities, and could spur the migration of many men to seek
              available women. The Centers for Disease Control and
              Prevention's Kevin DeCock stated that the AIDS epidemic is
              "Africa's worst social catastrophe since slavery."

              "Circumcision Debated in Control of AIDS"
              Washington Post (www.washingtonpost.com) (07/11/00) P. A17;
              Brown, David
              Research presented at the 13th International AIDS Conference
              in Durban, South Africa, on Monday discussed the relationship
              between male circumcision and HIV infection. Several studies
              have shown that uncircumcised men are two to eight times more
              likely to be infected with HIV than circumcised men. Daniel T.
              Halperin, an AIDS researcher at the University of California at
              San Francisco, noted that even if the low numbers in those
              studies are correct, almost 50 percent of the infections in men
              in some high-prevalence nations could be "attributable" to not
              being circumcised. However, data from a study of men in the
              Rakai District of Uganda suggests that such conclusions can be
              complicated. A total of 17 percent of the men in Rakai are
              circumcised, with a 99 percent rate among Muslims and a 4 percent
              rate among non-Muslims. While the overall infection rate among
              circumcised men is about half that of the uncircumcised men, in
              the subgroup of circumcised non-Muslims, there is little effect
              on risk. The results indicate that religion could be a
              protective factor, perhaps because Muslim men may have fewer
              casual sex partners since they can have more than one wife, or
              because religious instruction emphasizes frequent washing, which
              could reduce viral transmission.

              "Vaccine Targeting HIV in Africa to Begin Human Tests This
              Wall Street Journal (www.wsj.com) (07/11/00) P. B1; Waldholz,
              Researchers are expected to announce today details of HIV
              vaccine trials set to begin later this summer. First, 18 healthy
              volunteers in Britain will be used to test the safety of the
              vaccine and to determine whether it can generate the kind of
              immune system response that has helped to protect a small group
              of Kenyan women from HIV infection. The vaccine, developed by
              researchers from Oxford University and the University of Nairobi
              with funding from the International AIDS Vaccine Initiative, is
              designed to fight an HIV strain that is common in Africa.
              According to the researchers, the vaccine is made up of genetic
              material that prompted a T-cell response in animal tests and
              which is attached to a weakened version of an animal virus; it
              also includes a gene removed from HIV that is thought to generate
              a killer T-cell response.

              "Cheap Antibiotics Seen Helping HIV Patients"
              Reuters (www.reuters.com) (07/11/00); Fox, Maggie
              Researchers from the Centers for Disease Control and Prevention
              have concluded that inexpensive antibiotics may be useful in
              preventing HIV-infected individuals in Africa from developing
              AIDS, even if access to potent antiretroviral therapy is limited.
              Led by Dr. Mark Dworkin, the researchers tested the antibiotic
              trimethoprim-sulphamethoxazole--which is used in the United
              States to preventing Pneumocystis carinii pneumonia (PCP)--and
              found that it was effective against a number of diseases. The
              researchers noted that while the cheap drug did not affect
              viruses and could not control HIV, it was effective against
              several opportunistic infections that affect HIV patients. The
              drug, sold under the names of Bactrim and Septra, lowered the
              risk of PCP by 40 percent, of toxoplasmosis by 30 percent, and of
              salmonella by 60 percent.

              "Africa Reacts Coolly to German AIDS Drug Offer"
              Reuters (www.reuters.com) (07/08/00); Sithole, Emelia
              Boehringer Ingelheim's announcement that it would provide
              its Viramune AIDS drug at no charge for five years was met with
              wariness from Southern Africa Development Community health
              ministers, who are worried about the terms of the agreement since
              they were not consulted on the offer. Based on data from a study
              published in the medical journal The Lancet, up to 110,000 HIV
              infections of newborns caused by mother-to-child transmission
              could be prevented in the next five years if all pregnant women
              in South Africa alone received treatment. The international
              medical charity Medecins Sans Frontieres noted that while
              manufacturers are likely to make such announcements at the world
              AIDS conference, more action is required. Other concerns remain,
              including the fact that the drug has not yet been approved in
              South Africa, although results of a study of the drug in South
              Africa and Uganda are slated for release at the Durban
              conference, and the fact that benefits of the drug become negated
              if the infected mother breast-feeds the infant, a common practice
              in South Africa.

              The PreventioNews Mailing List is maintained by the National
              Prevention Network (NPIN), part of the Centers for Disease
              Control and Prevention's National Center for HIV, STD, and TB
              Prevention. Regular postings include the Prevention News
              Update, conference announcements, current funding opportunities,
              select articles from the Morbidity and Mortality Weekly Report
              series, and announcements about new NPIN products and services.

              To subscribe to the mailing list, send a blank message to
              preventionews-subscribe@.... To remove your name from
              the mailing list, send a blank message to

              Back issues of the CDC HIV/STD/TB Prevention News Update can be
              found at ftp://ftp.cdcnpin.org/PrevNews. You can search for
              back issues in the Prevention News Update Database at

              Please send all e-mail inquiries to info@....

              **This message may be copied and distributed; however, it may not
              be distributed for profit.**
            • Bell, Elizabeth
              **************************************************************** GENERAL MEDIA **************************************************************** Intermittent
              Message 6 of 29 , Jul 12, 2000
              • 0 Attachment
                GENERAL MEDIA

                "Intermittent Drug Therapy for AIDS Is Tested"
                New York Times (www.nytimes.com) (07/12/00) P. A11; Altman,
                Lawrence K.
                As scientists continue to scramble for ways to improve patient
                reactions to AIDS drugs, a prominent U.S. government researcher
                revealed at the 13th International AIDS conference in Durban,
                South Africa, that giving AIDS patients breaks in their difficult
                combination medication regimens not only reduces the occurrence
                of side effects, but helps the body to fight the virus on its
                own. The news raises hopes in the battle against AIDS, as
                regulatory bodies like the Centers for Disease Control and
                Prevention are concerned that combination therapies may only be
                effective for a limited time as the virus adapts to resist the
                drugs. The practice of extending life expectancies with planned
                medication breaks is currently in about 10 different trials in
                the United States and Europe, basing the length of the
                interruptions on HIV viral loads in the bloodstream. So far,
                those stopping their drug regimens for as long as a month have
                experienced increased HIV levels, but have pushed their viral
                loads back down to unmeasurable levels after re-starting therapy.
                Dr. Anthony S. Fauci, who leads the National Institute of Allergy
                and Infectious Diseases, hopes that the studies will lead to a
                better understanding of AIDS drugs and their effects, permitting
                patients to halt their regimens for as long as six or eight
                months at a time, though he cautions that the cyclical break
                system is not a cure by any means.

                "Sparks Fly at AIDS Meeting Over Breast-Feeding"
                Wall Street Journal (www.wsj.com) (07/12/00) P. B2; Waldholz,
                Participants at the 13th International AIDS Conference in Durban,
                South Africa, are debating the issue of whether a simple and
                inexpensive drug treatment can help prevent millions of pregnant
                women with HIV from transmitting the virus to their children.
                Results from a number of clinical studies reportedly show that
                giving one of several AIDS drugs to HIV-infected pregnant women
                during labor and then to their infants just after birth can
                substantially lower at birth the risk of HIV transmission.
                However, some of the data, which is to be presented on Thursday,
                indicates that the treatment strategy is affected if the
                mothers breast-feed their children and transmit the virus via
                their breast milk. While some experts note that because most
                women in Africa breast-feed their children, making the drug
                therapy less effective than expected, other conference
                participants have suggested that African women be urged to
                bottle-feed, reviving a decades-old debate about nursing versus
                bottle-feeding. Thirty years ago, many experts claimed that
                infant-formula makers got many women to depend heavily on baby
                formula and that the babies were at risk because some of the
                women used contaminated water or diluted the product. The issue
                has been resurrected, however, with the advent of HIV. Although
                University of California at San Diego researcher Stephen Spector
                said, "The evidence strongly suggest we should now be
                aggressively promoting the use of infant formula for infected
                mothers who have been treated" with AIDS drugs, Dr. Hoosen M.
                Coovadia of King Edward Hospital in Durban pointed out that many
                women cannot afford formula and some will not bottle-feed for
                fear of being identified as infected with HIV.

                "Young People Found Uninformed on AIDS"
                New York Times (www.nytimes.com) (07/12/00) P. A11
                The United Nations Children's Fund (UNICEF) has found that
                many young people in developing nations, particularly girls, do not
                know much about HIV transmission and AIDS. According to the
                group's study of 34 countries, more than 50 percent of the 15- to
                19-year-old girls in about half of the nations surveyed said that
                they did not know an AIDS patient could appear healthy; that
                number soared to 80 percent or higher in Chad, Niger, and Nepal.
                "This knowledge gap is one important element in understanding the
                higher HIV infection rate among girls in many countries," the
                report noted. The UNICEF survey, which is part of the agency's
                annual Progress of Nations report, also found that in Haiti,
                Zambia, and Zimbabwe, more than 50 percent of sexually active
                girls did not consider themselves in danger of HIV infection.

                "Lilly Will Donate Drugs to Battle Tuberculosis"
                Wall Street Journal (www.wsj.com) (07/12/00) P. A3; Zimmerman,
                In what will be the first joint initiative between the public
                and private sectors to focus drug-resistant tuberculosis (TB), Eli
                Lilly is in discussion with the World Health Organization,
                Medecins Sans Frontieres, and Jacobus Pharmaceuticals to provide
                free supplies of its high-priced antibiotics. A deal should be
                announced within weeks, with Lilly expected to donate an unknown
                quantity of two expensive anti-TB drugs, capreomycin and
                cycloserine, and to sell an additional amount at market price.
                TB, the leading cause of death from a single infectious disease
                worldwide, was nearly eliminated in the 1940s; however,
                drug-resistant strains have surfaced, particularly in the Russian
                prison system, and could become a serious global health threat if
                allowed to remain unchecked. Negotiators believe that the drugs
                will initially be used in a campaign to treat 1,000 Russian
                prisoners and civilians and may eventually expand to other parts
                of Russia, Latvia, Estonia, Peru, the Philippines, Morocco,
                Chile, and other regions where multidrug-resistant TB strains

                "Tests Offer New Hope on AIDS in Africa"
                Washington Post (www.washingtonpost.com) (07/12/00) P. A1; Brown,
                Three studies presented at the 13th International AIDS
                Conference in Durban on Tuesday suggested that combination AIDS
                drug therapies, which are currently available only in the world's
                wealthy nations, may be useful for infected groups in many parts
                of the Third World. While top AIDS experts have said that the
                drug regimens require too much logistical support for basic
                health systems in poor regions, the studies demonstrated
                successes in giving the drug cocktails in the Ivory Coast,
                Senegal, and Ugandan capitals. The studies were fairly
                small--involving less than 1,000 people--but they indicated the
                logistical problems could be overcome in some situations. For
                the Ugandan study, 350 individuals were give single or double
                drug therapies at a cost of about $250 a month. Fifteen months
                later, more than half were still taking the drugs. A similar
                study in Ivory Coast involving 422 people found that after a year
                and a half, 71 percent of the patients were still taking the
                cocktail therapies. Nearly 90 percent of the 75 patients in a
                home-grown study in Senegal were still enrolled two years into
                the research. The researchers noted that mortality was fairly
                high in the three programs, since most of the patients had
                advanced AIDS when the study began, and full virus suppression
                was rare, since many of the individuals were receiving two drugs
                instead of three.

                "U.S. Researcher Criticizes Mbeki for Backing 'Dissidents' on
                Washington Times (www.washtimes.com) (07/12/00) P. A18;
                Swindells, Steven
                Dr. David Ho, head of the Aaron Diamond AIDS Research Center in
                New York City, criticized South African President Thabo Mbeki on
                Tuesday for questioning whether HIV is the cause of AIDS. In a
                speech at the 13th International AIDS Conference in Durban, Ho
                said, "President Mbeki, I beg you not to let your legacy be
                defined by inaction on this human tragedy." Ho stated that HIV
                is the cause of AIDS and showed a microscope photograph of the
                virus attacking a cell to reinforce his point. Mbeki's attitude
                regarding the cause of AIDS has sparked controversy and protests
                that have overshadowed much of the new research being presented
                at the conference. Also, at the conference center on Tuesday,
                activists called on the World Health Organization to add
                anti-AIDS drugs to its list of essential drugs. Providing drugs
                to at least 12 million HIV-infected individuals worldwide would
                cost about $60 billion annually, according to the London-based
                Panos Institute.
              • Bell, Elizabeth
                *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** The
                Message 7 of 29 , Jul 13, 2000
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                  PEER-REVIEWED JOURNALS

                  "The Durban Declaration"
                  Nature (www.nature.com) (07/06/00) Vol. 406, No. 6791, P. 15
                  The Durban Declaration, which was signed by over 5,000
                  researchers and experts, is a document developed in response to
                  the controversy in South Africa about whether HIV is the cause of
                  AIDS. The declaration states that there is definitive,
                  scientific proof that AIDS is caused by HIV-1 or HIV-2. The
                  paper lists several criteria to support its point, including the
                  fact that all AIDS patients, no matter where they live, are
                  infected with HIV. The authors write that while there are
                  different patterns of HIV and AIDS throughout the world and that
                  a variety of factors help determine the risk of disease,
                  scientific evidence still clearly shows that HIV is the sole
                  cause of AIDS. "Prevention of HIV infection must be our greatest
                  worldwide public-health priority," the declaration asserts, also
                  calling for new drug treatments that are easier to take, have
                  fewer adverse reactions, and which cost less, so more people can

                  GENERAL MEDIA

                  "Hopes for Anti-H.I.V. Treatment Dashed"
                  New York Times (www.nytimes.com) (07/13/00) P. A6; Altman,
                  Lawrence K.
                  A UNAIDS study presented at the 13th International AIDS
                  Conference in Durban, South Africa, revealed that of nearly 1,000
                  HIV-negative prostitutes in Africa and Thailand, those using the
                  nonoxynol-9 gel were more likely to contract HIV than those using
                  a placebo gel. UNAIDS officials said that 59 infections were
                  discovered in the spermicidal group, while just 41 infections
                  were noted within the placebo group. The Centers for Disease
                  Control and Prevention's Dr. Ann Duerr notes that for people at
                  high risk for HIV infection, "condoms with or without nonoxynol-9
                  should be used." Duerr said that the implications of the UNAIDS
                  study's findings for the low levels of nonoxynol-9 on lubricated
                  condoms are not certain. As a result of the study, the CDC has
                  halted planned research among women at high risk for HIV in Los
                  Angeles and Miami.

                  "AIDS Spurs a Crisis of Orphanhood Across Africa"
                  Washington Post (www.washingtonpost.com) (07/13/00) P. A18;
                  Brown, David
                  A survey conducted by the U.S. government suggests that the
                  AIDS crisis will create an epidemic of orphanhood in Africa for at
                  least a generation, as by 2010 one in seven children under the
                  age of 15 years in sub-Saharan Africa will have lost at least one
                  parent. The study, to be presented by the U.S. Agency for
                  International Development (USAID) today, remarks that this group
                  of orphans is not typical; most orphaned groups are left without
                  a parent by a catastrophe such as war, genocide, or natural
                  disaster. Ten years ago, just one-fifth of the orphaned children
                  in sub-Saharan Africa were that way because of AIDS. Today,
                  however, nearly half of all orphan cases are caused by AIDS, and
                  a decade from now 70 percent of orphaned children will have lost
                  a parent to AIDS. The agency estimates that 44 million
                  sub-Saharan children have lost their fathers, with most of them
                  to AIDS-related deaths. The eventual toll on the continent is
                  difficult to predict, according to the report, as many of the
                  factors that arise from losing a parent are subtle and affect
                  children in various ways. Orphaned children also cost about
                  $2,000 per year to raise, a total that is tremendously high in
                  the poor nations of southern Africa. While most orphan studies
                  concerning AIDS deaths concern themselves with children who lose
                  both parents or a mother, the USAID study also included the
                  factor of losing a father--an important aspect considering that
                  men are often the only working members of the family in Africa,
                  and especially in southern Africa, where the AIDS epidemic is at
                  its worst.

                  "HIV a Crisis for Third World Children"
                  Washington Times (www.washtimes.com) (07/13/00) P. A13; Nessman,
                  The United Nations Children's Fund (UNICEF) revealed on Wednesday
                  in its Progress of Nations report that the AIDS crisis and its
                  effects on children have been underestimated, as millions have
                  lost parents and hundreds of thousands have lost teachers to
                  AIDS, reducing their chances for both a normal home life and a
                  good education. In addition, many children in developing
                  countries do not know ways to protect themselves from contracting
                  HIV; for instance, almost 75 percent of Mozambique girls and 62
                  percent of boys between the ages of 15 years and 19 years do not
                  know one way to prevent infection. The difference is alarming,
                  because women face a higher risk of contracting HIV than men, and
                  reports indicate that girls between the ages of 15 years and 19
                  years believe they are not at risk for the disease. In addition,
                  sub-Saharan Africa has witnessed the deaths of teachers for
                  approximately 860,000 schoolchildren. However, there are a
                  number of small prevention programs in African nations that
                  suggest the situation is not hopeless, though they are difficult
                  to monitor given their size and budgets. The total budgets for
                  AIDS programs in developing countries is just $600 million, as
                  compared with the United States domestic AIDS prevention budget
                  of $800 million and assistance programs for other countries
                  budgeted at $7 billion.

                  "African Nations Studying Generic AIDS Drugs"
                  Wall Street Journal (www.wsj.com) (07/13/00) P. A3; Waldholz,
                  In private meetings at the 13th International AIDS Conference in
                  Durban, South Africa, representatives from over a dozen African
                  countries are talking with U.S. and European generic drug makers
                  and UNAIDS to develop a program similar to those found in Brazil
                  and India to produce AIDS drugs at substantially lower prices
                  than those charged for branded drugs. While not committing to
                  the proposal, the African nations hope that the talks will induce
                  AIDS drugs makers like Merck and Bristol-Myers Squibb to reduce
                  their prices or offer deals to nations that cannot afford the
                  medications for their citizens. However, any changes to the
                  present market would be a major threat to leading drugs
                  companies, who are concerned that lower prices in some countries
                  will create demand in developed countries for reduced prices as
                  well, where drugs firms make most of their money. The difference
                  in generic pricing is tremendous in Brazil, where Glaxo
                  Wellcome's AZT and 3TC combination therapy sells for $1.50 when
                  produced by generic makers, as compared with its $7 daily cost in
                  Uganda and $18 price in the United States.

                  "Gates, Wife Give $25 Million to Va. Study"
                  Washington Post (www.washingtonpost.com) (07/13/00) P. B3
                  The Bill & Melinda Gates Foundation, created by Microsoft founder
                  Bill Gates and his wife, has $25 million to Virginia researchers.
                  The grant is meant to finance studies of preparations that can be
                  used to protect women against HIV and other sexually transmitted
                  diseases. Announced at the 13th International AIDS Conference in
                  Durban, South Africa, the funding is intended to help researchers
                  with connections to the Eastern Virginia Medical School of
                  Norfolk for the study and advancement of microbicides, whether in
                  the form of gels, creams, suppositories, or sponges.

                  "Re-Use of Female Condom in African Countries Stirs Worries"
                  Agence France Presse (www.afp.com) (07/11/00)
                  The World Health Organization and UNAIDS expressed concern on
                  Tuesday that poor African women are re-using the female condom.
                  The two agencies noted that women in several sub-Saharan nations
                  were re-using the polyurethane prophylactic because they could
                  not afford or obtain new ones. Officials noted that using soap
                  and water or diluted bleach may not be sufficient to remove HIV
                  from its surface, and the condom may also be weakened by any
                  chemicals used. In a statement, the two groups said that "re-use
                  of the female condom is not recommended."

                  "Drugs Help Mothers Stop Giving HIV to Babies"
                  Reuters (www.reuters.com) (07/11/00)
                  On Tuesday, Bristol-Myers Squibb released data from a study in
                  South Africa demonstrating that two of its HIV drugs, Videx and
                  Zerit, are equivalent to AZT in preventing mother to child
                  HIV-transmission. Bristol-Myers noted that its two medications
                  are in the same class as AZT and Viramune, both of which are
                  highly regarded as HIV-transmission preventatives. Scientists at
                  Chris Hani Baragwanath Hospital near Johannesburg administered
                  the drugs to pregnant mothers a few weeks before delivery and
                  then to the babies after birth in various combinations and doses.
                  Preliminary six-week data indicates that the transmission rates
                  for children treated with Videx, Zerit, or a combination of the
                  two drugs were comparable to those treated with AZT.

                  The PreventioNews Mailing List is maintained by the National
                  Prevention Network (NPIN), part of the Centers for Disease
                  Control and Prevention's National Center for HIV, STD, and TB
                  Prevention. Regular postings include the Prevention News
                  Update, conference announcements, current funding opportunities,
                  select articles from the Morbidity and Mortality Weekly Report
                  series, and announcements about new NPIN products and services.

                  To subscribe to the mailing list, send a blank message to
                  preventionews-subscribe@.... To remove your name from
                  the mailing list, send a blank message to

                  Back issues of the CDC HIV/STD/TB Prevention News Update can be
                  found at ftp://ftp.cdcnpin.org/PrevNews. You can search for
                  back issues in the Prevention News Update Database at

                  Please send all e-mail inquiries to info@....

                  **This message may be copied and distributed; however, it may not
                  be distributed for profit.**
                • Bell, Elizabeth
                  Senate OKs $600M for AIDS Las Vegas Sun Online (www.lasvegassun.com) (07/26/00) The Senate has passed legislation that grants up to $600 million in U.S.
                  Message 8 of 29 , Jul 27, 2000
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                    "Senate OKs $600M for AIDS"
                    Las Vegas Sun Online (www.lasvegassun.com) (07/26/00)
                    The Senate has passed legislation that grants up to $600 million
                    in U.S. funding to fight HIV and AIDS in Africa and other parts
                    of the world. The Senate approved the bill, proposed by Sens.
                    Bill Frist (R-Tenn.) and Jesse Helms (R-N.C.), which calls on the
                    U.S. Treasury to set up a trust fund with the World Bank for HIV
                    prevention and treatment and also for the care of children
                    orphaned by AIDS. The measure will supply $300 million in U.S.
                    aid in each of the next two years and also provides $120 million
                    to fight tuberculosis in developing nations.
                  • Bell, Elizabeth
                    Tanzania Declares AIDS National Catastrophe Africa News Service (www.africanews.org) (08/09/00) Tanzania s government has declared AIDS a national disaster.
                    Message 9 of 29 , Aug 10, 2000
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                      "Tanzania Declares AIDS National Catastrophe"
                      Africa News Service (www.africanews.org) (08/09/00)
                      Tanzania's government has declared AIDS a national disaster.
                      Given the disease's impact on both the economy and the community,
                      Permanent Secretary of the Ministry of Health Mariam Mwaffisi
                      announced, "[Nongovernmental organizations], religious groups,
                      and other institutions should join in the war against the
                      epidemic in order to reduce its spread and mitigate its impact."
                      While she did not provide any statistics about AIDS in Tanzania,
                      Mwaffisi said Tuesday that she has set up a seminar to help the
                      13 registered political parties better understand AIDS and the
                      issues surrounding it before the general elections this fall.
                      Earlier this year, Vice President Dr. Omari Juma urged various
                      religious groups to join the fight against AIDS, and he also
                      called on the nation to end customs and traditions that could
                      help spread HIV, such as wife inheriting.

                      "Liberia Earmarks $6.5 Million for HIV/AIDS Program"
                      PANA Wire Service (www.africanews.org/PANA) (08/09/00); Kahler,
                      Liberia needs $6.5 million to prevent the spread of AIDS for
                      the next three years, and a strategic plan drawn up by participants
                      at a recent health workshop said the money should be used for
                      advocacy, education, behavioral change, treatment of sexually
                      transmitted diseases, and blood safety. Participants at the
                      workshop include members of government ministries, United Nations
                      agencies, the donor community, and community-based organizations.
                      The new plan aims to boost the nation's ability to respond to
                      AIDS and also to lower HIV prevalence by 15 percent by 2003.

                      "Angola Needs $12 Million to Fight AIDS"
                      PANA Wire Service (www.africanews.org/PANA) (08/09/00)
                      Angola's deputy health minister, Natalia do Espirito, stated
                      at a recent AIDS symposium that the country requires $12 million to
                      help fund its national AIDS control program. She said better
                      educational campaigns are needed to make people more aware of the
                      disease and to change their sexual behaviors. The symposium,
                      whose theme was "Fighting AIDS Together," also focused on AIDS in
                      the workplace. Statistics show that more than 43,700 cases of
                      HIV or AIDS had been reported in Angola as of December 1999.

                      "HIV Vaccine Trials Planned for Africa"
                      Nature Medicine (medicine.nature.com) (08/00) Vol. 6, No. 8, P.
                      844; Birmingham, Karen
                      Oxford University immunologist Andrew McMichael announced at
                      the recent International AIDS Conference that human testing of the
                      gag DNA element of a DNA/modified vaccinia virus prime boost HIV
                      vaccine will begin Phase I trials this month in Oxford, England.
                      Testing of the vaccinia boost part will begin in September, with
                      tests of both parts expected soon after. The vaccine, being
                      developed in conjunction with the University of Nairobi, is also
                      set to start testing in Kenya later this year. Separately, the
                      South African AIDS Vaccine Initiative (SAAVI) continues to work
                      on its HIV vaccine--a Venezuelan equine encephalitis virus
                      vaccine that could begin human trials in January 2001. SAAVI has
                      seven other vaccines in various stages of development. Also, in
                      a move that will help further South Africa's vaccine efforts, the
                      U.S. National Institutes of Health recently gave the South
                      African Medical Research Council $14.7 million over five years
                      for AIDS research, with part of the money to be used for testing
                      microbicides and the effectiveness of nevirapine in preventing
                      HIV transmission by breast-feeding mothers.
                    • Bell, Elizabeth
                      Biotech Firm Seeks Funding for AIDS Tests San Francisco Chronicle (www.sfgate.com) (08/10/00) P. C1; Abate, Tom Calypte Biomedical Corp. of Alameda, Calif.,
                      Message 10 of 29 , Aug 14, 2000
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                        "Biotech Firm Seeks Funding for AIDS Tests"
                        San Francisco Chronicle (www.sfgate.com) (08/10/00) P. C1; Abate,
                        Calypte Biomedical Corp. of Alameda, Calif., is hoping to
                        obtain international funding to send a simple HIV test to Africa.
                        The test uses urine samples instead of blood to detect the presence
                        of HIV. Calypte says that it has a verbal agreement from an
                        international agency to fund the six mobile testing clinics it
                        has set up with a partner in South Africa. However, the two
                        firms are looking for additional international support so they
                        can set up mobile clinics in other African nations. According to
                        Calypte officials, the mobile clinics would enter a village and
                        workers would request help from village elders in persuading
                        individuals to submit urine samples. The clinics could then
                        analyze the samples and deliver the results, as well as
                        counseling, the following day.

                        "AIDS Study Prompts New Look at Prevention"
                        Washington Post (www.washingtonpost.com) (08/14/00) P. A3; Okie,
                        Some experts are worried that the use of the spermicide
                        nonoxynol-9 may no longer be advisable for women at risk for HIV,
                        following the release of a UNAIDS study which found that women
                        who used the gel became infected more often than women who used a
                        placebo. Nonoxynol-9 is commonly found in condoms but is also
                        used in contraceptive creams, gels, foams, and sponges. Dr.
                        Helen D. Gayle, director of the National Center for HIV, STD, and
                        TB prevention at the Centers for Disease Control and Prevention,
                        stated, "Clearly, women who are potentially at risk--who have
                        multiple partners, who don't know what the risk of their partner
                        may be--may not be a group of women who should be using
                        nonoxynol-9." The ingredient kills sperm cells but can irritate
                        the vaginal lining if used too much; test tube studies also
                        suggest that nonoxynol-9 can kill HIV and the bacteria that cause
                        certain other sexually transmitted diseases (STDs). Two
                        U.S.-funded studies of nonoxynol-9 are being conducted among
                        African women at risk for HIV. The first study is testing the
                        ability of nonoxynol-9 to prevent STDs among women in Cameroon,
                        while the second hopes to look for protection against HIV
                        infection in women in Zimbabwe and Malawi. Ward Cates of Family
                        Health International, which is coordinating the second project,
                        noted, however, that following the release of the UNAIDS study
                        about nonoxynol-9, they will not test nonoxynol-9. The
                        researchers have not yet identified a substitute product.
                        Scientists are now testing potential new microbicides and
                        considering what steps to advise women to take. Possible
                        products to be tested include cellulose sulfate and antiviral
                        drugs for the vagina; however, it will be years before any new
                        microbicide reaches to the market.

                        "AIDS Cuts Swath Through Africa's Teachers"
                        New York Times (www.nytimes.com) (08/14/00) P. A1; Onishi,
                        In Africa's Ivory Coast, where nearly 11 percent of the
                        population is thought to have HIV, AIDS is taking the lives of
                        many teachers. "AIDS constitutes one of the biggest crises and
                        the biggest threats to the global education agenda that we have
                        known," UNAIDS head Dr. Peter Piot asserted earlier this year.
                        In 1998, six teachers a week in the Ivory Coast died from AIDS,
                        and the disease took the lives of over 1,300 teachers in Zambia.
                        Lack of knowledge about AIDS and low condom are two factors
                        behind the spread of HIV. A study from 1996 to 1998 found that
                        641 educators died of AIDS in the Ivory Coast, and 69 percent of
                        teachers' deaths during the second year were AIDS related. Also
                        contributing to the spread of disease is the fact that many
                        African teachers, most of whom are men, take their first teaching
                        positions in rural areas, and young women vie for their
                        attention. The lack of outside interruptions in these rural
                        areas leads many teachers to have multiple sexual relationships,
                        and the women often refuse to wear condoms to prove their virtue.
                        Few teachers are willing to get tested for HIV, as the epidemic
                        continues to move throughout Africa.

                        "AIDS, HIV Victims in 14 Africa Countries to Set Up Common
                        Agence France Presse (www.afp.com) (08/13/00)
                        HIV-infected people in 14 central and west African Countries have
                        agreed to set up a network to help each other fight HIV. The
                        network was agreed upon at a two-day conference in Cameroon, the
                        first meeting of the African Network of People Living with HIV
                        and AIDS. Officials from national AIDS groups explained that
                        they wanted to "formulate a plan of action to support other AIDS
                        sufferers and to increase awareness among the rest of the
                        population." The meeting was attended by several United Nations
                        officials, who vowed to support the proposals that were unveiled.

                        "UNICEF to Spend $4 Million to Fight AIDS in Mozambique"
                        Agence France Presse (www.afp.com) (08/12/00)
                        UNICEF official Ian MacLeod announced Friday that $4 million will
                        be spent on anti-AIDS programs in Mozambique this year. MacLeod
                        noted that UNICEF has already provided the National AIDS Council
                        with $30,000 so it can "start [its] operations as soon as
                        possible." MacLeod called on the government, nongovernmental
                        organizations, and the public to work together in the fight
                        against AIDS. An estimated 16 million people in Mozambique are
                        infected with HIV, according to statistics.

                        "AIDS Tops Normally Economic Agenda at Southern Africa Meeting"
                        Agence France Presse (www.afp.com) (08/12/00)
                        AIDS will be the leading issue at a southern African conference
                        that typically focuses on economics. The South Africa
                        International Dialogue (SAID), set to meet later this month,
                        joins leaders to discuss issues like trade and economic growth;
                        however, this year AIDS will be the primary issue for discussion.
                        The fourth annual meeting of SAID is expected to draw over 400
                        delegates to Maputo, South Africa on August 20.
                      • Bell, Elizabeth
                        Researchers Prepare Vaccine Trials in Heart of Africa s AIDS Crisis Detroit Free Press Online (www.freep.com) (08/18/00); Collins, Huntly In Hlabisa, South
                        Message 11 of 29 , Aug 18, 2000
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                          "Researchers Prepare Vaccine Trials in Heart of Africa's AIDS
                          Detroit Free Press Online (www.freep.com) (08/18/00); Collins,
                          In Hlabisa, South Africa, researchers are preparing to begin
                          testing an HIV vaccine based on strains of the virus found in
                          sub-Saharan Africa. The potential vaccine has shown effective on
                          macaques, and was created using genetic engineering. In
                          Hlabisa, most people live in huts and have no electricity or
                          running water. The area was selected for the vaccine test
                          because of its high HIV infection rate. Last year, the HIV
                          infection rate among women seeking prenatal care at the local
                          hospital was 33 percent, and the infection rate is nearly 40
                          percent among women between the ages of 15 and 30. The stigma of
                          AIDS continues in this rural area, and people rarely say the word
                          for AIDS, "ingulaza," which means "powerful sexually transmitted
                          disease." The experimental vaccine, set to begin testing by
                          2002, was developed by researchers at the University of North
                          Carolina and the University of Cape Town. As the trial draws
                          closer, the researchers are working educate area residents about
                          AIDS and also to resolve ethical issues related to testing the
                          vaccine in the largely uneducated population that does not even
                          have words for "placebo" or "control group."

                          "South Africa Tourism Fights Perceptions"
                          Wall Street Journal (www.wsj.com) (08/18/00) P. A11
                          South Africa's tourism industry is fighting perceptions about
                          its safety, as crime and HIV take their toll on the country's
                          economy. The largest wave of visitors to South Africa this year
                          was for the recent International AIDS Conference in Durban. Last
                          year, there were 6 million foreign visitors to the country.

                          "South Africa to Probe Reports of HIV-Linked Dismissals"
                          Reuters (www.reuters.com) (08/17/00); Sithole, Emelia
                          South Africa will investigate claims by Mozambique that South
                          African mining companies are ending contracts with HIV-infected
                          Mozambican workers. South African Labor Minister Membathisis
                          Mdladlana said they will gather more information, even though the
                          South African Chamber of Mines denies wrongdoing. Mario Sevene,
                          Mozambique's top labor official, also said that some of the
                          mining companies were privately testing workers for HIV, breaking
                          South Africa labor laws. The mining industry in South Africa has
                          been hard hit by the AIDS epidemic.

                          "Isolation Camps Proposed for Swazi HIV Victims"
                          Reuters (www.reuters.com) (08/16/00)
                          Tfohlongwane Dlamini, chairman of the Swaziland National Council
                          Standing Committee, has proposed setting up camps to isolate HIV
                          and AIDS patients from the public. The suggestion--an apparent
                          attempt to stem the spread of HIV--was condemned by Swaziland's
                          healthcare workers, who asserted he needed more information about
                          the virus. The Health Ministry noted that HIV cannot be
                          transmitted via casual contact, and the camps would only increase
                          the problems that HIV and AIDS patients face. Swaziland has made
                          several controversial proposals to fight AIDS, including banning
                          mini-skirts in the country's schools.
                        • Bell, Elizabeth
                          Loans to Buy AIDS Drugs Are Rejected by Africans New York Times (www.nytimes.com) (08/22/00) P. A6; Swarns, Rachel L. South Africa and Namibia have refused
                          Message 12 of 29 , Aug 24, 2000
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                            "Loans to Buy AIDS Drugs Are Rejected by Africans"
                            New York Times (www.nytimes.com) (08/22/00) P. A6; Swarns, Rachel
                            South Africa and Namibia have refused the United States' offer
                            of $1 billion in yearly loans to finance the purchase of AIDS drugs.
                            The African countries stated that affordable drugs are needed and
                            that the loans would only burden their economies and send them
                            further into debt. The U.S. Export-Import Bank made the loan
                            offer to 24 southern African countries, but none have formally
                            accepted the offer so far. Developing countries have been urging
                            the West to make less expensive anti-AIDS drugs and to allow poor
                            countries to overcome patents in order to manufacture generic
                            versions of the drugs. Earlier this year, the Clinton
                            administration issued an executive order promising not to
                            interfere with African countries that did not follow American
                            patent law to secure cheaper drugs. Dr. Kalumbi Shangula, the
                            permanent secretary for the Namibian Ministry of Health, believes
                            that efforts to support generic drugs are more helpful than loan
                            programs. He stated that accepting the loans would send the
                            country "deeply into debt."

                            "Battling AIDS in Africa by Empowering Women"
                            New York Times (www.nytimes.com) (08/22/00) P. D3; Dreifus,
                            An interview with Dr. Nancy Padian, an epidemiologist who
                            is director of research for the AIDS Research Institute of the
                            University of California at San Francisco, sheds light on her
                            work in Zimbabwe. Dr. Padian commutes between San Francisco and
                            Harare to teach Zimbabwean health workers about how to control
                            the AIDS epidemic. By running studies on the effects of
                            contraception in preventing HIV in women, Padian teaches the
                            women to use barrier methods like condoms. She explains that
                            women have little power to negotiate condom use, but she teaches
                            them to plan for obstacles. Compared to American women, women in
                            southern Africa are much more vulnerable to HIV because of there
                            is a higher prevalence of other sexually transmitted diseases;
                            some women engage in "dry sex," using chemical or other means to
                            dry up cervical and vaginal secretions prior to having sex; and
                            it is not unusual for African men to have several sex partners.
                            Being married is a risk factor for HIV in Zimbabwe, Padian
                            explains, because the women are typically monogamous, but their
                            husbands may not be. The infection rate in Zimbabwe is about 25
                            percent to 30 percent. Padian notes, "The bottom line,
                            universally is, If you cannot negotiate what you are doing with
                            your body, you will not be able to lead a healthy and long life."
                          • Bell, Elizabeth
                            Gates Foundation on Big Funding Spree Science (www.sciencemag.org) (08/11/00) Vol. 289, No. 5481, P. 845; Hagmann, Michael The Bill and Melinda Gates
                            Message 13 of 29 , Aug 29, 2000
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                              "Gates Foundation on Big Funding Spree"
                              Science (www.sciencemag.org) (08/11/00) Vol. 289, No. 5481, P.
                              845; Hagmann, Michael
                              The Bill and Melinda Gates Foundation has made several large
                              donations for health studies recently. These include $40 million
                              for the London School of Hygiene & Tropical Medicine to study
                              malaria, $44.7 million for the Harvard Medical School for
                              tuberculosis (TB), $20 million to Johns Hopkins School of Public
                              Health for child and maternal health, and $90 million for
                              HIV/AIDS-related studies at a number of institutions. Jim Yong
                              Kim of Harvard Medical School--working with the World Health
                              Organization, local health officials, and others--will be
                              investigating a treatment program for multidrug-resistant TB
                              patients in Peru.

                              "President Urges Nigeria to Fight Tyranny of AIDS"
                              New York Times (www.nytimes.com) (08/28/00) P. A1; Lacey, Marc
                              President Clinton, in his visit to Nigeria this week, has
                              urged the country to confront AIDS and overcome taboos. This is a
                              challenge not just for Nigeria but for all of Africa, which has
                              been slow to educate its people about AIDS and the virus that
                              causes the disease. Clinton said, "We have to break the silence
                              about how this disease spreads and how to prevent it. And we
                              need to fight AIDS, not people with AIDS." Clinton offered
                              American support for Nigeria's battle against AIDS, but he did
                              not offer any new funding. He did, however, discuss the $20
                              million the United States is providing to control AIDS, malaria,
                              and polio in Nigeria this year. Clinton stated that freedom for
                              Nigeria would come only after infectious diseases are controlled.
                              Nigerian President Olusegun Obasanjo also urged debt relief for
                              his country. He noted, "We don't see [AIDS] as a Nigerian
                              disease. We see it as a world disease that is ravaging Africa
                              most." According to the White House, approximately 5.4 percent
                              of Nigeria's 114 million people are infected with HIV.
                            • Bell, Elizabeth
                              African Leaders to Meet Annan, Discuss Flash Points Reuters (www.reuters.com) (09/05/00); Mseteka, Buchizya The presidents of South Africa, Malawi, Namibia,
                              Message 14 of 29 , Sep 5, 2000
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                                "African Leaders to Meet Annan, Discuss Flash Points"
                                Reuters (www.reuters.com) (09/05/00); Mseteka, Buchizya
                                The presidents of South Africa, Malawi, Namibia, and Zimbabwe
                                will meet with United Nations Secretary-General Kofi Annan today
                                to discuss war, debt relief, and AIDS in their countries.
                                According to analysts, Africa's huge debt load has forced many
                                countries to spend more on debt problems than on health issues
                                like AIDS. U.N. statistics indicate that Africa needs at least
                                $3 billion annually to battle AIDS.

                                "AIDS Activists Take South African Government to Court"
                                Lancet (www.thelancet.com) (08/26/00) Vol. 356, No. 9231, P. 746;
                                Baleta, Adele
                                South African AIDS activists plan to take their government to
                                court because it refuses to provide HIV-positive pregnant women
                                with drugs to help prevent vertical transmission of HIV. The
                                Treatment Action Campaign set an August 18 deadline for the
                                health department to change its policies on treating pregnant
                                women. After no response, legal action is expected. Health
                                Minister Manto Tshabalala-Msimang recently announced that clinics
                                will be chosen for research into nevirapine's use in protecting
                                newborns from HIV. Antiretroviral drugs are only available in
                                South Africa on a trial basis at selected sites. After the big
                                AIDS conference in July, activists had hoped that a shift in
                                policy would take place. The health department has offered
                                several reasons for not providing the drugs, including toxicity
                                and their high price.
                              • Bell, Elizabeth
                                (a major step forward from Mugabe) Mugabe Announces That AIDS Had Killed Ministers PANA Wire Service (www.africanews.org/PANA) (09/07/00) Zimbabwe s
                                Message 15 of 29 , Sep 8, 2000
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                                  (a major step forward from Mugabe)

                                  "Mugabe Announces That AIDS Had Killed Ministers"
                                  PANA Wire Service (www.africanews.org/PANA) (09/07/00)
                                  Zimbabwe's President, Robert Mugabe, told participants at the
                                  United Nations Millennium Summit this week that three of his
                                  cabinet ministers and many traditional chiefs have died from AIDS
                                  in the last several years. Mugabe asked for international help
                                  to fight the disease, which is taking the lives of an estimated
                                  2,000 Zimbabweans a week. Mugabe, who also noted he has lost a
                                  "countless number" of extended family members to AIDS, encouraged
                                  global participation to halt the epidemic.

                                  "Trade in Infected Blood Raises International Furor"
                                  Reuters Health Information Services (www.reutershealth.com)
                                  (09/06/00); Kumar, Sanjay
                                  Austrian, Swiss, and U.K. officials are trying to track down
                                  blood plasma contaminated with HIV, hepatitis C, and syphilis,
                                  that was allegedly sold by South African firms to brokers in
                                  Switzerland and the United Kingdom. Authorities fear that
                                  brokers have been selling relabeled contaminated blood products
                                  to various countries for over 10 years. A recent confidential
                                  investigation conducted by South Africa's Department of Health
                                  determined that infected blood plasma not suitable for human use
                                  had been exported within the past decade. Although he noted that
                                  more information is needed about the situation, Dr. Luc Noel--the
                                  coordinator of blood transfusion safety for the World Health
                                  Organization--said that anyone who relabels unsafe blood
                                  products, thus putting others at risk, should be punished.
                                • Bell, Elizabeth
                                  U.S. Efforts on HIV/AIDS and Infectious Diseases U.S. Newswire (www.usnewswire.com) (09/08/00) The Clinton administration has released a statement showing
                                  Message 16 of 29 , Sep 8, 2000
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                                    "U.S. Efforts on HIV/AIDS and Infectious Diseases"
                                    U.S. Newswire (www.usnewswire.com) (09/08/00)

                                    The Clinton administration has released a statement showing its
                                    strong support for United Nations Secretary-General Kofi Annan's
                                    call for international action to fight HIV. The statement notes
                                    that the White House also backs Annan's recommendation that
                                    health research be focused on issues that affect the majority of
                                    the world's people. AIDS, for example, took the lives of 2.8
                                    million people in 1999, while millions continue to die from
                                    vaccine-preventable infections and many more die from disease
                                    which still need vaccines, including AIDS and malaria. The
                                    statement also lists actions the administration has taken that
                                    support the recommendations of the U.N. Millennium Report in
                                    terms of the threat of global disease issues.
                                  • John Spurlock Romweber
                                    Howdy to all of you in ujeni world. I am sending this lettle update as I am changing all of my addresses. Email jsrinbf@hotmail.com. Snailmail is
                                    Message 17 of 29 , Sep 10, 2000
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                                      Howdy to all of you in ujeni world. I am sending this lettle update as I
                                      am changing all of my addresses. Email jsrinbf@.... Snailmail is
                                      jsr/BP110/Kaya/Burkina Faso. I have to mosey off to the A's game
                                      now...the mighty Devil Rays are in town. Love to all.

                                    • Bell, Elizabeth
                                      Nurse in Malawi Wages War on AIDS and Apathy New York times (www.nytimes.com) (11/07/00) P. A12; Crossette, Barbara Nurse Catherine Phiri of Malawi
                                      Message 18 of 29 , Nov 8 5:56 AM
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                                        "Nurse in Malawi Wages War on AIDS and Apathy"
                                        New York times (www.nytimes.com) (11/07/00) P. A12; Crossette,
                                        Nurse Catherine Phiri of Malawi contracted HIV during the
                                        rule of Hastings Kamuzu Banda, who prohibited any public discussion
                                        of the disease. When a democratic government took over in 1994,
                                        Phiri founded a support group for anyone affected by HIV, and
                                        last month, she received a Race Against Poverty Award from the
                                        United Nations Development Program and UNAIDS. Phiri said the
                                        new president of Malawi, Bakili Muluzi, has helped increase
                                        awareness about HIV and AIDS. She also noted that the press is
                                        now free enough to help show residents the extent of the problem
                                        in the country, where 25 percent of the urban work force is
                                        expected to die from AIDS within 10 years. Phiri said, "I hope
                                        that we will be recognized by being given the award, and that the
                                        government will now have something to do with us. ... I've been
                                        writing [the president] proposals that have never been answered."
                                        The three other recipients of the Race Against Povery Awards were
                                        Maire Bopp Dupont, a radio journalist who has worked to inform
                                        Pacific islanders about AIDS; Rita Arauz, a Nicaraguan
                                        psychologist who set up a foundation to study and deal with HIV
                                        and other sexually transmitted infections; and the Rev. Arkadiusz
                                        Nowak, a priest who opened the first AIDS hospice in Poland.

                                        "AIDS Smothers African Kingdom; Swaziland: AIDS Is Destroying a
                                        Baltimore Sun (www.sunspot.net) (11/04/00) P. 1A; Murphy, John
                                        Swaziland, located between South Africa and Mozambique, has
                                        been ineffective at responding to the AIDS epidemic thus far. The
                                        latest measures involved parliament banning miniskirts in schools
                                        to reduce sex between teachers and students. AIDS activists in
                                        Swaziland struggle against the country's traditions and shame
                                        surrounding AIDS. Out of a population of 1 million, an estimated
                                        22 percent are infected with HIV, and 40 percent of all pregnant
                                        women are HIV-positive. According to Christabel Motsa,
                                        chairwoman of the government's crisis committee on disease,
                                        people there are afraid to talk about AIDS and deny that it is a
                                        problem. Tradition is hard to overcome, as the kingdom is ruled
                                        by a monarch with seven wives. Polygamy is rampant in rural
                                        areas, and contraceptives are ignored. King Mswati declared HIV
                                        a national disaster last year and has urged HIV testing, but
                                        proposals to place HIV-infected people in camps or sterile them
                                        highlight the mindset of the kingdom. Without frank talk about
                                        AIDS, little prevention or treatment can be reached. Motsa is
                                        worried that her group's five-year plan to fight AIDS will be
                                        overshadowed by odd suggestions from lawmakers. The nation's
                                        plan will center on AIDS prevention and education of traditional
                                      • Bell, Elizabeth
                                        African and US Leaders Sign Agreement on AIDS Reuters Health Information Services (www.reutershealth.com) (11/16/00); Clark, Margaret A. A new document
                                        Message 19 of 29 , Nov 21 4:50 AM
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                                          "African and US Leaders Sign Agreement on AIDS"
                                          Reuters Health Information Services (www.reutershealth.com)
                                          (11/16/00); Clark, Margaret A.
                                          A new document approved earlier this week by 24 African nations,
                                          representatives of the pharmaceutical industry, U.S. policy
                                          advisors, and researchers focuses on fighting AIDS in Africa.
                                          The document, "Principles of Collaboration: When Confronting AIDS
                                          in Africa," is expected to serve as a basis for an AIDS alliance
                                          between the United States and Africa; however, Dr. Richard
                                          Marlink, head of the Harvard AIDS Institute, which hosted the
                                          summit, noted that African nations must be the ones to take the
                                          initiative. The agreement urges African countries to determine
                                          their needs and set their priorities in terms of AIDS,
                                          specifically prevention efforts to keep the virus from spreading
                                          further and treatment for people already infected with HIV.

                                          "Carter Urges Africans to Take Initiative on AIDS"
                                          Agence France Presse (www.afp.com) (11/16/00)
                                          Former U.S. president Jimmy Carter said Thursday that African
                                          leaders must take the initiative in the war against AIDS, to help
                                          prevent the destruction of national economies and even entire
                                          cultures. Carter, writing in the International Herald Tribune
                                          newspaper, detailed a three-point strategy to help fight the
                                          epidemic. He noted, "AIDS now exceeds malaria as the single
                                          leading cause of death [in Africa], turning back the clock on
                                          hard-won gains in life expectancy achieved by many countries in
                                          recent decades." Carter's plan calls on heads of state and
                                          governments to publicly acknowledge the threat of AIDS and
                                          address the issue on television and radio. The proposal also
                                          recommends that African nations and international partners focus
                                          on preventing new cases of HIV and providing affordable medical
                                          care for those already infected. The last point of Carter's plan
                                          calls for broad partnerships, because "this problem is bigger
                                          than any one country, agency, group, or individual."

                                          "Annan Says TV Should Help Educate Developing World"
                                          Reuters (www.reuters.com) (11/17/00); Bases, Daniel
                                          Television should be used to both inform and educate
                                          people in the developing world, according to United Nations
                                          Secretary-General Kofi Annan. Annan, speaking at the fifth
                                          annual U.N. World Television Forum, noted that new information
                                          technology could help encourage economic growth and also reduce
                                          poverty. However, he warned that while television can inform
                                          people about the value of advances like the Internet, it also
                                          must help with literacy and other basic issues. Harri Holkeri,
                                          the president of the U.N. General Assembly, also pointed out that
                                          the new technology can be used to help promote awareness of
                                          diseases like AIDS in the developing world.
                                        • Bell, Elizabeth
                                          HIV s Onslaught Slows Down in Africa USA Today (www.usatoday.com) (11/28/00) P. 11D; Sternberg, Steve A United Nations report to be released today indicates
                                          Message 20 of 29 , Nov 28 2:33 PM
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                                            "HIV's Onslaught Slows Down in Africa"
                                            USA Today (www.usatoday.com) (11/28/00) P. 11D; Sternberg, Steve
                                            A United Nations report to be released today indicates that the
                                            number of new HIV case in sub-Saharan Africa dropped slightly
                                            this year, although prospects for the region are still grim.
                                            UNAIDS head Dr. Peter Piot warned that the decline is "no reason
                                            to cry victory. It doesn't make us very optimistic." Possible
                                            reasons for why the sub-Saharan epidemic has stabilized, Piot
                                            said, could be that prevention efforts may have helped in several
                                            nations or that the people at greatest risk of infection have
                                            already contracted HIV. Meanwhile in Russia, the number of new
                                            HIV infections skyrocketed from 130,000 in 1999 to 300,000 this
                                            year. Piot predicted that if this pace of new infections
                                            continues, the country could see over 1 million HIV cases by
                                            2005. Globally, an estimated 5.3 million people have contracted
                                            HIV this year, including 600,000 children aged 15 or younger.
                                            Some 72 percent of the new HIV infections are in southern Africa.

                                            "U.N. Takes AIDS Battle to Internet"
                                            Atlanta Journal-Constitution (www.accessatlanta.com) (11/28/00)
                                            P. 5C; McKenna, M.A.J.
                                            As the number of HIV infections worldwide continues to soar, an
                                            online project of the United Nations Development Program offers a
                                            suggestion for how people can help. Located at www.NetAid.org,
                                            the site focuses primarily on extreme poverty; however, an
                                            HIV/AIDS program was recently added. The program asks for
                                            donations to buy "kits"--specific amounts for supplies, training,
                                            and transportation--to help fight AIDS in Third World nations.
                                            The site provides detailed data sheets for every project and a
                                            "donation counter" to show how much has been donated and spent
                                            for each program.

                                            "[AIDS in South Africa]"
                                            Christian Science Monitor (www.csmonitor.com) (11/24/00) P. 24
                                            A recent insurance industry conference in Cape Town warned that
                                            unless aggressive measures are taken to stem the spread of HIV
                                            and to improve treatment for those already infected, AIDS will
                                            take the life of one South African every minute within five
                                            years. According to a statement from Lifeworks, an industry
                                            organization established to deal with AIDS, the disease is "the
                                            single most strategic issue facing our economy."
                                          • Bell, Elizabeth
                                            South African Village Prepares for First HIV Vaccine Trial Nature Medicine (medicine.nature.com) (11/00) Vol. 6, No. 11, P. 1199; Connett, Harold South
                                            Message 21 of 29 , Nov 30 9:02 AM
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                                              "South African Village Prepares for First HIV Vaccine Trial"
                                              Nature Medicine (medicine.nature.com) (11/00) Vol. 6, No. 11, P.
                                              1199; Connett, Harold
                                              South Africa's Medical Research Council plans to begin HIV
                                              vaccine trials in February 2001, with phase III tests slated for
                                              completion by 2005. The trial will test a Venezuelan equine
                                              encephalitis (VEE) virus vaccine, which uses an attenuated form
                                              of VEE with genes from subtype C isolates of South African
                                              seroconverters. Robert Olmstead, vice president at AlphaVax the
                                              vaccine producer, said that VEE targets lymphoid tissue and will
                                              be a good source. The South African AIDS Vaccine Initiative is
                                              funding development of the vaccine, together with the U.S.
                                              National Institute of Allergy and Infectious Diseases and the
                                              International AIDS Vaccine Initiative. Informing trial subjects
                                              regarding the vaccine has been a careful process, requiring the
                                              trust of South African tribal leaders. Hlabisa, which is located
                                              about four hours from Durban, is the site of the phase II and III
                                              trials. Health workers have been training educators to reach the
                                              Hlabisa area, using song and dance to communicate HIV prevention messages.

                                              "New Cases of HIV Decline in Africa for First Time"
                                              Washington Post (www.washingtonpost.com) (11/29/00) P. A3; Brown,
                                              A new report from UNAIDS indicates that the number of people who
                                              contracted HIV in sub-Saharan Africa declined this year for the
                                              first time. Officials noted, however, that the finding must be
                                              interpreted with caution, because it is not known whether the
                                              drop is an actual turning point or just something temporary.
                                              "The least we can say is that the trend of an accelerating
                                              epidemic is now slowing down, and perhaps going down," said Dr.
                                              Peter Piot, executive director of UNAIDS. Worldwide, there were
                                              5.3 million new HIV infections this year, compared to 5.6 million
                                              in 1999. The number of people living with HIV or AIDS increased
                                              from 33.6 million last year to 36.1 million this year, while the
                                              number of deaths from the disease also rose, from 2.6 million to
                                              3 million. The report showed the Eastern Europe and the former
                                              Soviet Union saw substantial increases in HIV cases, rising from
                                              420,000 in 1999 to 700,000 now. Furthermore, UNAIDS' estimates
                                              indicate that more than 50 percent of Russia's 300,000 people
                                              with HIV contracted the disease this year. "What we had
                                              predicted and fear is now happening," said Piot, "and that is an
                                              explosion of HIV."

                                              "U.N. Requests $3 Billion From Western Governments to Combat AIDS
                                              Crisis in Africa"
                                              Philadelphia Inquirer (www.philly.com) (11/29/00); Collins,
                                              Western governments need to give $3 billion a year for the next
                                              five years to fight the growing AIDS epidemic in sub-Saharan
                                              Africa, the United Nations said Tuesday. Also, during a
                                              teleconference with AIDS activists in South Africa and the United
                                              States, the humanitarian organization Doctors Without Borders
                                              called on the five top drug firms to reduce the prices of their
                                              AIDS drugs in poor nations by 95 percent starting in January. In
                                              response, pharmaceutical industry spokesman Mark Grayson said
                                              they have already made a deal with Senegal for price cuts and
                                              similar agreements are planned for other countries in Africa. A
                                              new "report card" for the drug firms shows that American AIDS
                                              activists gave the companies failing grades on their vows to
                                              increase access to lifesaving drugs for poor people in Africa.

                                              "Pfizer Offers AIDS Drug to South Africa"
                                              Wall Street Journal (www.wsj.com) (11/29/00) P. A3; Zimmerman,
                                              Pfizer is expected to announce on December 1, World AIDS Day,
                                              that it will donate $50 million worth of its antifungal drug
                                              Diflucan, which is used by many AIDS patients, to South Africa
                                              over two years. New statistics from the United Nations and the
                                              World Health Organization show there were 3.8 million new HIV
                                              infections in sub-Saharan Africa last year and that about 70
                                              percent of all HIV-infected adults worldwide live in the region.
                                              Under the deal, Pfizer would provide Diflucan free of charge to
                                              individuals with cryptococcal meningitis and a kind of meningitis
                                              of the esophagus that results from thrush and affects between 20
                                              percent and 40 percent of AIDS patients. South African and U.S.
                                              AIDS activists, as well as the humanitarian group Doctors Without
                                              Borders, have criticized the drug company's offer, calling it a
                                              public-relations move that will likely include several
                                              restrictions on the drug's distribution.

                                              "South Africa: Benefit of Anti-Retrovirals Outweigh the Risks--US
                                              Surgeon General"
                                              Africa News Service (www.africanews.org) (11/29/00); Harvey,
                                              U.S. Surgeon General David Satcher stated Tuesday that the
                                              benefits of antiretroviral treatments outweigh any risks
                                              involved. Speaking at a press briefing in Pretoria, Satcher said
                                              the drugs have been especially useful in preventing
                                              mother-to-child HIV transmission in the United States, and also
                                              for treating people with AIDS. The price of the drugs is high,
                                              Satcher admitted, and he noted that South Africa and the United
                                              States are in very different situations regarding the
                                              affordability of the medicines. The surgeon general did say,
                                              however, that Brazil is in a very "similar [socioeconomic] place"
                                              to South Africa, and that country's government has established
                                              the necessary infrastructure to provide the drugs and also
                                              reduced the price of the treatments by manufacturing them
                                              locally. The briefing was for the Health Working Group of the
                                              US-SA Bi-National Commission's special meeting on HIV/AIDS, which
                                              was chaired by Health Minister Manto Tshabalala-Msimang and
                                              Satcher. The two officials signed a joint agreement for better
                                              financial and political cooperation on AIDS.

                                              "South Africa: Truckers Take to the Road for AIDS"
                                              Africa News Service (www.africanews.org) (11/29/00); Harvey,
                                              On Friday, World AIDS Day, 100 truck drivers will participate in
                                              a special procession to South Africa's Department of Transport,
                                              to highlight the spread of HIV infection among drivers in the
                                              country. According to Marlea Clarke, a University of Capetown
                                              researcher, three truck drivers die every day from AIDS-related
                                              conditions. There are concerns that the drivers could be one of
                                              the groups that have a key role on the spread of the virus in
                                              South Africa, as prostitutes line major highways. Clarke noted
                                              that the average truck driver spends three days or less at home
                                              every month, and "there is [a] flourishing commercial sex network
                                              along the freeway system in the region." Clarke said that mine
                                              workers, who also visit sex workers frequently, are at risk for
                                              HIV infection as well.
                                            • Sara Hersey
                                              I have a research question for anybody interested in the following article that Liz posted. How can UNAIDS measure new HIV infections with such authority?
                                              Message 22 of 29 , Nov 30 9:32 AM
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                                                I have a research question for anybody interested in the following article
                                                that Liz posted. How can UNAIDS measure 'new' HIV infections with such
                                                authority? Slightly sceptical but also interested in how they come about
                                                these numbers - if anyone can enlighten me.

                                                >"New Cases of HIV Decline in Africa for First Time"
                                                >Washington Post (www.washingtonpost.com) (11/29/00) P. A3; Brown,
                                                > A new report from UNAIDS indicates that the number of people who
                                                >contracted HIV in sub-Saharan Africa declined this year for the
                                                >first time. Officials noted, however, that the finding must be
                                                >interpreted with caution, because it is not known whether the
                                                >drop is an actual turning point or just something temporary.
                                                >"The least we can say is that the trend of an accelerating
                                                >epidemic is now slowing down, and perhaps going down," said Dr.
                                                >Peter Piot, executive director of UNAIDS. Worldwide, there were
                                                >5.3 million new HIV infections this year, compared to 5.6 million
                                                >in 1999. The number of people living with HIV or AIDS increased
                                                >from 33.6 million last year to 36.1 million this year, while the
                                                >number of deaths from the disease also rose, from 2.6 million to
                                                >3 million. The report showed the Eastern Europe and the former
                                                >Soviet Union saw substantial increases in HIV cases, rising from
                                                >420,000 in 1999 to 700,000 now. Furthermore, UNAIDS' estimates
                                                >indicate that more than 50 percent of Russia's 300,000 people
                                                >with HIV contracted the disease this year. "What we had
                                                >predicted and fear is now happening," said Piot, "and that is an
                                                >explosion of HIV."

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                                              • Paul DEVER
                                                They go to a hospital this year on this day. They count the AIDS victims. Then they come back next month, next year, etc., and count the umber of cases, minus
                                                Message 23 of 29 , Dec 1, 2000
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                                                  They go to a hospital this year on this day. They count the AIDS victims.
                                                  Then they come back next month, next year, etc., and count the umber of
                                                  cases, minus the number who have died, then they have their new
                                                  number...Very scientific, just like their extrapolations of 33% infection
                                                  among city dwellers they were tossing around about five years back.

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                                                • Bell, Elizabeth
                                                  AIDS Drugs for Africa Scientific American (www.sciam.com) (11/00) Vol. 283, No. 5, P. 98; Ezzell, Carol The AIDS epidemic in Africa faces many obstacles, but
                                                  Message 24 of 29 , Dec 8, 2000
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                                                    "AIDS Drugs for Africa"
                                                    Scientific American (www.sciam.com) (11/00) Vol. 283, No. 5, P.
                                                    98; Ezzell, Carol
                                                    The AIDS epidemic in Africa faces many obstacles, but the
                                                    chief one is finding affordable antiretroviral drugs to prevent HIV
                                                    transmission to newborns and to treat those already infected.
                                                    Most developed nations now routinely offer antiviral therapies to
                                                    HIV-infected mothers; however, there are few clinics in Africa
                                                    that can offer the drugs to these women. Cost is a determining
                                                    factor, as the drugs often cost more than many Africans'
                                                    salaries. Five companies have agreed to cut their drug prices to
                                                    Africa by 80 percent, but that alone will not be a solution.
                                                    According to David Bloom, a professor at Harvard University
                                                    School of Public Health, AIDS is tied into poverty and a lack of
                                                    health infrastructure. Lower drug costs must be accompanied by
                                                    testing to measure the drugs' success in each patient. Rampant
                                                    poverty in South Africa makes the drug AZT unattainable. With
                                                    the help of a discounted price, AZT costs 40 cents for each
                                                    100-milligram pill. Nevirapine is another drug that offers hope
                                                    to prevent HIV transmission to infants. It requires only three
                                                    doses and has been shown to reduce transmission to 14 percent for
                                                    a trial of 652 pregnant women. AZT, by contrast, requires months
                                                    of treatment. South Africa has not accepted an offer of
                                                    nevirapine from Boehringer Ingelheim, as Health Minister Manto
                                                    Tshabalala-Msimang said they do not believe the only answer to
                                                    AIDS is antiretroviral therapy. The government's plan to prevent
                                                    HIV is to treat AIDS-related infections, and form home-based
                                                    care, she said. Tshabalala-Msimang noted that even an 80 percent
                                                    reduction in price would still not be affordable for the 4.2
                                                    million HIV-infected individuals in South Africa. If the issue
                                                    of price is ever overcome, patients would then face the need for
                                                    resistance testing. HIV's ability to mutate quickly requires
                                                    careful monitoring of a patient's therapy. Testing CD4 cells and
                                                    viral load is expensive, however, and not stressed in places like
                                                    Thailand. Christopher Ouma, a worker for Doctors Without Borders
                                                    in Nairobi, Kenya, believes Africa cannot wait for viral load
                                                    testing to become the norm, since they need the drugs now. And
                                                    even after antivirals become widely available to Africa, the
                                                    trick will be adhering to the difficult therapy, which requires a
                                                    strict timetable and food requirements.

                                                    "U.N.'s Annan Demands War Against AIDS in Africa"
                                                    Reuters (www.reuters.com) (12/07/00); Murray, Kieran
                                                    Speaking at a conference in Addis Ababa, Ethiopia, United
                                                    Nations Secretary-General Kofi Annan said African leaders must make
                                                    fighting AIDS their top priority. Annan noted that the disease
                                                    has taken the lives of millions of people, and it is also a key
                                                    impediment to fighting poverty in the developing world and could
                                                    affect political stability. The official called for concerted,
                                                    comprehensive action against AIDS; however, he pointed out that
                                                    while the world is prepared to spend billions of dollars battling
                                                    the disease, African officials must work to make sure the money
                                                    goes where it is needed most. Annan also said that while the
                                                    majority of AIDS cases are in Africa, the disease is also
                                                    spreading rapidly in Eastern Europe, Russia, and India, and these
                                                    regions could face a situation like the one in Africa unless
                                                    aggressive steps are taken.

                                                    "More Evidence Supports Congo as the World's HIV-1 Epicenter"
                                                    Reuters Health Information Services (www.reutershealth.com)
                                                    A team of researchers from France, Congo, and the United
                                                    Kingdom has identified a high level of genetic diversity within
                                                    HIV-1 group M in the Democratic Republic of Congo. The scientists
                                                    studied 247 HIV-1 isolates from three parts of the country and
                                                    characterized them for diversity within the HIV-1 envelope
                                                    protein V3-V5 region. According to their report in the Journal
                                                    of Virology (2000;74:10498-10507), the most common subtype was
                                                    subtype A; however, all known HIV-1 group M subtypes were
                                                    identified in the samples. The researchers, noting a high level
                                                    of intrasubtype genetic diversity in the isolates and high levels
                                                    of possible recombinant viruses, said the findings lend support
                                                    to Congo being the epicenter of HIV-1 group M viruses.

                                                    "Bottled Up: As UNICEF Battles Baby-Formula Makers, African
                                                    Infants Sicken"
                                                    Wall Street Journal (www.wsj.com) (12/05/00) P. A1; Freedman,
                                                    Alix M.; Stecklow, Steve
                                                    Between 1.1 million and 1.7 million infants, mostly in Africa,
                                                    have contracted HIV from breast-feeding. Often in the developing
                                                    world, HIV-infected mothers are not told that infant formula is
                                                    an alternative to breast-feeding that could help protect their
                                                    children from AIDS. The issue has pitted the $3 billion
                                                    infant-formula industry, which says it is prepared to donate
                                                    loads of free formula to infected women, against UNICEF, which
                                                    will not approve the donations because it does not want to
                                                    support an industry that it has accused of abusive practices in
                                                    developing nations. During the 1970s, Nestle SA and other
                                                    formula companies aggressively promoted formula in developing
                                                    nations; however, by the time the free samples were used up, the
                                                    women were often no longer producing their own milk and the
                                                    formula was too expensive for them to buy. As some women diluted
                                                    the milk to make it last longer and some babies starved as a
                                                    result, a global boycott of Nestle was organized by activists and
                                                    UNICEF began to reject cash donations from any of the large
                                                    formula makers--something it has also done with land mine
                                                    producers and cigarette companies. In the 1980s, UNICEF and the
                                                    World Health Organization developed a voluntary marketing code
                                                    for formula makers, one which restricted advertising and
                                                    virtually prohibited the distribution of free and low-cost
                                                    formula. But that code was not developed with the AIDS epidemic
                                                    in mind, and many experts say UNICEF should look past previous
                                                    events to help poor mothers with HIV and their babies. However,
                                                    UNICEF head Carol Bellamy asserts that "breast is best," and she
                                                    points out that the lack of adequate sanitation in many areas
                                                    poses its own risks for formula users, possibly exposing babies
                                                    to diarrhea and other deadly diseases, while antibodies in breast
                                                    milk could help prevent such illnesses. Research indicates that
                                                    about 15 percent of HIV-infected pregnant women in Africa will
                                                    transmit the virus to their infants via breast-feeding. UNICEF
                                                    officials have also voiced concerns that giving formula to
                                                    HIV-infected mothers could affect support for breast-feeding
                                                    among healthy mothers. Two years ago, UNICEF and other United
                                                    Nations agencies modified their position on breast-feeding in the
                                                    developing world. The "informed choice" policy holds that
                                                    infected women should be told about the benefits and risks of
                                                    breast-feeding and of alternatives like formula, but the
                                                    statement does not say how poor HIV-infected women who want to
                                                    use formula are supposed to obtain it.
                                                  • Bell, Elizabeth
                                                    Suddenly, a Plan to Treat AIDS in Africa Boston Globe (www.boston.com/globe) (02/13/01) P. A1; Donnelly, John In response to the recent pricing drop for AIDS
                                                    Message 25 of 29 , Feb 15, 2001
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                                                      "Suddenly, a Plan to Treat AIDS in Africa"
                                                      Boston Globe (www.boston.com/globe) (02/13/01) P. A1; Donnelly,
                                                      In response to the recent pricing drop for AIDS drug cocktails in
                                                      the world's poorest nations, economists, scientists, AIDS
                                                      specialists and politicians have designed a "blueprint" for
                                                      treatment to be used in countries where the greatest need is.
                                                      The blueprint calls for wealthy nations to pay for the drugs,
                                                      paring the price of AIDS cocktails down to $500 annually per
                                                      patient, and the selection of two African nations and more than
                                                      one dozen projects to be set up as working models. When
                                                      successful, the models could be replicated and repeated across
                                                      Africa. Initially, the projects will focus only on individuals
                                                      with full-blown AIDS, and the plan also calls for piggybacking
                                                      treatment with existing tuberculosis-control programs.

                                                      "World Bank Grants $473 Million Loan to Ethiopia"
                                                      Reuters (www.reuters.com) (02/14/01)
                                                      Ethiopia has been granted a $473 million loan from the World Bank
                                                      to aid in the nation's post-war efforts to rebuild. According to
                                                      Wednesday's announcement by the ministry of finance, $65 million
                                                      of the loan will be used toward the fight against HIV. An
                                                      estimated 3 million Ethiopians have HIV or AIDS.

                                                      "South Africa Mining Firms Test Workers for AIDS"
                                                      Reuters (www.reuters.com) (02/13/01); Swindells, Steven
                                                      Anglo American Platinum, a major South African mining firm,
                                                      has gained the union's approval to begin testing miners in the
                                                      country for HIV. The results of the anonymous testing is
                                                      expected to have a significant impact on the overall mining
                                                      business, which represents the majority of Africa's foreign
                                                      exchange revenue. Economic consultants from WEFA South Africa
                                                      estimate that 4 million semi- and unskilled South African
                                                      laborers could die from the disease between 2010 and 2015, with
                                                      the most significant impact among miners. Health experts said
                                                      Tuesday that an estimated 25 percent of South Africa's 500,000
                                                      miners may be infected with HIV.

                                                      "Zambia: Government Sets Aside K31 Billion for AIDS Fight"
                                                      Africa News Service (www.africanews.org) (02/13/01)
                                                      Zambia's finance and economic development deputy minister Godfrey
                                                      Simasiku said the government has earmarked 31 billion kwacha for
                                                      the battle against AIDS. Simasiku, speaking to group of
                                                      businessmen and civic leaders at a budget meeting in Solwezi last
                                                      Friday, also said that the number of AIDS orphans in the country
                                                      could increase from about 700,000 now to 1 million in the next
                                                      four to five years.
                                                    • Bell, Elizabeth
                                                      Toward a Global AIDS Fund New York Times (05.02.01) The public attention given in recent months to Africa s AIDS crisis has not been matched with money,
                                                      Message 26 of 29 , May 2, 2001
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                                                        "Toward a Global AIDS Fund"
                                                        New York Times (05.02.01)
                                                        "The public attention given in recent months to Africa's
                                                        AIDS crisis has not been matched with money," began the editors.
                                                        "Last year the world spent about $1 billion on AIDS in
                                                        developing countries-a sum that will not even buy adequate
                                                        prevention campaigns, much less health infrastructure, care for
                                                        AIDS orphans and necessary medicines for the sick." The editors
                                                        noted UN Secretary-General Kofi Annan's speech last week at the
                                                        African AIDS summit in Nigeria, which "lays out a solid basis
                                                        for a global attack on AIDS, tuberculosis and malaria." In his
                                                        speech, Annan called for a global AIDS fund totaling $7 billion
                                                        to $10 billion a year to help stem the epidemic.
                                                        The editors projected how a global AIDS fund would be used.
                                                        "At least initially," they wrote, "a large part of the money
                                                        will go toward building a health infrastructure in the African
                                                        nations most ravaged by AIDS." The editors are encouraged that
                                                        "African leaders from 43 nations have pledged to increase their
                                                        spending on health, and especially on AIDS," which "is a welcome
                                                        sign that African leaders are taking AIDS and health issues more
                                                        But the global AIDS fund will depend on more than Africa's
                                                        commitment to improving its AIDS-fighting programs, and the
                                                        editors fear that US contributions won't be enough. "The global
                                                        AIDS fund ... is likely to be handicapped by a lack of leadership
                                                        from the United States. While Bush administration officials speak
                                                        about AIDS as a catastrophe, the president's 2002 budget adds
                                                        less than 10 percent to this year's spending for AIDS overseas....
                                                        Former President Clinton suggested to the Nigeria AIDS conference
                                                        that Washington should provide a quarter of the global AIDS fund.
                                                        President Bush's budget falls more than $1 billion short of
                                                        that," the editors concluded.

                                                        "First Rule of AIDS in Africa: Do No Harm"
                                                        Wall Street Journal (05.02.01) Holman W Jenkins, Jr
                                                        The editorial addressed the ongoing debate surrounding the
                                                        pharmaceutical industry's price reductions for AIDS drugs,
                                                        specifically for those countries in Africa ravaged by the
                                                        disease. "There is no doubt that a strictly applied drug regimen
                                                        could prolong millions of African lives, but high prices have
                                                        nothing to do with why it's not happening," insisted the author.
                                                        "If Africans and other Third Worlders are left out, it's not
                                                        because of 'corporate greed' but because there is no price at
                                                        which they would become customers for antiretroviral therapy,"
                                                        the author said, citing that several drug companies offered AIDS
                                                        drugs to African governments at or below manufacturing cost, but
                                                        "There were no takers."
                                                        The author discussed the difficulty that delivering and
                                                        managing drug treatment in Africa would present. He quoted a
                                                        recent issue of Patient Care that concurred: "'Patients need to
                                                        be told specifically about the serious consequences of
                                                        nonadherence and that treatment failure may result if even a few
                                                        doses are missed.'" The author pointed to a San Francisco
                                                        General Hospital study that found that "anything less than 95%
                                                        compliance can raise to 50% the chances of treatment failing and
                                                        a resistant virus emerging." And, "This is to say nothing of the
                                                        long-term toxicities that have emerged," which include liver
                                                        failure, kidney failure, a weakening of the bones, nausea,
                                                        diarrhea, vomiting, lactic acidosis and a skewed fat metabolism.
                                                        The author also noted how "many of the drugs come with stringent
                                                        dietary restrictions" that are much easier to adhere to in the
                                                        Western world where "patients have access to adequate nutrition
                                                        in sanitary conditions and clean water."
                                                        "Today's high prices represent not an absence of
                                                        competition but an absence of piracy," the author continued.
                                                        Drug companies have brought out 20 antiretrovirals since AZT was
                                                        introduced, he said, and such "progress doesn't come cheap." He
                                                        warned in conclusion, "This work will come to a screeching halt
                                                        if the mau-mau crowd wins the day because recovering [research
                                                        and development] costs would become impossible. And somewhere
                                                        down the road lies a drug that really would help save African

                                                        "What the World Needs Now"
                                                        POZ (05.01) Gregg Bordowitz
                                                        Leaders of the three-year-old South Africa-based Treatment
                                                        Action Campaign (TAC) have succeeded in issuing a wake-up call to
                                                        governments and pharmaceutical companies around the world. Last
                                                        July, TAC activists seized the world stage with a massive protest
                                                        before the AIDS Conference in Durban. In November, TAC led the
                                                        way to the first-ever waiver allowing importation of a generic
                                                        medication for South Africa's 4 million people with HIV. And it
                                                        was TAC's call to make HIV and opportunistic infection medicines
                                                        available to all HIV-positive South Africans that finally brought
                                                        drug companies to the negotiating table regarding price
                                                        reductions for AIDS drugs in developing countries.
                                                        At TAC's helm is 38-year-old, gay, HIV-positive activist
                                                        Zackie Achmat, who was jailed and beaten by police for his anti-
                                                        apartheid efforts in the late 1970s. In October he was arrested
                                                        and charged with illegal importation of drugs for bringing 5,000
                                                        capsules of Biozole, the Thai version of Pfizer's patented
                                                        fluconazole, into South Africa. Yet Achmat refuses to take
                                                        medications himself. Supporters have offered to purchase
                                                        antiretroviral drugs for him outright, but he has publicly
                                                        declared that he will not take any drugs unless they are
                                                        available to everyone in South Africa. "I have decided not to
                                                        take antiretrovirals because I don't want to live in a world that
                                                        devalues the lives of poor people simply because they are poor. I
                                                        could never look those people in the eye, and I couldn't lead
                                                        them, if I was taking my medicines while they were going
                                                        without," Achmat told POZ.
                                                        Achmat's pledge is a display of the kind of leadership that
                                                        could turn around the AIDS epidemic. In three short years, TAC
                                                        has not only pushed the South African government to expand HIV
                                                        drug access, it has also helped establish an activist network
                                                        among poor nations producing, procuring and distributing quality
                                                        medicines despite trade restrictions and drug industry pressure.
                                                        "It's the activism that pushed my CD4 counts up. It's the fact
                                                        that I have so many more friends now-people with and without
                                                        HIV-because they realize that we are doing something together
                                                        and we can win. Not because of the stand I've taken, but because
                                                        TAC is giving them hope," Achmat said.

                                                        "Annan Speaks About the Fight Against AIDS"
                                                        Associated Press (05.01.01) Gina Cappello
                                                        "The world has the resources to defeat this epidemic if it
                                                        really wants to," UN Secretary-General Kofi Annan said of the
                                                        global AIDS epidemic Monday. "But at present, there's a lot of
                                                        confusion about how the money should be raised, where it should
                                                        be directed and who can ensure that it's well spent." Annan
                                                        addressed more than 2,000 philanthropists and business leaders at
                                                        the 52nd annual conference for the Council on Foundations, urging
                                                        public and private organizations to work together to fight the
                                                        spread of HIV and AIDS. Annan once again suggested the creation
                                                        of a global fund dedicated to the battle against HIV/AIDS and
                                                        other diseases to be brought before the June 25 special UN
                                                        session on HIV and AIDS.

                                                        "IMF Urges Countries to Contribute to AIDS Fund"
                                                        Associated Press (05.01.01) Harry Dunphy
                                                        At the conclusion of the spring meetings of the
                                                        International Monetary Fund and World Bank, finance ministers and
                                                        central bank governors announced their support for the
                                                        establishment of a global fund to combat AIDS and other diseases.
                                                        The ministers pledged there would be a substantial increase in
                                                        funds to fight AIDS and other infectious diseases in poor
                                                        countries. "What's clear now is that the commitment is growing
                                                        by leaps and bounds, particularly among finance ministers in the
                                                        industrialized countries as we saw this weekend," said Chris
                                                        Lovelace, director of World Bank's unit for health, population
                                                        and nutrition.
                                                      • Bell, Elizabeth
                                                        I have a new hero: Catholic Bishops to Fight AIDS South African Press Association (07.27.01) Catholic bishops from across southern Africa gathered on
                                                        Message 27 of 29 , Jul 30, 2001
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                                                          I have a new hero:

                                                          "Catholic Bishops to Fight AIDS"
                                                          South African Press Association (07.27.01)
                                                          Catholic bishops from across southern Africa gathered on
                                                          Wednesday at St. Peter's Seminary in Garsfontein, Pretoria, to
                                                          attend the Southern African Catholic Bishop's Conference (SACBC).
                                                          Bishop Reginald Cawcutt, spokesperson, said the six-day
                                                          conference was aimed at preventing the spread of HIV/AIDS. A
                                                          substantial part of the conference's discussions will focus on
                                                          the AIDS and a proposal that the church reconsider its ban on
                                                          condoms to combat the spread of disease, he said.
                                                          Almost five million South Africans are HIV-infected. Earlier
                                                          this month in the United States, Rustenburg Bishop Kevin Dowling
                                                          proposed that the church's ban on condoms be lifted, saying AIDS
                                                          was killing so many people he felt he could not duck the issue.
                                                          Dowling was supported in his proposal by the Catholic newspaper
                                                          Southern Cross, which said condoms provided one way of stemming
                                                          the AIDS pandemic. The newspaper called on the church to
                                                          reconcile its total ban on contraception with the philosophy of
                                                          the sanctity of life.
                                                          SACBC President Cardinal Wilfrid Napier said Dowling's
                                                          statement would be weighed against not only the church's
                                                          teachings, but also scientific evidence on the effectiveness of
                                                          condoms in preventing infection. The conference will also focus
                                                          on Angola, whose government the church has accused of encouraging
                                                          sexual permissiveness through a recently launched campaign to
                                                          promote condom use. The conference wraps up on Monday.

                                                          "World Education Leaders Sound Alarm over AIDS Pandemic"
                                                          Agence France Presse (07.26.01)
                                                          The AIDS pandemic has had a bigger effect on teaching than
                                                          any other profession and threatens to wipe out the trade in
                                                          Africa within 10 years, a global conference heard Thursday. "The
                                                          percentage of teachers who have died or carry the HIV virus is
                                                          higher than for most professional groups," said Fred van
                                                          Leeuwen, secretary general of Education International (EI). The
                                                          confederation of about 300 teaching unions and organizations from
                                                          155 countries is holding a conference in Thailand focusing on
                                                          teaching in the age of globalization.
                                                          Some 35-40 percent of secondary school teachers in Botswana
                                                          are infected with HIV, the EI said. "In the next 10 years, if
                                                          nothing is done, the ranks of teachers will completely disappear
                                                          in Africa," said Monique Fouiloux, EI's AIDS specialist. There
                                                          are also concerns that teachers are abusing their position to
                                                          sexually exploit children under their care, helping fuel the
                                                          transmission of the deadly disease. This year in conjunction with
                                                          other international institutions including UNESCO, EI intends to
                                                          make AIDS prevention an integral part of its education mission.
                                                          In the process, it will have to counter significant cultural
                                                          barriers that hamper frank discussion of AIDS, a problem that is
                                                          particularly severe outside the cities. "In Botswana, the only
                                                          place where it is difficult to talk about AIDS is in rural
                                                          areas," said Japhta Radibe, a representative of the Botwsana
                                                          Teachers Union. "Even before HIV/AIDS, we had a shortage of
                                                          teachers, but the pandemic has aggravated it," she said.

                                                          "AIDS Costs Kenya Heavily"
                                                          Xinhua (07.27.01)
                                                          According to Kenya's National AIDS Control Council, the
                                                          nation is losing about $2.6 million daily to the HIV/AIDS
                                                          epidemic. Speaking at the Nairobi Provincial AIDS Control
                                                          Committee workshop this week, Chair Mohammed Abdullah said that
                                                          certain practices are spreading the disease and his council is
                                                          now advocating an attitude change and measures to reduce
                                                          transmission. Chris Kirubi, a council member, urged the
                                                          government to end and criminalize female genital mutilation and
                                                          blamed the practice for helping the spread of HIV/AIDS. Other
                                                          measures recommended include ending prostitution along Nairobi
                                                          streets and curbing the influx of child prostitutes. Kenya is one
                                                          of the sub-Saharan African countries hardest hit by AIDS: 1.1
                                                          million Kenyans have died of the disease since 1984, and 2.2
                                                          million others are living with HIV.
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