Politics and Policy

Faith-Based Organizations Express Support for Needle-Exchange Programs

[Mar 05, 2008]

Faith-based organizations on Monday during an event voiced support for needle-exchange programs as a means of preventing the spread of HIV among injection drug users and their partners, CQ HealthBeat reports. The meeting -- sponsored by the Interfaith Drug Policy Initiative and the Drug Policy Alliance -- brought faith-based groups together to discuss ways to advance exchange programs and repeal a ban on federal funding for such programs (Mattingly, CQ HealthBeat, 3/4).

The meeting comes after President Bush in December 2007 signed a $555 billion fiscal year 2008 omnibus spending bill (HR 2764) that effectively lifted a ban on city funding for needle-exchange programs in Washington, D.C. Since 1999, the district has been the only U.S. city barred by federal law from using local funds for needle-exchange programs. A report released in November 2007 by district health officials found that injection drug use was the second most common cause of HIV transmission in the city (Kaiser Daily HIV/AIDS Report, 1/3). According to the North American Syringe Exchange Network, there are more than 200 needle-exchange programs operating throughout the country, mostly on the local and regional levels.

Charles Thomas, executive director of IDPI, said organizations that voiced support for needle-exchange programs include the Unitarian Church, the Episcopal Church, the Union for Reform Judaism and some Baptists. Mary Jo Iozzio, a board member of the Society of Christian Ethics, said, "Some would say this is a little left leaning for [SCE], and they would be right," adding, "But to do anything less is to fail to act to save human lives." William Martin, a senior fellow for Religion and Public Policy at Rice University, said that among conservatives, "there is a great deal of resistance on drug policy reform." He added, "But there are a lot of loose bricks on the wall."

According to CQ HealthBeat, any chance of lifting the ban on federal funds for needle-exchange programs "faces a difficult partisan battle" in Congress. Bill McColl, political director for AIDS Action, said, "I consider this a nonpartisan issue, but the change in administration will certainly help" lift the ban. Democratic presidential candidates Sens. Hillary Rodham Clinton (N.Y.) and Barack Obama (Ill.) both have said they support using federal funds for needle-exchange programs. Republican presidential candidate Sen. John McCain (Ariz.) has not given an official position on the issue, CQ HealthBeat reports. However, McColl said he has not dismissed the possibility that McCain would support efforts to repeal the ban (CQ HealthBeat, 3/4).

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Global Challenges

Mozambican Civil Society Groups To Launch HIV/AIDS Campaign Aimed at Disabled People

[Mar 05, 2008]

Mozambican civil society organizations this week will launch an HIV/AIDS campaign that aims to ensure improved access to HIV testing, medical assistance and treatment among disabled people in the country, AIM/AllAfrica.com reports. According to World Health Organization data, there are about two million people in Mozambique who are disabled to some degree. At least 324,000 of those people also are HIV-positive, according to 2007 statistics.

Organizations working with disabled people say the population is at a greater risk of HIV transmission but is largely excluded from HIV/AIDS services. The Forum of Mozambican Disabled Associations said disabled people in the country have been stigmatized, which gives them less opportunity to get married. FAMOD added that disabled people tend to have more than one sexual partner and have unstable sexual relationships. In addition, disabled women and children are at an increased risk of rape, and disabled people in general have less access to quality health care services and HIV/AIDS information, according to FAMOD.

The campaign, called the African Campaign on the Disabled and HIV/AIDS, will be coordinated by the Secretariat of the African Decade of Persons with Disabilities and Handicap International. FAMOD, Handicap International and other partners also have scheduled a workshop for this week in conjunction with the launch. The workshop will discuss the campaign's guidelines and attempt to increase awareness of the issue among political leaders and the public (AIM/AllAfrica.com, 3/3).

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Draft Legislation Seeks To Protect People in Malawi From Healers Claiming To Cure HIV/AIDS

[Mar 05, 2008]

Malawi lawmakers on Tuesday began examining draft legislation that aims to prevent traditional healers from claiming that they can cure HIV/AIDS, AFP/Mail & Guardian reports. Mary Shawa, principal secretary for nutrition and HIV/AIDS at the president's office, announced the legislation last week.

The bill seeks to "regulate and protect people from healers who prescribe sex with albinos, the disabled or virgins as a cure for HIV and AIDS," Shawa told a Parliamentary committee that was asked to provide input on the measure before it is submitted to the full Parliament later this year. Under the measure, the country's 30,000 traditional healers -- many of whom work in rural towns and villages -- would be required to register with a board created by the Ministry of Health. Shawa said that when the bill "passes into law, all traditional healers claiming to cure AIDS will be dealt with." She did not provide details on possible punishments for healers who claim to cure the disease. The bill was drafted in collaboration with traditional Malawi healers and the World Health Organization, AFP/Mail & Guardian reports (AFP/Mail & Guardian, 3/4).

The bill also would seek to prevent religious leaders from advising their congregations to give up antiretroviral treatment for prayer. The Malawi Council of Churches last month 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 (Kaiser Daily HIV/AIDS Report, 2/27).

According to AFP/Mail & Guardian, newspaper and radio advertisements for HIV/AIDS cures also are common in Malawi. A United Nations-funded study last year found that about 60% of people ages 15 to 49 in Malawi lack knowledge about HIV prevention. According to official figures, 14% of Malawi's 12 million residents are living with HIV, and there are about 78,000 AIDS-related deaths and 100,000 new cases annually (AFP/Mail & Guardian, 3/4).

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Baltimore Sun Examines Masai Practices That Could Lead to Spread of HIV

[Mar 05, 2008]

The Baltimore Sun on Sunday profiled the Masai communities in Kenya and Tanzania, including some of their practices that could lead to the spread of HIV. HIV prevalence is low among Masai because they generally do not have sexual relationships with other groups. Among Kenyan Masai, HIV prevalence is estimated at 2.5%, about half of the national average, the Sun reports.

According to the Sun, the risk of HIV is increasing among Masai communities because concurrent sexual partnerships are traditionally considered proper. In addition, many Masai have low awareness of HIV/AIDS and how to prevent transmission of the virus. Masai men are beginning to travel to urban areas for work, having sex with non-Masai women and then transmitting the virus when they return to their communities. In addition, polygamous marriages contribute to an increased risk of HIV among Masai.

Edward Porokwa, who directs a not-for-profit group that lobbies for Masai and other traditional groups, said, "It is a very dangerous environment for the Masai," adding that "everybody will be bombed" as members of the group begin to transmit HIV (Calvert, Baltimore Sun, 3/2).

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Science & Medicine

Researchers Discover Protein That Could Lead to Development of HIV Vaccine, New Treatments, Study Says

[Mar 05, 2008]

The discovery of a protein, known as FOX03a, found in the nucleus of CD4+ T cells could lead to the development of an HIV vaccine and new treatments, according to a study recently published in the online edition of the journal Nature Medicine, Toronto's Globe and Mail reports (Alphonso, Globe and Mail, 3/4).

For the study, Rafick-Pierre Sekaly of the University of Montreal and colleagues from the McGill University Health Center and San Diego, Calif.-based BD BioSciences compared HIV-negative men, HIV-positive men undergoing antiretroviral treatment and HIV-positive men who were able to control HIV without antiretrovirals, or "elite controllers" (Fidelman, CNS/Calgary Herald, 3/3). The study found that the elite controllers were able to suppress viral loads to undetectable levels without medication because their immune systems maintained their memory through control of the FOX03a protein, the Globe and Mail reports.

Elias Haddad, a researcher at the University of Montreal and co-author of the study, said FOX03a in the nucleus of T cells can induce the development of molecules that lead to the cell's death. Inhibiting this action can prevent the premature death of the T cell, the Globe and Mail reports. "We were able to [inhibit cell death] and restore or rescue memory cells from chronic infection so that they now become similar to those of elite controllers," Haddad said. He added that the findings are important because researchers now can try to "reverse the premature death of memory cells during chronic HIV infection." The researchers said the new findings can potentially be used to develop therapies for other diseases, including hepatitis C and some cancers (Globe and Mail, 3/4).

An abstract of the study is available online.

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Opinion

Fighting HIV/AIDS in Africa Requires More Than 'Fruits of Science,' Opinion Piece Says

[Mar 05, 2008]

The "fruits of science" and antiretroviral drug programs alone will not curb the spread of HIV in Africa, Jonny Steinberg -- author of "Sizwe's Test: A Young Man's Journey Through Africa's AIDS Epidemic" -- writes in a Los Angeles Times opinion piece. Antiretroviral programs should "heed the frailty and complexity of the human beings they aim to reach," Steinberg writes. He adds, "In particular, for men who have been disabled by shame, treatment needs a new face, one that presents AIDS not as the core of a new political identity but as a chronic illness like any other."

Raising issues such as the possibility that HIV/AIDS is seen by some Africans as an "attack on a man's generative capacity" or a "white conspiracy" is "uncomfortable for two reasons," Steinberg writes. "First, they suggest that helping a continent in need is complicated and difficult," he writes, adding, "Second, asking why sick Africans do not always rush to get treatment requires thinking and speaking about them anthropologically, which brings its own special fear: the fear of patronizing them, of blaming them and their indigenous ways for their illness."

According to Steinberg, no one in the U.S. "has seriously argued that medicine single-handedly" helped control the HIV/AIDS epidemic among men who have sex with men. Before advances in treatment, MSM "entered into a collective dialogue that slowly and painfully re-examined the fundamentals of their identities and sexual practices," according to Steinberg. MSM "were forced to think about themselves anthropologically and to recalibrate their relation to themselves and the world," he writes, adding, "And so it will have to be with Africans."

Steinberg notes that the need to make antiretrovirals universally accessible in Africa is "urgent," but the "odds are stacked against these drugs becoming the harbinger of a wider African redemption." Africa needs "fortification against the comforting Western fantasy" that it "will be saved by science alone," Steinberg writes. He adds that a "great epidemic by its nature assembles people into difficult relations with themselves and one another," concluding, "There is no substitute for working through this terrain. Africans, after all, are as complicated" as white MSM (Steinberg, Los Angeles Times, 3/5).

A kaisernetwork.org interview with Steinberg is available online.

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Federal Requirement for Pledge Against Commercial Sex Work Unclear, Letter to Editor Says

[Mar 05, 2008]

A U.S. policy requiring that recipients of federal HIV/AIDS service grants pledge to oppose commercial sex work puts public health groups working with sex workers "at risk," Daniel Pellegrom, president of Pathfinder International, writes in a Boston Globe letter to the editor. Two groups -- Pathfinder and the Alliance for Open Society International -- are exempt from the pledge following a federal court ruling, according to Pellegrom. He adds that although the lawsuit against the pledge "does not challenge the government's right to restrict the use of public funds," the pledge "forces groups to adopt an organizationwide policy, thereby restricting how organizations use their own private funds." Pathfinder and Open Society "believed this to be in violation of the Constitution," Pellegrom writes, adding that the judge in the federal case "agreed, placing the two organizations under protective order while the case is on appeal."

By requiring organizations to adopt the pledge, the government has "failed to explain exactly what is required," Pellegrom writes, adding that because "needed clarity" is missing, organizations do not "know how to comply with the rules and risk losing funding." Public health policies "based on ideology tie the hands of health workers and leave health care providers vulnerable to political posturing and congressional whim," Pellegrom writes (Pellegrom, Boston Globe, 3/4).

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Economics Among Challenges Blacks Face With HIV/AIDS, Opinion Piece Says

[Mar 05, 2008]

Economic conditions are a "fundamental" challenge that blacks face in terms of HIV/AIDS, Rep. Keith Ellison (D-Minn.) writes in an opinion piece for the Louisiana Weekly. He says, "When the economy sours, those who earn the least typically suffer the most. Unfortunately, those same people are statistically more likely to be suffering, literally, from diseases such as HIV/AIDS."

Ellison notes that the CDC Web site states that people facing tough economic conditions do not always have access to good health care. He adds that such "dilemmas are particularly acute for African-Americans, one in four of whom were living in poverty in 1999."

According to Ellison, the U.S. cannot devote funding to "lift Americans out of poverty or significantly improve health care for those living with HIV/AIDS while [it] spend[s] $10 billion per month on military activities in Iraq." He writes, "The consequence of the federal government's current spending priorities is, regrettably, that poor people can't access high-quality health care and that African-Americans don't encounter enough targeted outreach about HIV/AIDS. I am working to change these priorities."

Other challenges blacks face in dealing with HIV/AIDS include education, incarceration and homophobia, Ellison writes. In addition, he notes that CDC says a "history of racism, oppression and a lack of trust in governmental institutions make it more challenging for public health agencies to effectively reach African-Americans."

Ellison says, "We must take time to get involved in our local communities, urging our friends and families to get tested and get educated about transmission modes of HIV/AIDS. We must continue our efforts to ensure that treatment is accessible to all those who are currently living with HIV. It is essential that we see this crisis in its broader context if we hope to slow the spread of this epidemic in our communities" (Ellison, Louisiana Weekly, 3/3).

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