Africa: Talk or Action on AIDS?

[Paragon]

Nomads I thought i should share this article with you all. It may interest those of us who do development studies in SS-Africa. (Those of you who're in the states may find it relevant)

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AFRICA ACTION

Africa Policy E-Journal

July 7, 2003 (030707)

 

Africa: Talk or Action on AIDS?

(Reposted from sources cited below)

 

As President Bush departs for Africa today, key questions about his

AIDS policy remain unanswered, including the level of funding that

will actually be appropriated. While $3 billion a year has been

authorized by Congress, the president has requested no additional

funds for this fiscal year and less than $2 billion for fiscal year

2004, including only $200 million instead of $1 billion for the

Global Fund to Fight AIDS. News reports say Republicans in the

House of Representatives are planning to approve even less than the

president's low request.

 

This postings contains (1) an action alert from the Washington

Office of Africa, focusing on the expected vote this week on

funding levels for AIDS, (2) a notice of today's send-off

demonstration for President Bush by the Student Global AIDS

Campaign and ACT UP, and (3) an update from South Africa's

Treatment Action Campaign on continued South African government

delays on AIDS treatment. Another posting today focuses on the

role of the pharmaceutical industy and the U.S. stance on the use

of generic medicines.

 

For additional documents on issues related to President Bush's trip

to Africa, see http://www.africaaction.org/desk

and

http://www.africaaction.org/docs03/chr03.htm

 

+++++++++++++++++end summary/introduction+++++++++++++++++++++++

 

The Washington Office on Africa:

 

An Urgent Action Alert

 

http://www.woaafrica.org

 

July 3, 2003

 

HIV/AIDS Funding to be Decided July 10 in the House Foreign

Operations Subcommittee

 

On July 10 the House Appropriations Foreign Operations Subcommittee

will decide the amount of money that the U.S. will give to

bilateral and multilateral HIV/AIDS programs for the fiscal year

2004. The U.S. Leadership Against HIV/AIDS, Tuberculosis and

Malaria Act of 2003, passed recently, authorized $3 billion for

these efforts, including "up to" $1 billion for the multilateral

Global Fund. What "Foreign Ops" sets is important in this next

stage of the appropriations process.

 

Discerning our actions: What we at WOA think

 

We believe that the House Foreign Operations Subcommittee should

appropriate $3.5 billion to fight global AIDS, TB, and malaria, at

least $1.75 billion of which should go to The Global Fund to Fight

AIDS, TB and Malaria. According to conservative estimates from the

WHO and UNAIDS, $14.2 billion is needed globally to combat and

treat AIDS, TB, and Malaria in fiscal year 2004. While the U.S.

should be contributing 34.8 percent (its share of the global

economy), we are requesting that the U.S. contribute at least 25

percent of the total, or $3.5 billion.

 

AIDS spending must be both bilateral and multilateral. Some U.S.

agencies have high administrative overhead, and more than twelve

months may pass before benefits from their programs are realized.

We believe that a high percentage of this funding should go to the

Global Fund to Fight AIDS, TB and Malaria, which is already

functioning well, despite being starved for funds. Countries can

turn to the Global Fund with written proposals that are a

collaborative efforts between governments, NGOs, and the private

sector. Unfortunately, President Bush has only proposed providing

$200 million for the Global Fund in 2004, which will cause many of

the grant requests to be turned away. The international community

is looking to the U.S. as a leader in the Global Fund - our funding

is necessary because it will help to encourage other donors.

 

In. addition, Congress should agree to appropriate only NEW money,

meaning that funds should not be taken from other accounts,

including health-related programs and the core HIV/AIDS accounts.

We believe that the House needs to appropriate more funding without

removing precious resources from other development and humanitarian

aid programs.

 

Action

 

We ask that you contact your member of Congress, urging that the

Foreign Operations Subcommittee ensure that fiscal year 2004

appropriations include adequate funds to fight global AIDS, with

$3.5 billion for all HIV/AIDS programs, of which $1.75 billion

should go into the Global Fund. As a minimum, the Subcommittee

should meet the call of the U.S. Leadership Against HIV/AIDS,

Tuberculosis and Malaria Act of 2003, of $3 billion, including $1

billion for the Global Fund.

 

If your member of Congress sits on the Foreign Operations

Subcommittee of the House Appropriations Committee, please contact

the district office during the July 4th recess, or in Washington,

as soon as possible with the message above. Remember that the

Subcommittee will "mark up" (revise and decide) on AIDS

appropriations on July 10! Membership includes:

 

Jim Kolbe, Arizona (chair)

Joe Knollenberg, Michigan

Jerry Lewis, California

Roger F. Wicker, Mississippi

Henry Bonilla, Texas

David Vitter, Louisiana Mark

Steven Kirk, Illinois

Ander Crenshaw, Florida

 

Nita M. Lowey, New York (ranking)

Jesse L. Jackson, Jr., Illinois

Carolyn C. Kilpatrick, Michigan

Steven R. Rothman, New Jersey

Marcy Kaptur, Ohio

 

If your member of Congress does not sit on the Subcommittee, ask

that he or she weigh in with the Chairperson or the Ranking

Minority Member, depending on party.

 

A sample message appears below, which we encourage you to adapt and

make your own.

 

Given security delays with regular mail, we suggest contacting your

Member of the House of Representatives by e-mail or fax. You can

access e-mail links, get district office and other contact

information by going to

http://www.house.gov/house/MemberWWW_by_State.htm or you can call

202/225-3121. Write to Members of Congress at the U.S. House of

Representatives, Washington, DC 20515.

 

Sample Message

 

Dear Representative (name):

 

The House Appropriations Foreign Operations Subcommittee will soon

be deciding the amount of HIV/AIDS bilateral and multilateral aid

given by the U.S. in fiscal year 2004. The U.S. Leadership Against

HIV/AIDS, Tuberculosis and Malaria Act of 2003, passed recently,

authorizes $3 billion for these efforts. A minimum of $3 billion

should be given to these efforts, but I urge that we go beyond this

figure to provide $3.5 billion. This is the U.S. fair share.

 

From this $3.5 billion, $1.75 billion should be given to the Global

Fund to Fight AIDS, TB and Malaria, a multilateral initiative

designed by the UN. As a minimum the U.S. should fully fund the $1

billion authorized by the U.S. Leadership Against HIV/AIDS,

Tuberculosis and Malaria Act of 2003. Our government's example of

giving will influence other countries to do the same.

 

I also request that the funding not be removed from other key

accounts that work on health and development issues. The core

HIV/AIDS accounts and other programs that promote global health are

necessary components to the fight against AIDS. According to

conservative estimates from the WHO and UNAIDS, $14.2 billion is

needed globally to combat and treat AIDS, TB, and Malaria in fiscal

year 2004, and we should be giving as much funding as possible.

 

Global HIV/AIDS is an issue that we must prioritize to ensure

global health, safety, and security, and I request that my tax

money be used to support the prevention and treatment efforts.

Thank you very much for your consideration.

 

For further information call us at WOA at 202/547-7503, or write to

us at 212 East Capitol Street, Washington, DC 20003. Our e-mail

address is woa@igc.org., and you might also consult our website,

http://www.woaafrica.org.

 

***********************************************************

 

The Student Global AIDS Campaign and ACT UP

 

July 3, 2003

 

For Immediate Release Contact Micah Sucherman: (303) 641-2123

Sean Barry: (202) 361-8293 Alexander Post: (617) 230-7832

 

Grim Reapers Gather at White House

 

Bush Travels to Africa As Overworked Grim Reapers Protest AIDS

Policy

 

8500 Deaths per Day "Grim" Even by Their Standards

 

11:30 am meet at Office of National AIDS Policy (734 Jackson Place)

Followed by procession to White House Gate, arriving at 12:00 pm

 

On July 7th, dozens of Black-clad Grim Reapers wielding tall

scythes will gather at the White House gates to condemn President

Bush and his administration for an AIDS policy which has left them

harried and overworked. "Sure we're pro-death, but 8500 AIDS deaths

a day is ridiculous," complained a Reaper. "With over 14000 new

infections daily, this situation is grim even by our standards," he

added.

 

In January Bush took a significant step forward, pledging $15

billion dollars over the next five years to fight the global AIDS

pandemic. But after five months the President's promise has begun

to ring hollow. Despite signing and publicly endorsing the $3

billion AIDS authorization bill in May, it now appears that the

President will settle for the appropriation of only half that

amount - $1.52 billion - to pay for on-the-ground AIDS services. In

addition, the Bush Administration intends to gut funding for the

Global Fund to Fight AIDS, Tuberculosis, and Malaria, which experts

identify as the world's most potent institutional weapon against

the AIDS pandemic. The President's paltry $200 million request for

the Global AIDS Fund will leave the Global Fund unable to fully

fund worthy grants during its next round in October.

 

AIDS will not go away by itself - the virus will spread and sick

will die in overwhelming numbers until the United States begins

taking real steps to combat the disease. "Less rhetoric and more

action," the Reapers demand, "the AIDS pandemic is working us to

death!"

 

Photo Ops: AIDS activists and people living with AIDS dressed as

Grim Reapers carrying scythes, signs ("Too much AIDS - Too much

Work!") in front of White House.

 

AIDS Activists Demand that President Bush:

 

(1) DONATE THE DOLLARS: Request and ensure that Congress

appropriates the full $3 billion to fight global AIDS in 2004 that

was promised in the global AIDS bill President Bush signed. The

U.S. should provide at least $1 billion of this amount for the

super-efficient and effective Global Fund to Fight AIDS,

Tuberculosis, and Malaria.

 

(2) DROP THE DEBT: Implement the provision contained in his AIDS

Bill to deepen debt relief for poor countries, as well as countries

outside of HIPC - like Nigeria - thereby freeing up $1 billion in

debt service payments that could be re-directed to combat AIDS and

poverty.

 

(3) TREAT THE PEOPLE: Stop negotiating intellectual property

regimes in new free trade agreements which go beyond those

established by the World Trade Organization (WTO) meetings at Doha,

and thereby deny poor peoples access to essential life-saving

medications. Additionally, the President must ensure that his

emergency plan for AIDS relief allows countries the freedom to

procure generically manufactured drugs.

 

*************************************************************

 

Treatment Action Campaign

http://www.tac.org.za

 

TAC Electronic Newsletter 1 July 2003

 

[excerpts; for full newsletter see TAC website]

 

To subscribe send a blank email to news-subscribe@tac.org.za To

de-subscribe, send a blank email to news-unsubscribe@tac.org.za

 

1 July 2003

 

A Treatment and Prevention Plan: Where do we stand with

Government? Where to from here for TAC?

 

In late April, TAC suspended its civil disobedience campaign

following our meeting with Deputy-President Zuma. However,

presently there is growing concern among TAC members and

volunteers that we have received very little in return from

government. A commitment to a treatment and prevention plan that

includes antiretroviral therapy is still far from certain. As one

activist explained in a meeting discussing civil disobedience in

Johannesburg, we can suspend the civil disobedience campaign, but

we cannot suspend the pain of people with HIV/AIDS and their

friends and families.

 

We are at a critical turning point in South Africa's response to

the HIV epidemic. TAC suspended its civil disobedience campaign

to give government the space and opportunity to commit, on its

own terms, to a treatment and prevention plan that includes

antiretroviral therapy. There were some positive signs that the

Cabinet would soon make such a commitment. We are aware that the

costing study conducted by the task team composed of members of

the treasury and health departments was completed and awaited

approval by Cabinet since April. Furthermore, the Treasury put

aside contingency money for treatment in the 2003/04 budget

clearing the way for a change in policy. The NEDLAC negotiations

were also to have resumed. TAC's meetings with the

Deputy-President on 25 April and with a number of Cabinet

ministers at the SANAC meeting on 14 June gave hope that there

were some leaders in government who recognised the urgency and

the moral and legal imperatives to extend access to

antiretrovirals to South Africa's poor as part of the national

response. In addition, the Western Cape MEC for Health recently

made it clear that it is a matter of time before government

begins rolling out an antiretroviral treatment programme. In

private discussions, this sentiment has been echoed by a number

of senior civil servants.

 

These were tangible reasons to be hopeful and to give government

the benefit of the doubt by suspending civil disobedience. It is

in all our interests for a treatment and prevention plan to be

attained via a voluntary change in government policy, rather than

via civil disobedience and litigation at the Constitutional

Court. If we have to resume the latter route, the treatment

programmes that will ultimately be implemented are unlikely to be

as successful as a plan implemented by a government that is

politically committed to treatment. Despite protest by government

that it has a "five year strategic plan", we still believe that

the existing plan is inadequate and that policy to treat has to

be much more rigorously monitored in its implementation if it is

to be successful.

 

But the TAC leadership is being continually reminded that there

is a limit to the patience of people confronting their own

mortality. Government cannot dither any longer. The timeframe for

decisions to be taken is now days, at most weeks, not months.

Every delay is measured not in inconvenience, but in death and

suffering. If TAC is being mislead and if government promises

have been in bad faith, the subsequent return to civil

disobedience will be more intense than before, involve much

larger numbers of people and will not be suspended or stopped

without the implementation of a treatment plan.

 

A report that appeared in the Star (27 June) is reprinted in this

newsletter. It points out serious government delays such as the

failure to date to sign the Global Fund agreements, the failure

to release the costing study on antiretroviral treatment which

merely needs the go-ahead from Cabinet and the failure to release

the latest antenatal clinic study. To this we can add the failure

to officially release the report that was produced at the HST

scientists conference last year. We hope that there are no longer

senior people in government who intend to scupper moves towards

treatment. However, if there are, we cannot appeal to your

conscience. We cannot ask you to consider the lives and suffering

of hundreds of thousands of your fellow citizens. Instead we must

appeal to your self-interest and ask: are you willing to risk the

sustained pressure of civil disobedience, international

embarrassment and litigation through to the April 2004 general

elections and beyond?

 

In the meanwhile, irrespective of which route government chooses

and as TAC prepares for its provincial and national congresses

over the next month, activists must prepare for a new phase in

TAC in which we consolidate our branches so that they are better

equipped to assist with the implementation of the government's

current programmes and any new ones that might become policy,

such as antiretroviral treatment. It would be wrong of TAC to

expect government to take sole responsibility for the health

interventions for which we have advocated. Our duty to ensure

their successful implementation is critical. Therefore, in this

issue of the electronic newsletter, we have included two

important discussion documents that are being circulated at TAC

branches. One, written by Zackie Achmat, examines the role and

responsibilities of TAC branches. The other, written by Sipho

Mthathi, gives concrete suggestions for how TAC branches can

ensure that people become educated about HIV issues.

 

Let us work together to implement a successful treatment and

prevention plan that will build a better health care system.

 

...

 

It's all talk, no action as people succumb to AIDS

 

By Lynne Altenroxel, The Star, 27 June 2003

 

Just a few days ago, time finally ran out for Jenny*, an

HIV-positive nurse who worked at a government hospital in

Southern Gauteng.

 

Ever since she started working at the hospital thee years ago,

she had seen deaths of countless Aids patients in her care. By

this year, five to 10 Aids patients were dying each week in the

medical wards where she worked. Witnessing their painful demise

made her fearful of her own fate. She knew, she said a few weeks

ago, that it was the same way she would go too. Jenny died at her

parents' home on June 12 without ever accessing the

antiretrovirals which could have spared her from an early death

at the age of 29. A short six months after passing her staff

nurse exams with distinction in November, she had become one of

the 600 South Africans dying daily as a result of HIV.

 

She died frustrated and angered by government delays in

implementing a programme to provide antiretroviral treatment to

people who needed it. "She was very, very angry. Up to the last

day she was very angry," a colleague recalled, describing how she

knew that Jenny was distraught by witnessing the deaths of the

people she nursed.

 

"I would see that she was really affected. She wouldn't want to

talk when she came out of there She wouldn't even want to eat

when she came out of dealing with a very sick patient."

 

Now, several days after Jenny's death, there is still no answer

to the question of whether the government will ever provide

anti-Aids drugs to people who cannot afford them. On Wednesday

the cabinet met again without discussing a report on the cost of

providing antiretroviral therapy - even though more than two

months have passed since the report was finalized. For people

living with HIV, it seems as if there is no sense of urgency

about dealing with an issue which, for them, is a matter of life

and death. Lifeline counselor Isaac Skosana, who is HIV-positive,

will tomorrow bury one friend who succumbed to the virus. On

Wednesday, as the cabinet met without discussing anti-Aids drugs,

he buried another.

 

"What I hear is only promises. Bt commitment and things that are

practical, I see nothing," said Skosana, who is healthy but

dreads the day when his immune system needs antiretrovirals to

prop it up. ...

 

...

For health professionals such as Sister Sue Roberts, head of Helen

Joseph Hospital's HIV clinic, the list of people in desperate need

of antiretrovirals is growing. The clinic diagnoses 80 to 90 new

HIV infections in patients each week. More than half of the HIV

patients on its database are in desperate need of treatment, with

less than 5% able to afford to buy the drugs themselves. "We've had

a lot of patients who could have done extremely well on drugs. And

a lot of them are no longer with us," Roberts said.

 

So many people are dying without treatment that nurses who

suspect they are HIV infected are reluctant to acknowledge that

they, too, have the virus. "One of the biggest problems with

healthcare workers is that they see that nothing is done for HIV,

so they don't come forward," Roberts explained. "They're

petrified of being identified as positive... because they're

seeing sick patients dying in front of them all the time."

 

* Names have been changed to protect identity.

 

+++++++++++++++++++++Document Profile+++++++++++++++++++++

 

Date distributed (ymd): 030707

Region: Continent-Wide

Issue Areas: +health+ +US policy focus+

 

************************************************************

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