Kaisernetwork.org (Washington, DC)
1 July 2008
Politics and Policy
Draft G8 Communique Does Not Cite 2010 Deadlines for Development Aid, Universal Access to HIV Prevention, Care
[Jul 01, 2008]
A draft communiqué scheduled to be issued at the Group of Eight industrialized nations summit in July in Hokkaido, Japan, does not cite 2010 targets for universal access to HIV/AIDS prevention, care and treatment or for $25 billion in annual aid to Africa that were set at the 2005 G8 summit in Gleneagles, Scotland, the Financial Times reports. The Gleneagles commitments, which were reiterated at the G8 meeting last year in Germany, were seen as an "important boost" for Africa, according to the Financial Times.
The 2008 draft says that the G8 will continue "working towards the goal of universal access" to HIV/AIDS prevention, treatment and care, as well as commit to fulfilling "our commitments on [development aid] made at Gleneagles," but it but does not specifically mention the target dates, the Financial Times reports. Some diplomats said that the draft, dated June 25, might change, especially if African leaders increase opposition to the language over the next week.
G8 leaders also appear "divided" on how to fulfill a pledge made at the 2007 G8 summit in Heiligendamm, Germany, to provide $60 billion "over the coming years" to bolster health care systems in developing countries and fight HIV/AIDS, tuberculosis and malaria, the Financial Times reports. According to the Financial Times, the pledge is in brackets in the 2008 draft communiqué, indicating that "no agreement has been reached" (Williamson, Financial Times, 6/30).
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Across The Nation
HIV/AIDS Cases Among Adults Ages 50, Older in Georgia Increasing, Health Department Says
[Jul 01, 2008]
New HIV/AIDS diagnoses among adults ages 50 and older in Georgia has nearly doubled in the last 10 years, according to recent data from the state Department of Human Resources' Division of Public Health, the Atlanta Journal-Constitution reports. Georgia recorded 341 new cases of HIV/AIDS in 2007 among people ages 50 and older, compared with 189 cases reported in 1998, according to the Journal-Constitution.
David Rimland -- chief of infectious diseases at the Atlanta VA Medical Center and professor of medicine at Emory University -- said, "What accounts for these numbers is a mixture of patients infected previously who are presenting late in the course of the disease as well as patients with high-risk activities who are getting infected later in life." Rimland said that over the last few years at the Atlanta VA center, which serves a predominantly male population, people ages 50 and older accounted for about two-thirds of new HIV/AIDS cases.
To reduce the spread of HIV among the age group, CDC guidelines recommend HIV screening in individuals up to age 64. The guidelines recommend "opt-out" HIV screening, which means health care providers do not need separate written consent to test for HIV. In Georgia, people must sign a written consent form before they undergo HIV testing, with the exception of pregnant women. According to the Journal-Constitution, seniors are the least likely of all age groups to get tested for HIV.
Teresa Kochinsky-Bell, health program representative for the Fulton County, Ga., Health Department's Communicable Disease Prevention Branch, said that people ages 50 and older might not realize that "unless they ask specifically for the HIV test, they won't get the test done nor will they know their HIV status." Gillian Sanders -- associate professor of medicine at Duke University and author of a recent study that found HIV testing might be cost-effective for people up to age 75 -- said that HIV screening among older people should be increased to reduce stigma and allow HIV-positive individuals to modify their behavior. She added, "Age alone should not be a contraindication for HIV screening" (Lee, Atlanta Journal-Constitution, 6/29).
HIV Cases Among Adults Ages 50, Older in Florida Increasing
In related news, the percentage of new HIV diagnoses that were among people ages 50 and older in Florida increased from 11% of all new diagnoses in 1998 to 15% in 2006, according to data from the state Department of Health, the Orlando Sentinel reports. According to the health department's Bureau of HIV/AIDS, about 20% of people residing in the state who are living with HIV/AIDS do not know their status. In addition, of the 125,000 recorded HIV/AIDS cases, about 26% are older than age 50.
"It's a problem," Marlene LaLota of the Bureau of HIV/AIDS said, adding, "We have an epidemic of HIV in older people in Florida." Debbie Tucci, program coordinator for the Orange County, Fla., Health Department, said that anyone having sex regardless of age needs to be tested for HIV. She added, "It isn't who you're sexually active with, just that you are sexually active." Anthony Chester, a senior health educator at the Stewart-Marchman Center in Volusia County, Fla., said that perceived immunity from HIV is not the only reason seniors are susceptible to HIV transmission, adding that physicians are not doing enough. "A lot of doctors don't want to disrespect elderly people" by asking sensitive questions about their sex lives, Chester said (Hernandez, Orlando Sentinel, 6/27).
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Media & Society
Minnesota Researchers Developing Web Site That Aims To Curb Spread of HIV Among MSM
[Jul 01, 2008]
The Minneapolis Star Tribune on Sunday profiled Sexpulse, a Web site in development at the University of Minnesota School of Public Health that is the latest strategy to curb a "second wave" of HIV/AIDS cases among young men who have sex with men. According to a recent report published Thursday in CDC's Morbidity and Mortality Weekly Report, the number of new HIV diagnoses recorded between 2001 and 2006 among men who have sex with men ages 13 to 24 increased by 12.4% annually.
According to the Star Tribune, Sexpulse is attempting to capitalize on the prevalence of online social sites in an attempt to stop the epidemic. Professor Simon Rosser, along with others at the university, received a $3.5 million federal grant to create a prototype for online HIV intervention specifically for MSM. Rosser has recruited 2,700 men to test the Web site, and results will be available next year, the Star Tribune reports. If his surveys show men who use the site increase their safer-sex practices and return regularly, then the site will go live, and the link and advertisement for it will be posted on MSM social networking sites. "If this is successful, it is huge," Rosser said, adding, "We can flick a switch and make it available to every gay man in the world."
According to the Star Tribune, some experts debate whether the Internet is driving risky sexual behavior among MSM. Rosser and Gary Remafedi, an expert on adolescent health and HIV at the university, recently published a study comparing behavior of men who find partners on the Internet with those who find them in bars or elsewhere and with those who do both. The study found the Internet alone did not increase sexual behavior, but MSM who use both outlets were more likely to engage in risky sexual behaviors, Rosser said. He added that the Internet appears to be having an indirect effect -- the number of cases might be rising in part because the Internet increases the sheer number of sexual encounters by MSM. Remafedi said, "The technology is not the problem. But it may be the solution. Millions of people are using the Internet to meet partners, so it's a wonderful venue to intervene."
Michael Allen, CEO of Allen Interactions, is working with Rosser and other experts at the university to build the site. "A lot of health education Web sites are ... constantly trying to scare you or tell you how bad things are," Allen said, adding that Sexpulse is different because it is fun, funny and designed to change behavior through both education and boosting self-esteem (Marcotty, Minneapolis Star Tribune, 6/29).
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Product RED To Begin Digital Music Service To Fight HIV/AIDS in Africa
[Jul 01, 2008]
Product RED on Monday announced that it is launching a digital music service that will give half of the money collected from a $5 per month user fee to the Global Fund To Fight AIDS, Tuberculosis and Malaria, the New York Times reports. The other half of the monthly fees will go to artists who contribute songs and their record companies.
Through the service, which is scheduled to begin in September, customers will receive three new pieces of exclusive content weekly. According to the Times, two songs will be delivered in an MP3 format, one from a well-known act and another from a less-established artist. The third piece will be a "crackerjack surprise," such as a song, video or short story, the Times reports. The venture has arranged to release new songs from U2, Bob Dylan, Elvis Costello, Elton John, Emmylou Harris and Death Cab for Cutie.
Don MacKinnon, RED's president for content, who previously has put together music products for Starbucks, said, "The idea, then as now, is music discovery," adding, "People want someone to send them music from artists they love as well as acts that are emerging." Irish musician and HIV/AIDS advocate Bono, who co-founded RED, said, "I have no doubt that some of the music software we are working on at RED will help change the way music is received, as well as changing the lives of Africans who will die without the AIDS drugs that RED can provide." RED's music software will deliver updates on how the organization's money is being used in Africa, and will encourage customers to share the service with friends and colleagues.
Some critics of RED have said it does not direct enough of the profits from its products to HIV/AIDS relief in comparison to the amount of money companies spend promoting their RED products. The organization's approach is to find businesses that can finance HIV/AIDS treatment in a sustainable way, and a subscription music service that generates steady revenue would fit that approach, according to the Times (Levine, New York Times, 6/30).
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Drug Access
Indian Generic Drug Companies, HIV/AIDS Advocacy Group File Opposition to Patent of Roche's Antiretroviral Valganciclovir
[Jul 01, 2008]
Indian generic pharmaceutical companies Cipla and Matrix Laboratories and the HIV/AIDS advocacy group Delhi Network of Positive People, or DNP+, recently filed an objection to an Indian patent office's decision to give a patent to Roche's antiretroviral valganciclovir, which helps prevent blindness in HIV-positive people, TopNews reports (Diwan, TopNews, 6/28).
The Chennai, India, patent office granted the patent last year without hearing arguments against the patent from DNP+ and another group that filed pre-grant opposition to the patent, according to the Economic Times. The groups claim that the patent is a new form of an existing drug and that Roche has not shown the new version has improved efficacy. In addition, DNP+ is arguing that many patents approved by the Chennai patent office have been rejected in the U.S., which is considered to have more liberal patent laws, according to the Times.
The Chennai patent gives Roche exclusive rights to market the drug in India for the next two decades. Roche currently sells the drug for 270,000 Indian rupees, or about $6,300, for a full course of treatment in the country. DNP+ and other groups have said the high cost is preventing thousands of people living with HIV/AIDS in India from receiving treatment.
Loon Gangte, president of DNP+, said thousands of HIV-positive people are "unnecessarily losing their vision and their livelihoods simply because the treatment is too expensive" (Economic Times, 6/28).
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Global Challenges
Bill Gates Announces $23 Million Foundation Grant for HIV/AIDS in India
[Jul 01, 2008]
Bill Gates on Friday announced that the Bill & Melinda Gates Foundation has approved a three-year, $23 million grant to India's National AIDS Control Organisation to fight HIV/AIDS in the country, the Times of India reports. According to the Times, Gates made the announcement after meeting with Union Health Minister Anbumani Ramadoss in Seattle.
The Times reports that Gates has appreciated the efforts made by Ramadoss to improve the health sector in India, as well as the effective implementation of the National Rural Health Mission. The Bill & Melinda Gates Foundation has already approved a five-year $58 million grant for its Avahan program, which also fights HIV/AIDS in India (Times of India, 6/27).
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Miami Herald Examines African HIV/AIDS Groups' Efforts To Fight Disease
[Jul 01, 2008]
The Miami Herald on Sunday examined efforts of HIV/AIDS advocates and organizations to wage a sometimes "lonely fight" in combating epidemics in African countries where they receive little support. According to the Herald, many organizations continue to criticize some African governments for failing to devote the necessary time and energy to prevent their populations from contracting HIV/AIDS, as well as treating those who are HIV-positive.
In Zimbabwe, a long-running political feud between President Robert Mugabe and opposition politicians has been a barrier to better care for those living with HIV/AIDS, the Herald reports. Farai Mahaso -- an officer with the HIV/AIDS support group Batanai, whose mother, Auxillia Chimusoro, was the first person in Zimbabwe to publicly declare her HIV-positive status in 1989 -- said many physicians and nurses have fled the country because of fear of political violence and intimidation. "A lot of good personnel leave to go to rich countries," Mahaso said, adding, "We train people, then they leave. I feel the government could do a lot more to help."
According to the Herald, some African leaders are beginning to "get the message." At the recent United Nations 2008 High Level Meeting on AIDS, several presidents pledged to more aggressively fight the disease in their countries. Togo President Faure Gnassingbé said that his country, which has missed two rounds of international funding, needs aid to scale up its efforts to fight HIV/AIDS. Gnassingbé said that he was concerned about how the stigma of HIV/AIDS affects the nation's HIV-positive population and that "[w]e should not add moral suffering to the physical suffering that those with the virus are already suffering."
Mahaso has established international partnerships and is operating centers throughout Zimbabwe that provide counseling and medical supplies through funding from the U.S. and other countries. Mahaso added that his organization in the future plans to open more counseling centers to keep up with the need. According to a U.N. report, about 25 million people are living with HIV/AIDS in sub-Saharan Africa, which is 64% of the world's entire HIV-positive population (Yearwood, Miami Herald, 6/29).
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Opinion
White House, GOP Leadership Must Take 'Lead' in Convincing Senators To Drop PEPFAR Reauthorization Objections, Editorial Says
[Jul 01, 2008]
The White House and Republican leadership must "take the lead" in convincing Sen. Jim DeMint (R-S.C.) and other Republican senators to "change their minds" about holding up the proposed five-year extension of the President's Emergency Plan for AIDS Relief, a Washington Post editorial says.
The Post says that the reauthorization measure (S 2731) was originally blocked by a group of seven senators led by Sen. Tom Coburn (R-Okla.), who objected that the measure would continue a requirement that 55% of PEPFAR money go to treating people with HIV/AIDS, instead of being spent to prevent new infections and for other purposes. Coburn dropped his objections after senators reached a compromise that more than half of U.S. bilateral aid would go to medical care -- "but care is defined expansively," according to the Post.
DeMint and some other senators in the group continued to express concern about the bill's authorization of $50 billion over five years for PEPFAR, blocking unanimous consent to let the bill proceed to the Senate floor, the editorial says. According to the Post, the measure is a "vast expansion" over the $15 billion originally allocated for the initiative and more than the $30 billion President Bush requested for reauthorization, but "this is not a case of throwing good money after bad." Since the program began in 2003, it has provided HIV testing and counseling for more than 33 million people and care for more than 6.6 million, the editorial says, adding that the reauthorization measure would allocate about $13 billion of the $50 billion to fight tuberculosis and malaria.
Increasing PEFPAR funding "would beef up one of the wisest investments the United States has ever made -- in humanitarian terms and in terms of our nation's image abroad," the editorial says, adding that if the White House and Republican leadership "fail" to persuade DeMint and others to drop their objections, Senate Majority Leader Harry Reid (D-Nev.) "simply must find the time to pass PEPFAR, even if it means a longer process than he and his colleagues would like," the editorial says. The Post concludes, "If the price of saving lives is a few lost vacation days for Congress, we say: Pay it" (Washington Post, 7/1).
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