sorry about the wrong order!
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Date: Mon, 10 Dec 2001 20:11:12 -0500
From: Africa Action <[log in to unmask]>
To: [log in to unmask]
Subject: Africa: AIDS Policy Updates, 1
Africa: AIDS Policy Updates, 1
Date distributed (ymd): 011210
Document reposted by APIC
Africa Policy Electronic Distribution List: an information
service provided by AFRICA ACTION (incorporating the Africa
Policy Information Center, The Africa Fund, and the American
Committee on Africa). Find more information for action for
Africa at http://www.africapolicy.org
+++++++++++++++++++++Document Profile+++++++++++++++++++++
Region: Continent-Wide
Issue Areas: +economy/development+ +health+
SUMMARY CONTENTS:
This posting contains several documents related to the current
status of AIDS funding and related issues: an op-ed in the Seattle
Post-Intelligencer by Africa Action executive director Salih
Booker, excerpts from an interview with Stephen Lewis, the UN
Special Envoy for HIV/AIDS in Africa, and a press advisory from
U.S. Representative Henry Hyde on legislation to be voted on in the
House of Representatives on Dec. 11.
The Hyde bill authorizes $750 million for the Global Fund in Fiscal
Year 2002, the highest level among legislative proposals currently
under consideration. If approved, this would set an upper limit--
the funds would still have to be appropriated. Current
appropriations bills still being considered by Congress include
much smaller sums. The higher figure would in all likelihood
require a supplemental appropriation.
Another posting today has the concluding statement from a meeting
of international experts held in Paris on care for people living
with HIV/AIDS. The statement clearly spells out the need for the
Global Health Fund for AIDS, TB, and Malaria to prioritize
financing for AIDS treatment, inclusive of antiretroviral drugs.
The XIIth International Conference on AIDS and STDs in Africa is
being held 9-13 December 2001 in Ouagadougou, Burkina Faso. More
information, including a daily conference journal, is expected to
be available on the conference web site at: http://www.cisma2001.bf
+++++++++++++++++end profile++++++++++++++++++++++++++++++
Seattle Post-Intelligencer
Seattle, Washington
http://seattlep-i.nwsource.com/
AIDS pandemic threatens planet
Friday, December 7, 2001
by Salih Booker
Whether judged by the number killed each day or by the potential
collapse of entire nations, the AIDS pandemic is a greater threat
to global human security than are organized terrorist groups. Yet
the Bush administration refuses to acknowledge this fact.
This past weekend, as the international community once again
commemorated World AIDS Day by noting new estimates of 3 million
more dead, 5 million new HIV infections and 40 million people now
living with HIV/AIDS, even these shocking new statistics failed to
stir action from those whose intervention could turn the tide of
the pandemic. And most media outlets gave the occasion only
perfunctory attention.
Those on the front lines -- people living with AIDS, medical
professionals and community activists, family and friends -- are
fighting the war on AIDS with the resources they have. But they are
not nearly enough. Indeed, they are a pittance compared to the
billions quickly mobilized for the war on terrorism. The rich
countries that could easily fund a serious defense against the
global threat of AIDS have refused to make more than token
contributions to the United Nations' Global Health Fund created to
fight the war against it. As the pandemic continues to devastate
Africa, and threatens to explode in other regions, including Russia
and south Asia, policymakers in Washington are hardly noticing.
Nowhere has the AIDS crisis had a more terrible impact than in
Africa. The continent has already lost more than 17 million people
to AIDS and is currently home to 28 million of the 40 million
people worldwide living with the disease. While the crisis is most
severe in Africa, HIV infection rates are rising around the world.
The pandemic highlights the shared vulnerability of all countries
to global threats to human security and it underscores the need for
a strong global coalition to win the war on AIDS.
Twenty years into the pandemic, the failure of world leaders to
respond to HIV/AIDS in Africa, and their incapacity to grasp the
global implications of their inaction, has fanned the flames of the
global crisis. This failure is directly related to Africa's
marginalization in the international system. The perception that
Africa lies outside the interests of the world's major powers, and
that intervention is therefore unwarranted, has allowed HIV/AIDS to
inflict devastation on the continent. The unstated but clear
assumption that African lives are expendable is at the root of the
West's disinterest.
AIDS is the worst plague humankind has ever known, and world
leaders must take urgent action to combat it. The Global Health
Fund, launched in April to finance prevention and treatment
efforts, aims to mobilize $10 billion a year to fights AIDS. But it
has been undermined from the outset by the stinginess of rich
country governments. The United States has pledged (though not
appropriated) only $300 million, which is but a fraction of the
$2.5 billion that would represent a contribution commensurate with
its share of the global economy. Despite the enormous scale of the
pandemic, the leaders of the world's richest countries still rank
the fight against AIDS low on their list of priorities.
Beyond funding, there are other immediate measures that need to be
taken -- at an international level -- to remove the obstacles that
hinder African governments' own efforts to respond to the AIDS
pandemic. The cancellation of sub-Saharan Africa's illegitimate
foreign debt would stop the diversion of resources from health care
systems and social services in Africa. It would halt the
hemorrhaging of resources from African countries to the rich
countries and financial institutions of the global North, now
running at more than $13.5 billion a year.
Enhancing the ability of African governments to acquire affordable
treatment for those living with HIV/AIDS, by taking full advantage
of international trade rules, would help prolong the lives of
millions of people and would also help in prevention efforts. These
steps would do much to confront the spread of HIV/AIDS in Africa
and would promote global public health efforts in the long-term.
On World AIDS Day, as every day now, more than 8,000 people
worldwide died of the disease -- the equivalent of two World Trade
Center tragedies each and every day.
It is obvious that AIDS threatens the stability of all countries in
the world. Yet there is no talk of a strong global coalition to
fight this threat. While the resources exist to change the course
of the pandemic, the necessary political will is still lacking.
With the numbers infected with HIV/AIDS rising rapidly across the
globe, the continued inertia of the world's most powerful leaders
will have global consequences we cannot yet begin to imagine.
*************************************************************
Interview with Stephen Lewis, UN Special Envoy
by UN Integrated Regional Information Network (IRIN)
[Excerpts only. Full text available on IRIN web site:
http://www.irinnews.org, under PlusNews. PlusNews is produced
under the banner of RHAIN, the Southern African Regional HIV/AIDS
Information Network.]
NEW YORK, 3 December (IRIN) - Stephen Lewis is the UN
Secretary-General's Special Envoy for HIV/AIDS in Africa. In an
interview with PlusNews recently, Lewis said that gender
inequality, ineffective leadership and lack of resources were key
issues facing the world in the battle against HIV/AIDS in Africa.
QUESTION: What do you see as your greatest challenges?
ANSWER: In a pretty fundamental way the biggest challenge is
gender. It is to get the entire continent to understand that women
are truly the most vulnerable in this pandemic, that until there
is a much greater degree of gender equality women will always
constitute the greatest number of new infections and there is such
a degree of cultural oppression that has to be overcome before we
really manage to deal with the pandemic. You simply cannot have
millions of women effectively sexually subjugated, forced into sex
which is risky without condoms, without the capacity to say no,
without the right to negotiate sexual relationships. It's just an
impossible situation for women and there has rarely been a disease
which is so rooted in the inequality between the sexes. Therefore,
gender is at the heart of the pandemic and until governments and
the world understand that it will be very difficult to overcome
it. ...
Second, there is still not a sufficiently effective leadership in
the countries. There is a much greater awareness in Africa than
there ever was before and there is some evidence of behaviour
change in some countries. In Uganda and Senegal there is evidence
that you can lower the rate of infection and begin to stall the
pandemic. But the leadership that is growing at the president
level must somehow infiltrate leadership at every level of
society: political, bureaucratic, professional, community, NGOs
etc and that has not yet happened.
Third, I am absolutely persuaded as I travel that there are so
many good things happening in many countries that if we were able
to take them to scale we would be able to turn the tide of the
pandemic. I don't feel despair. I am tortured by the numbers as
everyone is but not paralysed by the tremendous challenge that is
involved because we know how to turn the pandemic around. We know
how to decrease dramatically mother-to-child transmission, we know
how to do testing and counselling, we know how to undertake
prevention of many kinds through the schools and targeted at
vulnerable groups. We know how to do antiretroviral therapy -
initially limited of course but available to us. We know what it
means to find a way of integrating orphans back into the community
when their parents have died. We have all over the continent
individual projects and programmes that are successful and the
frustration lies in our inability to take them to scale. ...
What it really needs is the fourth challenge. It needs dollars. It
is the single most inhibiting factor. It's not just drug prices,
you can lower drug prices as low as they will go and countries
will still not be able to afford them so you've got to have the
resources. And that's where the Global Fund comes in and that's
where we are struggling. No question.
Q: Why is the Global Fund to fight AIDS, tuberculosis and malaria
so grossly under funded? Why have donors not been forthcoming?
A: I'm not sure they haven't. ... Countries have started to
contribute to it. The amounts are not yet sufficient but once
you've got some global funds going it will build in momentum. You
won't be able to turn it back. The one-and-a-half billion
[dollars] which I think will move pretty quickly to two billion
has got to start being distributed, it's got to reach communities,
it has to start making a difference in the lives people lead, it
has to give money for care, money for treatment, money for
prevention and then there will be so much recognition of its value
that the donors will start giving more money. ...
Q: Would the Fund ever buy or recommend generic antiretrovirals
over brand name drugs?
A: I don't know whether it would be over brand name drugs. You are
putting it in an unnecessarily combative fashion. I'm not sure it
couldn't be done in conjunction with brand name drugs. I'm not
sure that you couldn't have a range from which you pick based on
price and availability and application - what has worked and what
hasn't worked. You understand that you have me at your mercy
because I am not privy to the discussions, but I would imagine
that any sensible person would recognise that as all of us have
talked about how generic drugs have been indispensable to bringing
down drug prices of major manufacturers that they will be a part
of this. They are already being used in countries. [Nigerian
President] Obasanjo sent his Minister of Health to India and said
go to [generic drug manufacturer] Cipla and negotiate the best
price possible. And he went to India and he negotiated a price of
$350 per person per year and the drugs have now arrived in
Nigeria. So surely the Global Fund will respect what many of the
countries are doing and generics will be a part of the package but
they won't be the sole package.
QUESTION: Nigeria took a bold step earlier this year with a
programme to provide generic antiretrovirals to 15,000 people
living with HIV/AIDS. Was this a demonstration of positive African
leadership, and what do you make of the delays to the
implementation of the programme?
ANSWER: Every delay is desperately painful as human life is
hanging in the balance but this was actually a valuable delay.
Initially, Nigeria was thinking of a two drug combination. They
brought a UNAIDS team into Nigeria to take a hard look at how they
wanted to handle the antiretrovirals and what the regimen should
be. They came to the conclusion that they needed three drugs and
not two. So the delay was in part changing the regimen which they
had intended to purchase and making sure Cipla had the required
combination of drugs. And now I gather they have arrived. So
instead of being two years this delay was two months and I think
the programme is about to begin. It is supposed to start on
December 10th ...
(President Festus) Mogae's in Botswana seems to me to be the most
dramatic (programme) of all. It hopes to have well over 100,000
people in treatment starting dramatically in the year 2002 and
building in numbers. And they've really laid the groundwork. It's
just truly impressive. I sense that the preparation they're doing
means that there will probably be success and Botswana will be
seen as the country against which antiretroviral treatment is
measured because they will have the largest numbers. They
obviously have an advantage as they have money. But the actual use
of antiretroviral drugs and the way they restore life, the way
people start eating and look better and their hair doesn't fall
out and they return to work and it's like a miracle transformation
in a very short period of time. All of that will be happening in
Botswana and it will have an impact. According to the UNAIDS
report there are now 10 countries in East and Southern Africa
which are introducing antiretroviral drugs to a greater or lesser
degree.
Q: In South Africa, the government has come in for criticism over
its HIV/AIDS policies, which have been marked by an alleged lack
of political commitment. What can be done when national
governments appear hesitant to tackle the epidemic head-on?
A: I am not going to comment on things like the court case because
that it something distinctly internal to South Africa and it
involves a legal interpretation of the South African constitution.
The arguments have been made and it would be presumptuous to
comment on a high profile court case. But I would say that the
policy of UNAIDS and WHO and therefore the UN system is absolutely
clear. It is that nevirapine should be available in
mother-to-child transmission clinics, that it is an effective
drug, that any side effects or difficulties are far, far
outweighed by the positive impact of the drug itself because kids
emerge HIV negative and huge numbers of children's lives are
saved. ...
And now ... a group of foundations, headed by Rockefeller, are
introducing something called [prevention of
mother-to-child-transmission] PMTC-plus. And the plus is
antiretroviral treatment for the mothers because until now, of
course, you had the very difficult human situation where you saved
the life of the child and the mother looks at you and says with a
kind of poignant terror: 'What about me?' And now there will be a
significant effort made first on a pilot basis to introduce
antiretroviral treatment for the mother and this is being launched
in a few days time. ...
Q: What is your prognosis for the future? Do you believe that
HIV/AIDS will eventually be brought under control?
A: For 20 years we watched this plague grow exponentially and
ruthlessly. HIV/AIDS is the most apocalyptic thing that has
happened in the history of disease. For 20 years African
leadership was largely silent, in denial, frightened, traumatised,
paralysed. For 20 years the Western world, which had the
resources, was developing the drugs and knew how to deal with the
pandemic. The Western world contributed a negligible quantity of
money to Africa.
It only started to turn around in the year 2000. In the process 17
million lives were lost and 25 million people were already
infected. It is one of the most astonishing moral lapses in
post-war history. I really feel frustrated and extremely angry at
the inertia in response to the epidemic ...
*************************************************************
NEWS ADVISORY
House International Relations Committee
Congressman Henry J. Hyde
CONTACT: Sam Stratman, (202) 226-7875, December 6, 2001
Committee on International Relations
http://www.house.gov/international_relations
Hyde Global HIV/AIDS Legislation
Scheduled for House Vote December 11
December 7, 2001
(WASHINGTON) - A $1.3 billion one-year authorization bill to
address the global HIV/AIDS crisis is scheduled for a vote in the
House of Representatives on Tuesday, December 11 its chief
sponsor, U.S. Rep. Henry J. Hyde (R-IL), chairman of the House
International Relations Committee announced Thursday.
The bipartisan legislation, the Global Access to HIV/AIDS
Prevention, Awareness, Education and Treatment Act (HR 2069), was
approved 32-4 in June by the committee with support from
cosponsors U.S. Reps. Tom Lantos (D-CA), Jim Leach (R-IA) and
Barbara Lee (D-CA).
"The scourge of HIV/AIDS is one of the great moral challenges of
our era, for it is one of the most compelling humanitarian and
national security crisis of modern times," Hyde said, adding,
"Everyone has a stake in what tragically could be the plague of
the 21st century, and we must meet this test by reaching out now
to those most in need. It is the right thing to do for our
children, our country, and our world," Hyde added."
Highlights of the HR 2069 (As amended):
* $750 million for an international AIDS trust fund.
* $485 million in bilateral assistance largely through
non-governmental organizations including faith-based organizations
and administered by the U.S. Agency for International Development
(USAID) to undertake a comprehensive program of HIV/AIDS
education, and treatment; including prevention activities that
promote behavioral change.
* $50 million for a pilot program for treatment of those infected
by assisting developing countries in procuring pharmaceuticals and
anti-viral therapies.
* Establishes programs to strengthen and broaden indigenous health
care delivery systems and the capacity of such systems to deliver
HIV/AIDS pharmaceuticals.
* Provides assistance aimed at the prevention of transmission of
HIV/AIDS from mother to child.
* Provides assistance to strengthen and expand hospice and
palliative care programs.
* Funds care and support of children who are orphaned by the
HIV/AIDS pandemic.
* Funds vaccine research and development partnership programs to
develop a safe, effective, accessible, preventive HIV vaccine for
use throughout the world.
* Establishes microenterprise programs that provide poor families
affected by HIV/AIDS with the economic means to care for
themselves, their children, and orphans.
* Establishes an aggressive oversight program to monitor projects,
and activities.
...
************************************************************
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