News (Updated July 20, 2008)

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US Senate triples funding for global AIDS fight

Wed Jul 16, 10:03 PM

WASHINGTON (AFP) - The US Senate gave a major boost Wednesday to a program to combat AIDS and malaria around the world, voting to triple funding for a cause championed by President George W. Bush.

The Senate voted 80 to 16 to authorize 48 billion dollars over the next five years -- 18 billion dollars more than Bush had requested -- for the program, which also includes funds to battle tuberculosis.

"This bill will expand American leadership on global health and foster hope around the world. Once fully funded, it will not only help poor countries but serve America 's interests as well," said Paul Zeitz, executive director of the Global AIDS Alliance.

The legislation has provided a rare moment for the Democrats who control Congress to agree with the Republican president.

"We've been negotiating this legislation for many months and it is a product of bipartisan compromise and commitment to saving lives worldwide," Senator Joseph Biden, chairman of the foreign relations committee, said in a statement.

"I would also like to thank the President. His decision to launch this initiative was bold and unexpected and I believe historians may regard it as his finest hour," he said. "We will be proud to send this legislation to his desk."

The bill has already been approved by the House of Representatives.

Bush, who launched the program in 2003 with 15 billion dollars in funding, praised lawmakers for passing what he called "life-saving legislation."

The US leader said 50,000 people in sub-Saharan were receiving anti-retroviral treatment for HIV/AIDS when he launched the program in 2003. Today, 1.7 million people receive treatment around the world, he said.

"With passage of today's bill we are one step closer to ensuring that this excellent program continues to help those in need," he said. "I encourage the full Congress to move quickly to send me final legislation that I can sign."

US ban on visitors with HIV could end soon

Clinton unveils deal to cut malaria drug prices

 

 

 

 

 

 

By Michelle Nichols

NEW YORK (Reuters) - Former President Bill Clinton unveiled a deal on Thursday with six Chinese and Indian companies to cut a key malaria drug price by a third and slash the price volatility of a vital ingredient by 70 percent.

Artemisinin-based combination therapies, or ACT drugs, are recommended by the World Health Organization because of growing resistance to older treatments such as chloroquine.

But the supply of artemisinin, a plant extract long used in Chinese medicine that takes up to 14 months to produce, has been volatile, with prices ranging from $150 to $1,100 a kilogram (2.2 lb) in the past four years.

"We have reached agreement with the suppliers at every level of the production chain from the extraction of the raw ingredient to the manufacturer of the final drug to allow for sustained and lower pricing," Clinton told a news conference.

The Clinton Foundation HIV/AIDS Initiative has struck deals with India's Cipla Ltd and IPCA Laboratories Ltd, which both manufacture ACT drugs, India's Calyx and Mangalam Drugs, which turn the plant extract into an active pharmaceutical ingredient, and China's Holleypharm and PIDI Standard, which grow the plants.

The lower prices will be available to the 69 countries in Africa, Asia, Latin America and the Caribbean who make up the foundation's purchasing consortium.

Cipla and IPCA have agreed to offer two of the most widely used ACT drugs at lower prices -- artesunate and amodiaquine at or below an average ceiling price of 48 cents per treatment, 30 percent below current market rates, and artemether-lumafantrine at or below an average ceiling price of 91 cents.

NO SINGLE PLAYER

Malaria, caused by a parasite carried by mosquitoes, infects between 300 million and 500 million people each year, killing more than 1 million of them, according to the World Health Organization.

Novartis AG is the dominant ACT drug supplier and the large Swiss company has been able to absorb the volatile costs of artemisinin rather than passing it on to patients. It said it has lost more than $100 million on the drug.

"We know first-hand addressing the health problems of the developing world is challenging and no single player can be successful," said Daniel Vasella, chairman and chief executive officer of Novartis.

Because of the price and supply instability of artemisinin, the foundation said few additional suppliers had entered the market because of the financial risks and if they did, they may not be able to shield patients from costs like Novartis has.

"With rapidly but unevenly growing demand -- and the prospect of a potential global ACT subsidy that could accelerate this growth dramatically -- the risk of volatility in the future remains high," the Clinton Foundation said.

International organizations and governments are considering a multimillion-dollar global subsidy plan for the ACT drugs.

The foundation said the agreements will help to mitigate risk so new suppliers can enter the market and current suppliers like Cipla and IPCA can expand their manufacturing.

The Clinton Foundation said that currently about 100 million doses of ACT drugs are distributed a year. It has forecast that demand for ACT drugs will at least double over the coming four years and could grow to more than 400 million doses annually if a global subsidy plan is agreed.

Malaria causes fever, vomiting, body aches, diarrhea, anemia, loss of concentration, delirium, convulsions, coma and eventually, death.

(Editing by Ellen Wulfhorst and Eric Walsh)

Is AIDS still an emergency?

18 Jul 2008 16:22:55 GMT

Source: IRIN

Reuters and AlertNet are not responsible for the content of this article or for any external internet sites. The views expressed are the author's alone.

JOHANNESBURG , 18 July 2008 - The rate of new HIV infections, which has fuelled the global HIV/AIDS epidemic since the 1980s, has peaked throughout the world and is now declining.

But population growth and the life-prolonging effects of antiretroviral (ARV) treatment mean that the total global number of HIV-infected people is likely to remain about the same for another two decades and will continue to increase in sub-Saharan Africa .

Based on these findings from the study, Has the HIV epidemic peaked?, published in the June issue of Population and Development Review, its lead author, John Bongaarts, believes it is time for the international community and governments to rethink their prioritisation of AIDS over other infectious diseases.

"AIDS has gotten special treatment because of its emergency status; that view is no longer valid because the epidemic has peaked," he told IRIN/PlusNews on the phone from the New York headquarters of the Population Council, an international non-governmental research organisation of which he is vice-president.

The study, which Bongaarts carried out with three demographers from the United Nations Population Division, examined the course HIV epidemics have taken in different regions and used mathematical models that combined population projections with data collected by UNAIDS to project the future demographic impact of HIV/AIDS.

The authors explain that peaks in HIV prevalence, which reflect the total number of people living with the virus, lag about a decade behind peaks in HIV incidence - the rate of new infections. This is because someone infected with HIV can live with the virus for about a decade after infection, and for much longer if they start ARV treatment.

Research showed that the global peak in HIV incidence occurred as long ago as 1995, with the first peak occurring in North America in the early 1980s, and the last in Eastern Europe in 2001. According to Bongaarts, this finding is not new, but it has been against the interests of agencies like UNAIDS to highlight it.

"I think UNAIDS was afraid that donors would decide not to spend so much money on AIDS and, secondly, that governments would say, 'this is no longer something to worry about'," he said. "My own feeling is that the amount that's devoted to AIDS treatment is out of proportion to other health problems."

His comments come on the heels of recent admissions by former senior UNAIDS and World Health Organisation officials that they exaggerated the size of the HIV epidemic and its potential for further growth to create public alarm and maintain the flow of donor money to the global industry that AIDS had spawned.

The backlash against global HIV expenditure started in February with an article in the British Medical Journal by Roger England of Health Systems Workshop, a health-policy charity, who pointed out that AIDS receives about a quarter of global health aid but constitutes only five percent of the disease burden in low- and middle-income countries.

Speaking to IRIN/PlusNews, Bongaarts agreed with England 's argument that more lives could be saved by investing in strengthening health systems and combating other diseases with inexpensive interventions like immunisations, mosquito nets and family planning.

"AIDS should now be treated like any other disease, and the world community should look at its investments in health and prepare the most cost-effective interventions," he said. "I'm not advocating less money for AIDS treatment, but I want more spent on AIDS prevention and other diseases. We can save lives for a few dollars."

What is new about the Population Council study are the predictions it makes about the future demographic implications of the HIV epidemic. According to the authors, the presence of AIDS will not prevent populations from increasing. Even in sub-Saharan Africa , where the death toll from AIDS will continue to be high, the population is expected to grow by one billion between 2005 and 2050.

However, AIDS will slow population growth in the worst-hit countries: in South Africa , for example, the population size by 2050 is projected to be 29 percent lower than it would have been without the presence of AIDS.

Rice gets medal for helping to free HIV medics

SOFIA (Reuters) - Secretary of State Condoleezza Rice on Wednesday received Bulgaria 's top honor for helping to free Bulgarian nurses from a Libyan jail.

The five Bulgarian nurses and a Palestinian doctor, who had been sentenced to death on accusations of deliberately infecting 460 Libyan children with HIV, were freed a year ago after the European Union brokered a cooperation deal with Tripoli .

The United States had made the release of the six, who spent more than eight years in jail, a priority and Rice said she had repeatedly raised the issue with Libyan officials.

"I am glad that they are home safe," Rice said after Bulgarian President Georgi Parvanov presented her with the "Stara Planina" medal. "It was indeed a terrible ordeal, one that I am very glad has ended".

The medal, created during the communist era, was once given to foreign dignitaries like Iraq 's Saddam Hussein and Romanian communist dictator Nicolae Ceausescu.

French President Nicolas Sarkozy and his ex-wife, Cecilia, received it for their role in the HIV case last year.

Bulgaria and its allies in Brussels and Washington had suggested not freeing the nurses would hurt Libya 's efforts to emerge from more than three decades of diplomatic isolation imposed for what the West called its support of terrorism.

Before flying on to Georgia , Rice met two of the nurses and the Palestinian doctor, Ashraf Alhajouj, who was granted Bulgarian citizenship last year, in the U.S. embassy in Sofia .

Alhajouj asked Rice for U.S. support to clear their names and get compensation from Libya . The six have always maintained their innocence and said they were tortured to confess.

Washington has dramatically improved relations with Tripoli since it abandoned a banned weapons program in 2003, dropping many U.S. sanctions, removing it from a U.S. terrorism blacklist and restoring diplomatic links after decades of enmity.

ISRAEL: Low infection rates but condoms still needed

Source: IRIN

Reuters and AlertNet are not responsible for the content of this article or for any external internet sites. The views expressed are the author's alone.

JERUSALEM , 10 July 2008   - In spite of the blockade imposed on the Gaza Strip, Israeli officials said they were still allowing condoms into the enclave as part of efforts by UN agencies and Palestinian organisations to keep family planning and disease prevention programmes going.

While some were concerned at first that the Hamas takeover of the Gaza Strip about a year ago would affect these programmes, such fears have proved to be largely unfounded.

"Condoms are available through planned parenting programmes, run by international and local agencies," said an aid worker with an international agency in the enclave.

Although the government's programmes generally only offer contraceptives for married couples or others in special circumstances, such as people with sexually transmitted infections (STIs), condoms are available in shops and public places, even if somewhat less easily than a year ago.

The trick, experts say, is to keep up the education programmes, particularly on HIV-related issues, so that those who require contraceptives know they need to use them.

The oPt's current infection rate is very low: only 36 Palestinians are known to be living with HIV/AIDS, according to the Palestinian Ministry of Health. Altogether, there have been 61 recorded cases of HIV/AIDS in the West Bank , Gaza and East Jerusalem since 1987, with five times as many men infected as women. Israel 's tight control over the Palestinian borders serves to minimise infection rates, experts said.

In February this year the Palestinian Authority announced that all ARVs would be part of the national drug list and available for free. Its National HIV/AIDS and TB Prevention Committee also works in coordination with a national education committee, various ministries, NGOs and UN agencies, to develop educational plans.

"We conduct monthly meetings on HIV and plan educational campaigns," Asad Ramlawe from the ministry of health's HIV/AIDS and TB department, told IRIN, adding that the ministry of religion was also included in the committee.

"We are trying to educate parents, and to work with religious leaders," said Ziad Yaish, a Jerusalem-based advocacy officer with an international development agency, the UN Population Fund (UNFPA), who employs TV and radio spots to reach his audiences, particularly vulnerable young people.

In a conservative society, working hand-in-hand with religious leaders would bring about the best results and help allay any concerns they might have about programmes, such as family planning, experts have said.

An official involved in educational efforts in the West Bank said appearances could be deceptive: while some cities might appear more liberal, based on dress codes and open social behaviour, this did not always mean they were open to sex education.

"I found it easier to work in Jenin, a conservative town, than in Ramallah [which is perceived as more liberal]," said the official, adding that living in out-of-the-way areas left people less informed, and more curious and eager for information.

Organisations like the Palestinian Family Planning and Protection Association (PFPPA) train "peer educators" - older high school and university students who are taught by professionals in how to reach out to their friends and inform them about the risks involved in growing up.

"We focus on 16-to-18-year-olds and university students, especially those who will go abroad to study," said Amina Stavridis, the director of the PFPPA.

Congo kids to get free AIDS checks and malaria drugs

MOZAMBIQUE : Attitudes to HIV are changing in jail

11 Jul 2008 17:39:59 GMT

Source: IRIN

Reuters and AlertNet are not responsible for the content of this article or for any external internet sites. The views expressed are the author's alone.

CHIMOIO , 11 July 2008 - Sex between prison inmates is a reality at Manica Provincial Prison, in central Mozambique , but because same-sex relations are taboo, and conjugal visits are not allowed, many HIV-positive inmates say they were infected before they were sent to the largest prison in Manica Province .

The reality is often different. "Based on the analyses we carried out, we found that some inmates were indeed infected before being locked up, but the majority was infected inside the jail," said Elsa Thaibo, director of the health department in Chimoio, who is also responsible for providing medical assistance to the prison located in the city.

Carlos Alid, 38, who was jailed in 2005 for counterfeiting money and has four more years left to serve, told IRIN/PlusNews: "Because of the lack of other options, some men seek what they should be getting from their wives or from other women, in men."

He discovered he was HIV positive after a voluntary test in prison, and suspects he was infected after becoming an inmate. Alid said some of the younger prisoners have sex with older ones in exchange for food and protection, especially since many do not enjoy the support of their families. The sex does not always include condoms.

HIV behind bars

The prison, located near a mountain with the shape of man's head, known as "Cabeça de Velho" (old man's head in English), has an HIV prevalence rate of 4.5 percent among the approximately 1,000 inmates, according to official data.

"It's been very difficult to keep this [HIV] outside. You can't see it coming and it's impossible to see it being transmitted," said prison director Francisco Mate.

Between January and May of 2008, 43 of the 246 of the prisoners examined – both men and women – were diagnosed as HIV positive; of these, eight are taking antiretroviral (ARV) treatment.

UNAIDS has encouraged the authorities to acknowledge that sex between men occurs, and that preventative measures be adopted. Nevertheless, three years ago, several prisons in Mozambique rejected the proposal that condoms be distributed to inmates, arguing that there was no homosexual activity taking place in prisons.

This is slowly changing. "The government already understands that the distribution of condoms in jails does not promote homosexuality, but rather contributes toward HIV prevention. That's why it's begun to distribute them," said Thaibo.

Besides unprotected sexual relations, specialists point to needle sharing to inject drugs and unsterilised tattooing instruments as factors that could contribute to the spread of HIV in the nation's prisons.

"Prison authorities are unable to control the high-risk practices," said David Demo, 33, who has been in prison for two years for homicide.

Signs of change

But prevention means more than just condom distribution. In addition to giving out free condoms, the group Shinguirirai (support, in the Shona language) holds lectures and education sessions, provides psychological assistance and helps prisoners stick to their ARV treatment regimen.

Rui João, 27, in the prison's high-security wing for the murder of a neighbour in 2006, discovered he was HIV positive in September 2007 and began taking ARVs. He is now one of Shinguirirai's activists and gives other prisoners information about AIDS, and supports those on treatment.

Prison employees are also included in the awareness-raising campaigns, and with the support of the Provincial Nucleus for the Fight Against AIDS, Shinguirirai organised courses last year for both prison workers and inmates.

According to João, prison conditions are not ideal for HIV-positive individuals to live healthy lives, such as a nutritious diet and an adequate environment, which are fundamental to the success of ARV treatment.

Some NGOs and religious institutions have sought to make up for these shortcomings with balanced meals and medical assistance for HIV-positive inmates on two Saturdays a month, but the need persists.

Even so, prison director Mate believes there are signs of change. "There was a time when a considerable number of inmates died because of a lack of care, but this has gone down now because it's not easy for a prisoner to see a fellow inmate die. Little by little, we're managing to get somewhere."

ZAMBIA : Wanted - more people for HIV testing

Source: IRIN

Reuters and AlertNet are not responsible for the content of this article or for any external internet sites. The views expressed are the author's alone.

LUSAKA , 9 July 2008   - The drugs to manage HIV are available, and so is knowledge about how to prevent it, but far too few people in Zambia are coming forward to be tested.

"I would rather die than go for VCT [voluntary counselling and testing]," Joseph Mwewa, 28, a resident of the capital, Lusaka , told IRIN/PlusNews.

"As far as I am concerned, it is better to remain ignorant of your status. We have seen so many people dying quickly upon knowing their HIV [positive] status. I know what I have done, and I also know what I haven't done, but believe me, having an HIV test is the last thing on my mind ... not even on my death bed."

Mwewa is not alone. The government estimates that almost two million of the country's 11.7 million people have been tested for HIV, but Zambia 's prevalence rate of 15 percent puts it among the world's highest.

Although the government recently announced a slight decline in HIV prevalence to 14 percent, the rate in some urban areas, including Lusaka , are still as high as 21 percent.

"The uptake of VCT services is still unacceptably low in Zambia ... despite government and non-governmental organisations' efforts to make VCT as widely available as possible," said Brian Chituwo, Zambia 's health minister.

Drugs become more widely available

About 170,000 people are accessing antiretroviral (ARV) drugs from various government clinics and hospitals, according to the ministry of health, but the number of HIV-positive people needing medication is estimated at nearly 300,000.

"Comprehensive antiretroviral therapy services are now available in all [73 of] our districts. This is as opposed to the situation that existed only five years ago, when we only had two such sites," Chituwo noted.

Frederick Mulenga, a peer educator working at a VCT centre in Lusaka , said most people shunned the services because of the myths associated with HIV. In the minds of many, HIV/AIDS is linked with promiscuity, and this misperception is reflected onto HIV-positive people, who are often scorned and suffer discrimination, especially in rural areas.

"The thing is: there is a very big misconception that catching HIV is a form of punishment from God for one's sins or promiscuous life. Just the other day, I had a case of a lady - I think in her late 20s - who wept uncontrollably after her results came out [HIV] positive. She said, 'God has betrayed me; I have lived a sinless life and I am still a virgin, why should I be HIV positive?'."

Even if we encourage them to know [their HIV status] so that they can seek medication earlier, many people still look at HIV/AIDS as a killer and an incurable disease – this is really undermining our efforts," Mulenga said.

HIV/AIDS consultant and former health minister Nkandu Luo believes VCT services are still not widely accessible. "VCT hasn't attracted a lot of people because we are not looking at access to facilities ... people have to travel [from the townships] ... into town [to be tested], which costs money," she pointed out.

"And, obviously, when it comes to competing with finding food, no one would give preference to going for VCT. Services must be taken to the people. As it is, we don't have enough structures to support the level of intervention operations that we would like to see."

Luo suggested that another reason for people's reluctance to be tested was because for a long time there was nothing in it for them; there was no incentive. Even though ARVs were more widely available and people knew about this service, there was still no nutritional support.

"The programme should have been comprehensive; there must be drugs, there must be food, and there must be facilities all over," she said.

The UN Population Fund [UNFPA] has supported the Zambian government's prevention and education efforts for the past five years by providing condoms, prevention of mother-to-child transmission of the virus, and focusing on the human rights of HIV-infected people.

"VCT promotes early knowledge of HIV status, which is now recognised as a critical component in controlling the spread of new HIV infections," said Deji Popoola, country director for UNFPA in Zambia, who also noted that people would not change their behaviour if they did not know their status.

"It is hoped that if individuals know their HIV status, they would adopt behaviours that would either reduce their risk of infection if they were HIV negative, or reduce the risk that they would transmit the virus to others or get re-infected if they were HIV positive."

Cameroon refugee on trial in Poland for infecting women with HIV

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