Politics and Policy

House Foreign Affairs Committee Members, White House Officials Meet To Discuss PEPFAR Reauthorization

[Feb 27, 2008]

House Foreign Affairs Committee members and White House officials met on Tuesday to create a compromise draft bill to reauthorize the President's Emergency Plan for AIDS Relief, CQ Politics reports (Graham-Silverman, CQ Politics, 2/27).

The original reauthorization draft bill included Democratic-proposed changes to PEPFAR, such as the removal of a requirement that at least one-third of HIV prevention funds that focus countries receive through PEPFAR be used for abstinence-until-marriage programs. It also included a provision to revoke a requirement that PEPFAR recipients pledge opposition to commercial sex work in order to receive funding. Some Republicans also said that the original draft bill would have removed rules that allow family planning groups to receive PEPFAR money for HIV/AIDS programs only if the money was not spent on abortion. In addition, the original bill would allocate $50 billion for PEPFAR over the next five years. President Bush has called on Congress to authorize a $30 billion, five-year extension of PEPFAR (Kaiser Daily HIV/AIDS Report, 2/8).

Tuesday's compromise draft bill also would allocate $50 billion for PEPFAR over the next five years and remove the abstinence spending requirement, according to CQ Politics. The compromise bill would require "balanced funding" for abstinence, fidelity and condom programs based on evidence in each PEPFAR focus country. It also would require reports to Congress on prevention spending.

In addition, the compromise draft bill would retain the requirement that PEPFAR recipients pledge opposition to commercial sex work. It also would continue to prevent family planning groups from spending HIV/AIDS funds on reproductive health services, CQ Politics reports. The compromise bill would allow funding for HIV testing and education in family planning clinics but would not explicitly authorize funding for contraception. The foreign affairs committee is scheduled to consider the compromise bill on Wednesday (CQ Politics, 2/27).

The Tuesday meeting was the first time that committee members and White House officials met to discuss the draft bill, which was written by late Rep. Tom Lantos (D-Calif.), who chaired the committee until he died on Feb. 11. Acting committee Chair Howard Berman (D-Calif) "appeared ready" to move forward with negotiations, CQ Today reports. "I very much want it to be bipartisan, but I also want the program to be effective," Berman said on Tuesday, adding, "Effectiveness is the key."

Democratic committee spokesperson Lynne Weil said it is "very encouraging that the White House and the minority staff finally came to the table on this bill." Bill O'Keefe, senior director for advocacy at Catholic Relief Services, said, "They're all good people who want desperately to preserve the program, and they don't want to do anything to jeopardize what is possibly the most successful U.S. policy venture in the last eight years." However, some groups have said that a compromise on the reauthorization bill "would be a disappointment" and that a "harsh debate was inevitable," according to CQ Today. "There's nothing about offering contraception to women that isn't going to be turned into something about abortion," Jodi Jacobson, director of advocacy at the American Jewish World Service, said (Graham-Silverman, CQ Today, 2/26).

Bush Calls on Candidates To Support Africa

In related news, Bush on Tuesday called on all of the 2008 presidential candidates to continue to support U.S. commitments to Africa, AFP/Yahoo! News reports. "Presidential candidates of both parties should make clear that engagement with Africa will be an enduring priority" of the U.S., Bush said during a speech that reviewed his recent five-nation tour of the continent (AFP/Yahoo! News, 2/26). Bush -- who spoke at the Leon Sullivan Foundation in Washington, D.C. -- also said that Congress "needs to make America's commitment clear by fully and promptly funding our development programs." He added, "America is on a mission of mercy. We are treating African leaders as equal partners. ... We expect them to fight corruption and invest in the health and education of their people and pursue market-based economic policies" (Stearns, VOA News, 2/26).

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Global Challenges

Malawi Drafts Law To Prevent Claims of HIV/AIDS Cures

[Feb 27, 2008]

Malawi has drafted a law to prevent traditional healers from claiming that they can cure HIV/AIDS and religious leaders from advising their congregations to give up treatment for prayer, Mary Shawa, principal secretary for nutrition and HIV/AIDS at the president's office, said on Tuesday, Reuters South Africa reports. The draft bill will be presented to Malawi's Parliament on March 4, Shawa said, adding that when the bill "passes into law, all those traditional healers claiming to cure AIDS and religious leaders stopping people from taking" antiretroviral drugs "will be dealt with." She added, "These are desperate times, and we need stern action to deal with these people misleading people." According to Shawa, the details of the draft bill will be made public when Parliament meets.

The Malawi Council of Churches last week said that five HIV-positive people who had been taking antiretrovirals died after their church pastor advised them to stop taking the drugs because the pastor said they had been cured by prayer. Some health officials estimate that one million people are living with HIV in Malawi and that about 640,000 people have died from AIDS-related causes since 1985 (Reuters South Africa, 2/26).

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Post-election Violence in Kenya Preventing Nearly 2,400 From Accessing Antiretrovirals, AIDS Council Says

[Feb 27, 2008]

Post-election violence in Kenya has prevented 2,391 HIV-positive people from accessing antiretrovirals, the country's National AIDS Control Council recently said, Business Daily/AllAfrica.com reports. More than 300,000 people have been internally displaced since the violence began in late December 2007. "Basing our estimates on the national prevalence rate, 15,000 HIV-positive people have been affected, with half of them remaining on treatment," NACC said in a statement.

Peter Mutie, head of communications at NACC, said restrictions on movement through some regions of the country have affected the delivery of antiretrovirals. Mutie said preliminary data showed that most of the internally displaced people living with HIV/AIDS are not eating the recommended foods. Mutie noted that efforts have been made in some IDP camps to supply condoms, information and post-exposure prophylaxis for rape survivors. Ten rape cases have been reported so far in three camps in Nairobi, and six have been treated, according to Business Daily/AllAfrica.com.

Displacement of people is seen as a heavy setback in the fight against HIV/AIDS, BusinessDaily/AllAfrica.com reports. According to a 2007 UNAIDS report, HIV prevalence in Kenya has decreased from a high of 14% in the mid-1990s to 5% in 2006. Mutie said that if the violence is not "urgently contained, we expect a sharp increase in infections and death of patients due to the poor conditions in the camps and lawlessness that makes it easier for sexual offenses to be committed." He also noted that the economy will suffer as people who cannot access their medicines become ill and are not able to work. "If the situation does not go back to normal, Kenya is going to suffer very much in the fight against AIDS," Mutie said (Business Daily/AllAfrica.com, 2/25).

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Hong Kong Reports Large Increase in Number of Recorded HIV Cases in 2007

[Feb 27, 2008]

Hong Kong's Centre for Health Protection on Tuesday announced that 414 new cases of HIV were confirmed for 2007, the largest increase in the number of new cases ever recorded, Xinhuanet reports. According to the center, the number of cases was 11% higher than the number recorded in 2006.

Sexual intercourse was the primary mode of transmission in Hong Kong, Wong Ka-hing, a consultant for the health protection center, said. Of the new recorded cases in 2007, 168 were among men who have sex with men, 103 were transmitted through heterosexual sex, 43 through injection drug use, two through blood transfusions and one through mother-to-child transmission. There are now 3,612 cases of HIV/AIDS recorded in the city since 1984, Xinhuanet reports. Seventeen new AIDS cases were recorded in the fourth quarter of last year, bringing the total to 934 since 1985 (Xinhuanet, 2/26).

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Drug Access

40% of AIDS-Related Deaths in British Columbia Among People Who Never Received Treatment, Study Finds

[Feb 27, 2008]

About 40% of the 1,436 people who died of AIDS-related conditions in British Columbia, Canada, from 1997 to 2005 never received antiretroviral drugs even though the medication is provided at no cost, according to a study released Friday by the B.C. Centre for Excellence in HIV/AIDS, the Vancouver Province reports.

The study found that 567 people in British Columbia had died of AIDS-related causes during the study period without receiving treatment (Lazaruk, Vancouver Province, 2/23). According to Julio Montaner, director of the B.C. center, low-income people, homeless people, people with mental illnesses and drug users were the most likely to die without receiving treatment. In addition, about 25% of people living with HIV in Canada do not know they have the virus, so the number of people dying of AIDS-related conditions without receiving treatment could be higher, Montaner said.

Ken Buchanan of the British Columbia Persons With AIDS Society said the long-term solution to the problem is to bring stability to the lives of people living with HIV/AIDS so they are more likely to follow their treatment regimens. "For a person who is homeless, taking medications, even free medications, is pretty low in their priorities," Buchanan said. The B.C. center has proposed a plan to the provincial government that would form outreach teams to provide rapid-response HIV testing to people most vulnerable to the virus and offer treatment to people who test positive (Moore, CP/Globe and Mail, 2/23).

A representative from the B.C. Ministry of Health was not available for comment, the Province reports (Vancouver Province, 2/23).

Program Launched To Curb HIV Among Aboriginal Community

In related news, the B.C. Centre for Disease Control on Monday launched a five-day program aimed at reducing the spread of HIV and other sexually transmitted infections among aboriginal communities in Prince George, B.C., the CP/Globe and Mail reports. The Chee Mamuk Aboriginal HIV/STI Program will link health providers with HIV/AIDS and sexual health services in the aboriginal community in an effort to develop community-based solutions to build networking among participants.

According to Melanie Rivers, acting manager of Chee Mamuk, aboriginal people account for about 5% of the province's population but accounted for 15% of all new HIV infections in 2006. The "overrepresentation" of aboriginal people in new HIV cases is even "more pronounced" among women, Rivers added. In 2006, 54 new HIV cases were reported among aboriginal people in British Columbia.

The program is scheduled to end Friday, but two more sessions are planned in the coming months, the CP/Globe and Mail reports (CP/Globe and Mail, 2/26).

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Across The Nation

Atlanta Journal-Constitution Profiles Advocacy Group HealthSTAT, Including Work With HIV/AIDS

[Feb 27, 2008]

The Atlanta Journal-Constitution on Tuesday profiled the advocacy group HealthSTAT, which stands for Health Students Taking Action Together, including its work on HIV/AIDS policy in Georgia. Members of the group include students in nursing, pharmacy, physical therapy, public health and related fields from nine colleges and medical schools in Georgia.

According to the Journal-Constitution, the students have hosted peer programs on HIV prevention and policy and have organized service projects with groups that provide services for people living with AIDS. In addition, the students have collected and distributed stories about people who have benefited from HIV prevention programs. Some members also worked at HIV clinics before joining the group.

HealthSTAT was incorporated as a not-for-profit organization in 2002. Before addressing any health issue, the group holds a two-day symposium and invites community experts to help study the problem and then decides on appropriate service projects or advocacy opportunities, the Journal-Constitution reports.

Kate Neuhausen, a member of the group and a student at Emory University School of Medicine, said the group's "vision" is to "furnish the [future] leaders" of professional groups, such as the Medical Association of Georgia. Neuhausen added that members of the group will be "creating policy" on health-related issues, including HIV/AIDS, for "decades from now" (White, Atlanta Journal-Constitution, 2/26).

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