Kaisernetwork.org (Washington, DC)
22 July 2008
Election 2008
Presidential Candidates McCain, Obama To Attend Forum at Saddleback Church
[Jul 22, 2008]
Presumptive presidential nominees Sens. John McCain (R-Ariz.) and Barack Obama (D-Ill.) have agreed to attend a forum at Saddleback Church in Lake Forest, Calif., on Aug. 16, the New York Times reports. According to the Times, the candidates will appear together for the first time since presidential campaign efforts began. The Rev. Rick Warren, who called the candidates personally to invite them to the forum, said that the event will focus on how they make decisions and on some of Warren's main focus areas, such as HIV/AIDS, poverty and the environment (Rutenberg, New York Times, 7/21).
Warren said that at the request of McCain and Obama, the forum will be held in a nondebate format and open to all media, although only Warren will ask questions. The candidates will appear briefly together before each one takes questions from Warren for an hour, according to the AP/Contra Costa Times. "While I know both men as friends, and they recognize I will be frank, but fair, they also know I will be raising questions in ... four areas beyond what political reporters typically ask," Warren said, adding, "This includes pressing issues that are bridging divides in our nation, such as poverty, HIV/AIDS, climate and human rights" (AP/Contra Costa Times, 7/21). According to Warren, he will develop his questions with feedback from the Muslim, Jewish and Christian leaders associated with the group (New York Times, 7/21).
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Global Challenges
Use of Methadone To Curb Rising Injection Drug Use, Spread of HIV in Russia Examined at Conference
[Jul 22, 2008]
Faced with a "steady increase" in injection drug use that is cited as the leading cause of the spread of HIV/AIDS in Russia, a meeting of physicians and specialists was held in the country in February to discuss the use of methadone in treating injection drug users, which number between three million and six million in Russia, the New York Times reports. Although injection drug use is "widely linked" to the country's HIV/AIDS epidemic, "the issue of methadone treatment is all but taboo" in Russia, according to the Times.
Injection drug use in Russia accounted for about 66% of new HIV/AIDS cases in 2006, and the numbers continue to grow, though not as quickly as in the past, according to UNAIDS. The Russian government estimated that as of 2007, more than 400,000 people in the country were HIV-positive, out of a population of about 142 million. The United Nations' estimated in 2005 that 940,000 were living with HIV in the country. The Times reports that although methadone is central to a therapy endorsed by the United Nations and 55 other countries to treat IDUs, there is considerable opposition to the treatment in Russia. Some opponents argue that methadone keeps patients in lifelong addiction, while others say that Western countries push the treatment on Russia for commercial profit. There also are fears that methadone could enter the black market, because there is a considerable amount of corruption at many clinics throughout the country, according to the Times.
At the conference, Gennady Onishchenko, Russia's chief sanitary physician, said health officials "are not convinced" that methadone "is effective," adding, "There is little optimism for legalizing methadone therapy in the near future." Nikolai Ivanets -- the country's top narcotics specialist, who criticized the professional credentials of some conference participants -- said, "Everyone has become so annoyed with methadone, with the exception of a few groups of people who call themselves specialists." Ivanets added, "This is a group of dissenters." Vladimir Mendelevich -- director of the Institute for Research Into Psychological Health and organizer of the conference who supports methadone use -- said, "There is no possibility to have a normal discussion about this issue."
According to the Times, some Russian specialists, along with current and former IDUs, "have begun to challenge the official line." Evgeny Krupitsky, head of a laboratory that conducts research on drug addiction at St. Petersburg State Pavlov Medical University, said, "Scientific arguments, evidence-based data, are not convincing" opponents of methadone. Russian methodology regarding opiate addiction "is not evidence-based," but relies on "subjective opinions of major leaders in the field," Krupitsky added. Although not all IDUs would benefit from methadone treatment, more than 60% in Russia would, Krupitsky said. The Times reports that many researchers on both sides of the methadone debate agree that only a small fraction of heroin users in Russia seek treatment at detoxification centers and that most who do -- some say more than 90% -- relapse into drug use shortly after leaving.
At the clinics, physicians encourage immediate abstinence from drug use rather than the gradual process that methadone substitution therapy entails. Patients also receive sedatives and painkillers to cope with withdrawal symptoms. Many are allowed to leave after one or two months with the expectation that they will remain drug-free; however, few do so, the Times reports.
Consequently, methadone supporters or other opiate substitution therapies say that if properly administered by medical professionals, the treatment can end IDUs' dependence on drugs, acting as a surrogate to ease withdrawal symptoms while decreasing the risk of overdose (Schwirtz, New York Times, 7/22).
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Human Rights Watch Urges Iran To Release or Charge Two HIV/AIDS Advocates
[Jul 22, 2008]
Human Rights Watch on Monday said that Iranian authorities have not disclosed why two physicians known for their work on HIV/AIDS prevention and treatment were detained last month or where they are being held, BBC News reports. The physicians, brothers Arash Alaei and Kamyar Alaei, are credited with encouraging Iranian authorities to tackle the stigma of HIV/AIDS "in a country where sex, drug abuse and the disease itself are taboo subjects," BBC News reports. HRW called on Iran to immediately release or charge the physicians, whom the group says have not had legal representation.
Joe Amon, HRW's HIV/AIDS program director, said that Iran's work to combat the disease is internationally acclaimed, largely because of the work of the brothers, who established educational campaigns among injection drug users and commercial sex workers. They also introduced harm-reduction programs in prisons, working closely with Iran's government and religious leaders (BBC News, 7/22). Amon added, "The detention without charges of the Alaei brothers has a chilling effect on all of those efforts" (HRW release, 7/21). The brothers, who have traveled widely outside of Iran to take part in HIV/AIDS conferences, planned to attend the XVII International AIDS Conference in Mexico City next month. Arash Alaei was scheduled to present in Mexico about Iran's innovative HIV programs, according to HRW (BBC News, 7/22).
According to the Albany Times Union, Kamyar Alaei is enrolled in the University at Albany's doctorate of public health program. Philip Nasca, the university's dean, said, "We are obviously very concerned. We're kind of in the dark like everybody else is." Kamyar Alaei had returned home to Iran for the summer and was expected back in Albany for the fall semester, the Times Union reports.
Neither brother is known to be involved in politics, the Times reports. They have spoken about the health situation in Iran during professional visits to the U.S. (Parry, Albany Times Union, 7/22). According to BBC News, Iran in recent years has arrested a number of academics with ties to the U.S. (BBC News, 7/22).
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Antiretroviral Treatment Programs Should Take Poverty, Hunger Into Account, Report Says
[Jul 22, 2008]
Programs that provide access to no-cost antiretroviral drugs have had a significant impact on people living with HIV/AIDS, but they also should take into account the effects of poverty and hunger, according to a report recently released by the Catholic Agency for Overseas Development, PlusNews reports. According to CAFOD, the "long-term sustainability" of people living with HIV/AIDS who need treatment is "threatened by the continuing lack of food and economic independence."
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