|
|
| by Christopher
Spencer |
Former Senior
Advisor International Organizations,
Canadian Department of
Foreign Affairs and International Trade |
| Updated: 25 MAY
09 | |
(A) COST/PATENT DILEMMA; GLOBAL REACTION
(B) INFECTION RATES; SOCIO-ECONOMIC ISSUES
(C) MEDICAL DEVELOPMENTS AND CHALLENGES
(D) POLICY ISSUES AND CONFERENCES
(A) AIDS: THIRD WORLD: COST-PATENT DILEMMA; GLOBAL REACTION
Donald G.McNeil Jr."Drug Companies and the Third World: A Case Study in Neglect"in New York
Times 21 May 1999:-this substantial report deals with an extremely serious global issue. Major
pharmaceutical firms are deeply dependent upon stockholders/markets for their competitive
survival and the huge investments (billions of dollars and years of work)now required to do the
R&D necessary for developing new drugs. They therefore concentrate on drugs which, if
successful, will have a very large market(i.e. the rich world), insulate their investments with
patents, and charge the highest possible (monopoly?) prices while the patents last. The
appalling result is that very little commercial R&D or production is allocated to cures, treatments,
or techniques mainly or wholly relevant to the bulk of the world that is poor(i.e. offers a small
market), while those with global relevance are available at a cost often far beyond the reach of
poor peoples. The author uses sleeping sickness as a tragic case study but this dilemma lies
behind the AIDS crisis. Barbara Crossette,"Gore Presides Over Security Council Debate on
AIDS"NYT 11 Jan 2000:-US Vice-President Gore, chairing a UNSC session on the AIDS crisis in
Africa, pledged $150m to help combat AIDS and other infectious diseases in the poorest
countries, plus funds to share US expertise on controlling AIDS in the military with African
nations. The debate recognized the epidemic as an international security issue since it could
"decimate the economic, political and military establishments in many countries[and]is being
more effective than war in destabilizing[them]". Peter Piot(UNAIDS)said he needed $1-3b a year
in Sub-Saharan Africa alone. The Economist 29 Apr 00"Africa’s Twin Scourges"(17-8);"Aid for
AIDS"(76):-these articles are valuable in going beyond the schemes to fund urgent research on
cures for Third World diseases(as pharmaceutical companies see no profit),to also consider
market costs. Already AIDS kills 2.5m and malaria 2m annually, mostly in Africa and climbing
fast. The economic impact is huge. Malaria's cost is over 1% of GNP. Since AIDS weakens/kills
prime workers, skills and productivity are hit hard. Moreover, in any given country a year of basic
HIV medical treatment for one now costs 2-3 times per capita GNP, and once the adult infection
rate reaches 8%(the case in 21 countries), per capita growth is lowered .4%(Africa recently
averaged only 1.2%). Yet global AIDS vaccine research in 1999 drew only $300m, of which a tiny
fraction was specifically for LDCs. Since any successful vaccines must be marketed very
cheaply there, the authors urge that donors heavily subsidize both research and distribution. The
costs of tackling malaria are estimated at $1b annually, but this could benefit sub-Saharan
Africa’s combined GNP $3-12b. Neil A. Lewis"Clinton Tries to Expedite AIDS Drugs Into
Africa"NYT 11 May:- article reports that, in spite of strong opposition from the pharmaceutical
industry, President issued an executive order on 10 May declaring US government will not seek
to interfere with any countries in sub-Saharan Africa that may violate American patent law in
order to provide AIDS drugs at lower prices. (An identical Congressional proposal was
withdrawn because of industry opposition.) The order would allow African states to licence local
companies to produce cheap generic versions or import the drugs cheaply from third countries
without paying US prices kept high by patents. Reuters"Roche Says to Slash AIDS Drugs
Prices"11 May:-Swiss pharmaceuticals giant Roche announced it would slash prices of AIDS
drugs for LDCs, and offer free logistics support, under a UN initiative responding to the African
crisis. Arrangement also involves four other companies, but the timing and prices are”subject
to negotiations”. McNeil"Companies to Cut Cost of AIDS Drugs for Poor Nations"NYT 12 May:-the next day five major pharmaceutical companies offered to negotiate, with WHO and other aid
groups, steep cuts in the price of their patented AIDS drugs for Africa and other poor regions.
UNAIDS acknowledged a“promising step in a long-term process [but] only one critical factor
in what must become a much broader and more urgent effort". The allusion is to the additional
need globally for much more Third World-relevant medical research and much better AIDS-related education and health systems in the Third World(see Economist 14 Aug 99, 29 Apr 00,
Olson op.cit.). McNeil"Prices for Medicine Are Exorbitant in Africa, Study Says"NYT 17 Jun:-article reports huge anomalies in the prices of vital drugs. One study found "the price of life-saving medicine in Africa, where the need is greatest and the poverty is worst, is often higher
than in Europe and North America... [T]he medicine...patients need for AIDS...are often available
only at exorbitant prices”(by any standards)-particularly in South Africa. A UNAIDS study of
prices in Brazil, which like India ignores Western patents and makes cheap copies of new drugs,
found them very low compared with Africa or US, but also unreliable. Many poor countries use
a low-price WHO bulk-purchasing system, but have high loss rates. Kenyan Health Minister
summed up the basic problem:”How can we be denied access to drugs that prolong life when
people are dying?” Reuters,“SADC(Southern African Development Community) Ministers Unable
to Respond to AIDS Drugs Offer”NYT 17 Jun:-five leading drug companies offered to cut the
prices of HIV/AIDS therapies by up to 80% for poor countries as part of a UN deal, but the SADC
concluded they still had neither the funds nor infrastructure to afford the offer. McNeil“Writing
the Bill for Global AIDS”NYT 02 Jul:-an AIDS expert explains that in the Third World the
epidemic is”really a welfare and education issue rather than a medical one”. The $2b estimated
in a UNAIDS report as the annual cost of providing Africa with ”minimum prevention and
care”would have to go almost entirely for preventive measures even if cheap drugs were
available. Of the 34m HIV-infected people worldwide, at least 30m are so desperately poor that
most have to be simply“written off”so limited funds available/realistic can be invested in
prevention, not treatment. Financial triage. Lawrence Goldyn“Africa Can’t Just Take a Pill for
AIDS”NYT 06 Jul:-President Mbeki of South Africa has been justly criticized for doubting the
(proven) value of AZT and the (clear) sequence from HIV to AIDS, but he was right in claiming
that the pharmaceutical-based model of HIV care in the West is not applicable to(South)Africa.
“Cost is the obvious barrier to drug therapy”; even if subsidized to 10% of their cost in the West,
they would be well beyond African means. But "the lack of social, economic and medical
structures to support drug treatment"means that even if cheap“drugs arrived by the shipload” -
as proven by past TB programs, the problem is getting people to take them.”What Africa most
needs is an HIV vaccine” - but potential African returns are not so far worth massive research
investment by drug companies. Moreover, controlling HIV in(South)Africa would require a huge
international investment, not merely sufficient to create incentives to produce drugs, but also
to distribute them, and to provide clean water, sanitation, clinics, health education, refuge for
women, and care for children. Lawrence K. Altman“A Call for Fair Access to Future AIDS
Vaccine”NYT 07 Jul:- reports on a “blueprint” proposed by the International AIDS Vaccine
Initiative, a research consortium that works closely with UNAIDS. This addresses exactly the
dual economic and infrastructure challenges just outlined. The consortium urges that:”Though
a vaccine to prevent AIDS is years away, steps should be taken now to enable a vaccine to be
distributed widely in the third world as soon as it becomes available”. It admits both public and
private sectors must learn new ways of doing business to accomplish "sweeping changes in the
way vaccines are produced, licensed, priced, bought and distributed"-and offer special delivery
systems and counselling. There is usually a 15-year lag between availability of key vaccines in
rich and poor countries; but an avoidable 5-year lag in distributing an AIDS vaccine would
severely damage many African economies - and cost at least 20m lives! Existing WHO programs
can be exploited, but pricing structure is WTO business. Reuters “Botswana Pres.: Nation Faces
Extinction From AIDS”NYT 08 Jul:-”AIDS has put the people of Botswana, probably more than
any other, on a knife-edge between prosperity and poverty”. Perhaps the most democratic and
prosperous state in Africa now has the highest rate of HIV/AIDS infection in the world - mainly
spread by the sex trade. One in three adults is already infected, and advanced AIDS will not peak
for 5-10 years, so President Mogae was not being rhetorical when he told the Reuters journalist
a country of 1.6m people“faces extinction from the disease”. No antiretroviral drugs are
available: even at reduced prices, they are simply too expensive even for“successful”African
states to buy, distribute and administer. Reuters“Gates, Merck to Give Botswana $100m AIDS
Help”NYT 10 Jul:-in direct response to Mogae’s statement to Reuters, the Gates Foundation and
Merck and Co. will contribute $100m over five years in cash, expertise, antiretroviral drugs, etc.
to”help Botswana strengthen its primary health care system. German/British/Dutch firms will
also donate medication and expertise. McNeil“As Devastating Epidemics Increase, Nations Take
On Drug Companies”NYT 09 Jul:- an extraordinary article containing extraordinary information.
It relates to attempts by Pfizer, supported by the US government, to defend its patent, and high
prices, for fluconazole, an effective anti-fungal treatment for cryptococcal meningitis, an AIDS
complication that blinds and then kills within two weeks, and attacks about 9% of all AIDS
patients(20+% in Thailand). Fluconazole’s cost in Kenya is $18 per pill. Treatment requires two
a day for 8 weeks($1,080), then one a day for the rest of the patient’s life($540 a month). Good
Kenyan earnings would be $40-45 a month; the national health budget averages $5 per person
per year. Local doctors at a foreign aid agency are"so furious at Pfizer’s pricing policy"they
illegally smuggle generic Thai fluconazole pills(60 cents)into Kenya -"part of the titanic
struggle...between pharmaceutical companies and public health advocates over the cost of
drugs like fluconazole and who has the right to produce and market them". Thai action is based
on 1994 World Treaty on Intellectual Property(TRIPS)that allows countries to manufacture or
import generic drugs to avert national disaster(AIDS) -“compulsory licensing”. When South
Africa first proposed to use this clause, both Pfizer and the US government threatened severe
sanctions, but when it became a presidential campaign issue, the US changed its position. Pfizer
will now provide fluconazole free to any South African with AIDS who could not afford it; the
offer might eventually be extended to all Africa. Associated Press“US Hopes To Raise Anti-AIDS
Funding”NYT 11 Jul:-article reports that US government is raising its budget to stop the spread
and effects of AIDS to more than $200m, double the 1999 amount, but hopes for similar
increases from other donor countries. Head of the White House AIDS office stressed that,“With
no vaccine or cure in sight, we are at the beginning of an epidemic, not at the end”. Reuters“HIV
Drugs for All Would Cost $60 Billion - Report”NYT 11 Jul:-Panos Institute(London) report
estimates at least 12m with HIV worldwide(40% of those infected)need antiretroviral therapy at
a cost of $60b a year at current prices. Building national health systems and providing skilled
personnel ”would cost additional billions”, so prices must fall by 95% for the drugs to be
available to the majority of people infected. Hence, Panos recommends “compulsory licencing”
which grants the right to manufacture and sell locally at low prices. Since most drug companies
oppose this, debt relief is another possible solution. Joseph Kahn“U.S. Offers Africa Billions to
Fight AIDS”NYT 19 Jul:-the US Export-Import Bank will offer Sub-Saharan Africa $1b in loans
annually to finance the purchase of American AIDS drugs and medical services. Most of the new
loans would be provided at commercial interest rates(now about 7%)but at long(5-year)terms,
although a few “might be at a lower concessional rate”. This decision follows the agreement by
five multinational drug companies to cut the prices they charge African states for drugs to
combat AIDS, since these will still be expensive at prices discounted 80-90%. Some argue that
the straight donation of drugs is necessary; others that debt forgiveness of as much as $100m
globally would be a better way to free up funds. The UN estimates the cost of fighting AIDS in
Africa at”$3b annually if the nations hardest hit are to make significant progress in education,
prevention and care”. It is exploring the possibility of Africa buying generic drugs from Brazil
and India at even lower than 90% discounted prices (still $2000 per patient per year).
Reuters“Australia Hikes Overseas Spending on HIV/AIDS”onhealth.com, 27 Jul:-FM Downer
announced at a regional conference that the Australian pledge for ODA on world AIDS
assistance had been raised from A$130m to A$200m. Most will be allocated to the Asia-Pacific
region which has been relatively successful in holding the HIV epidemic at bay. Only three Asian
countries have infection rates above 1% among 15-49 year olds according to UNAIDS. These are
Cambodia, Myanmar and Thailand, and Thailand has been praised for instituting a successful
program to control an already serious outbreak. While the Australian six-year overseas initiative
already is committed to projects in Indonesia and Papua New Guinea, much funding is available
for new projects. This may be fortunate: the low UNAIDS rates are known to miss huge numbers
of already infected Asians. In India, 3.7m are known/admit to be infected already; in China, .5m -
mainly drug users - are(officially?)estimated to have HIV/AIDS. XINHUA“SADC Calls for Cheaper
Anti-AIDS Drugs” onhealth.com, 07 Aug:-the SADC Council of Ministers, with UN cooperation,
met the pharmaceutical companies’ unrealistic offer of discounted anti-AIDS drugs alone with
the reasonable counter-proposal that if very poor countries are expected to accept(and pay
for)the drugs package, it must be“as comprehensive as possible” and provide not only
medicines but “the whole range of services needed to make these interventions effective”.
Rachel L. Swarns, “Loans to Buy AIDS Drugs Are Rejected by Africans”NYT 22 Aug:-US Export-Import Bank offered 24 African countries $1b in annual loans(at commercial rates: 7%)to finance
purchase of anti-AIDS drugs - but none has accepted or is likely to, however desperate their
health situations. Those officials consulted for the article(South African, Namibian, AIDS experts
at the 14-member SADC)all said poor African countries are“already burdened by debt. Making
drugs affordable is the solution rather than offering loans that have interest”. Ironically, the West
is currently planning to forgive as much as $100b of poor countries’ debt precisely to free scarce
funds for health etc., and UNAIDS is seeking a steep drop in prices of costly anti-AIDS therapies
from drug firms for poor regions stricken by the pandemic. Further, South Africa and Thailand
recently authorized seizure of patents for AIDS drugs(with full US government approval)and
India, Bangladesh and Brazil simply ignore drug patent treaties in such circumstances and
produce generic drugs. Marc Lacey“President Urges Nigeria to Fight Tyranny of AIDS”NYT 28
Aug:-Clinton, on Nigerian visit, rightly urged elimination of AIDS-associated taboos:“we need
to fight AIDS, not people with AIDS”. He offered no new funds but promised duty-free status to
Nigerian exports and noted AIDS education is part of the military course US troops offer Nigerian
peacekeepers. President Obasanjo gives AIDS priority, but pointedly stressed:”We don’t see it
as a Nigerian disease. We see it as a world disease that is ravaging Africa most”. The Economist
30 Sep“Generic Genius: Indian Pharmaceuticals”(66-9);“A Problem of Patents”(69):-related
articles illustrate the fact that the global pharmaceutical industry is in a period of rapid and
important change: more/critical discoveries; huge/desperate needs; evolving
manufacturing/trade; bitter conflicts over patents; wildly divergent prices for some life-saving
drugs. More specifically the first reveals: drugs with sales of $40b are likely to lose patent
protection in the next three years; some Third World countries are major producers of cheap
generic drugs(some before patents run out); and some of India’s 20,000 drug makers in
particular are trying to break into rich world markets. The second article sees such low-cost
producers as a possible means of getting more expensive new drugs to the poor. Fluconazole,
protected by patents, now costs $10 a pill wholesale in the US, but only 25 cents in India where
its patent is not recognized and there are no R&D costs to recoup. Medecins Sans Frontieres
want to expand sales of affordable drugs from capable generic companies in Brazil, India,
Thailand in other poor countries. However, the latter also must have a “loose”patent policy.
Those with tough patent laws(e.g. South Africa)have to apply for special dispensation from the
patent holder, or invoke the TRIPS “national disaster”clause(see above) - and all countries are
now under obligation from WTO to implement strong TRIPS-type laws. AIDS is getting even
costlier for the poor.
(HENCEFORTH, I’m afraid coverage of items will have to be shorter, or it will simply not be
possible to keep up with the media. The gist of articles can be derived from their titles, UNLESS
titles are so ambiguous/ uninformative that brief notations are necessary. Unless it is otherwise
indicated, all articles were published for, or at least in, New York Times(NYT). Authors' names
are identified fully only the first time they are listed. After that, they may be identified only by
surnames. Dates are identified by: two-digit day-number, followed by first three letters of month.
All four (or last two) numbers of year ONLY IF AMBIGUOUS/NEW.)
A1. SOURCE/LEVEL OF DRUG PRICES IN NEEDY
COUNTRIES(COST)
McNeil“Selling Cheap‘Generic’ Drugs, India Copycats Irk Industry”01 Dec 00. Indian patent law
allows for generic drugs to be produced in the country, angering many pharmaceutical
companies. Tina Rosenberg“Look at Brazil” 27 Jan 2001:-Indian/Brazilian examples of how the
AIDS cost-patent crisis may be soluble: Third World generic production and sale. Reuters"Brazil
May Defy U.S. and Make More AIDS Drugs”03 Feb:-Brazilian patent law which enables patients
to take free antiretroviral drugs is being criticized by the US due to intellectual property rights.
AP“Drug Co. Offers Cheap AIDS Drugs”07 Feb:- company, Cipla Ltd, to sell AIDS drugs for $350
a year rather than $10 000. Reuters“Indian Firm Offers AIDS Cocktail for $1 a Day”07 Feb:-Cipla
Ltd. will sell cheap triple-cocktail of AIDS drugs to developing nations. McNeil“Indian Company
Offers to Supply AIDS Drugs at Low Cost in Africa”07 Feb:-Cipla Ltd. to sell their generic drugs
at $350 a year. AP“OXFAM Takes Aim at Pharmaceuticals” 11 Feb:-Oxfam is urging the WTO to
renew its position towards patent laws so that poor nations can receive generic versions of
AIDS drugs. Sara Chartrand“ Patents: In Health Emergencies, Brazil Allows the Copying of
Drugs”19 Feb. Reuters“ S.Africa Okays Pfizer AIDS Drug Distribution”21 Feb:-US pharmaceutical
Pfizer to give its AIDS drug Diflucan for free distribution within hospitals in order to prevent
resale of the drug. AP“South Africa to Get Free AIDS Drug”21 Feb:-same coverage as above.
Reuters“CIPLA to Meet With WHO on Discounted AIDS Drugs”26 Feb:-:Cipla’s offer to the charity
is aimed primarily at Africa, where antiretroviral drugs used in the West are out of reach of
virtually all the 25.3 million people on the continent who are infected with the HIV virus”.
Reuters“Firm Creates Africa AIDS Fund to Deliver Free Drugs”28 Feb:-small US firm Phyto-Riker
creates $250m fund to buy and distribute AIDS drugs free in Africa. Reuters“Merck Leads New
Round of AIDS Drug Price Cuts”07 Mar:-US pharmaceutical Merck and Co Inc. says it will
distribute their AIDS drugs in poor nations at cheaper price even though the company will
receive no profit on their sale. Reuters “AIDS Drugs Land in South Africa Amid Patent Dispute”08
Mar. Pharmaceutical Manufacturers Association of South Africa (PMA)is in a legal dispute with
the S. African government over the free distribution of AIDS drugs donated by US. Sheryl Gay
Stolberg“AIDS Drugs in Africa: If Cedes to When”10 Mar:-PMA who represents 39 drug
companies have sued S. African government over distribution of free AIDS drugs while
protesters demand price cuts in region. McNeil“Yale Pressed to Help Cut Drug Costs in
Africa”12 Mar:-legal battle among university students and the university’s patent contract
agreement with Bristol-Myers Squibb over the distribution of the AIDS drug d4T to Africa.
AP“Romania to Get HIV Drug Price Cut”12 Mar:-Merck & Co. to provide reduced prices on their
AIDS drugs due to “only 40 percent of AIDS and HIV infected patients receive drug therapy”.
AP“Studies: HIV Drugs a Good Buy”14 Mar:-US study shows AIDS drugs are of better value at
extending patients’ life than drugs for other illnesses. Petersen and McNeil“Maker Yielding
Patent in Africa for AIDS Drug”15 Mar:-US pharmaceutical Bristol-Myers Squibb will no longer
try to stop cheap generic versions of AIDS drugs “d4T”, since they are distributed to many
infected people in Africa. AP “Abbott Cuts African AIDS Drug Prices”27 Mar:-US drug maker
Abbott Laboratories will sell their AIDS drugs “Kaletra” and “Norvir” at extremely cheap prices
to African nations. Reuters“Brazil Wins Fight Over Prices of Merck AIDS Drugs”29 Mar:-due to
pressure from the Brazilian government, US drug manufacturer Merck and Co. will reduce the
price of its two AIDS drugs “Indinavir” and “Efavirenz” in the country. Petersen and Larry
Rohter“Maker Agrees to Cut Price of 2 AIDS Drugs in Brazil”31 Mar:-Swiss pharmaceutical
Hoffman-La Roche is also pressured by the Brazilian government to slash the price of their AIDS
drug “nelfinavir”. Bloomsberg News“ F.T.C. Accuses Drug Makers of Collusion to Delay
Generics”03 Apr:-Federal Trade Commission has discovered a $90m payment by many big
pharmaceutical companies to small generic drug maker firms in order to delay the distribution
of low-cost AIDS drugs. Reuters“6 Companies in New AIDS Pact”06 Apr:-UNSG Annan wins
agreement from major drug companies to continue cutting prices of AIDS drugs to poor nations.
Petersen “Consumer Groups Unite To Fight For Generic Drug” 08 Apr:-US consumer groups
have filed a lawsuit to Bristol-Myers Squibb because the company is trying to block other cheap
generic versions of their drugs available to the public. AP“Bush Plan Cuts Drug
Reimportation”09 Apr:-Bush administration will not allow cheap, re-imported US-made drugs
to be distributed within the country. AP“South Africa Drug Suit Postponed”18 Apr:-lawsuit by
pharmaceutical companies to the S. African government over patent rights on the distribution
of AIDS drugs, is receiving wide criticism by AIDS activists and labour unions and demand the
lawsuit to be removed. Rachel L. Swarns“Drug Companies Begin Talks With South Africa”18
Apr:-amidst popular and international dissent over the lawsuit by the 39 pharmaceutical
companies, the drug companies are negotiating with the S. African government over importing
generic drugs. Swarns“Drug Firms Drop South African AIDS Case”19 Apr:-the attempt to stop
S. Africa importing/producing cheaper anti-AIDS medication ends. Andrew Pollack“New
Analysis: Defensive Drug Industry Fuels Fight Over Patents”20 Apr:-editorial dealing with
pharmaceutical companies and their protection of patent laws are under attack due to the high
cost of the drugs in which people in poor nations cannot afford to buy. AP“Profits Still Plague
AIDS Drug Cos.”21 Apr:-closer look as to how several major drug companies are concerned over
patent laws and the rise of public opinion weakening its importance. Petersen“Lifting the Curtain
on the Real Costs of Making AIDS Drugs”24 Apr:-generic drug-makers talk about the low cost
of producing generic AIDS drugs and how if benefits the survival of many HIV infected victims.
Reuters“Global AIDS Fund To Push Drug Firms To Cut Prices”01 May:-British ministers propose
rich nations to contribute money to the UN’s Global AIDS Fund in order to pressure
pharmaceutical companies to lower their prices of AIDS drugs. Barbara Crossette“Brazil’s AIDS
Chief Denounces Bush Position On Drug Patents”03 May:-Bush accused in being tough on
Brazilian generic AIDS drugs. AP“Drug Companies Cut Africa Prices”03 May:-many
pharmaceutical companies considerably reducing the price of their AIDS drugs, among these
companies Swiss-based Novartis. WHO and Medecins Sans Frontieres are grateful for the offers.
Terence Neilan “President Pledges $200 Million to New Fund To Fight AIDS”11 May:-money to
be given to developing nations especially Africa. AP“WHO Adopts Weakened AIDS Statement”19
May:-US and European states dismiss any authority the WHO has over the patent laws, which
they claim the WTO is responsible. Reuters“Glaxo to Cut Cost of AIDS Drugs for Kenya”24 May:-major AIDS drug maker will reduce price after Kenyan threat to acquire cheaper drugs. AP
“Pfizer expands Free AIDS Drug Plan”06 Jun:-US company will lower price of AIDS drugs to 50
poor nations. Crossette“AIDS Fungus Drug Offered to Poor Nations”07 Jun:-same story. Andrew
Ross Sorkin “Bristol-Myers Squibb to Acquire DuPont Unit”08 Jun:-$7.8b paid for drug unit in
order to compete in world market. AP“Swiss Insurer Gives to UN AIDS Fund”08 Jun:-the first
corporate donation of $1m by Winterthur Insurance to the UN AIDS Fund. Don Colarusso“Hope
for AIDS Vaccine Fuels a Stock’s Ascent”10 Jun:-Vaxgen a small US pharmaceutical company
has been using human test subjects for their newly developed AIDS drug “AIDS vax” which has
proven to be effective, giving them a rise on the company’s stock price, many researchers are
skeptical of the effectiveness of the drug. Robert Pear “Measure Easing Imports Passes in
House”12 Jul:-US House of Representatives allowed for public to import cheap generic drugs
for personal use, angering many pharmaceutical companies. AP“Gates Donates $100M to U.N.
for AIDS”19 Jun. AP“Coca-Cola to Help Africa AIDS Fight”20 Jun:-among other MNCs allowing
for transport t/distribution of AIDS drugs in many AIDS-stricken regions of the continent
particularly S. Africa. McNeil “U.S. at Odds With Europe Over Rules on World Drug Pricing”20
Jul:-Bush and the EU debating as to how to better distribute AIDS drugs to developing nations.
The US president stance is to protect patent rights of the AIDS drugs while the EU is pushing
for more generic drugs to be allowed in poor countries. Christopher S.Wren “Holbrooke Has New
Role: Leading Fight Against AIDS”20 Jun:-former US ambassador to UN pressing MNCs to
contribute to AIDS costs in LDCs. AP“U.N. Welcomes Corporate AIDS Funds”21 Jun:-Due to
many MNC’s such as Coca Cola and Chrysler contributing by giving donations for the fight
against AIDS, UN is encouraging them to give to the Global AIDS fund as well . Crossette “U.S.
Drops Case Over AIDS Drugs in Brazil”26 Jun:-US allows patent case to be settled out of court.
Peterson”Drug Maker Is Set to Ship Generic Prozac”02 Aug. US company awaiting the Food and
Drug Association (FDA)approval in order to ship their product all over the world. Reuters
”Central America Teams Up to Buy AIDS Drugs”11 Aug:-six countries to buy drugs at bulk-price
from major companies. AP“Brazil to Strip Patent on AIDS Drug”23 Aug:-claiming national
emergency, Brazil removes patents on AIDS drugs distributed by Roche pharmaceuticals.
AP“HIV Vaccine Creators Share Patents”24 Aug .US and British drug manufacturers have signed
a three year agreement on the ownership of their AIDS vaccine which is in a testing phase.
Peterson “Roche Asks for Meeting With Brazil Health Minister”24 Aug. Reuters “Brazil and
Roche Agree on AIDS Drug Price Cut”31 Aug:-Brazil persuaded Roche to lower price since its
government will allow for the production of the“nelfinavir”a generic AIDS drug that Roche
manufactures. Mcneil“A Rush for Cipro, and the Global Ripples”17 Oct:-As the US is desperate
to buy Cipro, an antibiotic designated to cure against Anthrax, from cheaper generic companies,
the developing nations will copy the US’s move for the purchase. Pollack“Drug Makers Wrestle
With World’s New Rules”21 Oct:-major drug companies claim that their production of antibiotics
such as Anthrax is due to US demand for countering bioterrorism but their real priority reflects
the US government’s creation of a rich market for Anthrax cures. Edmund L.Andrews“Bayer
Reaches Deal on Cipro to Protect Patent in Canada”23 Oct. Keith Bradsher with Edmund
L.Andrews “U.S. Says Bayer Will Cut Cost of Its Anthrax Drug”24 Oct:-A price concession
between the Bush administration and Bayer has been made in order for the US to buy Cipro at
a patent price. AP “Smallpox Vaccine Makers Watch Feds”25 Oct:-Pharmaceutical industries are
worried that the US will not purchase their vaccine drugs but rather generic. Economist“Dealing
with anthrax: Patent problems pending”25 Oct:-Article discusses how developed nations are
able to break patent laws while developing nations cannot. Bradsher “Bayer Halves Price for
Cipro, but Rivals Offer Drugs Free”26 Oct:-Keith Bradsher with Melody Peterson “Drug
Companies Aim to Please”27 Oct:-Major drug companies are looking to maintain their patent
laws through public relations and their contribution to bio-terrorism in the US. Daniel Akst “It’s
Time for Teamwork on New Drugs”04 Nov:-an editorial commenting the problems of patent laws
and its effect on poorer nations who cannot afford to buy AIDS drugs. Leslie Wayne and Melody
Petersen“A Muscular Lobby Tries to Shape Nation’s Bioterror Plan”04 Nov:-Major
pharmaceutical companies winning concessions to maintain their patent laws in the US while
maintaining a close relationship with the Bush administration. McNeil“Patens or Poverty? A New
Debate Over Poor AIDS Care in Africa”05 Nov. Milt Freudenheim“ Court Reverses U.S. Approval
of Generic”07 Nov:-US federal court overturned the government’s approval for the distribution
of a generic pill. Amy Harmon“Suddenly , ‘Idea Wars’ Take on a New Global Urgency”11 Nov:-As
the meeting for global trade in Doha, Qatar is near, many questions by developing nations
emerge over the US handling of patent laws. Reuters“Trade Round Hopes Rise After WTO Deal
on Drugs”12 Nov:-An agreement over the sale of generic drugs to developing nations has
emerged during the Doha Round conference. McNeil“Tuberculosis Group Tries to Spur Research
for New Antibiotics”15 Nov:-Pharmaceutical companies research for cure that bring in $1billion
yield of return, many diseases such as tuberculosis do not get the proper research due to the
lack of financial incentive. Louis Uchitelle “U.S. Industries Largely Favor Decision on Global
Trade”15 Nov:-Generic medicine can be made in developing nations for the treatment of AIDS
and other lethal epidemics. Celia W.Dugger “A Catch-22 on Drugs for the World’s Poor”16 Nov:-Poor countries do not have the essential resources for the possibility of producing generic
medicine for the treatment of AIDS. Jennifer L.Rich“Brazil Welcomes Global Move on Drug
Patents”16 Nov. AP“Activists Slam Drug Dev. Cost Study”30 Nov:-A study shows that
pharmaceutical companies’ claim for the cost of their medicine is deliberately overpriced.
AP“Profits From AIDS Drug Help Samoans”14 Dec:-The healing knowledge of a particular tree
in Honolulu might bring a cure for AIDS. Larry Rohter“Brazil Sees Promise in Jungle Plants, but
Tribes See Peril”23 Dec:-By having “nearly one-quarter of the world’s plant species”, Brazil is
pushing for restrictions that will allow these plants to be researched for medicinal purposes
only. McNeil “New List of Safe AIDS Drugs, Despite Industry Lobby”21 Mar 2002:-WHO
listed/approved generic drugs thus angering multinationals. AP “AIDS Group Battles
GlaxoSmithKline”27 May:-Activists are arguing that the British pharmaceutical is still overpricing
its product. Economist “The bitter pills”05 Jun:-Bristol Meyer, US drug company, being sued
over its prevention of not allowing for generic medicine. Reed Abelson“Glaxo Freezes Prices
AIDS Drugs in U.S.”21 Jun. Elizabeth Olson“U.S. Backs New Trade Rules on Drugs”25 Jun:-US
agrees on the sale of generic drugs against AIDS to be available in poorer nations. Reuters
“AIDS Conference Opens Amid Controversy”07 Jul:-Barcelona international AIDS conference
was overshadowed due to AIDS activists demanding for cheaper drugs to be sold to poorer
nations. NYT“Brazil to Share AIDS Drugs”09 Jul. Reuters“AIDS Activists Trash EU Commission
Stand at Meeting”10 Jun:-AIDS activists in Spain want the EU to contribute to the AIDS effort.
Economist“AIDS: Hope for the best, Prepare for the worst”11 Jul:-A concise article dealing with
the positive results from the AIDS conference in Spain. Howard W. French“Whistling Past the
Global Graveyard”14 Jul:-Richer nations reluctant to contribute to AIDS fund due to their focus
on terrorism or the gulf war. Economist“Generic drugs: A good week for copycats”01 Aug:-Generic manufacturers receive legislative support in producing their medicine. Henri E.
Cauvin“Mining Company to Offer H.I.V. Drugs to Employees”07 Aug:-A company in South Africa
is supplying AIDS drugs to its employees. Economist“Business and AIDS: Digging Deep”08
Aug:-South African miners receive AIDS drugs from its employer. Economist“AIDS and South
African business: Strategic Caring” 03 Oct:-Many companies in South Africa are initializing new
policies to stop the spreading of AIDS. AP“FDA to Review New AIDS Drug Fuzeon”11 Oct:-An
expensive AIDS drug has been discovered in which its approval process will be shortened.
NYT“Annan Warns China of an AIDS Epidemic”15 Oct:-Gregory Crouch“Europeans Investigate
Resale of AIDS Drugs”29 Oct:-Trafficking of AIDS drugs which were meant to be sold to poorer
nations are being sold in the European market. Economist“Face value: The acceptance face of
capitalism?”12 Dec:-Drug companies’ bosses need an exceptional public relations image in
order for their companies to be seen credible. Economist“Drugs and Developing Countries: Pill
Paupers”19 Dec:-Report on the WTO pushing for a concession between drug companies and
the generic manufacturing of their product. Elizabeth Becker“U.S. Official to Discuss Trade as
Africa Hopes to Talk AIDS”11 Jan 2003:-Elizabeth Becker and Edmund L.Andrews“Performing
a Free Trade Juggling Act, Offstage”08 Feb:-US trade representative will decide if generic drugs
should be sold to sub-Saharan Africa. Economist 22 May“The Cost of AIDS: An Imprecise
Catastrophe”(68-71):-"The most dreadful cost of AIDS is in lives lost. A second cost, shared by
those not infected, is economic. However, estimating the damage done by the disease, especially
in southern Africa’s mostly feeble economies, is an inexact exercise even by the standards of
economics, because AIDS has struck hardest in areas where data are least accurate:
subsistence farming, casual labour markets, rural barter and so forth”; Amelia Gentleman & Hari
Kumar“AIDS Groups in India Sue to Halt Patent for U.S. Drug”NYT 11 May 2006:-“AIDS groups
this week brought important test of India’s new patent law, which restricts ability of Indian
companies to produce low-cost generic drugs. Two patients-rights groups sued to stop Gilead
Sciences, California biopharmaceutical company, from patenting the antiretroviral drug Viread -
company’s brand-name version of tenofovir, which is available [in India] as a generic drug. If it
is patented, the groups contend, making the cheaper versions will become illegal, and the drug
will become too expensive for patients...in developing countries... Doctors Without Borders
[stated:] ‘People in Africa and Caribbean are relying on India to produce these drugs. Quality
matches that of US-manufactured drugs, but prices affordable’. Lawyers for two [Indian]
groups... presented arguments contending tenofovir not new drug, but modified version of
earlier drug, and therefore not eligible for new patent under India’s new law. Those backing legal
challenge hoping to gain legal precedent for use in other patent applications... WHO recently
recommended tenofovir for patients just starting treatment for AIDS and those who have been
receiving antiretroviral treatment therapy but resistant to other treatments. In [rich] countries,
Gilead’s tenofovir costs $5,718/person/year. Cipla, one of largest companies in India, marketing
version called Tenvir, at cost of $700/person/year in India. Chairman Cipla said drug eventually
available in Africa for about half that price. But Tenvir would have to be withdrawn if Gilead were
given patent,.. in effect for 12 years. Gilead Sciences said... ‘[W]e believe Viread represents
innovation and parentable under Indian law. We will use this patent responsibly, and not block
access to our medication in India or other resource-limited countries where HIV epidemic hit
hardest’. Company... ‘pursuing broad policy of nonexclusive voluntary licensing under patent
to generic manufacturers in India for local Indian market as well as provision for manufacturers
to export product to 97 developing-world countries included in Gilead’s access program’”;
A2. EFFECT/ADJUSTMENT OF DRUG PRICES IN
NEEDY COUNTRIES
Jennifer L. Rich“Explosion of Generics About to Occur in Brazil”23 Nov 2000:-joint venture
between Teva, generics manufacturer, and local Loboratorios Biostetica, makes more generics
available. Reuters“Chirac Says EU Not Doing Enough to Combat Aids”01 Dec:-French President
claims EU should increase anti-AIDS work in Africa. Swarns“South Africa to Distribute $50
Million in Donated AIDS Drugs”02 Dec. AP“U.N. Steps up AIDS Fight in Africa”07 Dec:-UNSG
Annan and African leaders pledge to unite political-economic resources to conquer AIDS.
AP“U.S. to Help Fight AIDS in Botswana”12 Dec. McNeil“Romania’s AIDS Children: A Lifetime
Lost”07 Jan 2001. Reuters “Bill Gates Gives $100 Million for AIDS Vaccine”27 Jan.
Reuters“Economic Leadership Lacking in Global AIDS Epidemic”05 Feb:-Dr. Jeffrey D. Sachs
claims economic response to AIDS pandemic ‘utterly inadequate’. McNeil“Oxfam Presses to
Make Drugs Cheaper for Poor Countries”13 Feb. Reuters“UN Agency Urges Drug
Cooperation”16 Feb:-head of Joint UN Program on HIV/AIDS(UNAIDS)urges cooperation among
activists, pharmaceutical firms, governments. Economist “Science and Profit”17 Feb:-Editorial
argues drug companies must cover R&D costs somewhere. They would be willing to increase
their sales in poor countries through extremely low prices there - if they could maintain their
profits in the West. “The case for much more generous provision of life-saving drugs to the
developing countries is irresistible both morally and as a matter of economics. But it is naive,
wrong, and in the long run counter-productive, to expect the cost of this aid to be met out of
drug-company profits.” Reuters“AIDS Drug Costs Must Fall in Poor Nations: UN”21 Feb:-UNSG
Annan’s report to UNGA states: "people in developing countries are dying needlessly for lack
of appropriate care”; hence drug companies and governments must do more”through all
possible means”to bring down the cost of AIDS therapies so patients in poor nations can gain
access. AP“Priest To Import AIDS Drug to Kenya”21 Feb:-US priest working with HIV-positive
orphans in Kenya plans to import cheap generic drugs from India. McNeil“Bush Keeps Clinton
Policy on Poor Lands’ Need for AIDS Drug”22 Feb. AP“Aid Agency To Distribute AIDS Drugs”24
Feb:-Doctors Without Borders will buy anti-AIDS cocktail from Indian company Cipla for 10 poor
countries. Reuters “Protests As Drug Firms Take on S.African Govt”05 Mar. AP“South Africa
Fights Over Aids Drugs”05 Mar. Reuters“South African AIDS Drug Case Postponed Until April”06
Mar. AP“Botswana Firm Subsidizes AIDS Drugs”07 Mar:-DeBeers (diamonds)will subsidize anti-AIDS drugs. AP“S.Africa: AIDS Drug Need Is Heeded”08 Mar:-Merck and Co plans to sell two key
AIDS drug to poor countries at 1/10 normal price, while Indian-based Cipla offers to sell cheap
generics. Swarns“South Africa May Cite Crisis to Lower Cost of AIDS Drugs”12 Mar:-government
considering declaration of national emergency to eliminate legal obstacles to
importing/producing cheap generic HIV/AIDS drugs. AP“No State of Emergency in S. Africa”14
Mar:-President Mbeki refuses to declare state of emergency over AIDS epidemic. Swarns “No
National Emergency, South African Leader Says”15 Mar. AP“Ivory Coast Winning AIDS Drug
War”19 Mar:-Ivory Coast quietly importing generic AIDS drugs for years without problems.
Swarns“AIDS Obstacles Overwhelm a Small South African Town”29 Mar:-in Hlabisa, single
doctor must dispense all desperately-needed anti-AIDS drugs. Reuters“South Africa Says Key
AIDS Drugs Still Too Costly”06 Apr. AP“Mali Gets Deal on Western HIV Drugs”08 Apr:-Mali to
obtain cut-rate HIV drugs from four major firms. AP“Few Benefit From African HIV Deals”11 Apr:-six sub-Saharan countries strike deals with major Western drug firms but only few thousand
expected to benefit. Reuters“South Africa Confident of Winning Drug Court Case”12 Apr:-government(sic) expects to win landmark patent case against world’s most powerful drug firms.
Economist “Economics Focus: Markets for Ideas”12 Apr:-discusses the economic arguments
pro and con intellectual property rights, concluding that since ideas are not reduced through
use, “Poor countries have every reason to question the [intellectual property-related] trade-policy bargain”. Reuters“Mandela Slams Drug Makers, Chides S. African Government”20 Apr:-former president castigates 39 major drug firms for taking South Africa to court to prevent
import/manufacture of cheap AIDS drugs. AP“Africa Ministers OK AIDS Drug Plan”25 Apr:-agree
on joint declaration to import generic AIDS drugs, and boost spending dramatically on AIDS
programs. Reuters“A Call for AIDS Superfund”26 Apr:-UNSG Annan proposes global superfund
to halt/reverse pandemic which kills 2.8 million annually. AP“African Leaders Discuss AIDS
Drugs”27 Apr. NYT “Africans Unite in Seeking More Funds to Halt Spread of AIDS”28 Apr.
Joseph Kahn“Rich Nations Consider Fund of Billions to Fight AIDS”29 Apr. Crossette “Experts
Say That Cheaper Drug Treatments Alone Are Not Enough”30 Apr:-claim need more effective
education/prevention, better clinics, more trained health care workers, imaginative development
projects to tackle AIDS epidemic. Reuters“Annan Calls on Foundations to Back AIDS War
Chest”30 Apr:-UNSG calls on US foundations to throw financial weight behind new global AIDS
fund. Crossette“U.N. Chief Asks for New Funds to Fight AIDS”09 May:-Annan asks Bush
Administration to give more for Africa. Reuters“Glaxo To Cut Cost Of AIDS Drugs For Kenya”24
May. Reuters“UN’s Annan Warns AIDS Wrecks World Economic Growth”01 Jun:-Annan tells US
Chamber of Commerce,”As AIDS creates more poverty and deepens inequalities, it fuels the
growing public backlash against globalization.” Economist“Aid and AIDS: Gambling with
Lives”31 May:-an independent global fund to pay for ending global diseases is attainable
through voluntary donations. Among donors: UN, rich and poor countries, NGOs. Reuters“South
Africa Seeks Cheaper Drugs After Court Win”04 Jun:-gains legal victory over companies trying
to stop import of generic AIDS drugs. AP“Pfizer Expands Free AIDS Drug Plan”06 Jun.
Crossette“AIDS Fungus Drug Offered To Poor Nations”07 Jun:-Pfizer offers 50+ poor nations
unlimited free supply of AIDS-related drug. Reuters “African Ministers Say AIDS Drugs Too
Costly”08 Jun. AP“Swiss Insurer Gives To UN AIDS Fund”08 Jun:-Winterthur Insurance first
corporate donor to new UN AIDS fund. Don Colarusso“Hope For AIDS Vaccine Fuels A Stock’s
Ascent”10 Jun:-despite skepticism, shares of biotech company Vaxgen soar. AP“In Africa, HIV
Treatment Erratic”18 Jun:-widespread poverty makes chances of treatment very uncertain.
AP“Gates Donates $100M To UN For AIDS”19 Jun. Christopher S. Wren “Holbrooke Has New
Role: Leading Fight Against AIDS” 20 Jun:-ex-US Amb. to UN returns to international arena.
Robert Pear“Measure Easing Drug Imports Passes in House”12 Jul. AP“Study: Fighting AIDS
May Cost $9B”18 Jul. AP“Health Experts Ask G8 for AIDS Money”18 Jul. Reuters“G8 to Launch
AIDS Fund, But Short of U.N. Target”20 Jul. AP“Coca-Cola to Help Africa AIDS Fight”20 Jul.
McNeil“US at Odds With Europe Over Rules On World Drug Pricing”20 Jul. AP“UN Welcomes
Corporate AIDS Funds”21 Jul. Crossette“US Drops Case Over AIDS Drugs in Brazil”26 Jul:-US
unexpectedly withdraws patent complaint and agrees to settle out of court. Petersen“Drug Maker
is Set to Ship Generic Prozac”02 Aug. Reuters“Central America Teams Up to Buy AIDS Drugs”23
Aug:-six nations buy AIDS drugs in bulk in attempt to negotiate lower prices. AP“Brazil To Strip
Patent on AIDS Drug”23 Aug. AP“HIV Vaccine Creators Share Patents”24 Aug. Petersen and
Rich“Roche Asks for Meeting With Brazil Health Minister”24 Aug:-Brazil may break Roche patent
in order to produce generic AIDS drugs. Reuters“Brazil and Roche Agree On AIDS Drug Price
Cut”31 Aug. AP“S.Africa Official: AIDS Drugs Costly”13 Sep:-while drug companies have cut
price of medications, country still cannot afford to provide them. Agence France-Presse“Nigeria
Buying Generic Drugs for an AIDS Treatment Trial”30 Sept:-will begin trial program in order to
receive cheap imported generic drugs. Marc Lacey“Kenya Losing Needed M.D.’s as Low Pay
Causes Flight”07 Oct:- Many Kenyan doctors are leaving for Southern parts of Africa due to
better working conditions/wages. AP“Generic AIDS Drug in South Africa”07 Oct:-S. African drug
manufacturer will be allowed to produce and sell three key AIDS medicines in region.
McNeil“Patents or Poverty? A New Debate Over Poor AIDS Care in Africa”05 Nov. AP “Study:
Cycling Drugs May Curb AIDS”03 Dec:-AIDS patients take drug combination for week and then
stop for week. May be able to control HIV, reduce side effects and cut costs in half. Daniel
Altman “Diagnosis of World’s Health Focuses on Economic Benefit”21 Dec:-WHO claims foreign
aid plus poor governments’ own funds could improve health of people. Report states how money
from donor states could tackle AIDS, malaria, tuberculosis and diseases common to Third World.
AP“Generic AIDS Drugs Come to S. Africa”29 Jan 2002:-humanitarian aid organization importing
three AIDS medicines into S. Africa due to country’s refusal to legalize these cheap copies of
patented AIDS drugs. Reuters“Global Anti-AIDS Fund Swings Into Action”29 Jan:-Geneva-based
UN organization, Global Fund, calling all countries to suggest projects to contain spread of
AIDS, tuberculosis and malaria, and generate funds from donor states. Reuters“W. Bank Sets
$500 Million Anti-Aids Loan for Africa”07 Feb:-total World Bank anti-AIDS assistance is $1 billion
in financial year, “helping African countries act with much greater speed and flexibility against
HIV”. Sheryl Gay Stolberg“AIDS Fund Falls Short of Goal and U.S. Is Given Some Blame”13 Feb:-Annan urges donors to contribute $7 billion a year in fight against AIDS. US pledge of only $200
million sets poor example. Kahn“A Star Close to the Heart of Aid Policy”15 Mar:-Bono, lead
singer of band U2, has lobbied White House to contribute more to fight AIDS. McNeil“New List
of Safe AIDS Drugs, Despite Industry Lobby”21 Mar:-WHO releases list of manufacturers of
safe/cheap AIDS drugs, challenging pharmaceutical multinationals -who want only patent-holders to decide what discounts to offer on products. Reuters“Calls for Help Exceed Global
AIDS Fund Resources”25 Mar:-large number of requests by poor nations, particularly African,
seeking $1.15 billion this year to fight AIDS, tuberculosis and malaria. Global Fund states amount
is 50% more than it has available. Adam Clymer“Helms Reverses Opposition to Help on AIDS”26
Mar:-former US senator Jesse Helms has changed his negative view on AIDS funding, by
pushing for $500 million to be put towards $27 billion requested. AP“Cheap AIDS Drugs Not
Getting to Africa”28 Mar:-25,000 of 2.5 million people infected by AIDS are receiving drugs.
Causes: high cost of daily treatments and price of medicine in Africa. NYT“Demand For AIDS
Funds Exceeds Supply”28 Mar:-poor nations seek $1.7b, more than half Global Fund has been
able to collect from donors. AP“U.S. to Help Caribbean Fight AIDS”21 Apr:-US agrees to send
health experts to Caribbean and pledges to give $500m this year, and proposes to give $1.1b
next year to fight AIDS. McNeil“W.H.O. Moves to Make AIDS Drugs More Accessible to Poor
Worldwide”23 Apr:-WHO releases guidelines on which AIDS drugs poor nations should use,
while allowing competition between patent-based and generic-drug manufacturers. AP “AIDS
Fund Issues $378M in Grants”25 Apr:-Africa will receive 52% of money with rest to be distributed
to other poor nations. Economist“How to live with it, not die of it”05 May:-Africans infected with
AIDS could later create negative economic impact due to rise in orphaned children, halting
much-needed development. Economist“AIDS in southern Africa: Fighting back”05 May:-southern
region of Africa, especially Botswana and Mozambique, with world’s highest rate of HIV
infection, could create 1m orphans, poverty, and violence in region. Stolberg“Unlikely Coalition
Stirs Congress in AIDS Battle”12 May:-Republican reps in US are pushing to add $200m towards
Global AIDS Fund. AP“Zimbabwe Lifts Import Restriction on AIDS Drugs”28 May. Henri E.
Cauvin“Zimbabwe Acts to Obtain AIDS Drugs at Low Prices”01 Jun:-HIV has become national
emergency in Zimbabwe, allowing it to obtain generic drugs at low prices. AP“Bush Proposes
Spending $500 Million on AIDS”19 Jun:-money intended only to stop transmission of virus from
mother to child during pregnancy and after birth. Stolberg “Bush Offers Plan to Help Mothers
Avoid Passing H.I.V. to Babies”20 Jun:-provides treatment for 2m mothers in Africa and
Caribbean over each of next 5 years. Altman“Modest Anti-AIDS Efforts Offer Huge Payoff,
Studies Say”05 Jul:-research provided by variety of government and private groups shows that
proper measures(e.g. condom distribution, improved status of women, voluntary
counselling)would save 29m from AIDS. AP“Caribbeans to Buy AIDS Drugs at Discounts”07 Jul:-6 AIDS drugs manufacturers allow sales at lower prices. Reuters“AIDS Conference Opens with
Call for Drugs for Poor”07 Jul:- 14th International AIDS Conference in Barcelona: activists and
top officials demand AIDS drugs at lower prices in countries where most needed. NYT“Brazil to
Share AIDS Drugs”09 Jul:-through donation of generic drugs, plus knowledge of drugs.
Reuters“AIDS Activists Trash EU Commission Stand at Meeting”10 Jul:- activists push EU to
donate more towards Global Fund against AIDS. AP “Health Gap in Rich, Poor Countries”11 Jul:-
AIDS Conference illustrates need for wealthier nations to contribute more for AIDS epidemic.
Projects life expectancy of 30 years in many AIDS-stricken regions of Africa. Economist “AIDS:
Hope for the best, Prepare for the worst”11 Jul:- AIDS Conference has allowed positive changes
to take effect: better treatment for infected; cheaper AIDS drugs for poor nations.
Economist“AIDS: The long war”11 Jul:-as number of people dying reaches 9,000 a day, crucial
need for donor nations to provide more to stop virus. Reuters“Clinton to Tell West to Pay Up for
AIDS Treatment”11 Jul:-Being the co-founder of the International AIDS Trust, Clinton sees AIDS
as the most troublesome issue in world. Altman“ Former Presidents Urge Leadership on
AIDS”13 Jul:-Nelson Mandela and Bill Clinton urged heads of state and business executives to
take a stand against AIDS. Howard W. French “Whistling Past the Global Graveyard”14 Jul:-
AIDS epidemic is slowly affecting other nations who were not affected by the disease, such as
Russia and China. Experts argue that in future all countries in world will be affected by disease.
Reuters“S.Africa Health Minister Slams AIDS Global Fund”21 Jul. AP“African AIDS Activists
Unite”22 Aug:-the movement organized in South Africa are pushing for easier accessibility of
AIDS medicine. Agence France-Presse“China Raises Estimates of HIV Cases and Warns of
Increases”06 Sep. Elisabeth Rosenthal “China Now Set to Make Copies of AIDS Drugs”07 Sep.
Economist“China: Owning up to AIDS A “state secret” is revealed”12 Sep:-Chinese government
has allowed for AIDS drugs which have expired patents across world, are permitted to be
produced. Economist“Intellectual property: Patently problematic”12 Sep:-Intellectual-Property
Rights (IPR) known for its patent and copyright laws have modified their views on the need for
AIDS medicine to be copied from existing drugs. Economist“Intellectual property: Imitation v
inspiration”12 Sep:-A debate among pro/anti patent supporters when dealing with developing
nations. AP“China OKs Generic Anti-AIDS Drug”16 Sep. AP“AIDS Group Files Drug Price
Complaint”19 Sep:-AIDS activists are pushing for two companies to drop the price on their anti-AIDS drug. Reuters“Cheap Vaccine Sought for Africa”20Sep:-Aid agencies are urging drug
companies to make cheaper drugs against a new strain of meningitis in Africa. Geoff Dyer“UN-backed Aids fund approves generic drugs”12 Oct:-Global AIDS fund is issuing a list from WHO
which indicates generic AIDS drugs at cheaper price. McNeil“U.N. Disease Fund Opens Way to
Generics”16 Oct:-Global Aids Fund to fight AIDS will encourage poor countries to buy cheap
generic medicines. Gregory Crouch“ Europeans Investigate Resale of AIDS Drugs”29 Oct.
Reuters”World Trade Talks Struggle Over Cheap Drugs Access”25 Nov:-25 WTO members
debate in a conference in Geneva as to which developing nations are able to receive cheap AIDS
generic drugs or should there be any restrictions. Reuters “Trade Talks Fail to Break Deadlock
Over Cheap Drugs”27 Nov. Agence France-Presse“Limits Proposed on Low-Cost Drug
Program”29 Nov:-Drug manufacturers arguing that cheap medicine should only be available to
countries that are suffering major epidemics and not for other less dangerous diseases”
AP“Diplomats Prod U.S. on Affordable Drugs”17 Dec:-Members who participated in Geneva
Conference are blaming Bush administration for not allowing cheaper medicines to be attainable
for poor countries. Elizabeth Becker“U.S. Official to Discuss Trade as Africa Hopes to Talk
AIDS”11 Jan 2003:-Social unrest as US ambassador is travelling to discuss his country’s
decision to block trade deals to import generic drugs into poor countries. AP“Chinese Co.
Distributes Anti - AIDS Drug”28 Jan. Economist “AIDS: The other war”30 Jan:-With Bush
promising to pledge $15 billion over 5 years in the fight against AIDS, questions arise as to how
the money should be spent. James Lamont“UN Fund to Fight Aids in Jeopardy”30 Jan:-Global
Fund to fight Aids agency has declared that it will run out of money and not be able to afford new
projects. Rachel L. Swarns“Free AIDS Drugs in Africa Offer Dose of Life”08 Feb:- Outlook of
town in South Africa that suffers from AIDS victims and its government’s perception. Richard
W.Stevenson“Bush to Allow AIDS Money to Supporters of Abortion”16 Feb:-US president will
give donations to countries who have organizations which allow for abortions under some
certain conditions. Stolberg“Redeeming a $2 billion Pledge for Global AIDS”23 Feb:-AIDS
activists are criticizing Bush administration for lowering promised donation amount for fight
against the disease. NYT“Lawmakers Agree on AIDS Bill Details”17 Mar:-Members of US House
of Representatives are pushing for Bush’s promised donations to become larger.
Stolberg“Politics of Abortion Delays $15 Billion to Fight Global AIDS”06 Mar:-Debate between
Bush administration and opposition on allocation of promised funds by president: on the exact
amount and which poor country will receive money. Economist“The World Health Report: Battle
Ready”15 May 2004:-Article states this year’s WHO report concentrates on “3 by 5”anti-AID
initiative that agency and several collaborators announced and whose aim is to provide anti-AIDS drugs to 3m people in poor countries by end of 2005. Marc Santora & Lawrence
K.Altman"Rare and Aggressive H.I.V. Reported in New York"New York Times 12 Feb 2005:-disturbing report introduces a potentially very serious medical development in the global threat
of HIV/AIDS. Item states:"Rare strain of HIV, highly resistant to virtually all anti-retroviral drugs
and appears to lead to rapid onset of AIDS, detected in New York City man...It was first time
strain of HIV had been found that both showed resistance to multiple drugs and led to AIDS so
quickly, the officials said. While extent of disease's spread unknown, officials...say that situation
alarming...Virus found in...man in mid-40's who engaged in unprotected anal sex...with hundreds
of partners...While HIV strains resistant to some anti-retroviral drugs have been on rise in recent
years,...new case worrisome. Viral strain in unnamed patient resistant to 3 of 4 classes of drugs
used". The potential seriousness of this pandemic report justifies printing here a collection of
recent/unusually-striking articles on the truly global crisis of infectious diseases - which convey
both encouraging and shocking facts, and are relevant to the health/life of every human being -
whether we want to know about them or not. One very serious survey of the global situation is
found in major source that is op.cit.: Laurie Garrett Betrayal of Trust: The Collapse of Global
Public Health. Another broad global survey is found in Dennis Pirages"Containing Infectious
Disease". His 17-page essay contributes to serious broad subject addressed in the annual:
Worldwatch Institute State of the World 2005: Redefining Global Security, also op.cit.. Its careful
research on global issues is summarized/sub-titled:"Reducing worldwide death toll from
infectious disease should receive the highest priority". The Dynamics of Disease Outbreaks.
Environmental change can upset established equilibriums between people and pathogens,
facilitating new disease outbreaks. Each year more than 2.3m people, primarily in poor countries,
die from eight diseases that could easily be prevented by vaccination. Widespread and often
indiscriminate use of antibiotics and other anti-bacterial agents is creating families of drug-resistant microbes. The Current State of"Microsecurity". Table 3-1. Deaths from Major
Communicable Diseases, 2000 and 2002. Most worrisome near-term threat from traditional
diseases is posed by influenza. Table 3-2. Healthy Life Expectancy in Selected Countries, 2002.
Economic Consequences of Infectious Diseases. Ranks of the most productive people in some
of the world's poorest countries are being systematically depleted by HIV/AIDS. Table 3-3.Countries Most Affected by HIV/AIDS. Managing Future Disease Outbreaks. Box 3-1 HIV/AIDS
in the Military. Box 3-2 Biowarfare. Number of countries in which polio is endemic has declined
from 125 to just 6 - Afghanistan, Egypt, India, Niger, Nigeria, Pakistan. There is pressing need
to create innovative mechanisms to provide affordable drugs to disease victims in poor
countries. The rest of this concentrated item includes serious and related subjects found over
just a few weeks. Associated Press"Religious Leaders Talk AIDS Prevention"NYT 13 Dec 2004:-More than 80 religious leaders, Muslim and Christian, met at UN-sponsored Cairo conference
on HIV/AIDS."[D]ebated methods to halt spread of AIDS - usually taboo subject in conservative
Arab world - but stopped short of agreeing to recommend use of contraceptives to prevent the
disease". Community made move from only supporting abstinence/fidelity to a new message of
compassion/helping ill people/fighting discrimination. Donald G.McNeil Jr."Furor in Africa Over
Drug for Women With H.I.V."NYT 21 Dec :- "A series of articles critical of past trials of an
important AIDS drug has created a furor in Africa, causing many public health experts to worry
that some countries will stop using the drug, which prevents mothers from infecting their babies
with virus that causes AIDS." Nevirapine long been part of arsenal of antiretrovirals. NYT article
reports both medical and political positions relevant in (South)Africa and US. Nicholas D.Kristof
"It's Time to Spray DDT"Op-Ed Columnist in NYT 08 Jan 2005:-argues that West's refusal to
provide DDT to malaria-ravaged countries has contributed to surge of the disease - probably
killing 2m-3m people/year. "Instead, UN/Western donors encourage use of insecticide-treated
bed nets/medicine to cure malaria", but they are not enough."Existing anti-malaria strategy is
an underfinanced failure." While harm DDT can cause in environment recognized,"overall, one
of the best ways to protect people is to spray inside of a hut, about once a year, with DDT." This
uses tiny amounts, and is acceptable/essential. Donald G.McNeil Jr."A Path to Cheaper AIDS
Drugs for Poor Nations"NYT 26 Jan 05:-US"Food and Drug Administration has approved first
generic triple-therapy AIDS cocktail, opening way for US taxpayer dollars to be used to buy
cheaper medicines for use in poor countries." South African-made drugs are priced 1/3-1/2 of
brand-name ones. WHO already endorses dozens of generic AIDS drugs. AP"Number of People
Using HIV Drugs Improves"NYT 26 Jan 05:-"Though numbers... using HIV/AIDS drugs in
developing world, including Africa and Asia, nearly doubled in 2004, more work needed to
meet...goals of 3m getting treatment by end of 2005",warned WHO/Joint UN Program on
HIV/AIDS heads. Needed: better access to cheaper drugs and help to ensure preventative
education; 72% still missing drugs in Africa."About 40m worldwide infected with AIDS virus, and
5m new cases recorded annually. [E]pidemic now pushing deep into Asia." Sharon
LaFraniere"Poor Lands Treating Far More AIDS Patients"NYT 27 Jan 05:-"AIDS patients receiving
life-saving drug treatment in poor/middle-income nations rose 60% in past 6 months, WHO
said...,largely because of huge influx of international aid funds and a growing determination by
governments to confront the pandemic...Still, anti-retroviral treatment reaches only one in eight
needy people in developing world, leaving estimated 5.1m without such protection. Last year,
disease took more than 3m lives, 75% of them in sub-Saharan Africa."The Economist 29 Jan
05"The Gates Foundation: Missionary Zeal"(Edit.10); "Global Health: Foundation"(76-7):-major
essay tells much about global action against tropical diseases. Focus:Bill Gates' second gift of
$750m to Global Alliance for Vaccines and Immunisation (GAVI) which is aimed at giving
comprehensive vaccine protection to 90% of newly born children - and is more demanding of
donor governments to help meet its $8-12b need by 10 years. Gates' total foundation is richest
charity in world, with endowment worth $28b. Its most ambitious aim is"to free the world - and,
in particular, those regions of it that are poor - of ill health.It has formed largest non-governmental gifts to the Global Fund to Fight AIDS, Tuberculosis and Malaria, set up by UNSG
Kofi Annan. Economist 02 Jul 05"G8: Helping Africa Help Itself"(Edit.11):-Lots more money for
Africa will not make poverty history. But it might just do some good";"Aid to Africa: The $25
Billion Question"(Special Report 24-6):-"Years of mistakes have taught donors a bit about how
to spend aid money better"; "Lexington: Evangelicals and Aid: Right On" (34):-"Bob Geldof and
Bono have some unlikely friends in America... During discussion of a plan to spend $15 billion
fighting AIDS, [US President Bush] turned to his silver-penned speech writer... 'Mr President',
came the reply, 'if this is possible , and we don't do it, we will never be forgiven'"; "AIDS In
South-East Asia: There's Good News and Bad News"(38-9):-"Good prevention work has tamed
the AIDS epidemic in some countries, yet it is getting much worse in others"; "The Grand
Challenges in Global Health: 43 Ways To Save the World"(69-70):-"The Gates Foundation's latest
largesse has just been announced. It will pay for some intriguing and original research. But will
it translate into healthier people? [References to several AIDS research projects]; "AIDS: Moving
Targets" (70):-"Progress, and problems, in treating AIDS around the world". Economist 08 Oct
05 "Pharmaceuticals in South Africa: Aspen's Upward Slope"(74):-item asks: "Can South Africa's
generics manufacturer become a global giant?.. Number of South Africans with HIV-AIDS tragic
and alarming. [O]ver 800,000 people need treatment -but only about 100,000 are getting it...
Aspen Pharmacare is local firm doing most to supply the market with the generic drugs South
Africa will need. It now has ambitions to do the same for rest of Africa - and then to expand into
market for generic HIV-AIDS drugs in US and Europe... Both government and health insurers -
keen to keep medical costs down - have pushed for generics against the more expensive patent-protected drugs. As result, over 40% of prescribed drugs in South Africa are now generics.
Government and local pressure groups have arm-wrestled with pharmaceutical multinationals
over anti-retrovirals (ARVS) - the drugs used to fight HIV-AIDS. As result, companies such as
Merck and Eli Lilly have licensed local manufacturers to produce their patent-protected drugs...
Aspen now offers six different ARVS"; Donald G.McNeil Jr."Clinton in Deal to Cut AIDS
Treatment Costs"NYT 12 Jan 2006:-"Former [US] President Bill Clinton plans to announce today
that his foundation has negotiated lower prices on AIDS tests and on two important AIDS drugs.
Four companies, from US, India and China, will offer rapid HIV tests for 49 cents to 65 cents,
which will reduce typical cost of a test in poor countries by half, Clinton said in written
statement. Another four companies - three from India and one from South Africa - will make
antiretroviral drug efavirenz for as little as $240 per patient per year. One of Indian companies,
Cipla, will also make the antiretroviral abacavir for $447"; Donald G.McNeil Jr."Bristol-Myers
Allows Powerful AIDS Drug to Be Sold Cheaply"NYT 15 Feb 06:-"One of the newest and most
powerful AIDS drugs will be licensed to generic drug makers in India and South Africa so that
it can be made inexpensively for patients in many poor countries. Drug is atanazavir, made by
the Bristol-Myers Squibb Co. under the brand name Reyataz and introduced only last year in
many wealthy countries. It is a protease inhibitor, which is useful in second-line treatments for
patients who have developed resistance to their first antiretroviral cocktails. It will be licensed,
without charge, to Emcure Pharmaceuticals Ltd. of India and Aspen PharmaCare of South Africa.
Under the deal, the generic companies will set the pricing for atanazavir in Africa and India. At
moment, second-line treatments in Africa cost $3,000 to $6,000 a year for each patient, compared
to about $200 for first-line treatments... However, guidelines from WHO require that protease
inhibitors be given with what is called a booster drug - usually ritonavir, sold under brand name
Norvir [, which] must be refrigerated, especially in hot climates. As a result, move by Bristol-Myers puts pressure on Abbott Laboratories, maker of ritonavir, to make a heat-stable version";
AP"Clinton Urges Help for Kids With AIDS"NYT 18 Feb 06:-"Former [US] President urged
governments and public foundations to buy anti-AIDS drugs from low-cost manufacturers so
more children can receive treatment for the disease. Clinton... said last month that Cipla and 3
other Indian pharmaceuticals would offer antiretroviral drugs at prices up to 30% cheaper than
current market rate... Since his Clinton Foundation's 2002 HIV/AIDS initiative began, foundation
has concentrated on making affordable drugs available, buying second line AIDS drugs from
generic drug makers for 21 countries in Asia, Africa and the Caribbean, he said. His foundation
planned to get anti-AIDS drugs to 60,000 children in worst-affected countries this year... 'We've
had a 3-year partnership with Cipla, and because of them an enormous number of HIV/AIDS-infected people are alive', he said. India has 5.13m cases of the illness, second largest number
of people infected with HIV after South Africa. Indian government claims its anti-AIDS campaign
has stabilized the epidemic and says there has been a sharp decline in the number of new HIV
cases"; Reuters"Clinton Group, India to Train Nurses in AIDS Care"NYT 19 Feb 06:-"Former US
President and Indian government announced a joint plan to train nurses in AIDS care in a
country which has world's second-largest number of HIV/AIDS cases... Partnership between
National AIDS Control Organization of India (NACO) and Clinton Foundation, aims to develop
training material and program for nurses... 'Nurses not only deliver clinical care, needed to keep
people alive, but they also act as counselors and play an important role in reducing the myths,
stigma, and discrimination surrounding this disease', [Clinton said]"; Reuters "Relief Group
Seeks Access to New HIV Drug in Africa"NYT 15 Mar 06:-"A humanitarian group urged US
drugmaker Abbot Laboratories Inc. on [15 Mar] to make a new HIV drug accessible in developing
countries, especially Africa. Relief organization Medecins Sans Frontieres said a new
formulation of Abbot's lopinavir/ritonavir drug had critical advantages for patients in poor
countries, including lower daily pill count, storage without refrigeration and no dietary
restrictions... Sub-Saharan Africa has about 10% of world's population but 60% of people living
with HIV/AIDS... More than 3m Africans became infected with HIV in 2005, representing 64% of
all new infections globally and more than in any previous year for the impoverished continent,
according to UNAIDS. MSF provides anti-retroviral drugs for over 60,000 patients in nine
countries in Africa, Asia and Latin America. It said it urgently needed the new drug because
refrigeration is unavailable to many people in poor countries. The new formulation, marketed
under the name Kaletra, is in tablet form and does not melt at high temperatures unlike the old
version which is in capsules. MSF said the new version of Kaletra, which was approved by US
Food and Drugs Administration [Oct 05], was not available in any developing country. It urged
Abbot to register the new version in developing countries, sell it at less than $500 per patient per
year and remove patent barriers to allow production of generic versions... Abbott said it was
pursuing registration for the new formulation in developing countries as rapidly as possible. It
also said it was making its HIV medicines available in 69 of the world's poorest countries...
Kaledra is a 'second line' drug which can be used when standard anti-retroviral drugs stop
working... One MSF program found that after four years of ARV treatment, 16% of patients
needed second-line drugs"; Economist 01 Apr 06"Treating AIDS: A Missed Target"(64-5):-"World
Health Organization(WHO)'s attempt to roll out AIDS drugs in poor countries has missed its
target. A shame, but not a disaster[op.cit. AP 28 Mar]. The '3 by 5' initiative to get 3m HIV-positive
people in poor/middle-income countries on to anti-retroviral drugs by end of 2005 has got less
than halfway there. [WHO/UNAIDS reported] a mere 1.3m of those infected in target countries
are on courses of drugs. [Yet shift from pure prevention to care offered incentives for] those who
might...be infected[: new] reason to find out the truth [and encourage modified behaviour to
reduce transmission. Also, even 3+ times the previous number under treatment] averted about
250,000 premature deaths in 2005. One problem [was] that in most countries the [essential]
infrastructure... did not exist. [Hence] the initiative may have been more successful than [new]
figure suggests, since part money has gone on infrastructure [and] this sort of work has spin-offs beyond the treatment of AIDS. Expense of treatment also tackled[:] big change...in market
for AIDS drugs. Clinton Foundation HIV/AIDS Initiative has helped to defragment market for
generic anti-retroviral drugs by signing contracts... in India and South Africa that guarantee large
order-volumes and reliable payment. As result, price in some cases... below $150 per person per
year.. Progress, then, being made. [Possible] 3m figure by end of 06"; AP"AIDS Conference Ends
With Appeals"NYT 26 Apr 06:-"International AIDS conference [in Cape Town, of 1,000 scientists/
researchers,] ended [26 Apr] with impassioned appeals to political/pharmaceutical industry
leaders to fund development of a virus-killing [vaginal] gel to protect women from the disease
and so save millions of lives. Peter Piot, head of UNAIDS,.. said safe/effective microbicides could
be ready in 5-7 years, with only minimal additional funding, and thus turn the dream of saving
millions of lives into reality... In the hard hit African countries, women account for nearly 60% of
infections. Most are infected through heterosexual intercourse... UNAIDS/WHO have long
promoted microbicides as a potentially valuable weapon in fight against the epidemic, not least
because it allows women to protect themselves without having to rely on partners who refuse
to wear a condom or be faithful. Yet despite this, research has proceeded slowly. [Piot] said
investment in microbicide development should be doubled - and even then would still only reach
about US$150m per year... Microbicides can take the form of a gel, cream, sponge or ring that
releases an ingredient that can kill or deactivate HIV during intercourse. There are currently five
different products being tested[, mainly in Africa on thousand of women]. Dozens of agents that
could interrupt HIV transmission have so far been identified. There are also hopes that the
microbicides could be used to prevent other sexually transmitted diseases and unwanted
pregnancies. One of the products, cellulose sulphate, has the potential to be a contraceptive and
shield against HIV... Another microbicide, Carragard, coats vaginal cells and prevents the virus
from entering... Much of the funding for research comes from Gates Foundation and US
government... Trying to dismiss fears that microbicides would mainly be used in developing
countries and therefore offer only low profit margins, [WHO] cited their potential for use in
contraception in wealthy countries"; Amelia Gentleman & Hari Kumar“AIDS Groups in India Sue
to Halt Patent for U.S. Drug”NYT 11 May 2006:-“AIDS groups this week brought important test
of India’s new patent law, which restricts ability of Indian companies to produce low-cost generic
drugs. Two patients-rights groups sued to stop Gilead Sciences, California biopharmaceutical
company, from patenting the antiretroviral drug Viread - company’s brand-name version of
tenofovir, which is available [in India] as a generic drug. If it is patented, the groups contend,
making the cheaper versions will become illegal, and the drug will become too expensive for
patients...in developing countries... Doctors Without Borders [stated:] ‘People in Africa and
Caribbean are relying on India to produce these drugs. Quality matches that of US-manufactured
drugs, but prices affordable’. Lawyers for two [Indian] groups... presented arguments contending
tenofovir not new drug, but modified version of earlier drug, and therefore not eligible for new
patent under India’s new law. Those backing legal challenge hoping to gain legal precedent for
use in other patent applications... WHO recently recommended tenofovir for patients just starting
treatment for AIDS and those who have been receiving antiretroviral treatment therapy but
resistant to other treatments. In [rich] countries, Gilead’s tenofovir costs $5,718/person/year.
Cipla, one of largest companies in India, marketing version called Tenvir, at cost of
$700/person/year in India. Chairman Cipla said drug eventually available in Africa for about half
that price. But Tenvir would have to be withdrawn if Gilead were given patent,.. in effect for 12
years. Gilead Sciences said... ‘[W]e believe Viread represents innovation and parentable under
Indian law. We will use this patent responsibly, and not block access to our medication in India
or other resource-limited countries where HIV epidemic hit hardest’. Company... ‘pursuing broad
policy of nonexclusive voluntary licensing under patent to generic manufacturers in India for
local Indian market as well as provision for manufacturers to export product to 97 developing-world countries included in Gilead’s access program’”; UNAIDS“2006 Report on the Global AIDS
Epidemic”UN NYC 30 May 06:-to special UNGA; text at:
www.unaids.org/en/HIV)_data/2006GlobalReport/default.asp. Sub-titles: 1 Introduction 2
Overview of the global AIDS epidemic 3 Progress in countries 4 The impact of AIDS on people
and societies[corrected] 5 At risk and neglected: four key populations 6 Comprehensive HIV
prevention 7 Treatment and care 8 Reducing the impact of AIDS 9 The essential role of civil
society 10 Financing the response to AIDS 11 Getting the best out of national responses 12 From
crisis management to strategic response. Text in english|french| russian|spanish; whole is
downloadable; Reuters“25 Years On, Anti-AIDS Drive Still Falling Short”NYT 30 May 06:-“Twenty-five years after AIDS first recognized, world still falling short in its battle against the disease with
severe gaps in prevention and treatment, UN said [30 May]. ‘Response to AIDS epidemic to date
has been nowhere near adequate’, said UNAIDS... Since...1981, AIDS and HIV virus that causes
it have spread relentlessly from a few widely scattered hot spots to virtually every country in the
world, infecting 65m and killing 25m, UNAIDS said in 630p report... Anti-AIDS initiatives and their
results vary widely from country to country, and many are falling short of benchmarks set in a
landmark high-level UNGA session in 2001, UNAIDS said... Dr. Peter Piot of UNAIDS... expected
long-term commitments at this week’s meeting...and hoped for $20m annually by 2010... Global
AIDS incidence rate is believed to have peaked in 1990s. About 1.3m in developing world now
on life-extending antiretroviral medicines, which saved about 300,000 lives last year alone. Still,
some 4.1m were newly infected and 2.8m died in 2005... Global supply of condoms was less than
50% of what was needed, and antiretroviral drugs, while more widely available, remained costly
and hard to get. Ignored in many countries are prostitutes, said... ex-dir of UN Population Fund...
However, final statement by governments at conference this week not expected to refer to
prostitutes, drug users or homosexuals, due to objections from Islamic nations, some Catholic
countries and US, which fear that merely mentioning these groups would endorse their
behaviour. Infected individuals still suffer from ostracism and discrimination, while vast majority
of world’s 40m infected have never been tested for HIV and are unaware of their status, report
said. While $8.9b expected available in 2006, $14.9b will be needed, UNAIDS said. By 2008, it
predicted $22.1b would be needed, including $11.4b for prevention plans alone. Report called
for more and better-targeted education and prevention strategies, more treatment opportunities,
and more drug research, particularly on drugs for children, whose needs ‘have been largely left
out of the research agenda’”; Lawrence K.Altman “U.N. Urges Tripling of Funds by ‘08 to Halt
AIDS”NYT 01 Jun 06:- “Stopping epidemic of AIDS will require $22b/year by 2008 and possibly
more in following years, officials of UNAIDS program said. The $22b is nearly triple the $8.3b
spent 05 by all sources, including governments and private sector. Urging that countries spend
more, UNSG Kofi Annan said a costlier and more sustained effort needed because AIDS "has
spread further, faster and with more catastrophic long-term effects than any other disease"... Of
projected figure, half is needed for prevention and a quarter for treatment and care of infected
people. Remainder is for care of orphans, children at risk of becoming infected and program
costs. UNSG and Piot of UNAIDS spoke as UNGA began meeting aimed at renewing political
commitment and setting new goals for expenditures and for measuring progress... Annan urged
delegates to challenge countries trying to avoid goals that mention gay people, prostitutes,
intravenous-drug users and others at high risk of becoming infected. ‘Governments concerned
need to be realistic and responsible’, UNSG said. He also said that ‘if we are here to try to end
the epidemic, we will not succeed by putting our head in the sand and pretending that these
people do not exist or they do not need help’... Report cards showed that most countries missed
more goals than they met. More than 20m have become infected since 2001 meeting. Now
countries must fundamentally change the way they think and deal with epidemic, moving from
crisis management to ‘sustained attention and the kind of “anything it takes” resolve that
member states apply to preventing global financial meltdowns or wars’, Piot said... Global
Business Coalition on HIV/AIDS released a study showing that private companies have become
more likely to provide treatment for employees as cost of antiretroviral drugs has fallen over last
six years, to $140-$300/year, from $10,000. In African countries with a high prevalence, more than
70% of companies surveyed are fully subsidizing access to HIV treatment, coalition said.
Study...found increasing trend to expand such treatment to employees’ dependents. Companies
also offering access to voluntary testing/counseling”; Lawrence K.Altman & Elisabeth
Rosenthal“U.N. Strengthens Call for a Global Battle Against AIDS”NYT 02 Jun 06:-“[UNGA]
adopted strongly worded declaration [02 Jun] aimed at pressing nations of the world to
strengthen their battle against AIDS, global pandemic [UNSG] called ‘greatest challenge of our
generation’. Language of document surprised even anti-AIDS groups, which said that while it
did not satisfy all their objectives, they had feared it would be watered down... Nonbinding
declaration reaffirms commitments made in 01, when UN defined AIDS as far more than a
medical issue, framing it in terms of political/human rights/ economic survival... New document
is political blueprint, not plan of action. Calls for strong commitment to bolster the rights of
women/girls so they can protect themselves from infection with HIV... Declaration calls on
countries to: use scientifically documented prevention strategies, including condoms;make
clean needles accessible to drug users; take steps to provide universal access to prevention
programs/ care/antiretroviral drugs. Includes politically charged terms like ‘condoms’/‘vulnerable
groups’, though those groups not specified... Countries expected to measure their progress over
next 5 years against targets to be determined by UN... Said world will need to spend up to
$23b/year by 2010... Earlier in day, UNSG Annan delivered a gloomy assessment, saying world
was losing the battle. ‘The epidemic continues to outpace us’, he told packed UNGA. ‘There are
more new infections than ever before; more deaths than ever before; more women/girls infected
than ever before’... [US’s] Mrs.Bush speech steered away from many of the criticisms that have
been labled against administration, notably that it promotes sexual abstinence over scientifically
proven strategies, particularly condom use. Indeed, she said, ‘ABC’ model - initials stand for
abstain, be faithful and use condoms - had brought sharp declines in infections in Africa.
Britain’s international development [minister] said in interview: abstinence alone did not work
...Dr. Peter Piot [UNAIDS] said: while no document could make anyone ‘100% happy’, final
version was ‘a major advance’ and far stronger than weaker drafts circulating earlier in week”;
Reuters “Nations Resist New Financial Commitments on AIDS”NYT 02 Jun 06:-“A major UN
meeting on AIDS strategy fell short of concrete financial commitments but recognized the
growing spread of the disease among women and their right to protect themselves. Last day of
3-day meeting brought together heads of state, PMs and health officials from 151 countries... ‘I
know that none of you got all you wanted in this declaration’, UNGA President Eliasson said in
closing session. But he said thanks to advocacy groups, ‘the draft got stronger - not weaker’...
Document says $23b will be needed annually by 2010 to fight AIDS ...Nations agreed to search
for additional resources to ensure universal access to treatment by 2010. But delegations did
not commit themselves to a timetable for raising the funds as they did in 2001 when the financial
target was met... Squeamishness over sex was evident.,. with Islamic groups and conservative
Roman Catholic countries using the term ‘vulnerable groups’ rather than referring to prostitutes,
homosexuals and drug addicts... Yet the document, in addition to abstinence, advocated male
and female condoms and ‘harm reduction’ efforts related to drug use, a euphemism for needle
exchange programs for addicts... Declaration called for sex education, reproductive health
services and condemned ‘abuse, rape and other forms of sexual violence’ as well as ‘trafficking
in women and girls’”; [For the time being, I must limit guides to AIDS items by normally
summarizing only 1-2 of their (initial) key paragraphs, since both number/length of the relevant
articles(2-3 pages long) being published is so high. ‘Basic text’ underlining, then, is also not
necessary. In addition, since all the items relate to POLICY ISSUES and the very special 16th
International AIDS Conference (16IAC) in Toronto, all are listed under sub-section D. Rather than
re-list virtually all of them four times in each of the sub-sections on AIDS issues, I simply ask you
to survey material on all four topics under POLICY for the time being.]
B. INFECTION RATES; SOCIO-ECONOMIC ISSUES
(PANDEMIC)
Economist 02 Jan 1999"AIDS in the Third World: A Global Disaster"(42-4):-statistics to date are
disturbing: at least 47m people have been infected with AIDS virus and pandemic is “still
nowhere near its peak. If India, China and other Asian countries do not take it seriously, the
number of infections could reach `a new order of magnitude’, says... head of UN’s AIDS
programme... For many poor countries, there is no greater or more immediate threat to public
health and economic growth. Yet few political leaders treat it as a priority.”(42) Since finding a
vaccine is “hugely difficult” and expensive, LDCs’ only course is to stress prevention, but this
is hard because: condoms are unpopular, myths abound, many cannot afford antibiotics against
the facilitating STDs, migrant labor/armies draw prostitutes, much forced sex and alcohol
contribute. Apathy and embarrassment are the most serious blocks to AIDS control. Lawrence
K. Altman"More African Women Have AIDS Than Men"New York Times 24 Nov 99:-UNAIDS-WHO
have reported the latest global information on the HIV/AIDS pandemic. This year about 5.6m
persons will become infected with HIV. This brings to over 50m the total infected since the virus
was recognized in 1981. AIDS has already killed 16m, of which 2.6m will die in 1999, a record for
any year. Threat of HIV has not diminished in any country; despite research, AIDS remains fatal.
Future numbers now depend mainly on infections in Asia, but are unpredictable. Steepest
increase in infection rates in 1999 was in former USSR, with Russia recording nearly half its
cases in the first nine months. AIDS is the single greatest threat to development in many
countries. Sub-Saharan Africa has the highest incidence of HIV: 22.3m or 8% of all adults, 70%
of all cases in the world, and life expectancy likely to drop from almost 60 years back to 45 years
over the next decade. Surprisingly, new data shows 55% of those Africans infected are women.
Economist, 27 Nov 99"AIDS: Bust the Stigma"(49):-article on same report, but with some
differences in stress(of the 5.6m infected in 1999, 570,000 will be children). Article includes a
chart listing:% of adults infected; infected people(m); infected in 1999(m); % of infected who are
women, both for the whole world, and divided into eight geographical areas. The key point
made:“ignorance, complacency and the stigma attached to the disease are potent killers...above
all, the epidemic has to be given public recognition”. Altman,"U.N. Issues Grim Report on the
11 Million Children Orphaned by AIDS”NYT 02 Dec:-a UNAIDS-UNICEF report issued on World
AIDS Day(01 Dec) estimated that more than 11m children have been orphaned by AIDS since the
epidemic was recognized in 1981. This number is expected to reach 13 million by the end of
2000, and is believed to far outstrip the total orphaned by other causes. (These orphans are
defined as children 15 and under who lost either their mother or both parents to AIDS.) All but
5% of the orphans live in Sub-Saharan Africa, where in 1998 alone over 2m people died of AIDS
compared with 200,000 in all types of conflict, “and the worst is yet to come”. The key UN official
predicts the number of AIDS deaths could eventually undermine the stability of affected
countries. The orphans also face the stigma and discrimination that go with AIDS, leaving them
isolated, deprived and vulnerable. Economist 22 Apr 2000"The Caribbean: Deadly Silence"(34):-"Africa apart, nowhere in the world suffers more from AIDS than the countries of the
Caribbean...the impact is broad, growing and potentially devastating”. However, the stigma of
having HIV-AIDS means that few talk about it, making it much harder to track down and control.
In the area, only Cuba has set up an effective screening and reporting system, i.e. it alone has
the critical information on who has HIV but does not yet show visible symptoms. This fact alone
makes it much easier to follow the speed, location and demographic structure of infection, and
so get a much better idea of how the HIV is spread, and what preventive, medical, and care
facilities and staff are, and will be, necessary. Reuters"Study Says AIDS Will Devastate African
Workforce"NYT 08 Jun:-article summarizes the dismal findings of a study of one future impact
of AIDS on Africa, released by the International Labor Organization(ILO). It reports that AIDS will
destroy the labor market of sub-Saharan Africa“with projected workforce declines of up to a fifth
or more in the worst-hit countries by 2020"(Namibia 22%; Botswana/Zimbabwe 21%;
Mozambique 19%; South Africa 17%; Kenya 15%; Malawi 13%; Uganda 12%). Orphans, widows,
elderly will have to fill the gaps, and business costs will increase. This huge challenge will also
be unusually difficult to deal with economically, medically and socially because of the special
circumstances in Africa. Donald G. McNeil Jr.,"AIDS Is Moving Into Rural Areas, U.N. Study
Says”NYT 23 Jun:- more alarming facts on the AIDS situation. This article reports UNAIDS sees
the epidemic “shifting strongly to rural areas in the Third World [with] dire implications for
people with the disease and the countries that are involved [because] HIV hits particularly young
adults, and they are the core of the labor force, the keystone of the farm household.” Farms may
collapse and/or city food supply suffer. Transmission in/to rural areas can result from part-time
urban work, prostitution along truck routes, and poverty-created sexual vulnerability. Also,
preventive programs are as rare as pre-AIDS sexual customs are prevalent. Altman,”U.N.
Warning AIDS Imperils Africa’s Youth” NYT 28 Jun:-a new UNAIDS report:”The world has never
before experienced death rates of this magnitude among young adults of both sexes across all
social strata”. More specifically, about half of all 15-year-olds in the worst-affected African
countries will eventually die of AIDS even if their rates drop substantially. If current rates
continue, two-thirds will die - and ominously most people with HIV do not know they are
infected. Thus the African pandemic will grow much worse unless $2b annually is given for
minimum prevention and care, and most governments start high-priority control programs.
Already 16 African countries have adult rates over 10%(11% in Ethiopia, 20% in South Africa, 36%
in Botswana). Washington Post“AIDS in Numbers”Jul 00:-statistical chart showing the estimated
life expectancy and death rate of AIDS victims worldwide corresponding the year 2000.
Washington Post“A Difference of 15 Years”Jul 00:-Africa map containing the number of the
population infected with AIDS. NYT"Young People Found Uninformed on AIDS"12 Jul:-United
Nations Children’s Fund(UNICEF) annual report concludes that”a dangerously large number of
young people in the developing world do not know how to protect themselves from the virus that
causes AIDS”. Girls are especially ignorant about the disease: a survey of 34 countries found
that in about half, more than 50% of girls 15-19 said they did not know that a person with HIV-AIDS could appear healthy(in Chad, 83%; in Niger, 81%; in Nepal, 80%). The gap helps explain
the higher HIV infection rate among girls in many countries, but efforts to reach and inform them
are hampered by”poverty, local customs, violence and social or religious bias”. Even some
knowledge of how HIV is transmitted does not necessarily change young people’s perceptions
about their vulnerability, or change behaviour. In Haiti, Zambia and Zimbabwe more than half of
sexually active girls said they did not consider themselves at risk. AP“Nearly 28 Million
Orphaned by AIDS”NYT 13 Jul 00:-even more discouraging projections on the orphan crisis than
those put forward by UNAIDS-UNICEF(2 Dec 99 above)are contained in a USAID report “Children
on the Brink 2000". It estimates than”nearly 28 million children in Africa will have lost at least
one of their parents to AIDS by the year 2010", and the disease”will continue to create millions
of new orphans for decades”. There are already nearly 16m children who have lost at least one
parent, about 90% of these in Africa. These estimates do not even count the rapidly growing
number of babies born with HIV since most of them will likely die before they reach age 5. “The
best way to deal with the crisis is not to put the children in...orphanages... but to [help] their
extended families...cope”. Reuters,”UN Council Calls for AIDS Training for UN Troops”NYT 17
Jul:-UNSC voted unanimously“to intensify AIDS education among peacekeepers and encourage
voluntary testing so they did not contract or spread HIV/AIDS while on UN missions”. The
resolution also urges countries to consider developing effective long-term strategies to roll back
the epidemic in the military and to encourage voluntary and confidential HIV/AIDS testing,
counselling and treatment ”as an important part of their preparation for their participation in
peacekeeping operations”. The US representative claimed, ”Peacekeepers bring AIDS with them
and take it home...Wherever peacekeepers go they attract prostitutes”. Earlier, the UN decided
to distribute a condom a day to each soldier it planned to send abroad this year. While discussed
by Vice-President Gore earlier, this was the first resolution making AIDS an international security
issue, and the head of UNAIDS agreed that, with 16 African countries in which more than 10%
of the population between 15 and 49 years of age was infected,”No wonder that AIDS is the first
health and development issue to be considered a threat to global peace and security”. Itar-Tass,"Over 53,000 HIV-Infected Registered in Russia”onhealth.com 25 Jul:-according to the head
of the national anti-AIDS center, 53,170 HIV-infected people are currently registered in Russia,
with the highest concentrations in Moscow and the southern Siberian Irkutsk region. Over the
past five years, AIDS has mostly been spreading among drug addicts, who comprise half the
above total(81% are men). Very much more ominous are two other figures. (1)Over 22,000 of
those registered contracted HIV this year - almost 305% more than in the same period of 1999.
If this reflects the actual rate of increase, Russia will have 600,000 infected by the end of the
year. (2)It was stressed that only 10% of those infected are registered. If true, at the current pace
of infection, Russia would have six million persons with HIV-AIDS by the close of 2000, and the
center believes the rate of infection is growing in the general Moscow and St. Petersburg areas,
and both east and west of the central Urals, all zones with big population pools to draw on.
Khadija Magardie,"Women Are Worst-Hit By AIDS"Mail and Guardian/onhealth.com 07 Aug:-an
eye-opening collection of reliable social, statistical and medical facts about how and why poor
women are suffering disproportionately from HIV/AIDS. Though focused on South Africa, most
comments apply in most LDCs. The key points, derived from a new UNAIDS report, and each
then forcefully amplified, are:”[W]omen comprise a marginalized group [with] increased
vulnerability to the virus. This is due to a variety of factors, but mainly because of fewer
contraceptive choices, unequal health care access, and, for many... physical and psychological
violence that critically affects their health”. Norimitsu Onishi"AIDS Cuts Swath Though Africa’s
Teachers"NYT 14 Aug:-a very disturbing personal account of the disastrous impact of AIDS on
African rural education. While highly-mobile soldiers and truck drivers are rapid distributors of
infection,(mostly male)village teachers, often the only educated people in rural areas, have also
been dying at an exceptional/ expanding rate - the combined result of boredom, ignorance,
prestige and hence the availability of willing partners. Condoms(when available)are highly
unwelcome to both men and women(the latter because use implies doubt regarding their virtue).
Already classrooms are badly overcrowded, many schools remain closed for lack of staff and
the death rate is“expected to be catastrophic in the near future”. “AIDS constitutes one of
the...biggest threats to the global education agenda that we have known...There is no other
single factor in the world today that so systematically undermines the gains of decades of
investment in human resources, education, health and the well-being of nations”(UNAIDS). David
Gonzalez"Caribbean, Badly Hurt, Is Promised Help on AIDS"NYT 13 Sep:-a slightly more hopeful
report than that in Economist, which emphasized lack of government action. Caribbean still
faces the highest rate of HIV infection outside Sub-Saharan Africa(2% compared with 8%)with
social and economic development under threat in the region’s small economies. Official
estimates of total HIV/AIDS cases is 360,000, but many experts believe it is actually over 500,000
because of under-reporting. A vast number of cases are in Haiti and Dominican Republic (parts
of Haiti have an infection rate of 12%), but even in the English-speaking Caribbean it is leading
cause of death for men and women aged 15 to 44. Its spread has been fueled by tourism, inter-island migration, poverty, and religious and cultural resistance to the use of condoms and sex
education. Local leaders now recognize the need for urgent, cooperative action; at a Caribbean
Conference on AIDS, donors/banks pledged $120m to regional strategy($85-100m IBRD loans).
AP“China To Combat Rise in STDs”06 Nov:-8m Chinese people are infected with STD. Beijing
to set up a new medical center“State Diseases Control Center”which will oversee treatment for
victims. Barbara Crossette “Nurse in Malawi Wages War on AIDS and Apathy”07 Nov:-UN
awarded Mrs. Phiri for her work in setting up an AIDS support group in her country. Economist
11 Nov"Myanmar Sickening : Growing Health Problems"(55):-"Thanks to a combination of
ravaging infectious diseases, an atrocious health care system, and the military regime’s refusal
to admit that anything is amiss, public health officials fear that average life expectancy...could
fall to as low as 45 years in the next two decades”. While the junta claims only 25,000 people are
infected with HIV, the IBRD estimates over 700,000 in a population of 48m. Perhaps 8% of
soldiers are HIV-positive, while the growing use of intravenous drugs and more production of
heroin and amphetamines by ethnic minorities exacerbate the epidemic. Besides AIDS, malaria,
anthrax and malnutrition(in Asia’s former rice-bowl)are “decimating” the population. Near
Thailand, a new combined epidemic may have killed 10,000 since July, and medical
facilities/supplies are totally inadequate. The regime, denying any crisis, has launched a literacy
program that may empower women, thereby helping slow HIV transmission, but no sex/drugs
education is required. AP“Report: 3M AIDS Deaths in 2000"24 Nov:-WHO study finds 80% of
people infected will come from Africa. Elizabeth Olson“AIDS Infections Rise Globally, but Sub-Saharan Cases Stabilize”25 Nov:-WHO study reports that 3.8m new victims were infected in the
region in the year 2000, in contrast with 4m victims in 1999. AP“U.N. Warns of AIDS
Complacency”28 Nov:-UN director of UNAIDS, Peter Piot, reports on how wealthy countries are
investing less in AIDS education programs even though the threat of the disease is rising
throughout the world. AP“Worldwide, Regional Impact of AIDS”28 Nov:-UN statistics chart
shows the numbers of infected with AIDS in the world. Reuters “HIV / AIDS Infections Rise to 36
Million in 2000"28 Nov:-with 5m newly infected cases according to UNAIDS, Africa being the
worst area hit by the disease. AP“African AIDS Outlook Is Bleak”28 Nov:-UNAIDS programs
targeting Africa’s youth to delay having sex for three years, AIDS activists pleased on the rate
of the disease becoming stable in Sub-Saharan Africa. Reuters“AIDS Epidemic Threatens
Ukraine, Experts Say”01 Dec:-nationwide study shows the rate of AIDS is higher than other
countries in Europe. EU and US to contribute $4m for treatment/prevention programs.
Reuters“AIDS to Hit African Work Force Hard, ILO Says”01 Dec. Reuters“African Leaders Urge
Urgent Action Against AIDS”03 Dec:-leaders at conference on HIV/AIDS in Ethiopia warn of
spreading of disease, and the impact on social and economic structures of their nations.
Elizabeth Rosenthal“Chinese Media Suddenly Focus on a Growing AIDS Problem”17 Dec:-article
dealing with unprecedented media reports of AIDS cases in rural China, which local officials
tried to cover up. Reuters“AIDS Taking Deadly Toll on S. African Youth”10 Jan 2001:-200 infants
born with HIV every day in the region, public questions Mbeki’s government disallowing AIDS
drugs which prevents mother to child transmission. Christopher S.Wren“U.N. Council Takes Up
Issue of H.I.V. Among Peacekeepers”20 Jan:-Security Council meeting on the cost-related AIDS
tests of peacekeepers which many countries cannot afford. Reuters“South Africa Stops AIDS
Plan Over Fear of Attacks”11 Jan:-notification process which allows for public HIV testing in the
country has been stopped by the S. African government due to fear of violent discrimination
against AIDS victims. Reuters“One in 10 Urban Gays Have HIV, Study Finds”05 Feb:-US
government study shows most blacks are victims of the disease. Reuters“African AIDS Crisis
Is Still Largely Ignored”05 Feb:-discussion at the 8th Annual Retroviral Conference in Chicago
on the alarming rate of deaths caused by AIDS(80% of people)come from Africa. Altman“New
Ideas Sought to Help AIDS Orphans”05 Feb:-12m orphans in Africa, since their family members
are also affected by the rapid spread of the disease, according to an AIDS expert working in the
region. AP“Catching HIV in Single Sex Act Low”08 Feb:-US study shows the probability of
getting AIDS without the use of condoms is one in 588. Results encouraged the impact of AIDS
drugs in containing the spread of the disease. Reuters“South Africa Mining Firms Test Workers
for AIDS”13 Feb. Reuters“AIDS Treatment May Lead to Unsafe Sex”15 Feb:-US health study finds
that HIV victims taking AIDS drugs are getting other types of STD’s, it may be result of
unprotected sex. Reuters “Condom Under - Use Fuels AIDS Epidemic”16 Feb:-”15 billion too few
condoms are used globally each year” according to a US expert. Reuters“World Bank Warns on
AIDS Increase in Cameroon”15 Feb:-with one out of nine people that are sexually active are
infected in the country. Reuters“India Underestimates AIDS Cases, Says Activist” 16 Feb:-AIDS
activist points out the misrepresented number of people with AIDS in rural areas of the country.
Reuters “South African AIDS Campaign Targets Pre - Teen Sex”20 Feb:-LoveLife an AIDS
sponsored organization funded by the Bill and Melinda Gates Foundation, found that many S.
African teens are vulnerable due to the country’s highest rate of rape in the world. Reuters“China
Admits Having More Than 22,000 HIV Carriers”26 Feb:-Chinese Health ministers blame drug
users within rural areas for the increase of infections. Crossette“In India and Africa Women’s
Low Status Worsens Their Risk of AIDS”26 Feb:-Annan argues that women are vulnerable to get
infected due to their “weaker ability to negotiate safe sex, and their lower social and economic
status”. Reuters“Russia Rings Alarm Bells on Drugs, HIV Surge”13 Mar:-Moscow reports of
increasing drug use among young people through needle sharing, has multiplied 20-fold over
the last 10 years. AP“South Africa: More HIV Than Thought”20 Mar:-government study shows
that 4.7m are infected with HIV, Mbeki refuses to declare a state of emergency in which generic
drugs could be imported. Rachel L. Swarns“Newest Statistics Show AIDS Still Spreading, in
South Africa”21 Mar:-S. African government study shows optimism that the disease has reached
its peak with 4.7m people infected. Rosenthal“Deadly Shadow of AIDS Darkens Remote Chinese
Village”28 May:-coverage on Donghou residents in which “80 percent of adults carry H.I.V., and
more than 60 percent are already suffering debilitating symptoms”. AP“New Study Sees AIDS
Rates Jump”31 May:-4.4 percent of newly infected each year is within gays and bisexuals
according to a CDC study. Reuters“UN Says AIDS Has Killed 22 Million, Worst to Come”05 Jun:-UN is asking for $7 to $10 billion a year towards the rapid spread of AIDS in Africa. C. Claiborne
Ray“Q&A: AIDS in Africa”05 Jun:-continent’s economic, political and medical factors contribute
to the high rate of AIDS. AP“U.N. Discusses 20 Years of AIDS”05 Jun:-UNAIDS director Dr. Peter
Piot, warns that AIDS could spread to other countries who have never been affected. Ian Fisher
“Europe’s East Sees AIDS on the March”13 Jun:-needle sharing in Eastern Europe as the main
reason for the infection rate to rise. Crossette“AIDS Hidden in Myanmar, Expert Says”25 Jun:-US
AIDS expert claims that the Myanmar government is falsifying infection-rate statistics due to
alarming results of being the second worst country in the world with the pandemic.
Reuters“South Africa AIDS Orphans Struggle to Survive”21 Jun:-Study by Mandela shows that
the disease has left an increasing number of orphans close to starvation. Seth Mydans “Fighting
AIDS: A New War Is Killing Cambodians” 07 Jul:-170 thousand people affected according to UN
statistics, making the country hit hardest with the disease in Asia. Washington Post“HIV Cases
in Russia Rise Sharply”29 July:- 50,000 people infected with HIV has allowed for the disease to
spread at the rate of African nations, according to Russian health officials. Douglas Frantz“Drug
Use Begetting AIDS in Central Asia”05 Aug:-increase of drug trade, unreported AIDS statistics
and low standard of living could allow for the disease to spread within Central Asia according
to a US medical study. Rosenthal“Doctor’s Dirty Needles Spread Hepatitis in China”20 Aug:-”overuse of medical injections helps explain the alarming spread of blood-borne infections in
China, to a lesser extent, AIDS”. AP“Hepatitis Rate Spikes in China”22 Aug:-two thirds of China’s
population(1.26 billion)has been infected with Hepatitis due to the use of un-sanitized needles
by the nation’s hospitals, and has also allowed the AIDS pandemic to spread. AP“Reported AIDS
Cases in China Climb”23 Aug:-a 67% increase of HIV infected cases from last years findings has
been reported by health officials in Beijing, blaming drug users and prostitutes for the spread.
Reuters“China Admits ‘Very Serious’ AIDS Epidemic”23 Aug:-similar coverage as above,
Chinese health officials focusing on Henan province as being hit the most with the pandemic.
Rosenthal“China Now Facing an AIDS Epidemic, a Top Aide Admits”24 Aug:-Chinese health
minister criticizes his government for trying to cover up the rise of AIDS and not developing
prevention measures. AP “AIDS Leads Causes of Thailand Deaths”31 Aug:-nation’s health
officials agreed that 16 percent of all deaths result from AIDS. Gina Kolata“The Genesis of an
Epidemic: Humans, Chimps and a Virus”04 Sep:-scientific perspective on the origin of AIDS from
a mutated virus to humans getting the disease from primates in Africa. Reuters“Report Says
AIDS Leading Cause of Death in S. Africa”16 Sep:-S. African medical report shows that 40
percent of deaths last year. were AIDS related. Economist“AIDS in Asia: Sex Bomb”04 Oct:-rate
on the rise of the pandemic in Asia in contrast with its leaders and the WHO attending an AIDS
congress in Melbourne agree that the disease is being contained. Rosenthal “Poorly Prepared
Asian Countries Warned of AIDS Epidemic”05 Oct:-UNAIDS report shows an increase of the
infection rate mainly in China and India due to its population size. AP“AIDS Cases Rise in
China”27 Oct:-Beijing reports 5,616 new cases of AIDS have been found, drug abuse,
prostitution and homosexual activity are believed to be the cause. AP“Russian City Is Closed to
Foreigners” 08 Nov:-suspected reason for the closure of the Siberian city of Norilsk may be due
to a high percentage of the population infected with HIV. AP“UN Warns of AIDS Spreading in
China”13 Nov:- China’s first AIDS conference, UN estimates that “600,000 Chinese had been
infected with HIV in 2000". Swarns“A South African Hospital Fights AIDS and Despair”26 Nov:-S.
African hospital coping with an increasing number of AIDS victims without proper equipment
and space to treat them. McNeil“AIDS Crisis Leaves Africa’s Oldest Ways at a Loss”27 Nov:-S.
African traditional healers not able to cure their patients but are aware of the cause and
symptoms of HIV. AP“AIDS Epidemic Hits Russian Teens”28 Nov:-UN report shows that in
Eastern Europe the infection rate is highest in the world with more youths doing drugs and
having unprotected sex. Reuters“World AIDS Epidemic on Rise; E. Europe Cases Swell”28 Nov:-similar coverage as listed above. McNeil“Witnesses to an Epidemic Shrug Off Shame to Fight
a Dangerous Fear”28 Nov:- how people in S. Africa with HIV create awareness groups for public
discussion. McNeil“A Lonely Crusade Warning Africans of AIDS”28 Nov:-recollection of a S.
African doctor, Dr. Jorgensen who tried desperately to create an AIDS prevention center by
showing the rise of the pandemic in 1991. McNeil“Rare Condoms, Deadly Odds for Truck-Stop
Prostitutes”29 Nov:-S. African health study shows that truck drivers who have sex with
prostitutes is the primary reason for rampant spread of AIDS. Economist "AIDS: Unhappy
Anniversary”29 Nov:-”Almost 70% of new infections and existing cases-a daunting 28.1m
people-are in sub-Saharan Africa.”. Altman“H.I.V. ‘Explosion’ Seen in East Europe and Central
Asia”29 Nov:-UN report on AIDS shows that both continents face an infection rate that is 15
times more than the rate it was three years ago. McNeil“AIDS and Death Hold No Sting for
Fatalistic Men at African Bar”29 Nov:-conversation of men in a small village in S. Africa and their
negative views on condoms, and their lack of knowledge of sex education. McNeil“South African
Victims Face Rapists and H.I.V.”30 Nov:-public health system in S. Africa does not provide AIDS
drugs to rape victims, “country widely believed to have one of the highest rape rates”.
Reuters“Pope Sends World AIDS Day Message to Sufferers”01 Dec:- Vatican to be working
alongside AIDS scientists to find a cure. Reuters“South Africans Protest Rape of Five - Month -
Old Baby”04 Dec:-protesters demand that their government’s judicial system convict the HIV
infected rapists, the belief of having intercourse with a virgin will cure people infected with AIDS
is rampant in the region. Economist“AIDS in Africa: Burkina Faso’s fight against AIDS”12th
international conference on AIDS with “thousands of scientists, activists and politicians...are
publicly alarmed” for the rate of the disease with 2.3m Africans who have perished last year.
Rosenthal “A Poor, Ethnic Enclave in China Is Shadowed by Drugs and H.I.V.”21 Dec:-the impact
of intravenous drug use by young people in poorer rural areas of the country due to drug
trafficking from Myanmar. Reuters“S.Africa Drops Baby Rape Charges Against Six Men”17 Jan
2002:-DNA testing proves the men were not the perpetrators, 21,000 child rape cases were
reported to the country’s police last year. Fisher“AIDS in Ukraine Jumps to the General
Population”23 Jan:-1 percent of the country’s adult population are infected, UN trying to raise
$50m to provide for a three year AIDS prevention program aimed at young people. Reuters“AIDS
Set to Surpass Black Death as Worst Pandemic”25 Jan:-NGO health official is advocating for
AIDS drugs to be distributed to the 40m people affected with the disease. Reuters “Official: AIDS
in Russia Being Ignored”10 Feb:- Russian health expert warns that the infection rate of AIDS will
increase if the public is unaware of the social impact the disease will bring, e.g. “children
orphaned by the disease”. AP “Scientists Warn on Primate Meat Sale”19 Feb:-illegal, large-scale
commerce in primate(“bush”)meat, as non-essential, exotic food in Africa and elsewhere,
threatens to spread deadly infections(human AIDS virus may have originated via chimpanzee
bushmeat), and dangerous reductions in the species. The latter would also affect medical
research on AIDS and other deadly diseases for which chimpanzees are critical. Andrew
Pollack“Technique May Improve Safety of Donated Blood”02 Apr:-US Cerus Corporation devised
a new process of blood transfusion ”pathogen inactivation”that will eliminate AIDS and other
blood related bacteria. Emma Daly “U.N. Says Elderly Will Soon Outnumber Young for First
Time” 09 Apr:-UN study in S. Africa and India shows that AIDS is responsible for poverty, and
the decrease of younger people. AP“Mogae: We Must Hand out AIDS Medicine”09 Apr:-Botswana’s president plans to open more treatment clinics and is looking to provide AIDS drugs
to victims of the disease, 19% of the population is known to be infected. AP“China Announces
Jump in AIDS Cases”11 Apr:-Beijing shows 17% increase in number of victims infected with
AIDS. Needle-sharing and unsanitary blood-donations are the cause. Rosenthal“China Raises
H.I.V. Count in New Report”12 Apr:-Beijing health officials state that 68 percent of HIV cases
were due to needle sharing, while 9.7 percent is due to unprotected sex, and 7.2 percent comes
from poor maintained blood banks. Economist“Worry about the Children”07 May:-”The spread
of HIV/AIDS has undercut many of the development gains of the past decade, devastating in
particular the lives of children in sub-Saharan Africa.” Diana Jean Schemo“Education Suffers
in Africa as AIDS Ravages Teachers”08 May:-World Bank study shows teachers parts of Africa
are dying from AIDS, while nations are not able to train new replacements. Economist“AIDS in
southern Africa: Fighting Back”09 May:-”About 5m South Africans are living with HIV and, at the
current rate of infection, about half the country’s teenagers under 15 can expect to contract it.”
Henri E. Cauvin“H.I.V. Survey in South Africa Suggests Plateau in Infections”11 Jun:-annual
survey shows that the infection rate of the country has levelled at about one quarter of the
population. Crossette“U.N. Finds AIDS Knowledge Still Lags in Stricken Nations”23 Jun:-UN
global study on AIDS shows that people in poor nations are aware of the disease but are not
taking precaution measures to protect themselves from it. AP“U.N. Predicts Chinese AIDS
Epidemic”27 Jun:-UN AIDS report projects 10m chinese to be infected by 2015, study also is
urging Beijing to spend on more sex education and prevention programs. Rosenthal“U.N.
Publicly Chastises China for Inaction on H.I.V. Epidemic”28 Jun:-similar coverage as above.
AP“China Officials Reject AIDS Report”28 Jun:-Chinese health officials argue that prevention
programs have proven to be unsuccessful, and argue that Beijing has funded $2 million for five
years on these programs. AP“U.N. Says HIV / AIDS Spreading Rapidly”02 Jul:-UN report shows
the rapid increase of AIDS in the world mainly in areas such as China, southern Africa, and
Eastern Europe, UNAIDS director Peter Piot warns that its only the beginning of the epidemic.
AP“Zimbabwe Plagued by AIDS Crisis”02 Jul:-UNAIDS statistics show that the country has the
second-highest HIV infection rate in the world, leaving 900,000 orphaned children. Altman“U.N.
Forecasts Big Increase in AIDS Death Toll”03 Jul:-UN will present a world AIDS report that
predicts that 65m people will be infected by 2020 at the 14th International AIDS Conference in
Barcelona. AP“45 Million More AIDS Cases Predicted”05 Jul:-a scientific statistical report
published in the Lancet medical journal predicts that 29m people could be saved if $27 billion
is put towards prevention programs across the world. NYT“Russia Lacks AIDS Funds”05 Jul:-Russian AIDS expert states that Moscow is not funding enough for AIDS prevention/treatment
programs. Altman“Modest Anti-AIDS Efforts Offer Huge Payoff, Studies Say”05 Jul:-similar
coverage of Lancet report, scientists also claim that improving women status, condom
promotion and distribution, sex education for young people will prevent 29m people to be
infected. NYT “World Briefing Africa: African H.I.V. Strains Feared More Resistant”06 Jul:-US
scientists warn that the AIDS virus may mutate in order to become immune to retroviral drugs.
Reuters“Asia Criticized for Silence in Face of AIDS Menace”08 Jul:-AIDS activists along with UN
officials denounced Asian leaders for allowing the disease to spread due to the government’s
lack of public awareness, activists are also advocating for reducing AIDS drugs in poor
countries. Economist“The Menace of AIDS”08 Jul:-”The UN report predicts that unless there is
a massive increase in prevention and treatment, 68m people will die of AIDS in the 45 most-affected countries between 2000 and 2020.” Reuters“HIV in Young May Soar by 70 Percent by
2010"09 Jul:-US statistics presented at the AIDS conference projects that 21.5m teens will be
infected, due to the number of new infections which were mostly children and young people
mostly from sub-Saharan Africa. Altman“AIDS Leaving Grim Legacy of Orphans, Report Says”
10 Jul:-joint UN and US study shows that there will be 20m orphans in Africa in 2010. AP“UN:
AIDS to Make More Kids Orphans”10 Jul:-similar coverage on the number of orphans in 2010,
another statistical report by a Swiss research group claims that 100m orphans will be seen by
2010. AP“AIDS Infections Up Among Young Women”10 Jul:-Scientists at the AIDS conference
state that half of the new infections are from young women. US study has found that rape in
many African nations is the most probable cause for the spread of AIDS. Economist“AIDS: The
Long War”11 Jul:-”Every day, 15,000 more people are infected. And most of these people will be
young...AIDS kills predominantly in poor countries”. AP“Needle Exchange Key to AIDS Effort”13
Jul:-prevention programs for needle sharing in Spain getting attention at AIDS conference since
they provide safe needles to drug addicts and hence lower the infection rate in the country.
Economist“AIDS: Hope for the Best. Prepare for the Worst”11 Jul:-”Conferences on AIDS...are
as much councils of war as scientific meetings. They offer an opportunity to take stock, review
progress and plan the next phase of the campaign.”. AP“Health Gap in Rich, Poor Countries”11
Jul:-debate over who is to provide financial aid to control spread of AIDS: rich nations,
pharmaceutical companies, or African nations themselves, was one of the highlights at the AIDS
conference. Howard W. French“Whistling Past the Global Graveyard”12 Jul:-”The world stood
by when AIDS was spreading in Africa; we can’t do the same thing now that it is spreading in
Eastern Europe, at the doorsteps of the E.U.” states UNAIDS director Dr. Peter Piot. Altman“The
Urgent Search for an AIDS Plan”16 Jul:-editorial illustrating the impact of AIDS killing over 20m
people since 1981, the author stressing that 45m people currently infected will die due to lack
of distribution of AIDS drugs and blood testing facilities in developing nations. Steven Lee
Myers“Alarming Portents on Frontier of Russia’s AIDS Crisis”21 Jul:-description of prevention
programs in the city of Kaliningrad in the form of vans distributing condoms to local prostitutes,
due to a 30 percent increase of AIDS infection in the region in 2001. Economist“AIDS in Uganda:
Was the Miracle Faked?”15 Aug:-”No one seriously disputes that infection rates have been
falling in Uganda, but many doubt that they have dropped as precipitously as the authorities
claim.”. AP“Case of 2nd HIV Infection Documented”04 Sep:-Swiss researchers and
GlaxoSmithKline a pharmaceutical company have found that AIDS victims can also be infected
with a second strain of the disease. AP“China: Year End AIDS Cases at 1M”06 Sep:-the nation’s
health official also states that the rate of infection has been declining. UN reports that 10m
people could be infected by 2010. Agence France-Presse“China Raises Estimates of HIV Cases
and Warns of Increases”06 Sep:-similar coverage as above, with UN statistical figures of 1.5m
currently infected in China. AP“A Look at AIDS Statistics in Africa”16 Sep:-UN statistics on the
newly infected cases in sub-Saharan Africa in 2001, with 28.5m people infected and 58 percent
of women and children mostly infected. AP“HIV Infection Rate Is Skyrocketing”18 Sep:-UNICEF
warns that 80 percent of newly cases have been reported in Eastern Europe and Russia, and the
majority of new victims of the disease are people under 29 years old. Economist“AIDS in Russia:
A Looming Plague”26 Sep:-”The first big wave of AIDS-connected deaths will probably hit
Russia in 2007. By then, it is feared, some 2-3% of its people [approximately 150m] will be HIV-positive. So far the medical service is hopelessly ill-prepared.”. AP“Russia, China, India Face HIV
Crisis”01 Oct:-US intelligence report states that 75m cases will be seen by 2010 mainly in
populated areas of Asia and Africa. The findings also estimate that 23m people in the area are
currently with infected. Altman“AIDS in 5 Nations Called Security Threat”01 Oct:-similar
coverage as above, US studies lists China, Ethiopia, India, Nigeria and Russia with 40 percent
of the world’s population as a national threat by 2010. Economist“AIDS: The next wave”17 Oct:-detailed article on the functions of the Global Fund to Fight AIDS, Tuberculosis and Malaria and
the shortage of pledges to the organisation by developed nations to combat these three
diseases. AP“AIDS Kills More in S. Africa Prisons”21 Oct:- S.African study shows that 1,000
prison inmates have died last year, and 45,000 could also perish by 2011. Rape, needle sharing
and lack of AIDS testing in prisons are the cause of the deaths. AP“WHO Ranks Top Health
Hazards”31 Oct:-unsafe sex ranks as the second worst health hazard in the poorest areas of the
world, mainly sub-Saharan Africa. Amy Waldman“As AIDS Spreads, India Struggles for a
Workable Strategy”11 Nov:-AIDS care facility in Tamil Nadu a rural village faces the increase of
AIDS victims which has the world’s second highest number of cases. AP“AIDS Main Killer of S.
Africa Women”21 Nov:-government study shows 9.8% of female deaths(compared to 8.7% of all
deaths)were AIDS-related and concludes women are more at risk than men since biologically
vulnerable and lack control in sexual relationships. Cauvin“ Stability of Africa Is Threatened as
AIDS Infects Armies”24 Nov:-African military, with undetermined but high infection rates,
threaten to raise national rates as they are demobilized/ dispersed(e.g. in Angola where 5.5% of
adults already have HIV). Due to increased strategic interest in Africa, and military’s stabilizing
role there, US is assisting vulnerable African countries to control military-related
AIDS“explosion”. AP “Report: Women Make Up Half of HIV Cases”26 Nov:-UN study shows that
AIDS has spread in Eastern Europe and Asia, to countries never affected before and with as
many women as men being targeted. Reuters“U.N. Report Finds Women Make Up 50 Percent of
HIV Infections”26 Nov:-”AIDS will have killed 3.1 million by the end of this year... 42 million
people, half of them women, are living with HIV/AIDS, according to the latest figures from
UNAIDS”. Reuters“U.N. Envoy: AIDS Root of Africa Food Crisis”27 Nov:-UN officials claims that
14m people facing food shortage is due to the lack of the agricultural workforce in which AIDS
has decimated. Altman“Women Catch Up to Men in Global H.I.V. Cases”27 Nov:-”Of the 38.6
million adults living with H.I.V. worldwide, 19.2 million are women.” UNAIDS director Peter Piot
states that sexual intercourse is the main cause for women to be infected. Economist“A
Continent of Orphans”27 Nov:-”Africa already had 34m orphans last year. By the end of the
decade, that is predicted to 42m, half because of AIDS.”. Economist“AIDS”28 Nov:-“An
estimated 3.1m people will have died of AIDS in 2002, according to new figures from UNAIDS and
the WHO.”with a chart illustrating which continents have been hit the most with the disease.
AP“India AIDS Activist Crusades for Change”29 Nov:-US CIA study estimates that 4m people are
infected with AIDS in India, and the number will rise to 25m people by 2010. Reuters“Britain Has
Record Number of HIV Diagnoses in 2002"29 Nov:- British health experts state that a 20 percent
increase of HIV cases has arisen in their country since the 1990's, 41,200 people are known to
be infected in Britain. Nicholas D. Kristof“China’s Deadly Cover-Up”29 Nov:-article dealing with
Beijing’s denial of the figures given by the UN which 10 m people will die from the disease in
2010, but rather the country arrests journalists covering the epidemic, and bans humanitarian
organizations trying to help AIDS victims. AP“Chinese AIDS Estimate Gains Credibility”30 Nov:-after ignoring the UN projected figure of AIDS victims of 10m people, Beijing is active in
promoting preventive and awareness measures of the disease. Reuters “Stigma Major Barrier
to Fighting AIDS, Says Piot”30 Nov:-Piot warns that social prejudice towards AIDS victims could
prove to be as fatal as AIDS, since it deprives them from health support. AP“Study: AIDS
Rampant Among S. Africa Kids”05 Dec:-survey spearheaded by former president Nelson
Mandela shows that 5.6 percent of children in the region are infected with HIV while a 13 percent
of children have become orphans due to the epidemic. Economist“South Africa and AIDS: No
More Denial”05 Dec:-”...South Africans are well informed about AIDS. Some 80% are sure, unlike
Mr Mbeki, that HIV causes AIDS...young people aged between 15 and 24 are changing their
sexual behaviour.”. Melissa Fay Greene“What Will Become of Africa’s AIDS Orphans”22 Dec:-coverage of orphans living conditions in Addis Ababa, Ethiopia which is estimated that 1m
children have lost their parents due to AIDS. Swarns“South Africans With AIDS Seek Out a Quiet
Place to Die”28 Dec:-”South Africa is believed to five million people infected with H.I.V. Nearly
a quarter of all adults are infected. Government officials have often closed their eyes to the
devastating epidemic.”. Kofi A. Annan“In Africa, AIDS Has a Woman’s Face”29 Dec:-editorial
stating the link between AIDS creating famine in Africa, and how women in the region play a
central role in agrarian society is being undermined due to their numbers declining.
Rosenthal“Despite Law, China’s H.I.V. Patients Suffer Bias”14 Jan 2003:-HIV victims in
Guangzhou, China are being discriminated due to their disease, and are also unable to find living
quarters since landlords in the area won’t allow them to rent. Reuters“AIDS Epidemic
Overshadows U.S. - Africa Trade Deal”17 Jan:-US trade officials warn that AIDS threatens the
labor workforce in Africa, which can result in deterring US investment to take shape. Reuters
“Zimbabwe Crisis Dims Anti - Hunger Gains in Africa”29 Jan:-UN humanitarian envoy finds that
AIDS has killed 7m people in the country over the course of 10 years and, due to the death of
many agricultural workers, famine has set in. Stolberg“The White House Gets Religion on AIDS
in Africa”02 Feb:- President Bush has promised to donate $15 billion dollars to the Global AIDS
Fund over the course of five years to African countries as well as Haiti and Guyana.
McNeil“Where AIDS Stalks, Everyone Lives in Fear”02 Feb:-similar coverage as above, with
50,000 out of 30m people in Africa are taking antiretroviral drugs. Reuters“AIDS Seen Worsening
Africa Hunger”04 Feb:-UN World Food Program(WFP)states the impact of AIDS which has
disrupted the flow of food supplies and services in Africa, “2 1/2 million AIDS orphans, infection
rates among adults--depleted public health infrastructure and private economies”.
Economist“Cursed, Twice Over”13 Feb:-”...most of the 30m HIV-infected Africans are young
women and men in their most productive years...With Fewer hands to plant and harvest, crop
yields drop.”. Economist“South Africa: A Town Like Alice” 10 Apr 2004(37-9):-unusually
informative article about the successes, failures and prospects of the South African situation
after the first decade of democracy. The article offers description that not only has relevance to
the republic, but history that can be applicable in numbers of other cultures in the world. Issues
discussed include the general policies of African National Congress(ANC), liberation movements
that ruled the country since apartheid was finally ended; the employment trends and serious
problems of black and white inhabitants; the important yet inadequate welfare,
education/training, housing and legal situations; fastest-growing and valuable tourism industry.
The last half-page describes an inadequate - but widespread - local policy falling totally behind
the HIV/AIDS situation. Economist 17 Apr 04“AIDS in India: When Silence is Not
Golden”(10);“AIDS in India: Abating, or Exploding” (21-3):-clear-worded Editorial and well-researched Special Report offer masses of facts on a expanding epidemic and a still imperfect
official Indian policy. Economist 22 May“The Cost of AIDS: An Imprecise Catastrophe”(68-71):-”The most dreadful cost of AIDS is in lives lost. A second cost, shared by those not infected, is
economic. However, estimating the damage done by the disease, especially in southern Africa’s
mostly feeble economies, is an inexact exercise even by the standards of economics, because
AIDS has struck hardest in areas where data are least accurate: subsistence farming, casual
labour markets, rural barter and so forth.” Economist 02 Jul 2005 "The Grand Challenges in
Global Health: 43 Ways To Save the World"(69-70):-"The Gates Foundation's latest largesse has
just been announced. It will pay for some intriguing and original research. But will it translate
into healthier people? [References to several AIDS research projects]; "AIDS: Moving Targets"
(70):-"Progress, and problems, in treating AIDS around the world". Economist"AIDS In South-East Asia: There's Good News and Bad News"02 Jul 2005(38-9):-"Good prevention work has
tamed AIDS epidemic in some countries, yet it is getting much worse in others".
[Reference to Earlier, But Relevant, Book: Laurie Garrett Betrayal of Trust: The Collapse of
Global Public Health (New York: Hyperion 2000):-this major(750+pp) - but selective - volume of
criticism about the serious global inadequacy of identifying, constraining, preventing, handling
and curing of current/ potential infectious diseases could be all read in sequence (i.e. from page
1 to page 585). Alternatively, the volume could be used for reference, not simply of individual
diseases or societies but of serious types of health problems now found in much more than one
location. The publishers' guide states inter alia: "Garrett takes on perhaps the most crucial
global issue of our time... Using riveting detail and finely honed story-telling and reportorial
skills, Garrett exposes the underbelly of the world's globalization." Following the Preface and
Introduction, the very distinct six chapters describe different and serious health problems as
follows: ONE: Filth and Decay: Pneumonic plague hits India and the world ill responds. TWO:
Landa-Landa:An Ebola virus epidemic in Zaire proves public health is imperiled by corruption.
THREE: Bourgeois Physiology:The Collapse of all semblances of public health in the former
Soviet Socialist Republics. FOUR: Preferring Anarchy and Class Disparity:The American public
health infrastructure in an age of antigovernmentalism. FIVE: Biowar:Threatening biological
terrorism and public health. SIX: Epilogue:The changing face of public health and future global
prophylaxis.]
Laurie Garrett"The Next Pandemic?"[First essay in four-item Special Section, all summarized as
in]Foreign Affairs Vol.84/No.4 (Jul/Aug 2005):-"Since it first emerged in 1997, avian influenza has
become deadlier and more resilient. It has infected 109 people and killed 59 of them. If the virus
becomes capable of human-to-human transmission and retains its extraordinary potency,
humanity could face a pandemic unlike any ever witnessed." Michael T.Osterholm"Preparing for
the Next Pandemic":-If an influenza pandemic struck today, borders would close, the global
economy would shut down, international vaccine supplies and health -care systems would be
overwhelmed, and panic would reign. To limit the fallout, the industrialized world must create
a detailed response strategy involving the public and private sectors." William B.Karesh &
Robert A.Cook"The Human-Animal Link":-Recent outbreaks of avian flu, SARS, the Ebola virus,
and mad cow disease wreaked havoc on global trade and transport. They also all originated in
animals. Humanity today is acutely vulnerable to diseases that start off in other species, yet our
health care remains dangerously blinkered. It is time for a new, global approach." Laurie
Garrett"The Lessons of HIV/AIDS":-"To get a sense of the broader damage a new pandemic
might do, it helps to consider the one the world is currently enduring: HIV/AIDS. Because this
deadly scourge moves slowly, many of its social, political, and economic effects have yet to be
understood. But the impact is hard to overstate. And it is growing."
Jim Yardley"New Estimate in China Finds Fewer AIDS Cases"New York Times 25 Jan 2006:-"China countered the long-held suspicion that it has undercounted the number of people with
HIV and AIDS by releasing a new, more extensive estimate that found the opposite: that the
country had actually overestimated its number of cases. New estimate, conducted with World
Health Organization and UN AIDS program, lowered the country's estimated number of HIV and
AIDS cases to 650,000 from the official figure of 840,000 released by government in 2003. Many
experts and AIDS workers have long believed that China has at least 1.5 million cases, possibly
far more, and some expressed skepticism that the new figure was any more reliable than past
estimates. At a news conference..., Chinese and international health officials endorsed the new
findings but also warned that while the overall number of cases is less than previously believed,
the rate of infection is still rising, with 70,000 new cases in 2005. Drug users and prostitutes are
transmitting HIV... in most of new cases, but the report also found that the disease is now
spreading from such high-risk groups into the general population, raising the risk of broader
infection"... [article over 2.5 pages long]; Reuters"China Overestimated Number of People With
AIDS, Report Says"NYT 25 Jan 06:-related 1.5 page article; Associated Press"China Lowers
Estimate of HIV Cases"NYT 25 Jan 06:-another related 1.5 page article; AP"Clinton Urges Help
for Kids With AIDS"NYT 18 Feb 06:-"Former [US] President urged governments and public
foundations to buy anti-AIDS drugs from low-cost manufacturers so more children can receive
treatment for the disease. Clinton... said last month that Cipla and 3 other Indian
pharmaceuticals would offer antiretroviral drugs at prices up to 30% cheaper than current market
rate... Since his Clinton Foundation's 2002 HIV/AIDS initiative began, foundation has
concentrated on making affordable drugs available, buying second line AIDS drugs from generic
drug makers for 21 countries in Asia, Africa and the Caribbean, he said. His foundation planned
to get anti-AIDS drugs to 60,000 children in worst-affected countries this year... 'We've had a 3-year partnership with Cipla, and because of them an enormous number of HIV/AIDS-infected
people are alive', he said. India has 5.13m cases of the illness, second largest number of people
infected with HIV after South Africa. Indian government claims its anti-AIDS campaign has
stabilized the epidemic and says there has been a sharp decline in the number of new HIV
cases"; Reuters"Clinton Group, India to Train Nurses in AIDS Care"NYT 19 Feb 06:-"Former US
President and Indian government announced a joint plan to train nurses in AIDS care in a
country which has world's second-largest number of HIV/AIDS cases... Partnership between
National AIDS Control Organization of India (NACO) and Clinton Foundation, aims to develop
training material and program for nurses... 'Nurses not only deliver clinical care, needed to keep
people alive, but they also act as counselors and play an important role in reducing the myths,
stigma, and discrimination surrounding this disease', [Clinton said]"; Reuters"Clinton, Australia
Launch Tri - Nation AIDS Campaign"NYT 22 Feb 06:-"Former US President Bill Clinton and
Australia announced plans to combat AIDS in China, Vietnam and Papua New Guinea, warning
that 40% of all new infections could be in Asia-Pacific region by 2010... [Combined]
money...would be used to make anti-retroviral drugs... more readily available and to improve
testing and monitoring systems in the three countries... Clinton...said about 500,000 children
died of AIDS around the world in 2005... Vietnam, China and Indonesia face fastest-growing HIV
epidemic in the world. Papua New Guinea... faces an epidemic of similar proportions... With an
annual infection rate increasing by 33% a year, country is on verge of an African-style disaster
that could kill millions and destroy the economy"; Reuters"Schools Teach Survival to Africa's
AIDS Orphans"NYT 23 Feb 06:-"...Swaziland has world's highest rate of HIV/AIDS, which is killing
key workers and whittling away the tiny country's capacity to deal with a drought that has left
some 10 to 12 million people in southern Africa dependent on food aid. Around a quarter of
Swaziland's 1 million people rely on the UN World Food Program and many families eat just one
basic meal of corn or rice a day. UN Food and Agriculture Organization (FAO) launched junior
farmer field and life schools in Mozambique 2003 and has since opened schools in Kenya,
Nambidia and Zambia, targeting some 1,000 young people between the ages of 12 and 18. FAO
has now launched first phase of the project in Swaziland... Program combines farming skills with
lessons on personal hygiene, money management and, crucially, about dangers of HIV in
country where some 40% of adults are infected with virus that causes AIDS"; Reuters "Relief
Group Seeks Access to New HIV Drug in Africa"NYT 15 Mar 06:-"A humanitarian group urged
US drugmaker Abbot Laboratories Inc. on [15 Mar] to make a new HIV drug accessible in
developing countries, especially Africa. Relief organization Medecins Sans Frontieres said a new
formulation of Abbot's lopinavir/ritonavir drug had critical advantages for patients in poor
countries, including lower daily pill count, storage without refrigeration and no dietary
restrictions ... Sub-Saharan Africa has about 10% of world's population but 60% of people living
with HIV/AIDS... More than 3m Africans became infected with HIV in 2005, representing 64% of
all new infections globally and more than in any previous year for the impoverished continent,
according to UNAIDS. MSF provides anti-retroviral drugs for over 60,000 patients in nine
countries in Africa, Asia and Latin America. It said it urgently needed the new drug because
refrigeration is unavailable to many people in poor countries. The new formulation, marketed
under the name Kaletra, is in tablet form and does not melt at high temperatures unlike the old
version which is in capsules. MSF said the new version of Kaletra, which was approved by US
Food and Drugs Administration [Oct 05], was not available in any developing country. It urged
Abbot to register the new version in developing countries, sell it at less than $500 per patient per
year and remove patent barriers to allow production of generic versions... Abbott said it was
pursuing registration for the new formulation in developing countries as rapidly as possible. It
also said it was making its HIV medicines available in 69 of the world's poorest countries...
Kaledra is a 'second line' drug which can be used when standard anti-retroviral drugs stop
working... One MSF program found that after four years of ARV treatment, 16% of patients
needed second-line drugs"; Reuters "Women, Hit Hard by AIDS, Need Own UN Agency: Envoy"
NYT 17 Mar 06:-"Women and girls are far more vulnerable to AIDS than men and need their own
UN agency to defend them, just as the UN children's fund UNICEF protects young people, a top
UN envoy said. 'What has happened to women is such a gross and palpable violation of human
rights that the funding must be found', said Stephen Lewis, UNSG Kofi Annan's special envoy
for AIDS in Africa. 'We must right the wrong'. Lewis... said 56% of pregnant women between 25
and 29 years old in Swaziland were infected with HIV... In Lesotho, roughly 30% of girls 15 to 17
years of age were infected, he added. 'Reconfirms yet again the wildly disproportionate
vulnerability of women and girls'. An estimated 57% of infected adults 15 to 49 years old in
Lesotho are women... Lesotho and Swaziland broadly reflect what is happening across Africa,
he said, arguing that situation would be different had a well-funded and powerful agency
representing women's interests been in place... Across all of sub-Saharan Africa,.. estimated
4.6%of young women age 15 to 24 are infected with HIV, compared to 1.7% of young men,
according to the latest available UN statistics"; AP"AIDS Said Orphaned 1.5M Asia - Pacific
Kids"NYT 22 Mar 06:-"AIDS has orphaned an estimated 1.5m children in Asia-Pacific region, but
they are often overlooked in the mix of other issues surrounding a disease that has historically
focused on adults, officials told a regional conference... About 121,000 children in the region
have been infected by the disease, according to UNAIDS figures from 2004. Another 35,000 also
need anti-retroviral drug treatment to survive. Three-day meeting has drawn some 250 delegates
from UN agencies, governments and NGOs to Hanoi to discuss what can be done to limit spread
of the disease among youth and how to help children already infected or orphaned by it...
UNICEF regional director... said there needs to be increased prevention efforts targeting youth,
more focus on prevention of mother to child transmission, provision of drugs to children
suffering from the disease, and creation of support groups for kids infected with the virus or
orphaned by it... A Save the Children survey... found that many children cannot go to school
because someone in their family is sick with the disease, they are commonly ridiculed and
ostracized by society and are sometimes forced to work as slaves or sex workers after becoming
orphans"; AP"Group Warns of More Child AIDS Deaths"NYT 24 Mar 06:-"Number of children
orphaned by AIDS in East Asia-Pacific region could grow from 450,000 to 1.7m in less than a
decade if resources aren't increased for prevention and treatment, UNICEF official said... Also
said number of child deaths could reach nearly 20,000 a year during that time if more isn't done...
It would take up to $5.5b annually until 2015 to lessen effects of HIV/AIDS on children in the
region, in increasing to an estimated $6b a year after that, he said... [UNICEF epidemiologist also
said] there are an estimated 450,000 children in the region who have lost one or both parents to
the disease, and that could grow to 1.7m by 2015 without more funding... A document released
at end of conference called for reducing the stigma and discrimination associated with HIV,
boosting steps to prevent mother-to-child transmission, and enhansing care and protection for
children. Other provisions included more pediatric HIV testing and greater access to anti-retroviral drugs for children. HIV/AIDS epidemic is growing faster in East Asia than anywhere
else in the world. In many countries epidemic still largely concentrated in high-risk groups;
AP"Bid to Give AIDS Drugs to Poor Nations Lag"NYT 28 Mar 06:-"UN's attempt to put 3m HIV-infected people around the world on antiretroviral drugs by last year fell far short of its goal, but
it saved hundreds of thousands of lives nonetheless, [WHO] said. So-called '3 by 5 program' -
3m people on antiretroviral drugs by end of 05 - was launched in Dec 03. However, a progress
report issued by WHO said only 1.3m people in poorer countries were being treated at end of
05... Program helped lay groundwork for more ambitious goal of achieving nearly universal
access to medicine by 2010, set by leaders of G8 nations in 05... Some 3m people die of AIDS
each year, [Global AIDS Alliance exec.dir.] said, and WHO believes program averted between
250,-350,000 deaths in 05... WHO report said world spent $8.3b on AIDS 05, up from $4.7b in 03...
Treatment in southern Africa, a focus of program, has risen sharply... Other regions also of
concern, such as India where large number of people infected and treatment access still very
low. A general goal is to expand testing because most people who are HIV-positive don't know
it. Testing for children in particular needs to be more widespread so that infected youngsters can
be identified quickly and started on treatment, WHO AIDS director said. Health workers have to
act quickly because about half of AIDS-infected children die before age of 2"; Lawrence K.Altman
"Study Finds Drop in H.I.V. Cases in South India"NYT 31 Mar 06:-"Prevalence of new HIV
infections has fallen significantly in southern India, region of that country where the disease has
occurred most often, scientists reported. Many health officials have predicted major increases
in HIV in India, which has world's second highest number of infected people, after South Africa.
But new infections among young aduts declined by more than a third from 2000 through 2004,
according to a statistical study. [Article contains selected statistics from study and varied
information about sources.] Authors attributed favorable trend to an increasing use of condoms
by men and an insistence by prostitutes that their partners use them. That decline, in turn,
reduced transmission of HIV to spouses. Experts cautioned against drawing too firm a
conclusion from one study and added that the new findings did not mean India's HIV epidemic
was over. Still, the study has two key implications, researchers said. One is that strategies that
emphasize education about how HIV can be transmitted and the use of condoms offer the best
hope for reducing the spread of the virus in India. Second is that routine monitoring of HIV and
other sexually transmitted diseases are powerful and cost-effective ways to control AIDS in
India. But experts urged constant vigilance for signs of a reversal of the favorable trend...
Reductions were more modest in 14 northern states, where prevalence of HIV infections is about
one-fifth that in the four southern states"; Economist 01 Apr 06"Australia and AIDS: Help Thy
Neighbour"(35):-"Partnership between Australian government and Clinton Foundation[op.cit.]...
will work in China, Vietnam and Papua New Guinea (PNG), mainly to supply tests and anti-retroviral drugs... HIV has grown alarmingly in PNG to reach 50,000 estimated cases, about 2%
of adult population.... Possibly rising to 500,000 cases by 2025. Unprotected sex has driven most
of the spread in PNG. In China (500,000 estimated cases) and Vietnam (260,000 cases),
contaminated blood transfusions, prostitution and intravenous drug use are the main avenues...
AIDS left unchecked could prove another potential source of regional instability along with
terrorism... Having 8.3m people infected with HIV in Asia and the Pacific threatens the economic
life of Asia, especially that of China... The outlook is grim: the number of sufferers is forecast
to more than double to 20m by 2010 unless rich countries... start exporting their own successful
experience in curbing AIDS"; Economist 01 Apr 06"Treating AIDS: A Missed Target"(64-5):-"World Health Organization(WHO)'s attempt to roll out AIDS drugs in poor countries has missed
its target. A shame, but not a disaster[op.cit. AP 28 Mar]. The '3 by 5' initiative to get 3m HIV-positive people in poor/middle-income countries on to anti-retroviral drugs by end of 2005 has
got less than halfway there. [WHO/UNAIDS reported] a mere 1.3m of those infected in target
countries are on courses of drugs. [Yet shift from pure prevention to care offered incentives for]
those who might...be infected[: new] reason to find out the truth [and encourage modified
behaviour to reduce transmission. Also, even 3+ times the previous number under treatment]
averted about 250,000 premature deaths in 2005. One problem [was] that in most countries the
[essential] infrastructure... did not exist. [Hence] the initiative may have been more successful
than [new] figure suggests, since part money has gone on infrastructure [and] this sort of work
has spin-offs beyond the treatment of AIDS. Expense of treatment also tackled[:] big change...in
market for AIDS drugs. Clinton Foundation HIV/AIDS Initiative has helped to defragment market
for generic anti-retroviral drugs by signing contracts... in India and South Africa that guarantee
large order-volumes and reliable payment. As result, price in some cases... below $150 per
person per year.. Progress, then, being made. [Possible] 3m figure by end of 06";
Reuters"S.Africa in New Row with AIDS Group Over UN Meeting"NYT 03 Apr 06:-"South Africa's
Health Ministry has barred the country's top AIDS activist group from a major UN forum on the
epidemic, the group said, sparking a new row over AIDS policy. Treatment Action
Campaign(TAC), nominated for Nobel prize in 2004, said government excluded it from a list of
South African groups invited to UNGA Special Session(UNGASS), to be held 31 May-02 Jun in
NYC. 'We can only speculate (we have been barred because) we have taken an approach that
doesn't play around with the issues and that we ask the questions that need to be asked', TAC
gen-sec told Reuters. Health Ministry officials conceded TAC had been taken off official list of
invitees. 'There was concern raised as to the position they have taken traditionally', spokesman
said. TAC's campaign for anti-retroviral (ARVs) drugs has frequently pitted it against President
Thabo Mbeki's government, which bowed to pressure in late 2003 to provide public treatment
in the country worst affected by the disease. TAC and other critics say the roll-out since has
been too slow, due partly to a lack of political will... South Africa's ARV program is second
largest in the world after Brazil's, with more than 100,000 people on treatment. Activists say 900
South Africans die of AIDS-related diseases every day, and official data estimates 5.6m of
country's 45m people are infected with HIV. Health Department said prepared to meet with TAC
to try find an amicable solution"; Richard Cockett "Chasing the Rainbow: A Survey of South
Africa" Economist 08 Apr 06(5-6):-Summary of major section on government's HIV/AIDS policy
only: "[G]reatest weakness of [ruling African National Congress] ANC's top-down system is that
party is inclined to dismiss ideas from outside its own bureaucracy. Most obvious example has
been [President Thabo] Mbeki's well-documented response to the HIV/AIDS crisis. For a long
time [op.cit.] Mbeki stood out against the combined weight of world medical opinion on the
causes/treatment of AIDS, and particularly on use of anti-retroviral drugs. Main group
campaigning for their use, Treatment Action Campaign, was made up almost entirely of ANC
members, and Mbeki seems to have resisted their arguments as much because he felt they were
breaking party ranks as for their prescriptions on AIDS (with which he disagreed). In 2003,
government eventually caved in to domestic/ international pressure and gracelessly introduced
a comprehensive management regime involving anti-retroviral drugs to combat HIV/AIDS. May
have signalled change of policy by government, but not, it seems, much of a change of mind. In
a country with 5.2m HIV-positive people on record, the largest number in the world, there is
almost no public acknowledgement of the problem or public education about it. [M]inisters (with
a few honourable exceptions) still seem loth to talk about the illness, which kills about 900
people a day and undermines much else the country is trying to achieve. It handicaps the army,
with an infection rate said to be up to 40%, breaks up families and kills much-needed teachers.
Chillingly, Actuarial Society of South Africa estimates that it will be another ten years before the
pandemic peaks. Tardiness with which government responded to HIV/AIDS crisis, together with
Mbeki's own strange take on underlying science, has tarnished own reputation, as well as that
of ANC. Critics argue government remains ambivalent about its commitment to fighting
pandemic with anti-retroviral drugs. Government's plan to combat HIV/AIDS may be model of its
kind in intent, but it is already falling behind. By end of 2006 about 225,000 patients will be
receiving anti-retroviral drugs, well short of the plan's target of 380,000 by 2005-06. Mbeki's
unorthodox views on causes/cures of HIV/AIDS undoubtedly have something to do with his
agenda of finding African solutions (rather than expensive Western ones) to Africa's problems...
But AIDS saga, together with ANC's unresponsiveness to its own supporters and its failure to
deliver on its promises, has diminished aura of moral authority it has earned"; Celia
W.Dugger"Ukraine: World Bank Suspends TB and AIDS Fund"NYT 14 Apr 06:-"The World Bank
[IBRD] has suspended a $60m loan to Ukraine for prevention and treatment of tuberculosis and
HIV/AIDS. After three years, government has spent only 2% of the money. Ukraine has one of the
fastest growing rates of HIV infection in Europe, with more than 1% of the adult population
already infected, but government has resisted the Bank's suggestion that the funds be given to
nonprofit groups that could act more quickly to reach prisoners, drug users and prostitutes at
high risk of infection, said Nicholas van Praag, bank spokesman"; Reuters"Triple Treatment Cuts
Malaria in HIV Patients"NYT 14 Apr 06:-"Combining anti-AIDS drugs, an antibiotic and bed nets
treated with insecticide could cut the rate of malaria infections in people infected with HIV by up
to 95%, researchers said. Malaria and HIV are leading infections in sub-Saharan Africa. In
adults/children with HIV, malaria is more common and can be more severe... Researchers found
that antiretroviral drugs, the antibiotic co-trimoxazole and bed nets are each effective in
combating malaria in HIV patients, but when combined their impact is cumulative. Malaria... kills
more than a million a year, mostly young children in Africa. HIV weakens the patient's immune
system, making it more vulnerable to opportunistic infections such as malaria and AIDS... Co-trimoxazole, a standard treatment worldwide for patients infected with HIV, reduced the
incidence of malaria in patients by 76%. When combined with anti-AIDS drugs it hit 92% and cut
cases by up to 95% when bed nets were included. Researchers... believe the impact of the anti-AIDS drugs was due to its effect in strengthening the immune system rather than any direct
effect of the drugs on the malaria parasite... Most malaria deaths occur in Africa, where the
disease kills a child every 30 seconds, according to WHO. More than 40m woldwide are living
with HIV/AIDS; more than 25m in sub-Saharan Africa. In 2005 about 2.4m in the region died from
HIV/AIDS; AP"AIDS Conference Ends With Appeals"NYT 26 Apr 06:-"International AIDS
conference [in Cape Town, of 1,000 scientists/researchers,] ended [26 Apr] with impassioned
appeals to political/pharmaceutical industry leaders to fund development of a virus-killing
[vaginal] gel to protect women from the disease and so save millions of lives. Peter Piot, head
of UNAIDS,.. said safe/effective microbicides could be ready in 5-7 years, with only minimal
additional funding, and thus turn the dream of saving millions of lives into reality... In the hard
hit African countries, women account for nearly 60% of infections. Most are infected through
heterosexual intercourse... UNAIDS/WHO have long promoted microbicides as a potentially
valuable weapon in fight against the epidemic, not least because it allows women to protect
themselves without having to rely on partners who refuse to wear a condom or be faithful. Yet
despite this, research has proceeded slowly. [Piot] said investment in microbicide development
should be doubled - and even then would still only reach about US$150m per year... Microbicides
can take the form of a gel, cream, sponge or ring that releases an ingredient that can kill or
deactivate HIV during intercourse. There are currently five different products being tested[,
mainly in Africa on thousand of women]. Dozens of agents that could interrupt HIV transmission
have so far been identified. There are also hopes that the microbicides could be used to prevent
other sexually transmitted diseases and unwanted pregnancies. One of the products, cellulose
sulphate, has the potential to be a contraceptive and shield against HIV... Another microbicide,
Carragard, coats vaginal cells and prevents the virus from entering... Much of the funding for
research comes from Gates Foundation and US government... Trying to dismiss fears that
microbicides would mainly be used in developing countries and therefore offer only low profit
margins, [WHO] cited their potential for use in contraception in wealthy countries"; Sharon
LaFraniere"Circumcision Studied in Africa as AIDS Preventive"NYT 28 Apr 06:-"Growing number
of clinicians/policy makers in [southern Africa] are pointing to a simple and possibly potent
weapon against new infections: circumcision for men... New studies suggest that male
circumcision can reduce chance of HIV infection in men, and perhaps in women... Validity of the
approach is still being tested... Evidence so far, while intriguing, is not definitive... Most striking
studies suggest that men can lower their own risk of infection by roughly two-thirds, and that
inflected men can reduce the odds of transmitting the virus to their partners by about 30%,
simply by undergoing circumcision. Research suggests that the cells on the underside of the
foreskin are prime targets for the virus and that tears and abrasions in the foreskin can invite
the infection. But WHO experts say it would be premature to recommend circumcision until
results come in from two controlled trials... Preliminary results could be released by late Jun...
Of the nearly 5m people worldwide who became infected last year, 3.2m live in sub-Saharan
Africa, [UNAIDS] said... An epidemiologist and HIV specialist in Africa for USAID argues that low
rates of circumcision and high rates of multiple, concurrent sexual partners are the main
reasons that the AIDS epidemic has raged in southern Africa but left western Africa mostly
unscathed. According to a study, seven southern African countries, where fewer than one in five
men were circumcised, had HIV prevalence in adults of 14% to 26% in 1998. In nine western
African countries, where more than four in five men were circumcised, HIV prevalence rates were
below 5%... Studies appeared to show that uncircumcised men were more than twice as likely
to be infected than circumcised men. Perhaps the most compelling evidence came from a study,
financed by France, of 3,274 men outside Johannesburg. Half of them underwent circumcision;
the others were uncircumcised. After 17 months, 49 of the uncircumcised men became infected
with HIV, while only 20 of the circumcised men caught the virus... Researchers estimated that
the procedure reduced the risk of contracting HIV by roughly two-thirds [and] that circumcised
men infected with HIV were about 30% less likely to transmit it to their female partners ...
Worries: if circumcision is oversold, circumcised men may think they are free to engage in risky
sex... Other specialists concerned that studies may encourage unsafe circumcisions by
traditional healers"; Ian Fisher"Debate Over Condoms and AIDS Tests the Pope"NYT 01 May 06:-"Even at the Vatican, not all sacred beliefs are absolute. Thou shalt not kill, but there is still 'just'
war. Now, behind the quiet Vatican walls, a clash is shaping up between two poles of near-certainty: the church's long-held ban on condom use and its advocacy of human life. The issue
is AIDS. Church officials recently confirmed that Pope Benedict XVI has requested a report on
whether it might be acceptable for Catholics to use condoms in one narrow circumstance: to
protect life inside a marriage when one partner is infected with the HIV virus or is sick with AIDS.
Whatever the pope ultimately decides, church officials and other experts broadly agree that it
is remarkable that so sensitive an issue is being taken up. But they agree that such an inquiry
is logical, and particularly significant from this pope, who as Cardinal Joseph Ratzinger was
Pope John Paul II's strict enforcer of church doctrine... The issue has surfaced repeatedly in
recent years as one of the most complicated and delicate facing the church. For years, some
influential cardinals and theologians have argued for a change for couples affected by AIDS in
the name of protecting life, while others have fiercely attacked the possibility as demoting the
church's long advocacy of abstinence and marital fidelity to fight the disease. [W]ith regard to
condoms, the only change being considered, according to reports, is in the specific case of a
married couple. But any change, however narrow, would be unpopular with conservative
Catholics... It is too soon to know where the pope is heading... The debate has two levels: one
on moral theology and church doctrine, the other public relations and politics. Many factors are
driving the debate: The church is experiencing its greatest growth in Africa, which has the most
severe AIDS problems. Much health care in Africa is provided by Catholic charities, whose
workers, barred from providing condoms, have often spoken of being torn between church
doctrine and the need to prevent disease. More broadly, critics of the current Vatican policy say
it is hard for the church to remain consistent on 'life' issues, like its opposition to abortion and
euthanasia and the death penalty, when condom use can help prevent the spread of AIDS. But
there is a deep vein of feeling against any change... The moral arguments stretch back nearly two
millennia, to the idea that the church has a responsibility, in difficult moral cases, to advocate
the 'lesser evil'... There are other related arguments: One is of 'self defense', in which an
uninfected partner could demand condom use to protect against infection. Another is that using
a condom against AIDS could be considered medical intervention rather than contraception. But
the 'lesser evil' argument is not universally accepted among Catholic thinkers, and the theology
is complicated. Among many other issues, there is the user's intent: whether it is possible to use
a condom without the intention of contraception... A change would address a relatively small
part of the problem since most transmission of AIDS is not between married couples";
AP"Vatican Re - Examines Ban on Contraception"NYT 03 May 06:-"A Vatican study on whether
it could permit condoms to battle AIDS has a very narrow scope; [b]ut its theological
underpinnings are centuries old, and could lay the groundwork for an end to church's blanket
ban on contraception. The principle of 'double effect' entered mainstream Catholic debate more
than 300 years ago and draws on questions about the 'lesser of two evils' raised by theologians
[long ago]. Some groups, including the Southern Africa Catholic Bishops Conference, have even
given a tacit nod to condoms for married couples with one partner infected. The Vatican -
however tentatively - now could be moving to formally recognize that position... There's no
chance the Vatican would fundamentally revise its opposition to contraception, [b]ut even the
targeted discussions... are further evidence of Pope... shedding [his] tradition-bound
reputation... Benedict, a widely respected theologian, has shown a willingness to re-examine
church attitudes toward advances in genetic engineering and in-vitro fertilization. But none
approach the sensitivity of whether to open the door - even a crack - for condoms... If the Vatican
allows condoms as an AIDS control measure within a marriage, it would open the way for
Catholic groups to take a more direct role in anti-AIDS campaigns in ravaged places such as
Africa... '[L]esser of two evils' views boil down to moral damage control. A priest should always
advise against doing 'evil', but encourage a 'lesser evil' if they can't stop the act"; Reuters
"Zimbabwe Running Out of AIDS Drugs as Crisis Worsens"NYT 03 May 06:-"Zimbabwe is
running out of anti-retroviral drugs to treat HIV/AIDS as a foreign currency shortage hobbles
government efforts to provide 20,000 people with the life-saving medicine, state media said.
Acting director of Zimbabwe's National Pharmaceutical Company said his firm was struggling
to find funds to buy ARVs for people with AIDS, which experts say kills an average of 3,000
Zimbabweans every week, Herald newspaper said... Health sector is among those hardest hit by
Zimbabwe's severe economic crisis [super-inflation]... The embattled southern African country
also lies close to the heart of Africa's HIV/AIDS epidemic, with the government estimating 1.61m
people infected with the virus. But in a rare bit of good news, Zimbabwe's adult HIV prevalence
has fallen to about 20% from 25% five years ago, apparently due to increased condom use and
people having fewer sexual partners"; AP"HIV / AIDS Conference Eyes Indigenous People"NYT
04 May 06:-"More than 1,000 people gathered for five-day conference on HIV and AIDS for
indigenous people in North America. 'HIV/AIDS is rapidly becoming a terrible predator in native
communities, and most of these communities are unprepared to protect themselves', said...
keynote speaker... 'Cases are being reported in even the most remote communities'.
[P]rofessor... said researchers need to study the effectiveness of medication on native peoples...
Conference participants included...natives.,.as well as physicians, nurses, pharmacists,
researchers, elders and spiritual leaders"; Reuters"In Tiny Kingdom, Bono Presses New Africa
Agenda” NYT 16 May 06:-“Irish rock star Bono began a new African tour in Lesotho where he
will unveil a new initiative to fight AIDS in its ailing textile industry... Bono has billed this as
‘Measuring Success and Promises’ to highlight the progress in the treatment of HIV/AIDS in
Africa, the search for economic growth and rich nations’ pledges to cancel some debts and more
than double aid to Africa by 2010... Lesotho...has history of food shortages caused by drought,
and struggles with one of the world’s highest rates of HIV/AIDS with nearly a third of its adult
population infected. Bono is due to announce a new initiative to fight HIV/AIDS in Lesotho’s
textile and garment industry with US clothing maker Gap Inc... Gap is contributing 50% of its
profits from the sale of GAP Red products to a global fund for AIDS in Africa and has committed
to make some of the Red Products in Africa. The Apparel Lesotho Alliance to Fight AIDS (ALAFA)
project will ensure workers have access to free drug therapy for the prevention and treatment
of AIDS among factory workers”; Celia W.Dugger"Letter From Kenya: Where AIDS Galloped,
Lessons in Applying the Reins"NYT 18 May 06:-major article describes/discusses US influence
on Kenya policy, but summary mainly on current pandemic conditions. "Kenya rarity in Africa:
nation where experts say AIDS shows signs of easing. So... attracting policy makers/researchers
looking for keys to slowing relentless spread of AIDS on continent. Trends heartening. Medical
experts estimate new HIV infections... plummeted over last decade from peak of more than
200,000/year to fewer than 90,000. And changes in sexual habits seem contributing to decline.
Men say having sex with fewer partners, and women report losing virginity later. Many teenagers,
once sexually active, say they are abstaining entirely. Such shifts... suggest abstinence
programs... have some chance of success...Kenyan health officials frankly acknowledge
evidence lacking on effectiveness of programs that promote condoms or abstinence. According
to UN AIDS agency, Kenya, Uganda, Zimbabwe: the sub-Saharan with documented declines in
HIV prevalence. Researchers agree fall partly because AIDS deaths have reduced population of
HIV-positive people. But also say likely behaviour change has helped. In Uganda, increased use
of condoms important. Health officials [in Kenya] say spread of knowledge about how to prevent
infection and rising tide of death been catalytic... As donors racheted up financing of anti-AIDS
programs, landscape for prevention changed. Since...2003, US dominant donor in Kenya: $208m
this year to combat AIDS... More than half that financing feverish drive for diagnosis of AIDS and
treatment of infected... AIDS patients receiving drug treatment rocketed to 70,000 from fewer
than 10,000 in 2003. Paradoxically, explosive growth in testing/treatment may be US's most
important contribution to preventing spread of disease. Once people know AIDS not a death
sentence, more willing to be tested, and once know their HIV status they can protect
themselves/sexual partners... Experts' judgement[:] more than half new infections in Kenya are
with couples in which one partner HIV-positive. US also paying programs aimed at changing
behaviour. This year,.. $15.7m on programs that promote abstinence/faithfulness, and $7.8m to
prevent sexual transmission of HIV, including... condoms to high-risk groups. [D]ebate that
rages in WashDC over AIDS/sex sometimes seems [here] more reflection US culture wars than
African realities... Under guidelines, US funds can be used to educate children 14/younger about
abstinence/faithfulness, with condom education added for 15/older... Scholars say much work
remains to figure out which of so-called ABC programs - abstain, be faithful, use condoms -
effective...But efforts to prevent spread of AIDS will not wait for definitive evidence. [If] sex can
lead to death, many people on both sides of ideological divide agree abstinence for the young
should be embraced. Also clear many young people will have sex despite the dangers, and that
abstinence programs alone will not protect them"; Reuters“Children Called “Missing Face” of
AIDS Pandemic”NYT 27 May 06:-“Some 2.3m children under 15 years of age are living with HIV,
with little access to treatment, according to a report by child advocacy groups. ‘Children are the
missing face of the AIDS pandemic’, executive director of UNICEF told a news conference [NYC]
in introducing a report by seven humanitarian groups. Over 90% of children with HIV... are in
sub-Sahara Africa, where diagnosis rare, treatment expensive and most available drugs
produced for adults, report said... Vast majority of infants are infected by their mothers during
pregnancy, where drugs are available to prevent transmission to infants but only about 10%
receive them. Children rarely given needed anti-retroviral drugs, report said... AIDS among
adolescent females as well as mother-to-child transmission increasing, despite affordable
treatments available over past 15 years. New report/earlier one by UNICEF showed that each year
more than 650,000 children under 15 account for 1 in 6 AIDS-related deaths. A child under 15
dies of an AIDS-related illness every minute, and a young person aged 15-24 contracts HIV every
15 seconds. All officials emphasized lack of research to combat AIDS in children, which means
treatment is less precise and more expensive. Development of new drugs are focused mainly
on adults. Although Africa governments pledged to spend 15% of their budgets on public health,
less than a third have done so... [P]ledges from G8 industrial nations have not fully materialized.
[Officials] spoke out in favor of sex education, tailored to age groups, and the need to keep girls
in school. In some African nations, one third of girls under 18 are the victims of forced sex, often
during forced marriages... Report on children was released ahead of UNGA Session on AIDS”;
Seth Mydans“Shunned, Women With H.I.V. Join Forces in Vietnam”NYT 28 May 06:-“The dying
women [who] have gotten together again...are members of a support group for people infected
with HIV in a society where they are widely shunned, where drugs are scarce/treatment is
expensive, and where a diagnosis of infection is still, for most people, a sentence of death... In
the face of discrimination and in absence of adequate health care, they are for most part one
another’s only support. [Vietnam] is a country teetering on brink of a nationwide epidemic, with
more than 250,000 people infected with virus that causes AIDS, and only 10% of those who fall
ill receiving treatment they need, according to UNAIDS... Country’s health care system is well
organized, but the disease has until now been concentrated among intravenous drug users and
has not been treated as a priority. Experts say it is beginning to spread quickly into the broader
population, and one of the chief barriers to prevention/treatment is the stigma that makes
outcasts of those who carry [HIV]. Support group - called Haiphong Red Flamboyant - is
expanding.,.and a model for similar groups around the country. What the women rarely talk
about... is near-certainty that in time they, too, will fall ill, and that they will be feeding/bathing/
consoling one another, and caring for one another’s children, as one by one they die... Over past
3 years scores of women have been members of Red Flamboyant. Many have died, but group
has only grown - and spawned new groups - as more infected women step from the shadows
and join. Most of the women gathered... said they had been infected by their husbands, in a city
where drug addiction is widespread, and most said their husbands had already died. All had lost
their jobs when their employers discovered they were infected... The government is preparing
new legislation now to combat the epidemic, some $50m in assistance is arriving from abroad,
and more drugs are becoming available”; UNAIDS“2006 Report on the Global AIDS Epidemic”UN
NYC 30 May 06:-to special UNGA; text at:
www.unaids.org/en/HIV)_data/2006GlobalReport/default.asp. Sub-titles: 1 Introduction 2
Overview of the global AIDS epidemic 3 Progress in countries 4 The impact of AIDS on people
and societies[corrected] 5 At risk and neglected: four key populations 6 Comprehensive HIV
prevention 7 Treatment and care 8 Reducing the impact of AIDS 9 The essential role of civil
society 10 Financing the response to AIDS 11 Getting the best out of national responses 12 From
crisis management to strategic response. Text in english|french|russian|spanish; whole is
downloadable; Lawrence K.Altman“Report Shows AIDS Epidemic Slowdown in 2005"NYT 30 May
06:-“New surveys suggest that global AIDS epidemic has begun to slow, with decline in new HIV
infections in about 10 countries, leader of UNAID program said. Outside of those countries,..
number of new AIDS infections continues to rise or hover at its current pace. Meanwhile, public
health efforts are reaching only a small proportion of people at risk, Dr.Peter Piot, executive
director of UNAIDS, said at news conference in UN NYC ...India has 5.7m infected people and
South Africa 5.5m, but India’s population far greater. Showing no sign of decline, South Africa
has a prevalence rate of about 19% of 47m people. In India, rate is less than 1% of its population
of 1.1b. Progress against AIDS in some regions represents dividends from a surge in financing
since 2001, when UN pledged its commitment to stem epidemic by 2010. Declaration called for
countries to report regularly on their responses to AIDS. This week, UNGA will receive the
progress that 126 countries have said they have made. Report(op.cit.), most comprehensive
survey ever compiled from country data, pointed to the 2001 UN meeting as a turning point for
AIDS financing. In 2005,.. world spent $8.3b on AIDS, compared with $1.6b in 2001. ‘We are
seeing the impact’, Piot said. He cited increased condom use, a rise in postponement of sexual
intercourse and a decrease in number of sex partners as factors in slowing of epidemic.
Summarizing report’s findings, Piot said ‘2005 was least bad year in the history of the AIDS
epidemic’... Despite the positive trends, Piot reported grim findings from China, Indonesia,
Papua New Guinea, Russia and Vietnam(op.cit.), with signs of outbreaks in Bangladesh and
Pakistan. Ending the pandemic will depend largely on changing social norms like empowering
women, reducing stigma of the disease and encouraging a greater reduction in the number of
sex partners, report said. Most countries have strong foundations for building an effective
response against AIDS, report said, but systems to carry out plans remain inconsistent.
Thoroughness of the individual national reports varied, and many countries did not provide data
for all categories... Still, replies identified significant weaknesses, he said. Fewer than 50% of
young people achieved comprehensive knowledge levels about HIV, far fewer than the 90% goal.
Only 9% of gay men and fewer than 20% of intravenous drug users received any kind of HIV
prevention help in 2005. Services to prevent HIV infections in infants have not scaled up as
rapidly as programs to provide antiretroviral therapy. Just 9% of pregnant women were covered...
Report shows that epicenter of the epidemic remains in sub-Saharan Africa. There epidemic has
reached peak, but incidence remains unacceptably high, Piot said. Across most of Africa, HIV
prevalence among pregnant women attending clinics has remained roughly level for several
years. UN disputed contentions by some observers that the leveling off showed a turning point
in the AIDS epidemic in Africa... Piot said, ‘actual number of people infected continues to rise
because of population growth’”; Reuters“25 Years On, Anti-AIDS Drive Still Falling Short”NYT
30 May 06:-“Twenty-five years after AIDS first recognized, world still falling short in its battle
against the disease with severe gaps in prevention and treatment, UN said [30 May]. ‘Response
to AIDS epidemic to date has been nowhere near adequate’, said UNAIDS... Since...1981, AIDS
and HIV virus that causes it have spread relentlessly from a few widely scattered hot spots to
virtually every country in the world, infecting 65m and killing 25m, UNAIDS said in 630p report...
Anti-AIDS initiatives and their results vary widely from country to country, and many are falling
short of benchmarks set in a landmark high-level UNGA session in 2001, UNAIDS said... Dr. Peter
Piot of UNAIDS... expected long-term commitments at this week’s meeting...and hoped for $20m
annually by 2010... Global AIDS incidence rate is believed to have peaked in 1990s. About 1.3m
in developing world now on life-extending antiretroviral medicines, which saved about 300,000
lives last year alone. Still, some 4.1m were newly infected and 2.8m died in 2005... Global supply
of condoms was less than 50% of what was needed, and antiretroviral drugs, while more widely
available, remained costly and hard to get. Ignored in many countries are prostitutes, said... ex-dir of UN Population Fund... However, final statement by governments at conference this week
not expected to refer to prostitutes, drug users or homosexuals, due to objections from Islamic
nations, some Catholic countries and US, which fear that merely mentioning these groups would
endorse their behaviour. Infected individuals still suffer from ostracism and discrimination, while
vast majority of world’s 40m infected have never been tested for HIV and are unaware of their
status, report said. While $8.9b expected available in 2006, $14.9b will be needed, UNAIDS said.
By 2008, it predicted $22.1b would be needed, including $11.4b for prevention plans alone.
Report called for more and better-targeted education and prevention strategies, more treatment
opportunities, and more drug research, particularly on drugs for children, whose needs ‘have
been largely left out of the research agenda’”; Reuters“New Battle Lines Emerging in Asia Anti -
AIDS Fight”NYT 31 May 06:-“While Thailand is a success story in the battle against HIV/AIDS,
Myanmar and Vietnam[op.cit.] threaten to emerge as new regional hotbeds... Failure to work hard
enough on prevention and a dearth of access to treatment were feeding growing HIV/AIDS
epidemics [there]... Even Thailand, a former HIV/AIDS hot spot which has more than halved the
number of new infections over past decade, could suffer a resurgence if public vigilance
waned... According to report,.. Vietnam has seen HIV spread to all of its 59 provinces and cities.
Out of population of 84m, 260,000 live with HIV. In Myanmar... 360,000 had HIV in 2005 and
proportion of adults with HIV was 1.3% versus 0.3% in Vietnam... A major focal point in the fight
against HIV/AIDS has been Asia, where some 8.3m were HIV-positive at end of 2005 - and two-thirds of them in India... In China, injecting drug users account for almost half the 650,000 with
HIV... Women all over Asia are seen as increasingly vulnerable due to straying partners and a
robust sex trade... The disease had yet to have a serious impact on Bangladesh, Philippines,
Indonesia and Pakistan, but prevention methods needed to be improved to keep the disease
from burning out of control, report said”; AP“AIDS Activists Protest at U.N. Building”NYT 31 May
06:-“Police used bolt cutters to separate AIDS activists who had chained themselves to each
other in the lobby of the building that houses US mission to UN”; Lawrence K.Altman “U.N.
Urges Tripling of Funds by ‘08 to Halt AIDS”NYT 01 Jun 06:-“Stopping epidemic of AIDS will
require $22b/year by 2008 and possibly more in following years, officials of UNAIDS program
said. The $22b is nearly triple the $8.3b spent 05 by all sources, including governments and
private sector. Urging that countries spend more, UNSG Kofi Annan said a costlier and more
sustained effort needed because AIDS ‘has spread further, faster and with more catastrophic
long-term effects than any other disease’... Of projected figure, half is needed for prevention and
a quarter for treatment and care of infected people. Remainder is for care of orphans, children
at risk of becoming infected and program costs. UNSG and Piot of UNAIDS spoke as UNGA
began meeting aimed at renewing political commitment and setting new goals for expenditures
and for measuring progress... Annan urged delegates to challenge countries trying to avoid
goals that mention gay people, prostitutes, intravenous-drug users and others at high risk of
becoming infected. ‘Governments concerned need to be realistic and responsible’, UNSG said.
He also said that ‘if we are here to try to end the epidemic, we will not succeed by putting our
head in the sand and pretending that these people do not exist or they do not need help’...
Report cards showed that most countries missed more goals than they met. More than 20m have
become infected since 2001 meeting. Now countries must fundamentally change the way they
think and deal with epidemic, moving from crisis management to ‘sustained attention and the
kind of “anything it takes” resolve that member states apply to preventing global financial
meltdowns or wars’, Piot said... Global Business Coalition on HIV/AIDS released a study showing
that private companies have become more likely to provide treatment for employees as cost of
antiretroviral drugs has fallen over last six years, to $140-$300/year, from $10,000. In African
countries with a high prevalence, more than 70% of companies surveyed are fully subsidizing
access to HIV treatment, coalition said. Study...found increasing trend to expand such treatment
to employees’ dependents. Companies also offering access to voluntary testing/counseling”;
Reuters“Annan Tells Leaders to Help Prostitutes on AIDS”NYT 01 Jun 06:-“UNSG challenged
world leaders to protect the most marginal groups in society from AIDS - prostitutes/drug
users/homosexuals. Annan and UNGA President Jan Eliasson opened 3-day conference on AIDS
that includes thousands of activists/ministers/diplomats to assess progress so far. [I]n a final
statement now under negotiation,... many delegations prefer citing ‘vulnerable’ groups, fearing
that specific mention would endorse [prostitutes/drug users/homosexuals]. Also in dispute are
rights for girls and sex education, among other issues. US took same position at last major
UNAIDS conference in 2001, but US officials said this no longer was the case... Annan also
stressed the increase of women contracting the disease... Particularly disadvantaged are women
who have been raped, including child brides by their husbands, and women who are never
diagnosed/treated. ‘I believe we are having such a big epidemic, among other reasons, because
of the lack of control of women over sexuality’, [said] Piot of UNAIDS”; Reuters “Nations Split
at AIDS Meeting”NYT 01 Jun 06:-“President of UNGA sought to break deadock over UN
declaration on AIDS, with Islamic countries objecting to empowerment for girls and US/others
resisting defining financial targets. Under pressure from more than 800 advocacy groups,
[UNGA] President Eliasson produced a new draft compromise text... Peter Piot of UNAIDS...said
delegates were being more flexible since Eliasson produced compromise. US, backed by Islamic
nations, objects to any firm commitments to international financial goals”;Reuters“Wealthy
Nations Accused of AIDS Funding Shortfall”NYT 01 Jun 06:-“AIDS advocates accused wealthy
nations of falling behind on 2005 pledge to greatly step up their contributions to global programs
set up to combat pandemic in developing countries. Looming shortfall...repesents ‘a scandalous
betrayal’ of commitments made by G-8 at summit last Jul, said Stephen Lewis, UN special envoy
for HIV/AIDS in Africa”; Lawrence K.Altman & Elisabeth Rosenthal“U.N. Strengthens Call for a
Global Battle Against AIDS”NYT 02 Jun 06:-“[UNGA] adopted strongly worded declaration [02
Jun] aimed at pressing nations of the world to strengthen their battle against AIDS, global
pandemic [UNSG] called ‘greatest challenge of our generation’. Language of document surprised
even anti-AIDS groups, which said that while it did not satisfy all their objectives, they had feared
it would be watered down... Nonbinding declaration reaffirms commitments made in 01, when
UN defined AIDS as far more than a medical issue, framing it in terms of political/human rights/
economic survival... New document is political blueprint, not plan of action. Calls for strong
commitment to bolster the rights of women/girls so they can protect themselves from infection
with HIV... Declaration calls on countries to: use scientifically documented prevention strategies,
including condoms;make clean needles accessible to drug users; take steps to provide universal
access to prevention programs/ care/antiretroviral drugs. Includes politically charged terms like
‘condoms’/‘vulnerable groups’, though those groups not specified... Countries expected to
measure their progress over next 5 years against targets to be determined by UN... Said world
will need to spend up to $23b/year by 2010... Earlier in day, UNSG Annan delivered a gloomy
assessment, saying world was losing the battle. ‘The epidemic continues to outpace us’, he told
packed UNGA. ‘There are more new infections than ever before; more deaths than ever before;
more women/girls infected than ever before’... [US’s] Mrs.Bush speech steered away from many
of the criticisms that have been labled against administration, notably that it promotes sexual
abstinence over scientifically proven strategies, particularly condom use. Indeed, she said, ‘ABC’
model - initials stand for abstain, be faithful and use condoms - had brought sharp declines in
infections in Africa. Britain’s international development [minister] said in interview: abstinence
alone did not work ...Dr. Peter Piot [UNAIDS] said: while no document could make anyone ‘100%
happy’, final version was ‘a major advance’ and far stronger than weaker drafts circulating earlier
in week”; Reuters “Nations Resist New Financial Commitments on AIDS”NYT 02 Jun 06:-“A
major UN meeting on AIDS strategy fell short of concrete financial commitments but recognized
the growing spread of the disease among women and their right to protect themselves. Last day
of 3-day meeting brought together heads of state, PMs and health officials from 151 countries...
‘I know that none of you got all you wanted in this declaration’, UNGA President Eliasson said
in closing session. But he said thanks to advocacy groups, ‘the draft got stronger - not weaker’...
Document says $23b will be needed annually by 2010 to fight AIDS ...Nations agreed to search
for additional resources to ensure universal access to treatment by 2010. But delegations did
not commit themselves to a timetable for raising the funds as they did in 2001 when the financial
target was met... Squeamishness over sex was evident.,. with Islamic groups and conservative
Roman Catholic countries using the term ‘vulnerable groups’ rather than referring to prostitutes,
homosexuals and drug addicts... Yet the document, in addition to abstinence, advocated male
and female condoms and ‘harm reduction’ efforts related to drug use, a euphemism for needle
exchange programs for addicts... Declaration called for sex education, reproductive health
services and condemned ‘abuse, rape and other forms of sexual violence’ as well as ‘trafficking
in women and girls’”; Economist 03 Jun 06“Special Report: Twenty-Five Years of AIDS: Unhappy
Anniversary”(24-5):-“Quarter of a century on, AIDS epidemic shows signs of peaking. But now
the cost of its consequences is becoming clearer... According to UNAIDS, world spent $8b+ in
2005 trying to prevent spread of HIV... in poor/middle-income countries... and care for those
already infected - about 39m. [Since UNGA commitments in 2001,] increase in fraction of
population infected has slowed dramatically; in sub-Saharan Africa where 60% of infected live,
this fraction has remained unchanged for 5 years [and] prevalence rate... rising only at rate
population as whole is growing... Need today...is for a few success stories[:] AIDS can be
contained if prepared to spend the money to contain it... UNAIDS report contains evidence
prevention methods are working in parts of Africa where they did not seem to work before. In
8 of 11 African countries studied in detail, people having sex before they reached 15 has
dropped; use of condoms increased; and in six there was decline of 25%+ from peak prevalence
among those aged 15-24. Drop at this end of age range suggests reduced infection rates, rather
than increased mortality...Figures for treatment are going in right direction, too. More being
treated with anti-retroviral drugs. Figure at end of 2005 was 1.3m [-] less than half target of 3m
UNAIDS had set itself, but not negligible. [M]aking these drugs available to all who need them
by end of decade is still within reach[:] goal is to see 10m treated by 2010... Rate money has been
made available for AIDS from all sources... underwent a step change in 2001[:] pledge was to find
$7-10b by 2005, and what turned up was $8.3b. [Money particularly via two large funds.] Global
Fund to Fight AIDS, Tuberculosis and Malaria...has internationalist credentials that most
activists like. Financed by many countries/large charities/contributions from business [and]
novel feature is regular assessment of its projects by outside consultants. [Other major fund is]
PEPFAR, President’s Emergency Plan for AIDS Relief, [by US’s] George Bush. [A]ctivists are
happy to take... US taxpayers’ money, but... comes with strings they do not like [, and] when
large sums are at stake, tensions may be inevitable... AIDS is still incurable. Treatment works
only as long as take the drugs. [A]ll realise on a mission without an end [, yet] 50th anniversary
of AIDS may be more cheerful than the 25th”; Economist 17 Jun 06“AIDS: Nef Off”(87):-“The
reason HIV is so virulent may have been found... The human immunodeficiency virus, HIV-1, is
the most intensively studied pathogen in history. It still has secrets to reveal. One is why it is so
deadly. Many of man’s primate relatives in Africa harbour similar viruses. Yet,.. simian
immunodeficiency viruses (SIVS) have little impact on their hosts’ health... Investigation
suggests it is result of a change in the role of a single viral gene, called nef...In most SIVS, one
role of nef is to remove a protein called TCR-CD3 from the surfaces of the cells that host the
virus. Host cells in question are immune-system cells called T-cells. Specifically, they are ‘helper’
T-cells, which orchestrate the immune system’s response to pathogens such as viruses... In the
case of AIDS, immune system continues to be stimulated, and this prolonged stimulation results
in high death rates among T-cells. Eventually, that exhausts immune system’s capacity to
regenerate itself. Result is a collapse in the number of T-cells, and the accompanying symptoms
of AIDS. In most simian infections, this does not happen because nef keeps the TCR-CD3 level
too low for this exaggerated response to occur. That is also true in a rarer form of human AIDS
caused by a virus called HIV-2. This form of AIDS is found in West Africa, but has not spread
much beyond that part of the world. Indeed, of the 16 immunodeficiency viruses, all but five had
nef genes that removed TCR-CD3 from the cell surface. Three of those five were closely related
monkey viruses. The fourth was HIV-1. The fifth was the chimpanzee virus that is the direct
ancestor of HIV-1"; [For the time being, I must limit guides to AIDS items by normally
summarizing only 1-2 of their (initial) key paragraphs, since both number/length of the relevant
articles(2-3 pages long) being published is so high. ‘Basic text’ underlining, then, is also not
necessary. In addition, since all the items relate to POLICY ISSUES and the very special 16th
International AIDS Conference (16IAC) in Toronto, all are listed under sub-section D. Rather than
re-list virtually all of them four times in each of the sub-sections on AIDS issues, I simply ask you
to survey material on all four topics under POLICY for the time being.]
C. MEDICAL DEVELOPMENTS AND CHALLENGES
Abigail Zuger“Epidemic: An Overview”in New York Times 02 Dec 1999:-a brief, non-technical and
extremely clear account of the development of the AIDS epidemic, and the stages involved in
determining what it did, what it was, how and why it spread. The article then describes how
methods were gradually found to reduce or slow its spread and lethality - at the cost of
constantly developing new drugs. “HIV is a virus with thousands of different strains and
mutations, and it can develop resistance to drugs very quickly”. More important, in the poor
countries of Africa and Asia where the vast majority of the HIV-infected are now found, and
where the pandemic is spreading with frightening speed, current treatments are far too
expensive ($15,000+ a year) and require good health systems. “For these countries, the best
hope against AIDS lies in the development of a vaccine that can prevent people who are exposed
to HIV from acquiring the infection. But the same variability that allows HIV to elude drugs also
makes it very difficult to trap the virus into a vaccine”.Research is now along two lines. First, we
need safe, easy and effective drugs to keep already-infected people from getting sick(see next).
Second, HIV must be stopped from passing person-to-person and causing new infections.
Pending a vaccine, it means education, HIV testing, reduced illicit drug use, increased condom
use. Donald G. McNeil Jr.,“Simple Antibiotic Urged for Africans With H.I.V.”NYT 06 Apr 2000:-WHO/UNAIDS advise that the 23m Africans infected with HIV be given regular preventive doses
of Bactrim, a common, affordable antibiotic already available in most village pharmacies, to ward
off fatal secondary infections. Many could add years to their lives and have longer gaps between
debilitating complications for $8-17 a year. Two one-year studies cut death rates and dangerous
complications by 50%, so it was decided not to wait to determine longer-term effects. Its use in
Africa seems appropriate against bacterial pneumonias, diarrheal diseases, some septicemias,
and perhaps parasitic infections. Preventive Bactrim use in Asia is pending study results there.
But meanwhile, Barbara Crossette"Most Nations Fail to Supply Safe Blood, W.H.O. Finds"NYT
07 Apr:-WHO claims over two-thirds of the world’s nations are failing to supply safe blood to
their people. This adds significantly to the spread of HIV, as well as potentially deadly forms of
hepatitis and other diseases. These nations, containing 80% of the world’s population (4.8b), are
already the poorest and most unhealthy. The Reasons: not only costs, but the low priority given
to public health and essential hygiene. The Result: WHO estimates that annually tens of
thousands pick up HIV, and millions are infected with hepatitis B and C, which can lead to liver
failure or liver cancer, simply through receiving or selling infected blood. On the other hand,
Lawrence K. Altman"US to Study Vaccine’s Ability to Suppress HIV Levels"NYT 11 May:-a major
test is being made of Remune, a vaccine for people already infected with HIV, that may stop the
virus progressing into AIDS. Altman"New Therapy Strategies Pushed as AIDS Drugs’ Promise
Fades"NYT 12 Jul:-”As the widely publicized hopes of a cure for AIDS have vanished and the
limitations of standard drug therapy have become increasingly apparent, scientists are urgently
seeking new strategies to make better use of therapies they have”. A US government scientist
has announced “promising early findings”from two new trials aimed at giving long breaks in
treatment to people infected with HIV. The aim is to help the body cope with the virus on its own
for varying periods and also help patients absorb(and afford)the drug more easily. This would
not be a cure, but would address indications that drug combinations can lose effectiveness if
continued for too long, let alone for a lifetime. Optimum doses and time schedules are still being
tested, but longer time cycles seem feasible, easing both costs and side-effects. HIV-level tests
are essential, and would have to be expanded in Africa. Katrina Woznicki"On-and-Off Approach
for AIDS Drugs"onhealth.com 12 Jul:-a description of the same trials, but here the procedure is
called”structured intermittent therapy”, and the hope is raised that it might reduce the chance
of the AIDS virus developing resistence to medication. Altman"Hopes for Anti-HIV Treatment
Dashed"NYT 13 Jul:-”Women at high risk of contracting [HIV] should not use the widely sold
spermicide, nonoxynol-9, because it may increase the risk of HIV” according to UNAIDS. It had
been hoped it would act against HIV. Over 50 other compounds are being tested because of the
great need in Africa. Woznicki"New AIDS Drug in the Works"onhealth. com 14 Jul:-scientists are
hopeful a new drug may help AIDS patients who have not responded to standard treatments.
An”entry inhibitor”,” T-20 is an experimental treatment that works by blocking the virus from
getting inside blood cells, its primary means of spreading in the body. Standard AIDS drugs work
by preventing the virus from replicating itself”. In a test, T-20"significantly cut viral levels in 41
patients”, but did not help 16. As regards the heart-breaking number of babies born with HIV or
contracting it soon after birth, two articles(run together here because of their direct
relationship)report on two apparently conflicting test results. Altman"Report Dims Hope for
AIDS Therapy"NYT 08 Jul:-this article offers another warning about Africa’s special problems.
A UN-sponsored AIDS study has”confirmed earlier reports that a relatively simple drug regimen
can stop many infected mothers from infecting their children during pregnancy and childbirth.
But it also found that the protection does not last for as long as experts had hoped, and the
therapy appears to leave children vulnerable to infection from breast milk”.By 18 months all
benefit is lost. The insuperable dilemma is that long“breast-feeding...is [already a serious]
medical risk but a cultural, religious or economic necessity for millions of African women”-plus
now to hide the fact that they are infected(see below). However Altman"AIDS Studies on Infants
Appear to Conflict"NYT 14 Jul:-reports that second study found another simple drug
regimen“given to women during labour and to their newborns in first three days of life”seems
to protect babies from HIV. As both systems meet African low-cost capabilities, resolution of the
dilemma created by the findings will get top priority. Economist 15 Jul"The Battle With
AIDS"(Edit.17-8);"A Turning-Point For AIDS?"(77-9):-remarkable essay (backed by Editorial), that
conveys a mass of information about the pandemic, analyses why it spreads so fast, and
suggests how to stop it. Fatal social attitudes simplify its blitzkrieg(particularly in Africa):
silence, stigma, discrimination and denial. These block transfer of vital pre- and post-exposure
information; isolate, hide or punish the infected; stifle the reality that AIDS“is a disease of
ordinary people leading ordinary lives”. Yet AIDS’ tastes are fastidious: it kills those -both men
and women- in the prime of their lives, producing”social dislocation on a grand scale”. Using
Senegal and Uganda as rare cases where AIDS has been prevented/controlled, the essay deals
with three components involved in stopping a mainly sexually-transmitted disease: (1)its
”transmissability”; (2)the average rate at which an infected person acquires new, uninfected
partners; (3)the average length of time someone is infectious. Counter-actions: (1)AIDS is not
easily transmissable. Hence a substantial defense can be offered by(a combination of):
condoms(plus increased female”bargaining power”); microbicides to kill the virus in the vagina;
treatment of other sexually-transmitted diseases(lesions make people more vulnerable). To
reduce transfers from mothers to(unborn)children: give infected pregnant women antiviral drugs
just before giving birth, and avoid breast-feeding(but see above). (2)Rate of infection can also
be reduced by less mating between high-risk(prostitutes/addicts) and low-risk groups. Female
bargaining power(to refuse, or at least demand condoms) is also useful here, but the best
defense is(self)control through effective public information. (3)The real solution to the length of
time the disease remains infectious is a vaccine, which is not yet available. While current drugs
help, they are costly, and viruses become resistant. Fairly effective and cheap vaccines are much
better than none. Reuters"Intron Research May Lead to New HIV Therapies"onhealth.com 27
Jul:-US researchers claim introns, small pieces of genetic material that can be inserted into
targeted areas of DNA,”may hold the key to new therapies to fight HIV”. They might be”used to
shut off the function of a gene or to introduce new functional genes”at specific DNA sites. Thus
introns might be used as gene therapy to halt HIV replication, but an efficient mechanism needs
to be developed for introducing introns into cells. New Vision(Kampala)"Canadian Firm in Novel
AIDS Kit Marketing Bid"onhealth.com 27 Jul:-Canadian pharmaceutical company, Medmira Inc.,
has begun distributing in Uganda “a rapid HIV testing kit that gives results in two minutes...[T]he
test is quick, portable, can be done by a lay person, and does not require refrigeration”.
Distributed only through hospitals, clinics and pharmacies, the company would
hold”sensitization workshops on the use and significance of the...kits”. The company
representative said they have now stocked”enough to supply the entire nation and the Great
Lakes region” and that stocks could be replenished within seven days. Kits are also in use in
China, Russia and Europe. Woznicki"Stress Speeds Up AIDS Progression" onhealth.com, 01
Aug:-”A patient’s ability to cope with adversity and everyday stresses in his or her life can affect
the progression of AIDS”. A researcher at the University of North Carolina claims:”if we can
develop treatments to help people deal with stress and cope with stressful life events and HIV,
perhaps we might see these as having some efficacy for the course of this disease”. [Tragically,
if true this constitutes a sentence of earlier death for those with HIV in most poor countries. Life
is stressful enough to survive in the first place. The usually unanswerable question of being
infected or not, adds more stress. Once confirmed, the stress multiplies: probably social
ostracism, plus lack of anti-HIV treatment, concluded by an inadequately mitigated death - all
with no hope for any sort of anti-stress medication except alcohol.] XINHUA"China-Made Anti-AIDS Drug Experimented in Thailand"onhealth.com, 07 Aug:-reports that clinical trials in
Thailand on 28 people with AIDS“have proven that a China-made compound pharmaceutical
drug is effective in the treatment of AIDS”. After three months’ tests, the virus in nine patients
were reduced considerably. The infection remained stable(controlled?)in 16 others. The drug
was derived from 13 years of tests on 1000 kinds of medicinal herbs; 150 were found active
against the AIDS virus, and a compound drug was created using five of them as the principal
ingredients. It has also“proven safe, non-toxic and cheap”.Reuters "Experimental Cancer Drug
May Battle HIV"onhealth.com, 11 Aug:-researchers have discovered that a drug being studied
for cancer treatment may“hold promise”as an HIV therapy. Flavopiridol apparently blocks HIV
cells from making copies of themselves. It also works at concentrations much lower than those
being tested in cancer trials, and so gives indications of having less side effects. One of the
major obstacles in treating HIV is the ability of the virus to mutate into drug-resistant strains; but
in this case the replication process is related to body, not viral, cells so patients would
theoretically not develop resistance to flavopiridol. Economist 16 Sep"Science and Technology:
AIDS Wars"(87-8):-excellent and up-to-date report on the various theories now under study
regarding origin of HIV/AIDS. Main and most interesting element is the story of the influence, and
then almost total debunking, of the theory that AIDS was the accidental result of a polio
vaccination campaign conducted in central Africa in the 1950s. Most theories, however, now
start from the assumption that HIV-1 was a chimpanzee virus that has leapt the“species
barrier”to man. Its apparently 20th century appearance more or less simultaneously in different
forms in different locations in Africa is another interesting mystery. Two theories are mentioned:
(1) African population growth increased opportunities for both human promiscuity and contact
with chimpanzees; (2) wide multi-use of syringes increases virulence. Gina Kolata“Vaccine
Controls AIDS Virus in Early Tests on Monkeys”20 Oct:-monkeys were injected with DNA of two
AIDS virus genes that would enable to control the disease by not allowing the animals to become
ill. Philip J. Hilts “Company Tried to Bar Report That H.I.V. Vaccine Failed”01 Nov:-a
pharmaceutical company is pushing to stop the publication of its failed AIDS drug Remune and
is asking $7m dollars in damages. Reuters“Work on AIDS Drugs Shows Long Road Ahead”01
Dec:-report on the US funding labs in order to find a cure for AIDS, since 21 million people
across the world are infected with the disease and some AIDS medicine have lost their potency.
AP“Modified Protein May Fight AIDS”12 Jan 2001:-a genetically modified protein, 5-Helix is able
to protect cells from being infected from the AIDS virus. Andrew Pollack“When Gene
Sequencing Becomes a Fact of Life”17 Jan:-gene sequencing machine will allow to map the
genes of the AIDS virus in order for doctors to prescribe the proper AIDS medications, is being
distributed for public use. Reuters“Back Off a Bit on HIV Drugs, Experts Decide”18 Jan:-medical
AIDS experts are relaxing their usual methods of prescribing strong AIDS drugs with better
treatment tactics. Reuters“Italy AIDS Vaccine at Human Testing Stage”19 Jan:-a new type of
AIDS vaccine, TAT protein, will be allowed to be used for human testing in order to stop the
spreading of the disease in the body before it has time to grow within the human cells.
Reuters“Goal for HIV Vaccines Said to Be Set Too High”24 Jan:-HIV researcher Dr. Jay A. Levy
argues that a vaccine to prevent the AIDS virus to spread all over the human body is more
foreseeable than a vaccine to get rid of the disease all together. Lawrence K. Altman“The AIDS
Questions That Linger”30 Jan:-a 5-part article on the questions AIDS scientists will propose at
the Chicago conference on the pandemic. Article also gives a historical analysis of AIDS and its
impact throughout the globe. Altman“U.S. Panel Seeks Changes in Treatment of AIDS Virus”04
Feb:-health experts are recommending for longer treatment methods to AIDS victims due to the
overuse of retroviral drugs. Reuters“Scientists Grope for Small Gains at AIDS Meetings”04 Feb:-the forthcoming 8th Annual Retrovirus Conference being held in Chicago will gather the AIDS
experts across the world to discuss the development of HIV drug cocktails and the proper
dosage of the drugs. AP“C.D.C. Hopes to Cut New AIDS Cases”07 Feb:-Centers for Disease
Control and Prevention has planned to cut the number of new HIV infections in half by 2005,
through identifying unaware HIV victims within the US. Altman“Study Reports Drug- Resistant
Strains Have Increased to 14 Percent Among New H.I.V. Cases”08 Feb:-within Canada and the
US. Altman “Newly Discovered Molecule Is a Clue to the Spread of AIDS”09 Feb:-AIDS
researchers have identified dendritic cells who transmit the HIV virus to the rest of the body are
responsible for the disease to spread much faster. Altman“To Combat the Wily H.I.V., Newer and
Safer Drugs Are Necessary”13 Feb:-3-part article on the medical advances of AIDS drugs but
many health experts warn of the overuse of the medicine while other experts warn of the
increasing rate of the pandemic in developing nations. Reuters“HIV Vaccine Shown Effective in
Monkeys”23 Feb:-a drug developed by GlaxoSmithKline through the combination of HIV
molecules and a vaccine to improve the immune system. Reuters “Britain And Italy Propose
Global Medicines Fund”26 Feb:-a global fund to allow for the delivery of HIV, malaria and
tuberculosis drugs to developing nations have been approved by Britain and Italy, bringing relief
to the UN and other AIDS supporters such as Nelson Mandela. Reuters“Molecule Produced by
Pregnant Women Blocks HIV”02 Mar:-a molecule located in the placenta within the umbilical
cord prevents the growth of HIV within pregnant women. AP“Study Backs AIDS Drug Combo”06
Mar:-a drug without “protease inhibitor”(current use of medicine to contain HIV from spreading)
is shown as being equally effective. AP“AIDS Vaccine Goes on Trial in Africa”06 Mar:-report on
the first vaccine trial in Kenya. AP“AIDS Vaccine Experiments Are Said to Be Promising”09 Mar:-a vaccine that has allowed for HIV-infected monkeys to stay healthy is showing optimism
throughout the medical core, the drug uses proteins of the AIDS virus and smallpox vaccine.
Reuters“AIDS Drugs Extend Survival Time Fourfold”14 Mar:-a study by the Center for Disease
Control and Prevention has showed “that drug treatment has quadrupled to four years”. Abigail
Zuger“A Molecular Offspring, Off to Join the AIDS Wars”20 Mar:-new AIDS drug “stavudine” to
be distributed to the Third World. Ian Fisher“In a Kenyan Preacher’s Prayer, an Instant AIDS
‘Cure’”01 Apr:-people in the region who cannot afford to buy AIDS drugs, are looking for other
ways to be healed. Barnaby J. Feder“South Africa Expected to Approve Use of Blood
Substitute”10 Apr:-due to AIDS spreading in the country, S. African doctors are allowed to use
purified cow’s blood to replace human blood supplies. Denise Grady“Generic Medicine for AIDS
Raises New Set of Concerns”24 Apr:-AIDS drugs may be available to 25m people in sub-Saharan
African victims. Health experts are worried re proper dosage of the drugs. AP “AIDS Drugs,
Transmissions Studied”24 Apr:-combination of two AIDS drugs lowers the chances for pregnant
mothers to transmit HIV to their offspring. Stolberg“In AIDS War, New Weapons and New
Victims”03 Jun:-report on AIDS victims in the US and coping with the effects of retroviral drugs.
Kolata“On Research Frontier, Basic Questions”05 Jun:-new treatment of newly infected HIV
victims which allows for their immune system to control the virus to spread without the need of
AIDS medicine. Grady“Quest for AIDS Vaccine Rises From Ashes of Dashed Hopes”05 Jun:-report on the lack of vaccine of diseases such as AIDS, Malaria and Tuberculosis. AP“Uganda
Gets AIDS Training Center”11 Jun. Reuters “Tracking H.I.V.’s Lightning Attack on Cells”19 Jun:-researchers looking at how AIDS virus kills immune cells. Sharon Lerner“Product to Protect
Women From H.I.V. Is Elusive”03 Jul:- AIDS prevention products “vaginal microbicide” in
developing nations are in decline. Altman“Recollections on the Age of AIDS”03 Jul:-author
remembering the spread of AIDS and the world’s approach to the disease from the 1970's to the
1980's. AP“Study Backs AIDS Drug Cocktails”10 Jul:-current retroviral drugs are able to control
the virus from spreading without the need of higher dosages. AP“SAfrican Bishops Consider
Condom Use”11 Jul. AP“HIV Program in Thailand Cuts Risk”19 Jul:-the infection rate of mother-to-child transmissions has declined due to programs designed to treat and test women for AIDS.
NYT “Study Finds Condoms Usually Block H.I.V.”20 Jul. Reuters“Experts Caution Against an
AIDS Therapy”20 Jul:-AIDS drugs must be given to patients at all times even if there are
debilitating symptoms. Washington Post“AIDS Vaccine Hopes Rise From Africa”11 May:-discovery of a stronger immune system in Kokutona, Kenya among its inhabitants may allow for
a vaccine to be distributed. Linda Villarosa“A Charge to Take AIDS Messages From a National
to a Global Scale”28 Aug:-interview of senior advisor of the Bill and Melinda Gates Foundations
, a program designed to contribute donations towards the AIDS crisis. AP“Predictions on HIV
Infections Made”31 Aug:-42% increase in HIV infections by 2005 due to ineffective AIDS drugs.
Elizabeth Rosenthal“China Asks U.S. Agency to Help Combat H.I.V. Epidemic” 31 Aug:-CDC
cooperating with Beijing to control spread of AIDS since threat of “20 million Chinese carrying
the virus by 2010". AP“Virus May Help Fight HIV”05 Sept:-apparently harmless/common GBV-C
virus is found to block HIV’s ability to enter and fatally infect blood cells. AP“AIDS Vaccines May
Protect Infected”07 Sep:-drugs designed to protect the healthy from catching AIDS, may be
prescribed for the already-infected to boost their immune systems. AP“Gene-Based AIDS Test
Hits Market”27 Sept:-Trugene, a testing device by Visible Genetics Inc, is approved by US to
identify when a virus starts to mutate against a drug therapy being used, so it can be switched.
AP“AIDS Vaccine Said Ready in 10 Years”07 Oct:-US researchers believe vaccine prototypes
now being developed could be effective against some strains of disease in 5-10 years. AP“Study:
Drug Cocktail Cut Death Rate”21 Sept:-combination of protease inhibitors and AIDS drugs as
effective in children in lowering death rates. Reuters“Formula Supported for Mothers With
H.I.V.”21 Nov:-Kenyan study finds formula-feeding vs breast-feeding reduces HIV transmission
44%, but makes no significant difference to child mortality or general illness rate. AP “Study:
Faster HIV Blood Tests Help”22 Nov:-when seeking optimum drug cocktail, viral-level blood tests
taken just 6 days after patients start any new HIV drug is found best. AP“Some With AIDS Visit
Voodoo Doctor”01 Dec:-Haiti has among highest infection rates in Caribbean(5.2%),but has only
$8m/year for care. As full AIDS treatment costs up to $4000, 400 a month consult voodoo doctor
for $6.30. AP“Study: Cycling Drugs May Curb AIDS”03 Dec:-US researchers found that drug
therapy consisting of taking stronger dosages one week and stopping the week after will cut
down on side-effects and costs. Jeff Stryker“H.I.V. Patients Get Fresh Hopes for Donor
Organs”11 Dec:-due to better drug cocktails and therapy in the US, HIV victims are able to
receive donor organs. AP“AIDS Fund Officials to Meet Soon”17 Dec:-Global Fund to organize
and allocate $1.6 billion to AIDS-stricken nations. AP“Half of American HIV is Drug - Resistant”18
Dec:-a study shows HIV mutation impedes AIDS drugs to be ineffective. AP“Monkey Dies in AIDS
Vaccine Test”16 Jan 2002:-study by Merck & Co.’s researchers in the US found that the disease
creates stronger types of immune cells for countering the vaccine. AP“HIV - Like Virus Found
in Wild Chimp”17 Jan:-Dr. Hahn trying to find the origin of the virus, found a chimp in Tanzania
found to have a different strain of AIDS proves the theory that the disease originated from
monkeys. Gina Kolata“Chimp Study Clouds Origins of AIDS”29 Jan:-similar report of Dr. Hahn
research on the different genetic HIV virus in monkeys which is not as deadly as it is to humans
who contract the virus. AP“AIDS Expert Cites New Opportunities”09 Feb:-HIV treatment reduces
HIV to spread from mother to baby according to the director of US National Institute of Allergy
and Infectious Diseases. Grady “Cocaine and Intensity of H.I.V. are Related in a Study of Mice”15
Feb:-US study shows cocaine allows HIV to spread faster. AP“AIDS Care Improving, Government
Says”26 Feb:-CDC announced an increase in the number of americans with AIDS is due to the
successful disease treatment/therapy which allows for them to live longer. AP“AIDS Vaccine
Shows Promise in Tests”26 Feb:-drug developed by Merck & Co.’s which protects human’s
immune system shows promising results in monkeys. AP“Genetic Test Shows Risk of AIDS
Drug”27 Feb:-the drug “abacavir” shows which AIDS drugs could prove fatal to patients after
long exposure. Economist“HIV microbicides: Free to choose”28 Feb:-pharmaceutical companies
are not investing in the production of microbicides which allows for the protection of women
from AIDS. AP“Study: AIDS Drugs May Raise Heart Risk”28 Feb:-at the ninth annual Retroviral
Conference, researchers have found that AIDS Drugs could create permanent damage to the
human body. AP“AIDS Vaccine May Be 10 Years Away”15 Mar:-according to US AIDS experts.
McNeil“New List of Safe AIDS Drugs, Despite Industry Lobby”21 Mar:-WHO released a list of
manufacturers of safe AIDS drugs, including some generic counterparts. AP“Co. Withdraws
AIDS Drug Application”22 Mar:-the drug “nevirapine” which prevents HIV transmission from
mother to child will not be allowed to be used in the US due to the FDA’s finding of the drug
standards. Pollack“AIDS Drug Fares Well in Big Trial”19 Apr:-a drug “T20" which prevents the
HIV virus to infect the cells of the immune system could be available by 2003. AP“HIV May Target
Attacking Cells”01 May:-the National Institute of Health(NIH) found that cells that guard against
the disease virus“CD4 T”have five times more HIV than other human cells. AP “Researchers
Develop HIV Fighter”02 Jun:-an MIT developed chemical agent RNA(ribonucleic acid)stops the
genes which produce proteins used by the HIV virus to infect human cells. Stolberg“AIDS Drugs
During Pregnancy Don’t Harm Fetus, Study Finds”13 Jun:-study conducted by the NIH. AP“New
HIV Treatment Guidelines”06 Jul:-HIV victims must wait longer to receive treatment to increase
the effectiveness of the AIDS drugs and lower their side effects says the International AIDS
Society. Altman“Drug Reduces H.I.V. Rates in Newborns, Thai Study Shows”07 Jul:-findings
were shown at the 14th annual International AIDS conference in Barcelona. AP“Discarded AIDS
Drugs Help Africans”08 Jul:-Starfish Project, a charity group collects unused AIDS drugs and
gives them to HIV victims in Nigeria. Reuters“Asia Criticized for Silence in Face of AIDS”08 Jul:-10m people are expected to get AIDS in China in 2010, which Beijing is in a state of denial, AIDS
activists are pushing for AIDS to be reduced in price are some of the highlights from the AIDS
conference in Spain. Altman“Drug Offers Hope With Resistant H.I.V., Scientists Say”09 Jul:-report on the “T20" drug which showed positive results in two “large late-stage” trials which
increases immunity cells to counter the HIV virus. Reuters “Protesters Blast U.S. over AIDS
Funding”09 Jul:-angry AIDS activists at the Barcelona Conference heckled US Health
representative for not contributing more to the AIDS cause. AP“Thailand to Host HIV Vaccine
Trial”09 Jul:-5 year experiment conducted by the US. Economist“AIDS: Hope for the best.
Prepare for the worst”11 Jul:- “Surprisingly, the mood in Barcelona, where the 14th of these
conferences has just been held, was cautiously optimistic.” Howard W. French“Whistling Past
the Global Graveyard”14 Jul:-Indifference to AIDS spreading in the developing nations due to
lack of coverage of AIDS conference in Spain in wealthier countries. Altman“Cheaper Drug
Prevents H.I.V. in Newborns, Study Shows”14 Jul:- S. African study shows that the cheap drug
“nevirapine” prevents the infection. Altman“The Urgent Search for an AIDS Plan”16 Jul:-report
on the rapid spread of AIDS in which 45 million people to be infected with AIDS by 2010. Swarns
“South African Village, Fearing AIDS, Trusts God More Than Drugs”10 Aug. David Tuller“New
Tactic to Prevent AIDS Spread”13 Aug:-CDC to spend$3.8m on providing AIDS education for HIV
victims. AP“Gates Foundation Gives $46M for HIV”28 Aug. AP“Study: Chimps May Have
Survived AIDS”29 Aug:-a theory by Dutch researchers explains how chimps are resistant to the
AIDS virus due to their highly-evolved immune system. AP“S. Africa to Manufacture AIDS
Drugs”26 Sep:-three new vaccines will be manufactured and tested by humans in Cape Town.
AP“Agency Links HIV, Syphilis Outbreak”26 Sep:-CDC study shows an increase in syphilis
among gay/bisexual men in New York indicating a rise of unprotected sex in the area.
Pollack“Scientists Say They’ve Found Protein That Might Help Fight AIDS”27 Sep:-AIDS
Research Center in New York found a protein in the human immune cells(CD8 T)which produces
an antiviral factor which limits the spread of HIV in the body. McNeil“Global War on AIDS Runs
Short of Key Weapon”09 Oct:-decline of condom donations by rich nations to poor nations.
AP“FDA to Review New AIDS Drug Fuzeon”11 Oct:-drug companies Roche and Trimeris await
approval of their expensive drug aimed at HIV victims with drug-resistant strands of HIV and to
be used in combination with other AIDS drugs. Alan Cowell“Extracurricular Task: Testing
Condoms”25 Oct:-German company Condomi allows condom testing to be done by young
British people. AP“Vatican Prefers Chastity to Condoms”06 Nov. Stolberg“Drug Agency
Approves a Quick Test for H.I.V.”08 Nov:-20 minute blood test to detect HIV might encourage
more people to get tested, claims the FDA. Bill Gates“Slowing the Spread of AIDS in India”09
Nov:-report on the increase of AIDS in India “25 million(with HIV)by 2010". Amy Waldman“Gates
Foundation to Give $100 Million to Fight AIDS in India”11 Nov. Waldman“As AIDS Spreads, India
Struggles for a Workable Strategy”11 Nov:-Indian city, Tamil Nadu, having the world’s second
highest number of HIV cases caused by a weak health system and prevention efforts. AP“Gates
Ups India Investment to $400M”12 Nov. AP“Therapeutic AIDS Vaccine Said Promising”22 Dec:-US experimental vaccine reduced the spread of HIV by 50% in monkeys. David Gonzalez“A
Haitian Doctor’s Success in the Fight Against Disease”22 Dec:-UN to grant Dr. Jean W. Pape
$25m due to his preventive measures which have lowered the AIDS epidemic in the country.
Nicholas D. Kristof“The Secret War on Condoms”10 Jan 2003:-critique of the Bush
administration’s view of condoms while AIDS activists and UN health experts argue that it saves
lives. Elizabeth Becker“U.S. Official to Discuss Trade as Africa Hopes to Talk AIDS”11 Jan:-US
ambassador Robert Zoellick to be confronted by AIDS activists due to the US opposition for poor
nations importing generic AIDS drugs. NYT“The War Against Women”12 Jan:-Bush
administration undermining women’s right of abortion by elevating the right of the fetus. Jane
E. Brody“Fact of Life: Condoms Can Keep Disease at Bay”21 Jan:-US study shows that young
adults are not using condoms consistently. AP“Chinese Co. Distributes Anti - AIDS Drug”28
Jan:-unprecedented distribution of cheap generic drugs(dd1 and d4t)by a Chinese company to
Shanghai. Stolberg“Bush to Seek $16 Billion for Epidemic of AIDS in U.S.”01 Feb:-US president
to ask Congress for the sum. AP“Vaccine Said Unlikely to Protect From AIDS” 12 Feb:-AIDS
researchers in Boston announce that vaccines to aid the human immune system still needs to
be studied. Reuters“Human Trial of AIDS Vaccine Starts in Uganda”12 Feb:-prototype HIV
vaccine to be given to volunteers who suffer from the disease. Altman“Officials Push Use of a
20-Minute H.I.V. Test”12 Feb:-at the 10th Conference on Retroviruses in Boston, CDC wants the
20 min. test to be part pf routine health care for americans who are at risk. AP “Virus May Block
HIV’s Destructive Power”13 Feb:-AIDS experts in Boston have discovered an ancient virus(GB
virus C)which has proven to minimize HIV infection within humans. AP“Outlook for People With
HIV Is Improving”14 Feb:-study conducted by a British medical school shows that the “risk of
AIDS or death has fallen by 80 percent”. Altman“AIDS Expert Helps Doctors Learn From
Autopsies”18 Feb:-British pathologist presents autopsy results during the Boston Conference,
showing the grizzly infections of HIV on the human immune system. Economist“AIDS in Haiti:
H For Hope”19 Jun 2004:-in encouraging contrast to nation’s terrible political and economic
situations, it has pretty good record in tackling HIV/AIDS -reversal of disaster which hit Haiti both
hard and early. Economist“Women and HIV: The New Face of AIDS” 27 Nov 2004:-describes
report on new global estimate of HIV spread, and on women’s special problems with HIV/AIDS,
particularly in Africa.“[R]eport on global AIDS epidemic ...by UNAIDS...estimated 4.9m new
infections in 2004, and 3.1m people died of AIDS. About 40m people now infected, a small
majority...male. But women catching up fast. In sub-Saharan Africa, 57% of those infected are
female. Economist 27 Nov“Health Care in Poor Countries: Doctors’ Dilemma”:-although health
workers very scarce in Africa, insufficient numbers being educated and many of these work in
better paying countries. Economist 27 Nov“AIDS in Jamaica: The Fear That Spreads Death”:-reports serious homophobian /religious social problems that complicate an HIV/AIDS epidemic.
“Caribbean has world’s highest HIV prevalence after sub-Saharan Africa, with 2.3% of adults
infected”. Economist 04 Dec“AIDS in Angola: Good News, Maybe”(46):-could postwar state
become second African to roll back AIDS? Fact that AIDS has not yet taken hold means[may be
time to educate young how to protect themselves and strengthen anti-AIDS fight].”There may
be hope. Economist 02 Jul 2005"G8: Helping Africa Help Itself"(Edit.11):-Lots more money for
Africa will not make poverty history. But it might just do some good";"Aid to Africa: The $25
Billion Question"(Special Report 24-6):-"Years of mistakes have taught donors a bit about how
to spend aid money better"; "Lexington: Evangelicals and Aid: Right On" (34):-"Bob Geldof and
Bono have some unlikely friends in America... During discussion of a plan to spend $15 billion
fighting AIDS, [US President Bush] turned to his silver-penned speech writer... 'Mr President',
came the reply, 'if this is possible , and we don't do it, we will never be forgiven'"; "AIDS In
South-East Asia: There's Good News and Bad News"(38-9):-"Good prevention work has tamed
the AIDS epidemic in some countries, yet it is getting much worse in others"; "The Grand
Challenges in Global Health: 43 Ways To Save the World"(69-70):-"The Gates Foundation's latest
largesse has just been announced. It will pay for some intriguing and original research. But will
it translate into healthier people? [References to several AIDS research projects]; "AIDS: Moving
Targets" (70):-"Progress, and problems, in treating AIDS around the world". AP"Clinton Urges
Help for Kids With AIDS"NYT 18 Feb 06:-"Former [US] President urged governments and public
foundations to buy anti-AIDS drugs from low-cost manufacturers so more children can receive
treatment for the disease. Clinton... said last month that Cipla and 3 other Indian
pharmaceuticals would offer antiretroviral drugs at prices up to 30% cheaper than current market
rate... Since his Clinton Foundation's 2002 HIV/AIDS initiative began, foundation has
concentrated on making affordable drugs available, buying second line AIDS drugs from generic
drug makers for 21 countries in Asia, Africa and the Caribbean, he said. His foundation planned
to get anti-AIDS drugs to 60,000 children in worst-affected countries this year... 'We've had a 3-year partnership with Cipla, and because of them an enormous number of HIV/AIDS-infected
people are alive', he said. India has 5.13m cases of the illness, second largest number of people
infected with HIV after South Africa. Indian government claims its anti-AIDS campaign has
stabilized the epidemic and says there has been a sharp decline in the number of new HIV
cases"; Reuters"Clinton Group, India to Train Nurses in AIDS Care"NYT 19 Feb 06:-"Former US
President and Indian government announced a joint plan to train nurses in AIDS care in a
country which has world's second-largest number of HIV/AIDS cases... Partnership between
National AIDS Control Organization of India (NACO) and Clinton Foundation, aims to develop
training material and program for nurses... 'Nurses not only deliver clinical care, needed to keep
people alive, but they also act as counselors and play an important role in reducing the myths,
stigma, and discrimination surrounding this disease', [Clinton said]"; Reuters"Clinton, Australia
Launch Tri - Nation AIDS Campaign"NYT 22 Feb 06:-"Former US President Bill Clinton and
Australia announced plans to combat AIDS in China, Vietnam and Papua New Guinea, warning
that 40% of all new infections could be in Asia-Pacific region by 2010... [Combined] money...
would be used to make anti-retroviral drugs... more readily available and to improve testing and
monitoring systems in the three countries... Clinton...said about 500,000 children died of AIDS
around the world in 2005... Vietnam, China and Indonesia face fastest-growing HIV epidemic in
the world. Papua New Guinea... faces an epidemic of similar proportions... With an annual
infection rate increasing by 33% a year, country is on verge of an African-style disaster that
could kill millions and destroy the economy"; Sharon LaFraniere"Slowly, Africa Starts to Care
for AIDS Children"NYT 08 Mar 06:-"Staff members of the new pediatric AIDS clinic [in Maseru,
Lesotho] are used to seeing sick children. But rarely had they seen one so ill... In Lesotho, as
throughout much of sub-Saharan Africa, children with AIDS were generally considered a lost
cost. Treatment, to the extent it existed, was limited to adults, for whom antiretroviral therapy
is cheaper and easier. Now, that is slowly changing. Through some charitable foundations,
pediatric AIDS medication is available for as little as $200 a year, half of what it used to cost and
only $60 more a year than adult medication. Governments, international agencies and private
charities have begun to train region's ragtag care corps to treat children... Still, only a few
children get help... Death comes swiftly for those who go without... 'We just haven't stepped up
to the plate to make sure they get it'. There are several reasons. Fewer children are infected -
an estimated 2.1m in sub-Saharan Africa, compared with 25m adults. Specialized and costly
tests are needed to determine whether a child under 18 months is infected, although treatment
can begin based on symptoms alone". [Total article 4 pages long]; Reuters "Relief Group Seeks
Access to New HIV Drug in Africa"NYT 15 Mar 06:-"A humanitarian group urged US drugmaker
Abbot Laboratories Inc. on [15 Mar] to make a new HIV drug accessible in developing countries,
especially Africa. Relief organization Medecins Sans Frontieres said a new formulation of
Abbot's lopinavir/ritonavir drug had critical advantages for patients in poor countries, including
lower daily pill count, storage without refrigeration and no dietary restrictions... Sub-Saharan
Africa has about 10% of world's population but 60% of people living with HIV/AIDS... More than
3m Africans became infected with HIV in 2005, representing 64% of all new infections globally
and more than in any previous year for the impoverished continent, according to UNAIDS. MSF
provides anti-retroviral drugs for over 60,000 patients in nine countries in Africa, Asia and Latin
America. It said it urgently needed the new drug because refrigeration is unavailable to many
people in poor countries. The new formulation, marketed under the name Kaletra, is in tablet
form and does not melt at high temperatures unlike the old version which is in capsules. MSF
said the new version of Kaletra, which was approved by US Food and Drugs Administration [Oct
05], was not available in any developing country. It urged Abbot to register the new version in
developing countries, sell it at less than $500 per patient per year and remove patent barriers to
allow production of generic versions... Abbott said it was pursuing registration for the new
formulation in developing countries as rapidly as possible. It also said it was making its HIV
medicines available in 69 of the world's poorest countries... Kaledra is a 'second line' drug which
can be used when standard anti-retroviral drugs stop working... One MSF program found that
after four years of ARV treatment, 16% of patients needed second-line drugs"; AP"Ugandans
Report Mixed Messages on AIDS Plan"NYT 18 Mar 06:-"Question of why Ugandans didn't use
a condom is at the heart of a dispute between some health activists and US government.
Activists, as well as some Ugandan officials, accuse US of blunting the condom message in
favor of abstinence, while the Americans say they are victims of misinformation and have
actually increased nearly tenfold the number of condoms they supply to this African nation of
26 million... Billboards urging condom use have disappeared from the capital, Kampala. In their
place are posters, some funded by US government, urging youth to delay sex until marriage...
HIV prevalence crept up to 7.1% in 2004-2005, after stagnating at around 6% the preceding three
years, according to government figures"; AP"Gilead AIDS Drugs Show Prevention Promise"NYT
27 Mar 06:-substantial article discusses current global hopes in seeking action both against and
avoiding HIV/AIDS. Begins: "Twenty-five years after the first AIDS cases jolted the world,
scientists think they soon may have a pill that people could take to keep from getting the virus
that causes the global killer. Two drugs already used to treat HIV infection have shown such
promise at preventing it in monkeys that officials last week said they would expand early tests
in healthy high-risk men and women around the world...'If it works, it could be distributed quickly
and could blunt the epidemic'. Condoms/ counseling alone have not been enough - HIV spreads
to 10 people every minute, 5 million every year. A vaccine remains the best hope but none is in
sight. If larger tests show the drugs work, they could be given to people at highest risk of HIV -
from gay men in US cities to women in Africa who catch the virus from their partners... The
drugs are tenofovir (Viread) and emtricitabine, or FTC (Emtrive), sold in combination as Truvada
by Gilead Sciences Inc."; Reuters"Clinton Supports Wider AIDS Testing" NYT 28 Mar 06:-"Former US President Clinton voiced support for mandatory testing for HIV/AIDS in countries
with high infection rates and means to provide lifesaving drugs... Clinton said countries where
there was no discrimination against people with the illness and where anti-AIDS drugs were
available should now consider universal testing... More than 40m people worldwide are
estimated to be living with HIV/AIDS but many do not know they are infected. 'Now we can save
people's lives and we can reduce the stigma. There is no way we are going to reduce the spread
of this epidemic without more testing because 90% of the people who are HIV positive don't
know it', he added... A budget of $100m could pay for 200m tests... Clinton Foundation HIV/AIDS
Initiative(CHAI)... is working with 22 countries in Africa, Caribbean and Asia to provide anti-AIDS
drugs to more than a quarter of a million patients through special drug deals"; Economist 01 Apr
06"Australia and AIDS: Help Thy Neighbour"(35):-"Partnership between Australian government
and Clinton Foundation[op.cit.]... will work in China, Vietnam and Papua New Guinea (PNG),
mainly to supply tests and anti-retroviral drugs... HIV has grown alarmingly in PNG to reach
50,000 estimated cases, about 2% of adult population.... Possibly rising to 500,000 cases by 2025.
Unprotected sex has driven most of the spread in PNG. In China (500,000 estimated cases) and
Vietnam (260,000 cases), contaminated blood transfusions, prostitution and intravenous drug
use are the main avenues... AIDS left unchecked could prove another potential source of regional
instability along with terrorism... Having 8.3m people infected with HIV in Asia and the Pacific
threatens the economic life of Asia, especially that of China... The outlook is grim: the number
of sufferers is forecast to more than double to 20m by 2010 unless rich countries... start
exporting their own successful experience in curbing AIDS"; Economist 01 Apr 06"Treating
AIDS: A Missed Target"(64-5):-"World Health Organization (WHO)'s attempt to roll out AIDS
drugs in poor countries has missed its target. A shame, but not a disaster[op.cit. AP 28 Mar]. The
'3 by 5' initiative to get 3m HIV-positive people in poor/middle-income countries on to anti-retroviral drugs by end of 2005 has got less than halfway there. [WHO/UNAIDS reported] a mere
1.3m of those infected in target countries are on courses of drugs. [Yet shift from pure
prevention to care offered incentives for] those who might...be infected[: new] reason to find out
the truth [and encourage modified behaviour to reduce transmission. Also, even 3+ times the
previous number under treatment] averted about 250,000 premature deaths in 2005. One problem
[was] that in most countries the [essential] infrastructure... did not exist. [Hence] the initiative
may have been more successful than [new] figure suggests, since part money has gone on
infrastructure [and] this sort of work has spin-offs beyond the treatment of AIDS. Expense of
treatment also tackled[:] big change...in market for AIDS drugs. Clinton Foundation HIV/AIDS
Initiative has helped to defragment market for generic anti-retroviral drugs by signing contracts...
in India and South Africa that guarantee large order-volumes and reliable payment. As result,
price in some cases... below $150 per person per year.. Progress, then, being made. [Possible]
3m figure by end of 06"; Richard Cockett "Chasing the Rainbow: A Survey of South
Africa"Economist 08 Apr 06(5-6):-Summary of major section on government's HIV/AIDS policy
only: "[G]reatest weakness of [ruling African National Congress] ANC's top-down system is that
party is inclined to dismiss ideas from outside its own bureaucracy. Most obvious example has
been [President Thabo] Mbeki's well-documented response to the HIV/AIDS crisis. For a long
time [op.cit.] Mbeki stood out against the combined weight of world medical opinion on the
causes/treatment of AIDS, and particularly on use of anti-retroviral drugs. Main group
campaigning for their use, Treatment Action Campaign, was made up almost entirely of ANC
members, and Mbeki seems to have resisted their arguments as much because he felt they were
breaking party ranks as for their prescriptions on AIDS (with which he disagreed). In 2003,
government eventually caved in to domestic/ international pressure and gracelessly introduced
a comprehensive management regime involving anti-retroviral drugs to combat HIV/AIDS. May
have signalled change of policy by government, but not, it seems, much of a change of mind. In
a country with 5.2m HIV-positive people on record, the largest number in the world, there is
almost no public acknowledgement of the problem or public education about it. [M]inisters (with
a few honourable exceptions) still seem loth to talk about the illness, which kills about 900
people a day and undermines much else the country is trying to achieve. It handicaps the army,
with an infection rate said to be up to 40%, breaks up families and kills much-needed teachers.
Chillingly, Actuarial Society of South Africa estimates that it will be another ten years before the
pandemic peaks. Tardiness with which government responded to HIV/AIDS crisis, together with
Mbeki's own strange take on underlying science, has tarnished own reputation, as well as that
of ANC. Critics argue government remains ambivalent about its commitment to fighting
pandemic with anti-retroviral drugs. Government's plan to combat HIV/AIDS may be model of its
kind in intent, but it is already falling behind. By end of 2006 about 225,000 patients will be
receiving anti-retroviral drugs, well short of the plan's target of 380,000 by 2005-06. Mbeki's
unorthodox views on causes/cures of HIV/AIDS undoubtedly have something to do with his
agenda of finding African solutions (rather than expensive Western ones) to Africa's problems...
But AIDS saga, together with ANC's unresponsiveness to its own supporters and its failure to
deliver on its promises, has diminished aura of moral authority it has earned"; Reuters"Triple
Treatment Cuts Malaria in HIV Patients"NYT 14 Apr 06:-"Combining anti-AIDS drugs, an
antibiotic and bed nets treated with insecticide could cut the rate of malaria infections in people
infected with HIV by up to 95%, researchers said. Malaria and HIV are leading infections in sub-Saharan Africa. In adults/children with HIV, malaria is more common and can be more severe...
Researchers found that antiretroviral drugs, the antibiotic co-trimoxazole and bed nets are each
effective in combating malaria in HIV patients, but when combined their impact is cumulative.
Malaria... kills more than a million a year, mostly young children in Africa. HIV weakens the
patient's immune system, making it more vulnerable to opportunistic infections such as malaria
and AIDS... Co-trimoxazole, a standard treatment worldwide for patients infected with HIV,
reduced the incidence of malaria in patients by 76%. When combined with anti-AIDS drugs it hit
92% and cut cases by up to 95% when bed nets were included. Researchers... believe the impact
of the anti-AIDS drugs was due to its effect in strengthening the immune system rather than any
direct effect of the drugs on the malaria parasite... Most malaria deaths occur in Africa, where
the disease kills a child every 30 seconds, according to WHO. More than 40m woldwide are living
with HIV/AIDS; more than 25m in sub-Saharan Africa. In 2005 about 2.4m in the region died from
HIV/AIDS; AP"AIDS Conference Ends With Appeals"NYT 26 Apr 06:-"International AIDS
conference [in Cape Town, of 1,000 scientists/researchers,] ended [26 Apr] with impassioned
appeals to political/pharmaceutical industry leaders to fund development of a virus-killing
[vaginal] gel to protect women from the disease and so save millions of lives. Peter Piot, head
of UNAIDS,.. said safe/effective microbicides could be ready in 5-7 years, with only minimal
additional funding, and thus turn the dream of saving millions of lives into reality... In the hard
hit African countries, women account for nearly 60% of infections. Most are infected through
heterosexual intercourse... UNAIDS/WHO have long promoted microbicides as a potentially
valuable weapon in fight against the epidemic, not least because it allows women to protect
themselves without having to rely on partners who refuse to wear a condom or be faithful. Yet
despite this, research has proceeded slowly. [Piot] said investment in microbicide development
should be doubled - and even then would still only reach about US$150m per year... Microbicides
can take the form of a gel, cream, sponge or ring that releases an ingredient that can kill or
deactivate HIV during intercourse. There are currently five different products being tested[,
mainly in Africa on thousand of women]. Dozens of agents that could interrupt HIV transmission
have so far been identified. There are also hopes that the microbicides could be used to prevent
other sexually transmitted diseases and unwanted pregnancies. One of the products, cellulose
sulphate, has the potential to be a contraceptive and shield against HIV... Another microbicide,
Carragard, coats vaginal cells and prevents the virus from entering... Much of the funding for
research comes from Gates Foundation and US government... Trying to dismiss fears that
microbicides would mainly be used in developing countries and therefore offer only low profit
margins, [WHO] cited their potential for use in contraception in wealthy countries"; Sharon
LaFraniere"Circumcision Studied in Africa as AIDS Preventive"NYT 28 Apr 06:-"Growing number
of clinicians/policy makers in [southern Africa] are pointing to a simple and possibly potent
weapon against new infections: circumcision for men... New studies suggest that male
circumcision can reduce chance of HIV infection in men, and perhaps in women... Validity of the
approach is still being tested... Evidence so far, while intriguing, is not definitive... Most striking
studies suggest that men can lower their own risk of infection by roughly two-thirds, and that
inflected men can reduce the odds of transmitting the virus to their partners by about 30%,
simply by undergoing circumcision. Research suggests that the cells on the underside of the
foreskin are prime targets for the virus and that tears and abrasions in the foreskin can invite
the infection. But WHO experts say it would be premature to recommend circumcision until
results come in from two controlled trials... Preliminary results could be released by late Jun...
Of the nearly 5m people worldwide who became infected last year, 3.2m live in sub-Saharan
Africa, [UNAIDS] said... An epidemiologist and HIV specialist in Africa for USAID argues that low
rates of circumcision and high rates of multiple, concurrent sexual partners are the main
reasons that the AIDS epidemic has raged in southern Africa but left western Africa mostly
unscathed. According to a study, seven southern African countries, where fewer than one in five
men were circumcised, had HIV prevalence in adults of 14% to 26% in 1998. In nine western
African countries, where more than four in five men were circumcised, HIV prevalence rates were
below 5%... Studies appeared to show that uncircumcised men were more than twice as likely
to be infected than circumcised men. Perhaps the most compelling evidence came from a study,
financed by France, of 3,274 men outside Johannesburg. Half of them underwent circumcision;
the others were uncircumcised. After 17 months, 49 of the uncircumcised men became infected
with HIV, while only 20 of the circumcised men caught the virus... Researchers estimated that
the procedure reduced the risk of contracting HIV by roughly two-thirds [and] that circumcised
men infected with HIV were about 30% less likely to transmit it to their female partners ...
Worries: if circumcision is oversold, circumcised men may think they are free to engage in risky
sex... Other specialists concerned that studies may encourage unsafe circumcisions by
traditional healers"; Economist 29 Apr 06"AIDS: Bitter Fruit"(85):-"Another idea for stopping
AIDS falls flat... This is that, if applied to the vagina, [lime juice] might protect a woman from HIV
infection, and thus from AIDS... Women have been putting acids into their vaginas for millennia,
in the hope of preventing pregnancy and sexually transmitted diseases. Indeed, cleaning with
lime juice is common practice in parts of Africa. [A]re they sensible to do so? Acids immobilise
sperm and kill pathogens, including HIV... And, in addition to its high citric-acid content, lime
juice has a second attractive feature: it literally grows on trees. However, there is also the matter
of the damage that citric acid causes to the vaginal lining. [Studies] have shown that anything
more concentrated than a one-to-one dilution of lemon juice would damage the cells that line
the vagina. Such damage would make it easier, rather than harder, for HIV to get into the
bloodstream... There is a second problem... Seminal fluid is alkaline. The need to overcome this
alkalinity means it takes at least a 50% solution of lime juice to inactivate the virus during real
sexual intercourse. The upshot is that, as a microbicide, lime juice is safe when it is ineffective,
and effective when it is unsafe"; Ian Fisher"Debate Over Condoms and AIDS Tests the Pope"NYT
01 May 06:-"Even at the Vatican, not all sacred beliefs are absolute. Thou shalt not kill, but there
is still 'just' war. Now, behind the quiet Vatican walls, a clash is shaping up between two poles
of near-certainty: the church's long-held ban on condom use and its advocacy of human life. The
issue is AIDS. Church officials recently confirmed that Pope Benedict XVI has requested a report
on whether it might be acceptable for Catholics to use condoms in one narrow circumstance:
to protect life inside a marriage when one partner is infected with the HIV virus or is sick with
AIDS. Whatever the pope ultimately decides, church officials and other experts broadly agree
that it is remarkable that so sensitive an issue is being taken up. But they agree that such an
inquiry is logical, and particularly significant from this pope, who as Cardinal Joseph Ratzinger
was Pope John Paul II's strict enforcer of church doctrine... The issue has surfaced repeatedly
in recent years as one of the most complicated and delicate facing the church. For years, some
influential cardinals and theologians have argued for a change for couples affected by AIDS in
the name of protecting life, while others have fiercely attacked the possibility as demoting the
church's long advocacy of abstinence and marital fidelity to fight the disease. [W]ith regard to
condoms, the only change being considered, according to reports, is in the specific case of a
married couple. But any change, however narrow, would be unpopular with conservative
Catholics... It is too soon to know where the pope is heading... The debate has two levels: one
on moral theology and church doctrine, the other public relations and politics. Many factors are
driving the debate: The church is experiencing its greatest growth in Africa, which has the most
severe AIDS problems. Much health care in Africa is provided by Catholic charities, whose
workers, barred from providing condoms, have often spoken of being torn between church
doctrine and the need to prevent disease. More broadly, critics of the current Vatican policy say
it is hard for the church to remain consistent on 'life' issues, like its opposition to abortion and
euthanasia and the death penalty, when condom use can help prevent the spread of AIDS. But
there is a deep vein of feeling against any change... The moral arguments stretch back nearly two
millennia, to the idea that the church has a responsibility, in difficult moral cases, to advocate
the 'lesser evil'... There are other related arguments: One is of 'self defense', in which an
uninfected partner could demand condom use to protect against infection. Another is that using
a condom against AIDS could be considered medical intervention rather than contraception. But
the 'lesser evil' argument is not universally accepted among Catholic thinkers, and the theology
is complicated. Among many other issues, there is the user's intent: whether it is possible to use
a condom without the intention of contraception... A change would address a relatively small
part of the problem since most transmission of AIDS is not between married couples";
AP"Vatican Re - Examines Ban on Contraception"NYT 03 May 06:-"A Vatican study on whether
it could permit condoms to battle AIDS has a very narrow scope; [b]ut its theological
underpinnings are centuries old, and could lay the groundwork for an end to church's blanket
ban on contraception. The principle of 'double effect' entered mainstream Catholic debate more
than 300 years ago and draws on questions about the 'lesser of two evils' raised by theologians
[long ago]. Some groups, including the Southern Africa Catholic Bishops Conference, have even
given a tacit nod to condoms for married couples with one partner infected. The Vatican -
however tentatively - now could be moving to formally recognize that position... There's no
chance the Vatican would fundamentally revise its opposition to contraception, [b]ut even the
targeted discussions... are further evidence of Pope... shedding [his] tradition-bound reputation
... Benedict, a widely respected theologian, has shown a willingness to re-examine church
attitudes toward advances in genetic engineering and in-vitro fertilization. But none approach
the sensitivity of whether to open the door - even a crack - for condoms... If the Vatican allows
condoms as an AIDS control measure within a marriage, it would open the way for Catholic
groups to take a more direct role in anti-AIDS campaigns in ravaged places such as Africa...
'[L]esser of two evils' views boil down to moral damage control. A priest should always advise
against doing 'evil', but encourage a 'lesser evil' if they can't stop the act"; Reuters "Zimbabwe
Running Out of AIDS Drugs as Crisis Worsens"NYT 03 May 06:-"Zimbabwe is running out of anti-retroviral drugs to treat HIV/AIDS as a foreign currency shortage hobbles government efforts to
provide 20,000 people with the life-saving medicine, state media said. Acting director of
Zimbabwe's National Pharmaceutical Company said his firm was struggling to find funds to buy
ARVs for people with AIDS, which experts say kills an average of 3,000 Zimbabweans every
week, Herald newspaper said... Health sector is among those hardest hit by Zimbabwe's severe
economic crisis [super-inflation]... The embattled southern African country also lies close to the
heart of Africa's HIV/AIDS epidemic, with the government estimating 1.61m people infected with
the virus. But in a rare bit of good news, Zimbabwe's adult HIV prevalence has fallen to about
20% from 25% five years ago, apparently due to increased condom use and people having fewer
sexual partners"; AP"HIV / AIDS Conference Eyes Indigenous People"NYT 04 May 06:-"More than
1,000 people gathered for five-day conference on HIV and AIDS for indigenous people in North
America. 'HIV/AIDS is rapidly becoming a terrible predator in native communities, and most of
these communities are unprepared to protect themselves', said... keynote speaker... 'Cases are
being reported in even the most remote communities'. [P]rofessor... said researchers need to
study the effectiveness of medication on native peoples... Conference participants
included...natives.,.as well as physicians, nurses, pharmacists, researchers, elders and spiritual
leaders"; Amelia Gentleman & Hari Kumar“AIDS Groups in India Sue to Halt Patent for U.S.
Drug”NYT 11 May 2006:-“AIDS groups this week brought important test of India’s new patent
law, which restricts ability of Indian companies to produce low-cost generic drugs. Two patients-rights groups sued to stop Gilead Sciences, California biopharmaceutical company, from
patenting the antiretroviral drug Viread - company’s brand-name version of tenofovir, which is
available [in India] as a generic drug. If it is patented, the groups contend, making the cheaper
versions will become illegal, and the drug will become too expensive for patients...in developing
countries... Doctors Without Borders [stated:] ‘People in Africa and Caribbean are relying on
India to produce these drugs. Quality matches that of US-manufactured drugs, but prices
affordable’. Lawyers for two [Indian] groups... presented arguments contending tenofovir not
new drug, but modified version of earlier drug, and therefore not eligible for new patent under
India’s new law. Those backing legal challenge hoping to gain legal precedent for use in other
patent applications... WHO recently recommended tenofovir for patients just starting treatment
for AIDS and those who have been receiving antiretroviral treatment therapy but resistant to
other treatments. In [rich] countries, Gilead’s tenofovir costs $5,718/person/year. Cipla, one of
largest companies in India, marketing version called Tenvir, at cost of $700/person/year in India.
Chairman Cipla said drug eventually available in Africa for about half that price. But Tenvir would
have to be withdrawn if Gilead were given patent,.. in effect for 12 years. Gilead Sciences said...
‘[W]e believe Viread represents innovation and parentable under Indian law. We will use this
patent responsibly, and not block access to our medication in India or other resource-limited
countries where HIV epidemic hit hardest’. Company... ‘pursuing broad policy of nonexclusive
voluntary licensing under patent to generic manufacturers in India for local Indian market as well
as provision for manufacturers to export product to 97 developing-world countries included in
Gilead’s access program’”; Celia W.Dugger"Letter From Kenya: Where AIDS Galloped, Lessons
in Applying the Reins"NYT 18 May 06:-major article describes/ discusses US influence on Kenya
policy, but summary mainly on current pandemic conditions. "Kenya rarity in Africa: nation
where experts say AIDS shows signs of easing. So... attracting policy makers/researchers
looking for keys to slowing relentless spread of AIDS on continent. Trends heartening. Medical
experts estimate new HIV infections... plummeted over last decade from peak of more than
200,000/year to fewer than 90,000. And changes in sexual habits seem contributing to decline.
Men say having sex with fewer partners, and women report losing virginity later. Many teenagers,
once sexually active, say they are abstaining entirely. Such shifts... suggest abstinence
programs... have some chance of success...Kenyan health officials frankly acknowledge
evidence lacking on effectiveness of programs that promote condoms or abstinence. According
to UN AIDS agency, Kenya, Uganda, Zimbabwe: the sub-Saharan with documented declines in
HIV prevalence. Researchers agree fall partly because AIDS deaths have reduced population of
HIV-positive people. But also say likely behaviour change has helped. In Uganda, increased use
of condoms important. Health officials [in Kenya] say spread of knowledge about how to prevent
infection and rising tide of death been catalytic... As donors racheted up financing of anti-AIDS
programs, landscape for prevention changed. Since...2003, US dominant donor in Kenya: $208m
this year to combat AIDS... More than half that financing feverish drive for diagnosis of AIDS and
treatment of infected... AIDS patients receiving drug treatment rocketed to 70,000 from fewer
than 10,000 in 2003. Paradoxically, explosive growth in testing/treatment may be US's most
important contribution to preventing spread of disease. Once people know AIDS not a death
sentence, more willing to be tested, and once know their HIV status they can protect
themselves/sexual partners... Experts' judgement[:] more than half new infections in Kenya are
with couples in which one partner HIV-positive. US also paying programs aimed at changing
behaviour. This year,.. $15.7m on programs that promote abstinence/faithfulness, and $7.8m to
prevent sexual transmission of HIV, including... condoms to high-risk groups. [D]ebate that
rages in WashDC over AIDS/sex sometimes seems [here] more reflection US culture wars than
African realities... Under guidelines, US funds can be used to educate children 14/younger about
abstinence/faithfulness, with condom education added for 15/older... Scholars say much work
remains to figure out which of so-called |