AFRO-NETS> Kaiser Daily HIV/AIDS Report - Tue, 28 Aug 2001

[Cecilia Snyder <csnyder@ccmc.org>]

Kaiser Daily HIV/AIDS Report - Tue, 28 Aug 2001
-----------------------------------------------

* South African Children Affected by HIV/AIDS Speak at First National
  Children's Meeting
* Inconsistencies Found in Kenyan Blood Safety Procedures; Assessment
  Could Serve as Model in Developing Countries
* Princess Diana Memorial Fund Launches $7.2 Million Initiative to
  Help Africans Dying of HIV/AIDS
* Triangle Pharmaceuticals Sells Shares to Sustain Operations for Two
  More Years


--
South African Children Affected by HIV/AIDS Speak at First National 
Children's Meeting

South African children met in Cape Town last Friday for the first na-
tional conference of children with HIV/AIDS or with relatives living 
with the virus, the AP/Nando Times reports. The children, ages seven 
through 18, spoke about "being shunned by their peers, abandoned by 
their families," forced to leave school to care for infected family 
members, orphaned by the disease and "even blamed by health care 
workers" for becoming infected. South African society, which consid-
ers HIV a "shameful illness," has often "stigmatized" those with the 
virus. An estimated 4.7 million South Africans have tested positive 
for HIV, and the disease has orphaned 700,000 children in the coun-
try. AIDS activists have "lambasted" the South African government for 
promoting an "inconsistent policy" on fighting AIDS and for refusing 
to provide antiretroviral drugs through the public health system to 
HIV-positive pregnant women with HIV/AIDS. Dr. Nono Simelela, who 
heads the South African health department's AIDS program, told the 
children last Friday that the government "was doing the best it 
could," adding, "It's clear that more resources are going to be 
needed. As far as humanly possible, we are responding to these chal-
lenges, (but) the processes are slow" (Cohen, AP/Nando Times, 8/24).


--
Inconsistencies Found in Kenyan Blood Safety Procedures; Assessment 
Could Serve as Model in Developing Countries

A 1994 assessment of Kenyan blood safety practices found that HIV-
positive blood was transfused 2% of the time due to inconsistent 
screening practices at Kenyan government hospitals, according to a 
research summary in the Aug. 25 issue of the Lancet. Researchers from 
the CDC collected information and blood samples from 1,290 donor-
recipient pairs for 12 weeks from April to July 1994 at six govern-
ment hospitals in Kenya. The blood samples were screened for HIV us-
ing each hospital's "standard practice[s]" and were then later 
screened by a reference laboratory at the CDC in order to make a com-
parison. Overall, HIV was found among 6.4% of the blood donors, with 
prevalence varying from 2% to 20% by hospital. Thirty-one of the 
1,482 units of blood (2.1%) used in transfusions contained HIV, and 
of the 1,290 transfusions that were performed using the screened 
blood, 26 contained HIV-positive blood. Blood was not regularly 
screened in the hospitals due primarily to a shortage of testing 
kits. For four weeks during the study period "no HIV test kits were 
available nationwide," so the researchers supplied the hospitals with 
kits "with which hospital laboratory personnel were familiar." Data 
entry errors were also to blame for some of the disparities between 
screenings. Results for 99 blood samples were not found in hospital 
log books, but had been written down on the testing laboratory 
logsheets. "Inconsistent" refrigeration was also a problem, with 
blood being kept in household refrigerators that often had "limited 
space" and HIV-positive and HIV-negative blood sometimes being stored 
together "without clear labels." Equipment problems such as a period 
of no electricity and malfunctions with one hospital's antibody test 
reader also compromised the safety of the blood supply. A "lack of 
quality-assurance programs" and an inconsistency between what types 
of donations hospitals screened was also found, according to the re-
searchers. One hospital did not "routine[ly]" test the blood of in-
fants born to HIV-positive mothers because "hospital personnel as-
sumed that children of HIV-infected mothers were also HIV-infected." 
The authors concluded, "Although blood screening removed two-thirds 
of infected donations, increased attention to blood safety is needed 
to prevent this unacceptable risk of HIV transmission by transfu-
sion."

Developing a Model

Although the risk of contracting HIV from tainted blood donations has 
been negligible in most Western nations for years, blood screening 
programs have been "difficult to implement and sustain" in developing 
countries because of limited resources for donor recruitment and 
staff training, improper distribution of the needed testing reagents 
and "waning support" from international agencies. Based on their 
findings, the CDC team recommended that the government pay "increased 
attention to training, supervision, quality assurance, enforced regu-
lation and accountability" to improve blood supply safety. Using 
those recommendations, the Kenyan Ministry of Health was able to pro-
cure financial support to purchase and distribute rapid HIV test kits 
and develop a national training program to improve laboratory prac-
tices. Funding was also found to recruit volunteer donors and to de-
velop "regional transfusion centers" and a "standardized quality as-
surance program" for the government's hospitals. These "[p]ractical 
and feasible interventions could dramatically improve blood safety in 
many resource-poor countries," the researchers concluded, adding, 
"Given the burden of HIV throughout sub-Saharan African countries, it 
is time to bring increased attention and resources to eliminate this 
preventable mode of HIV transmission" (Moore et al., Lancet, 8/25). 


--
Princess Diana Memorial Fund Launches $7.2 Million Initiative to Help 
Africans Dying of HIV/AIDS

The Diana, Princess of Wales Memorial Fund begins a $7.2 million ini-
tiative today to "ease the suffering" of Africans in the final stages 
of HIV/AIDS and cancer, the AP/Tampa Tribune reports (AP/Tampa Trib-
une, 8/28). Fund grants will be distributed over five years for hos-
pice programs and training and education programs for policy makers, 
medical staff and caregivers. Fund Chair Christopher Spence said, 
"For millions of people in this region, the approach of death is 
characterized by appalling pain, deprivation and neglect. The fund's 
Palliative Care Initiative is essentially a challenge to health pol-
icy makers, donors, practitioners and others who care about the issue 
-- to recognize that people who are dying are human and that the 
close of life should bring dignity and not diminish their humanity" 
(Associated Press, 8/28). In addition to pain relief, the initiative 
will fund bereavement projects aimed at helping families cope with 
the imminent deaths of relatives, especially children orphaned by 
AIDS. One project will encourage South African children to make mem-
ory boxes -- aluminum containers that children paint and then discuss 
with their dying parents what "reminders of their parents' love" to 
put into the boxes (London Daily Telegraph, 8/28). The launch of the 
initiative marks the fourth anniversary of Diana's death and the es-
tablishment of the fund. The fund, which receives donations and prof-
its from the sale of approved memorabilia, has pledged more than 
$64.9 million to charities thus far this year (Associated Press, 
8/28).

--
Triangle Pharmaceuticals Sells Shares to Sustain Operations for Two 
More Years

Triangle Pharmaceuticals Inc., which is developing the experimental 
HIV drug known as Coviracil, will raise $75 million to sustain opera-
tions for the next two years through the sale of about 28.3 million 
shares of stock at $2.65 per share, the AP/Raleigh News & Observer 
reports. Last year, two South African patients participating in a 
clinical trial of Coviracil and several other AIDS drugs died of 
liver toxicity. Triangle proved that Coviracil did not trigger the 
deaths, but the issue forced an FDA review, and the company subse-
quently delayed an application for FDA approval. Earlier this month, 
Triangle laid off 85 employees -- about one third of the company's 
staff. The firm had accumulated a $375 million deficit by the end of 
June and expects annual losses for the next few years (AP/Raleigh 
News & Observer, 8/27). 

--
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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