AFRO-NETS> Kaiser Daily HIV/AIDS Report - Fri, 29 Jun 2001

[Cecilia Snyder <csnyder@ccmc.org>]

Kaiser Daily HIV/AIDS Report - Fri, 29 Jun 2001
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* U.N. Special Session on HIV/AIDS Provides African Nations with 'New 
  Determination' to Fight the Disease
* Kaiser Daily HIV/AIDS Report Rounds Up Commentary on U.N. Special
  Session, Other AIDS-Related Issues


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U.N. Special Session on HIV/AIDS Provides African Nations with 'New 
Determination' to Fight the Disease

While the U.N. General Assembly special session on HIV/AIDS included 
three days of "tumultuous meetings," when the conference ended 
Wednesday, African leaders -- "often at odds and sometimes at war" -- 
had "come together to dominate the session" with a "markedly new de-
termination to fight the disease that has decimated their homelands," 
the New York Times reports (Crossette, New York Times, 6/28). The 
Wall Street Journal also reports that the fight against HIV/AIDS has 
provided African governments with "an opportunity to pull themselves 
together in ways that could some day lift them" out of an economic 
"rut" (Phillips, Wall Street Journal, 6/28). African leaders and in-
ternational health experts said that the U.N. session on HIV/AIDS, as 
well as a "summit-level meeting" of Africans in April, has helped 
halt efforts from some leaders to "obscure mounting evidence that 
AIDS was spreading rapidly." In addition, the meetings have provided 
African leaders with "numerous proposals" for fighting HIV and "tak-
ing a new look at shortcomings in national development" (New York 
Times, 6/28). Western nations' foundations and companies "are getting 
out their checkbooks" for the Global AIDS and Health Fund, in hopes 
of raising $7 billion to $10 billion a year to combat AIDS, malaria 
and tuberculosis in developing nations, the Journal reports. However, 
a "panel of experts" will "pass judgment on each expenditure," which 
will require African nations to "do something they haven't done much 
recently" -- develop and enact health programs "quickly, efficiently 
and honestly" (Wall Street Journal, 6/28). Mark Malloch Brown, admin-
istrator of the U.N. Development Program, said that the global AIDS 
fund will put African nations and donors "out on a long limb" (New 
York Times, 6/28). While Malloch Brown predicted that the global AIDS 
effort would "succeed," the Journal asks, "[W]hat if African govern-
ments ... fritter away huge sums through corruption and clumsiness?" 
Malloch Brown answered that the region would become a "pariah for do-
nors" (Wall Street Journal, 6/28).

The Annan Factor

U.N. Secretary-General Kofi Annan, who organized the global AIDS 
fund, has led a campaign to "raise the consciousness" of Africans on 
a number of trips and in reports. He has "spoken out against stigma-
tization and denial in dealing with AIDS" and has urged African gov-
ernments to "make themselves attractive to investors rather than 
blaming the global economy for all their economic ills." Gro Harlem 
Brundtland, director-general of the World Health Organization, said 
that "rising international attention to Africa," including campaigns 
for less-expensive AIDS drugs, debt cancellation and "significant aid 
to weak public health systems," has also buoyed African efforts. In 
addition, she said that the "falling price" of "vital" drugs has 
"given many African health officials new hope," pointing out that re-
cent meetings on AIDS have "elevated" the disease to an issue of na-
tional security and forced government leaders to recognize the "im-
portance of the disease." Still, several African leaders pointed out 
that "huge obstacles" remain.

Where's Thabo?

Meanwhile, the Times reports that "missing from this united effort 
and open debate was President Thabo Mbeki of South Africa," the na-
tion with the largest HIV-infected population. According to the 
Times, his "absence was widely noticed and described as inexplica-
ble." Mbeki sent South African Health Minister Manto Tshabalala-
Msimang to the special session. In a speech, Tshabalala-Msimang "al-
luded" to Mbeki's "questions about what causes AIDS and whether pri-
ority should be given to antiretroviral drugs in dealing with the 
epidemic." Doctors Without Borders founder Bernard Kouchner, minister 
of health in France, said that "intellectual resistance to what are 
seen as western prescriptions is not new" and he predicted that the 
"controversy generated by Mbeki will fade" (New York Times, 6/25). 


--
Kaiser Daily HIV/AIDS Report Rounds Up Commentary on U.N. Special 
Session, Other AIDS-Related Issues

In newspapers throughout the country, editorials and op-eds continue 
to comment on the U.N. General Assembly special session on HIV/AIDS 
and other AIDS-related issues. The following is a summary of the com-
ments, arranged by the day of the week the article appeared.

Monday

* New York Times: "The world cannot underestimate the threat of AIDS, 
but it would be equally wrong to fall into despair," U.N. Secretary-
General Kofi Annan writes in a New York Times op-ed. He states that 
the world has "more reason for hope [now] than we have had in the 
last 20 years" because "poor and middle-income countries" can imple-
ment prevention and treatment strategies and political leaders in Af-
rica have "faced up to the problem as never before." Annan concludes 
that the "proper strategy" for attacking HIV/AIDS includes prevention 
strategies, treatment for HIV-positive people, more HIV testing, ad-
ditional research to find AIDS vaccines and "protection" for children 
orphaned by the epidemic (Annan, New York Times, 6/25).

Tuesday

* Washington Post: "We all have AIDS. ... The earth has AIDS," Donald 
Berwick, president and CEO of the Institute for Healthcare Improve-
ment, writes in a Post op-ed. Berwick states that no lines should be 
drawn between some members of the population and others, saying that 
because AIDS affects a portion of humanity, it ultimately affects the 
entire human race. He writes, "Successful, life-prolonging management 
of HIV infection is not simple. ... But it is a mistake to ignore the 
role of medications." He adds that the world "needs free anti-AIDS 
medicines," and calls on the heads of pharmaceutical companies to 
provide them. "The devastated nations of the world need AIDS medi-
cines at no cost at all, or, at a bare minimum, medicines available 
at exactly their marginal costs of manufacture, not loaded at all 
with indirect costs or amortized costs of development," he writes, 
adding that drug company executives could realize this in "one simple 
action." He states, "No one could stop them; none would dare try. For 
the small profit they would lose, they would gain the trust and 
gratitude of the entire world" (Berwick, Washington Post, 6/26).

* Guardian: The "concept" of the global fund is "inherently flawed" 
because "a global fund would need to be channelled through a new, 
top-heavy global administration, [while] the key to tackling HIV/AIDS 
in poor countries is to start at the bottom, not the top," Mark Cur-
tis, director of policy for Christian Aid, writes in a Guardian op-
ed. In addition, the global fund is "a distraction from addressing 
the poverty upon which HIV/AIDS thrives," he writes. He concludes, 
"If the global fund gets the go-ahead in New York, in all probability 
it will prove to be yet another false dawn for the poor. In the mean-
time, leaders at the U.N. meeting will enjoy the kudos of being seen 
to be doing something about AIDS. In truth, however, they will be 
dressing the window without stocking the shop" (Curtis, Guardian, 
6/26).

* USA Today: The Global AIDS and Health Fund allocates a large chunk 
of funding toward providing anti-AIDS medicines to HIV-positive peo-
ple in African nations, but the lack of doctors and nurses in African 
nations and other problems with the health care infrastructure on the 
continent will hamper efforts to deliver these drugs, a USA Today 
editorial states. The editorial says that "none" of the money pledged 
for the fund is earmarked for health care infrastructure, adding that 
without such infrastructure, AIDS drugs "can't get to patients." The 
editorial concludes, "[U]ntil donors tackle the fundamentals of 
building clinics and training staff, the AIDS juggernaut will thunder 
on" (USA Today, 6/26).

* Chicago Tribune: A Chicago Tribune editorial states that efforts to 
discuss AIDS prevention strategies become "bog[ged] down in the dis-
ease's connection to sex and drug addiction, topics that unnerve some 
people." The editorial concludes, "[I]f [health officials] can't even 
talk about [AIDS] openly, how are these countries or the United Na-
tions ever going to devise an effective battle plan against the dis-
ease?" (Chicago Tribune, 6/26).

Wednesday

* San Francisco Examiner: The Bush administration, "holding hands 
with the pharmaceutical industry," has "floated a smokescreen over 
the U.N. special session on the global AIDS crisis that clouds the 
economic and medical issues of staggering death in Africa," San Fran-
cisco Examiner Associate Editor Warren Hinckle writes in an op-ed in 
that paper. The global fight against AIDS is "degenerating into a fa-
miliar set piece of the haves versus the have nots," with the goal of 
raising $10 billion for the Global AIDS and Health Fund "already 
melting like an ice cream in the summer New York heat." Hinckle 
writes that Henry McKinnell, who was a "point man" on the U.S. dele-
gation to the conference and also the chair of PhRMA and CEO of 
Pfizer, stated that Africa does not have the infrastructure to admin-
ister AIDS medications to its HIV-positive population. Hinckle notes 
that the "Bush administration's push on AIDS is to emphasize far 
cheaper 'prevention' policies," adding that "[i]f the infrastructure 
doesn't exist to take a pill, it doesn't exist to teach about con-
doms." Hinckle concludes, "Maybe ... Bush and big pharma don't want 
to get the drugs there at all" (Hinckle, San Francisco Examiner, 
6/27).

Thursday

* Wall Street Journal: The economic and human "toll of AIDS on sub-
Saharan Africa is at once incomprehensible and chilling," but "ges-
tures" such as those made at this week's General Assembly session 
"will not affect the spread of the disease in Africa," George Ayit-
tey, a professor at American University and president of the Free Af-
rica Foundation, writes. Ayittey states that the Declaration of Com-
mitment drafted at the conference is "an essentially rhetorical docu-
ment" and the money pledged by governments and corporations may 
"merely [be] the expression of good intentions" and may not ever ma-
terialize. He states that African governments and AIDS activists 
should not focus on "pressur[ing]" pharmaceutical companies to pro-
vide cheaper AIDS medicines, since African health care infrastruc-
tures are not adequate to deliver them. He concludes that the tactic 
of concentrating on gaining discounts for AIDS drugs "not only dis-
tracts attention from the delivery and prevention aspects of combat-
ing the disease, but also shields African governments from responsi-
bility for its lightning, and lethal, spread" (Ayittey, Wall Street 
Journal, 6/28).

* Hartford Courant: "If lives are to be saved, it will take unprece-
dented cooperation among governments, foundations, civil society and 
industry to agree on priorities, strategies and specific goals" for 
fighting HIV/AIDS in the developing world, Michael Merson writes in a 
Hartford Courant op-ed. Merson, dean of the Yale University School of 
Public Health and former director of the World Health Organization's 
Global Program on AIDS, states that to tackle the epidemic, all in-
volved must develop new prevention methods, such as microbicides and 
vaccines, promote sexual equality and commit "resources of an unpar-
alleled scale" (Merson, Hartford Courant, 6/28).

* Newsday: Although delegates at this week's U.N. conference agreed 
to drop language referring to homosexuals, intravenous drug users and 
prostitutes as "vulnerable" populations, "[a]ll societies have wres-
tled with ... questions" of morality and sexuality, Newsday columnist 
Joseph Dolman writes in an op-ed. He states, "In the end, the diplo-
mats wisely decided to punt on a few crucial issues in an otherwise 
fine document" (Dolman, Newsday, 6/28).

*Washington Times: "[W]hatever money is given to Africa [to fight 
HIV/AIDS] must be allocated with care, and there are many necessary 
prerequisites to obtain that aid," a Washington Times editorial 
states. The editorial says, "Funding to Africa is necessary and ur-
gent. However, it must follow the lead of governmental and cultural 
reform. Wars must end, infrastructures must be built and attitudes 
must change. Then, as a joint effort, real progress can be made" 
(Washington Times, 6/28).

* Orlando Sentinel: Colin Powell's promise to increase the United 
States' contribution toward the Global AIDS and Health fund was a 
"welcome" announcement, an Orlando Sentinel editorial states. Such 
support by political leaders is important in fighting the epidemic, 
the editorial says, adding, "Short of a cure, the best chance that 
people have against AIDS lies in the efforts of political leaders and 
others to educate. They must do a better job" (Orlando Sentinel, 
6/28).

Friday

* Guardian: In a letter to the Guardian, Mark Curtis of Christian Aid 
writes that world governments should dedicate 0.7% of their Gross Na-
tional Products to "combat" HIV/AIDS. The priorities of these re-
sources should be to "strengthen health systems" and "support local 
... care and prevention programs." Noting that the United Kingdom 
will donate to the global health fund, Curtis writes "the world's 
HIV/AIDS sufferers need more than giant PR exercises" (Curtis, Guard-
ian, 6/29).

* Philadelphia Inquirer: In an Inquirer column, Trudy Rubin writes 
that the special U.N. assembly on AIDS should have been held in Bra-
zil, because it is the "only developing country that has found a suc-
cessful formula to combat the AIDS menace." Infection rates in Brazil 
are below predictions due to three principles: "committed" political 
leadership, "heavy" involvement of civic and community groups and 
"cheap" HIV/AIDS medication. However, because Brazil has a public 
health system, such a "model may be out of reach" for Africa. Until 
African nations develop a public health system, they can "adopt Bra-
zil's first two principles of top-down, bottom-up leadership to push 
prevention and develop a health network." Rubin concludes, "Without 
such leadership, no amount of cheap drugs will do any good" (Rubin, 
Philadelphia Inquirer, 6/29). 

* Washington Times: In his Washington Times column, Wesley Pruden 
writes than the U.N. declaration on AIDS is a "high-sounding" decree 
on a disease that has killed 22 million people worldwide, a number 
"dwarfed by [those] taken by cancer and heart disease." Pruden writes 
that the United Nations is "trying to ... reprise the hysteria of a 
decade ago when, we were confidently told, everybody would be dead by 
now." In describing the media coverage and activist commentary on the 
disease, Pruden says, "It was a civic duty to regard smoking as a 
form of suicide, but mean and hateful to warn that sodomy was folly." 
Now that AIDS is again being described as a "Holocaust," Pruden con-
cludes, "AIDS is a horrific disease, and Africa needs a lot of help 
from grown-ups. But it doesn't need the hysteria" (Pruden, Washington 
Times, 6/29).

* Newark Star-Ledger: The "commitment" made by the nations that at-
tended the U.N. special session to "fight" HIV/AIDS will be a "waste 
of words" unless the wealthy countries of the world, "particularly 
the United States, provide the funding to put the plan to work," a 
Star-Ledger editorial states. In addition to the "humanitarian call" 
to fight HIV/AIDS, the editorial says that the disease has the "po-
tential" to cause "economic and political chaos." As HIV/AIDS is be-
coming the "great moral challenge of our age," the "first steps" 
against the disease will require funding. Noting that the House In-
ternational Affairs Committee has worked out a plan to spend more 
than $1.3 billion on a variety of HIV/AIDS initiatives, the editorial 
concludes: "Congress and the President must make good on the pledge. 
And the world will be grateful if they do" (Newark Star-Ledger, 
6/29). 

* New York Daily News: Although the United States has already pledged 
"millions" to fight HIV/AIDS in Africa, "without even more aid, Af-
rica will be decimated" by the disease, a Daily News editorial says. 
While "commend[ing]" the United Nations for "confronting this 
scourge," the editorial concludes: "While some are still in denial 
about AIDS' global reach, the numbers of dead, dying and infected do 
not bode well for Africa, or the world. Africa must have resources to 
fight this war" (New York Daily News, 6/29). 

* Wall Street Journal: Western nations and the United Nations do "no 
favors" for Africa by not discussing the "root cause" of HIV/AIDS 
transmission in Africa, which is "almost entirely the result of prom-
iscuity," a Journal editorial states. The editorial says, "If you 
have relations with only one healthy partner, you don't get sick. 
This awkward fact makes everybody concerned with Africa's AIDS epi-
demic squeamish." Noting that the disease in America's gay community 
was "curtailed" by "individual self-control and plenty of latex," the 
editorial says that "Africans can avoid HIV" without money from the 
West or condoms. "It just takes sexual fidelity," the editorial says. 
The editorial concludes that "personal responsibility ... will save 
more lives in Africa than an oil tanker's worth of antiretrovirals" 
(Wall Street Journal, 6/29).

--
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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