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AIDS in Africa

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  • Bell, Elizabeth
    there are not many true heroes in this world, but jonathan mann was one. bless him. **************************************************************** GENERAL
    Message 1 of 29 , Jul 10, 2000
      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 2 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 3 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
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          Message 4 of 29 , Jul 13, 2000
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            "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.


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            "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 5 of 29 , Jul 27, 2000
              "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 6 of 29 , Aug 10, 2000
                "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 7 of 29 , Aug 14, 2000
                  "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 8 of 29 , Aug 18, 2000
                    "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 9 of 29 , Aug 24, 2000
                      "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 10 of 29 , Aug 29, 2000
                        "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 11 of 29 , Sep 5, 2000
                          "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 12 of 29 , Sep 8, 2000
                            (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 13 of 29 , Sep 8, 2000
                              "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 14 of 29 , Sep 10, 2000
                                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 15 of 29 , Nov 8, 2000
                                  "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 16 of 29 , Nov 21, 2000
                                    "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 17 of 29 , Nov 28, 2000
                                      "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 18 of 29 , Nov 30, 2000
                                        "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 19 of 29 , Nov 30, 2000
                                          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 20 of 29 , Nov 30, 2000
                                            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 21 of 29 , Dec 8, 2000
                                              "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 22 of 29 , Feb 15, 2001
                                                "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 23 of 29 , May 2 11:23 AM
                                                  "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 24 of 29 , Jul 30, 2001
                                                    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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