Kaisernetwork.org (Washington, DC)
26 February 2008
Politics and Policy
Clinton Reiterates Commitment To Invest $50B To Fight Global HIV/AIDS
[Feb 26, 2008]
Sen. Hillary Rodham Clinton (D-N.Y.), who is running for the Democratic presidential nomination, on Monday during a speech at George Washington University in Washington, D.C., reiterated her commitment to address the global HIV/AIDS epidemic, the Cleveland Plain Dealer reports (Kleinerman, Cleveland Plain Dealer, 2/26).
Clinton in her speech Monday said she "was proud" to sign a pledge to invest $50 billion by 2013 to combat HIV/AIDS, adding that the U.S. "will lead the world in combating AIDS." She also said she has seen how diseases such as HIV/AIDS, tuberculosis and malaria "undermine progress across" Africa. "I'm very hopeful that we will make progress in Africa dealing with the multiplicity of challenges that the continent faces," including HIV/AIDS, Clinton said, adding that the U.S. needs a "consistent coherent strategy in dealing with Africa and that is something that I will promote" (Speech transcript, 2/25).
In a plan released in November 2007, Clinton also proposed doubling funding for HIV/AIDS research at NIH to $5.2 billion annually, as well as doubling the number of people worldwide who receive HIV/AIDS treatment through U.S. funding. In addition, Clinton said that if elected president, she would try to eradicate malaria deaths in Africa within eight years. She also said that she would commit $1 billion annually for global malaria control efforts (Kaiser Daily HIV/AIDS Report, 11/30/07).
A Kaiser Family Foundation issue spotlight, available at health08.org, summarizes each presidential candidate's position on HIV/AIDS and global health, along with a selection of quotes and links to additional resources.
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Global Challenges
Reported HIV/AIDS Cases in China Increase 45% From 2006 to 2007, Health Ministry Report Says
[Feb 26, 2008]
The number of HIV/AIDS cases reported in China in 2007 was 45% higher than the number reported in 2006, according to a report released Friday by the country's Ministry of Health, Xinhua/Shanghai Daily reports. The government in November 2007 estimated that about 700,000 HIV-positive people were living in China in 2007, compared with an earlier estimate of 650,000. According to Xinhua/Daily, 223,501 HIV/AIDS cases had been officially reported at the end of 2007 (Xinhua/Shanghai Daily, 2/25).
The health ministry's report did not include exact figures or give the increase in reported cases (Reuters Health, 2/22). Gao Qi, a project manager with the China HIV/AIDS Information Network, said the report "doesn't mean the HIV/AIDS situation is getting worse," adding, "The increase might be due to more screening tests" (Juan, China Daily, 2/23).
The number of sexually transmitted infection cases increased by nearly 7% in 2007, while the number of bloodborne diseases increased by 3.55%, according to the report, Xinhuanet reports. The report noted that the number of hepatitis C cases increased by 30% and that syphilis cases increased by 24% in 2007. More than 4.7 million cases of infectious diseases were reported in China last year, an increase of nearly 3% from 2006, according to the report. There were 13,037 deaths due to infectious diseases in 2007, 2,311 more than in 2006 (Xinhuanet, 2/23).
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Rwanda To Launch Campaign Aimed at Addressing Circumcision Myths, Encouraging Procedure in Effort To Prevent HIV
[Feb 26, 2008]
Health authorities in Rwanda are planning to launch a nationwide campaign this year aimed at addressing myths about male circumcision and encouraging men to be circumcised in an effort to prevent the spread of HIV, McClatchy/Miami Herald reports (Bengali, McClatchy/Miami Herald, 2/24).
Rwanda announced plans to launch the campaign in September 2007. According to final data from two NIH-funded studies -- conducted in Uganda and Kenya and published last year in the journal Lancet -- routine male circumcision could reduce a man's risk of HIV infection through heterosexual sex by 65%. The results of the Uganda and Kenya studies mirrored similar results of a study conducted in South Africa in 2005. In response to the findings, the World Health Organization and UNAIDS in March 2007 recommended the procedure as a way to help reduce transmission of the virus through heterosexual sex (Kaiser Daily HIV/AIDS Report, 1/24).
The campaign will initially target the army, police officers and university students, Innocent Nyaruhirira, the country's health minister, said. The campaign will aim to reduce the cost of the procedure, which can be as much as $55 at private hospitals, as well as ensure it is covered by basic health insurance policies.
According to McClatchy/Herald, many men in the country have already received the procedure. Justin Gatete -- a nurse at a clinic in Kigali, Rwanda's capital -- said he performed more than 1,000 circumcisions last year.
"We're not going to wake up one morning and have all men be circumcised," Anita Asiimwe, director of Rwanda's Treatment and Research AIDS Center, said, adding, "We need to see how best to implement this."
Health experts from the U.S. are helping Rwandan officials develop the campaign. The Bush administration has said it would allocate funds in the President's Emergency Plan for AIDS Relief to make circumcision more accessible in Africa. Kenya, Swaziland and Zambia have announced plans to make the procedure available in public clinics, McClatchy/Herald reports (McClatchy/Miami Herald, 2/24).
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Science & Medicine
Experimental Microbicide Tenofovir Safe for Women To Use Daily, Study Finds
[Feb 26, 2008]
The experimental microbicide tenofovir is safe for women to use daily, according to results from clinical trials funded by NIH and conducted in three locations in the U.S. and India, though it is too early to tell if it actually prevents HIV infection, Reuters reports (Fox, Reuters, 2/25). Microbicides include a range of products -- such as gels, films and sponges -- that could help prevent the sexual transmission of HIV and other infections (Kaiser Daily HIV/AIDS Report, 2/6). A study released last week showed that the microbicide candidate Carraguard, though safe, was ineffective in preventing HIV transmission. Other candidates, including nonoxynol-9 and Ushercell, have been found to increase women's risk of HIV infection, according to Reuters (Reuters, 2/25).
The study -- presented at Microbicides 2008, the biannual international conference that began on Sunday in New Delhi, India -- was conducted from August 2006 to September 2007 at the National AIDS Research Institute in Pune, India; the Bronx-Lebanon Hospital Center; and at the University of Alabama-Birmingham, the Times of India reports. Tenofovir gel is a HIV-specific microbicide that is designed to prevent HIV from replicating when it comes in contact with uninfected T-cells (Sinha, Times of India, 2/23). The study involved 200 HIV-negative women of reproductive age who were asked to apply the gel either daily or before sexual intercourse for about six months. The women were asked to use condoms as well as the gel, AFP/Yahoo! News reports.
The study found no disruption of blood, liver or kidney function and found that women were willing to follow the treatment guidelines. According to the study, more than 90% of the participants said they would consider using the gel to prevent HIV transmission if it were approved. More than 80% of the participants followed the experimental regimen, the study found.
Sharon Hillier, lead investigator and director of reproductive infectious diseases at the University of Pittsburgh School of Medicine, said, "Based on what we have learned, we can proceed with greater confidence on a path that will answer whether tenofovir gel and other gels with HIV-specific compounds will be able to prevent sexual transmission of HIV in women when other approaches have failed to do so" (AFP/Yahoo! News, 2/25). Craig Hoesley of UAB said a "key message" of the results is that the "gel is safe to use and well-tolerated by HIV-negative women," adding, "This sets the stage for larger studies to see if tenofovir can prevent HIV infection" (Reuters, 2/25). According to the Times of India, a Phase II trial is under way among 1,000 women in South Africa to test the microbicide's effectiveness at preventing HIV transmission (Times of India, 2/23).
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