Kaisernetwork.org (Washington, DC)
12 December 2007
Election 2008
Huckabee Says He Is Willing To Meet With Family of Ryan White
Politics and Policy
HIV/AIDS Treatment Programs Will Not Keep Pace Unless Number of New Cases Decreases, Experts Say at PEPFAR Reauthorization Hearing
Across The Nation
HIV/AIDS Education in Washington, D.C., Schools Lacking, Other City Efforts Improving, Group Finds
Global Challenges
African Employers Gather for Conference To Discuss Impact of HIV/AIDS on Workplaces
Large Percentage of HIV-Positive Women in Arab Countries Contracted Virus From Their Husbands, UNDP Regional Coordinator Says
U.N. Agencies Launch Manual To Teach AIDS Orphans in Africa Farming Skills
Election 2008
Huckabee Says He Is Willing To Meet With Family of Ryan White
[Dec 12, 2007]
Former Arkansas Gov. Mike Huckabee, who is running for the Republican presidential nomination, on Tuesday said that he is "very willing" to meet with the mother of Ryan White, the Los Angeles Times reports (Mehta, Los Angeles Times, 12/12). The Human Rights Campaign and the AIDS Institute on Tuesday sent a letter to Huckabee asking him to meet with White's mother to discuss comments he made in 1992 about people living with HIV/AIDS.
Huckabee -- who made the statements in an Associated Press survey while running for Senate in 1992 -- wrote that in order for the federal government to effectively address the spread of HIV, "we need to take steps that would isolate the carriers of this plague." He added in the survey, "It is the first time in the history of civilization in which the carriers of a genuine plague have not been isolated from the general population, and in which this deadly disease for which there is no cure is being treated as a civil rights issue instead of the true health crisis it represents." Huckabee in the survey also said that HIV/AIDS research was receiving too much federal funding.
Huckabee in an interview with Fox News Channel's "Fox News Sunday" said, "I still believe this today" that "we were acting more out of political correctness" in responding to HIV/AIDS. "I don't run from it, I don't recant it," he said of his statements in 1992. He added that his comments were not meant as a call to quarantine HIV-positive people. Huckabee said that he would state his position "a little differently" today.
Jeanne White-Ginder -- the mother of the late Ryan White, an Indiana teenager who died of AIDS-related causes in 1990 at age 18 -- on Monday in an interview with the Associated Press called Huckabee's comments "alarming" and "completely beyond comprehension." She added that she wants to meet with Huckabee to discuss his 1992 comments (Kaiser Daily HIV/AIDS Report, 12/11).
Huckabee on Tuesday said that if he met with White's family, he would "tell them that we've come a long way in research and treatment, and I certainly never would want to say anything that would be hurtful to them or anybody else." He added that he would have "great regret and anxiety if I thought my comments were hurtful or in any way added to the already incredible pain that families have felt, regardless of how they contracted AIDS."
Huckabee did not comment on his current thinking about HIV/AIDS, according to the Times. A statement issued by his campaign last month said that HIV/AIDS care domestically and abroad should be increased (Los Angeles Times, 12/12). In addition, during a recent trip to New Hampshire, Huckabee said that he supports the Bush administration's proposal to double global HIV/AIDS funding. He added that he does not want to neglect other diseases. "I want to make sure that when we look at a disease -- whether it is AIDS, diabetes or cancer -- we look at it from the macro perspective, and we don't just single out one thing that affects, in America, you know, about 5,000 people a year," Huckabee said. According to CDC, there were 42,514 new HIV cases and 13,064 AIDS-related deaths in 2004 (Kranish, Boston Globe, 12/12).
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Politics and Policy
HIV/AIDS Treatment Programs Will Not Keep Pace Unless Number of New Cases Decreases, Experts Say at PEPFAR Reauthorization Hearing
[Dec 12, 2007]
HIV/AIDS treatment programs in Africa will not be able to keep pace unless the number of new cases significantly decreases, experts said Tuesday at a Senate Health, Education, Labor and Pensions Committee hearing to reauthorize the President's Emergency Plan for AIDS Relief, the Boston Globe reports (Donnelly, Boston Globe, 12/12). PEPFAR's original mandate is scheduled to expire in September 2008. President Bush in May called on Congress to double current funding levels to $30 billion over five years (Kaiser Daily HIV/AIDS Report, 12/3).
Experts at the hearing testified that the "most important battle" in curbing HIV/AIDS is stopping HIV transmission but disagreed on how to stop the spread of the virus, the Globe reports. Some witnesses at the hearing debated the effectiveness of a PEPFAR requirement that one-third of HIV prevention funds focus countries receive through the program be used for abstinence-until-marriage and fidelity programs (Boston Globe, 12/12).
Norman Hearst, a professor at the University of California-San Francisco School of Medicine, said that encouraging married men to be faithful to their wives and delaying the onset of sexual intercourse are the two main ways to stop the spread of HIV in Africa (Walker, CQ HealthBeat, 12/11). Hearst added that Congress should set target abstinence and fidelity rates for countries receiving PEPFAR aid because prevention programs in such countries are designed by "Western consultants," who promote condom use as the primary way to prevent HIV. According to Hearst, programs that focus on promoting condom use have "never worked" in areas where HIV is generalized (Boston Globe, 12/12). "It's easier to change sexual behavior than getting the people to use an imported sexual device all of the time," Hearst said (CQ HealthBeat, 12/11).
Helen Smits, co-chair of a recent Institute of Medicine PEPFAR report, said that spending requirements should be dropped so that PEPFAR focus countries can direct programs on their needs. "If a country discovers it has a big problem with needle-sharing (spreading HIV), they could devote all their money in one year to stamp it out," she said. Sen. Edward Kennedy (D-Mass.), chair of the committee, also said he supports a comprehensive approach that would allow focus countries flexibility in spending money for prevention programs (Boston Globe, 12/12). Sen. Richard Lugar (R-Ind.) has introduced a measure (S 1966) that would remove PEPFAR's abstinence and fidelity requirement and instead allocate 50% of prevention funding for comprehensive prevention programs, including abstinence and condom use, CQ HealthBeat reports. The measure also would pledge $30 billion through fiscal year 2013 for PEPFAR (CQ HealthBeat, 12/11).
Mark Dybul, U.S. Global AIDS coordinator who administers PEPFAR, said he favors Lugar's proposal because evidence supports abstinence and monogamy as ways to prevent the spread of HIV. Dybul added that this prevention strategy could change because he is not "sure 50% (of the budget) will be needed in five years."
Other HIV prevention strategies discussed during the hearing include programs to prevent mother-to-child HIV transmission and expansion of male circumcision, the Globe reports (Boston Globe, 12/12). The witnesses at the hearing also discussed the importance of PEPFAR programs that increase laboratory capacity and improve access to antiretroviral drugs, diagnostic testing for infants and nutrition for people living with HIV/AIDS (CQ HealthBeat, 12/11).
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Across The Nation
HIV/AIDS Education in Washington, D.C., Schools Lacking, Other City Efforts Improving, Group Finds
[Dec 12, 2007]
Delays in implementing a comprehensive HIV/AIDS education program in Washington, D.C., public schools are putting students at risk and undermining the city's efforts to fight the disease, according to a report released Wednesday by the DC Appleseed Center for Law and Justice, the Washington Post reports. The center has given the district's public school system a "D" grade for its lack of progress in providing HIV/AIDS education to students, according to the Post.
"In the midst of this crisis, students should be getting information in school that will help prevent infection for the rest of their lives," the report said, adding that despite several school board resolutions for immediate action, "fewer and fewer" young people have received HIV/AIDS education in recent years. The group called on school board leaders and Mayor Adrian Fenty's administration to set strong standards and curricula on HIV/AIDS before classes start next fall. "The district's young people are entitled to nothing less," the report said.
Appleseed Executive Director Walter Smith said the report would have given the school system a failing grade if officials had not committed to making changes. HIV/AIDS education "simply wasn't made a high priority," Smith said. District School Chancellor Michelle Rhee in a statement released Tuesday acknowledged the issues. "Going forward," the school system is "committed to implementing comprehensive health curriculum that includes instruction on HIV/AIDS and other infectious diseases," Rhee said. The school board is scheduled to vote on Thursday on the overall standards that will be the initial steps toward the health curriculum goal, the Post reports.
Other Evaluations
According to the Post, the school system's grade is a "glaring negative" in a report card that also reflects signs of improvement in the district's HIV/AIDS efforts. The group issued an "A" to two of the 12 areas evaluated in the report, and six other categories received their highest score to date. This is the third assessment that Appleseed has issued since March 2006. Appleseed said that the scores reflect the district government's success this year "in creating the beginnings of an infrastructure of a properly functioning public health system to address the epidemic, something lacking in the district for quite some time."
The most recent HIV/AIDS figures for the district found that almost 12,500 people were known to be living with the disease in 2006 and that more than 80% of several thousand new HIV cases since 2001 occurred among black residents, the Post reports. Although the figures "renewed criticism" of the HIV/AIDS Administration's prior handling of the epidemic, they represented an important statistical "breakthrough" for which Appleseed awarded an "A," according to the Post. The report also includes a number of accomplishments on disease surveillance by the HIV/AIDS Administration, such as fixing a HIV/AIDS case backlog and working with community groups, laboratories and doctors for better data collection. The report said that the improvement in HIV/AIDS surveillance "does not by itself advance the city's response to the epidemic" but provides "a much needed new tool for targeting that response."
The report also noted that the HIV/AIDS Administration now has more than four dozen hospitals, clinics, private doctors and not-for-profit groups doing routine HIV testing during medical care. In addition, the agency increased its distribution of no-cost condoms from 115,000 last year to a projected one million this year, and it responded quickly when groups complained about some of the condom packaging, Appleseed said. HIV/AIDS Administration Director Shannon Hader, who took office in mid-October, has pledged to triple the number of condoms distributed by 2009. Hader expressed satisfaction with the evaluation, adding, "It helps us to have another eye on what we're doing, to give us feedback."
The district's Department of Corrections received the highest score from the group. About 75% of inmates at the district jail are screened for HIV/AIDS on arrival, the Post reports. Beginning in January, HIV-positive inmates will receive a 28-day supply of antiretroviral drugs on discharge so their treatment is not interrupted. The two initiatives are "at the forefront of the nation," Appleseed's report said. "Enormous progress has been made," Susan Galbraith -- director of the not-for-profit Our Place DC, which assists women who have been incarcerated -- said (Levine, Washington Post, 12/12).
The report is available online (.pdf).
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Global Challenges
African Employers Gather for Conference To Discuss Impact of HIV/AIDS on Workplaces
[Dec 12, 2007]
Employers from across Africa on Monday ended a two-day workshop in Nairobi, Kenya, that aimed to address the impact of HIV/AIDS in the workplace and review strategies for mitigating the situation, Kenya's Daily Nation reports. The conference, themed "Reinforcing Employers' Interventions on HIV/AIDS in the Workplace in Eastern and Southern Africa," was sponsored by the International Labour Organization. It drew participants from Botswana, Kenya, Lesotho, Malawi, Mauritius, Namibia, Tanzania, South Africa, Swaziland, Uganda, Zambia and Zimbabwe.
Jacqueline Mugo, executive director of the Federation of Kenya Employers, during a speech at the conference said employers have developed a new evaluation method to gather accurate data about the effect of HIV/AIDS on the workplace. The new method involves assessing the total impact of the disease on a business and factors in medical costs and loss of productivity (Mwiti, Daily Nation, 12/10). According to Mugo, employers estimate that a Kenyan company loses more than 3.6 million shillings -- or about $57,000 -- annually to HIV/AIDS expenditures, the East African Standard reports. "The figure we have given is only the medical bill incurred by employers for eight" HIV-positive employees, Mugo said, adding, "Employers with many infected employees incur bigger losses." According to Mugo, the federation's "monitoring and evaluation mechanisms indicate that the impact of the scourge to business is enormous, and the trend continues to have a negative impact on financial bottom line." She also said businesses experience losses in productivity from absenteeism, medical expenses, and loss of skilled manpower through replacement and training (Adero, East African Standard, 12/11).
Mark Bor, permanent secretary in Kenya's Ministry of Labour and Human Resource Development, said that the government is concerned about the impact of HIV/AIDS on the informal sector, the Nation reports. "Small profit margins and too few workers at any one site are among the difficulties encountered in this sector, which employs 6.8 million Kenyans," he said. Bor proposed that HIV/AIDS advisory committees incorporate a cross section of industries to address the problem (Daily Nation, 12/10). "It has been more difficult to implement HIV/AIDS programs in the informal sector for reasons such as too few workers at any one site, lack of appropriate venues for educational sessions and small profit margins that discourage small-business owners from releasing employees for educational sessions," Bor said. "It is therefore necessary that employer organizations aim to promote an enabling business environment that takes into consideration issues of care and support," he added. Bor said that there is a need to develop or evaluate codes of conduct to address emerging issues, perform focused HIV/AIDS surveys and identify at-risk groups (East African Standard, 12/11).
Sophia Kisting, director of ILO's global program on HIV/AIDS in the workplace, said that a lack of coordination among employers' organizations, workers, union representatives and the government is hampering efforts to address the disease, Business Day/AllAfrica.com reports. "There are so many voices in the war against AIDS and this is not bearing fruit," Kisting said, adding, "Stigma and policy gaps remain a big hurdle in the fight against AIDS at the workplace, putting at risk the lives of thousands of employees who fear losing their jobs upon declaring their HIV status" (Kimani, Business Day/AllAfrica.com, 12/10).
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Large Percentage of HIV-Positive Women in Arab Countries Contracted Virus From Their Husbands, UNDP Regional Coordinator Says
[Dec 12, 2007]
About 80% of HIV-positive women in the Middle East contracted the virus from their husbands, Saeed Al Zenari, United Nations Development Programme regional coordinator for HIV/AIDS programs, said Monday at a conference aimed at encouraging religious leaders to help increase prevention efforts in the region, the Gulf News reports. According to Al Zenari, the large percentage of women who contract the disease from their husbands poses a threat to families in the region.
Al Zenari at the conference said that there is a "wrong perception" in the Middle East that HIV is a "result of adultery," adding that HIV-positive people therefore are "discriminated" against. HIV-associated stigma and discrimination are widespread in the region, the News reports. A religious leader during an open session at the conference said that imans can encourage people to be abstinent before marriage and to "avoid adultery" but added that imans "cannot provide guidelines" on HIV prevention.
The number of people living with HIV/AIDS in the Middle East is between 500,000 and one million, but the number of new HIV cases in the region is higher than in Eastern Europe or North America, Al Zenari said. He added that it is difficult to collect data about the disease in the region. "We have no reliable data available because a majority of the people who have the disease either refuse to seek medical care, fearing to be discriminated, or they are unaware" they are HIV-positive, he said. About 90% of HIV-positive people in the region are not aware of their status, Al Zenari said.
Between 2002 and 2004, the number of new HIV cases in the region increased by 300%, according to UNAIDS. In 2006, 68,000 people in the region were newly diagnosed with HIV, and 36,000 died of AIDS-related causes, the News reports (Bibbo, Gulf News, 12/11).
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U.N. Agencies Launch Manual To Teach AIDS Orphans in Africa Farming Skills
[Dec 12, 2007]
The U.N. World Food Programme and U.N. Food and Agricultural Organization recently launched a manual that aims to teach AIDS orphans in sub-Saharan Africa about farming and other skills, BuaNews/AllAfrica.com reports. There are about 40 million orphans in sub-Saharan Africa, 11.4 million of whom have lost their parents to AIDS-related illnesses. The manual provides information on how to establish farming schools where orphans can learn how to create sustainable livelihoods and long-term food security.
The program aims to teach children practical skills, such as local agricultural methods, as well as how to protect themselves from HIV transmission and other diseases, BuaNews/AllAfrica.com reports. Since 2004, the program has targeted more than 7,000 children in 11 African countries: Cameroon, Kenya, Malawi, Mozambique, Namibia, Sudan, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. As part of the program, WFP also provides essential food support to children attending classes. Robin Jackson, chief of the WFP's HIV/AIDS service, said, "Providing a nutritional meal to children in the schools is both an incentive for them to attend lessons and gives them an energy boost to participate actively."
Marcela Villarreal -- FAO's focal point for HIV/AIDS and director of the organization's Gender, Equity and Rural Employment Division -- said, "Children and youth bear the heaviest burden of the AIDS crisis." She added that the "schools are an attempt to give orphans the means and confidence to survive in an often difficult environment" (BuaNews/AllAfrica.com, 12/11).
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