Kaiser Daily HIV/AIDS Report - Fri, 22 Jun 2001
-----------------------------------------------
* U.N. Releases Details on HIV/AIDS Assembly Events
* Global AIDS Efforts Will Require $9.2 Billion Annually, UNAIDS Re-
port Finds
* Mbeki to Visit Merck Labs, Promote Africa Development Plan On U.S.
Trip
* AIDS Journalists Discuss AIDS Vaccines, South Africa on NPR's
'Fresh Air'
* Corporate AIDS Initiatives in Africa -- Good Will, Good Business
Sense, Or 'Just Good P.R.'?
--
U.N. Releases Details on HIV/AIDS Assembly Events
"HIV/AIDS is a global problem of catastrophic proportions. The chal-
lenge is enormous, but we are not powerless to face it," U.N. Secre-
tary-General Kofi Annan, who has made combatting the disease a "per-
sonal priority," said in a statement detailing events planned for the
U.N. General Assembly's special session on HIV/AIDS, set to begin on
Monday. At the assembly, expected to be a "watershed event in the
fight against" HIV/AIDS, delegates are expected to adopt a draft Dec-
laration of Commitment, prepared after several months of "informal
talks," the main targets of which are as follows:
* Set "time-bound national targets" by 2003 to reduce HIV infection
by 25% among 15-to 24-year-olds by 2005 in the "most affected coun-
tries" and by 2010 worldwide;
* "Ensure" by 2005 that "at least" 90% of 15- to 24-year-olds have
access to information and services that can reduce their risk of
HIV infection;
* Reduce the number of HIV-infected infants by 20% by 2005 and by 50%
by 2010;
* Develop by 2003 national plans to "strengthen health care systems
and address factors affecting the provision of HIV-related drugs,"
including antiretroviral medications;
* By 2003, develop -- and by 2005, implement -- national strategies
to "provide a supportive environment" for AIDS orphans and children
infected with and affected by HIV/AIDS. Governments to be repre-
sented at the session have also "agreed in principle" to support
the establishment of the $7 billion to $10 billion Global AIDS and
Health Fund.
Events
Government representatives, consisting mostly of cabinet ministers
and a few heads of state, will make formal statements and will also
participate in four "round table" discussions. The round tables will
focus on the following "key issues":
* "HIV/AIDS Prevention and Care," chaired by the prime minister of
St. Kitts and Nevis;
* "HIV/AIDS and Human Rights," chaired by the prime minister of Po-
land;
* "Socio-Economic Impact of HIV/AIDS," chaired by the health minister
of Malaysia; and
* "International Funding and Cooperation," chaired by the president
of Tanzania.
CEOs of several corporations are also expected to announce new ini-
tiatives during the meetings, and the Global Business Council on
HIV/AIDS will launch its "blueprint for business action." In addi-
tion, representatives from 500 activist groups will also participate
in the formal talks and in the round table discussions. "We have
reached a point at which many factors and forces are coming together
in a unique way. I believe that we now have an opportunity for a
quantum leap forward in the way in which we respond, as an interna-
tional community, to the epidemic. The Declaration of Commitment that
national leaders adopt at the special session means that we will have
a new level of transparency and seriousness in turning back the epi-
demic. The millions of people infected and affected by HIV are watch-
ing this process, and they, quite rightly, have high expectations of
the process and its outcomes," Dr. Peter Piot, executive director of
UNAIDS said (U.N. release, 6/21).
--
Global AIDS Efforts Will Require $9.2 Billion Annually, UNAIDS Report
Finds
HIV prevention and treatment in the world's 135 poorest countries
will require $9.2 billion per year, according to a UNAIDS report pub-
lished in today's edition of the journal Science. The report, in-
tended to be a "financial blueprint" for the United Nation's proposed
Global AIDS and Health Fund, calls for a gradual increase in spend-
ing, starting with $3.2 billion next year and "steadily" increasing
to $9.2 billion in 2005, Reuters/New York Times reports. Once the
fund is at its full capacity, $4.8 billion would go toward prevention
efforts and $4.4 billion would be allocated for treatment
(Reuters/New York Times, 2/21). Half of the treatment funds would be
used to purchase antiretroviral drugs to treat "about half" of the
infected individuals who are "showing symptoms of the disease," Bern-
hard Schwartlander, chief epidemiologist for UNAIDS and the lead au-
thor of the report, said (Reuters/Philadelphia Inquirer, 6/22). But
allocating funding toward antiretrovirals could be a source of con-
flict because some donors to the AIDS fund, which has already re-
ceived about $500 million, have indicated that they "favor spending
on prevention rather than treatment," the Las Vegas Sun reports. "If
some of the donors decide they don't want to treat, that's going to
cause serious problems. Countries are not going to be viable if 25%
of the population are left to die," Daniel Berman, a campaign coordi-
nator for Doctors Without Borders, said (Las Vegas Sun, 6/21).
Realistic Figures?
Funding issues are "likely to dominate" the U.N. General Assembly
special session on HIV/AIDS, set to begin Monday in New York, the
Washington Times reports. Deputy U.N. Secretary-General Louise Fre-
chette said Tuesday that the fund is off to a "very good start" and
added that she "hope[d] to hear more commitments" during the three-
day meeting. She added that contributions to the fund should be "new
money" and not "reallocation[s]" of existing international aid. But
some observers noted that the global AIDS fund has a "long way to go"
before it amasses the projected $9.2 billion necessary to fight
HIV/AIDS. "I think past experience would suggest that $9 billion to
$10 billion is unachieveable, at least in the short run," one inter-
national health funding expert who asked not to be identified, said,
adding that $1.5 billion in new money was a "more realistic figure."
However, Mark Schneider, senior vice president of the International
Crisis Group, said it is "realistic to say that [$9.2 billion] is
within the realm of what the international community is able to do,"
adding that the United States already spends about half a billion
dollars annually on international AIDS efforts and that there is
"discussion" of that figure doubling (Pisik, Washington Times, 6/22).
Schwartlander called the $9.2 billion projection "truly possible,"
noting that the "key message is that we need a lot more commitment
and a lot more resources to really effectively fight the epidemic
(Reuters/New York Times, 6/21). "Many countries, including some of
the poorest, have shown political commitment and developed plans to
scale up treatment and prevention programs," he said. Under the model
used by the report's authors, the funds would allow for prenatal HIV-
screening of an additional 35 million women and the administration of
medications to nearly one million of those women to reduce the risk
of mother-to-child HIV transmission. The funding model also provides
for the annual distribution of six billion condoms worldwide.
Schwartlander "cautioned" that another $1.3 billion to $2.6 billion
would be needed to treat malaria and tuberculosis, two other epidem-
ics in the developing world, because the HIV/AIDS epidemic "cannot be
tackled in isolation" (Picard, Globe & Mail, 6/22).
'Vulnerable' Groups
Besides funding, references in the special session's draft declara-
tion to HIV "vulnerable groups," such as homosexuals and sex workers,
looks to be another source of contention during next week's assembly.
The Vatican and Muslim leaders have formed a "philosophical alliance"
in an attempt to "block" the inclusion of the language, which refers
to "men who have sex with men, people who have multiple sex partners,
sex workers and their clients [and] injecting drug users and their
sexual partners," the Wall Street Journal reports. "We believe in one
family -- it is the family of a man, a woman and their children. What
we are asking others is to respect such a background while we respect
their background and traditions," Fayssal Mekdad, head of Syria's
U.N. delegation, said. President Bush is also "uneasy" about the lan-
guage and administration officials are attempting to "broker a com-
promise." Representatives for Canada and members of the European Un-
ion said that the inclusion of such vulnerable groups is "vital to
ensuring that health programs reach people who need them most," and
added that they are not asking the Vatican or Muslim nations to "ap-
prove" of the behavior (Phillips, Wall Street Journal, 6/22).
--
Mbeki to Visit Merck Labs, Promote Africa Development Plan On U.S.
Trip
South African President Thabo Mbeki will visit Merck's research labs
in West Point, Pa., next week to learn about Merck's progress on an
HIV vaccine, the Wall Street Journal reports. Merck was "instrumen-
tal" in the development of some of the antiretroviral drugs to treat
the disease, and is now conducting research on an AIDS vaccine (Har-
ris, Wall Street Journal, 6/21). The company announced in April that
a Merck AIDS vaccine candidate was unable to block HIV infection or
rid the body of infection in trials with monkeys, but the vaccine did
suppress the virus to levels "too low to be detected" (Kaiser Daily
HIV/AIDS Report, 4/2). Mbeki, who has publicly questioned the causal
link between HIV and AIDS, is interested in talking about the vaccine
with Merck researchers, South African embassy spokesperson Sheldon
Moulton said. "One of the greatest needs in Africa is prevention of
infectious diseases like HIV/AIDS, which are major obstacles to sus-
tainable development," he added. South Africa is currently "embroiled
in an internal debate" over whether to spend "huge sums" on drug
treatment for HIV-positive South Africans or to "concentrate efforts"
on disease prevention instead. Mbeki's U.S. trip is intended to pro-
mote a "development plan for Africa" called the Millennium Africa Re-
covery Plan. Mbeki also plans to meet with President Bush (Wall
Street Journal, 6/21).
--
AIDS Journalists Discuss AIDS Vaccines, South Africa on NPR's 'Fresh
Air'
AIDS reporter Jon Cohen, author of "Shots in the Dark: The Wayward
Search for an AIDS Vaccine," and South African journalist and anti-
rape activist Charlene Smith joined Terry Gross as guests on NPR's
"Fresh Air" yesterday to discuss AIDS-related issues. Cohen called on
the international medical community to "organize a master monkey
trial" to standardize vaccine research, saying that it is not cur-
rently possible to compare results of vaccine tests done on monkeys -
- the primary vehicle for such testing -- across labs because there
is no consistency in virus strains used or in how the vaccines are
administered to animals. Cohen said, "Drugs aren't going to stop the
epidemic ... We know that vaccines are the most powerful medical in-
tervention, other than cleaning the water, that we have ever come up
with as humans." He added that he is "amused at how vaccines take a
back-seat" to drug treatment when researchers could "create great
good without having a great vaccine," explaining that "if you have a
mediocre AIDS vaccine right now that works 60% of the time ... it
will do more good down the road than a 90% effective vaccine intro-
duced five years later." When asked why it is so much harder to find
an AIDS vaccine than it was to find the smallpox or polio vaccines,
Cohen responded that "antibodies clearly protect people from polio
virus. With HIV, no one knows what exactly protects people from [the
virus]." In addition, Cohen said that pharmaceutical companies have
more incentive to find new AIDS drugs than vaccines, since drugs are
more lucrative.
Rape and HIV in South Africa
Smith, who became an activist after she was raped in South Africa in
1999, spoke about her difficulty after the incident in obtaining
drugs that could decrease her chances of contracting HIV from her as-
sailant. Smith's experience prompted her to spread awareness about
HIV and rape in South Africa and to push for legal and medical re-
forms. According to Smith, girls aged 13-19 have the highest rate of
HIV infection in South Africa. She noted that in addition to a high
rape rate overall, the rape of virgins in South Africa is an "unimag-
inable problem" because of the myth that such action allows men to
"cleanse" themselves of HIV. Smith said a belief also exists that men
can cleanse themselves of HIV through intercourse with elderly women,
which has resulted in many gang rapes. Smith said that "every govern-
ment in this region knows that it is happening, and is not doing any-
thing to stop it." She added that there is "still not good enough
treatment" for women who are raped, although some medical centers
provide free testing, counseling, and anti-HIV drugs. Smith said she
is optimistic about potential new laws that would require that rap-
ists be tested for HIV and that their victims be informed of the re-
sults. Smith's book, "Proud of Me: Speaking Out Against Sexual Vio-
lence and HIV," will be published in South Africa in August (Gross,
"Fresh Air," NPR, 6/21). To listen to the "Fresh Air" report in Real-
Audio, click here. Please note this link is available to Web readers
only, and you will need RealPlayer to access it.
--
Corporate AIDS Initiatives in Africa -- Good Will, Good Business
Sense, Or 'Just Good P.R.'?
Announcements this week of AIDS-related initiatives by Coca-Cola and
Daimler-Chrysler have been "mostly welcomed at the United Nations"
but have fueled speculation among activists that the moves are "just
good public relations" rather than "good will," AP/CNN.com reports.
Coke, Africa's largest corporate employer, recently announced a new
joint initiative with UNAIDS that will utilize the company's market-
ing expertise and distribution network to disseminate HIV prevention
materials and condoms to "hard-to-reach" places. The soft drink maker
also pays to treat its HIV-positive employees. Daimler-Chrysler also
announced it will provide free AIDS drugs to its infected South Afri-
can workers and their families. The CEOs of both corporations will
join U.N. Secretary-General Kofi Annan and other business leaders
Tuesday for a "high-profile" meeting during the U.N. special assembly
on HIV/AIDS. But despite "hard" pushes from Annan and other U.N. of-
ficials, none of those invited to the meeting have contributed to the
proposed U.N. Global AIDS and Health Fund, which is seeking $7 bil-
lion to $10 billion to fight HIV/AIDS in developing countries. So
far, the fund has received donations totalling $528 million, a "far
cry" from the amount AIDS experts say is needed to curb the spread of
HIV. Winterthur Insurance, a division of Credit Suisse, has contrib-
uted $1 million to the fund, the only corporate donation made so far,
with the rest coming from the United States, France, Great Britain
and the Bill & Melinda Gates Foundation. The fund, not private ini-
tiatives, is where corporations "should focus their attention,"
Sharonann Lynch of Global Treatment Access, an AIDS advocacy organi-
zation, said. "What we've seen from industry, be it pharmaceuticals
or soda companies, is that they take opportunities like this to an-
nounce positive public relations campaigns, often without even con-
sulting with governments and organizations on the ground," she added.
But Paul Zeitz, executive director of the Global AIDS Alliance, said
it is "not so bad" if the companies do not donate to the fund, as
long as they "take these initiatives." U.N. Deputy Secretary-General
Louise Frechette said Wednesday that she "would hope and ... expect,
that we will hear more indications of commitments from the part of
donor countries during the special session" (AP/CNN.com, 6/21).
Making Business Sense
Meanwhile, NBC's "Nightly News with Tom Brokaw" reported Wednesday
that the Coke and Daimler initiatives show both a humanitarian con-
cern for workers and good business sense for the future. Alexander
Cummings, president of Coca-Cola's African division, said, "Our em-
ployees are as affected as the entire continent. We believe that if
we don't get involved in AIDS today, the impact on our business, al-
though minimal today, will increase exponentially." Coke has found
that HIV/AIDS has caused increased absenteeism, decreased productiv-
ity, and employee deaths. Former U.N. Ambassador Richard Holbrooke,
who now leads the Global Business Council in its efforts to "get com-
panies to do more," said that private corporations must not replace
the role of governments, but must instead work with them. Holbrooke
said, "Government has to take the lead. But in many parts of the
world, the governments just aren't up to challenge. There is too much
social and political stigma attached" (Thompson, "Nightly News with
Tom Brokaw," NBC, 6/20). Other corporations implementing HIV-related
initiatives include Debswana, a joint venture between the Botswanan
government and the diamond firm DeBeers, which announced in March
that it would "subsidize" antiretroviral medications for its employ-
ees and one spouse in order to "extend employees' productive lives."
The company employs 6,000 people at its three mines and accounts for
a third of the world's diamond supply, 80% of the nation's export
earnings and half of the government's revenues (Kaiser Daily HIV/AIDS
Report, 3/8). In addition, Anglo American PLC, a London-based mining
conglomerate that employs more than 160,000 workers in Africa, last
month unveiled plans to offer its African employees and their spouses
anti-AIDS medications, saying it had been "profoundly affected" by
HIV/AIDS, which is responsible for frequent absenteeism and higher
medical costs (Kaiser Daily HIV/AIDS Report, 5/7).
--
The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org,
a free service of The Henry J. Kaiser Family Foundation, by National
Journal Group Inc. c 2001 by National Journal Group Inc. and Kaiser
Family Foundation. All rights reserved.
--
Send mail for the `AFRO-NETS' conference to `<afro-nets@usa.healthnet.org>'.
Mail administrative requests to `<majordomo@usa.healthnet.org>'.
For additional assistance, send mail to: `<owner-afro-nets@usa.healthnet.org>'.