Politics and Policy

Bush Calls on Congress To Pass PEPFAR Reauthorization Bill

[Feb 29, 2008]

President Bush on Thursday called on Congress to pass a bill (HR 5501) that would reauthorize the President's Emergency Plan for AIDS Relief, AFP/Google.com reports (AFP/Google.com, 2/28).

The bill was approved Wednesday by the House Foreign Affairs Committee following meetings between White House officials and committee members earlier this week. The measure would allocate $50 billion for PEPFAR over the next five years. Bush had called on Congress to authorize a $30 billion, five-year extension of PEPFAR. The bill also would remove 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 would require "balanced funding" for abstinence, fidelity and condom programs based on evidence in each PEPFAR focus country. In addition, the bill would retain the requirement that PEPFAR recipients pledge opposition to commercial sex work.

The bill would allow groups to use PEPFAR funding for HIV testing and education in family planning clinics but not for contraception or abortion services. The bill also would require reports to Congress if abstinence and fidelity programs comprise less than half of country-level spending on programs aimed at preventing sexual transmission of the virus. In addition, the bill would allocate about $9 billion to fight tuberculosis and malaria, which often affect HIV-positive people in Africa. That amount also would underwrite food supplements for people living with HIV/AIDS. The bill would provide loans to women widowed by the disease or ostracized because of their HIV-positive status (Kaiser Daily HIV/AIDS Report, 2/28).

The full House and Senate must approve the measure before it is sent to Bush for his signature. Bush on Thursday at a news conference said, "Obviously, I hope the House will act quickly and send the bill reauthorizing [PEPFAR] to the Senate, and I would like to sign it into law as quickly as possible" (AFP/Google.com, 2/28).

Related Editorials

Two newspapers on Friday published editorials regarding the PEPFAR reauthorization bill. Summaries appear below.

Boston Globe: The agreement between the White House and foreign affairs committee members on the reauthorization bill is "good news," a Globe editorial says, adding that the "effort can help save millions of lives in impoverished countries around the world." The "need" for HIV, TB and malaria treatments worldwide "has grown" since PEPFAR initially was passed in 2003, the editorial adds, concluding that Congress "should act quickly to leave no doubt that ... the U.S. can still lead the world's Samaritans" (Boston Globe, 2/29).

New York Times: The reauthorization bill "will be a welcome strengthening of a foreign aid program that was already one of the shining accomplishments of the Bush administration," a Times editorial says. Although some lawmakers are "grumbling over the amount of money proposed" in the bill, "it is important that Congress appropriate the full $50 billion if possible," the editorial says, adding, "Even that sum would almost certainly not provide universal access" to antiretroviral drugs (New York Times, 2/29).

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Global Challenges

Japan Gives $184M to Global Fund Ahead of G8 Summit

[Feb 29, 2008]

Japanese Foreign Minister Masahiko Komura on Friday announced that the country has pledged $184 million to the Global Fund To Fight AIDS, Tuberculosis and Malaria, the Kyodo News/Japan Today reports. The new donation will bring the country's total contribution to the Global Fund to $850 million, according to the ministry (Kyodo News/Japan Today, 2/29).

Japan announced its pledge ahead of hosting the Group of Eight industrialized nations' summit in July in the northern resort of Toyako. Officials said they plan to put global health issues, including the United Nations Millennium Development Goals, at the top of the summit agenda. "Japan continues to support measures against infectious diseases on a global scale and to stress the role of the Global Fund to strengthen those measures towards developing countries," the ministry said (AFP/Economic Times, 2/29).

"We are grateful to the Japanese people for their generosity in the fight against infectious diseases," Global Fund Executive Director Michel Kazatchkine said in a statement. "The continuous support from the Japanese government to the Global Fund shows the country's determination to help stem the spread of HIV/AIDS, tuberculosis and malaria," he said, adding, "We appreciate Japan's trust in the Global Fund as an effective vehicle to reach millions of people infected with and affected by these pandemics" (Global Fund release, 2/29).

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UNICEF Urges G8 To Recommit To Preventing Mother-to-Child HIV Transmission

[Feb 29, 2008]

The United Kingdom office of UNICEF has launched a campaign that calls on the U.K. government to ensure the Group of Eight industrialized nations fulfills its pledge to provide all HIV-positive pregnant women with access to antiretroviral drugs to prevent mother-to-child transmission of the virus, VOA News reports. UNICEF U.K. Ambassador Jemima Khan launched the campaign with the unveiling of a four-minute film called "The Gift." The film follows the story of an HIV-positive woman, named Mathakane Metsing, in Lesotho who gave birth to an HIV-negative infant because she had access to the antiretroviral nevirapine (Maphosa, VOA News, 2/27).

UNICEF also has launched a petition calling on U.K. Chancellor Alistair Darling to ensure that G8 countries commit to provide about 760 million pounds, or about $1.5 billion, for universal access to drugs to prevent MTCT, Metro.co.uk reports. The United Kingdom has pledged to provide 46 million pounds, or about $92 million, to the project by 2010. Actress Gwyneth Paltrow, Sir Roger Moore, Khan and other celebrities have joined to support the film and the petition ahead of Mother's Day (Metro.co.uk, 2/26).

UNICEF U.K. Communications Director Angela Travis said, "What we are doing with this launch and with this campaign is to try and keep up the pressure on the G8 leaders to fulfill the commitment made in 2007." Metsing, who works as a peer counselor for the group Mothers to Mothers, said that the major challenges facing women in Lesotho are discrimination, lack of education and limited access to drugs that help MTCT. "I am here today because I don't want to see more babies dying," Metsing said, adding, "I am pleading to world leaders to give the money they promised."

The movie, which is narrated by Paltrow, says, "Almost every minute of every day a baby is born with HIV. World leaders promised to prevent this. We need them to keep their promise and give all babies the chance to be born free of HIV. Tell world leaders to keep their promise" (VOA News, 2/27). Khan said, "All that's needed now is funding and political will. World leaders promised to help, but we are yet to see any concrete action or money." Paltrow added, "I hope that this new short film will raise awareness and funds about this issue and UNICEF will be able to reach every woman with the vital care and medicines they need" (Metro.co.uk, 2/26).

"The Gift" is available online.

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Asian Development Bank Projects Aimed at Improving Transportation, Infrastructure Fueling Spread of HIV in Some Areas, Study Finds

[Feb 29, 2008]

Asian Development Bank projects aimed at improving transportation and infrastructure in Asia could be fueling the spread of HIV in some parts of the region, according to an ADB study released Thursday, AFP/Google.com reports. According to the study, large construction and transportation projects draw men into rural areas, increasing the demand for sex. In addition, commercial sex work, as well as drug and human trafficking, follow major construction and transportation projects, increasing the spread of HIV in the areas surrounding the projects, the study found.

According to the study, long-distance truck drivers in Bangladesh have the highest rates of HIV in the country. It also found that the incidence of sexually transmitted infections in China is four times higher among truck drivers than the general population. The study also found an HIV prevalence of 16% along a transport route in southern India, compared with an HIV prevalence of less than 1% nationwide. In addition, the study found that the 1997 construction of the Mandalay-Muse highway, which connects Myanmar and China, led to an increase in injection drug use, fueling the spread of HIV among IDUs in three of Myanmar's provinces.

ADB said that although improved transportation "bring[s] many benefits," it also "increase[s] risks through greater mobility and connectivity." The bank added that mobile groups, especially "mobile men with money," are more likely to engage in risky sex and injection drug use. The bank added that it plans to integrate HIV prevention, education and treatment initiatives into its transportation and infrastructure programs, AFP/Google.com reports.

The United Nations estimated that 5.4 million people are living with HIV/AIDS in the region and that there have been nearly one million new cases since 2006. In addition, about 640,000 people in the region have died of AIDS-related causes (AFP/Google.com, 2/28).

The ADB study is available online (.pdf).

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Drug Access

Group Calls on Zimbabwe Health Ministry To Increase Access to PEP Among Assault Survivors, Health Workers

[Feb 29, 2008]

The Zimbabwe Women's Resource Centre Network last week called on the country's Ministry of Health and Child Welfare to increase access to post-exposure prophylaxis in an effort to curb the spread of HIV nationwide, the Herald/AllAfrica.com reports. The group called on the health ministry to adopt a multisectoral approach to make PEP more widely available to groups such as sexual assault survivors. ZWRCN program officer Sylvia Shekede said that lack of coordination in the distribution of antiretroviral drugs is hindering access to PEP. "We are calling upon the relevant ministry to formulate policies that cater for every one regardless of age," Shekede said, adding, "Some organizations which support rape victims cater for children under the age of 16 years only."

According to Shekede, health workers also have limited access to PEP. A study conducted by ZWRCN between 2005 and January 2008 found that 27 health care workers nationwide had accessed PEP. "Some people are getting infection after failing to access PEP, and yet the drug is lying idle in different health institutions," Shekede said, adding that PEP should be made available in various venues, such as supermarkets, especially for assault survivors (Herald/AllAfrica.com, 2/27).

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Opinion

'Still Time' To Prevent Global Outbreak of Drug-Resistant TB, Editorial Says

[Feb 29, 2008]

There is "still time to prevent" drug-resistant tuberculosis from causing the "hideous outcome" that has been seen with the HIV/AIDS pandemic, "but perhaps not much," a Los Angeles Times editorial says in response to a recent World Health Organization report.

Drug-resistant TB is "no longer a disease that threatens mainly" people living with HIV/AIDS or impoverished populations in developing countries, the editorial says, adding, "It threatens us all." Mario Raviglione, director of WHO's Stop TB Department, said that drugs effective against extensively drug-resistant TB might be available by 2015 and that the disease in the meantime will inevitably spread, according to the editorial.

Despite the "panic last year caused by Andrew Speaker," TB funding has "lagged," the editorial says. WHO estimates that it has a $2.5 billion shortfall in TB control resources "despite increases in funding from the U.S., Britain and private donors," the editorial says. Drug-resistant TB cannot and should not "be solved by the U.S. alone," the editorial says, adding that "[o]il-rich Russia and relatively affluent China can certainly afford to treat their own infected populations." The editorial concludes that both countries should be "exhorted to contribute more to the global fight against this awful disease" (Los Angeles Times, 2/28).

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