Global Challenges

Donors Pledge $9.7B for Global Fund at Berlin Conference

[Sep 28, 2007]

Governments and private donors on Thursday pledged $9.7 billion to the Global Fund To Fight AIDS, Tuberculosis and Malaria at a conference in Berlin, Germany, the New York Times reports (McNeil, New York Times, 9/28). The Global Fund said it hoped to raise about $8 billion at the conference, although it will need between $12 billion and $18 billion to fund its existing programs and launch new ones between 2008 and 2010, according to Global Fund spokesperson Jon Liden (GlobalHealthReporting.org, 9/26).

Kofi Annan, former United Nations secretary-general and conference chair, said the $9.7 billion in pledges includes "conservative" projections from Canada, Japan and the U.S. because the budgetary process prevents those countries from making pledges beyond one year, Reuters Africa reports. "These countries have indicated they will increase their contributions," Annan said (Chambers, cite>Reuters Africa, 9/27).

Pledges

The U.S. committed to maintain its current contribution level, which would amount to $2.2 billion over three years, until lawmakers pass a new budget, the Times reports. Japan plans to announce its pledge -- which would be $184 million or more -- when it hosts the Group of Eight industrialized nations 2008 summit (New York Times, 9/28). Canada has not released a pledge but is expected to give $375 million, the Associated Press reports (Froehlich, Associated Press, 9/27).

At the conference, Germany said it would give 600 million euros, or about $850 million. Spain contributed 424 million euros, or about $600 million, which is almost triple its current contribution levels, AFP/Google.com reports (AFP/Google.com, 9/27). Alexander Downer, Australia's foreign minister, said his country would contribute 93 million Australian dollars, or about $82 million, to the fund programs through 2009 (AAP/West Australian, 9/27). According to Annan, France pledged $1.7 billion, and the Bill & Melinda Gates Foundation pledged $300 million.

Other contributors included China with $6 million, India with $7 million, Italy with $551 million, the Netherlands with $325 million, Norway with $240 million and Russia with $217 million. "Some countries cannot pledge or cannot pledge fully," Annan said, adding that he expects pledges to "go up considerably" (Associated Press, 9/27).

Reaction

Annan said, "This is a good day for global health, for millions of poor people who are affected" by HIV/AIDS, TB and malaria. He added that another meeting that aims to bring total pledges to $12 billion to $18 billion would take place in early 2009.

According to Reuters Africa, some global health advocates said the pledges fell short of the Global Fund's long-term needs. "We were promised a war chest to fight three diseases but what we have got today demonstrates a weakening of nerve," Steve Cockburn of the Stop AIDS Campaign said. He added that the Global Fund was promised funding would triple in order to expand its programs but the amount donated is only enough to continue existing projects. Oliver Buston, European director of DATA, said that "pledges beyond 2008 don't yet reflect" that HIV/AIDS "infection rates are still rising fast, especially in Africa" (Reuters Africa, 9/27).

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HIV/AIDS Specialist Presses World Bank To Address Evidence of Allegedly Faulty HIV Diagnostic Kits Used in Public Health Centers in India

[Sep 28, 2007]

HIV/AIDS specialist Kunal Saha, who was commissioned by the World Bank earlier this year to investigate an HIV-prevention program in India, is calling on the bank to address evidence that some hospitals and blood banks allegedly were using faulty diagnostic test kits to screen for HIV, the Washington Post reports.

Saha, a professor at Ohio State University, traveled to India as a bank consultant on a team investigating potential problems with the $230 million AIDS control project funded by the World Bank between 1999 and 2006, according to the Post. Saha and two India-based medical specialists in March and April visited hospitals and blood banks in major cities, gathering lab documents that Saha said indicate the facilities were using defective diagnostic testing kits. He cited 2004 and 2005 test results from two Indian hospitals in which blood samples that were known to be HIV-positive tested negative during a second, confirmatory test performed with defective kits, according to the Post. Saha said he found a document suggesting that questionable kits were available for use as late as April despite public statements from Indian health workers and World Bank officials in the country that defective test kits were no longer available.

The bank has not released a draft report from the visit by Saha and the other two doctors, according to the Post. According to a copy of an April 26 e-mail, the draft notes that there were significant quality issues with HIV tests at blood banks and testing centers between 2003 and 2006. Saha said he discussed the matter with former World Bank President Paul Wolfowitz before he left the bank and in August briefed staff members at the bank about his concerns. This year, bank officials approved an additional $250 million to a new HIV program in association with India's National AIDS Control Organization after regarding the previous program as "satisfactory," the Post reports.

"If people are getting HIV because of defective test kits, it's horrendous, it's unthinkable," Saha said in a telephone interview.

Reaction

Kees Kostermans, the World Bank's lead public health specialist in South Asia, on Thursday said the bank's report on the issue will not be released for at least two months; however, he said the bank has no specific evidence that faulty diagnostic tests had led to the spread of HIV in the country. Kostermans added that NACO officials said defective kits had been removed from health facilities and none remained in use. Kostermans said, "It is in nobody's interest to have poor-quality test kits."

Beatrice Edwards, who monitors World Bank operations for the Government Accountability Project and is assisting Saha, called for stricter monitoring and a rapid public accounting of the problems. "If there's any project in the portfolio that needs to be monitored and where the equipment needs to be safeguarded, this is it," Edwards said (Johnson, Washington Post, 9/28).

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Mozambique Archbishop Chimoio Says European-Made Condoms, Antiretrovirals Tainted With HIV

[Sep 28, 2007]

Archbishop Francisco Chimoio, the head of the Roman Catholic Church in Mozambique, on Wednesday said that two European countries are manufacturing condoms that deliberately have been tainted with HIV as part of a plan to "colonize the continent," Reuters reports. Chimoio declined to name the countries or identify the source of the allegations. In addition, Chimoio said that some pharmaceutical companies are manufacturing antiretroviral drugs that are tainted with the virus "in order to finish quickly the African people" (Mangwiro, Reuters, 9/26).

Chimoio said that abstinence is the best way to prevent HIV. He added that a "new mentality" is necessary to fight HIV/AIDS in Mozambique. "It means marriage, people being faithful to their wives ... (and) young people must be abstaining from sexual relations," Chimoio said.

Chimoio's comments have upset some HIV/AIDS advocates, BBC News reports. "We've been using condoms for years now, and we still find them safe," Marcella Mahanjane, a Mozambican HIV/AIDS advocate, said. Gabe Judas -- director of Tchivirika, a drama group that promotes awareness about HIV/AIDS -- said that condoms are "one of the best ways of getting protection against" HIV/AIDS.

According to BBC News, about 17.5% of Mozambicans are Catholic (BBC News, 9/26). According to London's Guardian, Chimoio is "widely respected" in Mozambique, in part because of his work as a mediator during a 16-year civil war, which ended in 1992 (McGreal, Guardian, 9/27). More than 16% of the 19 million people living in Mozambique are HIV-positive, and about 500 new cases are recorded daily, Reuters reports (Reuters, 9/26).

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Politics and Policy

23 States, Cities Receive $35M in CDC Grants To Increase HIV Testing Among Blacks

[Sep 28, 2007]

CDC on Thursday announced that 23 states and large cities with large populations of blacks affected by HIV/AIDS will receive $35 million in grants to expand HIV testing, CQ HealthBeat reports. Blacks account for about half of those in the U.S. who are living with HIV and make up 13% of the U.S. population, according to CDC (CQ HealthBeat, 9/27).

CDC based eligibility and grant amounts on the percentage of AIDS cases among blacks in each locality. Individual grants will range from $690,000 to $5.4 million.

The main focus of the program is to implement routine, voluntary HIV testing in health care settings, such as emergency departments, community health centers, sexually transmitted infection clinics and correctional health facilities. However, about 10% of the tests will be provided in nonclinical settings. The program also aims to combine HIV testing with screening and prevention activities for other infectious diseases, including viral hepatitis, STIs and tuberculosis (CDC release, 9/27).

Kevin Fenton, director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, said the program aims to test more than one million people for HIV and increase early HIV diagnosis among blacks. According to CDC, more than 250,000 people in the U.S. are unaware that they are HIV-positive. Fenton said, "We estimate this program alone could identify nearly 20,000 people who are unaware they are infected, allowing them to seek care for their own health and take steps to protect their partners" (CQ HealthBeat, 9/27).

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Washington Post Profiles NIAID Director Fauci, Who Will Receive Lasker Award for Work To Fight HIV/AIDS

[Sep 28, 2007]

The Washington Post on Friday profiled Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Fauci on Friday in New York City will receive the Albert and Mary Lasker Foundation award for his work in fighting HIV/AIDS. According to the Post, a Lasker award is "one of medicine's most prestigious prizes" (Pressley Montes, Washington Post, 9/28).

Fauci will receive the award for his work with the President's Emergency Plan for AIDS Relief. Fauci is credited with urging President Bush to create PEPFAR. In addition, he will be recognized for his work to address biological hazards. As part of the Lasker award, Fauci will receive $150,000 (Kaiser Daily HIV/AIDS Report, 9/17).

According to the Post, Fauci has "made a career of long hours, exhaustive research and helping the public understand the health dangers stalking the planet." In addition, Fauci "is leading the fight against" infectious diseases, such as tuberculosis and anthrax, while helping direct PEPFAR, the Post reports (Washington Post, 9/28).

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Across The Nation

Arizona Republic Profiles Phoenix-Based Group Conducting Trials on Experimental Antiretrovirals

[Sep 28, 2007]

The Arizona Republic on Thursday profiled Phoenix, Ariz.-based Body Positive, a not-for-profit group that holds a nationally recognized clinical trial site used by pharmaceutical companies to test antiretroviral drugs.

Kirk Baxter, founder of the Body Positive center and Andy Myers, the group's medical director of clinical trials, launched the organization more than 10 years ago to help provide local HIV-positive residents with access to antiretrovirals. According to Baxter, he and Myers mailed letters to drug companies interested in testing such medicines.

Pharmaceutical company Roche responded to the group in the mid-1990s, introducing a test for Saquinivir, the first protease inhibitor approved in the U.S., in Phoenix and other clinical sites across the country. Since then the group has conducted more than 100 drug studies, and more than 24 drugs have been approved by FDA. Body Positive currently tests drugs produced by six companies, including Abbott Laboratories, Hoffman-La Roche and Merck.

The organization now has a $3.5 million annual budget and serves about 1,500 HIV-positive clients each year. The group provides behavioral health services, support groups, wellness programs, and a vitamin and herb shop, according to the Republic. The federal government in 2005 cut about $600,000 in funding for the group's wellness program, and Body Positive now relies on community donations to continue operating the initiative.

According to the Republic, drug companies fund the majority of the cost for the clinical trials, providing free medicines and paying for blood screenings for all trial participants. Body Positive spends about $200,000 annually to support the program, a large part of which goes to post-trial clients who need drugs that are not yet FDA-approved. More than 11,600 Arizonans are living with HIV/AIDS, and nearly 70% of them live in the Phoenix area, the Republic reports (Alltucker, Arizona Republic, 9/27).

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North Carolina Receives Additional Ryan White Funding, Plans To Increase Income Qualification Level for ADAP

[Sep 28, 2007]

North Carolina recently received $6.7 million in additional federal funding under the Ryan White Program reauthorization and will use about half to increase the income eligibility limits for its AIDS Drug Assistance Program, Evelyn Foust, head of HIV/STD Prevention and Care for the state Department of Public Health, said recently, the Raleigh News & Observer reports (Fisher, Raleigh News & Observer, 9/27).

ADAPs are federal- and state-funded programs that provide HIV/AIDS-related medications to low-income, uninsured and underinsured HIV-positive individuals (Kaiser Daily HIV/AIDS Report, 9/25). North Carolina's new eligibility requirements increase the maximum annual income individuals can have to qualify for the program from $20,420 to $25,525. The program's expansion will allow up to 300 more people to qualify for North Carolina's ADAP, the News & Observer reports. As of August, the program was providing no-cost antiretroviral drugs to 2,875 people in the state (Raleigh News & Observer, 9/27).

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Science & Medicine

BusinessWeek Profiles Microsoft Researchers Using Spam-Blocking Software To Develop HIV Vaccines

[Sep 28, 2007]

BusinessWeek in its Oct. 1 edition profiled researchers at Microsoft who are refocusing spam-blocking technology to locate HIV-infected cells to help produce vaccines. Researchers have reconfigured the technology originally developed to identify junk e-mail to correlate HIV-infected cell mutations with an individual's genetic profile.

According to BusinessWeek, David Heckerman and colleagues in June released their first set of detecting software on the Internet at no cost. The researchers run data through 320 computers at a rate that is 480 times faster than one year ago due to smarter algorithms and more powerful machines. Heckerman said he hopes within three years the technology will lead to vaccines that can be tested on humans.

One of the challenges for the researchers is to single out the combinations of protein that lead to an HIV-infected cell so the protein bits can be packaged into a vaccine, BusinessWeek reports. In addition, Heckerman said HIV-infected mutations appear to vary according to an individual's immune system. If researchers can find patterns, it could bolster development of an effective vaccine (Baker/Greene, BusinessWeek, 10/1).

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