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AIDS in Africa and Asia (a long one - but worth a look just for S waziland's innovative approach)

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  • Bell, Elizabeth
    Breaking the Silence: Setting Realistic Priorities for AIDS Control in Less-Developed Countries Lancet (www.thelancet.com) (07/01/00) Vol. 356, No. 9223, P.
    Message 1 of 1 , Jul 26, 2000
      "Breaking the Silence: Setting Realistic Priorities for AIDS
      Control in Less-Developed Countries"
      Lancet (www.thelancet.com) (07/01/00) Vol. 356, No. 9223, P. 55;
      Ainsworth, Martha; Teokul, Waranya
      In a World AIDS commentary in The Lancet, the World Bank's Martha
      Ainsworth and Waranya Teokul, of the National Economic and Social
      Development Board, in the Office of the Prime Minister in
      Thailand, note though there is still no vaccine or cure for AIDS,
      there is reason for optimism because we already have the means to
      prevent HIV infection. Doing this involves increasing condom
      use, treating sexually transmitted diseases (STDs), reducing the
      number of sexual partners, practicing safe injecting behavior,
      and using drugs to prevent mother-to-child HIV transmission. In
      attempting to discover why national AIDS control efforts have not
      been more successful, the researchers note the reluctance of
      governments to confront the AIDS epidemic and also the need for
      prioritization when faced with serious budgetary and
      administrative limits. The researchers thus propose three
      strategies: ensuring behavior change among individuals engaging
      in high-risk activities, ensuring universal access to treatments
      for opportunistic infections, and integrating AIDS into poverty
      alleviation plans. "By ensuring resources for national
      implementation of a limited set of priorities," Ainsworth and
      Teokul conclude, "policymakers can have a much larger impact on
      HIV/AIDS prevention, treatment, and mitigation, while building a
      foundation for implementation of more extensive measures as
      resources permit."

      "Number of AIDS Orphans to Reach 29M in 10 Years"
      USA Today (www.usatoday.com) (07/14/00) P. 8A; Sternberg, Steve
      A new report from the U.S. Agency for International Development
      estimates that by 2010, 29 million children in Africa, Asia, and
      Latin America will have been orphaned by AIDS. According to John
      Williamson, a co-author of the "Children on the Brink" report,
      the disease has already made 13.2 million children orphans, the
      overwhelming majority of whom live in sub-Saharan Africa. And
      because 34 million people worldwide are infected with HIV, the
      number of orphans will only continue to grow. Officials at the
      13th International AIDS Conference in Durban are trying to find
      solutions to the problem. Williamson recommended offering loans
      to families who have lost their primary wage earners so they can
      grow food and support their children.

      "House Acts on Foreign AIDS Help, Debt Relief"
      Washington Post (www.washingtonpost.com) (07/14/00) P. A1;
      Eilperin, Juliet
      As reports at the 13th International AIDS Conference reflect
      the continued spread of HIV, the U.S. House of Representatives passed
      a measure on Thursday to increase spending for international debt
      relief and AIDS funding in poor nations. Rep. Barbara T. Lee
      (D-Calif.), who was successful in adding an amendment for $42
      million in international HIV/AIDS funds to the measure, noted
      that "members of Congress are beginning to feel the outrage of
      this pandemic." The legislation now meets President Clinton's
      original demand for $244 million for the upcoming fiscal year, up
      $190 million from the previous year. However, the overall
      funding is still less than what Clinton had proposed as part of a
      move to relieve foreign debts in some Third World nations, and
      White House officials said the foreign aid measure would be

      "Uganda First in Africa to Show Drop in New HIV Infections"
      Reuters Health Information Services (www.reutershealth.com)
      (07/13/00); Mundell, E.J.
      Ugandan officials announced this week that the number of new
      HIV infections among adults in the country has declined. Using data
      collected from the interviews and HIV blood test results of more
      than 10,000 adults in the Masaka district of Uganda, the
      researchers found that incidence for new HIV infection dropped
      from 7.6 per 1,000 person-years in 1990, to 3.2 in 1998. Among
      individuals aged 13 to 34, the rate fell from 7.2 new infections
      per 1,000 person-years in 1990, to 3.3 in 1998. The authors note
      that overall adult HIV-1 prevalence dropped from 8.2 percent to
      6.6 percent during the study, and that incidence of new infection
      seems to be declining faster among men than in women.

      "Altered Food Sought in Africa AIDS Crisis"
      Atlanta Journal-Constitution (www.accessatlanta.com) (07/13/00)
      P. 15A; Michals, Lisa
      Former U.N. Ambassador Andrew Young told Congress this week that
      genetically engineered foods may be useful as a temporary measure
      against AIDS in Africa. Young, now the chairman of Goodworks
      International in Atlanta, said that good nutrition, while not a
      cure, is critical to help keep HIV patients as healthy as
      possible. Richard Holbrooke, the U.S. ambassador to the United
      Nations, also told the Senate panel that "denial is a real
      problem" in Africa, and he called on the United Nations to boost
      its HIV education campaigns.

      "Myths Increase Women's Vulnerability to AIDS"
      Reuters (www.reuters.com) (07/13/00); Reaney, Patricia
      AIDS activists expressed concern on Thursday that myths
      about AIDS in some cultures are making young women and girls more
      vulnerable to HIV. One myth is that having sex with a virgin can
      cure AIDS, and the activists noted that the practice of virginity
      testing could exacerbate the problem, since it identifies virgins
      for male AIDS patients. The activists said that HIV is also
      being spread in some poor urban areas where unemployment has left
      sex as some young people's only recreation.

      "African Scientists Launch Vaccine Strategy"
      PANA Wire Service (www.africanews.org/PANA) (07/13/00)
      At the 13th International AIDS Conference in Durban, African
      researchers unveiled a strategy to develop an HIV vaccine that
      benefits Africans. The researchers urged African governments,
      regional and international agencies, industry, and donors to
      accelerate vaccine research. Dr. William Malegapuru Makgoba,
      head of the Medical Research Council of South Africa and the man
      who spearheaded the South African AIDS Vaccine Initiative, noted
      that "a few vaccine development efforts are being prepared in
      Africa, and these need to be promoted and reinforced."

      "Mandela Pushes AIDS Conference Past HIV Debate"
      USA Today (www.usatoday.com) (07/17/00) P. 6D; Sternberg, Steve
      Former South African president Nelson Mandela closed the 13th
      International AIDS Conference in Durban, South Africa, with a
      rousing speech calling for increased prevention programs in the
      country, as he stated that half the nation's youth will die from
      AIDS. Mandela's speech ranged from issues such as HIV counseling
      and testing to a defense of current President Thabo Mbeki,
      despite their differing views on HIV. Mbeki, who has been
      attacked for suggesting that HIV may not be the cause of AIDS,
      received the support of Mandela, who urged both sides of the
      disagreement to ignore their differences and concentrate on
      helping HIV-positive individuals and preventing the disease's
      further spread. Mandela called for treatments to prevent the
      transmission of HIV from mother to child, a policy that conflicts
      with Mbeki's views. "Problems of this nature are not addressed
      by one person," Mandela said, "no matter how famous or
      influential. We must do what has been done in Senegal, Uganda,
      and Thailand," and everyone's help is needed.

      "Powwow on AIDS Productive, Yet No Big Promises"
      San Francisco Examiner (www.examiner.com) (07/16/00) P. A1;
      Torassa, Ulysses
      Stefano Vella, the new president of the International AIDS
      Society, hopes that his organization's 13th International AIDS
      Conference last week in Durban, South Africa, will help to force
      developing countries to form viable healthcare systems,
      especially for the treatment of AIDS, and bring the issue to the
      forefront of developed nations' attention. He believes that the
      countries involved in the conference, now fully aware of the AIDS
      crisis in Africa and its potential for disaster on that continent
      and others, will not be able to turn away without appearing
      callous and unconcerned with the rest of the world. Though the
      conference began on a sour note, it ended rather strongly,
      despite little hope for a cure in the near future; increased drug
      company philanthropy and African interest in prevention programs
      have raised expectations that the disease may be contained before
      further disaster strikes. While a major step forward for
      developing nations, some American doctors said there was little
      practical information that will affect their practices; however,
      all in attendance acknowledged that Africa is the first priority
      at this point.

      "LDS Group Helps Zimbabwe Fight AIDS With Frank Talk"
      Salt Lake Tribune (www.sltrib.com) (07/17/00) P. A1; Stack, Peggy
      A group of Mormons in Zimbabwe is working in public schools to
      lead discussions about sexuality and AIDS in a prevention program
      called "Education for Life." Members of Provo, Utah-based
      Deseret International teach the children about abstinence until
      marriage, marital fidelity, and having one sex partner--similar
      to, but probably more frank than, the teachings of the Church of
      Jesus Christ of Latter-Day Saints. Deseret's program, which is
      based on one in Uganda, informs youths about how to make the best
      decisions and change sexual behavior. Deseret International
      leader Steve Mann says that participants in the workshops are
      given the "language, skills, and comfort to talk about AIDS."
      According to Debbie Dortzbach, director of an HIV prevention
      program in Africa run by World Relief, the international aid
      branch of the National Association of Evangelicals, HIV infection
      rates have dropped in nations where African churches have fought
      the virus with local governments and nongovernmental
      organizations, and she cites Uganda as an example.

      "Thailand to Start Sex Education from Kindergarten Level"
      Agence France Presse (www.afp.com) (07/18/00)
      A new program in Thailand will teach students sex education
      starting in kindergarten, in an effort to reduce the number of
      teenage pregnancies and HIV infections. Suwanna Vorakamin of the
      Thai public health ministry's family planning and population
      control unit said that starting sex education with young children
      has worked well in some European nations and does not encourage
      sexual activity. She noted, "Sex education is the heart of
      reproductive health, which means its emphasis will lead to the
      development of other reproductive health issues like abortion,
      adolescent health, and reduction of HIV-AIDS infections." The
      new effort will start with simple lessons for young students,
      such as how they were born, and will expand as the children grow

      "U.S. Offers Loans to Fight AIDS in Africa"
      Washington Post (www.washingtonpost.com) (07/20/00) P. A17;
      Brubaker, Bill
      The U.S. Export-Import Bank announced Wednesday that it has
      offered to loan $1 billion a year for the next five years to
      governments and healthcare groups in sub-Saharan African so they
      can buy AIDS drugs and services from American companies. James
      A. Harmon, the president and chairman of the Ex-Im Bank, noted
      that the loans will likely spur a war over AIDS drug prices that
      would benefit Africa. He also predicted the United States' move
      will inspire other nations to offer similar forms of assistance.
      On Wednesday, a number of African governments praised the loans;
      however, they also highlighted the need for lower drug prices and
      for an infrastructure to dispense the treatments. Joelle Tanguy,
      the executive director of Doctors Without Borders, also asserted
      that the offer "does more to consolidate the monopoly and profit
      margins of U.S. drug manufacturers than really appropriately
      address the AIDS crisis with the most efficient use of public
      funds." According to Harmon, the new loans will be made
      available to 24 African nations at commercial interest rates,
      which now stand at about 7 percent, but some loans for
      AIDS-related health care services may be offered at reduced
      concessional rates. Some critics of the measure claim the loans
      will only further burden impoverished nations with debt, while
      others have suggested the loans could keep some African
      governments from less expensive generic drugs made by
      non-American firms.

      "U.S. Offers Africa $1 Billion a Year for Fighting AIDS"
      New York Times (www.nytimes.com) (07/19/00) P. A1; Kahn, Joseph
      The United States is slated to announce today that it will
      offer $1 billion in loans each year to sub-Saharan African nations
      so they can buy AIDS drugs and medical services. Of the loans,
      James A. Harmon, president of the U.S. Export-Import Bank, which
      is to announce the program, said, "This is at least a first step
      in showing the world that Africa is important to the United
      States and that we can make a dent in this terrible problem."
      Harmon predicted that export promotion groups in Europe and Japan
      would also provide loans, with wealthy nations ultimately
      offering Africa about $3 billion in annual financing for AIDS
      drugs and services. However, some officials have questioned the
      value of offering billions of dollars in exports credits to
      African governments just as the issue of debt relief is being
      pushed in Congress. The American loan may also aid U.S. drug
      companies in their efforts to prevent generic versions of their
      AIDS drugs from being sold in Africa. Even with the deep
      discounts several drug firms have offered, the cost of a typical
      AIDS drug cocktail is prohibitive for many AIDS patients in
      Africa. Jacob Gayle, a senior technical adviser for UNAIDS,
      noted that while the new loans are encouraging, African nations
      must still increase their education and prevention efforts and
      improve their health infrastructures.

      "G8 Leaders Seek to End World's Plagues"
      Reuters (www.reuters.com) (07/18/00); Russell, Rosalind
      At their upcoming annual meeting in Okinawa, the Group of
      Eight (G8) leaders will place high priority on infectious diseases
      like AIDS, malaria and tuberculosis. The three diseases affect
      millions of lives every year and have wreaked havoc on the
      economies of many developing nations. While French President
      Jacques Chirac said last week that he would ask other G8 members
      to help improve the quality of medical care in developing
      nations, the G8 has a poor record for following through on its
      goals for debt relief and medical care. Medecins Sans Frontieres
      spokeswoman Samantha Bolton said that G8 nations should focus on
      helping developing countries create generic versions of AIDS

      "Swaziland: Miniskirts and AIDS"
      New York Times (www.nytimes.com) (07/19/00) P. A8
      In an effort to stem the spread of HIV, miniskirts will not be
      allowed in Swaziland schools starting next year. According to a
      government official, the move aims to end sexual relationships
      between teachers and female students. At least 25 percent of the
      people in Swaziland are infected with HIV.

      "Africans Fault Rich Nations on Aid to the World's Poor"
      New York Times (www.nytimes.com) (07/21/00) P. A8; French, Howard
      On the eve of the Group of 8 summit meeting in Okinawa, Japan,
      leaders of South Africa, Nigeria, and Algeria called for faster
      action on debt relief and increased aid to the Third World. "It
      is no longer a question of what we should do," said Nigeria'
      president, Olusegun Obasanjo. "We all know what we should do.
      The question is do we have the political will." One of the goals
      of the meeting, which has been called the "information summit,"
      is reducing the digital divide between wealthy and poor nations.
      However, healthcare is also a top priority, and the
      industrialized leaders are said to have agreed on setting a
      10-year goal to reduce HIV infection by 25 percent among youths
      in the Third World. Japan has pledged $3 billion to fight AIDS
      and tropical diseases in the developing world, and the United
      States announced earlier this week that it would offer 24 African
      nations $1 billion in loans annually to help them pay for AIDS
      treatment and care.

      "UNAIDS Urges G-8 to Spend More to Fight AIDS"
      Reuters (www.reuters.com) (07/20/00)
      UNAIDS is urging the Group of 8 leaders to increase spending
      on fighting diseases like AIDS. Dr. Peter Piot, the executive
      director of UNAIDS, said that wealthy nations can help fight AIDS
      and halt the epidemic with more spending. Last year, the Group
      of 7, without Russia, agreed on a $100 billion debt relief
      package to 40 poor nations; however, little of the money has
      materialized under the Highly Indebted Poor Countries initiative.
      Africa nations owe more than $230 billion in debt, UNAIDS noted.

      "AIDS, HIV Hit 2,000 Kenyan Teachers in 1999"
      Kyodo News Service (home.kyodo.co.jp) (07/20/00)
      Last year, over 2,000 teachers in Kenya died from HIV or AIDS,
      the East Africa Standard reported Thursday. The newspaper,
      quoting the recent UNICEF "Progress of Nations 2000" report,
      noted that 95,000 primary school students in Kenya had no
      teachers due to the AIDS epidemic last year. The report
      estimated that 860,000 students in sub-Saharan Africa lost their
      teachers to the disease.

      "The G8 Summit: G8 Leaders Sign Up to Anti-Disease Targets"
      Financial Times (www.ft.com) (07/24/00) P. 10; Tett, Gillian
      Group of Eight leaders meeting over the weekend in Okinawa,
      Japan, set a number of ambitious disease-fighting goals. In
      their final communique, the leaders pledged to reduce the number
      of young people infected with HIV by 25 percent in 10 years and
      vowed to reduce tuberculosis deaths by 50 percent. The leaders
      also set a goal of reducing the "burden of disease associated
      with malaria" by half. Among other announcements made at the
      meeting, Japan said it would spend $15 billion to promote
      information technology in developing countries and $3 billion
      program to combat disease, and the United States said it would
      spend $300 million on a school nutrition program for children in
      developing nations. However, some nongovernmental organizations
      said the aid offers were not big enough, and they called for more
      action to cancel Third World debt.

      "How AIDS Undercuts Education in Africa"
      Christian Science Monitor (www.csmonitor.com) (07/25/00) P. 1;
      Crawley, Mike
      Many teachers in sub-Saharan Africa are dying from AIDS,
      according to a recent UNICEF report, with at least 860,000 school
      children in the region losing an instructor to the disease last
      year. In Kenya, 1,500 teachers died in 1999, compared to just 10
      teachers' deaths in 1993. UNICEF's "Progress of Nations 2000"
      report notes that "all over sub-Saharan Africa, hard-won gains in
      school enrollment--and the returns on investments countries have
      made to improve education--are being eroded." Kenya's education
      system is being hit hard, as the teachers' deaths, increased
      staff absenteeism, and reduced attendance by pupils who must care
      for their parents or who can no longer afford school take their
      tolls. While the country stopped hiring new instructors two
      years ago as part of a plan imposed by the International Monetary
      Fund, the UNICEF regional representative for Eastern and Southern
      Africa, Urban Jonsson, argued it is "short-sighted" for donor
      nations to tell developing countries to reduce their education
      budgets. "All these countries need more teachers and better
      teachers and better-supported teachers, not less teachers," he
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