Clinton Proposal | Global Issues | Suit Against Insurance Co. | MAPP's New Home | Gene's Cloaking Device | New Treatment for Cryptosporidiosis

During his weekly radio address, President Clinton outlined a proposal that he will be sending to the Congress to address the inequalities in our nation's current health care system. The proposal requests $400 million to be used over a five year period to eliminate disparity in health care between whites and people of color in six different target areas in which HIV/AIDS is one. The other areas targeted are infant mortality, cancer screening and management, cardiovascular disease, diabetes, and child and adult immunizations. Clinton cited statistics to make his case, including the facts that minority women and children account for 75 percent of all AIDS cases, and although the death rate from AIDS declined 23 percent overall, it only declined by 13 percent among Blacks. In the area of infant mortality, Black children die at a rate that is 2 1/2 times higher than white children, and Native Americans have a high rate of infant mortality and heart disease.

Clinton stated, "We must not be blind to the alarming fact that too many Americans still do not share in the fruits of our progress. Nowhere are the divisions of race and ethnicity more sharply drawn than in the health of our people." By the year 2010, Clinton hopes to see health care disparities eliminated.

If Congress approves the budget, $30 million per year will be awarded to 30 communities that will develop model strategies to approach a couple of specific health problems. This would be part of a national prevention and outreach campaign that would seek to mobilize a variety of local community constituents -- physicians and nurses, churches, private sector businesses -- and will include a coalition of 136 philantropic foundations to work together to produce a major national health conference this spring.

According to President Clinton, the primary mission of the conference is "to help solve this national problem community by community.

"America has the best health care system in the world, but we can't take full pride in that system until we know that every American has the best health care in the world," said Clinton.

Surgeon General David Satcher and former New York City Health Commissioner Peggy Hamburg were selected to spearhead the project. David Satcher cited some realistic factors that will have to be addressed. "It's not going to be that easy. It's a real challenge to do this...some of the factors are not in the health care system, they're in individual behavior," he said. He added, "All of these things have to work together in order for us to be successful."

Donna Shalala, Secretary of Health and Human Services, will be leading a task force to determine where racial and ethnic disparities exist in our nation's federal policies and procedures. Both Shalala and President Clinton made strong appeals to the American people to work together to insure the success of the project.

Shalala said, "We can't wait for everybody in this country to get good health insurance. When you really want to close a health care gap and you do not have a single health care system, you go to every part of the country and have everybody pull in the same direction."

International Developments

A study published on January 22 by Belgium's health ministry disclosed that more than half of the people diagnosed as suffering from AIDS in that country since the outbreak began in the mid-1980s have died. Up until the end of 1996, of the 10,666 Belgians diagnosed with HIV, 2,286 developed clinical AIDS symptoms; of this group, 1,376 died, 619 are still alive, and the whereabouts of the remaining 291 are unknown. The vast majority of cases among men was traced to homosexual or bisexual conduct; among women, heterosexual conduct. Six percent were IV drug users, a rate which rose to 17 percent among the 15-24 age group. Infections from blood transfusions were virtually unknown; in 1996 only three donors out of 300,000 were found to be infected with HIV during routine blood screenings. As compared to other European countries such as Spain, France and the Netherlands, HIV infection among Belgian female prostitutes was lower. Despite insufficient data to establish figures for their male counterparts, there were indications of a higher rate of infection....Among the violations revealed in a probe of 97 sex shops by Poland's State Trading Inspectorate late last year were condoms with expired sell-by dates, sex aids without instructions, and illegal aphrodisiacs. Eighty-four percent of the condoms inspected were withdrawn from sale, as were 66 percent of the aphrodisiacs, many of which contained prescription-only drugs. Also confiscated were vibrators lacking official test certificates, and 800 video cassettes "lacking official approval."

Insurance Company Being Investigated

A lawsuit brought in United States District Court on behalf of two HIV-positive Chicago-area men alleges Mutual of Omaha Insurance Company placed illegal limits on HIV-related healthcare coverage.

Heather C. Sawyer, a lawyer for Lambda Legal Defense and Education, which filed the suit along with the AIDS Legal Council of Ohio, claimed, "Mutual of Omaha caps HIV-related care at a fraction of the amount allowed for other illnesses or conditions. This discrimination severely limits access to standard, lifesaving therapies and is illegal."

One man's policy capped his lifetime benefits for HIV-related conditions at $25,000; the other man had $100,000 cap; this in contrast to the $1 million caps the insurance company would allow for other medical conditions. The lawsuit charges that such caps violate the Americans With Disabilities Act and Illinois Insurance Code, and that the two men have been forced to contemplate going without the life-prolonging treatments. Plaintiff "Richard Smith" commented, "Dealing with HIV is tough enough, but having my health and even my life put at risk because of Mutual of Omaha's refusal to provide fair coverage is outrageous."

A former Mutual claims processor told United Press International: "We were told to be on the lookout for anything that seemed AIDS-related -- lots of blood tests, anything that contained the word 'immunity.' We were not told 'We will not pay for AIDS treatment,' but unlike any other disease, we in the lower echelon could not send out a check for anything with an AIDS diagnosis. It had to be referred to a higher-up."

A spokesperson for Mutual said the company had not yet seen the complaint, and had no comment.

New Site for Largest HIV Agency in Michigan

Michigan's largest non-profit HIV agency, the Midwest AIDS Prevention Project ("MAPP"), will be the chief tenant in a new office building in the Detroit-area community of Ferndale. Currently, MAPP is a smaller building near the new location.

Craig Covey, MAPP's CEO, is excited about the move. "Right now, we're really overcrowded. The size of our organization has doubled since we first moved into our present office in 1993 -- more than twice as many employees share the space, which once housed six people. We're also looking forward to working more closely with the groups that locate in the new site."

Ferndale is quickly gaining a reputation as a growing center of the metropolitan Detroit area's gay and lesbian community. Several gay owned businesses and not-for-profits are currently calling Ferndale their home.

Among the groups exploring the new building as a possible headquarters are The Michigan AIDS Fund, the Names Project, FANS of Ferndale, and Outpost magazine.

Gene Cloaking Device

Scientists have discovered a single HIV gene, called "nef," which can apparently keep infected cells from reporting that they have the virus. The nef gene is also responsible for several other things that might promote continued infection, such as increasing the infective potential of fresh virus that leaves an infected cell.

The report, based on a test-tube study, was recently published in the British journal Nature. David Baltimore, a Nobel Prize laureate and one of the study's authors, explained that the next step will be to see what happens in infected people. Finding out how AIDS-infected cells get away from the disease-fighting immune system is vital to understanding AIDS development, and if doctors can discover drugs to hamper the gene's cloaking effect, it might help to control HIV infections.

This research was called an important step by Bryan Cullen, a Howard Hughes Medical Institute Investigator currently involved in studying genes at Duke University Medical School; however, he also cautioned that the nef gene has been known to do several other things that promote continued infection, including allowing a fresh infective virus that leaves an infected cell to flourish. Ways to block these negative effects are being researched.

Cryptosporidiosis Gets a New Treatment

Relief may be in sight for people with AIDS ("PWAs") dealing with chronic diarrhea and other symptoms of cryptosporidiosis. UNIMED Pharmaceuticals, Inc. filed its application in December with the FDA for approval of NTZ (nitazoxanide), an antiparasitic drug that has shown encouraging results against cryptosporidial diarrhea in clinical trials.

Cryptosporidiosis, which is caused by a parasite found in most municipal water supplies (including NYC), is a debilitating and dangerous disease to which PWAs -- particularly those who have low T-cell counts are especially vulnerable. It is characterized by chronic diarrhea -- often as many as 15 to 20 watery bowel movements a day -- and by severe abdominal pain and cramping. Cryptosporidiosis can cause severe weight loss and, without effective treatment, can be fatal.

While it's true that NTZ has shown considerable promise in controlling diarrhea and even in reducing the amount of the parasite in the stool, it has until now been available in this country only through participation in clinical trials or through buyers' clubs. The PWA Health Group has been importing, with doctor's prescription, through Mexico since mid-1996.

UNIMED says that the price of the NTZ has not been established, nor do they have a distribution date, but both are expected to be set by late summer.

Back to the March 1998 Issue of Body Positive Magazine.