Kaiser Daily HIV/AIDS Report - Wed, 6 Feb 2002
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* President's Fiscal Year 2003 Budget Plan Includes 'Flat' Funding
for HIV Prevention Programs
* South African Medical Groups Show Support for Use of Nevirapine to
Prevent Vertical HIV Transmission, Call Denial of Drug 'Unethical'
* KwaZulu-Natal Premier Profiled
* Bush to Meet With Leaders From Three South African Nations on
Feb.26
* American Scientist Says He Will Infect Himself With HIV to Disprove
Link to AIDS
* San Francisco Chronicle Reporter Receives PAHO Award for AIDS Se-
ries
--
President's Fiscal Year 2003 Budget Plan Includes 'Flat' Funding for
HIV Prevention Programs
Although President Bush's budget proposal for fiscal year 2003 calls
for a "major increase" in spending to prevent bioterrorism, funding
will remain "flat" for a number of health programs, including HIV
prevention projects and the Ryan White CARE Act, the New York Times
reports (Stolberg, New York Times, 2/5). Bush's budget plan, unveiled
yesterday, would allocate $12.9 billion to HHS to fight HIV/AIDS in
the United States and abroad, an overall spending increase of 8% over
the current fiscal year. This funding includes:
* Vaccine and treatment research:
NIH would receive $2.8 billion for research on HIV/AIDS, a 10% in-
crease from current funding levels. Included in this allocation is
$422 million for AIDS vaccine research, a 24% increase over the pre-
vious year's funding.
* HIV prevention:
CDC would receive $939 million to fund HIV prevention programs,
"about the same" amount that was allocated this year. Of this fund-
ing, $795 million would go toward domestic prevention programs and
$144 million would go toward foreign prevention programs.
* Worldwide efforts:
HHS will dedicate $100 million this year to the Global Fund to Fight
AIDS, Tuberculosis and Malaria, bringing the United States to its
promised two-year allocation of $200 million. USAID also plans to do-
nate $100 million to fight HIV/AIDS worldwide in FY 2003.
AIDS Groups 'Disappointed'
* Human Rights Campaign:
HRC "expressed disappointment" with Bush's budget proposal, stating
in a release that the spending plan "shortchange[s]" the Ryan White
CARE Act and HIV prevention programs. "There is a greater demand for
care than ever, yet we are not providing the proper resources. People
will be hurt if the budget is not adequately funded to meet the grow-
ing need," HRC Political Director Winnie Stachelberg said, adding
that the budget cuts will most likely affect minorities. However, HRC
"applauded" the budget's call for increased spending for the HOPWA
program and AIDS research at NIH (HRC release, 2/4).
* Los Angeles Gay & Lesbian Center:
The president's budget proposal is "not prioritizing HIV/AIDS pro-
grams," an L.A. Gay & Lesbian Center release states. "On World AIDS
Day, President Bush promised to provide the necessary resources to
combat the AIDS pandemic and ensure that people living with HIV and
AIDS would receive effective care and treatment. Did the president
only mean those words on World AIDS Day? Where is it in his budget?"
L.A. Gay & Lesbian Center Executive Director Gwenn Baldwin asked. The
center adds in its release that the "lack of adequate federal fund-
ing" for ADAPs has left states "scrambling" to meet treatment demand.
The release also states that the president's $200 million allocation
to the Global Fund "still falls well below the estimated need" for
the fund (L.A. Gay & Lesbian Center release, 2/4).
* Pangaea Global AIDS Foundation:
Eric Goosby, president and CEO of the Pangaea Global AIDS Foundation,
an affiliate of the San Francisco AIDS Foundation, said, "The amount
requested by the administration for the Global Fund is woefully in-
adequate. Billions of dollars -- not millions -- are needed to ad-
dress this global crisis, and as the world's richest nation, it is
incumbent upon us to lead the way" (SFAF release, 2/4).
* San Francisco AIDS Foundation:
SFAF expressed "deep disappointment" with the president's proposal
for HIV/AIDS funding, stating that the budget plan "underfunds criti-
cal programs that are meant to address the HIV pandemic both domesti-
cally and internationally," according to a release. SFAF Director of
Public Policy Fred Dillon said, "This budget sends the wrong message
to people living with HIV/AIDS in the United States and around the
world. With unprecedented increases in the budget for military and
homeland security spending, this administration has proven that bil-
lions of dollars are available to fight present and imminent threats
to our nation. HIV/AIDS is also a global threat and deserves appro-
priate commitment and attention from this administration" (SFAF re-
lease, 2/4).
--
South African Medical Groups Show Support for Use of Nevirapine to
Prevent Vertical HIV Transmission, Call Denial of Drug 'Unethical'
The Colleges of Medicine of South Africa, the country's "leading
body" for specialist physicians, today issued a statement saying it
supports the use of nevirapine to prevent vertical HIV transmission
and that failure to provide such treatment is "unethical," Agence
France-Presse reports. "We believe it is unethical and against medi-
cal principles to withhold preventive treatment for mother-to-child
transmission of HIV," CMSA President-elect Ralph Kirsch said, adding
that the group's stance was based on "indisputable evidence" that a
single dose of the drug can "dramatically" reduce the odds of passing
the virus on to an infant. AIDS activists estimate that use of the
drug could prevent 70,000 new infections in infants each year. CMSA
also criticized the government's statements that the drug may be
toxic, saying it is unethical to "create in the minds of the public
the belief that proven effective treatment is useless or even harm-
ful" (Agence France-Presse, 2/5). The national government is fighting
a court order to provide the drug to all pregnant women served by the
national health service and has restricted use of the drug to "a few
pilot sites," saying that the drug's "safety remains unproven" and
that "inadequate structures are in place to administer it" (Kaiser
Daily HIV/AIDS Report, 1/24). CMSA said that toxic side effects are
"rare" with nevirapine and added that the cost of treatment would be
"less than the increasing burden of treating AIDS complications." The
group also came out against the government policy of penalizing doc-
tors in the national health system who administer the drug to their
patients "in the proper manner" (Agence France-Presse, 2/5). The
South African Department of Health in 1999 issued national guidelines
for post-exposure antiretroviral treatment that barred doctors from
giving the drugs in government hospital to patients who had HIV expo-
sures, including victims of rape. According to the guidelines, post-
exposure treatment should only be given to health care workers who
may have been exposed to HIV-contaminated blood on the job (Kaiser
Daily HIV/AIDS Report, 1/14). Black Armbands
Meanwhile, the South African Junior Doctors Association (Judasa) at
its annual meeting in Durban on Saturday launched a "Black Armband
Campaign," endorsed by the Treatment Action Campaign, to call atten-
tion to the "urgent need" to fight HIV/AIDS, the South African Press
Association reports. The campaign's armband, which features the red
AIDS ribbon, represents the "mourning of patients" who have died from
AIDS-related causes and solidarity with HIV-positive people, Dr. Karl
le Roux, chair of Judasa, said, adding that one of the program's
goals is to encourage doctors to gather information about HIV/AIDS
and share it with the government (South African Press Association,
2/2). "We felt it was time for doctors to speak out," le Roux said,
adding that "all doctors" were encouraged to wear the armband, which
is already being worn by several doctors in the KwaZulu-Natal prov-
ince. Le Roux has also called for a "massive AIDS awareness campaign"
and for the government to begin distributing nevirapine to HIV-
positive pregnant women to reduce the risk of vertical HIV transmis-
sion. "No honest human being can argue that (the drugs) are not ef-
fective in saving lives," le Roux said (Associated Press, 2/2).
--
KwaZulu-Natal Premier Profiled
The New York Times today profiles Lionel Mtshali, premier of South
Africa's KwaZulu-Natal province, who has ordered his government to
initiate a program to dispense nevirapine to pregnant women with HIV
in defiance of national policy. KwaZulu-Natal has the nation's high-
est HIV prevalence with 36% of adults infected with the virus. The
full article is available online (Swarns, New York Times, 2/5).
--
Bush to Meet With Leaders From Three South African Nations on Feb.26
President Bush will meet with the leaders of Angola, Mozambique and
Botswana on Feb. 26 to discuss economic and security issues, includ-
ing HIV/AIDS, Reuters reports. White House spokesperson Ari Fleischer
on Monday said that Bush "looked forward" to speaking with Presidents
Jose Eduardo dos Santos of Angola, Joaquim Chissano of Mozambique and
Festus Mogae of Botswana, calling the three men "critically impor-
tant" to the future of southern Africa (Reuters, 2/4).
--
American Scientist Says He Will Infect Himself With HIV to Disprove
Link to AIDS
Dr. David Rasnick, an American chemist who does not think that HIV
causes AIDS, and South African professor Philip Machanick have agreed
to a challenge whereby Rasnick will intentionally infect himself with
HIV to prove that it does not cause disease, and Machanick will take
AIDS drugs to prove they are not toxic, the Sydney Morning Herald re-
ports. Under the agreement, which has been fleshed out in a "heated
exchange" of letters appearing in a Johannesburg paper, Rasnick would
inject himself with HIV on television and the two would meet annually
to compare health results. However, many observers say the deal will
never come to fruition. "This is a case of two people making offers
they know it will never be possible to take up," Udo Schuklenk, a
professor of bioethics at the University of Witwatersrand, said, not-
ing that "Machanick is never going to get a doctor to prescribe him
medication for a disease he doesn't have." Machanick himself appears
to think the deal will not proceed as planned because Rasnick will
stipulate that he be injected with a "highly purified" virus, a con-
dition that is "impossible." However, Rasnick, who served on Presi-
dent Thabo Mbeki's AIDS advisory panel that failed to determine
whether the virus and AIDS are linked, said he has "nothing at all to
fear from AIDS" (Itano, Sydney Morning Herald, 2/4).
A 'Bizarre Game of Chicken'
The "only thing that could make this [challenge] any more ludicrous
would be to have Jack Kevorkian administer the medications," a Flor-
ida Times-Union editorial states, likening the contest to a "bizarre
game of chicken." The editorial concludes, "Given the seriousness and
magnitude of the AIDS problem, it would seem two highly educated peo-
ple could find a more constructive way of using their time. The los-
ers of this game are already evident" (Florida Times-Union, 1/29).
--
San Francisco Chronicle Reporter Receives PAHO Award for AIDS Series
San Francisco Chronicle reporter William Carlsen has been awarded the
"prestigious" Pan American Health Organization award for Excellence
in International Health Reporting 2001 for his two-part newspaper se-
ries on the origin of the AIDS epidemic, the Chronicle reports. Carl-
sen's story, published in January 2001, highlighted two origin theo-
ries, "each suggesting that modern medicine may have played a central
role in spreading the disease." Carlsen, who has been a writer for
the Chronicle for 22 years and is now an investigative reporter,
"took the reader on a compelling round-the-world journey in search of
the source of one of the most horrific modern scourges," Chronicle
Managing Editor Jerry Roberts said. PAHO, the oldest public health
agency worldwide, works throughout North and South America to educate
the public and fight disease (San Francisco Chronicle, 2/3).
--
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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