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AFRO-NETS> Kaiser Daily HIV/AIDS Report - Thu, 25 Oct 2001

  • Subject: AFRO-NETS> Kaiser Daily HIV/AIDS Report - Thu, 25 Oct 2001
  • From: Cecilia Snyder <csnyder@ccmc.org>
  • Date: Thu, 25 Oct 2001 13:07:54 -0400 (EDT)

Kaiser Daily HIV/AIDS Report - Thu, 25 Oct 2001

* Mbeki Tells Parliament His Government Has No Immediate Plans to Al-
ter HIV/AIDS Tactics
* Kenyan Taxis to Carry HIV Prevention Messages
* Debate Over Cipro Patent Mirrors Controversy Over AIDS Drugs
* UNAIDS Executive Director Piot Reflects on AIDS Fight on NPR's
'Fresh Air'

Mbeki Tells Parliament His Government Has No Immediate Plans to Al-
ter HIV/AIDS Tactics

Speaking before Parliament yesterday, South African President Thabo
Mbeki said his government has no immediate plans to alter its exist-
ing HIV/AIDS tactics or allocate more funding toward fighting the
disease, Reuters/Contra Costa Times reports. "I do not believe that
at this particular moment, the government is going to do anything to
change the policy positions that is has announced in this regard,"
Mbeki said in response to questioning by members of Parliament (Boyle
Reuters/Contra Costa Times, 10/25). The president appears before Par-
liament to answer questions once per quarter (South African Press As-
sociation, 10/24). Mbeki's announcement comes one week after the of-
ficial release of a report by the Medical Research Council that cited
AIDS as the nation's leading killer. The report also estimated that
as many as seven million people could die of AIDS-related causes by
2010 if additional steps are not taken to fight the disease. Accord-
ing to Mbeki, who initially tried to block the release of the report,
the results are being reviewed by a government panel and officials
"are not considering any reapportionment of funding until this proc-
ess is complete" (Cohen, Associated Press, 10/24).

Calls For Policy Change

On Monday, the National Council of Provinces' select committee on fi-
nance called for a "fundamental" change in the government's HIV/AIDS
policy in light of the MRC report's findings. "The strength of the
response will not only lie with ensuring that medicines and medical
care is being directed to those who have the disease, but becomes
more holistic," the NPOC report stated, noting that the "minister of
social development and most of the members of provincial executive
councils and provinces have raised concerns that the social security
system is not tailored for the HIV/AIDS pandemic, and careful deci-
sions need to be made for the allocation of funds" (Hartley/Ensor,
Johannesburg Business Day, 10/23). According to Tony Leon, leader of
the opposition Democratic Alliance, the government spent only 0.6% of
its health budget on HIV/AIDS last year (Associated Press, 10/24). In
a statement released ahead of Mbeki's appearance, Leon said it would
"require an unambiguous statement on the president's part that AIDS
is caused by infection with HIV, followed by the announcement of some
decisive policies to indicate that the AIDS epidemic is being taken
seriously" (South African Press Association, 10/24). But Mbeki did
not back down from his previous statements. He has come under fire
for contesting the MRC report, instead citing 1995 World Health Or-
ganization figures he found on the Internet that said AIDS was re-
sponsible for just 2.2% of deaths in South Africa, and for his re-
fusal to provide antiretroviral drugs through the public health sys-

Why No Drugs?

MP Patricia de Lille of the opposition Pan Africanist Congress ques-
tioned the government's reasons for refusing to supply AIDS drugs.
Mbeki had said that the drugs were "toxic," but de Lille pointed out
that they had been approved for use in South Africa and that many
lawmakers are taking them. "Why are these drugs only toxic for poor
people?" she asked. Mbeki reinforced his position that the drugs are
toxic, citing recent U.S. treatment guideline revisions that called
for delaying treatment until patients become sick. "The reason was
that these drugs had toxicity that had not been foreseen," he said
(Associated Press, 10/24). Citing drug resistance and "dangerous"
side effects -- such as high cholesterol, kidney failure, liver me-
tabolism alterations and loss of nerve sensations -- the U.S. govern-
ment in February changed its HIV treatment recommendations, saying
that "less ill" patients should postpone such therapy until their vi-
ral load count increases and CD4 cell count decreases to meet the new
guideline levels (Kaiser Daily HIV/AIDS Report, 2/2).

Kenyan Taxis to Carry HIV Prevention Messages

Kenyan matatus, minibus taxis that are often covered with pictures of
"music idols and sports stars," will now feature HIV prevention slo-
gans, BBC News reports. The stickers are part of an "aggressive ini-
tiative" sponsored by the Belgium-based International Center for Re-
productive Health and the U.S. Agency for International Development
to educate Kenyans about HIV and safe sex. About 10,000 people a day
use the matatus and many more in Kenya -- where up to 600 people die
each day of AIDS-related causes -- will see the stickers. Matatu
drivers said they "welcomed" the initiative and are "optimistic"
about its chances for success.

Prevention Confusion

The campaign comes at a time when the traditional HIV prevention ef-
fort of condom distribution is facing opposition. Most "[m]ainstream"
religious leaders have spoken out against condom distribution, saying
it "promote[s] casual sex," the country's leading HIV transmission
route, and the government recently announced plans to halt its condom
distribution effort in an attempt to "cleans[e]" its policies. An in-
dependent poll of 3,000 Kenyans found that more than 55% thought con-
doms "encouraged immorality." While 91% of those surveyed said they
had heard of HIV/AIDS, 12% indicated that they had not altered their
sexual practices because of the disease. According to BBC News, the
poll demonstrated that although most Kenyans are aware of HIV/AIDS,
"they are confused about how to respond to it" (Mwakugu, BBC News,

Debate Over Cipro Patent Mirrors Controversy Over AIDS Drugs

Following the deaths of three Americans from anthrax, the United
States has threatened to allow generic production of Bayer's patented
anti-anthrax medicine Cipro, even though U.S. trade representatives
have opposed plans by developing nations to loosen international pat-
ent rules on medicines for HIV/AIDS, which kills more than two mil-
lion Africans each year, the Guardian reports (Boseley, Guardian,
10/24). The Bush administration this week threatened to override
Bayer's patent on Cipro and allow cheaper production of the drug if
the company did not lower its price. Bayer agreed on Tuesday to lower
the price of Cipro for the federal government to less than $1 per
pill, a nearly 50% reduction from the current price of $1.83 per tab-
let (American Health Line, 10/24).

Echoes of African Debate

The growing concern over anthrax in the United States has "brought
the patent issue -- and the parallels between the U.S. health crisis
and the AIDS epidemic" -- to the public's attention in the United
States, the Guardian reports (Guardian, 10/24). During a meeting in
September, World Trade Organization delegates from 52 developing
countries asked other WTO ministers to approve a proposal that would
clarify language in the Trade-Related Aspects of International Prop-
erty Rights (TRIPS) agreement to say that TRIPS would "not prevent
governments from taking measures necessary to protect public health,"
including the production or importation of generic AIDS drugs. The
proposal also asked for an agreement stating that developing nations
would be protected from "any legal action for alleged violations of
the TRIPS accord, including the lawsuits" currently pending in sev-
eral countries. The countries' proposal, however, was blocked by min-
isters from the United States, Switzerland, Japan, Australia and Can-
ada, who submitted an alternative proposal stating that "there is es-
sentially no problem with the [TRIPS] agreement and no need for
clarifications" (Kaiser Daily HIV/AIDS Report, 10/4). AIDS groups and
humanitarian organizations such as Oxfam and Medecins Sans Fron-
tieres, which supported the developing nations' proposal, hope that
the current "anthrax fears" in the United States will "put pressure
on the United States" at next month's WTO meeting in Doha, Qatar,
where TRIPS language will be discussed. Michael Bailey of Oxfam said
that the anthrax scare "might encourage the United States to be a bit
more sensitive" to the issue of access to medicines. Ellen t'Hoen of
MSF added, "What is very telling is that now [that] the United States
and Canada are facing a shortage [of antibiotics] and a problem of
providing the medicines that the government thinks are needed to pro-
tect health ... they are looking for ways of overcoming ... the pat-
ent ... barrier" (Guardian, 10/24). The proposals submitted by the
WTO ministers from the developing nations and the United States, as
well as a collection of TRIPS-related information, are available
online at the WTO Web site.

UNAIDS Executive Director Piot Reflects on AIDS Fight on NPR's 'Fresh

UNAIDS Executive Director Dr. Peter Piot answered a variety of ques-
tions about the AIDS pandemic on NPR's "Fresh Air" yesterday. When
asked how he would classify the current stage of the epidemic, Piot
responded that "we are only in the beginning" because of continued
increases in HIV infections. He added that "we have to look at this
[fight] in terms of decades" and called the denial that AIDS exists
and the stigma associated with HIV the "two main issues we have to
deal with in fighting AIDS." Piot said, "This is not only an issue
for some backwards countries, this is an issue for every single coun-
try I have been in," including Western nations. Part of the strategy
for combatting such problems is to involve religious groups, Piot
said, explaining, "We need to have the religious groups on our side,
so rather than being confrontational, we're trying to look for common
ground and to see where they can contribute and what we can do. ...
I'm asking that they not oppose condom promotion, and they also have
an increasing role in treatment and care of people with HIV. It's not
a rosy picture, but we've made enormous progress." Piot mentioned a
recent UNAIDS educational video and booklet on the role of imams in
preventing HIV, which used quotes from the Koran, as one example of
this strategy. Discussing his own persistence in the AIDS fight, Piot
said that he considers himself to be "more of a marathon runner than
a sprinter, so I guess we don't burn out as easily, but just take it
one step at a time."

A Link to Political Instability

Piot also discussed the connection between political instability and
AIDS. He said that while he considers AIDS and bioterrorism to be
"fairly unrelated issues," the spread of STDs has historically accom-
panied violent conflicts. Piot said that the level of HIV in Afghani-
stan and neighboring countries has "been a very small problem" so
far, but that the current regional instability could change that, as
could a shift toward increased use of injected -- rather than inhaled
-- opium or heroin as prices in Central Asia rise. Piot also touched
on Uganda's "effective" methods of reducing HIV infection rates and
the need for international bodies to "tal[k] about sex" without using
"incomprehensible diplomatic language" to discuss homosexuality, sex
education, women's rights and sexuality. The full interview is avail-
able online in RealAudio (Gross, "Fresh Air," NPR, 10/24).

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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