Kaisernetwork.org (Washington, DC)
17 November 2008
Global Challenges
Interpol Seizes $6.65M in Counterfeit HIV/AIDS, Malaria, TB Drugs in Southeast Asia
[Nov 17, 2008]
The International Criminal Police Organization recently confiscated $6.65 million worth of counterfeit HIV/AIDS, malaria and tuberculosis drugs in Southeast Asia and made 27 arrests as part of a five-month investigation involving nearly 200 raids, Aline Plancon, an officer involved in the operation, said on Monday, Bloomberg reports. During the investigation, called Operation Storm, authorities seized more than 16 million pills between April 15 and Sept. 15 in Cambodia, China, Laos, Myanmar, Singapore, Thailand and Vietnam. The operation was a joint effort between Interpol, the World Health Organization and the World Customs Organization. It was the first time customs officials, drug regulators, health authorities and police from different countries have collaborated to prevent the distribution of counterfeit medicines, Plancon said.
According to Bloomberg, health officials particularly are concerned about fake artemisinin-based combination therapies used to treat malaria. According to a recent study, counterfeit ACTs containing insufficient amounts of artemisinin are contributing to the development of drug-resistant parasites near the border of Cambodia and Thailand. The rise in drug resistance has reduced the effectiveness of genuine ACTs, thus placing more people at risk for developing drug-resistant malaria, Bloomberg reports.
According to WHO and the Center for Medicine in the Public Interest, worldwide sales of counterfeit drugs could reach $75 billion by 2010, an increase of more than 90% since 2005. An Organization for Economic Cooperation and Development report released last year identified Asia as the largest producer of counterfeit products worldwide. Of the 1,047 arrests made in 2007 related to counterfeit medicine, about 40% took place in Asia, the Pharmaceutical Security Institute reports (Bennett, Bloomberg, 11/17).
Related Opinion Piece
The seizure by Belgian authorities in September of more than two million fake malaria drugs and painkillers manufactured in India for African distribution "shines a light on one of the most pressing problems in delivering life-saving medicines to the world's poorest patients: the proliferation of low-quality and counterfeit products," Roger Bate, a director of Africa Fighting Malaria and fellow at the American Enterprise Institute, writes in a New York Times opinion piece. He adds, "If aid organizations are serious about combating the spread of deadly diseases in the developing world, they must do more to ensure the safety and quality of drugs."
Although WHO reports that about 30% of the world's population lacks essential medicines, "this problem cannot be solved by supplying bogus medicines," Bate writes. According to Bate, insufficient access to drugs has led many governments in developing countries to allow local drug makers to produce cheaper medicines. However, "local producers often make low-quality drugs," he writes, adding that this should be "no surprise" because "[e]ven countries with stringent regulatory systems sometimes turn up bad pharmaceuticals." According to Bate, many developing countries "lack the regulatory structure needed to monitor safety and effectiveness," do not have "laws against selling sub-standard drugs" and lack "sophisticated agencies like the FDA with the trained inspectors and laboratories needed to analyze pharmaceuticals."
According to Bate, it is "essential" for these countries to enact regulations, establish monitoring agencies and build scientific capacity to oversee drug manufacturing and inspect imported and local drugs. Bate also identifies three ways that international aid organizations can help ensure drug quality: providing financial and technical support; refusing to subsidize low-quality drugs; and insisting that only medicines approved by "stringent drug agencies like the FDA" be distributed. Bates writes, "If aid organizations are serious about combating the spread of deadly diseases in the developing world, they must do more to ensure the safety and quality of drugs." He concludes, "Thousands of lives depend on their efforts" (Bate, New York Times, 11/15).
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India's Cellular Ringtone Boosts Country's Condom Sales, Officials Say
[Nov 17, 2008]
Condom sales in India increased by 85 million in the months following a media campaign featuring a cellular phone ringtone that says "condom, condom," officials at India's National AIDS Control Organization said on Friday, AFP/Philippine Daily Inquirer reports (AFP/Philippine Daily Inquirer, 11/14). The ringtone was launched earlier this year by the BBC World Service Trust and features a professional singer repeating the word "condom" more than 50 times. It is part of NACO's efforts to reach youth through projects such as films, online games, mobile advertising and downloads, as well as television and radio advertisements to engage young people in discussions about safer sex (Kaiser Daily HIV/AIDS Report, 10/20). According to AFP/Inquirer, 660,000 people have downloaded the ringtone since August.
The media campaign includes radio and television advertisements, and 150 million men -- including migrant workers who frequent commercial sex workers -- have been reached through the campaign. Yvonne MacPherson, BBC World Service Trust country director for India, said the campaign has "encouraged people to start talking about the condom." The trust on Friday launched a mass media campaign that features a dog called Condom. According to AFP/Inquirer, Indian health officials hope to reach a target of distributing three billion condoms annually by 2010 -- an increase from the current target of 1.7 billion. Officials also aim to increase the use of female condoms by improving the retail network.
Sujatha Rao, head of NACO, said that "huge problems" still exist in promoting condom use in the country, adding that commercial sex workers have said that men "would rather pay more than use a condom." Rao also said the organization's "biggest barrier is the lack of a proper marketing network." The United Nations estimates that 2.4 million people in India are living with HIV/AIDS (AFP/Philippine Daily Inquirer, 11/14).
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Representatives From Indian Ocean Islands Hold Meeting To Address HIV/AIDS
[Nov 17, 2008]
More than 500 representatives from islands in the Indian Ocean -- including Comoros, Mauritius, Madagascar, Reunion Island and Seychelles -- recently expressed concern about the impact of HIV/AIDS on the region during a conference in Mauritius, IRIN/PlusNews reports. Although different issues are occurring in each nation, there is a shared belief that the impact of HIV/AIDS is changing in the region, IRIN/PlusNews reports. Delegates pointed to a common problem of stigma toward people living with the disease.
UNAIDS estimates that Comoros had 200 people living with HIV/AIDS as of 2007, and the country continues to face poverty, low condom use, a lack of knowledge about HIV/AIDS and a high incidence of sexually transmitted infections. IRIN/PlusNews reports that Madagascar's population is becoming increasingly vulnerable to HIV because of limited access to health care and social services, multiple concurrent partnerships and high rates of STIs. Despite these issues, Madagascar still has a relatively low HIV prevalence of 0.1%, and 14,000 people were living with the virus at the end of 2007.
In Mauritius, HIV/AIDS prevalence is 1.8%, and about 86% of the people living with HIV are injection drug users -- an increase since 2000, when IDUs comprised 2% of the HIV-positive population. In addition to providing no-cost antiretroviral drugs, the government has begun a needle-exchange program to address the recent shift in HIV transmission from heterosexual sex to injection drug use. According to IRIN/PlusNews, the move has received criticism. However, Willy Rozenblum -- head of the French National AIDS Council -- praised the Mauritian government for its decision to launch the program. Rozenblum said, "We can eradicate this disease in 50 years with the facilities and knowledge we have at present. We do not need to invent new things if we strictly apply what we have now. There must be strong political commitment to this and to stopping stigmatization, which is often more painful than the disease itself." Mauritius's Prime Minister Navinchandra Ramgoolam has said that the island should increase its efforts to curb the spread of the virus (IRIN/PlusNews, 11/14).
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Number of Newly Recorded HIV Cases in Czech Republic Reaches All-Time High
[Nov 17, 2008]
The 128 new HIV/AIDS cases recorded between the beginning of 2008 and the end of October in the Czech Republic have broken a record for the highest number of new cases registered in the country, Jana Vandasova of the National Reference Laboratory for AIDS said on Thursday, the CTK/Prague Daily Monitor reports. According to Vandasova, there were 122 new cases registered last year, and the National Reference Laboratory for AIDS said this year represents the largest growth in HIV/AIDS cases since the mid-1980s, when the country began testing for the virus.
Vandasova said that in September alone, 16 new HIV/AIDS cases were reported, while five were registered in October. A total of 1,170 HIV-positive Czechs and foreigners with long-term residence have been registered since the mid-1980s, 988 of whom were still registered as of the end of October, Vandasova said. A total of 142 people had died from AIDS-related illnesses by the end of October, the CTK/Prague Daily Monitor reports. In addition, the data, which has not yet been confirmed, indicated that 261 HIV-positive people had developed AIDS by the end of September.
Miroslav Hlavaty of the Czech Society for AIDS Help said some people who contracted HIV many years ago were registered among new HIV cases last year, which means that a large number of HIV-positive people could be contributing to the spread of the virus without being aware of their status. In addition, Hlavaty said the number of HIV-positive people in the country could be 10 times higher because of low testing levels (CTK/Prague Daily Monitor, 11/13).
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Across The Nation
Indiana Hosts 5th Annual Statewide HIV/AIDS Awareness Program
[Nov 17, 2008]
Health officials and public health advocates in Indiana on Friday hosted the Fifth Annual Statewide HIV Awareness Program in an effort to increase HIV/AIDS awareness and prevention, the Indianapolis Star reports. According to the Star, approximately 9,170 people are living with HIV/AIDS in Indiana, of whom one-third are black. Andrea Perez, Communities of Color program manager for the Indiana State Department of Health, said that the increase in the number of black people living with HIV/AIDS in Indiana is a "big cause for alarm," adding, "As much as we try to get the word out about the disease being 100% preventable, the numbers are still growing." She added that last year, Hispanics accounted for 7% of new HIV/AIDS cases among women in the state. The program includes information on where HIV testing and other services are available and prevention methods.
Mwangi James Murage -- director of training and evaluation for the Indiana Minority Health Coalition, which was a sponsor of the event -- said that a majority of the people who attended the event were aware of HIV/AIDS but might not be taking precautions to prevent transmission of the virus. "There is a difference between being aware and being aware to a point where you change your behavior in a specific way," Murage said.
About 900 people attended last year's event, many of whom were middle and high school students, Teresa White, director of support services for Bethlehem House, said. White said that the presence of new HIV cases among people as young as 12 and 13 makes it important to discuss prevention with young people. "Abstinence is the 100% way of not becoming infected," she said, "However, that's just not the reality of today." Perez said that people who engage in risky behaviors should use condoms during sexual activity and clean needles during injection drug use, as well as go for HIV testing regularly. "The power to prevent HIV infection is really in your hands," she said, "It's a matter of getting the information that you need and taking the steps that you need to" (Rudavsky, Indianapolis Star, 11/14).
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Opinion
Domestic Strategy for Combating HIV/AIDS in U.S. Should Mirror PEPFAR, Opinion Piece Says
[Nov 17, 2008]
President Bush's "efforts to reduce HIV infection and mortality rates through the President's Emergency Plan for AIDS Relief have made the first real dent in Africa's HIV/AIDS plight," and the program's success "should illustrate for the next administration the benefits that would come from creating a similar program to battle the rise of HIV infections in America's inner cities," Robert Gallo, director of the University of Maryland's Institute of Human Virology, writes in a Washington Post opinion piece. According to Gallo, although PEPFAR has extended antiretroviral treatment to more than 1.7 million people around the world and helped HIV-positive women give birth to nearly 200,000 HIV-negative infants, in 2008, "some places in the United States, chiefly poor urban areas, are home to the same rising HIV/AIDS statistics as those of some Third World countries."
Gallo writes that in light of recent CDC data about HIV/AIDS in the U.S., a "PEPFAR plan for America's inner cities would help to neutralize and diminish the number of people contracting HIV and the number dying of AIDS." He adds, "It would provide access to prescribed care and medical therapies so patients with HIV can live a normal lifespan." Furthermore, an "effort to help these Americans, among our country's poorest, could also strengthen U.S. international relations, sending a message to the world that America recognizes that it is not different from other countries and that we, too, have an HIV/AIDS pandemic."
According to Gallo, a domestic strategy for HIV/AIDS similar to PEPFAR also would assist in the construction of clinical infrastructures for diagnosis and treatment in inner cities. He writes, "Federal and state officials have already allocated enormous sums to fight bioterrorism. But in the past seven years, more Americans have been the victims of HIV/AIDS than have been affected or killed by any bioterrorist attack." Gallo adds that education "is the key to managing and preventing HIV infection" and that the U.S. "needs a program that can teach people about prevention and early detection." He writes, "As long as adverse socioeconomic conditions prevail, those living in HIV/AIDS 'hot spots' without education about the disease and facing other life challenges -- such as mental illness, drug abuse, homelessness and lack of health insurance -- will be at risk even if we do develop an AIDS vaccine."
Regardless of when such a vaccine is developed, Gallo writes that "we must actively address the growing HIV/AIDS pandemic in the United States." He adds, "When an AIDS vaccine does become available, a program to reduce HIV infection in inner cities would ensure that our nation is educated and positioned to readily distribute the medicine, helping to put an end to this terrible disease. In the meantime, the program would help stabilize a growing HIV pandemic and stop the spread of HIV."
Gallo writes, "Unless we develop a program to fight HIV infection in America's inner cities, our urban centers will continue to face an even more daunting pandemic." He concludes, "To improve the health of millions of Americans and reduce HIV infection rates, the next administration should craft and implement a PEPFAR plan targeting our inner cities" (Gallo, Washington Post, 11/16).
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