| | |  Health & Beauty | August 2008 
Kaiser Daily HIV/AIDS Report [Aug 05, 2008]
 Kaisernetwork.org
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Battle Against HIV/AIDS Not Over; Improved Prevention, Treatment, Health Systems Needed, Clinton Says at AIDS Conference
Former President Clinton at a session during the XVII International AIDS Conference in Mexico City on Monday said that the fight against HIV/AIDS is far from over and called for improved health systems, prevention and treatment worldwide, the Wall Street Journal reports (Chase, Wall Street Journal, 8/5). "AIDS is a very big dragon," he said, adding, "The mythological dragon was slain by Saint George, the original knight in shining armor, but this dragon must be slain by millions and millions of foot soldiers."
According to Clinton, increasing food and oil prices, as well as the mortgage crisis, have further compounded the lives of HIV-positive people. Clinton also said that there is no "silver bullet" to eradicate HIV/AIDS worldwide. "We know there is so much yet to be done: to expand prevention, treatment and care, to strengthen undeveloped health systems," he said (Nicholson, AFP/Yahoo! News, 8/4).
Clinton said the U.S. and other nations should reform their health systems to reach the groups at highest risk for HIV/AIDS, which have been neglected over the past 25 years (Pettypiece, Bloomberg, 8/4). He called for a 50% increase in funding to reduce the price of antiretrovirals and keep pace with expanding antiretroviral programs (BBC News, 8/5). Clinton also said that health clinics should routinely test for HIV, particularly in developing countries, where 80% of people living with the virus are unaware of their status.
Clinton said that the U.S. has failed to prevent the spread of HIV among blacks. He added that 30% of infants born to HIV-positive women in Africa contract the virus, although drugs can reduce the risk of mother-to-child HIV transmission to less than 2%. He said that the Clinton Foundation will work to reduce such rates (Bloomberg, 8/4).
Clinton also cited some of the successes of his foundation, including reducing the price of some pediatric antiretrovirals from $600 annually to $60 annually in the previous three years. He also discussed the possibility of using pre-exposure prophylaxis to prevent HIV transmission until a vaccine is developed, the Journal reports (Wall Street Journal, 8/5).
Clinton during the session praised the passage of legislation to reauthorize the President's Emergency Plan for AIDS Relief, which President Bush signed into law last week. "This is a stunning development for which we should all be grateful," he said. Clinton also lauded United Nations Secretary General Ban Ki-moon and Mexican President Felipe Calderon for speaking out against discrimination during the conference (AFP/Yahoo! News, 8/4).
He also commended Mexico for passing legislation to increase access to health care, adding that such legislation can help reduce new HIV cases (Bloomberg, 8/4). He also praised Mexico's policy of universal access to antiretroviral drugs for all people who need them and added that he hopes the Bush administration "will follow" and provide universal access to antiretrovirals in the U.S.
In addition, Clinton said that a recently released CDC study about annual new HIV infections in the U.S. highlights the need for increased attention to the virus in the country, particularly among blacks (Connolly, Washington Post, 8/5). The study "should be a wake-up call" for U.S. citizens "that even as we keep working globally we need to do much more to fight AIDS at home, and I intend to do so with my foundation" (Bloomberg, 8/4).
In a Washington Post interview after the speech, Phill Wilson, CEO of the Black AIDS Institute, , "I have been extremely disappointed with the Clinton Foundation, especially with it headquartered in Harlem of all places, that it has been silent" on the issue of blacks and HIV/AIDS. He said that HIV/AIDS is a "direct attack on black America." Wilson said, "I'm very grateful, and it is appropriate that President Clinton is committed to taking this on" (Washington Post, 8/5).
The recent CDC study found that 45% of new infections in the U.S. occur among non-Hispanic blacks (Kaiser Daily HIV/AIDS Report, 8/4).
A webcast of Clinton's session is available online. A webcast of the opening ceremony during which Ban and Calderon spoke also is available online. A webcast of a press conference featuring Phill Wilson on AIDS in black America is available online.
NPR's "Tell Me More" on Monday reported on the CDC study. The segment includes comments from Kevin Fenton, director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention (Martin [1], "Tell Me More," NPR, 8/4). The program on Monday also examined the issue of HIV/AIDS and blacks. The segment includes comments from Wilson (Martin [2], "Tell Me More," NPR, 8/4).
HIV Vaccine Research Efforts Should Be Scaled Up, Experts Say at AIDS Conference
Although results of HIV vaccine research have been "unrelentingly negative" in recent years, scientists still should increase efforts to develop a vaccine, HIV/AIDS experts said Monday during a workshop at the XVII International AIDS Conference in Mexico City, Toronto's Globe and Mail reports (Picard, Globe and Mail, 8/5).
According to AFP/Google.com, of the 50 HIV vaccine candidates that have been tested in humans, only two reached Phase III trials, and both of those were found to be ineffective. About 30 vaccine candidates currently are in trials, AFP/Google.com reports (AFP/Google.com, 8/4).
At the workshop, Tadataka Yamada, executive director of the global health program at the Bill & Melinda Gates Foundation, said that although HIV vaccine development is difficult, its benefits could be tremendous. "The challenges are huge, but I have no doubt that we will live in a world without HIV some day," Yamada said, adding that vaccine researchers need to be "unafraid to fail" (Globe and Mail, 8/5).
Yamada added that funding and collaboration for vaccine research need to be increased to avoid wasted or duplicated efforts. "We need big investments for the future ... not only in the basic science of HIV prevention, but also in clinical trials for an HIV vaccine," Yamada said. Yamada also said researchers should focus on basic research to fill fundamental gaps in knowledge about how HIV attacks the immune system (AFP/Google.com, 8/4).
Alan Bernstein, executive director of the Global HIV Vaccine Enterprise, added that researchers' "objective should be to stop" HIV and that the "best way to do so is with a vaccine." Bernstein said a major challenge in vaccine research is unrealistic expectations from the public. "We need to get away from this home-run mentality to research," he said.
Seth Berkley, president and CEO of the International AIDS Vaccine Initiative, said although there are many biological and social challenges in developing an HIV vaccine, a vaccine is "possible." He added that scientists, corporations and governments should redouble their commitments to vaccine research rather than be discouraged by recent setbacks in HIV vaccine research (Globe and Mail, 8/5). The researchers added that although they are optimistic, a potential breakthrough in vaccine development is several years away (AFP/Google.com, 8/4).
The researchers at the workshop also discussed the development of microbicides. Zeda Rosenberg, CEO of the International Partnership for Microbicides, said she is still optimistic about the research despite the "series of barriers" involved (Globe and Mail, 8/5). According to AFP/Google.com, there have been nine completed or halted trials of microbicide candidates, one of which found an increased risk of HIV transmission. Five microbicide candidates are in the early stages of trials, AFP/Google.com reports (AFP/Google.com, 8/4).
Shortage of Health Workers in Developing Countries Hindering Efforts To Fight HIV/AIDS, Experts Say at AIDS Conference
Health worker shortages in developing countries are hindering efforts to fight HIV/AIDS as more physicians and nurses leave lower-income countries for wealthier nations where they receive higher salaries, HIV/AIDS leaders said Sunday at the XVII International AIDS Conference in Mexico City, Reuters reports.
According to Reuters, in Lesotho, 54% of nursing positions in public clinics and 30% in hospitals are vacant. The shortage of health workers is hindering access to antiretroviral drugs, according to Pheello Lethola, an HIV and tuberculosis specialist in Lesotho. "You need health care workers to administer the drugs," Lethola said, adding, "Without health care workers, drugs are useless."
In Malawi, fewer than 100 physicians are trained to treat HIV/AIDS, and the country needs up to 400 doctors who can treat the disease. Moses Massaquoi, Medecins Sans Frontieres medical coordinator in Malawi, said that half of the HIV-positive people who need treatment, or 140,000 individuals, are not receiving it "because of the terrain of the country, and there are not enough resources to provide services." Nurses who treat HIV-positive people in Malawi earn about $3 per day, he said, adding that it is not surprising that health workers leave the country. "We need to assist poor countries to train more health staff, provide commensurate salaries to enable them to live better lives and carry out their work," Massaquoi said.
UNAIDS Executive Director Peter Piot also discussed the need to increase efforts to encourage health workers to work in developing countries. Piot said that HIV/AIDS is "far from over" and that "[t]here is a need to expand treatment to those who do not yet have treatment" (Lyn, Reuters, 8/3).
Former Botswanan President Mogae Calls for New Vigor in Fight Against HIV/AIDS
Former Botswanan President Festus Mogae at the Sunday opening of the XVII International AIDS Conference in Mexico City made a "passionate appeal for new vigor" in the fight against HIV/AIDS in Africa, South Africa's Cape Argus reports (Yeatman, Cape Argus, 8/4). Over the past few months, Mogae has been actively lobbying key African leaders to form an HIV/AIDS initiative and has raised funds for such a group, the Pretoria News reports.
According to Mogae, volunteerism, activism and leadership are needed to address HIV/AIDS on the continent. He said, "African leaders must come together to open dialogue among ourselves for conversation and learning about what works" (Boje, Pretoria News, 8/5). Mogae emphasized the need for efforts to prevent HIV/AIDS -- particularly certain risky behaviors, such as multiple and concurrent partners and girls initiating sex at an early age -- and community support for HIV-positive people, South Africa's Star reports. "We should not be afraid to take controversial steps, as long as we are caring and careful of people's rights," Mogae said (Cullinan, Star, 8/5).
According to the Cape Argus, Botswana a few years ago began routinely testing people for HIV in hospitals and clinics unless they opted out. Although the practice was controversial at the time, it is now accepted, the Cape Argus reports (Cape Argus, 8/4). Mogae added that governments need to distinguish between human rights and civil rights in such situations (Star, 5/8).
Mogae also praised the rollout of antiretroviral therapy, pointing out that Botswana's treatment program is reaching 90% of those who needed it, while only 4% of the country's HIV-positive women are passing the virus to their infants (Bisetty, Mercury, 8/5).
Male Circumcision Efforts Should Increase To Prevent HIV/AIDS, Particularly in Africa, Report Says
HIV/AIDS researchers and advocates on Monday at the XVII International AIDS Conference in Mexico City said governments and health communities need to scale up male circumcision efforts to prevent HIV, particularly in at-risk countries in Eastern and sub-Saharan Africa, Reuters reports.
According to Reuters, three studies were cut short in 2006 after they showed strong evidence that male circumcision could help reduce a man's risk of HIV. At the conference, researchers and advocates said there has been little effort since then to encourage more men to undergo the procedure (Tan, Reuters, 8/4). Supporters of circumcision say that sub-Saharan Africa, where two-thirds of the world's 33 million HIV-positive people live, could benefit the most from more widespread circumcision. However, enthusiasm for the procedure has been "tempered by worries that circumcision may face a backlash on cultural, religious or sexual grounds and may prompt men to abandon use of the condom," AFP/Yahoo! News reports.
According to data presented Monday at the conference, obstacles to promoting circumcision "are not as bad as feared," AFP/Yahoo! News reports (AFP/Yahoo! News, 8/4). Researchers at the conference said two circumcision studies in Africa indicated that the procedure did not reduce circumcised men's sexual pleasure or function. The studies also did not find any increase in risky behavior among newly circumcised men. "We found that there was no difference between the circumcised men and uncircumcised men -- that there is no increase in sexual dysfunction in circumcised men. And in fact, circumcised men did report greater penile sensitivity after circumcision," Robert Bailey, an epidemiologist at the University of Illinois, said.
Conference attendees are expected to discuss further details of a circumcision study involving 2,784 men in Kisumu, Kenya, on Tuesday.
Dvora Joseph, head of the HIV department at Population Services International, said, "This is a call to action ... to call for male circumcision. It's been two years and still there is not enough money, focus to scale up effort and more needs to be done." Joseph added that although people are beginning to accept this intervention measure, stigma associated with it is still strong. "There is no national male circumcision campaign to promote it ... more education is needed," Joseph said (Reuters, 8/4). Bertran Auvert, who conducted a circumcision study in South Africa, said the procedure could prevent up to 3.8 million HIV cases and half a million deaths in sub-Saharan Africa between 2006 and 2016, as well as up to 5.8 million deaths by 2026 (AFP/Yahoo! News, 8/4).
Delegates at XVII International AIDS Conference Welcome, Challenge Swiss Report on HIV Transmission
Swiss researchers on Sunday at the opening of the XVII International AIDS Conference in Mexico City discussed a report finding that some HIV-positive people who take antiretroviral drugs do not transmit the virus during unprotected sex, AFP/Australian Broadcasting Company reports. While the majority of conference delegates gave the presentation a "warm welcome," some challenged the presentation, fearing it could encourage unsafe sex practices, according to AFP/Australian Broadcasting Company (Courcol, AFP/Australian Broadcasting Company, 8/4).
The Swiss AIDS Commission in January released a report based on four studies that said that discordant couples, in which only one partner is HIV-positive, do not need to use condoms to prevent HIV transmission under certain conditions -- if the HIV-positive partner adheres to his or her treatment regimen, has a suppressed HIV viral load for at least six months and does not have any other sexually transmitted infections.
One of the studies -- published in the Swiss Bulletin of Medicine -- was conducted in Spain between 1990 and 2003 among 393 heterosexual couples with an HIV-positive person. The study found that none of the HIV-negative partners contracted the virus from an HIV-positive person taking antiretrovirals. Another study conducted in Brazil found that out of 93 discordant couples, six people became HIV-positive. All six of the new HIV cases in the Brazil study were attributed to the HIV-positive partners not using ARVs. The two other studies -- one conducted in Uganda and the other conducted among pregnant women -- had similar results (Kaiser Daily HIV/AIDS Report, 1/31).
At the event Sunday, Rolande Hodel, head of AIDSfreeAfrica, said the "message" of the Swiss report is "too broad," adding, "People will think it's OK not to use condoms anymore." Nancy Padian of the University of North Carolina said the report has "limited applicability" in low-income countries and "a large potential for doing more harm than good." Nikos Dedes of the European AIDS Treatment Group said the report "lifts the fear of being a threat to partners" (AFP/Australian Broadcasting Company, 8/4).
Houston Chronicle Examines HIV/AIDS-Related Discrimination, Stigma in Mexico
HIV/AIDS advocates at the XVII International AIDS Conference plan to "seize the opportunity" to confront discrimination and stigma associated with HIV/AIDS in Mexico, the Houston Chronicle reports. This is the first year the conference is being held in a Latin American country. According to Mexican government figures, about 200,000 Mexicans are HIV-positive and 57% are men who have sex with men. The country's recorded prevalence is three cases per 1,000 people, but experts say it actually could be double because most people do not get tested until they show symptoms of HIV/AIDS.
The Chronicle reports that "deep-rooted" homophobia has deterred thousands of HIV-positive people, mostly MSM, from seeking treatment or getting tested. Many experts liken the discrimination toward people living with HIV/AIDS in Mexico to that of the U.S. in the 1980s, "when the predominance of the disease within the gay community led to a homophobic backlash," according to the Chronicle. Tamil Kendall, an independent AIDS consultant in Mexico, said, "In Mexico, not all men who have sex with men consider themselves gay, so they aren't being reached by gay outreach organizations," adding, "There is a whole cultural identity and stigma around the disease."
People living with HIV/AIDS in Mexico also experience discrimination, according to the Chronicle. A survey conducted last year by the country's National Commission for Preventing Discrimination found that only 40% of Mexicans would be willing to live with someone who is HIV-positive and that 20% would offer an HIV-positive person a job. In addition, many HIV/AIDS patients complain of discrimination by nurses and physicians, including the refusal to perform lifesaving operations. A recent study by Mexico's National Institute of Public Health found that many physicians would not operate on fellow physicians who had treated HIV/AIDS patients.
According to the Chronicle, HIV-positive Mexicans also lack access to antiretroviral drugs. Although the government in 2003 created a nationwide network of HIV clinics for low-income residents and announced universal access to the drugs, shortages and delays in the distribution of the medications persist.
Anuar Luna, an HIV/AIDS advocate who is HIV-positive, said, "For the government and the decision makers, we're the scum of society," adding, "So to spend money on us brings them little political benefit." Luna said Mexican President Felipe Calderon should declare a national health emergency to ensure funding for prevention and treatment programs. "That would mean that accepting it's a generalized problem and that if you let it grow, there will be a huge cost for the country," Luna said (Lloyd, Houston Chronicle, 8/2).
AIDS 2008 New Studies and Development
Kaiser Daily HIV/AIDS Report Summarizes Reports, Initiatives From International AIDS Conference
As part of its expanded coverage of the XVII International AIDS Conference, which is being held Aug. 3 through Aug. 8 in Mexico City, the Kaiser Daily HIV/AIDS Report will feature studies and initiatives released during the conference. Summaries of select publications and initiatives appear below.
"Increased Vulnerability to HIV/AIDS for Mexicans Migrating to the United States," University of California: University of California researchers during the conference presented three studies that found Mexican migrants have an increased risk of HIV after coming to the U.S. The first study was conducted by researchers from the California HIV/AIDS Research Program, the California Office of AIDS and the Mexican National HIV/AIDS Center, or CENSIDA. The venue-based survey was conducted in San Diego and Fresno counties in California and showed large increases in HIV risk behaviors among male Mexican migrants. For the second study, researchers from the Mexican Secretariat of Health and CHRP collaborated on an ethnographic study of Zapotecan migrants in Oaxaca, Mexico, and Fresno. They found that HIV/AIDS information has been widely disseminated among the Zapotecan population. The third study -- conducted by researchers from the University of California-San Diego School of Medicine in collaboration with Pro-COMUSIDA and CENSIDA -- found that male injection drug users deported from the U.S. to Tijuana had a fourfold increased risk of HIV compared with those living in Tijuana who were not deported there (University of California release, 8/5).
"Policy Guidelines for Collaborative TB and HIV Services for Injecting and Other Drug Users: An Integrated Approach," World Health Organization: The guidelines are the first to include tuberculosis and HIV care within the context of support for drug users. According to the guidelines, health and criminal justice authorities should provide targeted services to drug users, particularly injection drug users, to prevent and treat TB and HIV. Although TB is a primary cause of death among HIV-positive people, drug users who are HIV-positive experience stigma, discrimination and barriers to treatment, according to WHO. The guidelines make recommendations to reduce such deaths, including increasing access to antiretroviral drugs and the TB drug isoniazid for drug users living with HIV (WHO release, 8/4).
"The Right to Health and Health Workforce Planning: A Guide for Government Officials, NGOs, Health Workers and Development Partners," Physicians for Human Rights: The guide -- which was created by PHR in collaboration with several African nongovernmental organizations, government officials and health providers -- examines how even impoverished countries can incorporate human rights into health work force planning and improve health standards. It also looks at why human rights-based approaches to health work force planning are needed and how countries can create plans that ensure universal access to health (PHR release, 8/4).
Science & Medicine
Earlier Treatment of HIV Could Help HIV-Positive People Avoid Long-Term Complications, Recommendations Say
A panel of the International AIDS Society-USA in the Aug. 6 issue of the Journal of the American Medical Association issued new recommendations for when doctors should begin antiretroviral treatment for patients with HIV, AFP/Google.com reports. The recommendations also were presented Sunday at the opening of the XVII International AIDS Conference in Mexico City (AFP/Google.com, 8/3).
Under previous recommendations, doctors delayed antiretroviral treatment until CD4+ T cells were nearly depleted and the body could no longer fight off infection from other illnesses because physicians wanted to keep the virus from developing resistance to treatment (Lauerman/Pettypiece, Bloomberg, 8/3). Usually doctors would begin treatment when CD4+ T cell counts reached fewer than 200 to 250 cells per milliliter of blood. Those recommendations were issued 12 years ago, when antiretrovirals were first introduced, treatment failure was common and there were few available treatments (AFP/Google.com, 8/3).
IAS-USA said those recommendations should be overhauled because there are now a greater number of more effective, less toxic drugs. The authors, led by Scott Hammer, an AIDS researcher at Columbia University, wrote, "The substantial toxicity and inconvenience of early regimens dampened enthusiasm for starting therapy at higher CD4 counts." They added, "However, newer regimens are potent, durable and less toxic."
IAS-USA recommended that doctors begin antiretroviral treatment when CD4+ T cell counts reach 350 copies per millileter of blood, though patients with heart, liver or kidney disease might require earlier treatment (Bloomberg, 8/3).
According to the researchers, benefits of earlier treatment of HIV include lower incidence of lung, anal, head and neck cancers; cardiovascular disease; and kidney and liver dysfunction (AFP/Google.com, 8/3). The organization's recommendations were based on a trial of more than 5,000 patients that ended last year that showed the advantages of starting treatment before the virus progresses (Bloomberg, 8/3).
The IAS-USA recommendations also could prompt doctors to combine recently approved drugs, including raltegravir, maraviroc and etravirine, with combination with older treatments to keep down viral levels and boost CD4 counts, AFP/Google.com reports.
According to AFP/Google.com, the IAS-USA recommendations are intended for high-income countries and "selected" middle-income countries where good diagnostic infrastructure and multiple drug options make it relatively easy for physicians to treat HIV-positive people.
In addition to less funding, low-income countries often have a smaller range of treatment options and lack the means to determine if a patient is responding to drugs. However, the researchers said the "core principles" of the IAS-USA guidelines are applicable to developing nations and provide ways to make treatment and patient monitoring simpler and less costly. "Progress with antiretroviral roll-out in the developing world is encouraging, but recent advances in the highly resourced world need to be adapted and translated to the developing world to realize these benefits," the researchers added (AFP/Google.com, 8/3).
Tuberculosis Drug Interferes With HIV Treatment, JAMA Study Says
The antiretroviral drug nevirapine is less effective in people with HIV/tuberculosis coinfection who begin taking nevirapine at the same time as the TB treatment rifampicin, according to a study published in Wednesday's HIV/AIDS-themed issue of the Journal of the American Medical Association and released at the XVII International AIDS Conference in Mexico City, BBC News reports.
For the study, Andrew Boulle of the University of Cape Town in South Africa and colleagues analyzed outcomes from approximately 4,000 people who began antiretroviral therapy between 2001 and 2006 (BBC News, 8/4). The researchers assigned 2,035 people to begin HIV treatment with the antiretroviral efavirenz, 1,074 of whom had TB. The researchers assigned nevirapine to 1,935 people, 209 of whom also had TB. All of the study participants with TB received rifampicin.
Among people receiving nevirapine who also had TB, 16.3% were about twice as likely to have increased HIV viral loads after six months, compared with 8.3% among HIV-positive people taking nevirapine who did not have TB. In addition, patients with HIV/TB coinfection were more than twice as likely to develop treatment failure at a faster rate as those without TB. However, after 18 months, 80% of people with HIV/TB coinfection taking nevirapine had reduced HIV viral loads (AFP/Melbourne Herald Sun, 8/4). Nevirapine also was found to be effective among patients who started taking it before beginning TB treatment. The researchers found no difference in the effectiveness of efavirenz among people who took it alone and those who took it in combination with rifampicin (BBC News, 8/4).
According to AFP/Herald Sun, the study's findings are important because approximately one-third of people living with HIV/AIDS also have TB, and the death rate among people with HIV/TB coinfection is five times greater than among those with only TB (AFP/Melbourne Herald Sun, 8/4). The findings also are important because physicians in developing countries often initiate antiretroviral therapy in TB clinics because TB is common among people living with HIV/AIDS, BBC News reports. In addition, nevirapine is commonly used as a first-line antiretroviral in developing countries because it is inexpensive and safe for pregnant women (BBC News, 8/4).
According to Boulle, it is unclear why rifampicin has an impact on nevirapine, but it is possible that the drugs have a shared toxicity when used in combination or that rifampicin induces a drug reaction when patients begin antiretroviral treatment (AFP/Melbourne Herald Sun, 8/4). Boulle said that further research on the interaction between nevirapine and rifampicin is needed given Africa's reliance on nevirapine-based therapies and the importance of treating TB in people with HIV/TB coinfection. Boulle added that a "striking" aspect of the study is that 40% of HIV-positive individuals starting antiretroviral treatment have concurrent TB, which "underscore[es] the public health importance of improving affordable treatment options" for patients with HIV/TB coinfection.
John Howson, associate director of the International HIV/AIDS Alliance, said that the study demonstrated that TB treatment may "compromise" antiretroviral therapy but added that "this needs more research" (BBC News, 8/4).
Drug Access
Mexico To Allow Drug Companies To Make, Sell Generic Antiretrovirals in Country, President Calderon Announces
Mexican President Felipe Calderon on Sunday at the opening ceremony of the XVII International AIDS Conference in Mexico City announced that he would lift restrictions on foreign pharmaceutical companies to allow them to produce and sell generic antiretroviral drugs in Mexico, NPR's "Morning Edition" reports (Beaubien, "Morning Edition," NPR, 8/4).
Calderon lifted a regulation by the Mexican Ministry of Economy that required drugmakers operating in Mexico to have a manufacturing plant in the country in order to sell generic versions of their drugs, including antiretrovirals, according to an AIDS Healthcare Foundation release. The announcement is "tremendous news" for Mexicans living with HIV/AIDS and other diseases, Patricia Campos, Latin America bureau chief for AHF, said (AHF release, 8/3).
Calderon recently announced that he would establish a commission to help negotiate the price of drugs and work to achieve fairer prices to help HIV-positive people receive treatment. Mexican Health Secretary Jose Angel Cordova recently said that Merck has agreed to sell two antiretroviral drugs, Stocrin and Isentress, at a reduced price in the country (Kaiser Daily HIV/AIDS Report, 8/4).
Global Challenges
Spain Announces $15.9 Million Donation to UNAIDS
Spain's First Vice President Maria Teresa Fernandez de la Vega on Sunday during her speech at the XVII International AIDS Conference in Mexico City announced her country's contribution of 10.2 million euros, or $15.9 million, to UNAIDS, BBC News/RedOrbit reports. Of that amount, three million euros, or $4.7 million, will be set aside to support the activities of the International AIDS Vaccine Initiative and 1.5 million euros, or $2.3 million, will go to the International Partnership for Microbicides.
During her speech, de la Vega emphasized that HIV is not only a health problem, but is also a problem of development, equality and social justice. According to the first vice president, "the huge differences in access to health resources, drugs and health services" demonstrate that HIV/AIDS is still a major epidemic in many regions of the world.
The government of Spain has already committed to providing $600 million to the Global Fund To Fight AIDS, Tuberculosis and Malaria from 2008 to 2012. In addition, Spain contributed $1.6 million to IAVI last year and has granted $1.6 million annually since 2005 to the European platform for HIV vaccine clinical trials (BBC News/RedOrbit, 8/4).
High Number of HIV Infections in Mozambique Concerns UNICEF
UNICEF is concerned by a high number of HIV cases in Mozambique stemming from unsafe sex practices, Executive Director Ann Veneman said recently at the end of her three-day visit to the country, the South African Press Association reports.
According to the South African Press Association, inflation levels of more than 6,000% in Zimbabwe and other economic problems have resulted in hundreds of women from Zimbabwe traveling to towns along the Mozambique-Zimbabwe border to participate in commercial sex work.
Veneman said UNICEF was involved in grassroots projects with organizations in the Mozambique provinces of Gaza, Manica and Sofala to fight HIV/AIDS (South African Press Association, 8/3). Veneman added, "We are working with the Ministry of the Interior in dealing with uncontrolled immigration of Zimbabwean women who are engaged in sexual activities in central Mozambique" (AFP/Google.com, 8/3).
Sixteen percent of those ages 16 to 49 in Mozambique are thought to have HIV/AIDS, according to official figures. However, nongovernmental organizations and other independent health groups say HIV prevalence has increased recently because of high levels of poverty (South African Press Association, 8/3).
Opinion
Obama, McCain Silent on HIV/AIDS Epidemic Facing the Black Community, Opinion Piece Says
The HIV/AIDS "plague has long been the single biggest health issue in poor black communities" in the U.S., which is "all the more reason" for presumptive presidential nominees Sens. Barack Obama (D-Ill.) and John McCain (R-Ariz.) to "speak out on the crisis and spell out just what they will do about it," Earl Ofari Hutchinson, author and political analyst, writes in a New America Media opinion piece, adding, "So far they haven't done that." He writes that the candidates "have given countless speeches on the terrorism fight, the Iraq War, the Iran missile threat, immigration, the housing and banking crisis, a tanking economy and affordable health care," which are "crucial problems" facing the U.S. However, "as devastating as these problems are to many families, they do not pile up bodies and wreak catastrophic havoc on entire sectors of the population, mostly poor black communities" like the HIV/AIDS epidemic does, according to Hutchinson.
"HIV/AIDS is not even mentioned as an item in the detailed health care plan on" McCain's official Web site. Obama and his wife publicly took HIV tests last year, and he subsequently offered a pledge to create a national strategy on AIDS. However, he "hasn't publicly addressed the issue since," Hutchinson writes, noting, "In a campaign position paper Obama has said he will push for more funds for AIDS treatment, education and testing. But much of his emphasis has been on African nations." Hutchinson writes that "even if McCain had boned up on the AIDS crisis and laid out a plan to confront the crisis, and Obama had fleshed out more details about confronting the crisis in African-American communities, it's still no substitute for speaking out on the campaign trail about the crisis and pushing government, health agencies and private donors to do more to combat the AIDS plague." He concludes that both candidates "should break their silence now" (Hutchinson, New America Media, 8/1).
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