AFRO-NETS> Kaiser Daily HIV/AIDS Report - Fri, 8 Jun 2001

[Cecilia Snyder <csnyder@ccmc.org>]

Kaiser Daily HIV/AIDS Report - Fri, 8 Jun 2001
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* Pfizer to Fund AIDS Treatment Training Clinic in Uganda
* Kenyan Parliament Considers Bill to Allow Importation and Manufac-
  ture of Generic Drugs
* Credit Suisse Subsidiary Announces First Corporate Donation to
  Global AIDS Fund
* Bristol-Myers Squibb Agrees to Purchase DuPont's Drug Business
* Editorials Reflect on 20 Years of AIDS, Look to Future of Epidemic
* AIDS 20th Anniversary Op-Eds Continue


--
Pfizer to Fund AIDS Treatment Training Clinic in Uganda

Pfizer Inc. will spend US$ 11 million for the construction and opera-
tion of a clinic in Kampala, Uganda, to train physicians in AIDS 
treatment, the physician coalition Academic Alliance for AIDS Care 
and Prevention in Africa is expected to announce on Monday, the Wall 
Street Journal reports. The clinic, slated to open late this year or 
early in 2002, will instruct 80 African physicians per year in four-
week sessions, with the health care providers expected to "spread the 
lessons to their colleagues upon their return home." Nelson Sewank-
ambo, dean of the Makerere Medical School, where the clinic will be 
located, and founding member of the coalition, said, "We will be able 
to train the physicians, nurses and hopefully laboratory technicians, 
and all this would contribute to the quality of care." The training 
will feature special emphasis on the proper use of antiretroviral 
drugs, which can be toxic or can quickly lead to resistant strains of 
HIV when used incorrectly. Such danger has fueled the reluctance of 
international drug giants to offer discounts on the drugs in Africa, 
the Journal reports. Program organizers currently are negotiating 
with other drug makers to provide medicine for the clinic. Pfizer Ex-
ecutive Vice President of Corporate Affairs Lou Clemente said, "We 
think that Pfizer and the industry should do more than provide drugs 
for free or at discounts," adding that drug firms should help "tackle 
the obstacles of infrastructure and weak medical systems." ACT UP/New 
York founder Eric Sawyer said, "While it's late in coming, it's good 
news." He noted that drug makers "have a responsibility to educate 
and train physicians and to help build infrastructure in the develop-
ing world in the same way they've done that in the United States." On 
Wednesday, Pfizer announced that it intends to expand the distribu-
tion of donated Diflucan, an antifungal medication used to treat in-
fections in HIV/AIDS patients, to approximately 40 developing nations 
(Hensley, Wall Street Journal, 6/8).


--
Kenyan Parliament Considers Bill to Allow Importation and Manufacture 
of Generic Drugs

The Industrial Properties Bill, which would allow the Kenyan govern-
ment to declare AIDS a national health emergency and waive patent 
rights to "essential drugs," was yesterday introduced in Parliament, 
along with a petition signed by 50,000 Kenyans calling for its "un-
fettered passage," the Associated Press reports. The petition, spon-
sored by the Kenyan Coalition for Access to Essential Medicines, was 
delivered to "[k]ey" members of Parliament and is part of the group's 
ongoing efforts to obtain legislative support for the bill. Activists 
and representatives of the pharmaceutical industry have been "lobby-
ing hard" on opposite sides to influence the bill, which would allow 
for the importation and manufacture of generic versions of "essen-
tial" medicines during a national health emergency. While "dropp[ing] 
their opposition to the bill as a whole," the drug companies have 
called for the inclusion of provisions to "ensure" they have the op-
portunity to match any prices offered by generic drug manufacturers 
before losing their patent rights. Activists worry that such a provi-
sion may "slow the delivery" of medications to AIDS patients. "We are 
going to use all of our power to get this bill passed as it is writ-
ten. This bill affects everybody, not just AIDS patients. It is for 
everyone who needs essential drugs," Oweno Achola, chair of the par-
liamentary committee on education, science and technology, said. 

Setting an Example

The bill would bring Kenyan law in line with World Trade Organization 
statutes regarding international intellectual property rights and 
would "comprehensively reform" the country's laws regarding business 
and international trade. It would make Kenya the second country to do 
so, behind South Africa, which faced a court battle over a similar 
law earlier this year. The Kenyan law "could set an example for other 
African nations," which must adopt WTO standards by 2006, according 
to the Associated Press. A vote is expected on the bill Tuesday 
(Tomlinson, Associated Press, 6/7).


--
Credit Suisse Subsidiary Announces First Corporate Donation to Global 
AIDS Fund

Winterthur Insurance, a subsidiary of the world's fourth-largest 
bank, Credit Suisse, will today announce a $1 million donation to the 
proposed Global AIDS and Health Fund, the Washington Times reports. 
The contribution is the first corporate donation to the fund, which 
was proposed in April by U.N. Secretary-General Kofi Annan and aims 
to amass $7 billion to $10 billion to fight AIDS, tuberculosis and 
malaria. The donation will be the "first of several contributions" 
Credit Suisse plans to make, according to a company spokesperson. Fu-
ture donations will come in the form of cash, technical assistance 
and education for the bank's corporate employees and "surrounding 
communities," the spokesperson added. Kraig Klaudt, a spokesperson 
for the World Health Organization, called the donation "hugely impor-
tant," adding that the G8 has called for the world's 1,000 leading 
corporations to donate $1 million each (Barber, Washington Times, 
6/8). 

Slow Response

Donations to the fund so far have been "slow to materialize," the 
Washington Post reports. Last month, the United States announced a 
$200 million donation for this year, and France has pledged $127 mil-
lion over the next three years. Great Britain has also promised an 
"unspecified amount." But no "major" foundation has yet made a dona-
tion, and American corporate response has been absent despite Annan's 
"personal appeal" to business leaders at the U.S. Chamber of Commerce 
last week. Despite the slow start, U.N. officials "insist" they are 
"not discouraged" and expect more donations to come after the U.N. 
General Assembly's special session on HIV/AIDS later this month and 
after next month's G8 meeting in Italy. "I think that investors, 
quite understandably, are saying, 'Let's see a little more what the 
shape of this is before we decide.' I'm pretty certain that it's go-
ing to happen, and it's going to be a serious thing," WHO Executive 
Director David Nabarro said. A Geneva meeting earlier this week -- 
which involved over 200 representatives from more than 50 countries, 
nongovernmental organizations and private foundations with an inter-
est in the fund -- represented the "most substantive move toward de-
termining the shape of the fund," the Post reports. The group recom-
mended that the fund be "operational" by year's end, but did not 
agree on how it would be administered (DeYoung, Washington Post, 
6/8).

Direction of the Fund

An ongoing debate over what direction the fund will take -- whether 
it will concentrate on prevention, treatment or a combination of both 
-- became even more "confus[ed]" yesterday after Andrew Natsios, the 
newly appointed director of USAID, said in an interview with the Bos-
ton Globe that the fund should be "devoted almost solely to preven-
tion," rather than treatment. Many Africans "don't know what Western 
time is. You have to take these (AIDS) drugs a certain number of 
hours a day, or they don't work. Many people in Africa have never 
seen a clock or a watch their entire lives," he said. The lack of 
medical infrastructure and electricity would further complicate 
treatment efforts, he said, adding that any money spent on treatment 
should go toward preventing vertical transmission and the purchase of 
anti-malarial and anti-TB drugs. His comments "rankled" activists, 
who have grown "increasingly fearful that western governments are 
balking on plans" to help pay for antiretroviral drugs. They also 
called the comments "racist." In response, a spokesperson for Natsios 
said the director would "issue a statement clarifying his position 
this morning," while Dr. Paul De Lay, USAID's chief AIDS expert, 
"backpedalled further" in an interview with the San Francisco Chroni-
cle yesterday, saying, "Care is a critical component of prevention. 
You can't do HIV prevention and counseling unless you have something 
to offer for people who are HIV positive" (Russell, San Francisco 
Chronicle, 6/8).


--
Bristol-Myers Squibb Agrees to Purchase DuPont's Drug Business

Drug manufacturer Bristol-Myers Squibb agreed yesterday to purchase 
DuPont Co.'s drug business for $7.8 billion, a deal that would boost 
Bristol-Myers' line of AIDS drugs, the Washington Post reports. Among 
other drugs, Bristol-Myers will acquire DuPont's best-selling AIDS 
drug Sustiva -- a component of some triple-combination drug therapies 
-- which garnered $386 million in sales last year for DuPont (Wash-
ington Post, 6/8). In addition, DuPont has three AIDS drugs in devel-
opment. Bristol-Myers manufactures the AIDS drugs Zerit and Videx -- 
both also drugs used in some three-drug therapies -- and also has new 
AIDS therapies under development. AIDS advocates, who plan to file a 
protest of the consolidation with the FTC, say it will lead to de-
creased competition and fuel higher AIDS drug prices. However, Bris-
tol-Myers spokesperson Charles Borgognoni said the company believes 
the AIDS drug production market will remain equally competitive fol-
lowing the consolidation. "Our perspective going into the deal is we 
don't expect there will be any overt regulatory problems," he said. 
The deal still requires regulatory approval, and is expected to be 
completed by the end of the year (Clendenning, Associated Press, 
6/8).


--
Editorials Reflect on 20 Years of AIDS, Look to Future of Epidemic

Newspaper editorials reflecting on the 20th anniversary of the first 
report of HIV/AIDS in the media continue to appear across the coun-
try. Excerpts of some of these editorials are outlined below:

* Boston Globe: The Globe states, "The enormous numbers of sick and 
dying can sometimes obscure the truth -- that it is possible to con-
tain AIDS, if not to cure it." The editorial suggests, "A key step 
toward prevention is HIV testing. In some countries HIV tests are not 
administered until a person is already showing symptoms of the dis-
ease -- too late for most treatments and far too late for the others 
that person may have infected." The Globe says, "The stigma and su-
perstition that still accompany the disease must be lifted." The edi-
torial also calls for a fight against "complacency and 'compassion 
fatigue'" and criticizes the refusal of some Massachusetts communi-
ties to approve needle-exchange programs (Boston Globe, 6/6).

* Syracuse Post-Standard: "While the AIDS pandemic runs riot in the 
developing world, where more costly medical therapies are not avail-
able, the "good news" in the United States has created its own mon-
ster: complacency," the Post-Standard states. A rise in HIV infec-
tions "doesn't have to happen. Painful years have provided clear les-
sons in what works, the editorial adds, endorsing "frank" sex educa-
tion and needle-exchange programs (Syracuse Post-Standard, 6/6).

* Toronto Globe and Mail: "At first glance, any optimism [about 
HIV/AIDS] might seem wildly at odds with reality," the Globe and Mail 
states. However, Stephen Lewis, the newly appointed U.N. special en-
voy for HIV/AIDS in Africa, "perceives glimmers of real light. One 
critical question is whether the rich countries of the world, Canada 
included, are willing to see it and act on it. They have every reason 
to do so." The paper adds, "[S]ince the spread of AIDS is inextrica-
bly linked to the poverty that underlies it, Canada's contribution to 
the battle should surely be increasing." However, the editorial notes 
that Canada does not finance any international AIDS research, and 
that the percentage of the country's GNP going toward foreign aid has 
decreased by about half. "Mr. Lewis, of whom Canada should be proud, 
believes that AIDS has evolved into a global crisis in which we all 
have a stake. If we agree, we should put our money where our mouth 
is," the editorial concludes (Toronto Globe and Mail, 6/7).


--
AIDS 20th Anniversary Op-Eds Continue

Columnists and op-ed writers from around the world have continued to 
reflect on the AIDS epidemic this week, 20 years after the first me-
dia reports on the disease. Summaries of some of the opinion pieces 
appear below:

* "Look to Darwin for Reality Check on AIDS": "When AIDS erupted 20 
years ago, politics was not far behind. ... Yet, AIDS is ultimately 
not political; it is viral. It is subject to the laws of nature, not 
human society. And so while AIDS may someday be cured, the Darwinian 
reality underscoring all natural phenomena will continue to flummox 
both liberals and conservatives," James Pinkerton writes in his News-
day column. "The AIDS virus, like everything else in the natural 
world, is constantly evolving and adapting. And that spells trouble 
for political ideologies," he continues. "Although some on the right 
still cling to Biblical creationism and decry the evolutionary theo-
ries of Charles Darwin, only the full acceptance of Darwinian biology 
-- past, present and future -- offers the hope that scientists will 
be able to keep pace with the ever-mutating AIDS virus," he states. 
"And for many on the left, disturbed by the full implications of that 
same Darwinian theory, the realization must come that nature, and its 
subset, human nature, presupposes endless competition, not egalitar-
ian cooperation," he continues. "The moral of this story is this: Not 
every technological solution to the dreads of nature will succeed. 
And that's a larger reality that should keep everyone -- right, left 
and center -- feeling small and humble," he concludes (Pinkerton, 
Newsday, 6/7).

* "Turn Despair to Hope": "The fight against AIDS is everywhere bur-
dened by taboos," Bob Herbert states in his "In America" column in 
the New York Times. "The tragic head-in-the-sand responses of some 
leaders in China, Africa and elsewhere are not uncommon. Fear, igno-
rance, poverty, shame and, to a large extent, the inability of most 
of us to grasp the enormity of this disaster are all standing in the 
way of effective action against AIDS," he continues. "Myriad taboos 
will have to be overcome, and alliances will have to be forged" be-
tween wealthy and developing nations to combat the epidemic, he 
states. Providing treatment is "[o]ne of the ways to break through 
the stigmas" of HIV/AIDS. HIV diagnosis in countries with little or 
no access to anti-AIDS medications is the "equivalent of a death sen-
tence," he states, adding that it gives people "very little incentive 
to learn" their HIV status. Although money is "desperately needed," 
it "won't be enough," he continues. "What's really needed are ade-
quately financed partnerships that span the globe, are based on mu-
tual respect and are committed to the very difficult long-term task 
of fighting the disease," he states. "We are in the early stages of 
an unprecedented threat to the health of the human species. The long 
dark night of AIDS has just begun," he concludes (Herbert, New York 
Times, 6/7).

* "Why is the Media Dropping the Ball on AIDS Orphans?": Albina du 
Boisrouvray, president of the Francois-Xavier Bagnoud Foundation and 
Association, which currently has AIDS projects in 13 developing coun-
tries, states in a Mediachannel.org op-ed that she has been "fighting 
an uphill battle to interest news organizations in the plight of ... 
children orphaned by AIDS" only to be met with "indifference." Much 
of the media has "shamefully .. refused to sound the alarm and crank 
up its megaphone" regarding the issue, she continues, citing a nine-
month study by the media monitoring organization Media Tenor, which 
found that only 0.06% of 13,237 media reports in 2000 "focused on 
AIDS." The report also found that those reports that did take up the 
issue focused on men three to one over women, despite a "nearly equal 
global infection rate" between the genders. "[W]hat's true of cover-
age of the whole epidemic is especially true of AIDS orphans," whom 
du Boisrouvray calls "voiceless and ignored." She cites an FXB press 
conference two weeks ago in Washington, D.C., where only four of 12 
news organizations that pledged to attend showed up. Among the broad-
cast news outlets, only BET and the PBS Newshour attended. "Media 
coverage is essential to galvanizing public attention and concern ... 
Only intensive and continuing media coverage will heighten awareness 
and action," she concludes (du Boisrouvray, Mediachannel.org, 6/5).

* "Twenty Years of AIDS -- and Counting": "[N]one of us involved in 
those early days of AIDS could have imagined the scale of the epi-
demic that has unfolded. It is a tale of globalization: of the rapid 
global spread of a mainly sexually transmitted virus, of global iniq-
uities in health and of the need for a truly global response and so-
lution," Peter Piot, director of UNAIDS, states in a Bangkok Post op-
ed. And because of the latent nature of HIV, "it is a tale that is 
still in its opening chapters," he continues. "But that does not mean 
that we have no choice but [to] succumb to an inevitably growing toll 
of the disease. The opposite is true," he states. A meeting last 
month of 30 "leading" AIDS researchers and policymakers led to five 
major conclusions, Piot states. First, "investment now will prevent 
tens of millions of new infections and extend the lives of millions 
already living with HIV," he states. Second, "special recognition of 
the needs of young people maximizes the effectiveness and impact of 
prevention." Third, prevention, medical treatment and "social support 
are all critical components of effective responses," he continues. 
Fourth, a "beginning can be made" with regard to antiretroviral ther-
apy, even though the cost of the drugs remains high. And fifth, "po-
litical commitment and planning" already exist in many places, ena-
bling programs to be built upon existing models. "What they lack are 
the resources," he states. The global AIDS trust proposed by U.N. 
Secretary-General Kofi Annan will fill that "gap," he continues. "For 
the first time in the history of this epidemic we have the opportu-
nity to turn the tide on a truly large scale -- the scale that 
matches the extent of the epidemic ... We know what we need to do to 
slow new infections and provide care for those who are ill. The only 
question .. is whether we have the will to do it," he concludes 
(Piot, Bangkok Post, 6/6).

--
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.

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