Kaisernetwork.org (Washington, DC)
17 April 2008
Global Challenges
African Countries Have Made Least Progress in Reducing Infant, Maternal Deaths, Report Says
[Apr 17, 2008]
Some countries in Africa have made the least progress among developing nations worldwide toward reaching targets in the United Nations Millennium Development Goal of reducing infant and maternal deaths, according to a report released on Wednesday, Reuters reports (Roelf, Reuters, 4/16). The report was released by the Partnership for Maternal, Newborn and Child Health, which includes about 240 members such as UNICEF, the World Health Organization and Save the Children (SAPA/Independent Online, 4/16). The report found that the 10 countries with the worst infant mortality rates are in sub-Saharan Africa, which is highly affected by HIV/AIDS, according to UNICEF Chief of Health Peter Salama. "Many of these countries where under-five mortality has actually increased since 1990 are high HIV prevalence countries ... such as Botswana, Swaziland, Zimbabwe, Lesotho and South Africa," Salama said.
The report calls for an additional $10 billion to improve health interventions and reduce mortality rates. About 10 million women and children die annually from preventable causes, and major challenges include poor nutrition, weak health infrastructures and a lack of funds. Many of the countries that made little or no progress on infant and maternal deaths are experiencing health care worker shortages, according to Reuters. Countries that have made progress took steps such as bolstering vaccine programs and distributing more vitamin supplements and insecticide-treated nets (Reuters, 4/16).
The report is available online.
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Relatives of Detained Chinese HIV-Positive Protesters Appeal for Their Release
[Apr 17, 2008]
The relatives of a group of HIV-positive people on Wednesday in Beijing appealed to police to release the group, which was detained after protesting in front of Chinese Premier Wen Jiabao, Reuters reports (Blanchard, Reuters, 4/16).
On April 5, Chinese police allegedly beat, shocked and detained 11 HIV-positive protesters from the Shahe province who were hoping to attract Wen's attention about their efforts to be compensated by a hospital where they allegedly contracted HIV through tainted blood in the mid-1990s, according to Beijing-based HIV advocate Wan Yanhai of the Aizhixing Institute. The protesters also were sprayed in the face with a substance that caused them to become unconscious, Wan said. They were then taken to a hospital and detained.
Wang Weijun, a friend of the protesters, said three women later were released after they agreed to drop their complaint against the government and not discuss the incident. The other protesters -- six men and two women -- did not agree to the conditions, Wang said.
According to Wan, the Shahe local court has refused to accept the group's case against the hospital, and the local government has not supported them despite making a pledge to do so. Although the Chinese government has acknowledged responsibility for HIV cases that were transmitted through tainted blood, many HIV-positive people who contracted the virus through blood transfusions have had difficulty receiving compensation (Kaiser Daily HIV/AIDS Report, 4/14).
A relative of one of the detained HIV-positive people, who asked to remain anonymous, said, "Our husbands have been detained, so how can we live?" She added, "We have come to Beijing to use the law to find out what happened to them." In response to repeated calls, police and government officials in Shahe have said that they are not familiar with the case or that it is not within their jurisdiction.
The detainees' lawyer Jiang Tianyong said police told him the case was a matter of national security, and they have refused to say what happened to the protesters or what charges could be brought against them. The protesters "just went hoping to meet Wen," Jiang said, adding, "They heard he was a person who cared about the people's suffering. We hope their husbands can be released as soon as possible" (Reuters, 4/16).
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Workplace Attitudes Toward HIV/AIDS, Acceptance of Condoms Improving, ILO Report Finds
[Apr 17, 2008]
Workplace attitudes toward people living with HIV/AIDS, and acceptance of condom use and other preventive measures have increased in some countries as a result of HIV policies and practices, according to a report by the International Labour Organization, the U.N. News Service reports (U.N. News Service, 4/15). The report, titled "Saving Lives, Protecting Jobs," was prepared by the ILO Programme on HIV/AIDS in the World of Work and presented Monday to the U.S. Department of Labor, which is the funding partner in the Strategic HIV/AIDS Responses in Enterprises, or SHARE, project, Occupational Health Safety reports.
The report tracked changes in attitudes related to HIV/AIDS and looked at data collected from the ministries of labor, and employers and employees from workplaces in six SHARE pilot countries, including Belize, Benin, Cambodia, Ghana, Guyana and Togo. According to the report, in all six countries, the proportion of workers who reported supportive attitudes toward co-workers living with HIV/AIDS increased on average from 49% in 2003 to 63% (Occupational Health Safety, 4/15). Attitudes toward condom use also improved in the six countries. The percentage of workers who reported using condoms with nonregular partners increased from 74% in 2003 to 84%, the report found. The recorded changes in behavior could be attributed partly to the increased access to HIV services in the workplaces in all six countries, the report noted (U.N. News Service, 4/15). According to an ILO release, the report also found that in 2003 when SHARE started, only 14% of the participating workplaces in the six pilot countries had codified HIV policies. The report found that 76% of the participating enterprises now have written policies.
ILO's SHARE project is active in more than 650 workplaces in 24 countries and covers about one million workers. Of the 24 countries, 16 have adopted a national policy or declaration on HIV. Sophia Kisting, director of ILO's Programme on HIV/AIDS in the World of Work, said the program "helps to protect the ILO's constituents from HIV, which challenges the implementation of its decent work agenda." She added, "Several countries offer outstanding examples of how they address HIV/AIDS using the workplace for prevention, care and support and tackle stigma and discrimination." The report also indicates that employers' and workers' organizations are using ILO's Code of Practice on HIV/AIDS to develop policies and practices for the workplace, according to the release (ILO release, 4/14).
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Politics and Policy
House Passes Bill That Would Expand Debt Relief Plan by 25 Developing Countries
[Apr 17, 2008]
The House on Wednesday voted 285-132 to approve a bill (HR 2634) that would expand the list of poor countries eligible for debt relief by 25 nations, the AP/Google.com reports. The bill, sponsored by Rep. Maxine Waters (D-Calif.), would require the Bush administration to initiate talks with international financial institutions, such as the World Bank, to establish an agreement allowing new countries to receive debt relief. To be eligible for debt relief, countries must commit to reducing poverty, practicing good governance, holding free elections, fighting corruption and denouncing terrorism and human rights violations, the AP/Google.com reports (Abrams, AP/Google.com, 4/16).
Leaders from the Group of Eight industrialized nations in July 2005 at the close of their summit in Gleneagles, Scotland, agreed to an immediate doubling of aid to Africa to $50 billion annually in order to fight poverty and disease on the continent. The final summit communique officially endorsed a debt relief plan, which canceled at least $40 billion in debt owed by the world's 18 poorest nations. The communique also included an agreement on providing universal access to HIV/AIDS treatment, according to former British Prime Minister Tony Blair (Kaiser Daily HIV/AIDS Report, 6/7/07).
Since 1996, more than 30 countries have received some form of debt relief equal to about $80 billion under the Heavily Indebted Poor Countries Initiative. Waters said that under the program, Uganda has been able to allocate $58 million from debt repayments to address electricity shortages, malaria and water contamination. She added that Zambia has diverted $24 million to eliminate fees for health care in rural areas under the program. "Tragically, many other countries are still starving their children in order to pay their debts," Waters said. The measure still requires Congress to approve agreements to cancel the debts of individual countries, the AP/Google.com reports.
The countries designated in the bill owe about $24 billion to the World Bank, $2 billion to the International Monetary Fund and $11 billion to the African Development Bank and Asian Development Bank. The measure also includes a nonbinding resolution that says the U.S. should pay $600 million it owes to multilateral development banks. An amendment that was included in the bill and advocated by Republican lawmakers would prohibit debt relief to countries that conduct business with Iran.
Reaction, Comments
The White House in a statement said it does not support the bill because some of the countries covered are managing their debts or are actively working toward expanded access to international capital markets. "Providing debt relief to countries that can service their debt sends the wrong message," the statement said. The Bush administration also expressed concerns over the cost of forgiving debt, which is estimated to be about $1 billion over nine years.
Rep. Spencer Bachus (R-Ala.), the ranking member of the House Finance Committee, said the new round of debt relief would cost every U.S. resident about $2. Debt relief "is dollar for dollar the most effective program in assuring our national security," Bachus said, adding, "We cannot just simply watch as these countries slip into chaos and discord." House Speaker Nancy Pelosi (D-Calif.) said debt relief could eliminate "some of the factors that contribute to the fury of despair that leads to violence that makes the world less safe." Bishop Thomas Wenski of the U.S. Conference of Catholic Bishops in a letter to lawmakers said the bill "represents a major new step" toward making debt cancellation a reality for almost all heavily impoverished countries (AP/Google.com, 4/16).
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Across The Nation
Minnesota Reports 325 New HIV/AIDS Diagnoses in 2007, Health Department Report Says
[Apr 17, 2008]
There were 325 new HIV/AIDS cases diagnosed in Minnesota in 2007, up from 318 in 2006 and 304 in 2005, according to a report released Tuesday by the Minnesota Department of Health, the AP/Rochester Post-Bulletin reports (AP/Rochester Post-Bulletin, 3/15). The increase represents the highest annual increase since the mid-1990s, according to Peter Carr, director of the STD and HIV Section at MDH (MDH release, 4/15).
According to the report, 8,504 Minnesota residents have been diagnosed with HIV/AIDS since 1982 when MDH began tracking the disease, including 2,912 people who have died of AIDS-related causes. Men accounted for 249 of the new diagnosed cases in 2007. Among the men, 52% were white, 32% black, 13% Hispanic and 3% were other races.
Diagnosed cases among black U.S.-born men in Minnesota increased 42% from 36 cases in 2006 to 54 in 2007, while diagnosed cases among black African-born men increased 33% from 18 to 24. Among white men, new diagnosed cases increased from 125 in 2006 to 129 in 2007, and diagnosed cases among Hispanic men decreased from 37 to 33, the report found. The report also found the number of new diagnosed cases among males ages 13 to 24 more than doubled from 18 in 2001 to 38 in 2007 (Wolfe, Minneapolis Star Tribune, 4/15). According to the report, 56% of new diagnosed cases in men were among men who have sex with men (MDH release, 4/15).
Of the 76 women diagnosed with HIV/AIDS last year, 26% were white, 54% black, 9% Hispanic, 7% American Indian and 4% were other races, the report found. According to the report, the number of new HIV/AIDS cases is increasing among minority communities, particularly among African immigrants. HIV prevalence was 13 times higher among U.S.-born blacks than among whites, 28 times higher among African-born blacks and eight times higher among Hispanics. The report said the disparities could be because of less education, access to health care, higher poverty, racism and greater drug use (Minneapolis Star Tribune, 4/15).
In addition, the report found that about one-third of people diagnosed with HIV/AIDS in the state last year were "late testers," meaning they had already progressed to AIDS or were diagnosed with AIDS soon after receiving an HIV test. About half of Hispanics were considered late testers, the highest percentage among all groups, the report said.
Carr said the higher prevalence among minorities "may indicate" that the health department is "not reaching all communities equally with our prevention messages and programs." He added that it also could "mean that people are not being tested early enough in their infection to help stop" further transmission of the virus (MDH release, 4/15).
The report is available online.
St. Paul Pioneer Press Examines 'Emerging Challenge' of Supporting Long-Term HIV/AIDS Survivors
In related news, the St. Paul Pioneer Press on Tuesday examined the "emerging challenge" in providing support services for long-term survivors of HIV/AIDS. According to the Pioneer Press, the percentage of HIV-positive people in Minnesota who are ages 50 or older increased from 16% in 2002 to 25% in 2007.
"We need to continually reinforce safe sex and the importance of not transmitting this virus further," Lorraine Teel of the Minnesota AIDS Project said, adding, "The challenge of maintaining 100% perfect behavior over a lifetime is very difficult." Luisa Pessoa-Brandao of MDH's STD and HIV Section, said that public health officials also are concerned that people have "become complacent" about HIV/AIDS as treatment and survival rates have improved. Pessoa-Brandao said state officials are seeking new ways of bringing attention to the epidemic and are encouraging routine HIV testing (Olson, St. Paul Pioneer Press, 4/15).
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Opinion
Conservative Senators Should Not 'Drag Their Feet' on PEPFAR Reauthorization, Opinion Piece Says
[Apr 17, 2008]
Conservative Senate Republicans should not "drag their feet and jeopardize" the reauthorization of the President's Plan for Emergency AIDS Relief during the current congressional session, former Sen. Rick Santorum (R-Pa.) writes in a Politico opinion piece, adding, "Delay is not the friend of those suffering abroad or ... of our own nation's health."
Although some lawmakers "balk" at the $50 billion price tag in the PEPFAR reauthorization bills (HR 5501, S 2731), authorizing funding for the program might be "some of the best money Congress can spend," Santorum writes. He adds, "It not only addresses a grave humanitarian crisis, it helps protect our nation" by creating "global goodwill."
Some senators also are concerned with the reauthorization's "focus on social policy," and it is "regrettable" that the new proposal lacks some provisions that protected abstinence funding, according to Santorum. However, he writes that the reauthorization measure actually "strengthens" PEPFAR's so-called "conscience clause," which ensures that groups would not be required to provide HIV/AIDS services they object to for moral or religious reasons. The proposal also maintains provisions that PEPFAR recipients pledge opposition to commercial sex work and excludes language that could possibly allow the use of funds for family planning services, according to Santorum.
PEPFAR "shows the world our heart and that America is a blessing to the oppressed and suffering across the globe," and it "needs reauthorizing now," he concludes (Santorum, Politico, 4/15).
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