nov07-1

Mon Nov 12, 5:42 AM ET

China plans to relax rules that are currently barring HIV/AIDS carriers from entering the country, the health ministry said on Monday.

Ministry spokesman Mao Qun'an said the decision was based on current knowledge of the way the AIDS virus spreads.

He said the existing restrictions, strongly criticised by AIDS activists as discriminatory, were introduced when people were "unfamiliar" with how the disease may spread.

Mao did not disclose when the new rules would take effect, or if the relaxation would mean a complete end to limits on HIV/AIDS carriers' entry into China.

China had 650,000 HIV/AIDS patients according to an estimate put forward jointly by the government and United Nations health agencies in January 2006.

Mao said the government would release its latest estimate of the number of people having HIV/AIDS in China at the end of November.

Gates Foundation Gives $50M to China HIV

SEATTLE (AP) -- The Bill & Melinda Gates Foundation will commit $50 million to expand HIV prevention efforts in China, in partnership with the Chinese government and non-governmental organizations.

The foundation said late Tuesday the funding will increase access to HIV prevention programs targeting those most vulnerable to infection, including injection drug users, sex workers, and men who have sex with men.

"By rapidly expanding access to effective HIV prevention, China has an opportunity to prevent a widespread HIV/AIDS epidemic," said Dr. Tachi Yamada, president of the Gates Foundation's Global Health Program. "China's leaders say they are serious about fighting AIDS, and we're pleased to partner with them on these efforts."

Although China's national HIV prevalence is low -- less than 0.1 percent of the total population -- infection rates are high among key risk groups. HIV prevalence among injection drug users exceeds 50 percent in some provinces, and in the past two years there have been substantial increases in HIV infection rates among men who have sex with men.

The foundation noted that stigma and discrimination against people with HIV remain major problems in China. For example, a 2005 study by researchers in Yunnan province found that nearly a third of doctors said they would refuse to treat an HIV-positive person.

In addition to prevention services for high-risk groups, the new Gates Foundation funding will support programs focused on increasing access to HIV counseling and testing, ensuring that HIV-positive people receive appropriate care and support -- including prevention programs to help reduce high-risk behavior that could pass on the virus to others -- and reducing the stigma of AIDS.

Of the $50 million, a $20 million grant will go to the Chinese Ministry of Health. The remaining $30 million will be used to provide grants to local, national and international non-governmental organizations. A small team of Gates Foundation staff in Beijing will administer the funding and provide technical advice and support.

The foundation's China office is led by Dr. Ray Yip, who was formerly the country director of China for the U.S. Centers for Disease Control and Prevention.

Unhealthy behavior, gay sex behind HIV growth in China

Unhealthy sexual behavior is the biggest culprit in spreading HIV/AIDS on the mainland, while men who have sex with men (MSM) are now the most likely to become infected by the disease, an official with the Ministry of Health said Thursday.

"In the past, between 1 and 3 percent of MSM in the mainland had HIV/AIDS. Now it is anywhere from 2.5 to 6.5 percent," Hao Yang, deputy chief of the disease prevention and control bureau under the Ministry of Health, said.

More than half of China's MSM have more than one sexual partner, but only between 10 and 20 percent of them use condoms, he said.

Also, many MSM are bi-sexual, meaning they run the risk of spreading HIV/AIDS to their girlfriends, wives or children, he said.

The number of people with HIV on the mainland increased by an average 3,000 a month between January last year and June this year, according to official figures.

To fight this problem, the Ministry of Health and the Bill and Melinda Gates Foundation Thursday jointly launched a five-year campaign to teach MSM about preventing and controlling HIV/AIDS.

The foundation will invest $50 million a year to support the campaign, which will operate in 14 large and medium-sized cities, including the four municipalities.

Huang Jiefu, vice-minister of the Ministry of Health, said: "The key purpose of this program is to contain the epidemic and reduce the rate of new infections among high-risk parts of the population living in the area covered by the campaign.

"We also want to promote the adoption of effective prevention and control strategies in areas not covered by the campaign.

"In the future, the government will focus more on international cooperation and experience-sharing in the fight against HIV/AIDS," he said at the campaign's launch ceremony Thursday in Beijing.

The government has been working with the Global Fund to Fight AIDS, Tuberculosis and Malaria; the United Nations and other bilateral agencies, he said.

Many non-governmental organizations such as the Clinton foundation and the Global Entrepreneur Association as well as companies such as Merck have also joined the country's fight against HIV/AIDS, according to the ministry.

"I feel very hopeful that China will be able to control AIDS within the next five to 10 years," Ray Yip, the country representative for the Bill and Melinda Gates Foundation, said Thursday.

He said China has committed to fighting the disease at a time when the overall prevalence is still very low - less than one in 1,000.

"I have seen two conditions necessary for controlling AIDS: Early response and high-level commitment.

"Now, the only remaining necessary condition is an effective prevention program," he said.

Tutu blasts Anglican church for gay 'obsession'

Sat Nov 17, 7:07 PM ET

Anglican Archbishop Desmond Tutu has slammed the church for being "obsessed" with homosexuality, in a BBC radio programme to be broadcast Tuesday.

The South African 1984 Nobel Peace Prize winner, 76, said he felt ashamed of his church for its attitude towards gays.

He also criticised Rowan Williams, the Archbishop of Canterbury and the leader of the world's Anglicans, for not demonstrating the attributes of a "welcoming God."

"Our world is facing problems -- poverty, HIV and AIDS -- a devastating pandemic, and conflict," Tutu said.

"God must be weeping looking at some of the atrocities that we commit against one another.

"In the face of all of that, our Church, especially the Anglican Church, at this time is almost obsessed with questions of human sexuality."

He said the Anglican church had appeared "extraordinarily homophobic" during the row over whether the openly gay priest Gene Robinson should be allowed to become the Bishop of New Hampshire.

Tutu said he was "saddened and "ashamed" of the church over the row.

Asked if he still felt ashamed, he replied: "If we are going to not welcome or invite people because of sexual orientation, yes.

"If God as they say is homophobic I wouldn't worship that God."

Tutu hit out at those religious conservatives who believe homosexuality is a choice.

"It is a perversion if you say to me that a person chooses to be homosexual," he said.

"You must be crazy to choose a way of life that exposes you to a kind of hatred.

"It's like saying you choose to be black in a race infected society."

Criticising Williams, he added: "Why doesn't he demonstrate a particular attribute of God's which is that God is a welcoming God."

Global Fund approves 132 million dollars to Kenya's anti-AIDS drive

Tue Nov 13, 1:45 AM

NAIROBI (AFP) - The Global Fund on AIDS, Tuberculosis and Malaria has approved a grant of 132.3 million dollars (90.7 million euros) to boost Kenya's anti-HIV/AIDS drive, the health ministry announced Tuesday.

The grant will finance programmes over the next five years, but an initial amount of 47.1 million dollars (32.3 million euros) will be released in the first two years, said health ministry permanent secretary Hezron Nyangito.

"The new grant to Kenya is targeted to provide ARV treatment with inclusion of a nutrition component, strengthening of health systems and strategic communication," he said.

The grant brings the total funding for HIV/AIDS, malaria and tuberculosis programmes in Kenya to 306 million dollars (210 million euros) since the fund was created in 2002.

Kenya's official AIDS prevalence rate is 5.1 percent, down from 5.9 percent in 2005 due to the use of free ARV therapy for adults and distributing new drugs to prevent child-mother transmission.

Since the savage virus roared from African jungles in the early 1980s, sub-Saharan Africa accounts for a staggering 72 percent of global AIDS deaths, and two-thirds of all people infected with HIV.

After the disease was first diagnosed in Kenya in 1984, it has killed at least 1.5 million people, overturned decades of healthcare gains and now threatens to burn through development efforts if it is not reversed.

As of June last year, around one million Africans were receiving anti-retroviral drugs. This was still less than a quarter of the estimated 4.6 million people in need of the drugs on the continent.

With this, African leaders have been forced to divert mammoth funds, stripping other sectors and failingly tried to enforce laws to counter traditional risky practices like wife inheritance.

More needed to combat TB, global conference in S Africa hears

by Mariette le RouxMon Nov 12, 12:43 PM ET

Fifty years after it was thought to have been contained, tuberculosis (TB) has re-emerged as a ruthless killer claiming a life every 20 seconds, a global lung health conference has heard.

Though treatable, the disease kills some 1.5 million people out of about nine million new cases diagnosed annually, the gathering of 3,000 experts from 100 countries heard in Cape Town over the past five days.

But as TB gains momentum, drugs to treat it with are more than 40 years old, the test method used in poor countries was developed over 100 years ago and the only available vaccine is approaching the century mark.

As drug resistance spreads and the threat of an untreatable TB strain grows, the introduction of new diagnostic and treatment tools remain years off.

"It is a scandal that this disease has not been given the proper attention," Nils Billo, executive director of the International Union Against Tuberculosis and Lung Disease told journalists as the conference drew to a close on Monday.

"And why has it not been given the proper attention? Because it is a disease that affects the poor. The pharmaceutical industry does not see necessarily a big profit ... in developing tuberculosis drugs."

Jerald Sadoff, president of the Aeras Global TB Vaccine Foundation, told delegates that TB was thought to have been brought under control 50 years ago.

Today, a third of the world's 40 million people with HIV/AIDS are also believed to have TB and up to half of AIDS deaths were attributed to the lung ailment.

The conference called for closer collaboration between national AIDS and TB programmes.

In 2005, only seven percent of TB patients globally were tested for HIV and less than one in 200 people living with HIV were screened for TB.

"We are missing vital opportunities to offer better care and prevent unnecessary deaths among people living with HIV and among TB patients," said Alasdair (CORRECT) Reid, HIV-TB advisor for the United Nations AIDS programme.

Participants heard that a new, untreatable strain of TB posed a serious public health threat as incidents of extreme-drug resistant (XDR) TB continued to spread.

Of about two billion people infected with TB world-wide, about 450,000 had a drug-resistant strain.

To curtail the spread of the disease, Billo appealed for a greater focus on infection control by separating patients complaining of a persistent cough from others in waiting rooms -- many of whom were HIV-positive and more susceptible to TB.

Many people don't think AIDS is fatal: survey

NEW YORK (Reuters Health) - In a nine-country survey released today, more than 40 percent of respondents did not understand that AIDS is always a fatal disease.

The survey from the MAC AIDS Fund, a philanthropy set up by Estee Lauder-owned MAC cosmetics, involved 4,510 interviews conducted in the US, UK, Russia, France, China, India, Mexico, Brazil and South Africa. The release of the findings coincides with a Fund board meeting and comes in advance of World AIDS Day on December 1.

"The strength of the survey lies in its exclusive focus on issues related to AIDS, its span of nine countries and the fact that it poses frank, specific questions at a time when we need frank, specific answers to increase the effectiveness of our global response to the epidemic," Nancy Mahon, Executive Director of the MAC AIDS Fund, told Reuters Health.

While most respondents believed that AIDS is always a fatal illness, many wrongly believed that a cure for HIV infection is available. For instance, 59 percent of Indians believed that a cure is available. In France, older adults were more likely than younger people to believe that the disease is curable. In the US, African-Americans were more likely than whites to think there is a cure.

"From my perspective, the most important general finding is that we have not done a good enough job educating people about HIV -- the facts and reality," Dr. Marsha Martin, director for HIV/AIDS programs in the Oakland, California mayor's office, told Reuters Health.

"When people believe the disease is not fatal and that there is a cure, that's because we haven't educated them well," Martin said.

Many people also harbor misconceptions about the availability of AIDS treatments, according to the survey. Almost 50 percent of respondents believed that most HIV-infected patients were receiving treatment, when in reality the figure is closer to 1 in 5, based on 2006 data.

However, education seems to help: in the UK, people with a higher education were more likely than those lacking a college degree to believe that most people with HIV go untreated.

The findings also highlight the prejudice, fear, and stigma that surround AIDS. Overall, almost half of respondents said they felt uncomfortable walking next to an HIV-infected person, 52 percent did not want to live in the same house, and 79 percent did not want to date someone harboring the virus.

"The most important message for those who are providing services is that they have to serve as role models in their interactions with individuals who are at risk or who are living with HIV. That would go a long way to reducing stigma in society," Dr. Geeta Rao Gupta, President of the International Center for Research on Women, told Reuters Health.

Gender roles and difficulty in discussing safe sex practices are key contributors to the pandemic, the survey indicates. For instance, 73 percent of respondents believe that the spread of HIV is fueled, in part, by women being uncomfortable in discussing safe sex practices with their partners.

"The results of this survey coupled with the recent failure of the most promising AIDS vaccine trial underscore that we are not going to vaccinate or cure our way out of this epidemic," Mahon emphasized.

"All of us, particularly in the funding community, need to redouble our efforts and resources and focus on basic and effective HIV prevention programs that address gender, age and race differences in a direct and culturally competent way," Mahon added.

Reuters - Wednesday, November 14

WASHINGTON, Nov 13 - Brazil's policy of haggling long and hard for lower prices for lifesaving AIDS drugs saved the country $1 billion between 2001 and 2005, U.S. researchers estimated on Tuesday.

Amy Nunn and colleagues at the Harvard School of Public Health analyzed the costs of individual AIDS drugs in Brazil and found that generic drugs produced in Brazil were usually more expensive than similar drugs made elsewhere.

But, by negotiating for lower patented drug prices, Brazil had lowered the overall average costs for AIDS drugs.

"Brazil's AIDS treatment program has been cited widely as the developing world's largest and most successful AIDS treatment program," they wrote in their report, published in the Public Library of Science journal PLoS Medicine.

"The program guarantees free access to highly active antiretroviral therapy for all people living with HIV/AIDS in need of treatment."

The program, begun in 1996, now covers 180,000 Brazilians and also provides free condoms. It has helped slow infection rates to a stable 0.6 percent of the population -- similar to rates seen in the United States.

Brazil produces generic versions of eight non-patented AIDS drugs.

It has used the threat of generic drugs to persuade companies to lower their prices for expensive AIDS drugs, even though Brazil has signed on to World Trade Organization patent agreements.

Last May, Brazil broke the patent on Merck & Co. Inc.'s efavirenz to import a cheaper generic version from India instead.

Other countries, including Canada and Italy, have also used a clause in World Trade Organization rules to flout drug patents in the name of public health.

In July, Brazil worked out an agreement with Abbott Laboratories Inc. to cut the price of its drug Kaletra by 29.5 percent.

(Reporting by Maggie Fox, editing by Will Dunham and David Wiessler)

U.S. regulators join HIV transplant probe

CHICAGO (Reuters) - The Centers for Medicare and Medicaid Services has joined an investigation into how four Chicago transplant recipients contracted HIV and hepatitis C from a single organ donor, U.S. officials said on Friday.

CMS, a federal agency that regulates organ procurement, is checking whether three Chicago hospitals fully informed transplant recipients that the organ donor was at high risk of being infected with the human immunodeficiency virus, which causes AIDS.

A Chicago attorney has asked the Cook County Circuit Court to order one hospital to preserve all records related to its organ donation procedures.

Thomas Demetrio said his client, one of the organ recipients, was not told the kidney she received was from a high-risk donor until this week.

Tests of the organs initially showed them to be free of infection, but a more sophisticated test done later detected HIV and hepatitis C, health officials said.

"We are still doing an investigation of the organ procurement organization and we also are looking at the hospitals to make sure information was shared with both the transplant programs and the recipients," said Jan Tarantino, director of the division of continuing care providers at CMS, a part of the U.S. Department of Health and Human Services.

Typically, CMS contracts with the state health department, but she said CMS has sent its own investigator to accompany state officials. "We've never gotten a report of this before and the consequences are very serious for the patients involved," she said.

Hospital officials have confirmed that two patients from the University of Chicago Medical Center, one from Northwestern Memorial Hospital and one at Rush University Medical Center tested positive for HIV and hepatitis C.

If the hospitals are found to have violated procedures, they could face sanctions and ultimately could be dropped from participation in Medicare, Tarantino said.

The U.S. Centers for Disease Control and Prevention has said the cases mark the first incidence of HIV infection contracted from organ donation since 1986.

Dave Bosch of the Gift of Hope Organ and Tissue Donor Network, the regional organ procurement agency that handled the donor organs, this week confirmed the organs came from a high-risk donor. He said standard tests failed to pick up the infections, likely because they occurred within three weeks of the donor's death -- too soon for the tests to detect.

Demetrio said in a telephone interview his client, a woman in her early 30s, had been on the transplant list for more than five years before receiving a kidney from the University of Chicago Medical Center. "Right now she's a wreck. She's still in shock," he said.

Demetrio said his client had been undergoing kidney dialysis and could have waited for another organ.

A University of Chicago Medical Center spokesman confirmed that the hospital received a petition from Cook County Circuit Court and said the hospital will provide necessary records with the patient's consent.

A spokeswoman for Rush said the hospital has been contacted by CMS and is cooperating with the investigation.

Bosch said about 9 percent of the 22,000 organ transplants in the United States involve high-risk organs.

HIV programs in workplace save money: IOM

Tue Nov 13, 2007 12:15 PM ET

GENEVA (Reuters) - Companies can save money and retain more staff by offering their workers HIV programs, particularly in areas where infection rates are high, an international aid agency said on Tuesday.

The International Organization for Migration (IOM) analyzed conditions in Zambia, where 17 percent of adults have HIV and many large private-sector companies depend on migrant workers who are particularly vulnerable to the disease.

Its study, which looked at copper mining and agricultural firms, found that HIV "had an enormous impact on all companies among all ranges of skills", IOM spokeswoman Jemini Pandya said.

"By implementing a range of HIV programs for staff, the benefits far outweigh the costs, both human and financial," she told a Geneva news briefing.

HIV programs in the workplace -- including health care, testing and counseling -- gave employees a chance to combat discrimination and learn about prevention, the IOM found.

They also helped prevent absenteeism, employee turnover, and lost productivity, according to the study which assessed data from seven of the biggest companies in Zambia, employing between 350 and 10,000 people.

The typical company spent nearly $9,000 per employee lost to the disease, including funeral expenses and the costs having a supervisor train a successor. Six of the seven companies showed net benefits for their programs, amounting to an average of $47 per employee in the year 2006, according to the report.

The largest company saved nearly $500,000 in what would have been lost productivity from sick employees, Pandya said, adding: "The larger the company, the greater the benefits it derived."

The IOM reported a general belief among companies in Zambia that labor was "plentiful, cheap and always there," but warned this was extremely short-sighted.

Drug injecting triggers most Mauritius HIV cases

ROCHE BOIS, Mauritius (Reuters) - Drug abuse accounts for 92 percent of new HIV infections in Mauritius, up from just 14 percent in 2002, the government said on Monday.

The Indian Ocean island nation has an estimated HIV prevalence rate of 1.8 percent, which is low for the region. On the African mainland, HIV infection rates stand at 16.1 percent in Mozambique and 18.8 percent in South Africa, for example.

But officials say risky practices like sharing needles used for injecting drugs are causing many more infections. Mauritius suffers the second highest rate of heroin and opiate use in the world, according to U.N. figures.

"Some 92 percent of the virus' transmission today is through the exchange of needles by drug addicts," said Mauritius' minister of health and quality of life, Satya Faugoo.

The government was expanding a needle exchange program to supply drug users, he said.

"Initially, we are targeting some 2,000 drug addicts by June," Faugoo told Reuters, adding that the authorities were also planning to treat another 1,000 addicts with opiate substitute methadone.

Mauritius has an estimated 20,000 drug addicts among its 1.3 million population, according to government figures, but many people who work with users think the real number is higher.

China to relax ban on HIV/AIDS carriers entering the country