Kaisernetwork.org (Washington, DC)
25 August 2008
Politics and Policy
Eight States, Puerto Rico Will Not Receive CDC Funding for Advanced HIV Monitoring System
[Aug 25, 2008]
CDC on Friday announced that it will no longer fund an advanced HIV/AIDS monitoring system in eight states and Puerto Rico, the New York Times reports. The eight states are Georgia, Illinois, Maryland, Missouri, Ohio, Oklahoma, Pennsylvania and Tennessee. According to the Times, the system uses a new test that distinguishes recent HIV infections from old ones, which helps "epidemiologists track [infections] in something much closer to real time than was previously possible."
Data from the advanced system were used in a recent report on new HIV infections in the U.S. based on 22 of the 34 states using the test, Terry Butler -- spokesperson at the National Center for HIV, STD and TB Prevention -- said. Butler added that future monitoring will include data from all 25 jurisdictions. The change in CDC funding will reduce the number of states using the advanced system from 34 to 25. Total funding for the advanced testing method will remain the same but the 25 states will receive a larger portion of funding, Butler said.
Butler added that the 25 states that will continue using the advanced test have the most reliable systems and could help CDC produce the most accurate estimate of HIV infections in the U.S. Julie Scofield, executive director of the National Alliance of State and Territorial AIDS Directors, said that more extrapolations would be necessary to estimate HIV infections nationwide if fewer states use the advanced test.
Scofield added that federal funding for HIV surveillance has decreased and that many states are struggling to meet CDC standards for HIV monitoring. She estimated that the eight states and Puerto Rico lost about $3 million in CDC funding with the announcement. "Surveillance funding is starving at the CDC," Scofield said, adding, "Their ability to say that they're going to have ongoing reliable reports of [HIV] incidence is somewhat questionable unless you have funding for that." NASTAD has called for a $35 million increase in funding for HIV surveillance efforts, the Times reports (Dewan, New York Times, 8/22).
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Public Health & Education
HIV/AIDS Groups Express Concern About Potential for New Antiretroviral Advertising To 'Scare Off' Patients
[Aug 25, 2008]
The Wall Street Journal on Monday examined a new trend for drugmakers marketing HIV/AIDS treatments to release ads that "tak[e] aim at rival HIV drugs, hinting at side effects and other drawbacks." Drug companies have "traditionally sold" antiretrovirals "with images of hope and by explaining the benefits of their treatments" and the "tough new tack has some patient groups unsettled, saying it could scare off patients," according to the Journal.
A recent GlaxoSmithKline ad shows shark-infested waters with the message: "Don't take a chance -- stick with the HIV medicine that's working for you." According to the Journal, another GSK ad in the monthly magazine Poz promotes the drugmaker's protease inhibitor Lexiva and advises patients to ask their physicians, "Will the HIV medicine make my skin or eyes turn yellow?" Other protease inhibitors have been associated with such a side effect, the Journal reports.
The AIDS Healthcare Foundation sent a letter to HHS last month expressing concerns about GSK's ads. The organization said it has not yet received a response, but a spokesperson for HHS said it has not received the letter. In addition, Bob Huff, antiretroviral project director at Treatment Action Group, said he complained to GSK about the shark-themed ad. Huff said the ad is offensive and intended to create fear among HIV-positive people.
According to GSK, the ads are "educational" and appropriate. Marc Meachem, a spokesperson for the company, said in a statement, "While we acknowledge that some people may find the headline and imagery of the materials to be provocative, GSK stands firmly behind the ads and their underlying message: Patients considering changing HIV therapy ought to consult closely with their physician to fully understand the near and potential long-term health implications of such changes."
Meachem said the ads are "just as likely to encourage a patient to stay with another medicine as it is one of our own, assuming that the medicine is working for a patient and is well-tolerated." Meachem said that he is aware of the concerns regarding the ads, adding that the shark-themed campaign "ends this September, and, as always, we will take all the community feedback we have received into consideration for future campaigns."
A recent print ad from Bristol-Myers Squibb shows an image of a toilet and says, "Ask your doctor if there are HIV medications with a low risk of diarrhea." Diarrhea is a side effect associated with Abbott Laboratories' Kaletra, but not BMS' Reyataz.
BMS spokesperson Brian Henry said the ad is appropriate. Abbott spokesperson Melissa Brotz said, "Kaletra has a well-established side-effect profile and profound and sustained effectiveness in combating HIV."
According to the Journal, part of the push behind the new "sharp-elbows advertising" is that the "market for HIV medicines has grown crowded and companies want to protect their market share." While GSK is one of the world's biggest sellers of antiretrovirals, its medicines are older and its share of the $11 billion global antiretroviral market has dropped from 39% in 2004 to 25% currently.
Regan Hoffman, editor of Poz, said, "Treatments have become so comparable, so [companies] are really trying to split hairs to have a marketing advantage" (Whalen/Wang, Wall Street Journal, 8/25).
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Global Challenges
Namibia To Launch Program That Will Address HIV/AIDS Among Workers at Sea
[Aug 25, 2008]
A program that will provide employees in Namibia who work at sea with information on HIV/AIDS and focus on antiretroviral treatment is in an advanced stage of development, the New Era/AllAfrica.com reports. According to the New Era/AllAfrica.com, the program is needed to address this group's vulnerability to HIV/AIDS because of a lack of information and to ensure that HIV-positive employees do not miss scheduled doses of antiretrovirals. Representatives from the Ministry of Health and Social Services, fishing companies and other HIV/AIDS service providers met last week to create a committee that will oversee the program's implementation.
According to assessments, the extended period of absence at sea can disrupt the antiretroviral regimens of employees living with HIV/AIDS because they often are unable to take the drugs at sea. Although the health ministry does make arrangements for HIV-positive employees to receive treatment, most employees are unaware of such arrangements, the New Era/AllAfrica.com reports.
Immanuel Mwilima of the Walvis Bay Multi-Purpose Centre Trust, which will lead the program, said the initiative could be effective in addressing the vulnerability of sea-going employees to HIV/AIDS. "Such a program will cater for the very basic needs in form of information and education for seafarers when it comes to HIV/AIDS," Mwilima said, adding, "These people are very vulnerable, as most information does not reach them due to their extended length of stay at sea."
Mwilima added that Namibia will pilot the program and that if successful, it could be rolled out to other countries. "We have very high expectations for this program and will do everything possible to make sure that it succeeds. If successful, Namibia could be used as a model for other countries facing the same scenario worldwide," Mwilima said (Tjatindi, New Era/AllAfrica.com, 8/21).
Link to this story.
HIV/AIDS Awareness Efforts Face Difficulties in Northern Kenya, Health Workers, Advocates Say
[Aug 25, 2008]
Some health workers and advocates in Kenya's North Eastern Province recently said that HIV/AIDS awareness campaigns face difficulties in the region because of its remote location and culture, IRIN/PlusNews reports. Ijara, a district in Kenya's North Eastern Province, has recorded the lowest number of people living with HIV in the province at 130. However, the "stigma associated with HIV/AIDS is very, very strong here," Mohamed Abdikadir Sheikh, Ijara's medical officer, said. According to Sheikh, HIV/AIDS still is associated with magic, witchcraft and evil spirits by many people in the region, leading them to seek ritualistic instead of medical treatment. The voluntary HIV counseling and testing center in Ijara "remains idle because the local community believe they cannot contract the disease," Sheikh said, adding, "We need an aggressive awareness campaign in these remote areas."
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