AFRO-NETS> Kaiser Daily HIV/AIDS Report - Mon, 2 Jul 2001

[Cecilia Snyder <csnyder@ccmc.org>]

Kaiser Daily HIV/AIDS Report - Mon, 2 Jul 2001
----------------------------------------------

* Kenyan President Seeks Death Penalty for Those Who Knowingly Trans-
  mit HIV
* South African Health Minister Stressed Poverty Issues at U.N. Spe-
  cial Session
* Libyan Trial of Bulgarian Health Workers Ends; Defendants' Wit-
  nesses, Expert Testimony Not Permitted
* South African Woman Sues Drug Firm, Claiming Antiretroviral Caused
  Husband's Death
* U.N. Foundation Creates Account for Individual Donations to Global
  AIDS and Health Fund


--
Kenyan President Seeks Death Penalty for Those Who Knowingly Transmit 
HIV

Kenyan President Daniel arap Moi has "demanded" that people who 
"knowingly" transmit HIV to others receive the death penalty, Phila-
delphia Inquirer reports (Philadelphia Inquirer, 7/2). Moi's proposal 
that those who knowingly infect others with the virus be hanged drew 
"mixed reactions" from women's groups and church leaders. The Federa-
tion of Women Lawyers called on Attorney General Amos Wako to "incor-
porate" the proposal into the 2000 Criminal Law Amendment Bill, along 
with "stiffer" penalties for rapists and "'adequate' legal deterrents 
for potential rapists." Executive Director Jane Kiragu called the 
president's proposal "timely," adding that it gives "renewed momen-
tum" to the nation's fight against HIV/AIDS. However, Dr. Newton Ku-
lundu, chair of the parliamentary committee on health, "cautioned" 
that although the president's "apparent enthusiasm in protecting peo-
ple against HIV/AIDS is welcome," it could lead to the "vic-
timiz[ation] of innocent people." Kulundu explained that with regard 
to HIV transmission, "it becomes very difficult to scientifically 
prove who infects the other." Religious leaders objected to Moi's 
plan, citing religious opposition to capital punishment. Bishop John 
Njue, chair of the Kenya Episcopal Conference, said, "Hanging is not 
a solution. People should be encouraged to lead conscientious lives," 
adding that people should "respect the dignity of others." Njue said 
that the church opposes all forms of capital punishment. The proposal 
came after the opposition Forum for Restoration of Democracy called 
on Moi to be "more vigilant" in the fight against HIV/AIDS and asked 
that he "intervene and insure speedy disbursement" of funding for 
"grasssroots" campaigns against the disease (BBC Monitoring/Daily Na-
tion, 7/2).


--
South African Health Minister Stressed Poverty Issues at U.N. Special 
Session

South African Health Minister Manto Tshabalala-Msimang said Friday 
that her country succeeded during the U.N. General Assembly special 
session on HIV/AIDS in "getting the world community to recognize the 
crucial role" that poverty plays in the spread of HIV in Africa, 
Reuters reports. Tshabalala-Msimang said that the nations of the 
South African Development Community "highlight[ed] issues of poverty, 
underdevelopment and illiteracy." During the conference, the United 
Nations General Assembly approved a "detailed blueprint" that sets 
"timetables for countries to devise and implement strategies for edu-
cation, prevention, treatment and a network of care programs," espe-
cially for orphans. "We believe that our input has contributed to 
shaping a global response that is relevant to the social conditions 
in most affected countries," she said (Reuters, 6/29).

Will Wait for 'Western Style' Treatment

Tshabalala-Msimang also "surpris[ed] AIDS doctors and activists in 
her own country" by saying that South Africa "will not provide AIDS 
drugs in public hospitals unless [the country] can provide exactly 
the same standard of care as offered in Western nations," the Wall 
Street Journal reports. During an interview in New York last week, 
Tshabalala-Msimang cited "a lack of infrastructure" in rural areas 
and "maintained that the drugs and associated costs of monitoring pa-
tients were simply unaffordable." The Journal reports that "[a]s the 
price of AIDS drugs has fallen, the cost of monitoring treatment 
looms as one of the largest financial barriers to treating AIDS pa-
tients in poor countries." Tshabalala-Msimang said, "Given the budget 
I have, there is no way that we can have the widespread scale of ad-
ministering antiretrovirals," adding, "We cannot apply substandards 
when it comes to our country ... We must exactly apply the same stan-
dards in the developing countries." For example, she explained, it is 
standard procedure in the United States to administer a viral load 
test when prescribing medication. But the $100 cost of the test is 
unaffordable for doctors and patients in many countries, and drugs 
are prescribed without using the test. "I would find it very unethi-
cal and morally very difficult for me to give a person medicine and 
then I'm not able to detect whether I am bringing down the viral load 
[or] whether I am increasing it," she said. However, Peter Mugyenyi, 
a Ugandan physician who runs the Joint Clinical Research Centre in 
Kampala, said that the response of patients that he is treating with 
medication and without the test "is excellent -- as good as those 
getting viral-load monitoring." He said, "It would be extremely un-
ethical to wait for Western-style monitoring and let these patients 
die" (Schoofs, Wall Street Journal, 6/28).

Death Toll Could Reach Five Million

In related news, South Africa's state-funded Medical Research Council 
said that AIDS could kill between five and seven million South Afri-
cans by 2011 "if proper treatment is unavailable," Reuters/Chicago 
Tribune reports. Debbie Bradshaw, director of the council's Disease 
Research Unit, said, "We appreciate that treatment is costly and very 
difficult given the health infrastructure, but there is a critical 
need to explore creative mechanisms to get more access to treatment." 
South Africa has the largest number of HIV-positive citizens in the 
world (Swindells, Reuters/Chicago Tribune, 6/29).


--
Libyan Trial of Bulgarian Health Workers Ends; Defendants' Witnesses, 
Expert Testimony Not Permitted

The Libyan trial of seven international health care workers facing 
the death penalty for allegedly infecting 393 children at a Benghazi, 
Libya, hospital with HIV ended June 18, after three days during which 
the defendants were not permitted to call witnesses or present expert 
testimony, the Washington Post reports (Finn, Washington Post, 7/1). 
The defendants, a Bulgarian doctor, a Palestinian doctor and five 
Bulgarian nurses, have been detained since February 1999, as the 
trial has been delayed 12 times. Libyan leader Moammar Kadafi 
"heightened" public concern over the trial when he suggested on April 
27 at an AIDS conference in Abuja, Nigeria, that the infections were 
"part of a Western plot" to spread HIV (Kaiser Daily HIV/AIDS Report, 
5/31). At the conference, Kadafi suggested the CIA or Mossad, the Is-
raeli intelligence service, was behind the alleged conspiracy. During 
the trial, prosecutors said the defendants infected the children with 
the virus in a "conspiracy to destabilize the Libyan state." Accord-
ing to wire service accounts, the lead prosecutor told the court, 
"(The defendants) have sold themselves to the Devil. To these (intel-
ligence) services, child-killing is nothing new. In this way, they 
want to prevent Libya from playing an important role in the Arab 
world and to disturb calm in the country. The killing of children by 
that virus is a means by which those secret services achieve their 
ends." Luc Perrin, a physician at Geneva University Hospital in Swit-
zerland who examined 37 of the children, said the "most likely sce-
nario" is that the "explosive spread" of HIV was caused by reused sy-
ringes, as at least 50% of the children also have hepatitis C and 40% 
have hepatitis B, which "suggests" needle sharing. "There is no doubt 
that the case of the Libyan government doesn't stand," he said. The 
Post reports that the Bulgarian government has put "intense" pressure 
on Libya and Kadafi, but has failed to end the case. Anton Girginov, 
a member of the Bulgarian government commission monitoring the trial, 
said, "For the regime ... to be accountable for its own mistakes is 
practically impossible, and so it is eagerly blaming foreigners. They 
have used torture instead of expert opinion and they have done every-
thing to avoid getting at the truth." A verdict in the case is sched-
uled to be handed down on Sept. 22 (Washington Post, 7/1).


--
South African Woman Sues Drug Firm, Claiming Antiretroviral Caused 
Husband's Death

A South African woman is suing Glaxo Wellcome South Africa -- a local 
subsidiary of drug firm GlaxoSmithKline -- over allegations that the 
"toxicity" of the company's antiretroviral drug AZT "killed her hus-
band," the Associated Press reports. Annet Hayman said in court pa-
pers that her late husband began taking AZT, or zidovudine, and 3TC 
in 1997, after he learned he was HIV-positive. Hayman said that her 
husband "was in reasonable health" before taking the drugs, but be-
came "very ill ... as soon as he began treatment." Her lawyers stated 
that "her husband's HIV-positive status did not mean he had AIDS and 
that he was suffering from a non-terminal form of anemia," adding 
that he died "directly as a result of the cellular toxicity of AZT." 
"[O]ne of the oldest and most established" antiretrovirals, AZT has 
been known to cause "slight side effects," but its manufacturers 
"deny it is toxic -- a view backed by most scientists," the Associ-
ated Press reports. The lawsuit seeks $125,000 in damages, and Glaxo 
said it will "defend" itself against the suit.

South African Government Involved in Case

South African President Thabo Mbeki and Health Minister Dr. Manto 
Tshabalala-Msimang are cited as "interested parties" in the suit, the 
Associated Press reports. The South African government has "consis-
tently refused" to finance the distribution of antiretroviral drugs, 
stating that the medicines "are unaffordable and their safety has not 
yet been proven" (Associated Press, 7/1). When the government re-
leased its first draft of South Africa's Medicines and Related Sub-
stances Control Act -- which allows the country to import cheaper 
versions of patented anti-AIDS drugs -- officials stated that the 
government will likely focus its efforts on importing drugs to treat 
opportunistic infections, as opposed to more costly antiretrovirals 
(Kaiser Daily HIV/AIDS Report, 6/5).


--
U.N. Foundation Creates Account for Individual Donations to Global 
AIDS and Health Fund

The United Nations Foundation on Friday announced the establishment 
of a special account to receive individuals' contributions to the 
Global AIDS and Health Fund, which won the U.N. General Assembly's 
full support last week, a U.N. release reports. The account will hold 
donations in readiness until the global fund becomes operational 
(U.N. release, 6/29). According to the Wall Street Journal, $961 mil-
lion has been contributed to the global fund by individuals, nations, 
corporations and not-for-profit organizations (Kaiser Daily HIV/AIDS 
Report, 6/28).

--
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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