| prevention-news@cdcnpin.org 2004-10-27, 7:11 pm |
| CDC HIV/STD/TB Prevention News Update
Wednesday, October 27, 2004
The CDC National Center for HIV, STD and TB Prevention provides the follo=
wing information as a public service only. Providing synopses of key scie=
ntific articles and lay media reports on HIV/AIDS, other sexually transmi=
tted diseases and tuberculosis does not constitute CDC endorsement. The f=
ollowing summaries were prepared without conducting any additional resear=
ch or investigation into the facts and statements made in the articles be=
ing summarized, and therefore readers are expressly cautioned against rel=
ying on the validity or invalidity of any statements made in these summar=
ies. This daily update also includes information from CDC and other gover=
nment agencies, such as background on Morbidity and Mortality Weekly Repo=
rt (MMWR) articles, fact sheets and announcements. Reproduction of this t=
ext is encouraged; however, copies may not be sold, and the CDC HIV/STD/T=
B Prevention News Update should be cited as the source of the=20
information. Contact the sources of the articles abstracted below for ful=
l texts of the articles.
HEADLINES
NATIONAL NEWS
NEW JERSEY: =93McGreevey Allows Needle Exchanges in 3 Cities for HIV Prev=
ention=94
INTERNATIONAL NEWS
ZAMBIA: =93USAID Gives Zambia $24 Million for Health Programs=94
GLOBAL: =93New Drugs, Plan Needed to Fight Killer TB =97 MSF=94
GLOBAL: =93Novartis Sets Deal to Seek New Drugs for Fighting TB=94
CHILE: =93Health: Chile Making Strong Gains in Fight Against AIDS=94
DEMOCRATIC REPUBLIC OF CONGO: =93Congo Urged to Help 40,000 Rape Victims=94
MEDICAL NEWS
BOTSWANA: =93Antiretroviral Therapy of HIV+ Moms Who Breastfeed May Prote=
ct Infants=94
NEWS BRIEFS
SUDAN: =93Sudan to Check Every New AU Soldier for AIDS=94
VIETNAM: =93Vietnam to Detect HIV/AIDS Infections in Army=94
CALIFORNIA: =93Tuberculosis Confirmed in O.C. Student=94
TEXAS: =93AIDS Walk Attracts Thousands=94
=20
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NATIONAL NEWS=09
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NEW JERSEY:
=93McGreevey Allows Needle Exchanges in 3 Cities for HIV Prevention=94
New York Times (10.27.04)::Damien Cave=20
On Tuesday, Gov. James McGreevey signed an executive order authorizi=
ng the New Jersey Department of Health and Senior Services (DHSS) to over=
see needle exchange programs in as many as three municipalities. The orde=
r covers only cities that have high HIV prevalence due to intravenous dru=
g-use and that have ordinances allowing needle exchange programs. Camden=
and Atlantic City fit both criteria and are expected to make clean syrin=
ges available within weeks. A third city has not yet qualified.=20
To support his contention that HIV constitutes an emergency in New J=
ersey, McGreevey cited statistical evidence and referenced a study showin=
g that HIV prevalence decreased by 29 percent in cities with needle excha=
nges, while prevalence increased by 5 percent in cities without the progr=
ams. =93The evidence is incontrovertible. We have resisted the evidence a=
t a high cost,=94 he said. =93The goal of the executive order is to demon=
strate that the science works and to move forward,=94 McGreevey said, eve=
n as he acknowledged the state's lack of political consensus on the issue=
..
McGreevey resigns his office on Nov. 15, when Senate President Richa=
rd J. Codey (D) will replace him. =20
=93We will review the order once we receive it,=94 said State Attorn=
ey General Peter Harvey's office. Codey's office said he =93wants to take=
a look at it and work with the other legislative leaders.=94 Republican =
state Sens. Robert Singer and Thomas H. Kean questioned both McGreevey's =
declaration of an emergency and the constitutionality of the order. Sen. =
Ronald Rice (D) said he hoped the order would be quickly challenged.
Needle-exchange programs are =93a very effective gateway to engage d=
rug users into health and social services, and into drug treatment,=94 DH=
SS Commissioner Dr. Clifton Lacy said. =93Regular visits to these syringe=
-exchange sites create an opportunity for referrals.=94
A future governor can rescind the executive order. McGreevey's actio=
n leaves Delaware as the only state that bars needle-exchange programs an=
d criminalizes possession of syringes without a prescription.
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INTERNATIONAL NEWS=09
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ZAMBIA:
=93USAID Gives Zambia $24 Million for Health Programs=94
Associated Press (10.26.04)
On Tuesday in Lusaka, the US embassy announced that the US Agency fo=
r International Development will give Zambia $24 million to fight AIDS an=
d malaria and to treat drinking water.=20
In a statement, the embassy said the money will fund health educatio=
n programs during the coming six years. The Zambian government and the in=
dependent Society for Family Health will coordinate the effort.=20
=93The project=85 will use proven strategies for making affordable, =
preventive health care products and services more accessible and availabl=
e to low income Zambians,=94 said the statement.=20
The program will promote condoms to high-risk groups and will also f=
ocus on increasing access to voluntary counseling and testing services to=
improve knowledge of, and dispel myths about, HIV/AIDS.=20
The funds will also be used to help buy insecticide-treated bed-nets=
for distribution in the nation's anti-malaria program.
At a weekend ceremony celebrating the 40th anniversary of Zambia's i=
ndependence, President Levy Mwanawasa promised to raise the number of peo=
ple receiving antiretrovirals from the current 12,000 to 100,000 by 2005.=
He also noted that the HIV prevalence rate among 15- to 49-year-olds had=
dropped from 26 percent in the 1990s to 16 percent at present. Mwanawasa=
reminded his nation that changes in sexual behaviors and attitudes are s=
till =93the most cost-effective method of reversing the pandemic.=94
GLOBAL:
=93New Drugs, Plan Needed to Fight Killer TB =97 MSF=94
Reuters (10.26.04)
Outdated and ineffective strategies to fight TB in poor countries ar=
e not working and new treatments are urgently needed, Medecins Sans Front=
ieres (Doctors Without Borders/DWB) said Tuesday. Treatment protocols use=
d by the World Health Organization and the International Union Against Tu=
berculosis and Lung Disease force doctors to work with =93archaic tools,=94=
the Paris-based group said. =93At the moment, we cannot properly detect =
and treat the sick,=94 DWB President Jean-Herve Bradol said in a statemen=
t.
Each year, TB infects an estimated 8.7 million people and kills 2 mi=
llion despite widely adopted control efforts. WHO's main strategy to cont=
rol TB, called =93Directly Observed Treatment, Short-course=94 or DOTS, i=
nvolves health workers watching patients take their antibiotics over a si=
x- to eight-month period. TB can become resistant to the drugs, which wer=
e developed 40-60 years ago, if a patient fails to take the full course. =
In poor countries, existing tests to diagnose TB can only detect one stra=
in of the disease.=20
DWB said better medicines and more effective diagnostic tests should=
be part of a new anti-TB strategy. Such a plan is also critical to tackl=
ing the dual TB and AIDS epidemic. TB is the leading cause of death among=
HIV patients worldwide, accounting for about 13 percent of AIDS-related =
mortalities, according to WHO.=20
DWB is not alone in its criticism of current TB control methods. Las=
t month, Harvard university researchers said DOTS would only modestly imp=
act the fight against TB and called for new approaches for TB control.=20
GLOBAL:
=93Novartis Sets Deal to Seek New Drugs for Fighting TB=94
Wall Street Journal (10.27.04)::Marilyn Chase
The Global Alliance for TB Drug Development, a nonprofit public-priv=
ate partnership, plans to partner with a unit of Novartis AG to develop m=
uch-needed new drugs for TB treatment. The alliance, which has offices in=
New York, Cape Town and Brussels, is expected to announce today it has s=
igned a letter of intent with the Novartis Institute for Tropical Disease=
s to work on a new TB drug family.
Phase I safety studies of the main compound in the family, PA-824, w=
ill begin next year in healthy volunteers. The partnership hopes to event=
ually launch studies of drug efficacy in Africa, Latin America or Asia. P=
A-824, licensed by the alliance from Chiron Corp., differs from existing =
antibiotics by killing both fast- and slow-growing strains of TB bacteria=
.. Lab tests have also indicated its promise against multi-drug resistant =
TB strains.=20
If successful, PA-824 could reach the market in six years, said Paul=
Herrling, head of corporate research for Novartis and chair of the Novar=
tis Institute for Tropical Diseases. However, any other drugs related to =
PA-824 could take 11 or 12 years to develop, Herrling added. =93The drug =
discovery effort is really not a quickie,=94 he said. =93It takes sustain=
ed efforts.=94 Global Alliance President Maria Freire said the hope is to=
make one new compound a year in the PA-824 family, also known as nitroim=
idazopyrans.=20
=93Promising compounds such as this need to be nurtured,=94 said Pet=
er Small, a TB expert with the Bill and Melinda Gates Foundation, which h=
elps fund the Global Alliance. =93Drug resistance is emerging in every co=
untry against a disease that is killing someone every 15 seconds, and the=
new-drug pipeline is little more than a trickle.=94
Novartis said it would make the drugs available without profit to po=
or patients in developing countries.=20
CHILE:=20
=93Health: Chile Making Strong Gains in Fight Against AIDS=94
Inter-Press Service (10.19.04)::Daniela Estrada
A decrease in the growth of new HIV infections in Chile is evidence =
that a joint government-civil society program is working. Backed by the G=
lobal Fund to Fight AIDS, TB and Malaria, the two-year effort has spent m=
ore than $6 million in its first year. Before the project's launch, forec=
asts predicted that Chile would have eight new cases per day =97 the actu=
al figure is six, a decrease that is expected to continue, said Annabella=
Arredondo, executive coordinator of Chile's National AIDS Commission (CO=
NASIDA).=20
All 4,838 AIDS patients registered in the public health system are n=
ow covered for antiretroviral treatment, with costs split 80 percent/20 p=
ercent between Chile's center-left government and the Global Fund.
The project is also helping to train health-care personnel who work =
with HIV/AIDS patients and rehabilitate the physical condition of 26 hosp=
ital pharmacies. Local project member agency Vivo Positivo established a =
legal defense system for people with HIV/AIDS in the Santiago region. Its=
focus is on finding employment for group members and fighting discrimina=
tion in the workplace and educational institutions. ASOSIDA, a coalition =
of private HIV/AIDS organizations, is working on nine initiatives, includ=
ing the creation of a national database of HIV/AIDS institutions and publ=
ishing of a community outreach manual and research papers. =20
With the help of the project, Chile has developed for the first time=
regional educational and awareness campaigns that reflect the culture of=
local audiences. Six research projects are studying emerging high-risk g=
roups, including youths, immigrants, indigenous peoples and homemakers. A=
special program has been developed to augment prevention efforts among t=
op-priority risk groups, including sex workers and the gay and bisexual c=
ommunity. =20
A cross-sectional panel is evaluating school-based HIV awareness and=
prevention efforts to formulate more effective sex education policies. C=
ondom imports grew by 25 percent last year, to 21 million units, one-thir=
d the number some estimate the country should be using. There are still o=
bstacles to distributing condoms in public places, though not in public h=
ealth care facilities, said Arredondo.
DEMOCRATIC REPUBLIC OF CONGO:=20
=93Congo Urged to Help 40,000 Rape Victims=94
Reuters (10.26.04)::Andrew Gray
On Tuesday, an Amnesty International human rights report said that f=
ighters in the Democratic Republic of Congo (DRC) have raped at least 40,=
000 women and girls in the last six years. While war in the DRC was decla=
red ended in 2003, fighting has continued sporadically in the east, and A=
I said all of the more than 20 groups engaged in fighting have continued =
to rape women and carry out other acts of violence and torture. Many rape=
d women fear they have caught diseases such as HIV/AIDS, and their commun=
ities often shun them.
=93The women we met often said: =93I've no future, I'd prefer to die=
,'=94 said Veronique Aubert, an AI researcher who worked on the report. A=
I said the government was indifferent to the women's plight. It called fo=
r authorities to crack down on sexual violence and demanded international=
efforts to improve security in the east.=20
In addition, AI urged that an expert team examine the health system'=
s needs. Only two hospitals can treat survivors of sexual violence, said =
the organization. =93Having the possibility of access to aspirin to calm =
your pain, being able to benefit from healthcare products at the hospital=
=97 these things are possible and don't need a lot of money,=94 said AI =
researcher Marcel Carlos Akpovo. =93It's the political will which is nece=
ssary.=94
=93It's good to remind people and the government of their obligation=
s,=94 said Marie-Madeleine Kalala, Human Rights Minister for Congo's tran=
sitional government. =93The state of degradation of this sector in our co=
untry is immense. We're not going to be able to change things in one mont=
h or two months.=94 The cabinet will pay close attention to the AI report=
, she said.
=20
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MEDICAL NEWS=09
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BOTSWANA:
=93Antiretroviral Therapy of HIV+ Moms Who Breastfeed May Protect Infants=
=94
Women's Health Weekly (10.21.04)=20
Women on combination HIV/AIDS drug regimens may pass along high leve=
ls of medication through breastfeeding, thus potentially protecting their=
infants from infection, recent findings suggest.=20
=93It's a really surprising finding and could potentially mean a two-for-=
one situation,=94 said Roger Shapiro, MD, research associate for the Harv=
ard School of Public Health and instructor at Harvard Medical School. Sha=
piro presented the findings on Sept. 30 at the 42nd Annual Meeting of the=
Infectious Diseases Society of America.
As many as one in eight babies born to women with HIV/AIDS acquire t=
he virus through breastfeeding. Due to the risk, HIV-positive women in in=
dustrialized nations are advised to feed their babies formula. But in dev=
eloping countries with limited access to formula and clean water, breastf=
eeding is often the most feasible option, and researchers are investigati=
on ways to decrease virus transmission during breastfeeding.
=93Although studies are ongoing, it is believed that putting uninfec=
ted babies on antiretroviral medication may prevent them from acquiring t=
he virus from their infected mothers while they are breast-feeding,=94 Sh=
apiro said. =93Our study suggests that putting mothers on antiretrovirals=
could provide infants with high enough levels of these medications throu=
gh breastfeeding, so that the infants may not have to take any medication=
separately.=94=20
However, Shapiro noted that exposing infants to antiretroviral thera=
py through breast milk alone could pose a risk for infants who have acqui=
red HIV in utero or during birth. In such babies, resistant mutations of =
the virus may develop from exposure to drug levels lower than those neede=
d for treatment and may potentially compromise future ART treatment.=20
The research involved 20 pregnant women with AIDS in Botswana who we=
re receiving nevirapine, lamivudine and AZT. All infants received one dos=
e of nevirapine at birth and oral AZT during the course of breastfeeding.=
Researchers measured levels of the drugs in breast milk and in the blood=
of mothers and infants either two or five months after birth. High level=
s of all three drugs were found in breast milk. Blood tests found that th=
e infants may have achieved sufficient levels of nevirapine (and possibly=
lamivudine and AZT) through breast milk to avoid becoming infected throu=
gh breastfeeding. In addition to the dangers of resistant mutations, howe=
ver, Shapiro noted the potential of other drug side effects in the infant=
s.
=93It is generally believed that maternal antiretroviral therapy wil=
l decrease the chances of HIV transmission to breastfeeding infants by lo=
wering the levels of virus in the blood and breast milk of mothers,=94 Sh=
apiro said. =93This study supports the possibility that maternal antiretr=
oviral therapy may also decrease HIV transmission from breast-feeding by =
providing the drugs directly to the infants.=94
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NEWS BRIEFS =09
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SUDAN:
=93Sudan to Check Every New AU Soldier for AIDS=94
Agence France Presse (10.26.04)
On Tuesday, Sudanese Health Minister Ahmed Bilal Osman said every me=
mber of the African Union contingent assigned to monitor a cease-fire in =
Darfur should provide a certificate proving he is not HIV-infected. The s=
emi-official Sudanese Media Center quoted him as saying the measure was a=
precaution aimed at =93safeguarding the health of the people of Darfur.=94=
Those who cannot produce internationally recognized health certificates =
would have to undergo medical tests before going to Darfur. The AU plans =
to deploy more than 3,000 troops from five countries to Darfur in the com=
ing weeks to calm the 20-month-old conflict that has claimed tens of thou=
sands of lives. In August, Tayeb Mustafa of the ruing National Congress P=
arty criticized the government for allowing 150 Rwandan troops to enter D=
arfur without health certificates.
VIETNAM:
=93Vietnam to Detect HIV/AIDS Infections in Army=94
Xinhua News Agency (10.20.04)
The local newspaper Pioneer reported that Vietnam will test all army=
officers and soldiers for HIV and drugs on a regular basis. In the past =
seven years, Vietnam has found 1,417 HIV cases among recruits. As of late=
2003, 130 HIV cases had been detected among men in military service.=20
CALIFORNIA:
=93Tuberculosis Confirmed in O.C. Student=94
Los Angeles Times (10.27.04)
Officials are offering screenings in response to a case of TB diagno=
sed in a student at Magnolia High School. The Orange County Health Care A=
gency informed school officials of the case late Thursday, said Principal=
Ken Fox. On Tuesday, officials sent a letter home with students to infor=
m parents and guardians about the case. The student is expected to make a=
full recovery. A meeting on the matter is scheduled for 6:30 p.m. on Nov=
.. 3 at the school; testing is tentatively scheduled for Nov. 8.
TEXAS:
=93AIDS Walk Attracts Thousands=94
Austin American-Statesman (10.25.04)
On Sunday in Austin, some 9,000 people took part in the city's 17th =
annual AIDS Walk. Lee Manford, executive director of AIDS Services of Aus=
tin, said participants raised more than $150,000. The money will benefit =
that agency and 11 other Central Texas groups serving people with HIV. Fo=
r more information visit www.aidswalkaustin.org.
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ANNOUNCEMENT: The 2005 National HIV Prevention Conference will be convene=
d by the Centers for Disease Control and Prevention (CDC) and many other =
national and community partners June 12-15 in Atlanta, Ga. The conference=
, which is held every two years, is noted for bringing together preventio=
n programs and science and for its exclusive focus on HIV prevention. Att=
endees include local, regional and national decision makers, researchers,=
policy makers, community leaders and practitioners working to prevent th=
e spread of HIV/AIDS. In 2003, this conference attracted over 3,000 parti=
cipants from across the country.
Abstract Submission Information: Online submission is available through t=
he conference Web site. Abstracts submitted on paper or diskette must be =
postmarked by Jan. 10, 2005. Abstracts submitted electronically must be r=
eceived by Jan. 17, 2005. For more information about abstract submission =
and other conference information, visit the conference Web site at http:/=
/www.2005HIVPrevConf.org, or telephone the conference hotline at 866-277-=
6313.
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