AFRO-NETS> Kaiser Daily HIV/AIDS Report Thursday September 20th

[Cecilia Snyder <csnyder@ccmc.org>]

Kaiser Daily HIV/AIDS Report Thursday September 20th
----------------------------------------------------

*United States' FAO Ambassador Calls AIDS the 'Greatest Threat' to 
Food Security in Africa 
*Official South African Death Statistics Due By End of Year 
*Central Intelligence Agency Releases World Fact book 2001, Includes 
  HIV/AIDS Statistics 
*Combination of Microbicide and Diaphragm Could Prevent HIV Transmis-
sion 
*Accurate AIDS Figures for South Africa Hard to Find, Columnist Says

Politics & Policy

United States' FAO Ambassador Calls AIDS the 'Greatest Threat' to 
Food Security in Africa

HIV/AIDS poses the "greatest threat to food security" and life in Af-
rica, U.S. Ambassador to the Food and Agriculture Organization George 
McGovern said yesterday. McGovern said that seven million farm work-
ers worldwide have died of AIDS-related illnesses over the past 15 
years and food production in Africa is "already suffering" as a re-
sult of these losses (Agence France-Presse, 9/19). McGovern was tour-
ing South Africa, Ethiopia and Senegal to assess agricultural pro-
grams and the provision of food to children in the three countries 
(Xinhua News Agency, 9/19). The FAO believes it will have to give ad-
ditional help to Angola, Ethiopia and Zimbabwe to help address the 
problems of food production, McGovern said (Agence France-Presse, 
9/19). McGovern urged African governments to work with the United Na-
tions to address the problems of HIV/AIDS and malnutrition on the 
continent (Xinhua News Agency, 9/19).   

Global Challenges

Official South African Death Statistics Due By End of Year

Official South African mortality figures for 1997 through 2000, which 
could lend support to a new report labeling AIDS the nation's leading 
killer, will be released by the end of the year, according to Statis-
tician-General Pali Lehohla, South Africa's Business Day reports. 
Stats SA, the goverment's official statistics agency, has had diffi-
culty compiling the figures because AIDS-related deaths are "often 
recorded under other causal categories" and researchers have been 
"forced to use indirect measurements rather than simply count[ing] 
the number" of AIDS-related deaths, a joint statement from the 
agency, the departments of health and home affairs and the national 
communication service said. News of the Stats SA report comes as the 
government is being accused of "deliberately delaying" the release of 
a report by the South African Medical Research Council that deter-
mined AIDS was responsible for the majority of the nation's deaths, 
killing 40% of South Africans between the ages of 15 and 49 last 
year. President Thabo Mbeki has disputed this finding, saying that 
external causes such as violence and poverty are the nation's largest 
killers. It is unclear whether the Stats SA report will refute or 
support the MRC data. The government declined to comment on the MRC 
report, which was leaked in the Sunday Times last weekend, saying 
that "[s]ince the release of the Stats SA's official mortality fig-
ures is expected within a few months, detailed government comment on 
the (council's) research will be reserved until it is possible to re-
view the two sets of figures in relation to each other." The MRC 
findings were presented to the home affairs, health department and 
Stats SA heads on Sept. 3 and are scheduled to be presented to the 
social ministers and cabinet in the near future, the government said 
(Business Day, 9/19).

Media & Society

Central Intelligence Agency Releases World Fact book 2001, Includes 
HIV/AIDS Statistics

The Central Intelligence Agency yesterday released its updated World 
Fact book 2001, the agency's "most popular and most widely dissemi-
nated product," according to a CIA release. The fact book, available 
in print and online, provides a "snapshot" of "wide-ranging, hard-to-
locate" information -- such as geographic coordinates, economic sta-
tistics, political parties, mortality rates and illicit drugs -- for 
countries "from Afghanistan to Zimbabwe." This year, the guide also 
includes a subcategory on HIV/AIDS, which provides HIV/AIDS preva-
lence rates, number of people living with HIV/AIDS and the number of 
deaths due to AIDS-related complications. The resource is accessible 
online through the CIA's Web site.

  Science & Medicine

Combination of Microbicide and Diaphragm Could Prevent HIV Transmis-
sion

Combining a microbicide with a diaphragm could be an effective method 
of preventing HIV transmission, as the chemical and device would pro-
tect the "infection-susceptible cervix and upper reproductive tract" 
from the virus, Dr. Nancy Padian, director of international programs 
at the University of California-San Francisco's AIDS Research Insti-
tute, writes in an editorial published in the Sept. 7 issue of the 
journal AIDS. HivandHepatitis.com reports that Padian and colleagues 
state that the cervix is "far more vulnerable" to HIV infection than 
the surface of the vagina because the cervical columnar epithelium is 
"thinner and more friable" than that of the vagina. The receptors re-
quired for HIV infection are also concentrated in the cervix. Padian 
and colleagues state that a cervical barrier can prevent virus parti-
cles from being transported by uterine peristaltic contractions into 
the fallopian tubes and peritoneal cavity. Although the scientists 
acknowledge that it is unclear whether a diaphragm/microbicide combi-
nation is as effective as a condom in preventing HIV transmission, 
they add that diaphragms are more likely to be accepted by societies 
in which men might not want to wear a condom. Most men cannot tell 
when their partner is wearing a diaphragm, and Padian states that 
women seem to be amenable to the device. Padian and colleagues are 
conducting an acceptability study of the diaphragm in Zimbabwe, and 
write that the acceptability measured thus far "seems to be much 
greater than we thought it would be."  They note that they are not 
promoting the diaphragm as a method of HIV prevention, but tell women 
who are "unable to use condoms" that the device "might offer protec-
tion" against the virus. They conclude, "Even in that very tenuous 
promotion of [the diaphragm], they're willing to use it. Women are 
desperate for methods they can use to protect themselves" (Gale, 
HivandHepatitis.com, 9/19).

Opinion Accurate AIDS Figures for South Africa Hard to Find, Colum-
nist Says

Reliable and accurate figures on AIDS cases and AIDS-related deaths 
in South Africa are difficult to come by, Ken Owens writes in his 
Business Day column, adding that what is available are only "esti-
mates, extrapolations, assumptions, theories, guesses, lies, damned 
lies and statistics." The majority of AIDS data are based on the 
Doyle model or a new mathematical model developed by the Actuarial 
Society of South Africa. However, both of those models are based on 
blood tests of pregnant women attending antenatal clinics and "must 
be generally manipulated" to produce the figures, he writes. Owens 
states he has "no doubt of the excellence and integrity" of the cal-
culations, but the math behind them is "impenetrable to a layman" and 
believing the figures is "essentially a matter of trust." South Afri-
can President Thabo Mbeki does not trust the figures either, Owens 
says. In fact, "Mbeki seems so embittered that he distrusts anything 
emanating from his white countrymen if it seems disparaging of 
blacks," he states. Mbeki's distrust "seems justified almost daily by 
the distorted and propagandistic use of the statistics to raise money 
for NGOs, or to influence allocations of the medical and research 
budgets, or simply to produce another shocking headline," he adds.  
Lacking an "incontestable, central source of information," Mbeki has 
turned to his own research to support his position that HIV does not 
cause AIDS, calling for the reallocation of funds so AIDS-related 
monies are reflective of the "objective reality," which he says is 
that causes such as poverty and voilence are the nation's leading 
killers. Owens says that while Mbeki is correct that the public 
health efforts should be directed by objective reality, he states 
that the government should not "misallocate resources." He concludes, 
"If [Mbeki] is correct to think the threat has been exaggerated, no-
body will thank him for averting a minor misallocation of funds; but 
if he is mistaken, and 'objective reality' manifests itself as an 
epidemic of funerals, he will go down in history as a buffoon and 
perhaps the author of a greater catastrophe than apartheid" (Owens, 
Business Day, 9/17).

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. , 2001 by National Journal Group Inc. and Kaiser 
Family Foundation. All rights reserved.

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