AFRO-NETS> Kaiser Daily HIV/AIDS Report - Wed, 4 Apr 2001

[Cecilia Snyder <csnyder@ccmc.org>]

Kaiser Daily HIV/AIDS Report - Wed, 4 Apr 2001
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* Sachs to Announce Plan for 'Massive New Effort' Aimed at Fighting
  AIDS in Africa

* Conference to Address Children Orphaned by AIDS Begins in Uganda


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Sachs to Announce Plan for 'Massive New Effort' Aimed at Fighting 
AIDS in Africa

Harvard economist Jeffrey Sachs is expected to announce today an "un-
precedented" coordinated effort to combat AIDS in Africa, the Phila-
delphia Inquirer reports. The United Nations, U.S. government offi-
cials, the European Union, African governments, the World Health Or-
ganization, the World Bank, pharmaceutical companies and private 
foundations, such as the Bill and Melinda Gates Foundation and the 
Rockefeller Foundation, have been discussing the plan -- which calls 
for US$ 6 billion a year from industrialized nations -- "privately 
for months," the Inquirer reports. Nearly half of the money raised 
would go toward the purchase of antiretroviral medications for more 
than 10% of the estimated 25.3 million HIV-positive Africans, while 
the rest would be used to "greatly accelerate" HIV prevention pro-
grams in Africa. Drugs would be "carefully" distributed using the 
continent's existing medical infrastructure and possibly a network of 
HIV prevention trial sites recently established by the National In-
stitute of Allergy and Infectious Disease, the agency responsible for 
coordinating AIDS trials in the United States, in South Africa, Zam-
bia, Zimbabwe, Malawi, Tanzania and Uganda. Drug therapies would also 
be "closely monitored," most likely using a system of "direct[ly] ob-
served therapy," which involves volunteers visiting patients at home 
to observe them taking their medications. The "proposed assault" on 
AIDS would be the largest campaign ever waged against a single dis-
ease anywhere in the world and would also include plans for improving 
treatment of tuberculosis and malaria. Today's announcement by Sachs, 
who is director of the Harvard Center for International Development 
and a consultant to the project, will offer the first details of the 
program, including the estimated number of Africans who will receive 
medication, the cost of the plan and the size of donations needed to 
subsidize the proposed programs. 

U.S. Involvement

The announcement is also "aimed at influencing the Bush administra-
tion to take the lead" in supporting the effort. It "remains to be 
seen" whether the administration will fully support the effort, but 
the Inquirer reports that Secretary of State Colin Powell is said to 
be "receptive to the relief program." The needed U.S. contribution is 
projected to be about US$ 2 billion a year, well above the current 
US$ 260 million the government currently spends on AIDS in Africa. 
Most of that money goes toward HIV prevention efforts and care of 
people affected by the epidemic, such as AIDS orphans. "Almost none" 
goes toward the purchase or distribution of antiretroviral medica-
tions. Sen. Bill Frist (R.-Tenn) is working on a budget amendment to 
increase U.S. funding for African AIDS programs, but does not cur-
rently have a dollar amount. "The U.S. will come in strongly and 
rightly. The current line they are taking is absolutely right. They 
are giving warm encouragement and waiting to see what will happen," 
an unnamed WHO official said. Italy and Great Britain have already 
come out in favor of an international fund for AIDS medicines. U.N. 
officials hope to have "specific financial commitments" from the 
United States and other G7 nations by their July meeting in Italy.

Why Now? What's Changed?

The new proposal was made possible by the recent price reductions 
from the world's major pharmaceutical companies, according to the In-
quirer. The price cuts have turned what was once thought to be "hope-
less" into a "do-able, if ambitious, treatment effort," the Inquirer 
reports. Most patients will be given a three-drug combination ther-
apy, projected to cost US$ 500 per patient annually. U.N. agencies 
have reached a "consensus" that in exchange for the price reductions, 
the pharmaceutical industry's patent rights will be protected in 
their "core markets" in the West. The plan now hinges on funding. 
"The beginning and end of this is U.S. money. The drug companies are 
not going to solve the problem on their own. This has finally come 
down to the bottom line of whether the taxpayers will help do that," 
Sachs said last week. The consortium hopes to have a "concrete plan" 
prepared in time for the U.N. General Assembly's special session on 
the AIDS epidemic at the end of June (Collins/Warner, Philadelphia 
Inquirer, 4/4).


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Conference to Address Children Orphaned by AIDS Begins in Uganda

The Eighth International Society of Women and AIDS in Africa Confer-
ence (SWAA) began Monday in Kampala, Uganda, with this year's summit 
focusing on children orphaned by the epidemic. Titled "Children and 
AIDS: Challenges and Strategies to Cope," the five-day conference 
will examine the epidemiology of HIV in children, the reduction of 
mother-to-child transmission, health care for HIV-positive children, 
"child-headed households" and social support systems for children af-
fected by the virus (Agence France-Presse, 4/3). Conference Chair Dr. 
Margaret Muganwa said, "The conference is a call for Africa to under-
take a critical appraisal of its HIV/AIDS priorities and re-focus in-
terventions and strategies to stop HIV/AIDS among and on behalf of 
our children, the next generation" (Muganwa speech, 4/2). Col Sec, 
director of country and regional support for UNAIDS, added, "There 
are orphans on [the] streets, orphans only with one parent, or or-
phans who are heading households. All this is really a disaster." Sec 
said that many orphans become "vulnerable to infection" as a result 
of sexual abuse, others "suffer from neglect" after their parents 
die, and some can "find themselves living with already over-burdened 
relatives." Janet Museveni, wife of Ugandan President Yoweri 
Museveni, opened the conference. Tanzanian first lady Anna Mkapa and 
Nigerian first lady Stella Obasanjo are also attending the event 
(Agence France-Presse, 4/3).

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Cecilia Snyder
mailto:csnyder@ccmc.org

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