Politics and Policy

Archbishop Tutu, AIDS Advocates Call on Senate To Pass PEPFAR Reauthorization Legislation

[Jun 19, 2008]

South African Archbishop Desmond Tutu joined other HIV/AIDS advocates Wednesday on a conference call organized by the Global AIDS Alliance and called on the Senate to vote on measures (HR 5501, S 2731) that would reauthorize the President's Emergency Plan for AIDS Relief, Reuters reports. According to Reuters, seven Republican senators, led by Sen. Tom Coburn (R-Okla.), are blocking a vote on the measures (Reuters, 6/18).

The Senate version of the PEPFAR reauthorization bill passed the Foreign Relations Committee in March, and the House version was approved 308-116 in April. Both the Senate and House versions of the bill would reauthorize PEPFAR at $50 billion over five years. However, Coburn and six other Republican senators are blocking the legislation because they are opposed to the legislation's cost and "mission creep" into health and development efforts. In addition, they want language inserted into the measure that would guarantee that 55% of PEPFAR funding goes toward treatment, including antiretroviral drugs. Some advocates have said that they would agree to the treatment language but that efforts to compromise with Coburn have been ineffective (Kaiser Daily HIV/AIDS Report, 6/16). Coburn declined to comment Wednesday, the Tulsa World reports.

Speaking on a conference call Wednesday, Tutu called on the Senate to make "God's world a better place" and to speed the passage of the legislation (Myers, Tulsa World, 6/19). PEPFAR has "already saved millions of lives, and the new legislation has the potential for sustaining a response to build on all of the gains that have already been achieved," Tutu said. He added, "I plead to the leaders, the members of Congress -- please, please, for the sake of the world, for the sake of the future, expedite the passing of the relevant legislation." Tutu earlier this month also wrote letters to Senate leaders expressing his concerns about the impasse (Reuters, 6/18). Annette Tillemann-Dick -- daughter of the late Rep. Tom Lantos (D-Calif.), who, along with late Rep. Henry Hyde (R-Ill.), created draft legislation to reauthorize PEPFAR -- said Senate leaders should push the bill to a floor vote as soon as possible to save millions of lives in Africa and in other parts of the world. She added, "This bill really is an opportunity for the good people of America to do something valuable" (Oremus, San Jose Mercury News, 6/19).

Paul Zeitz, head of the Global AIDS Alliance, said, "Negotiations are underway now." He added that presumptive Republican presidential nominee Sen. John McCain (Ariz.) could play a key role in breaking the impasse. "It's in the interests of the United States and the Democratic Congress that [President] Bush go to" the Group of Eight industrialized nations summit in Japan next month "with this legislation in hand," Zeitz said. Joanne Carter, associate executive director of RESULTS, said, "Passing this bill will be a signal to the (G8) countries that the U.S. is fully committed and that they should also move forward boldly with their own commitments" (Lobe, Inter Press Service, 6/18).

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Advocates Bono, Geldof Call on G8 To Fulfill Aid Pledges

[Jun 19, 2008]

Irish musicians and development advocates Bono and Bob Geldof on Wednesday criticized the Group of Eight industrialized nations for falling behind on their aid pledges to Africa, AFP/Google.com reports. Bono and Geldof also urged France, the next European Union president, to end the "disgrace." The two advocates, who were joined by tennis player Yannick Noah and singer Angelique Kidjo, also said that a 2005 G8 pledge to deliver increased aid to Africa by 2010 is currently only 14% fulfilled.

"It's a terrible disgrace that the rich world has failed so miserably," Geldof said, adding, "It is a disgrace that the lucky part of the world give a small fraction of its wealth to poor who live just 12 kilometers away," referring to the smallest distance between Europe and Africa. Referring to Africa's 6% annual growth rate, Bono said that the continent is "going to take off." He added, "We are their neighbors, we should be their partners. If we fail, we have no right to that special relationship."

Bono and Geldof also said that France, which reduced its aid to Africa last year and is set to take on the E.U. presidency next month, has a special role to play in ensuring that pledges are realized and should appropriate money to the continent. French President Nicolas Sarkozy "could be a great help to us" during the six-month E.U. presidency term, Bono said. He added, "European credibility is on the line."

However, Bono and Geldof said that aid reaching the world's lowest-income countries has been effective on the ground. According to Michel Kazatchkine -- executive director of the Global Fund To Fight AIDS, Tuberculosis and Malaria -- the lives of about 100,000 Africans are being saved monthly through programs assisted by the Global Fund. Increased assistance also has provided access to antiretroviral drugs to more than two million Africans, compared with 50,000 five years ago.

According to Bono, Britain and the U.S. are on course to meet their G8 commitments, and Germany has taken steps to meets its pledges. He also said that France needs to increase its flow of aid "in the next few weeks so we can say we have at least half of the G8 on course," adding, "Aid is a necessary foundation for the building blocks of the 21st century" (Rosemberg, AFP/Google.com, 6/18).

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Global Challenges

Zimbabwe Lifts Ban on Groups Providing HIV/AIDS, Food Services

[Jun 19, 2008]

Zimbabwe has lifted the suspension of field work for nongovernmental organizations involved in HIV/AIDS and supplementary feeding services, The Herald/AllAfrica.com reports. In a letter sent to the NGOs on Friday, Sydney Mhishi -- acting secretary for Public Service, Labor and Social Welfare -- said that the provision of antiretroviral drugs and food supplies is not affected by the recent suspension because such activities do not constitute community mobilization (The Herald/AllAfrica.com, 6/18).

The government earlier this month suspended all field work after accusing NGOs of siding with opposition leader Morgan Tsvangirai of the Movement for Democratic Change ahead of the election. Tsvangirai defeated President Robert Mugabe in the first round of the election. Zimbabwe's Social Welfare Minister Nicholas Goche said the government ordered NGOs to suspend their work because they were violating the terms of their agreement with the government. Zimbabwe's National Association of Nongovernmental Organizations said that the government's order would particularly endanger people living with HIV/AIDS (Kaiser Daily HIV/AIDS Report, 6/10).

"The suspension does not prohibit those on [antiretroviral] therapy and those benefiting from home-based care programs to continue accessing drugs and therapeutic feeding from clinics and hospitals," Mhishi said, adding, "Supplementary feeding is a community-based program which does not entail community mobilization by NGOs; hence, it falls outside those affected by the suspension."

The letter was sent after the government met with NGOs last Thursday to clarify the definition of field operations, as well as to discuss the reasons for and duration of the suspension (The Herald/AllAfrica.com, 6/18). Mugabe also met recently with United Nations officials to evaluate the political situation ahead of the run-off election (AFP/Google.com, 6/18). According to Mhishi, other suspended NGOs will be permitted to resume operations when investigations are completed.

NANGO Communications Manager Fambai Ngirande welcomed the announcement and said he hopes that the lifting of the suspension will be extended to all NGOs. More than 400 NGOs are involved in HIV/AIDS work in the country, according to The Herald/AllAfrica.com (The Herald/AllAfrica.com, 6/18).

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Ireland Announces New Plan To Provide No-Cost Condoms To Reduce Spread of HIV

[Jun 19, 2008]

Mary Wallace, Ireland's Minister of State, on Tuesday announced a new national action plan to reduce the spread of HIV/AIDS that includes providing no-cost condoms to at-risk groups at targeted health settings, the Irish Times reports. The plan also recommends major HIV/AIDS education and awareness campaigns to prevent complacency and to provide accurate information to the public. According to figures reported last week by the Health Protection Surveillance Centre, Ireland saw a 7% increase in newly diagnosed HIV cases in 2007, compared with the previous year. In 2007, there were 362 newly diagnosed cases of HIV reported, compared with 337 in 2006 and 318 in 2005, the Times reports.

The HIV and AIDS Education and Prevention Plan 2008-2012 was developed over 18 months using a national consultation that aimed to identify priorities and gaps in the fight against the disease, as well as areas for action over the next four years. According to the Times, the plan places a high priority on encouraging HIV testing among all groups that are at risk of HIV transmission. It also underlines the role of civil society groups in spreading awareness within communities, the Times reports.

"HIV is a preventable disease, and this plan gives clear guidance on how the Irish system should progress its prevention efforts," Wallace said during the launch of the report. Mary O'Shea, director of the Dublin AIDS Alliance, said, "We endorse the plan's findings that HIV prevention programs must be a sufficient scale and intensity to be effective and that primary care and other community settings should increase the availability of HIV and sexually transmitted infection screening and testing." She added that HIV/AIDS services should be adequately resourced and ranked higher on the list of health priorities. O'Shea also called for the full removal of value added tax on condoms (O'Brien, Irish Times, 6/18).

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Across The Nation

Alaska Has Low Rates of HIV, High Rates of Other STIs, Health Department Says

[Jun 19, 2008]

Alaska ranks first or second nationwide in the number of chlamydia cases but relatively low in the number of HIV/AIDS cases, according to new data from the Alaska Division of Public Health, the AP/Juneau Empire reports.

The state ranked 25th nationwide in gonorrhea cases and 28th in syphilis cases, but HIV prevalence remains low, according to the report. Although chlamydia typically facilitates HIV transmission, it is unclear whether that is the case in Alaska because the state has a high rate of chlamydia but low HIV prevalence, according to Mollie Rosier, manager of the Section of Epidemiology's HIV/STD program. There is no answer as to why the state has such high rates of chlamydia and gonorrhea, Donna Cerere, who worked on the report, said. She added that it could be because of more sensitive tests.

Alaska reported 4,911 chlamydia cases in 2007, an 8% increase from 2006, according to the report. The state reported 1,206 HIV cases from 1982 to 2007. Thirty-seven HIV cases were newly diagnosed in 2007. Of the new cases, 81% were among men and 58% were among whites. Most HIV cases were recorded among men who have sex with men, although some cases were contracted through heterosexual sex or injection drug use. Rosier said the state has low HIV prevalence and "would like to stay that way" (AP/Juneau Empire, 6/17).

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Opinion

Involvement of Churches, Condom Use Necessary To Fight HIV/AIDS, Opinion Piece Says

[Jun 19, 2008]

HIV/AIDS is "not only a disease" but also a "complex social problem that has considerable impact on development in affected countries," Guenter Apsel, a retired Lutheran minister, writes in an Orlando Sentinel opinion piece in response to a recent piece by Thomas Wenski, chair of the Committee on International Justice and Peace of the U.S. Conference of Catholic Bishops. According to Apsel, "[H]uge efforts are necessary to overcome" the HIV/AIDS pandemic -- "huge efforts not only by governments but also ... by churches."

Many churches have "now recognized that -- as the result of taboos, stigma and denial -- they have exacerbated" HIV/AIDS, Apsel writes. He adds that during the past few years, "churches have begun new efforts with positive new approaches toward undergoing self-critical reflection and overcoming stigma." However, some churches continue to argue that supporting condom use is "morally unacceptable," according to Apsel. If the highest priority of HIV/AIDS prevention efforts is to save lives, programs that stress abstinence and fidelity "will not be sufficient," Apsel writes, adding, "One must add condom use. Otherwise, you put a doctrine above the goal to 'save lives.'" Apsel concludes, "No misunderstanding, please: 'Use condoms' is not the solution, but it is a way of prevention. The broader approach to this problem must include education, responsibility and much more" (Apsel, Orlando Sentinel, 6/18).

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Recent Releases

MMWR Report Examines False-Positive Oral Fluid Rapid HIV Tests

[Jun 19, 2008]

"False-Positive Oral Fluid Rapid HIV Tests --- New York City, 2005--2008," Morbidity and Mortality Weekly Report: MMWR examines recent increase in the number of false-positive HIV test results in oral fluid testing with OraSure Technologies' OraQuick Advance Rapid HIV-1/2 Antibody Test in the New York City Department of Health and Mental Hygiene's 10 sexually transmitted infection clinics. MMWR reviews the two times these increases have been identified in New York City and how officials there responded. According to the report, the reason "for the episodic increases in false-positive oral fluid tests has not yet been determined." Currently, the health department has suspended the use of oral fluid testing in the STI clinics, and finger-stick whole-blood testing is the only rapid HIV test being used. These "findings underscore the importance of confirming all reactive HIV tests, both from oral fluid and whole-blood specimens," according to MMWR. The findings also indicate that the health department "strategy of following up reactive oral fluid test results with an immediate finger-stick whole-blood test reduced the number of apparent false-positive oral fluid test results and might be a useful strategy in other settings and locations," the report says. The report also notes that "CDC continues to encourage the use of rapid HIV tests because they increase the number of persons who are tested and who receive their test results" (MMWR, 6/18).

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