News (Updated April 10,
2005)
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Mon Apr 4, 2005 07:14 PM ET
NEW DELHI (Reuters) - India, which has the world's second largest HIV/AIDS
population, plans to introduce a law to stop discrimination against people
infected with the virus, the health minister said on Monday.
A huge stigma is attached to people who are HIV-positive in India and many of the country's 5.1 million people with AIDS face severe discrimination because of widespread lack of awareness about the illness.
Activists say many employees of hotels, factories and textile firms have lost jobs after testing positive. They are either forced to quit, given early retirement or declared unfit to work.
"We have finalized draft legislation to end discrimination against AIDS patients," Health Minister Anbumani Ramadoss told an AIDS conference. "It has gone to the law ministry and will be presented to parliament."
India's HIV problem has assumed serious proportions despite health programs to halt its spread. Over the years, HIV/AIDS has moved beyond traditionally high-risk groups such as prostitutes, drug users and homosexuals.
Experts say the number of those infected could quadruple by 2010 and the World Bank has warned the disease would become the single largest cause of death in the world's second-most populous country unless there is progress on prevention.
"People living with HIV/AIDS face stigma and discrimination and, therefore, care and support to such patients needs to be mainstreamed through general health services," said a health ministry statement.
The virus is spreading into families, infecting mothers and children, and many people do not even know they are infected. Experts say the most alarming trend is the spread of the disease to villages, with rural India accounting for 59 percent of infections compared with 41 percent in cities.
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Tue Apr 5, 9:40 AM ET
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LIBREVILLE (AFP) - AIDS activists in Africa describe the late Pope John Paul II's fierce opposition to the use of condoms as a major obstacle in the battle against AIDS in Africa, where the disease killed 2.3 million people in 2004.
"We
think that his position was a big obstacle in slowing the spread of AIDS in
Africa, even though his impact is difficult to measure on the ground," said
a spokesman for the South African lobby group Treatment Action Campaign, Nathan
Geffen.
Geffen said he hoped "the new pope will have an attitude much more progressive and less conservative regarding the utilisation of condoms and practise of contraception".
Father Laurent Charles Boyomo Assala, teacher at the Central African Catholic university, acknowledged that in the case of AIDS in Cameroon, "the prescriptions (of the pope) have sometimes been left to the liberal interpretation of the churches."
In Gabon the national anti-AIDS program, after much consultation, succeeded in obtaining the approval of Christian and Muslim communities for HIV-positive couples to use condoms, a position adopted in February in Yaounde by African bishops.
The coordinator of the UN aids program UNAIDS in the Democratic Republic of Congo (DRC), Pierre Somse, said the question of condom use was irrelevant in that country because they simply aren't available, especially in rural areas where the virus is most prevalent.
"The real question is about the implementation of a national health policy in a country where only two percent of some 400,000 (AIDS) patients have access to antiretroviral treatments," Somse said.
In the face of the spread of AIDS in Africa -- with 3.1 million people contracting the virus in 2004 -- many hope that the new pope will change the teachings of the church on the question of the use of condoms.
"We understand the position of the church, but you have to face reality," said Attaher Maiga, a member of the national anti-aids council in Mali. "There isn't an alternative, the use of condoms is one of the solutions to fight the spread of HIV."
In his edicts, the late pontiff fought tirelessly against condoms and in a landmark message in 1988 said that use of contraception was "intrinsically illicit."
"No personal or social circumstances could ever, can now, or will ever, render such an act lawful in itself," he said.
Africa is home to nearly two-thirds of all the estimated 40 million people living with HIV or AIDS in the world.
AIDS has driven life expectancy below 40 years in nine African countries: Botswana, the Central African Republic, Lesotho, Malawi, Mozambique, Rwanda, Swaziland, Zambia and Zimbabwe.
Friday April 8, 7:28 AM
Controversial U.S. research in Africa that violated federal patient protection rules was nevertheless conducted well enough to support its conclusions that the AIDS drug nevirapine could be used safely to protect babies, an expert scientific panel has concluded.
"The committee finds that there is no reason based in ethical concerns about the design or implementation of the study that would justify excluding its findings from use in scientific and policy deliberations," the Institute of Medicine panel said in a report first obtained by The Associated Press.
The report, released Thursday, will have implications in both Africa, where medical officials are debating whether to withdraw the drug, and in the United States, where investigators are examining whether U.S. research is complying with federal law.
The report was be welcomed as good news at the National Institutes of Health, the federal agency that funded the nevirapine study in Uganda and which has been engulfed in months of controversy but has insisted the drug is safe.
"NIH expects that the findings by the IOM will restore confidence in the validity of the conclusions of this study, allow the controversy surrounding the issue to subside and facilitate policy decisions that seek to promote the health of newborns at risk of HIV infection," the agency said in a statement.
The Elizabeth Glaser Pediatric AIDS Foundation, one of the largest providers of AIDS assistance in the Third World, also hailed the report's finding, saying those who have and are taking the drug in single doses can be sure it is safe.
"I think this will now allow us to put to rest the questions about the safety and efficacy of nevirapine," said Mark Isaac, the foundation's vice president. "Our sense is we now can focus on the real issue, saving lives."
AP reported in December that the U.S. Office of Human Research Protections had concluded the NIH experiment in Uganda that dated to the mid-1990s had violated federal patient safety rules.
However, NIH did not inform the Bush White House of the problems before the United States began sending hundreds of millions of dollars of nevirapine to Africa in 2002 to try to stop of AIDS from spreading from infected mothers to their babies.
NIH acknowledges its study suffered from flawed document keeping and violated some federal regulations, but says it believed its scientific conclusions about nevirapine's usefulness and safety remained valid. It requested the Institute of Medicine study.
The IOM report states that it, too, found "procedural lapses," record-keeping problems, some unreported adverse events and instances in which researchers failed to get consent to keep African children in the experiment longer than intended in instances where their mothers may have died.
The panel said the underreporting of some bad reactions, known as adverse events in the scientific world, "may limit the generalizability" of some of the study's conclusions.
But it added, "while there were some procedural deficiencies reported by auditors, none appeared to have affected the outcome of the study" and no patients in the experiment were ever put in serious jeopardy.
The document is unlikely to end congressional and federal investigations into whether the NIH safety and legal compliance officials' repeated concerns about this and other research projects were disregarded by managers and front-line researchers.
AP reported last month that six of the nine experts who served on the panel currently get money from NIH, the agency which supervised the research they were reviewing. Some members of Congress have questioned whether the financial ties would weaken the report's credibility.
And the IOM panel did not address emerging data showing nevirapine can create resistance that lasts for months in women or children who took even a single dose, rendering some treatments for their AIDS less effective.
That concern has caused South Africa to call for the end of nevirapine's use to prevent mother-to-baby transmission of AIDS. More expensive cocktail combinations of drugs are likely to be used.
Isaac said the resistance issue was a concern and that nevirapine should be used to protect babies only when other, better cocktail treatments aren't available. "This report makes clear nevirapine is part of our arsenal, but it is only part of the arsenal," he said.
Steve Kohn, the lawyer for Dr. Jonathan Fishbein, the NIH whistleblower whose allegations of noncompliance gave rise to the IOM review, said his client believes the report "verifies many of Dr. Fishbein's concerns regarding noncompliance with federal safety regulations. Unfortunately, it ignored some of the most salient safety concerns, such as resistance."
The study also steered clear of the controversy of whether the NIH study complied with Good Clinical Practices (GCP), a sweeping set of record-keeping and patient protections that NIH says it is requiring its researchers to follow.
The IOM panel said GCP was voluntary and that it remained confident the researchers for the study were in "substantial compliance" with the federal guidelines they were obligated to follow _ some of which were tougher than the GCP conditions.
Meanwhile, federal and congressional investigations into disputes between NIH's researchers and the agency officers charged with safety and compliance have elicited new information showing that some concerns reached high into the agency.
For instance, the No. 2 official in the AIDS division, Dr. Jonathan Kagan, wrote an e-mail rebuking his boss, AIDS division director Dr. Edmund Tramont, for trying to give an award to the frontline researchers in the Uganda study within months of the problems surfacing.
"We cannot lose sight of the fact that they screwed up big time," Kagan wrote Tramont in the 2003 e-mail provided to AP. "And you bailed their asses out. I'm all for forgiveness, etc. I'm not for punishing them. But it would be 'over the top' to me to be proclaiming them as heroes."
Fri Apr 8, 2005 11:34 AM ET
By Helen Nyambura
DAR ES SALAAM, Tanzania (Reuters) - Tanzania revised its HIV infection rate downwards to 7 percent Friday, from a previous estimate of 12 to 15 percent, but said the number of people infected by the deadly virus was still too high.
The revision was made to reflect the findings of a new poll, the first study to carry out HIV testing on a representative sample of the population.
"Tanzania continues to battle high HIV infection rates. According to the new Tanzania HIV/AIDS Indicator Survey (THIS) 7 percent of adult men and women are infected with HIV," a statement by the Tanzania Commission for AIDS said.
Previous studies took pregnant women or blood donated to blood banks as sample groups.
It collected data from questionnaires and voluntary blood tests of more than 12,000 people between 15 and 49 years.
Echoing the findings of a United Nations report released before World AIDS Day last December, the survey showed that the pandemic is increasingly taking on a female face.
Women make up nearly half the 37.2 million adults living with HIV around the world, and in sub-Saharan Africa they represent almost 60 percent of those infected.
The Tanzanian survey placed prevalence at 7.7 percent in women and 6.3 percent in men.
"In the 15 to 19 year age group about 2 percent of both men and women are HIV positive. Prevalence among women then rises steadily and peaks at 13 percent for women aged 30 to 34," the statement said.
The report found that more people were now practicing safe sex compared to five years ago although it noted that many expectant women were not aware that the chances of a baby getting infected fell when a woman took anti-retroviral drugs.
Last month, the Health Ministry said it planned to sharply increase the number of AIDS patients receiving anti-retrovirals (ARVs) to 44,000 by the end of this year with donor aid.
Currently, only 4,000 people are taking the government-sponsored ARVs although an estimated 200,000 are in dire need of the expensive drugs.
Despite a fall in price over the last few years, most Tanzanians surviving on less than a dollar a day, cannot afford the life-prolonging drugs..
Tanzania loses some 2,880 school teachers to AIDS every year while more than 1 million AIDS orphans in the east African country fall under the care of relatives above the age of 55.