Vidyya Medical News Service
Volume 6 Issue 192 Published - 14:00 UTC 08:00 EST 10-Jul-2004 Next Update - 14:00 UTC 08:00 EST 11-Jul-2004
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U.S. cuts participation in international AIDS conference

The United States has dramatically reduced the number of researchers it will send to the 15th International AIDS Conference beginning Sunday in Bangkok, prompting further criticism that the Bush administration is trying to "go it alone" in its global AIDS strategy, the Washington Post reports.

The decision to cut attendance to one-quarter the number who participated in the last conference in Barcelona comes well after many government scientists had made plans for the biennial event. Dozens of presentations have been withdrawn and over 50 reduced to summaries, while dozens of meetings — many designed to train researchers in the developing world — have been cancelled.

The administration has cast the move as a financial one, but many AIDS experts have interpreted it as a response to criticism of U.S. Health and Human Services Secretary Tommy Thompson at the Barcelona conference and more evidence of U.S. determination to forge its own path in the AIDS fight, the Washington Post reports.

"The largest group in the world in terms of AIDS expertise comes from the U.S., so it's important this expertise is at the conference," said Peter Piot, head of the Joint U.N. Program on HIV/AIDS. The diminished attendance "is a big deal for the quality of the conference," he said.

The cutbacks apply only to HHS, home to the National Institutes of Health and the Centers for Disease Control and Prevention, the two juggernauts of AIDS research. Other Cabinet-level departments with AIDS programs are not having their participation reduced.

William Pierce, a spokesman for HHS, said the decision was in keeping with an earlier policy to reduce travel to scientific meetings. "This is not exclusive to this conference — this is for all international conferences. A lot of it was simply looking at expenses," he said.

Yet this year's event will be unusually large — about 20,000 participants — and important because of new efforts to bring treatment to the developing world. Chief among these is the Bush administration's five-year, $15 billion AIDS program, which has garnered criticism from some quarters despite its unprecedented levels of spending.

Complaints include its restriction to 15 nations, its focus on abstinence, limits on the use of generic drugs and the relatively low level of funding, at $1 billion, for the Global Fund to Fight AIDS, Tuberculosis and Malaria.

The decision to reduce the U.S. presence at the AIDS conference could spark more frustration with U.S. policy abroad, the Post says.

"It's a perception from the rest of the world that the U.S. wants to be engaged, but the U.S. wants to call the shots," said a senior official at the Centers for Disease Control and Prevention.

AIDS scientists at CDC and NIH and others whose work is funded by the government expressed dismay at the move, although no one was willing to speak on the record because of fear of retaliation.

"What can I say? I can't say anything," said one NIH researcher.

An AIDS scientist called it "inappropriate and misguided" and said for the NIH staff "it is quite demoralizing to get an abstract accepted in the field of your choice, and then not be able to present your findings because you're not allowed to go to the meeting."

HHS officials had attempted to cancel a $250,000 CDC grant to the conference for scholarships for Third World AIDS researchers, said one person familiar with the program. When informed the money could not be reclaimed, Thompson restricted it to countries benefiting from the president's $15 billion AIDS program.

A CDC official dubbed as "bull" the HHS explanation that cutbacks were mainly to save money.

"This is clearly the result of the booing of Secretary Thompson in Barcelona, which he took quite personally," the official added.

At the Barcelona event, about 30 activists drowned out his 15-minute speech with shouts of "Shame, shame!" and "No more lies." Neither Richard Feachem, head of the Global Fund, nor former Director General of the World Health Organization Gro Harlem Brundtland, who spoke after the secretary, defended him or criticized the hecklers.

Within weeks of the conference, rumors emerged that HHS participation might be different in the future (David Brown, Washington Post, July 9).

HIV Shifting To Women, Particularly In United States

HIV is shifting to women in the United States at a faster rate than anywhere else in the world because of cultural messages that "sex is cool," the U.N. Development Fund for Women (UNIFEM) warned today ahead of the Bangkok conference.

Among Americans infected with HIV, the proportion that is female has increased from 20 to 25 percent — up from 180,000 in 2001 to 240,000 — a one-third rise that UNIFEM adviser Stephanie Urdang called "dramatic."

Increased pressure to have sex without condoms and widespread sexual innuendo in popular culture has contributed to the spread of the virus among females, Urdang said.

"This is having an enormous impact on young people and their minds," she said. "Among young people in America, there is a feeling that sex is cool, that it's okay to be growing up and to be sexually experienced."

She blamed the U.S. educational system, saying it has focused on teaching abstinence and faithfulness at the expense of protection.

The AIDS burden is shifting to women around the globe, with women making up 48 percent of the estimated 35.7 million adults living with HIV/AIDS.

The overall HIV/AIDS rate in the United States remains low, at about 0.6 percent, compared to rates of almost 40 percent in some of the worst-hit countries in sub-Saharan Africa (Michael Mathes, Agence France-Presse, July 9).

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