Kaiser Daily HIV/AIDS Report - Thu, 24 Jan 2002
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* Zambian President Appoints New Health Minister, Tasks Him With Se
curing Cheap AIDS Drugs
* South African Officials React to KwaZulu-Natal's Decision to Pro-
vide Nevirapine to HIV-Positive Pregnant Women
* Radio, Sporting Events and Adult Cinemas Used for AIDS Education
Efforts in Africa
* Bill & Melinda Gates Foundation Awards Three-Year, $600,000 Grant
to AIDS Vaccine Advocacy Coalition; Coalition Names New Executive
Director
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Zambian President Appoints New Health Minister, Tasks Him With Secur-
ing Cheap AIDS Drugs
Zambian President Levy Mwanawasa on Saturday appointed Brigadier-
General Brian Chituwo, who is also a doctor, as health minister and
tasked him with securing AIDS drugs for the nation at the lowest pos-
sible price, Reuters reports. "HIV and AIDS has taken away the lives
of many healthy men and women. We must step up the fight against the
pandemic. The health ministry must find life-prolonging antiretrovi-
ral drugs and get them to our hospitals," Mwanawasa, who has already
declared the disease a national disaster, said in a statement. Chi-
tuwo can expect to face some hurdles in obtaining cheaper drugs,
Reuters reports. Although Zambia has already entered into formal
price negotiations with several drug makers, the current "heavily
subsidized" $60 a month price tag is still "well beyond [the] reach"
of most Zambians. Without the government subsidy, the price would be
about $600 per patient per month. Garnering support for HIV preven-
tion programs may also prove difficult because of church objections
that condom promotion encourages promiscuity. A condom ad campaign
was called off last year after some church leaders objected. AIDS ad-
vocates hope that Chituwo will be effective because he has experience
with the military, which has an HIV/AIDS rate 20% higher than the na-
tional average of one in five adults. "As a soldier, he knows the
problem much better than everyone else. Zambia's army and the teach-
ing profession have been gravely affected by AIDS," one senior AIDS
researcher said (Reuters, 1/19).
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South African Officials React to KwaZulu-Natal's Decision to Provide
Nevirapine to HIV-Positive Pregnant Women
South African officials had mixed reactions to Monday's announcement
that KwaZulu-Natal province will defy national drug policy and supply
HIV-positive pregnant women with the antiretroviral drug nevirapine
to reduce vertical transmission of the virus, the South African Press
Association reports (South African Press Association, 1/22). KwaZulu-
Natal Premier Lionel Mtshali, leader of the Zulu nationalist Inkatha
Freedom Party-controlled province, said he made the decision to allow
the drug's distribution "on principle," adding that an HIV-positive
woman "should not have to contend with a hopeless situation of her
unborn child facing the same affliction if it can be prevented."
KwaZulu-Natal is the second South African province to make nevirapine
available; health officials in the Western Cape, which was controlled
solely by the Democratic Alliance, began distributing the drug in
2000. Although nevirapine is WHO-approved and may be able to reduce
mother-to-child HIV transmission by up to 50%, the African National
Congress, which controls "outright" the other seven South African
provinces and the national government, has restricted use of the drug
to "a few pilot sites," saying that the drug's "safety remains un-
proven" and that "inadequate structures are in place to administer
it" (Kaiser Daily HIV/AIDS Report, 1/22). National Health Minister
Manto Tshabalala-Msimang said she was "surprised" by the announce-
ment, adding that Mtshali did not consult national health officials
"as we would have expected him to do (under) section 40 and 41 of the
Constitution which binds us to cooperative governance." She said she
was not upset that she was not contacted, but noted that "consulta-
tion with the provincial (AIDS) council would have assisted (Mtshali)
to gain a better understanding of the challenges that come with the
use of this drug for reducing" vertical transmission of HIV. Tsha-
balala-Msimang said that the health department will form a policy on
nevirapine "after we have analyzed data from research and received
other information," adding, "The (policy) will be determined by the
people and not by a few doctors. I am confident that what we are do-
ing is absolutely correct."
A Welcome Change
The New National Party and the Democratic Alliance yesterday both
welcomed Mtshali's announcement. "It is now clear that the govern-
ment's defenseless policy on this issue is slowly but surely starting
to lose ground," NNP health spokesperson Dr. Kobus Gouws said (South
African Press Association, 1/22). Sandy Kalyan, the provincial
spokesperson for the Democratic Alliance, said the decision was in-
dicative of a escalating "national revolt" against the national gov-
ernment's HIV/AIDS policies. "The Democratic Alliance welcomes the
KZN government's decision ... we give them our full support, and we
are willing to provide them with any help we can from our experience
in the Western Cape," she added (South African Press Association,
1/22).
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Radio, Sporting Events and Adult Cinemas Used for AIDS Education Ef-
forts in Africa
In Africa, where knowledge about HIV transmission is low and the
stigma attached to the virus is high, public health officials and
AIDS experts are trying a variety of AIDS education methods that in-
clude radio programs, sporting events and even adult cinemas. Sub-
Saharan Africa is home to 75% of the 40 million people infected with
HIV/AIDS worldwide. Because only one in 1,440 African AIDS patients
has access to antiretroviral drugs, HIV prevention efforts "may be
the best hope" for the continent, Reuters Health reports (Mundell,
Reuters Health, 1/21). Educators are also trying to lessen the stigma
of HIV/AIDS, which is especially high in rural areas of Africa (Pit-
man, Associated Press, 1/21).
On an African Radio
Several countries have incorporated HIV/AIDS messages or plotlines
into popular radio broadcasts, figuring that listeners "prefer the
spice of romantic drama over stale lectures on HIV/AIDS." A Botswanan
radio program that debuted in August 2001 delivers AIDS messages in
the context of a soap opera-style drama that features "suspenseful
but credible stories and characters," Dr. Christine Galavotti of the
CDC's National Center for Chronic Disease Prevention and Health Pro-
motion said. A similar radio drama is also broadcast in Tanzania, and
Ethiopia is slated to begin broadcasting its own radio program in
March. Galavotti is helping establish a similar program in Zimbabwe,
where nearly two-thirds of adults and young people say they listen to
the country's main radio station at least once per week. The radio
programs in all of the countries are written and produced locally,
and some AIDS experts say that the AIDS messages are getting through
to audiences. Dr. William Ryerson, president of the Population Media
Center, said that 82% of those who listened to the Tanzanian program
said the show "caused them to adopt monogamy or use condoms to avoid
AIDS." Condom distribution increased 153% in the areas of Tanzania
where the drama was broadcast, but condom distribution rose by only
16% in areas of the country where listeners heard government-
sponsored anti-AIDS ads. The dramas' long-term effectiveness has yet
to be determined, Reuters Health reports (Reuters Health, 1/21).
Graphic Content
In Daloa, Ivory Coast, educators have chosen a different artis-
tic venue for AIDS messages: adult cinemas. Brou Barthelemi Saoure, a
local Red Cross official, is canvassing adult theaters and trying to
convince theater owners to let him hold AIDS discussions in conjunc-
tion with some adult films. Saoure said that many men visit prosti-
tutes after watching adult movies, and he wants to tell them that "if
they're going to try to do what they do in the films, then they have
to protect themselves." At one theater in Daloa, Saoure gave a half-
hour presentation on the dangers of AIDS, passed out condoms and
played an AIDS education video. For moviegoers who attended the lec-
ture, the entrance fee was waived. The HIV infection rate in Ivory
Coast is approximately 10% for people ages 15 to 49, and Saoure hopes
to bring his lectures to adult theaters across the country (Associ-
ated Press, 1/21).
Sporting AIDS Education
During the "African Cup of Nations" -- the continent-wide soccer
tournament that is Africa's largest sporting event -- soccer players
from four countries will speak about HIV/AIDS in an effort to reach
"as many young men as possible," Reuters Health reports. In the "Play
for Life" campaign, players from Mali, Nigeria, Ghana and Burkina
Faso will speak about personal "game plans" that outline their life-
style choices, which could include condom use, abstinence or monog-
amy. In addition, the team members will be available for interviews,
personal appearances and radio and television commercials that ad-
dress AIDS prevention issues. Organizers hope that the AIDS messages
will reach millions of young African men, many of whom "have not
taken even the most basic steps to reduce their risk of contracting
HIV," Reuters Health reports. "Since soccer is so popular in Africa,
it is possible to reach a wide audience of young men with a campaign
such as this," Kim Martin, a spokesperson for the Johns Hopkins Uni-
versity Center for Communication Programs, said. JHU/CCP has joined
with local nongovernmental agencies and international donors, includ-
ing USAID, to organize the event. The campaign is the latest in the
Caring Understanding Partners program, which uses sporting events to
disseminate AIDS information. The African Cup will be held from Jan.
19 to Feb. 7 (Mozes, Reuters Health, 1/22).
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Bill & Melinda Gates Foundation Awards Three-Year, $600,000 Grant to
AIDS Vaccine Advocacy Coalition; Coalition Names New Executive Direc-
tor
The Bill & Melinda Gates Foundation yesterday announced a three-year,
$600,000 grant for the AIDS Vaccine Advocacy Coalition, a consumer-
based advocacy group "working to speed development and delivery of
AIDS vaccines" throughout the world, according to an AVAC release.
"Stopping the transmission of HIV ... is the foundation's number one
global health priority. Developing a vaccine for AIDS in the near
term and focusing on prevention in the immediate term are our most
pressing and promising imperatives," Dr. Helene Gayle, a senior ad-
viser to the Gates' foundation, said, adding that "AVAC's contribu-
tion to vaccine development and delivery is critical to our continued
momentum and ultimate success."
AVAC Names New Executive Director
AVAC also named co-founder Chris Collins as its new executive direc-
tor. Collins, who previously served as a principal with the health
policy consulting firm Progressive Health Partners, said that it is
"now clear that an AIDS vaccine is possible," adding, "The question
is how soon we find it and who gets it when we do." He thanked the
Gates' foundation for its "continuing leadership on global health"
and said AVAC "look[s] forward to expanding our efforts with the
foundation's generous support" (AVAC release, 1/23).
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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. � 2002 by National Journal Group Inc. and Kaiser
Family Foundation. All rights reserved.
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