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AFRO-NETS> Kaiser Daily HIV/AIDS Report - Tue, 1 May 2001

Kaiser Daily HIV/AIDS Report - Tue, 1 May 2001

* South African, Indian Health Ministers Sign Agreement on Access to
  Cheaper AIDS Drugs

* Annan Calls on Foundations to Support Global Fund Against AIDS,
  World Bank Endorses Plan

South African, Indian Health Ministers Sign Agreement on Access to 
Cheaper AIDS Drugs

South African Health Minister Manto Tshabalala-Msimang yesterday 
signed a declaration of intent with Indian Health Minister C. P. Tha-
kur for cooperation on obtaining cheap drugs for the Southern African 
Development Community, the South African Press Association/BBC Moni-
toring reports. Tshabalala-Msimang said, "We will be discussing fur-
ther the possibility of transferring technology and building the ca-
pacity of our country and region with regard to pharmaceutical ser-
vices." South Africa's Health Department would also work with India 
on community-based HIV/AIDS and tuberculosis programs, nutrition pro-
grams, research and combatting waterborne diseases. In addition, In-
dia and South Africa would share health and medical information 
(SAPA/BBC Monitoring, 4/30). Now that the multinational drug compa-
nies have dropped their lawsuit against South Africa's Medicines Con-
trol Act, the country is "looking forward to partnerships for afford-
able medicines," Tshabalala-Msimang said. According to the Press 
Trust of India/BBC Monitoring, Thakur said that the agreement would 
increase the South African market for Indian drug makers, noting that 
several Indian companies have already begun their manufacturing base 
there and that South Africa may become a "gateway of entry" to the 
entire continent. He added that the countries would adhere to World 
Trade Organization agreements (PTI/BBC Monitoring, 5/1).

Annan Calls on Foundations to Support Global Fund Against AIDS,
World Bank Endorses Plan

Speaking yesterday before the annual meeting of the Council of Foun-
dations, an "umbrella group" of 1,800 charitable foundations and cor-
porations, U.N. Secretary-General Kofi Annan called on the philan-
thropic institutions to "put their financial might behind a new 
global fund designed to orchestrate a new coordinated attack on the 
AIDS pandemic," Reuters/Contra Costa Times reports. If the founda-
tions "make the fight against AIDS a top priority," Annan said he 
would "wager that governments and the general public will not be far 
behind." Annan proposed the fund Friday at the largest-ever African 
AIDS conference in Abuja, Nigeria, stating that on top of the $1 bil-
lion already spent annually on HIV/AIDS in developing nations, an ad-
ditional $7 billion to $10 billion a year is needed to launch an ef-
fective "global assault" on HIV/AIDS, malaria and tuberculosis. Yes-
terday, he asked the foundations to increase their monetary contribu-
tions and to "act as levers and advocates" to "stimulat[e] others to 
emulate your generosity." The foundations "have the flexibility to 
provide funds quickly, and use them to plug gaps, where other insti-
tutions may be held back by political considerations, or by the terms 
of their mandates," he told the conference (Morgan, Reuters/Contra 
Costa Times, 4/30). Annan stressed that the "heavy lifting" must come 
from wealthy industrial nations, which currently spend "100 times" 
the amount he is seeking for HIV/AIDS on their military budgets. Al-
though details of the fund have not been solidified, Annan said he 
hopes to have commitments from donors and an action plan ready when 
the United Nations convenes a special session on HIV/AIDS at the end 
of June (Collins, Philadelphia Inquirer, 5/1). 

A Five Point Plan

In his speech, Annan outlined five "key action areas" for the cam-
paign against HIV/AIDS, including:

1. Containing the epidemic: The campaign must prevent further spread 
   of HIV "especially by giving young people the knowledge and power to 
   protect themselves," Annan said. "Large-scale" awareness and preven-
   tion campaigns are needed, as well as additional counseling and test-
   ing and condom distribution programs.

2. Reducing vertical transmission: Annan called mother-to-child HIV 
   transmission the "cruellest, most unjust infections of all" and advo-
   cated HIV testing for all pregnant women, as well as the administra-
   tion of "short-term" antiretroviral drugs to HIV-positive pregnant 
   women and their newborns to reduce vertical transmission rates.

3. Accessible treatment: Based on his recent meeting with pharmaceu-
   tical industry leaders, Annan said that the industry is prepared to 
   supply anti-AIDS medications to the developing world at "greatly re-
   duced prices." These discounts will help increase drug access, but 
   drugs are only part of the "comprehensive HIV care package" that is 
   needed. Counseling and testing, home- and community-based care and 
   "simple" treatment of opportunistic infections is also needed.

4. Advances in science: The creation of an effective HIV/AIDS vaccine 
   and a cure for the disease must be given "higher priority" in scien-
   tific budgets, Annan said.

5. Orphans: Those made "most vulnerable" by HIV/AIDS must be "pro-
   tect[ed]," Annan said, adding that the world's 13 million AIDS or-
   phans, most of whom reside in Africa, must be given greater attention 
   (U.N. release, 4/30).

World Bank Gives Its Endorsement

At the close of the IMF/World Bank meeting in Washington, D.C., the 
World Bank's governing committee yesterday officially gave its en-
dorsement to the idea of a global AIDS trust fund and said it will 
administer the fund with the United Nations, the Washington Post re-
ports. The endorsement follows similar actions Sunday by the IMF and 
the G7 nations. World Bank President James Wolfensohn said he had the 
"distinct impression that industrialized countries are prepared to 
ante up the funds" for the trust and predicted that "proof" of that 
commitment will appear in the "next month or two." The bank estimated 
that a "well-funded effort" could reduce HIV transmission by a quar-
ter, despite Africa's lack of adequate health infrastructure. The 
bank also said that such an effort could prevent nearly 7.5 million 
deaths annually from infectious diseases such as malaria and TB. 
Treating those already infected with HIV would require the "full 
goal" of $7 to $10 billion Annan announced, Chris Lovelace, the 
bank's health director, said (Pearlstein/DeYoung, Washington Post, 

Doing the Grunt Work

The United Nations, the World Bank and the World Health Organization 
have not yet addressed how a new global fund would be divided between 
treatment and preventive measures. They also have not determined 
which agency will take the lead in the initiative. Although the 
United States and other Group of Seven nations have expressed support 
for the fund, exact contribution figures have not been determined, 
nor has the length of the commitment been discussed. In addition, de-
tails about whether the fund will address HIV/AIDS in developing 
countries outside of Africa and what, if any, other diseases will be 
targeted have not been worked out. Annan "side-stepped" these issues 
in an interview with the Philadelphia Inquirer yesterday, the paper 
reports. He also declined to comment on the role generic drugs would 
play in any treatment plans. Many activists credit generic drug com-
petition with helping to lower the cost of brand-name AIDS medica-
tions and are "concerned" that if generic drugs are not a "strong 
part" of any global AIDS program, the major pharmaceutical companies 
will lack any further incentive to reduce their prices. Annan said he 
is planning to meet with the heads of several generic drug manufac-
turers soon (Philadelphia Inquirer, 5/1). 

An 'Eye-Opener'

Annan's request for global AIDS funds was greeted with an "enthusias-
tic response" from Council of Foundation members, Reuters/Contra 
Costa Times reports. "It was an eye-opening speech," Paul Di Dinato, 
head of a consortium of AIDS-related foundations, said. He predicted 
that HIV/AIDS-related charitable giving could "easily rise" to $200 
million within three years. U.S. foundations donated an estimated 
$27.6 billion last year, of which less than $100 million went toward 
AIDS-related projects (Reuters/Contra Costa Times, 4/30). Susan Ber-
res Ford, president of the Ford Foundation, said that the council 
"heard" Annan's message. She predicted such a global effort would 
"promote collaborations between foundations and governments" and act 
as a "safeguard against duplication" (Carr, Atlanta Journal-
Constitution, 5/1).

The 'Lion's Share'

Annan added that he hoped the foundations' positive reactions would 
be well received by the Bush administration, and encouraged the White 
House to increase its funding of the global AIDS effort. "It would be 
presumptuous of me to say how much the U.S. should pay. I hope, con-
sidering the size of the government, that it would be substantial," 
he said (Cappello, Associated Press, 5/1). Administration officials 
said yesterday that they support the "idea of a multilateral attack" 
on HIV/AIDS, but it remained unclear how much the government is will-
ing to put toward the effort (Philadelphia Inquirer, 5/1). British 
Finance Minister Gordon Brown, who heads the International Monetary 
Fund's policymaking team, said that the United States could be 
"pressed" into lending greater support "by the enthusiasm of others." 
According to Brown, Great Britain and Italy have been "working behind 
the scenes" to promote a trust fund since February. "I want us to 
treat this issue with the same urgency that we treat the debt issue. 
We cannot stand by and allow lives to be lost when there are poten-
tially drugs and vaccines that can stop this needless loss of life," 
Brown added (Willard, Reuters/Contra Costa Times, 4/30). Brown will 
address the United Nations today to offer the G7's support of the 
fund. The "precise amount" of money to be provided by the nations -- 
including the United States, the United Kingdom, Canada, Germany, 
France and Italy -- will be decided later this year, but total con-
tributions could be as high as seven billion British pounds. "The 
scale of this would have to be very big indeed. Governments will 
pledge what they can afford and we expect the biggest countries are 
in a position to do the most," Brown said, adding that the United 
States, as the world's wealthiest nation, will be expected to con-
tribute the "lion's share" (Thornton, London Independent, 5/1).

Cecilia Snyder

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