Kaiser Daily HIV/AIDS Report - Tue, 19 Feb 2002
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* Colin Powell, White House Defend MTV Condom Remarks in Face of Con-
servative Backlash
* South Africa's ANC-Controlled Gauteng Province to Provide Nevirap-
ine to HIV-Positive Pregnant Women in Defiance of National Policy
* Mandela Breaks Rank With the ANC, Criticizes Mbeki Again
* Libyan Trial of Health Workers Accused of Infecting Children With
HIV Folds for Lack of Evidence, Case Returns to State Prosecutors
--
Colin Powell, White House Defend MTV Condom Remarks in Face of Con-
servative Backlash
Despite criticism from conservative groups, Secretary of State Colin
Powell over the weekend defended remarks he made last week on an MTV
youth forum in which he urged condom use as a way to prevent the
spread of HIV, the Washington Times reports (Price, Washington Times,
2/18). On CNN's "Late Edition" on Sunday night, when asked by host
Wolf Blitzer if he had "second thoughts" about what he said, Powell
answered, "Absolutely not," adding, "[W]e have to do everything we
can to teach people that, if they're going to be sexually active,
they have to protect themselves." He noted that U.S. policy "starts
with abstinence ... but then condoms for the simple reason that peo-
ple are sexually active around the world. And for me to have said
anything else would have been irresponsible" (Morton/Blitzer, "Late
Edition," CNN, 2/17). Earlier that day on NBC's "Meet the Press,"
Powell "stood firmly" in support of his comments, saying, "I don't
take one step back from the remarks I made" (Washington Times, 2/18).
He added, "For us to say that we shouldn't ... encourage people to
use the protection that we know is there is irresponsible. We have a
pandemic on the face of the earth right now, raging through sub-
Saharan Africa, the Caribbean, other parts of the world, and we have
to use all the tools at our disposal ... abstinence, faithfulness,
and yes, condoms" ("Nightly News," NBC, 2/17). "I believe condoms are
part of the solution to the HIV/AIDS crisis, and I encourage their
use by young people who are sexually active," Powell said (Washington
Times, 2/18).
Conservative Criticism
Powell's original comments on MTV "irritated" some conservative
groups, who urged the White House to "repudiate" the remarks. Groups
such as the Eagle Forum and the Family Research Council said that
Powell's support of condom use "undermine[s]" the administration's
support of abstinence-based sex education. Ken Connor, president of
the Family Research Council, said, "President Bush should publicly
exhort Secretary Powell for his irresponsible remarks." James Dobson,
president of Focus on the Family, "denounced" Powell's statements,
saying, "Colin Powell is the secretary of state, not the secretary of
health. He is talking about a subject he doesn't understand. He
clearly doesn't understand the science regarding condom efficacy."
However, several lawmakers and the White House defended Powell's com-
ments. White House spokesperson Ari Fleischer said that Powell was
not advocating sexual activity among teenagers. "The president and
the secretary are shoulder to shoulder on abstinence education, as
well as health education and sex education, as a way to prevent un-
wanted pregnancies and as a way to prevent sexually transmitted dis-
eases," he said (Sorokin, Washington Times, 2/16). Sen. John McCain
(R-Ariz.) defended Powell on "Meet the Press" on Sunday, saying, "I
agree with him." He added, "I think we need to use every means possi-
ble to try to eradicate [the HIV/AIDS] epidemic that has affected
particularly Third World countries" ("Meet the Press," NBC, 2/17).
Rep. Henry Hyde (R-Ill.), a "leading pro-life" Republican, said he
had "no complaints" about Powell's comments (Washington Times, 2/18)
Editorial Support
Several newspapers have published editorials in support of Powell's
comments, including the following:
* Boston Globe: Given that the U.S. Agency for International Develop-
ment is a "leader in buying and delivering" condoms overseas to slow
the spread of disease, Powell's comments to American and interna-
tional youth are simply "what has long been official U.S. policy
abroad," the Boston Globe editorial states. The Globe concludes that
Powell's statement "would have been even better if he had combined it
with an announcement of a major increase in support" for the Global
Fund to Fight AIDS, Tuberculosis and Malaria (Boston Globe, 2/18).
* Detroit Free Press: HIV/AIDS is "impossible to cure but easy to
prevent -- but only if leaders like Powell are willing and able to
speak the truth," a Detroit Free Press editorial says. "People always
say they want politicians to talk straight," although when former
Surgeons General David Satcher and Joycelyn Elders talked "honestly"
about sex they were "quickly denounced," the editorial states. Pow-
ell, "[i]nstead of getting credit for some sorely needed leadership"
on HIV/AIDS, also was denounced by conservative groups (Detroit Free
Press, 2/19).
* Philadelphia Inquirer: Powell "deserves applause," as his comments
"served the country well" by offering an "alternative" to the "absti-
nence-only" position of the White House, a Philadelphia Inquirer edi-
torial states. However, Powell also "served his boss well by making
himself accessible to young people through a network favored by young
people," which "probably left young people ... with an improved image
of American leaders." The Inquirer concludes, "Mr. Powell rocks"
(Philadelphia Inquirer, 2/16).
* Washington Post: To prevent discussion of condom use as a way of
stopping HIV/AIDS transmission "ignore[s] the reality" and will "con-
sign young people to behavior that can take their lives," the Wash-
ington Post says. Although Powell's remarks have social conservatives
"near cardiac arrest," the editorial says that they are "needlessly
polarizing the discussion about the prevention of AIDS and unintended
pregnancies." While abstinence "should be taught," censoring "any
talk about protected sex with condoms for the sexually active is
backward" (Washington Post, 2/16).
--
South Africa's ANC-Controlled Gauteng Province to Provide Nevirapine
to HIV-Positive Pregnant Women in Defiance of National Policy
Mbhazima Shilowa, premier of South Africa's Gauteng province, yester-
day announced that his government will make the antiretroviral drug
nevirapine available to all HIV-positive pregnant women at public
hospitals in an effort to reduce vertical HIV transmission, a move
that defies national policy set forth by Shilowa's own party, the Af-
rican National Congress, AP/Newsday reports. "Our long-term objective
is to make it possible for pregnant women throughout Gauteng to ac-
cess the full package of care within a reasonable distance from their
homes," Shilowa told the opening session of the province's Legisla-
ture (Kraft, AP/Newsday, 2/18). The project will be launched on Fri-
day at the Ga-Rankuwa-Soshanguve Complex in Pretoria and will open at
eight other hospitals within the next 100 days. Shilowa noted that
the province last year outfitted 40% of its hospitals with the tech-
nology and equipment necessary to distribute the drug, saying that
the "progress and experience of the past nine months" made the expan-
sion of the project possible (South African Press Association, 2/18).
He also said that the provincial government has earmarked $2.6 mil-
lion for the project. The announcement makes Gauteng -- the nation's
wealthiest province, which includes Johannesburg and Pretoria -- one
of four districts that plan to provide the drug (AP/Newsday, 2/18).
Peter Marais, the premier of the Western Cape province, on Friday
said that his administration will continue with its plans to distrib-
ute antiretroviral drugs to HIV-positive pregnant women and rape sur-
vivors. Thirty test sites have already been established in the prov-
ince, and Marais said he has secured a free, five-year supply of
nevirapine (Associated Press, 2/15). Officials in opposition-
controlled KwaZulu-Natal, which has the nation's highest prevalence
of HIV/AIDS, and ANC-led Eastern Cape have also gone public with
their intentions to distribute nevirapine. The national government
provides the drug at 18 test sites throughout the country but has re-
fused to expand the program -- despite a court order to do so -- say-
ing that it lacks the proper health infrastructure (AP/Newsday,
2/18).
Defying National Policy
Bheki Khumalo, a spokesperson for President Thabo Mbeki, who is con-
tinually criticized for questioning the causal link between HIV and
AIDS and for calling the safety and efficacy of AIDS drugs into ques-
tion, said yesterday that Mbeki "would not comment" on Shilowa's an-
nouncement, adding, "It's something that the Health Department should
comment on, not the presidency" (South African Press Association,
2/18). The health ministry yesterday initially said that Gauteng was
"in a position to advance the [nevirapine] program within the parame-
ters set" forth at a meeting of provincial and national health offi-
cials last month (South African Press Association, 2/19). However,
the health ministry today criticized Shilowa's decision, saying it
ran "contrary to the resolution" adopted at that meeting, Agence
France-Presse reports. Health Ministry spokesperson Sibani Mngadi
said in a statement that the resolution had called for "further study
and consultation in order to formulate an appropriate response in
line with national protocols on the management of mother-to-child
transmission of HIV," and Shilowa's announcement was therefore "in
breach of that resolution, as well as earlier decisions setting out
the envisaged roll-out program based on the experience and lesson
learnt from" the 18 government test sites. Mngadi added that the
health ministry "therefore disassociates itself from Gauteng's pro-
nouncement ... based on these reasons" (Agence France-Presse, 2/19).
National Health Minister Manto Tshabalala-Msimang warned AIDS activ-
ists not to "put the cart before the horse," noting that the first
children to receive nevirapine as part of South Africa's pilot pro-
ject were only eight months old. She "impl[ied]" that four more
months of monitoring are needed, saying, "Research must inform pol-
icy" (Agence France-Presse, 2/18). But Thabo Masebe, a spokesperson
for Shilowa, said Gauteng is "not acting in defiance of national pol-
icy," adding, "The president has said when a province is ready to ex-
pand the sites, the policy will not stop them" (Agence France-Presse,
2/19). Gauteng ANC Provincial Secretary David Makhura added that the
province's "comprehensive strategy is in [the party's] view within
the framework of the national government" (South African Press
Association, 2/18). However, national ANC spokesperson Smuts Ngonyama
said the party could not yet comment on the plan and its relation to
national policy because it had not received a copy of the plan (South
African Press Association, 2/18).
Reaction
AIDS activists and opposition leaders welcomed Gauteng's announcement
Monday. Mark Heywood, secretary of the Treatment Action Campaign,
which launched the lawsuit resulting in the court order that the na-
tional government expand its nevirapine program to include all public
hospitals, said Gauteng's move was "inevitable." He added, "This dis-
ease is more and more around us and to continue to hold a policy that
bases itself on limiting medical intervention was nonsensical"
(AP/Newsday, 2/18). Jack Bloom, health spokesperson for the opposi-
tion Democratic Alliance party, said the decision was "long overdue,"
adding, "I commend Premier Shilowa for providing this clear undertak-
ing as opposed to the mixed signals from the national health depart-
ment" (South African Press Association, 2/18). The Congress of South
African Trade Unions also "welcomed" the announcement, saying that
because Gauteng is the "country's most densely populated province and
the center of [South Africa's] economic life," it is "very signifi-
cant that this important province should recognize the seriousness of
the HIV/AIDS crisis, appreciate the future cost of doing nothing
about it and decide to make antiretroviral medicines (available) to
those who need them" (South African Press Association, 2/18).
--
Mandela Breaks Rank With the ANC, Criticizes Mbeki Again
In related South Africa news, former President and ANC leader Nelson
Mandela on Sunday spoke out against the government's "lackluster" re-
sponse to HIV/AIDS, the AP/Dallas Morning News reports. "This is a
war. It has killed more people than has been the case in all previous
wars and in all previous natural disasters. We must not continue to
be debating, to be arguing, when people are dying," Mandela told the
Sunday Times of Johannesburg. Mandela "has pointedly resisted" criti-
cizing Mbeki, his successor, but Sunday's interview marked the second
time this month Mandela has criticized the government's response to
the HIV/AIDS epidemic. In a Feb. 7 speech, he called for the preven-
tion of vertical HIV transmission to be "central to any government
prevention program" (AP/Dallas Morning News, 2/18). Mandela said Sun-
day that there was no South African leader "who can boast of having
done better than ... Mbeki," but said it "is necessary to say that
there are problems which I am finding difficult to answer and I will
spell them out inside the channels of the ANC" (Agence France-Presse,
2/17). He added that he was concerned that the ANC has "stifled"
criticism of Mbeki and created a climate of "hero worship" around the
leader (McGreal, Guardian, 2/18). However, Mandela said that he has
"no doubt that we have a reasonable and intelligent government, and
that if we intensify this debate inside, they will be able to resolve
it." Mandela was set to meet with senior ANC officials yesterday to
discuss the issue further (South African Press Association, 2/17).
--
Libyan Trial of Health Workers Accused of Infecting Children With HIV
Folds for Lack of Evidence, Case Returns to State Prosecutors
The trial of six Bulgarian health workers and one Palestinian doctor
who are accused of deliberately infecting Libyan children with HIV
folded on Sunday and was sent back to state prosecutors after the
court found a lack of evidence supporting the claim that the health
workers had undermined state security, Agence France-Presse reports.
The seven health care workers are accused of deliberately injecting
393 children at a Libyan pediatric hospital with blood products in-
fected with HIV (Agence France-Presse, 2/17). Prosecutors said that
the plotted infections were "part of a conspiracy of foreign intelli-
gence forces aimed at undermining the security of Libya and its role
in the Arab world" (Kaiser Daily HIV/AIDS Report, 6/19/01). Bulgarian
officials "welcomed" the court's decision, noting that it is a sign
that the defendants will not receive the death penalty. Defense at-
torney Othman al-Bizanti said that a new trial for the health workers
will begin in one or two months, although it is not clear what
charges they will face in the upcoming case (Agence France-Presse,
2/17).
--
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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