HIV/AIDS Newsroom: December 22, 2000
Life by Luck of the Draw
Washington Post (www.washingtonpost.com)
12/22/00 P. A1; Flaherty, Mary Pat; Struck, Doug
The AIDS epidemic has brought ethical issues to the forefront, as researchers from wealthy nations conduct research in partnership with countries in the developing world and experts question what nation's guidelines should apply. One of the controversial issues is whether researchers should provide the best available treatment in wealthy nations, or whether they should provide the best care that is available locally -- which in some areas may be no treatment at all. In Thailand, where 800,000 adults are infected with HIV, ethical questions have been repeatedly raised, particularly with studies into vaccines and the use of AZT to prevent mother-to-child HIV transmission. The CDC's 1996 test of AZT among HIV-infected pregnant women in Thailand is one study that sparked controversy, as half of the women were to be given a short-course of the drug, the other half would receive a placebo. The CDC -- and Thai ethics committee agreed -- that not using a placebo would have meant that more volunteers were needed, which would delay the launch of the study and alter the comparison. "We felt it was not only ethical, but it was essential to conduct" the research, Gayle said. In the end, the CDC found that a short-course of AZT could help significantly reduce mother-to-child HIV transmission, and the findings helped influence national health policy in the country. Earlier this year, Thailand agreed to provide the treatment free of charge to pregnant women infected with HIV.
The number of tuberculosis (TB) cases in King County, Washington, has increased this year. A total of 117 cases were recorded through November, compared to 104 for all of 1999. County officials note that 70 percent of the TB cases in the region are among foreign-born individuals; nationwide, about 40 percent of all TB cases are among foreign-born people. Health officials say the increase is not cause for alarm but is only an indicator that preventative care measures need to be provided for immigrants settling in the area.
State Stops Giving Schools in Valley TB Testing Gear; Plan Is to Refer Recent Immigrants to Health Offices
San Antonio Express-News (www.mysanantonio.com/expressnews)
12/21/00 P. 1A; Gregor, Alison
In response to a decline in the number of Rio Grande Valley students testing positive for tuberculosis (TB), Texas health officials have decided to discontinue supplying TB testing materials to area schools. Officials from the Texas Department of Health have assured the area residents that they will continue to test and treat current and future immigrants for the highly contagious disease, but it will be the school's responsibility to refer immigrant students to the health agency for screening. The number of positive TB cases in the Valley region has dropped from 7 percent to 10 percent of those tested in 1992 to under 4 percent of tested students this year. Some school district officials expressed concern about the state's decision to stop the free flow of testing materials; the cost of buying the serum and syringes needed for testing would be about $7,000 for the Brownsville School District, according to Ana Milan, the administrator for health services in the district.
In Toronto, 1,150 students have been warned that they may have been exposed to tuberculosis (TB). The warning letter to North Albion Collegiate Institute students follows the diagnosis of a 17-year-old grade 12 student with TB; the individual has not attended classes for nearly two months, and tests last week confirmed he had TB. The school will hold a TB testing clinic early next month for students who do not get tested over the holidays. Ann Ward, the acting TB manager for the Toronto public health department, noted that the case is not related to the multidrug-resistant TB infection of an immigrant from the Caribbean.
A position paper released by the American Dietetic Association (ADA) and Dieticians of Canada states that efforts to improve nutrition should be part of overall health care provided to HIV-infected individuals. Specifically, the groups recommended medical nutrition therapy and nutrition counseling. In addition, ADA spokesman Dr. Keith Ayoob notes that food and water safety issues should be discussed.
Louisiana's Office of Public Health has awarded a three-year HIV prevention contract to the Baton Rouge AIDS Society. Under the agreement, the organization will receive $75,000 annually to provide HIV testing and counseling, condoms, and outreach efforts. Cities that will benefit from the contract include Baton Rouge, Donaldsonville, Jackson, White Castle, and St. Francisville.
The National Institutes of Health has given PTC Therapeutics a $100,000 Small Business Innovation Research Grant to develop AIDS drugs. The company is working to create drugs that keep HIV from reproducing and spreading in the body of an individual who has contracted the virus.
In an effort to raise awareness about how men's health plays a vital role in the struggle against the spread of HIV, UNAIDS and other health agencies are now focusing on men, notes Pauline Ngunjiri of the Society of Women and AIDS in Kenya. Ngunjiri writes that, in general, men are less likely than women to be conscious of their overall health and safety regarding sexual behavior and consequences. Men generally have more sexual partners than women as well. Health officials agree that prevention programs for women and children still need to be expanded, but they note that there must also be programs for boys and men. Part of the struggle health officials face with health issues related to men are traditional roles that society assigns men, especially regarding risky behavior. Research has also shown that men do not have comparable coping skills and might be less likely to seek help from family or friends if HIV were a health issue.
Inspired by his son's death in 1986 from AIDS, former Zambian President Kenneth Kaunda has been outspoken regarding the effects of war on the struggle against HIV in the African nations. He believes that the poverty and destruction of family structures brought about by war are a major block to stopping the spread of the disease. As a step forward in his personal war against HIV, Kaunda has been named as a candidate for international mediator in the peace talks with warring nations in the Democratic Republic of Congo, succeeding former Botswana leader Ketumile Masire.
A broad new public health bill plans to target $919 million to combat drug-resistant pathogens and bioterrorism, spur clinical research and other initiatives, and construct state of the art research facilities. The new legislature comes as awareness increases of approximately 14,000 in-hospital deaths related to drug-resistant bacterial infections occur annually out of nearly 2 million patients. One broad arm of this law will provide grants to state, local health facilities for the training needed to recognize bioweaponry and know how to treat it. The legislation also calls for federal support of research into new therapeutics, including vaccines; provides grants to expand or renovate new research facilities; and authorizes research and training awards for scientists studying sexually transmitted diseases and Alzheimer's disease.