Kaisernetwork.org (Washington, DC)
1 October 2008
Across The Nation
California Gov. Schwarzenegger Signs Bill Requiring Insurers To Pay for HIV Testing
[Oct 01, 2008]
California Gov. Arnold Schwarzenegger (R) on Tuesday signed a bill (AB 1894) into law that requires health care plans operating in the state to pay for routine HIV testing, the Los Angeles Times reports (Rau/McGreevy, Los Angeles Times, 10/1).
According to the California Office of AIDS, about 40,000 Californians are HIV-positive but are not aware of their status. CDC figures show that about 40% of the U.S. population has ever received an HIV test (Kaiser Daily HIV/AIDS Report, 9/18).
In a statement, the AIDS Healthcare Foundation, which sponsored the bill by Assembly member Paul Krekorian (D), praised Schwarzenegger for signing the measure. AHF President Michael Weinstein said, "Nearly 40,000 Californians do not know they are HIV-positive, and they are unwittingly causing between 2,500 and 5,000 new infections in California each year."
According to AHF, "opt-out" HIV testing as part of routine care in all health care settings for people between ages 13 and 65 was recommended by CDC in 2006; however, the recommendation has not been implemented widely in California or throughout the rest of the country largely because of issues over who should pay for the tests. AHF said the bill will help California implement the guidelines (AHF release, 9/30).
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Science & Medicine
Scripps Research Institute Receives IAVI Grant To Develop HIV Vaccine, Create HIV Vaccine Research Center
[Oct 01, 2008]
The Scripps Research Institute on Monday received a $30 million, five-year grant from the International AIDS Vaccine Initiative to develop an HIV vaccine, the South Florida Sun-Sentinel reports.
The grant will finance a team of scientists who will work to develop an HIV/AIDS vaccine that would stimulate the body to produce antibodies to kill the virus, SRI spokesperson Keith McKeown said. The grant also will fund a research center that will be connected to other vaccine research efforts and projects worldwide. The center will be led by SRI researcher Dennis Burton (LaMendola, South Florida Sun-Sentinel, 9/30). The center will open in California, and no date has been announced for its opening, according to Reuters Africa (Reuters Africa, 9/30).
The center, called the HIV Neutralizing Antibody Center, will bring together scientists from several disciplines, including biology, virology, chemistry and immunology. "Collaboration is essential to making things happen so the more we bring people together to promote scientific interaction, the more rapid our progress will be toward the creation of an effective AIDS vaccine," Burton said. SRI President Richard Lerner added that SRI is "confident" the center "will facilitate more productive exchanges among researchers and stimulate new ideas that will help to accelerate AIDS vaccine science" (IAVI release, 9/30). "This reinvigorated approach will also make it easier for us t recruit and mentor the young scientists who represent the future of HIV/AIDS vaccine research," Burton said (Reuters Africa, 9/30).
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Global Challenges
Developing Countries Face Shortage of Medical Workers Trained To Treat HIV/AIDS, Malaria, TB, Reuters Reports
[Oct 01, 2008]
Many developing countries are facing a shortage of medical workers -- leaving health care gaps in nations with high HIV/AIDS, malaria and tuberculosis burdens -- Reuters reports.
Although Africa has 25% of the world's disease burden, it has only 3% of the world's health care workers, Reuters reports, adding that the continent also is most affected by medical brain drain worldwide. In addition, the continent's high HIV/AIDS prevalence has led to an even greater shortage of medical workers who have died from the disease. HIV/AIDS patients in Africa often use clinics staffed by a single nurse and a few untrained assistants, with a physician visiting once every few weeks, Reuters reports. "A nurse taking care of 400 patients is paid $3 a day in Malawi," a situation that leads many medical workers in the country to migrate abroad or work for private companies, Moses Massaquoi, a physician with Medecins Sans Frontieres in Malawi, said. According to Reuters, some international disease experts earlier this year called the recruiting of African health care workers by Western nations an international crime.
In India, which has the world's third highest HIV/AIDS caseload, people often sleep outside of health clinics while waiting for medications and tests, HIV/AIDS advocate Loon Gangte said. Gangte added that the challenge of obtaining care leads some patients to abandon treatment. According to Reuters, India has a significant shortage of medical workers, with one nurse for every 1,000 patients, compared with 11 nurses for every 1,000 patients in Europe. "Demand is greater than the supply," Sunita Maheshwari, a pediatric cardiologist in Bangalore, said.
Ezekiel Nukuro, an official with the World Health Organization, said that many developing countries are facing an increase in deaths from preventable diseases and a decrease in life expectancy. He added that the health systems in these countries are "on the brink of collapse due to the lack of skilled personnel." According to Reuters, some experts say the situation has worsened because of new immigration regulations in Western nations that allow medical workers from developing countries to migrate abroad for work. Some aid organizations have expressed concern that a proposed European Union "blue card" scheme, which in September received initial backing from ministers, would lead to a further migration of health care workers from developing countries.
Experts have said there "is no easy solution" to address brain drain, but retention strategies may reduce the problem, Reuters reports. "It would be impossible to solve or stop migration of health workers," Nukuro said, adding that "strong political and international commitment, innovative strategies ... partnerships and alliances and long-term investments" are crucial in retaining health care workers. WHO in a July report recommended that international aid to Africa should go towards increasing physician salaries and improving recruitment and training of medical workers. The report also suggested the use of "telemedicine" to connect African hospitals with laboratories and experts abroad through the Internet and telephones. In India, efforts have been made to reduce the burden on physicians by training housewives to provide medical advice and administer fever medicine, oral rehydration tablets and rapid diagnostic kits for malaria and pregnancy. Naresh Dayal, India's secretary of health, said this strategy is a "small intervention but it will have a big impact on reducing maternal mortality rates and infant mortality rates." Similar programs are being implemented in some African countries, especially in rural areas, according to Reuters (Chandran/Tan, Reuters, 9/30).
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Indian Health Minister Calls on Country To Legalize Homosexuality To Improve Fight Against HIV/AIDS
[Oct 01, 2008]
Following his recent efforts to legalize homosexuality in India, Health Minister Anbumani Ramadoss said the country should recognize the increasing acceptance of homosexuality worldwide because such tolerance would ensure "an effective fight against AIDS," IANS/Thaindian News reports (IANS/Thaindian News, 9/29).
Under Section 377 of the Indian Penal Code -- which was established under British rule in 1860 -- homosexuality is a crime that carries a punishment of life in prison. The Delhi High Court had been holding daily hearings on a petition that sought to legalize homosexuality, which was supported by the Ministry of Health and Family Welfare but opposed by the Ministry of Home Affairs. According to the Centre Party, legalizing homosexuality would have adverse health effects, and the party asked the court to ignore Ramadoss' position on legalizing homosexuality. The health ministry wants to make homosexuality nonpunishable particularly because of the latest figures from the National AIDS Control Organisation that estimate there are 22 million men who have sex with men in the country.
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