Abortion rights proponents in South Dakota submitted in excess of 37,000 petition signatures, more than double the amount required, in an attempt to force the issue to the ballot for a vote in November. Reuters has the full article here.
The South Dakota Campaign for Healthy Families said it had obtained nearly 38,000 signatures on a petition aimed at repealing an abortion ban signed into law by Gov. Mike Rounds on March 6.
The petition would be filed with the Secretary of State's office on Tuesday afternoon, and if at least 16,728 signatures are certified as valid, the scheduled July 1 implementation of the ban would be nullified and voters would be allowed to decide the issue at the ballot box in November.
"This law is just not feasible and is just very extreme," said Dr. Maria Bell, an obstetrician who helped sponsor the petition drive, in a press conference.
The South Dakota measure is considered one of the most restrictive in the United States. It bans nearly all abortions, even when pregnancies result from incest or rape. The law says that if a woman's life is in jeopardy, doctors must try to save the fetus as well as the woman. Doctors who perform an abortion could receive a $5,000 fine and five years in prison.
The ban's supporters have said they want the law to be challenged in court so it can make its way to a more conservative U.S. Supreme Court. They hope the law will help overturn the 1973 Roe v. Wade decision that established a woman's right to an abortion.
Daniel DiRito | May 30, 2006 | 11:27 AM |
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The latest HIV infection information from Uganda seems to indicate that the abstinence approach may be a disaster in the making. Uganda, long viewed as a model for HIV prevention success in Africa, appears to have taken a wrong turn in promoting the program described as ABC...A: abstinence first...B: be faithful in a committed relationship...C: use condoms if A and B fail. The Bush administration appears to be complicit in these alarming new infection rates by virtue of its push towards programs that emphasize abstinence while moving away from the promotion of condom usage.
From allAfrica.com:
Speaking at the ceremony, the Uganda Aids Commission (UAC) Director General, Dr Kihumuro Apuuli, said despite financial support from the donor community, the rate of people acquiring HIV/Aids is still increasing.
He said, in 2005 130,000 Ugandans got infected compared to 70,000 in 2003.
One must understand a little of the history of Uganda's AIDS prevention efforts in order to draw any conclusions. Uganda was one of the first African nations to openly discuss HIV and to direct energy and money towards awareness. In 1986, President Museveni toured the country with a message that HIV prevention was a patriotic endeavor and basically introduced the above described program that has come to be called the ABC's of AIDS prevention. There is little dispute about these basic facts. However, since that time the interpretation of the resulting data has been widely divergent and controversial.
When the Bush administration announced its five year, 15 billion dollar effort to combat HIV in Africa in early 2003, it immediately embraced the Ugandan ABC program as a model for the rest of Africa. Since that time, two opposing views have emerged with regard to an effective plan to combat HIV in Africa.
The administration and numerous religious groups (most of these groups have limited HIV experience) believe that abstinence should be the primarly prevention message. Those with significant HIV prevention experience caution that abstinence can be an adjunct to condom promotion and distribution, but it is not a method that ought to be singularly enbraced and endorsed. They cite abundant research and data to support this contention.
From talk2action.org:
Uganda was once an HIV prevention success story, where an ambitious government-sponsored prevention campaign, including massive condom distribution and messages about delaying sex and reducing numbers of partners, pushed HIV rates down from 15 percent in the early 1990s to 5 percent in 2001. But conservative evangelicals rewrote this history--with the full-throated cooperation of Uganda's evangelical first family, the Musevenis. As one Family Research Council paper put it:
"Both abstinence and monogamy helped to curb the spread of AIDS in Uganda...How did this happen? Shortly after he came into office in 1986, President Museveni of Uganda spearheaded a mass education campaign promoting a three-pronged AIDS prevention message: abstinence from sexual activity until marriage; monogamy within marriage; and condoms as a last resort. The message became commonly known as ABC: Abstain, Be faithful, and use Condoms if A and B fail."
This warped version of the true Uganda story became the mantra in Bush's Washington, with the "C" reduced more and more to an afterthought as time went by. For example, in piling on against a 2002 pro-condom comment by then Secretary of State Colin Powell, Focus on the Family's James Dobson wrote condoms out of the story entirely: "Secretary Powell seems to be ignorant of the fact the Uganda has made great progress against AIDS by emphasizing abstinence, not condoms."
To see more about this shifting Bush administration emphasis on abstinence and faith based programs, please see the prior Thought Theater posting on the topic here. Questions about the Ugandan effort and their reports of successful results began to surface in 2004.
From BBC News:
An organisation helping people living with HIV/Aids in Uganda has questioned the authenticity of the government's statistics on the disease.
bq. Uganda is often held up as a success story and the government lauded for the progress it has made with the official prevalence rate put at only 6%.
But after conducting research in districts across Uganda, an NGO suggests the real picture is far worse.
They found prevalence rates as high as 30% and bad access to anti-retrovirals.
Major Rubaramira Ruranga, the executive director of the National Guidance and Empowerment Network of people living with HIV/Aids in Uganda (NGEN), said he believed the HIV prevalence rate could be more than three times higher than previously thought.
"We have found the prevalence rate at this time is 17%," he told a news conference.
Additional data was reported in early 2005 in the San Francisco Chronicle. Take particular note that researchers seem to be confounded by the information they were gathering when they compared it to the reported declines in infection rates. Not only were they finding that abstinence was waning, they were puzzled that infection rates appeared to be declining. They point out that condom use seemed to be on the increase...possibly providing an explanation to the confusing data.
Research from the heavily studied Rakai district in southern Uganda suggests that increased condom use, coupled with premature death among those infected more than a decade ago with the AIDS virus, are primarily responsible for the steady decline in HIV infections in that area.
Uganda's "ABC" prevention formula -- standing for Abstinence, Be Faithful, and use Condoms -- has been widely credited with lowering that nation's infection rate from 30 percent in the early 1990s to below 10 percent today.
In the Rakai district, however, researchers found that abstinence and fidelity have actually been declining, but the expected rise in HIV infections stemming from such behavior has not occurred.
"Condom use may be offsetting other high-risk behaviors,'' said Maria Wawer, a professor at Columbia University's Mailman School of Public Health, who presented the study at a session of the 12th Annual Retrovirus Conference in Boston.
The Rakai findings are based on an extensive and continuing process of interviewing 10,000 adults each year --a so-called population-based survey that is considered the gold standard for this kind of epidemiological research.
Reports of consistent condom use by men rose to more than 50 percent by 2002, compared with 10 percent a decade earlier. Among women, reports of condom use rose from virtually zero to 25 percent.
In order to fully understand all the factors that may explain these new infection statistics, one must also realize what was taking place within the Ugandan condom distribution program. In 2004, the Ugandan government suddenly issued a recall for condoms that were being distributed for free at numerous clinics throughout the country. The President of Uganda indicated concerns about the quality of the condoms.
From Avert.org:
In 2004 the Ugandan government issued a nationwide recall of the condoms distributed free in health clinics, due to concerns about their quality. Although tests showed there was nothing at all wrong with the condoms, the government said that public confidence in the brand had been badly dented, so they would not redistribute them. By mid-2005 there was said to be a severe scarcity of condoms in Uganda, made worse by new taxes which made the remaining stocks too expensive for many people to afford.
Some have said the US is largely to blame for the shortages. According to Stephen Lewis, the UN Special Envoy for HIV/AIDS in Africa, "there is no question that the condom crisis in Uganda is being driven and exacerbated by PEPFAR and by the extreme policies that the administration in the United States is now pursuing".
Mr Lewis has also said that PEPFAR's emphasis on abstinence above condom distribution is a "distortion of the preventive apparatus and is resulting in great damage and undoubtedly will cause significant numbers of infections which should never have occurred".
However, speaking in August 2005, Uganda's coordinator of condom procurement at the Ministry of Health denied there was any shortage of condoms, and said that new stocks would be distributed soon. She also said the government was committed to promoting all three parts of the "ABC" strategy: Abstinence, Faithfulness and Condoms.
From Kaisernetwork.org:
U.N. Special Envoy for HIV/AIDS in Africa Stephen Lewis and other AIDS advocates in August said the Bush administration's policy of promoting abstinence prevention programs and cuts in federal funding for condoms have contributed to a condom shortage in Uganda and undermined the country's HIV/AIDS fight. Uganda needs between 120 million and 150 million condoms annually, but since October 2004 only 32 million have been distributed in the country, according to the U.S.-based Center for Health and Gender Equity, also known as CHANGE.
In 2005, Act Up also took up the issue of the reported condom shortage in Uganda and the fears about the shift to abstinence programs that were emerging since the introduction of the Bush administrations efforts to combat the disease in Africa.
From Actupny.org:
(Manhattan) A coalition of AIDS activists held a demonstration in midtown Manhattan outside of the Ugandan Permanent Mission to the United Nations today to bring attention to that nation's severe condom shortage which is putting people at dangerous risk of HIV infection. The crisis has developed over the past ten months as the government of Uganda has stopped its robust program of public sector condom distribution. These condoms previously accounted for 80% of condoms available in the country.
Since May 2004, new shipments--some 30 million quality-approved condoms--have been sitting in government warehouses. Activists are demanding to know why, nearly a year into the shortage, health clinics are still unsupplied and the government is refusing to state when or how they will distribute the condoms. "This crisis could have been averted by the government long ago. The condoms are there, but what is in woeful shortage is the political will of Ugandan leaders to distribute them and promote condom use," said Sharonann Lynch of Health GAP.
Now activists in Uganda say the program has been overtaken by abstinence-until-marriage approaches as President Yoweri Museveni and First Lady Janet Museveni are aligning Uganda's policies with the ideology touted--and financed--by the United States government.
Uganda is a country receiving funds from the President Bush's Emergency Plan for AIDS Relief (PEPFAR). The program requires a minimum of 33% of its prevention funds to be used for abstinence-only-until-marriage programs, and limits the distribution of condoms to specific high-risk groups. "The strident prevention politics tied to the Bush administration's AIDS funding are undermining sound prevention in the name of abstinence-only approaches. Scientific studies have shown the inadequacy of such methods, and President Museveni is neglecting the public health of Ugandans by bowing to Bush's pressure." said Eustacia Smith of ACT UP.
A comprehensive review of this body of information simply illuminates the misguided efforts of the Bush administration with regard to HIV prevention. The data not only show that the abstinence approach is at best suspect (and more likely, wholly insufficient); it clearly demonstrates that condom availability and usage are the essential tool in combating increasing infection rates.
One is left to wonder about the accuracy of the reported data. While the near doubling of infection rates is sufficiently alarming, it is even more frightening to consider the possibility that the information may be inaccurate. I have no way to verify the data and while I question the motivations of the Ugandan government, it may be several years before it can be determined if the numbers may have been deliberately under reported.
Uganda is a snapshot of a confluence of allegiances and events that will ultimately have led to more pain, suffering, and death. History will likely note that the matching ideologies of those in power in both nations directly led to the unnecessary spread of a deadly disease at a time when money and energy were available to enable the opposite. That is an unmitigated and inexcusable tragedy.
Daniel DiRito | May 25, 2006 | 9:46 AM |
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Using a new process to view the actual structure of the HIV virus, scientists were able to get the best look at the virus structure since it's discovery. The hope is that the new information will hasten the process to find a vaccine. Read the full article here.
LONDON (Reuters) - Scientists in the United States have taken a close up, three-dimensional look at spike proteins on the surface of the AIDS virus which could speed up the search for a vaccine.
The proteins, known as gp120 and gp41, allow HIV which causes AIDS to bind and fuse with human cells.
Dozens of AIDS vaccines using different approaches are being developed and tested. Roux believes part of the reason vaccines have failed so far is that, although scientists were aware of the spike proteins, nobody had really known how the spikes were put together.
Their findings, reported online by the journal Nature, show that the spikes consist of three gp120 proteins that make up the protRudyng cap and three gp41 proteins that make up the stalk.
"There are already two labs, that I am aware of, which have taken this information and are using it to try to redefine the vaccine," he said.
Scientist have not been able to scrutinize the intact spikes on the virus in such detail until now because the technology was perfected only in recent years.
Daniel DiRito | May 24, 2006 | 2:30 PM |
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Update II:
Reuters has an article detailing the pending opposition from the religious right to Gardasil, Merck's new cervical cancer vaccine. Read the full article here.
"We don't think it should be made mandatory for school attendance," said Peter Sprigg, vice president of policy at the Family Research Council, who attended the Food and Drug Administration (FDA) advisory panel meeting on Thursday.
That view is shared by evangelical Christian group Focus on the Family.
"We support the widespread availability of the vaccine, but we do oppose the mandatory vaccination for entry to public school," said Linda Klepacki, an analyst for sexual health for the group.
Dr. Gene Rudd of the Christian Medical and Dental Associations, which also supports the vaccine but opposes school mandates, said he believes states could resolve the matter by building in some wiggle room.
"Our position is to have an easy opt out," he said. "Make it mandatory in the sense that it is generally accepted, but parents can opt out."
I find it fascinating that any parent would even contemplate opting out of providing a child with a potentially life saving vaccine simply based upon fears of hastening a child's sexual activity. First, the premise, in my opinion is absurd. I find it hard to imagine that a key deciding factor in a child's election to engage in sex is guided by such considerations. That is not to say children aren't concerned about STD's...I just don't see it as the crux of the decision to become sexual.
Generally, children have been exposed to knowledge about most STD's prior to becoming sexually active. The important issue is whether they heed the warnings and take the appropriate precautions. A vaccine simply offers an added level of protection. Merck also points out that the dangers of HPV, the virus the vaccine protects against, are not widely understood by women, making it more important to educate them about the virus and to provide the vaccine.
Merck said it would continue its education efforts while regulatory agencies around the world review the product.
A U.S. television and print campaign, with the tagline "Tell Someone," makes no mention of the company or the vaccine, but Merck is now considering how to integrate the vaccine into its promotional materials, said Bev Lybrand, vice president of marketing.
She said the campaign was "born out of the finding that very little awareness exists among women about HPV and its consequences."
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Update:
An FDA advisory panel unanimously recommended approval of a vaccine designed to prevent some types of cervical cancer related to the Human Papillomavirus. Reuters reports the following:
GAITHERSBURG, Maryland (Reuters) - Merck & Co. Inc.'s (MRK.N: Quote, Profile, Research) experimental vaccine to prevent cervical cancer moved closer to the market on Thursday as U.S. advisers unanimously said it was safe and effective for females as young as 9.
The Food and Drug Administration usually approves products recommended by advisory panels. A final FDA decision is expected by June 8.
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Original Posting
Reuters is reporting good news on the vaccine that protects women against the virus (HPV) that is linked to cervical cancer. The vaccine has been submitted to the FDA for approval but it is likely to create significant controversy as many religious organizations are opposed to vaccinating young girls out of concern that it promotes sexual permissiveness and diminishes the message of abstinence only programs. Given the delays by the FDA on other health issues related to sex including the new day after contraceptive pill and the Bush administrations promotion of abstinence programs in Africa to prevent the spread of AIDS, the vaccine is likely to receive ample political attention...unfortunately. This should be a simple matter of protecting women's health. Read the Reuters article below.
LONDON (Reuters) - A vaccine that protects women against a virus that causes cervical cancer is effective for more than four years, researchers said on Thursday.
They found that women given GlaxoSmithKline Plc's cervical cancer vaccine Cervarix had high levels of antibodies against two of types of the human papillomavirus (HPV) for up to 4.5 years after receiving their last dose.
"These findings set the stage for widescale adoption of HPV vaccination for prevention of cervical cancer," said Dr Diane Harper, of Dartmouth Medical School in New Hampshire, who conducted the trial.
Cervical is one of the most common cancers in women. Each year 470,000 women around the world are diagnosed with the disease and 230,000, mostly in the developing world, die, according to the International Agency for Research on Cancer (IARC) in Lyon, France.
HPV is s sexually transmitted infection. Strains 16 and 18 of the virus are responsible for more than 70 percent of cervical cancers.
Results of a European survey released on Wednesday of more than 1,500 women in five EU countries showed that only 5 percent could identify HPV as the cause of cervical cancer.
Harper and her team followed up 800 women who took part in the original trial of the vaccine in which it was compared to a placebo. Their research is published online by The Lancet medical journal.
Women given the vaccine not only had high levels of antibodies against HPV-16 and HPV-18 but the levels did not decrease over time.
The vaccine also protected against new and persistent infections and was effective against HPV-45 and HPV-31, the third and fourth most prevalent cancer-causing types of the virus.
"The results show sustained immune response and long-term efficacy against HPV-16 and HPV-18 infection," Harper added.
Glaxo submitted the vaccine to the European Medicines Agency for approval in March. But Merck & Co. Inc's Gardasil vaccine was filed for marketing approval in Europe and the United States last December.
Merck is marketing the vaccine in partnership with Sanofi-Aventis in Europe.
Daniel DiRito | May 22, 2006 | 3:45 PM |
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An email from the office of an Indiana congressman to the Department of Health and Human Services prompted the Center for Disease Control to alter the previously peer reviewed panel for an upcoming conference on sexually transmitted diseases (STD's). Those bumped from the panel were astounded at the actions. Read the full article here and more from Slate here.
Bruce Trigg of the New Mexico Department of Public Health, the original organizer, condemned the decision as political meddling in the scientific process. The original panel was vetted through a formal peer-review process by independent researchers.
"It is unprecedented that this type of interference takes place at a scientific meeting," Trigg said. He said the original panel was not designed to be a balanced critique but to present the public health concerns about abstinence programs.
"I have nothing to fear from a balanced program. They would have been welcome to submit abstracts for review and consideration. The claim is this is about a public health program when it's really about ideology and religion," Trigg said.
Jonathan Zenilman, president of the American Sexually Transmitted Diseases Association, a co-sponsor of the conference, said he was "surprised and astounded."
"This is the first time I've seen the process of peer review subverted by pure politics," Smith said.
There is an increasing effort by abstinence only proponents to use political pressure to subvert the scientific process. One glaring example has been the delays in the approval process at the FDA for the Plan B contraceptive drug. Under Lester Crawford, former head of the agency, the process was repeatedly delayed despite receiving the necessary comittee approval recommendations. The upcoming approval for a vaccine to protect women from cervical cancer caused by HPV is expected to receive similar opposition from those who feel the vaccination will encourage sexual activity in young women.
Daniel DiRito | May 9, 2006 | 7:49 AM |
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As the May 15th deadline to sign up for the Medicare prescription drug benefit approaches, it appears that those with the greatest need, the poor, are participating the least. Read the full article here.
A report out today by Families USA, a liberal health care advocacy group, shows that only 24% of the 7.2 million people projected to be eligible for low-income subsidies have been approved. The participation rates vary from 12% in Arizona to 41% in Kentucky.
Federal officials say more than 37 million people on Medicare have joined or been automatically covered by the drug plan since it began Jan. 1, including 70% to 75% of eligible blacks, Hispanics and Asian-Americans. They acknowledge that millions of eligible low-income Americans are still not enrolled.
Low-income community organizers say the application process is too confusing and the personal financial data too intrusive. They say six months isn't enough time to get people enrolled - and the federal government has not been effective at infiltrating ethnic communities.
"The outreach by Social Security was not what I would consider outreach," said Jane Delgado, president of the National Alliance for Hispanic Health. Most seniors received a mass mailing, she said.
Daniel DiRito | May 9, 2006 | 7:22 AM |
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It was at a meeting in 1984 when I first heard the theory that AIDS would be a force in mainstreaming homosexuality. I was meeting with the publisher of a gay magazine at the time. His words have never left my psyche. At the time, it was a bold prediction in the face of what appeared to be the beginning of a relatively devastating, yet unknown future for the gay community. In retrospect, it was an insightful statement, though one few were willing to speak. Newsweek, in their May 10th edition, chronicles some of that very phenomenon. You can find the full article here. Some excerpts from the article follow.
The plague years: It brought out the worst in us at first, but ultimately it brought out the best, and transformed the nation. The story of a disease that left an indelible mark on our history, our culture and our souls.
At a time when the mere threat of avian flu or SARS can set off a coast-to-coast panic—and prompt the federal government to draw up contingency plans and stockpile medicines—it's hard to imagine that the national response to the emergence of AIDS ranged from indifference to hostility. But that's exactly what happened when gay men in 1981 began dying of a strange array of opportunistic infections. President Ronald Reagan didn't discuss AIDS in a public forum until a press conference four years into the epidemic, by which time more than 12,000 Americans had already died. (He didn't publicly utter the term "AIDS" until 1987.)
As AIDS made its death march across the nation, killing more Americans than every conflict from World War II through Iraq, it left an indelible mark on our history and culture. It changed so many things in so many ways, from how the media portray homosexuality to how cancer patients deal with their disease. Through the crucible of AIDS, America was forced to face its fears and prejudices—fears that denied Ryan White a seat in school for a year and a half, prejudices that had customers boycotting restaurants with gay chefs. Watching a generation of gay men wither and die, the nation came to acknowledge the humanity of a community it had mostly ignored and reviled. "AIDS was the great unifier," says Craig Thompson, executive director of AIDS Project Los Angeles and HIV-positive for 25 years.
Without AIDS, and the activism and consciousness-raising that accompanied it, would gay marriage even be up for debate today? Would we be welcoming "Will & Grace" into our living rooms or weeping over "Brokeback Mountain"? Without red ribbons, first worn in 1991 to promote AIDS awareness, would we be donning rubber yellow bracelets to show our support for cancer research?
"Gay Cancer," as it was referred to at the time, wasn't a story the press wanted to cover—especially since it required a discussion of gay sex. The New York Times ran fewer than a dozen stories about the new killer in 1981 and 1982, almost all of them buried inside the paper. (NEWSWEEK, for that matter, didn't run its first cover story on what "may be the public-health threat of the century" until April 1983.)
With death a constant companion, the gay community sobered up from the party that was the'70s and rose to meet the unprecedented challenge of AIDS. There was no other choice, really: they had been abandoned by the nation, left to fend for themselves. "Out of whole cloth, and without experience, we built a healthcare system that was affordable, effective and humane," says Darrel Cummings, chief of staff of the Los Angeles Gay & Lesbian Center. "I can't believe our community did what it did while so many people were dying."
It took a movie star to get the rest of the nation's attention. In the summer of 1985, the world learned that Rock Hudson—the romantic leading man who'd been a symbol of American virility—was not only gay, but had full-blown AIDS. "It was a bombshell event," says Gottlieb, who remembers standing on the helipad at UCLA Medical Center, waiting for his celebrity patient to arrive, as news helicopters circled overhead. "For many Americans, it was their first awareness at all of AIDS.
If TV was slow to deal with AIDS, cinema was downright glacial. "Longtime Companion," the first feature film about the disease, didn't make it to the screen until 1990, nine years into the epidemic. "There was a lot of talk before the movie came out about how this was going to hurt my career, the same way there was talk about Heath Ledger in 'Brokeback Mountain'," says Bruce Davison, who received an Oscar nomination for his role. As for "Philadelphia," Hanks is the first to admit "it was late to the game."
Broadway was the major exception when it came to taking on AIDS as subject matter—in part because so many early casualties came from the world of theater. By the time Tony Kushner's Pulitzer Prize-winning "Angels in America" made its Broadway debut in 1993, some 60 plays about the disease had opened in New York.
"Everywhere I go, I'm meeting young people who've just found out they've been infected, many with drug-resistant strains of the virus," says Cleve Jones, who two decades ago decided to start stitching a quilt to honor a friend who had died of AIDS. Ever-expanding, it was displayed several times in Washington, transforming the National Mall into what Jones had always intended: a colorful cemetery that would force the country to acknowledge the toll of AIDS. "If I'd have known 20 years ago that in 2006 I'd be watching a whole new generation facing this tragedy, I don't think I would have had the strength to continue," says Jones, whose own HIV infection has grown resistant to treatment.
Daniel DiRito | May 7, 2006 | 10:09 AM |
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