| September
18, 2003
This
Week In Washington
1. AIDS Action Witnessed Ryan White CARE Act Testimony
2. Robert Gallo Offers His Perspective on Reducing HIV in the
Developing World
In
the News
1. CDC Recommends Rapid-Test for Women in Labor
Announcements
1. United States Conference on AIDS Convenes Next Week
2. National Latino AIDS Awareness Day Set for October 15
3. NIH Announces New Cooperative Research Centers Application
for Sexually Transmitted Infections and Topical Microbicides
4. CDC Technical Guidance for HIV Prevention Available Online
5. Business and Labor Respond to AIDS through Updated Web site
This Week in Washington
1. AIDS Action Witnessed Ryan White CARE Act Testimony
On September 12, 2003, the Centers for Disease Control and Prevention
(CDC) /Health Resources and Services Administration (HRSA) Advisory
Committee on HIV and STD Prevention and Treatment, Ryan White
CARE Act Reauthorization Workgroup held the first public meeting
in a series of three. The meetings have been scheduled for oral
testimony on the Ryan White CARE Act. The meeting was part of
the overall Ryan White reauthorization process (The CARE Act will
be reauthorized in 2005). Before completing a report with recommendations
for reauthorization, the workgroup is soliciting testimony from
any and all persons who have been involved in either administering
or benefiting from Ryan White programs. AIDS Action staff was
in the audience to hear the public comments.
During
the all day meeting, the CDC/HRSA workgroup members heard from
a variety of sources with CARE Act experience, including national
advocacy organizations, community-based organizations, and consumers.
Witnesses discussed a variety of topics and many articulated vastly
different experiences with the programs; however, there were several
points of agreement among participants. Everyone unanimously supported
the reauthorization of the CARE Act but almost everyone who spoke
agreed that changes needed to be made to the legislation to make
it more effective in delivering care and treatment to people living
with HIV. Among the suggestions were the following recommendations
for changes:
•
Eliminate the reauthorization process. The Ryan White CARE Act
should become a permanent part of the health care structure
in the United States.
• Eliminate the 10 percent administrative cost cap. Title I
grantees’ administrative expenses are capped at 10 percent.
This unrealistic cap should be significantly raised as it prohibits
many smaller but vital organizations from providing services.
• Incorporate the Minority HIV/AIDS Initiative into the Title
structure.
• Allow for better coordination between AIDS Drug Assistance
Programs (ADAP) and Title I and III programs, so that resources
may be used more efficiently.
All
testimonies were followed by a brief question and answer period,
where the workgroup members asked for clarity and more information
on certain points. They repeatedly asked speakers to offer more
suggestions of changes that could be written into the legislation
that would respond to criticisms. Testimony is also being invited
in written format. There is no limit on the length of the written
testimony; whereas oral testimony is limited by the number of
witnesses. During the DC hearing, witnesses were allowed five
minutes to give comments.
The
public meeting series is not yet over. Upcoming meetings are being
held in Miami, Florida, Thursday, September 25 and in Los Angeles,
California, Friday, October 3. For more information about giving
testimony at these meetings, or submitting written testimony,
go to http://www.hab.hrsa.gov/news/publicmtg.htm.
2.
Robert Gallo Offers His Perspective on Reducing HIV in the Developing
World
On Tuesday, September 16, the George C. Marshall Institute held
a lunch hour discussion called, “The AIDS Global Health Crisis:
Strategies for Policy and Science for Its Resolution” at National
Press Club. Held at the National Press Club, the event was part
of an ongoing series of “roundtable” discussions organized by
the Institute, which is dedicated to encouraging the sound use
of science in policy making. The keynote speaker was Dr. Robert
Gallo. Dr. Gallo is widely identified as the co-discoverer of
HIV and is also known for his contributions to the development
of an HIV blood test. He currently serves as director of the Institute
for Human Virology and Division of Basic Science at the University
of Maryland Biotechnology Institute.
During
his remarks, Dr. Gallo stressed the importance of implementing
a reliable system of drug delivery. When HIV positive individuals
are unable to take their medications consistently, the virus can
mutate and become resistant to drugs. However, Dr. Gallo pointed
out, “If you treat properly today, drug resistance can be overcome.
To
support medical services in developing countries, Dr. Gallo suggested
that “centers of excellence in virology” be established in select
locations in both the industrialized and developing worlds. These
research centers could then establish a system of communication
to ensure that information is exchanged expediently. He postulated
that each center would require an investment of $10 to $40 million,
adding that it would be necessary to go outside the traditional
NIH academic scheme to procure adequate funding.
Dr. Gallo also emphasized the importance of continued vaccine
research. He indicated that HIV entry inhibitors, which prevent
the virus from attacking human CD4 immune cells and replicating,
are “coming strongly to the forefront” as both a vaccine and therapeutic
option. An effective HIV vaccine will encourage the human body
to produce antibodies to ward off HIV. According to Dr. Gallo,
however, vaccines that use dead HIV, sub-units of HIV, or modified
HIV to prompt this antibody response have proven ineffective because
the antibodies only attack the strain from which the vaccine was
developed. HIV entry inhibitors work differently and, thus, are
more promising, Dr. Gallo opined. This type of vaccine would prevent
the virus from ever entering CD4 cells by providing an agent onto
which the virus could attach itself. The virus would then be unable
to attack the body’s CD4 cells and use them to replicate. In doing
so, the HIV entry inhibitor would ultimately prevent infection.
This promising development, Dr. Gallo stressed, must be explored
further.
As Dr. Gallo pointed out, what causes HIV is straight forward:
a retrovirus. The cause behind the HIV epidemics is, however,
far more complicated; involving, among other things, economic
and cultural factors and inter-relationships among governments,
health services, industry, communities, and families. These factors
and relationships must also be carefully considered when determining
how best to respond to the global HIV epidemic.
To learn more information on the George Marshall Institute, link
to http://www.marshall.org.
In the News
1. CDC Recommends Rapid-Test for Women in Labor
In its latest issue of MMWR, a weekly health surveillance report,
the Centers for Disease Control and Prevention (CDC) suggest that
using OraQuick’s HIV rapid test at point of care to screen pregnant
woman during labor and delivery reduces the waiting time for results.
And, when appropriate, this screening enables obstetric staff
to administer antiretroviral prophylaxis (medications that can
reduce vertical HIV transmission; i.e., transmission from mother
to child) to infants more quickly. In addition, it presents women
with the opportunity to be diagnosed and, hopefully, treated.
Thus, the CDC encourages hospitals to “assess the cost and benefits
of implementing point-of-care HIV testing within their institutions.”
However, the MMWR further noted, “As rapid HIV testing becomes
more available in labor and delivery settings, implementation
will require training and logistic planning.”
The
CDC’s findings, which complement its new emphases on reducing
barriers to early diagnosis and preventing HIV infection in newborns,
were based on a study conducted at four Chicago hospitals. In
three of the hospitals, women seeking care in the labor-and-delivery
units were screened for HIV with the OraQuick test; whereas, medical
staff in the labor-and-delivery unit of the fourth hospital used
laboratory tests for diagnostic purposes. While women in the fourth
hospital had to wait a median time of 3.5 hours for their results,
the MMWR reports, women in the other three hospitals received
their results in a median time of 45 minutes.
To
read Rapid Point-of-Care Testing for HIV-1 During Labor and Delivery—Chicago,
Illinois, 2002, the report on which this news brief is based,
link to http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5236a4.htm.
Announcements
1. United States Conference on AIDS Convenes This Week
As the most widely attended gathering of HIV/AIDS service providers
in the country, the annual United States Conference on AIDS (USCA),
now in its seventh year, affords participants a unique opportunity
to assemble; exchange stories, data, points of view; and renew
hope for—and commitment to—ending the HIV epidemic everywhere.
This year’s conference will take place in New Orleans, Louisiana
from Thursday, September 18 to Sunday, September 21.
AIDS
Action is a partner organization in the conference, and our staff
will be presenting at and participating in many of the conference
workshops and sessions. In addition, AIDS Action will provide
full coverage of the USCA program in a special edition of The
Weekly Update to be issued the week of September 21. For more
information on USCA, go to http://www.nmac.org.
2. National Latino AIDS Awareness Day Set for October
15
October 15 marks the final day of Hispanic Heritage Month and,
for the first time, it will also mark the first annual National
Latino AIDS Awareness Day, which is designed to help raise awareness
about the number of people in the Latino community who are HIV
positive and the increasing number of people who are at risk for
HIV. According the Web site for the National Latino AIDS Awareness
Day, “different localities and leaders will use the day to promote
and sponsor activities on prevention.” It continues, “Others will
use the day to make religious leaders and public officials aware
of the needs in reducing new infections and caring for those Latinos
with the virus. Others will use traditional expressions as an
opportunity to demonstrate the curative power of our culture.”
For
more information on National Latino AIDS Awareness Day and its
events, link to http://www.latinoaids.org/programs/awarenessday/.
3. NIH Announces New Cooperative Research Centers Application
for Sexually Transmitted Infections and Topical Microbicides
The Sexually Transmitted Diseases Branch of the Division of Microbiology
and Infectious Diseases (DMID), the National Institute of Allergy
and Infectious Diseases (NIAID) of the National Institutes of
Health (NIH), and the Department of Health and Human Services
(DHHS) invite applications for the Sexually Transmitted Infections
and Topical Microbicides Cooperative Research Centers (STI TM
CRCs). The purpose of this program is to stimulate multidisciplinary,
collaborative research that is focused on developing tools and
strategies for prevention and control of sexually transmitted
infections and diseases. The goal of this initiative is to emphasize
research aiding in the development of vaccines, therapeutics,
diagnostics and behavioral and social interventions. Identification
and development of topical microbicide agents and formulations
is a priority. CRCs will conduct multiple interrelated research
projects organized around a central theme, will be supported by
administrative and other core resources, and will participate
in a central Executive Committee of all CRC Directors. Together,
the CRCs will form a consortium that: 1) conducts multi-disciplinary,
intervention-oriented research, 2) fosters interaction among established
STI investigators, and 3) supports development of investigators
new to the field of STIs. Letters of intent are due November 17,
2003 and completed applications are due December 16, 2003. More
information can be found at:
http://grants1.nih.gov/grants/guide/rfa-files/RFA-AI-03-042.html
4.
CDC Technical Guidance for HIV Prevention Available Online
As part of its Advancing HIV Prevention initiative, the CDC has
drafted an interim technical guidance called Advancing HIV Prevention:
Interim Technical Guidance for Selected Interventions for HIV
prevention grantees. The document does not discuss CDC policy;
instead, it provides guiding principles in prevention, outlining
seven activities to assist with the implementation and achievement
of the new initiative strategies. The CDC expects local experts
to modify the activities for the communities they serve. The activities
are as follows:
1.
Routinely recommending HIV testing as part of regular medical
care services
2. Rapid testing in non-clinical settings
3. Routine voluntary HIV testing of inmates in correctional
facilities
4. HIV partner counseling and referral services
5. Risk reduction for people living with HIV
6. Prevention in medical care settings
7. Achieving universal HIV testing of pregnant women.
To
review the CDC guidance Advancing HIV Prevention: Interim Technical
Guidance for Selected Interventions, link to
http://www.cdc.gov/hiv/partners/Interim-Guidance.htm.
5.
Business and Labor Respond to AIDS through Updated Web Site
The Centers for Disease Control and Prevention has updated its
Web site for two programs, Business Responds to AIDS and Labor
Responds to AIDS (BRTA and LRTA). These two programs are designed
to help large and small businesses and labor unions meet the challenges
of HIV/AIDS in the workplace and in the community. As part of
this work, the BRTA/LRTA’s Web site offers information on general
topics, such as workplace health promotion programs, disclosure
of workers' HIV/AIDS status; workplace education materials offered
by BRTA/LRTA ; HIV transmission; and local HIV/AIDS workplace
prevention programs; on policy and legal issues, such as the legal
rights of staff/workers with HIV/AIDS; disclosure of staff/workers'
HIV/AIDS status; disclosure of HIV/AIDS status of healthcare staff/workers;
and co-workers rights and responsibilities; and on transmission
and workplace issues like how to work with a fellow staff member/worker
who has HIV or AIDS; Transmission of HIV/AIDS; OSHA workplace
standards; and the use of protective equipment while on the job;
as well as issues related to HIV in work places outside the U.S.
The information is designed to help employers and employees alike
understand their rights and responsibilities and to dispel myths
about HIV/AIDS that are common workplace settings. The site also
includes links to newspaper articles and educational Web sites
related to HIV/AIDS.
To
view the BRTA/LRTA Web site, link to http://www.hivatwork.org/.
The
AIDS Action Weekly Update
The Weekly Update is written with a mind toward the interests
of AIDS Action members. If you read the Weekly Update and value
the information you receive through this service but are not yet
a member of AIDS Action, we invite you to learn more about AIDS
Action membership and its benefits by contacting Ryan Palsrok
at AIDS Action (202) 530-8030, ext. 3015 rpalsrok@aidsaction.org.
As a national advocacy organization dedicated to shaping
fair and effective AIDS policy, AIDS Action is committed
to advocating for everyone who is affected by HIV/AIDS until
it’s over—until HIV transmission is arrested, until people
living with HIV/AIDS get the care and support they need,
and until a cure is found. |
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