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AIDS in Africa

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  • Bell, Elizabeth
    *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** Is AIDS
    Message 1 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.


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      "Disease Spread Faster Than the Word"
      Washington Post (www.washingtonpost.com) (07/07/00) P. A1; Vick,
      Karl
      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
      Fall"
      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 2 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.


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        "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
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        Message 3 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.


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          "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
          Summer"
          Wall Street Journal (www.wsj.com) (07/11/00) P. B1; Waldholz,
          Michael
          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.


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        • Bell, Elizabeth
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          Message 4 of 29 , Jul 12, 2000
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            "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,
            Michael
            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,
            Rachel
            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
            dominate.

            "Tests Offer New Hope on AIDS in Africa"
            Washington Post (www.washingtonpost.com) (07/12/00) P. A1; Brown,
            David
            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
            AIDS"
            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 5 of 29 , Jul 13, 2000
            • 0 Attachment
              ***************************************************************
              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
              benefit.


              ****************************************************************
              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,
              Ravi
              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,
              Michael
              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.


              ****************************************************************
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            • 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 6 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 7 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,
                  Peter
                  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 8 of 29 , Aug 14, 2000
                  • 0 Attachment
                    "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., 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,
                    Susan
                    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,
                    Norimitsu
                    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
                    Network"
                    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 9 of 29 , Aug 18, 2000
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                      "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 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 10 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
                        L.
                        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,
                        Claudia
                        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 11 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 12 of 29 , Sep 5 1:23 PM
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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 13 of 29 , Sep 8 6:42 AM
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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 14 of 29 , Sep 8 2:49 PM
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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 15 of 29 , Sep 10 11:28 AM
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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.

                                  JSR
                                • 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 16 of 29 , Nov 8, 2000
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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,
                                    Barbara
                                    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
                                    Nation"
                                    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
                                    leaders.
                                  • 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 17 of 29 , Nov 21, 2000
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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 18 of 29 , Nov 28, 2000
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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 19 of 29 , Nov 30, 2000
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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,
                                          David
                                          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,
                                          Huntly
                                          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,
                                          Rachel
                                          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,
                                          Marjolein
                                          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,
                                          Marjolein
                                          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 20 of 29 , Nov 30, 2000
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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.

                                            Sara
                                            >
                                            >"New Cases of HIV Decline in Africa for First Time"
                                            >Washington Post (www.washingtonpost.com) (11/29/00) P. A3; Brown,
                                            >David
                                            > 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 21 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 22 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)
                                                (12/05/00)
                                                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 23 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,
                                                  John
                                                  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 24 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
                                                    seriously."
                                                    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
                                                    lives."


                                                    "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 25 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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