AIDS in Africa
- "Researchers Prepare Vaccine Trials in Heart of Africa's AIDS
Detroit Free Press Online (www.freep.com) (08/18/00); Collins,
In Hlabisa, South Africa, researchers are preparing to begin
testing an HIV vaccine based on strains of the virus found in
sub-Saharan Africa. The potential vaccine has shown effective on
macaques, and was created using genetic engineering. In
Hlabisa, most people live in huts and have no electricity or
running water. The area was selected for the vaccine test
because of its high HIV infection rate. Last year, the HIV
infection rate among women seeking prenatal care at the local
hospital was 33 percent, and the infection rate is nearly 40
percent among women between the ages of 15 and 30. The stigma of
AIDS continues in this rural area, and people rarely say the word
for AIDS, "ingulaza," which means "powerful sexually transmitted
disease." The experimental vaccine, set to begin testing by
2002, was developed by researchers at the University of North
Carolina and the University of Cape Town. As the trial draws
closer, the researchers are working educate area residents about
AIDS and also to resolve ethical issues related to testing the
vaccine in the largely uneducated population that does not even
have words for "placebo" or "control group."
"South Africa Tourism Fights Perceptions"
Wall Street Journal (www.wsj.com) (08/18/00) P. A11
South Africa's tourism industry is fighting perceptions about
its safety, as crime and HIV take their toll on the country's
economy. The largest wave of visitors to South Africa this year
was for the recent International AIDS Conference in Durban. Last
year, there were 6 million foreign visitors to the country.
"South Africa to Probe Reports of HIV-Linked Dismissals"
Reuters (www.reuters.com) (08/17/00); Sithole, Emelia
South Africa will investigate claims by Mozambique that South
African mining companies are ending contracts with HIV-infected
Mozambican workers. South African Labor Minister Membathisis
Mdladlana said they will gather more information, even though the
South African Chamber of Mines denies wrongdoing. Mario Sevene,
Mozambique's top labor official, also said that some of the
mining companies were privately testing workers for HIV, breaking
South Africa labor laws. The mining industry in South Africa has
been hard hit by the AIDS epidemic.
"Isolation Camps Proposed for Swazi HIV Victims"
Reuters (www.reuters.com) (08/16/00)
Tfohlongwane Dlamini, chairman of the Swaziland National Council
Standing Committee, has proposed setting up camps to isolate HIV
and AIDS patients from the public. The suggestion--an apparent
attempt to stem the spread of HIV--was condemned by Swaziland's
healthcare workers, who asserted he needed more information about
the virus. The Health Ministry noted that HIV cannot be
transmitted via casual contact, and the camps would only increase
the problems that HIV and AIDS patients face. Swaziland has made
several controversial proposals to fight AIDS, including banning
mini-skirts in the country's schools.
- "Loans to Buy AIDS Drugs Are Rejected by Africans"
New York Times (www.nytimes.com) (08/22/00) P. A6; Swarns, Rachel
South Africa and Namibia have refused the United States' offer
of $1 billion in yearly loans to finance the purchase of AIDS drugs.
The African countries stated that affordable drugs are needed and
that the loans would only burden their economies and send them
further into debt. The U.S. Export-Import Bank made the loan
offer to 24 southern African countries, but none have formally
accepted the offer so far. Developing countries have been urging
the West to make less expensive anti-AIDS drugs and to allow poor
countries to overcome patents in order to manufacture generic
versions of the drugs. Earlier this year, the Clinton
administration issued an executive order promising not to
interfere with African countries that did not follow American
patent law to secure cheaper drugs. Dr. Kalumbi Shangula, the
permanent secretary for the Namibian Ministry of Health, believes
that efforts to support generic drugs are more helpful than loan
programs. He stated that accepting the loans would send the
country "deeply into debt."
"Battling AIDS in Africa by Empowering Women"
New York Times (www.nytimes.com) (08/22/00) P. D3; Dreifus,
An interview with Dr. Nancy Padian, an epidemiologist who
is director of research for the AIDS Research Institute of the
University of California at San Francisco, sheds light on her
work in Zimbabwe. Dr. Padian commutes between San Francisco and
Harare to teach Zimbabwean health workers about how to control
the AIDS epidemic. By running studies on the effects of
contraception in preventing HIV in women, Padian teaches the
women to use barrier methods like condoms. She explains that
women have little power to negotiate condom use, but she teaches
them to plan for obstacles. Compared to American women, women in
southern Africa are much more vulnerable to HIV because of there
is a higher prevalence of other sexually transmitted diseases;
some women engage in "dry sex," using chemical or other means to
dry up cervical and vaginal secretions prior to having sex; and
it is not unusual for African men to have several sex partners.
Being married is a risk factor for HIV in Zimbabwe, Padian
explains, because the women are typically monogamous, but their
husbands may not be. The infection rate in Zimbabwe is about 25
percent to 30 percent. Padian notes, "The bottom line,
universally is, If you cannot negotiate what you are doing with
your body, you will not be able to lead a healthy and long life."
- "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.
- "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;
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.
- (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.
- "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.
- 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.
- "Nurse in Malawi Wages War on AIDS and Apathy"
New York times (www.nytimes.com) (11/07/00) P. A12; Crossette,
Nurse Catherine Phiri of Malawi contracted HIV during the
rule of Hastings Kamuzu Banda, who prohibited any public discussion
of the disease. When a democratic government took over in 1994,
Phiri founded a support group for anyone affected by HIV, and
last month, she received a Race Against Poverty Award from the
United Nations Development Program and UNAIDS. Phiri said the
new president of Malawi, Bakili Muluzi, has helped increase
awareness about HIV and AIDS. She also noted that the press is
now free enough to help show residents the extent of the problem
in the country, where 25 percent of the urban work force is
expected to die from AIDS within 10 years. Phiri said, "I hope
that we will be recognized by being given the award, and that the
government will now have something to do with us. ... I've been
writing [the president] proposals that have never been answered."
The three other recipients of the Race Against Povery Awards were
Maire Bopp Dupont, a radio journalist who has worked to inform
Pacific islanders about AIDS; Rita Arauz, a Nicaraguan
psychologist who set up a foundation to study and deal with HIV
and other sexually transmitted infections; and the Rev. Arkadiusz
Nowak, a priest who opened the first AIDS hospice in Poland.
"AIDS Smothers African Kingdom; Swaziland: AIDS Is Destroying a
Baltimore Sun (www.sunspot.net) (11/04/00) P. 1A; Murphy, John
Swaziland, located between South Africa and Mozambique, has
been ineffective at responding to the AIDS epidemic thus far. The
latest measures involved parliament banning miniskirts in schools
to reduce sex between teachers and students. AIDS activists in
Swaziland struggle against the country's traditions and shame
surrounding AIDS. Out of a population of 1 million, an estimated
22 percent are infected with HIV, and 40 percent of all pregnant
women are HIV-positive. According to Christabel Motsa,
chairwoman of the government's crisis committee on disease,
people there are afraid to talk about AIDS and deny that it is a
problem. Tradition is hard to overcome, as the kingdom is ruled
by a monarch with seven wives. Polygamy is rampant in rural
areas, and contraceptives are ignored. King Mswati declared HIV
a national disaster last year and has urged HIV testing, but
proposals to place HIV-infected people in camps or sterile them
highlight the mindset of the kingdom. Without frank talk about
AIDS, little prevention or treatment can be reached. Motsa is
worried that her group's five-year plan to fight AIDS will be
overshadowed by odd suggestions from lawmakers. The nation's
plan will center on AIDS prevention and education of traditional
- "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.
- "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."
- "South African Village Prepares for First HIV Vaccine Trial"
Nature Medicine (medicine.nature.com) (11/00) Vol. 6, No. 11, P.
1199; Connett, Harold
South Africa's Medical Research Council plans to begin HIV
vaccine trials in February 2001, with phase III tests slated for
completion by 2005. The trial will test a Venezuelan equine
encephalitis (VEE) virus vaccine, which uses an attenuated form
of VEE with genes from subtype C isolates of South African
seroconverters. Robert Olmstead, vice president at AlphaVax the
vaccine producer, said that VEE targets lymphoid tissue and will
be a good source. The South African AIDS Vaccine Initiative is
funding development of the vaccine, together with the U.S.
National Institute of Allergy and Infectious Diseases and the
International AIDS Vaccine Initiative. Informing trial subjects
regarding the vaccine has been a careful process, requiring the
trust of South African tribal leaders. Hlabisa, which is located
about four hours from Durban, is the site of the phase II and III
trials. Health workers have been training educators to reach the
Hlabisa area, using song and dance to communicate HIV prevention messages.
"New Cases of HIV Decline in Africa for First Time"
Washington Post (www.washingtonpost.com) (11/29/00) P. A3; Brown,
A new report from UNAIDS indicates that the number of people who
contracted HIV in sub-Saharan Africa declined this year for the
first time. Officials noted, however, that the finding must be
interpreted with caution, because it is not known whether the
drop is an actual turning point or just something temporary.
"The least we can say is that the trend of an accelerating
epidemic is now slowing down, and perhaps going down," said Dr.
Peter Piot, executive director of UNAIDS. Worldwide, there were
5.3 million new HIV infections this year, compared to 5.6 million
in 1999. The number of people living with HIV or AIDS increased
from 33.6 million last year to 36.1 million this year, while the
number of deaths from the disease also rose, from 2.6 million to
3 million. The report showed the Eastern Europe and the former
Soviet Union saw substantial increases in HIV cases, rising from
420,000 in 1999 to 700,000 now. Furthermore, UNAIDS' estimates
indicate that more than 50 percent of Russia's 300,000 people
with HIV contracted the disease this year. "What we had
predicted and fear is now happening," said Piot, "and that is an
explosion of HIV."
"U.N. Requests $3 Billion From Western Governments to Combat AIDS
Crisis in Africa"
Philadelphia Inquirer (www.philly.com) (11/29/00); Collins,
Western governments need to give $3 billion a year for the next
five years to fight the growing AIDS epidemic in sub-Saharan
Africa, the United Nations said Tuesday. Also, during a
teleconference with AIDS activists in South Africa and the United
States, the humanitarian organization Doctors Without Borders
called on the five top drug firms to reduce the prices of their
AIDS drugs in poor nations by 95 percent starting in January. In
response, pharmaceutical industry spokesman Mark Grayson said
they have already made a deal with Senegal for price cuts and
similar agreements are planned for other countries in Africa. A
new "report card" for the drug firms shows that American AIDS
activists gave the companies failing grades on their vows to
increase access to lifesaving drugs for poor people in Africa.
"Pfizer Offers AIDS Drug to South Africa"
Wall Street Journal (www.wsj.com) (11/29/00) P. A3; Zimmerman,
Pfizer is expected to announce on December 1, World AIDS Day,
that it will donate $50 million worth of its antifungal drug
Diflucan, which is used by many AIDS patients, to South Africa
over two years. New statistics from the United Nations and the
World Health Organization show there were 3.8 million new HIV
infections in sub-Saharan Africa last year and that about 70
percent of all HIV-infected adults worldwide live in the region.
Under the deal, Pfizer would provide Diflucan free of charge to
individuals with cryptococcal meningitis and a kind of meningitis
of the esophagus that results from thrush and affects between 20
percent and 40 percent of AIDS patients. South African and U.S.
AIDS activists, as well as the humanitarian group Doctors Without
Borders, have criticized the drug company's offer, calling it a
public-relations move that will likely include several
restrictions on the drug's distribution.
"South Africa: Benefit of Anti-Retrovirals Outweigh the Risks--US
Africa News Service (www.africanews.org) (11/29/00); Harvey,
U.S. Surgeon General David Satcher stated Tuesday that the
benefits of antiretroviral treatments outweigh any risks
involved. Speaking at a press briefing in Pretoria, Satcher said
the drugs have been especially useful in preventing
mother-to-child HIV transmission in the United States, and also
for treating people with AIDS. The price of the drugs is high,
Satcher admitted, and he noted that South Africa and the United
States are in very different situations regarding the
affordability of the medicines. The surgeon general did say,
however, that Brazil is in a very "similar [socioeconomic] place"
to South Africa, and that country's government has established
the necessary infrastructure to provide the drugs and also
reduced the price of the treatments by manufacturing them
locally. The briefing was for the Health Working Group of the
US-SA Bi-National Commission's special meeting on HIV/AIDS, which
was chaired by Health Minister Manto Tshabalala-Msimang and
Satcher. The two officials signed a joint agreement for better
financial and political cooperation on AIDS.
"South Africa: Truckers Take to the Road for AIDS"
Africa News Service (www.africanews.org) (11/29/00); Harvey,
On Friday, World AIDS Day, 100 truck drivers will participate in
a special procession to South Africa's Department of Transport,
to highlight the spread of HIV infection among drivers in the
country. According to Marlea Clarke, a University of Capetown
researcher, three truck drivers die every day from AIDS-related
conditions. There are concerns that the drivers could be one of
the groups that have a key role on the spread of the virus in
South Africa, as prostitutes line major highways. Clarke noted
that the average truck driver spends three days or less at home
every month, and "there is [a] flourishing commercial sex network
along the freeway system in the region." Clarke said that mine
workers, who also visit sex workers frequently, are at risk for
HIV infection as well.
- I have a research question for anybody interested in the following article
that Liz posted. How can UNAIDS measure 'new' HIV infections with such
authority? Slightly sceptical but also interested in how they come about
these numbers - if anyone can enlighten me.
>"New Cases of HIV Decline in Africa for First Time"
>Washington Post (www.washingtonpost.com) (11/29/00) P. A3; Brown,
> A new report from UNAIDS indicates that the number of people who
>contracted HIV in sub-Saharan Africa declined this year for the
>first time. Officials noted, however, that the finding must be
>interpreted with caution, because it is not known whether the
>drop is an actual turning point or just something temporary.
>"The least we can say is that the trend of an accelerating
>epidemic is now slowing down, and perhaps going down," said Dr.
>Peter Piot, executive director of UNAIDS. Worldwide, there were
>5.3 million new HIV infections this year, compared to 5.6 million
>in 1999. The number of people living with HIV or AIDS increased
>from 33.6 million last year to 36.1 million this year, while the
>number of deaths from the disease also rose, from 2.6 million to
>3 million. The report showed the Eastern Europe and the former
>Soviet Union saw substantial increases in HIV cases, rising from
>420,000 in 1999 to 700,000 now. Furthermore, UNAIDS' estimates
>indicate that more than 50 percent of Russia's 300,000 people
>with HIV contracted the disease this year. "What we had
>predicted and fear is now happening," said Piot, "and that is an
>explosion of HIV."
Get more from the Web. FREE MSN Explorer download : http://explorer.msn.com
- 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.
Get more from the Web. FREE MSN Explorer download : http://explorer.msn.com
- "AIDS Drugs for Africa"
Scientific American (www.sciam.com) (11/00) Vol. 283, No. 5, P.
98; Ezzell, Carol
The AIDS epidemic in Africa faces many obstacles, but the
chief one is finding affordable antiretroviral drugs to prevent HIV
transmission to newborns and to treat those already infected.
Most developed nations now routinely offer antiviral therapies to
HIV-infected mothers; however, there are few clinics in Africa
that can offer the drugs to these women. Cost is a determining
factor, as the drugs often cost more than many Africans'
salaries. Five companies have agreed to cut their drug prices to
Africa by 80 percent, but that alone will not be a solution.
According to David Bloom, a professor at Harvard University
School of Public Health, AIDS is tied into poverty and a lack of
health infrastructure. Lower drug costs must be accompanied by
testing to measure the drugs' success in each patient. Rampant
poverty in South Africa makes the drug AZT unattainable. With
the help of a discounted price, AZT costs 40 cents for each
100-milligram pill. Nevirapine is another drug that offers hope
to prevent HIV transmission to infants. It requires only three
doses and has been shown to reduce transmission to 14 percent for
a trial of 652 pregnant women. AZT, by contrast, requires months
of treatment. South Africa has not accepted an offer of
nevirapine from Boehringer Ingelheim, as Health Minister Manto
Tshabalala-Msimang said they do not believe the only answer to
AIDS is antiretroviral therapy. The government's plan to prevent
HIV is to treat AIDS-related infections, and form home-based
care, she said. Tshabalala-Msimang noted that even an 80 percent
reduction in price would still not be affordable for the 4.2
million HIV-infected individuals in South Africa. If the issue
of price is ever overcome, patients would then face the need for
resistance testing. HIV's ability to mutate quickly requires
careful monitoring of a patient's therapy. Testing CD4 cells and
viral load is expensive, however, and not stressed in places like
Thailand. Christopher Ouma, a worker for Doctors Without Borders
in Nairobi, Kenya, believes Africa cannot wait for viral load
testing to become the norm, since they need the drugs now. And
even after antivirals become widely available to Africa, the
trick will be adhering to the difficult therapy, which requires a
strict timetable and food requirements.
"U.N.'s Annan Demands War Against AIDS in Africa"
Reuters (www.reuters.com) (12/07/00); Murray, Kieran
Speaking at a conference in Addis Ababa, Ethiopia, United
Nations Secretary-General Kofi Annan said African leaders must make
fighting AIDS their top priority. Annan noted that the disease
has taken the lives of millions of people, and it is also a key
impediment to fighting poverty in the developing world and could
affect political stability. The official called for concerted,
comprehensive action against AIDS; however, he pointed out that
while the world is prepared to spend billions of dollars battling
the disease, African officials must work to make sure the money
goes where it is needed most. Annan also said that while the
majority of AIDS cases are in Africa, the disease is also
spreading rapidly in Eastern Europe, Russia, and India, and these
regions could face a situation like the one in Africa unless
aggressive steps are taken.
"More Evidence Supports Congo as the World's HIV-1 Epicenter"
Reuters Health Information Services (www.reutershealth.com)
A team of researchers from France, Congo, and the United
Kingdom has identified a high level of genetic diversity within
HIV-1 group M in the Democratic Republic of Congo. The scientists
studied 247 HIV-1 isolates from three parts of the country and
characterized them for diversity within the HIV-1 envelope
protein V3-V5 region. According to their report in the Journal
of Virology (2000;74:10498-10507), the most common subtype was
subtype A; however, all known HIV-1 group M subtypes were
identified in the samples. The researchers, noting a high level
of intrasubtype genetic diversity in the isolates and high levels
of possible recombinant viruses, said the findings lend support
to Congo being the epicenter of HIV-1 group M viruses.
"Bottled Up: As UNICEF Battles Baby-Formula Makers, African
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.
- "Suddenly, a Plan to Treat AIDS in Africa"
Boston Globe (www.boston.com/globe) (02/13/01) P. A1; Donnelly,
In response to the recent pricing drop for AIDS drug cocktails in
the world's poorest nations, economists, scientists, AIDS
specialists and politicians have designed a "blueprint" for
treatment to be used in countries where the greatest need is.
The blueprint calls for wealthy nations to pay for the drugs,
paring the price of AIDS cocktails down to $500 annually per
patient, and the selection of two African nations and more than
one dozen projects to be set up as working models. When
successful, the models could be replicated and repeated across
Africa. Initially, the projects will focus only on individuals
with full-blown AIDS, and the plan also calls for piggybacking
treatment with existing tuberculosis-control programs.
"World Bank Grants $473 Million Loan to Ethiopia"
Reuters (www.reuters.com) (02/14/01)
Ethiopia has been granted a $473 million loan from the World Bank
to aid in the nation's post-war efforts to rebuild. According to
Wednesday's announcement by the ministry of finance, $65 million
of the loan will be used toward the fight against HIV. An
estimated 3 million Ethiopians have HIV or AIDS.
"South Africa Mining Firms Test Workers for AIDS"
Reuters (www.reuters.com) (02/13/01); Swindells, Steven
Anglo American Platinum, a major South African mining firm,
has gained the union's approval to begin testing miners in the
country for HIV. The results of the anonymous testing is
expected to have a significant impact on the overall mining
business, which represents the majority of Africa's foreign
exchange revenue. Economic consultants from WEFA South Africa
estimate that 4 million semi- and unskilled South African
laborers could die from the disease between 2010 and 2015, with
the most significant impact among miners. Health experts said
Tuesday that an estimated 25 percent of South Africa's 500,000
miners may be infected with HIV.
"Zambia: Government Sets Aside K31 Billion for AIDS Fight"
Africa News Service (www.africanews.org) (02/13/01)
Zambia's finance and economic development deputy minister Godfrey
Simasiku said the government has earmarked 31 billion kwacha for
the battle against AIDS. Simasiku, speaking to group of
businessmen and civic leaders at a budget meeting in Solwezi last
Friday, also said that the number of AIDS orphans in the country
could increase from about 700,000 now to 1 million in the next
four to five years.
- "Toward a Global AIDS Fund"
New York Times (05.02.01)
"The public attention given in recent months to Africa's
AIDS crisis has not been matched with money," began the editors.
"Last year the world spent about $1 billion on AIDS in
developing countries-a sum that will not even buy adequate
prevention campaigns, much less health infrastructure, care for
AIDS orphans and necessary medicines for the sick." The editors
noted UN Secretary-General Kofi Annan's speech last week at the
African AIDS summit in Nigeria, which "lays out a solid basis
for a global attack on AIDS, tuberculosis and malaria." In his
speech, Annan called for a global AIDS fund totaling $7 billion
to $10 billion a year to help stem the epidemic.
The editors projected how a global AIDS fund would be used.
"At least initially," they wrote, "a large part of the money
will go toward building a health infrastructure in the African
nations most ravaged by AIDS." The editors are encouraged that
"African leaders from 43 nations have pledged to increase their
spending on health, and especially on AIDS," which "is a welcome
sign that African leaders are taking AIDS and health issues more
But the global AIDS fund will depend on more than Africa's
commitment to improving its AIDS-fighting programs, and the
editors fear that US contributions won't be enough. "The global
AIDS fund ... is likely to be handicapped by a lack of leadership
from the United States. While Bush administration officials speak
about AIDS as a catastrophe, the president's 2002 budget adds
less than 10 percent to this year's spending for AIDS overseas....
Former President Clinton suggested to the Nigeria AIDS conference
that Washington should provide a quarter of the global AIDS fund.
President Bush's budget falls more than $1 billion short of
that," the editors concluded.
"First Rule of AIDS in Africa: Do No Harm"
Wall Street Journal (05.02.01) Holman W Jenkins, Jr
The editorial addressed the ongoing debate surrounding the
pharmaceutical industry's price reductions for AIDS drugs,
specifically for those countries in Africa ravaged by the
disease. "There is no doubt that a strictly applied drug regimen
could prolong millions of African lives, but high prices have
nothing to do with why it's not happening," insisted the author.
"If Africans and other Third Worlders are left out, it's not
because of 'corporate greed' but because there is no price at
which they would become customers for antiretroviral therapy,"
the author said, citing that several drug companies offered AIDS
drugs to African governments at or below manufacturing cost, but
"There were no takers."
The author discussed the difficulty that delivering and
managing drug treatment in Africa would present. He quoted a
recent issue of Patient Care that concurred: "'Patients need to
be told specifically about the serious consequences of
nonadherence and that treatment failure may result if even a few
doses are missed.'" The author pointed to a San Francisco
General Hospital study that found that "anything less than 95%
compliance can raise to 50% the chances of treatment failing and
a resistant virus emerging." And, "This is to say nothing of the
long-term toxicities that have emerged," which include liver
failure, kidney failure, a weakening of the bones, nausea,
diarrhea, vomiting, lactic acidosis and a skewed fat metabolism.
The author also noted how "many of the drugs come with stringent
dietary restrictions" that are much easier to adhere to in the
Western world where "patients have access to adequate nutrition
in sanitary conditions and clean water."
"Today's high prices represent not an absence of
competition but an absence of piracy," the author continued.
Drug companies have brought out 20 antiretrovirals since AZT was
introduced, he said, and such "progress doesn't come cheap." He
warned in conclusion, "This work will come to a screeching halt
if the mau-mau crowd wins the day because recovering [research
and development] costs would become impossible. And somewhere
down the road lies a drug that really would help save African
"What the World Needs Now"
POZ (05.01) Gregg Bordowitz
Leaders of the three-year-old South Africa-based Treatment
Action Campaign (TAC) have succeeded in issuing a wake-up call to
governments and pharmaceutical companies around the world. Last
July, TAC activists seized the world stage with a massive protest
before the AIDS Conference in Durban. In November, TAC led the
way to the first-ever waiver allowing importation of a generic
medication for South Africa's 4 million people with HIV. And it
was TAC's call to make HIV and opportunistic infection medicines
available to all HIV-positive South Africans that finally brought
drug companies to the negotiating table regarding price
reductions for AIDS drugs in developing countries.
At TAC's helm is 38-year-old, gay, HIV-positive activist
Zackie Achmat, who was jailed and beaten by police for his anti-
apartheid efforts in the late 1970s. In October he was arrested
and charged with illegal importation of drugs for bringing 5,000
capsules of Biozole, the Thai version of Pfizer's patented
fluconazole, into South Africa. Yet Achmat refuses to take
medications himself. Supporters have offered to purchase
antiretroviral drugs for him outright, but he has publicly
declared that he will not take any drugs unless they are
available to everyone in South Africa. "I have decided not to
take antiretrovirals because I don't want to live in a world that
devalues the lives of poor people simply because they are poor. I
could never look those people in the eye, and I couldn't lead
them, if I was taking my medicines while they were going
without," Achmat told POZ.
Achmat's pledge is a display of the kind of leadership that
could turn around the AIDS epidemic. In three short years, TAC
has not only pushed the South African government to expand HIV
drug access, it has also helped establish an activist network
among poor nations producing, procuring and distributing quality
medicines despite trade restrictions and drug industry pressure.
"It's the activism that pushed my CD4 counts up. It's the fact
that I have so many more friends now-people with and without
HIV-because they realize that we are doing something together
and we can win. Not because of the stand I've taken, but because
TAC is giving them hope," Achmat said.
"Annan Speaks About the Fight Against AIDS"
Associated Press (05.01.01) Gina Cappello
"The world has the resources to defeat this epidemic if it
really wants to," UN Secretary-General Kofi Annan said of the
global AIDS epidemic Monday. "But at present, there's a lot of
confusion about how the money should be raised, where it should
be directed and who can ensure that it's well spent." Annan
addressed more than 2,000 philanthropists and business leaders at
the 52nd annual conference for the Council on Foundations, urging
public and private organizations to work together to fight the
spread of HIV and AIDS. Annan once again suggested the creation
of a global fund dedicated to the battle against HIV/AIDS and
other diseases to be brought before the June 25 special UN
session on HIV and AIDS.
"IMF Urges Countries to Contribute to AIDS Fund"
Associated Press (05.01.01) Harry Dunphy
At the conclusion of the spring meetings of the
International Monetary Fund and World Bank, finance ministers and
central bank governors announced their support for the
establishment of a global fund to combat AIDS and other diseases.
The ministers pledged there would be a substantial increase in
funds to fight AIDS and other infectious diseases in poor
countries. "What's clear now is that the commitment is growing
by leaps and bounds, particularly among finance ministers in the
industrialized countries as we saw this weekend," said Chris
Lovelace, director of World Bank's unit for health, population
- 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"
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.