HIV/AIDS Newsroom: September 11, 2000
Public Health in Developing Countries
09/02/00 Vol. 356, No. 9232, P. 841; Macfarlane, Sarah; Racelis, Mary; Muli-Musiime, Florence
Public health in less developed countries is tied to poverty, debt, and conflicts. While health improvements were made in Africa and Asia during the 20th century, political instability, weak health infrastructure, and the rise of AIDS have affected the quality of healthcare. Deaths from malaria, HIV, tuberculosis, cancer, and diabetes continue to burden these nations. The number of marginalized people has grown, although overall poverty has fallen. For its 2000 World Development Report, the World Bank created a series of studies called "Consultation with the poor," listening to over 60,000 poor women discuss their health services. Many of the participants expressed feelings of powerlessness and concern about poor quality of health and social services. International public health initiatives since the 1970s have tackled eradicating worms, oral rehydration, immunization programs, AIDS, polio, and malaria. UNICEF has worked with governments to help improve care, and the World Health Organization's "Roll Back Malaria" program aims to alter social conditions as well as health. Ghana has shown improvement in maternal and child health since 1988, and Uganda has had success in stemming the spread of HIV through its decentralization of authority to the district level and lower. The international level of commitment is also a factor for the poor. Disease surveillance and helping during disaster situations remain two ways to help public health abroad. According to the authors, "For public health to succeed, it must be re-crafted in a framework that locates organized and active communities at the center as initiators and managers or their own health."
A gathering of scientists at the Royal Society in London today will assess claims that HIV made its way to humans from monkeys, via a tainted live polio vaccine given to over 1 million children in Africa during the 1950s. Live vaccines at the time were often prepared using kidney tissue from monkeys. While those involved in the experimental polio vaccine trial and most scientists reject the hypothesis, renewed attention was drawn to the controversial theory last year in Edward Hooper's book, The River: A Journey Back to the Source of HIV and AIDS. Hooper argues that the generally accepted theory which suggests that HIV crossed species as the result of a monkey bite or when a hunter was infected while preparing or eating monkey flesh, does not clarify why HIV suddenly began to infect humans towards the end of the last century.
South Africa's Mbeki Clings to Controversial AIDS Stance
09/10/00; Seccombe, Allan
South African President Thabo Mbeki has once again sparked controversy, reiterating his belief that HIV is not the sole cause of AIDS. In an interview with Time magazine, published on the magazine's Web site, Mbeki stated that poverty, poor nutrition, and sexually transmitted diseases are all factors that contribute to immune deficiency. Mbeki's position has angered a number of groups, including the Treatment Action Campaign of South Africa, which has launched legal action to require the government to provide nevirapine to help prevent mother-to-child HIV transmission. Mbeki also failed to acknowledge the link between HIV and AIDS at the International AIDS Conference held in Durban earlier this summer.
The U.S. government is calling on businesses and labor unions to help fight HIV both in this country and overseas, in an effort to prevent a loss of labor and manufacturing capabilities. Health and Human Services Secretary Donna Shalala said Friday that by 2020, AIDS will have taken millions of people from the labor market. Shalala encouraged business leaders to promote HIV testing, although she also acknowledged that some workers are concerned that a positive test result may be used against them. Shalala said that the White House's soon-to-be released final regulations on medical records privacy, which will state that health data including HIV status only be used for medical purposes by employers and insurers, should help boost employees' trust of employer-sponsored HIV testing programs.
Last week's U.N. Millennium Summit, which brought together the largest number of heads of state ever, did not make progress towards ending regional conflicts ranging from the Balkans to Africa. However, the 150 kings, presidents, and government heads at the meeting did set a goal in their Millennium Declaration to reduce poverty by half, stem the spread of HIV, and offer primary education to all children within 15 years.
Researchers from the National Institutes of Health (NIH) have found that a bone disorder called osteo necrosis is disproportionately affecting people with HIV. They are unsure what is causing the bone destruction and why it is only being seen now. The disorder, which leads to bone death from lack of blood supply, is affecting the hip bones among people with HIV. Dr. Joseph Kovacs believes the prevalence of the disorder will grow. The researchers -- who presented their findings at a meeting of the Infectious Diseases Society of America in New Orleans -- said that although the condition was initially thought to be related to HIV drugs, this association has not yet been proven. Kovacs first detected osteo necrosis among HIV patients in May of 1999, after performing magnetic resonance imaging tests to identify the bone problem. A study of 339 HIV-infected individuals at NIH showed that 4.4 percent had avascular necrosis in at least one hip. None of the 118 HIV-negative volunteers had the bone disorder.
In Pennsylvania, the number of AIDS cases among Caucasians has been falling steadily, although the number of cases among African Americans is on the rise, according to a state official. At the annual meeting of AIDSNET, a federally mandated planning coalition for six counties, Janice Kopelman -- director of the state Health Department's Bureau of Communicable Diseases -- also said that intravenous drug use is a growing source of HIV. She noted that treatments are helping people live longer with HIV, but they are not accessible to everyone. Kopelman emphasized the need for HIV testing and better prevention awareness, as an estimated 175,000 to 275,000 people are not aware they are infected.
A study from Dr. Grant Colfax, director in clinical studies HIV research in the San Francisco Department of Public Health, shows that American gay men who attend dance events known as circuit parties frequently engage in drug use and unsafe sex there, leading to a high risk of contracting HIV. Colfax and colleagues studied 300 gay and bisexual men, comparing their drug habits and sexual practices at a recent circuit party to a weekend without a circuit party. Of the party-goers, nearly 30 percent of those with HIV and 10 percent of those who were HIV-negative had unsafe anal sex and did not know their partners' HIV status. Colfax, who reported his findings at the 13th International AIDS Conference in July, stressed that not all men at circuit parties participate in unsafe behavior.
Senior Iranian official Gholamreza Sahraian, a reformist ally of President Khatami and governor of Fars, is calling for AIDS education in school textbooks. He also stated that teachers should learn about AIDS and how it is spread. Formal education about sex has been taboo in the country for more than 20 years.
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.