                     AIDS Daily Summary
                     September 12, 1994

The Centers for Disease Control and Prevention (CDC) National AIDS
Clearinghouse makes available the following information as a public
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Copyright 1994, Information, Inc., Bethesda, MD

"F.D.A. Debate on Speedy Access to AIDS Drugs is Reopening"
New York Times (09/12/94) P. A13;  Kolata, Gina
     Three years ago, prodded by AIDS advocates, the FDA relaxed its 
approval process for new AIDS drugs so that they could enter the 
market faster.  Although many researchers thought it unwise to 
waive the requirement that the drug be clinically proven, the FDA
decision quickly resulted in available drugs, as the advocates 
had hoped.  Now, some of these advocates say the policy is not 
working because testing is so inadequate that no one can tell if 
the drugs work.  Other advocates urge that no unnecessary hurdles
be imposed on new drugs, as efforts for change threaten hard-won 
past victories.  All agree that the issue is timely because drug 
companies are starting studies on a new class of AIDS drugs known
as protease inhibitors.  The FDA will hold a meeting on Monday 
and Tuesday to allow researchers, statisticians, advocates, and 
drug companies to express their opinions, but the agency says it 
will not make a decision at the meeting.  Accelerated approval of
AIDS drugs allows the treatments to reach the patient faster, but
critics say that definitive follow-up studies have never been 
done on the drugs.  Others want the current policy to remain in 
effect but want the FDA to enforce adequate follow-up studies by 
the drug companies.
      
"Credibility of Red Cross Doubted"
Globe and Mail (09/08/94) P. A7;  Picard, Andre
     Groups representing Canadian users of blood products say that the
Canadian Red Cross has no place building a $150-million blood 
fractionation plant, if it cannot meet the U.S. and Canadian 
blood collection standards.  "Fractionation is a highly technical
and scientific operation and plants must adhere to the most 
stringent standards," says Derhane Wong-Rieger, president of the 
Canadian Hemophilia Society.  The FDA has blocked shipments of 
some Canadian plasma to the United States for treatment after 
finding 19 violations of U.S. regulations at a Toronto 
transfusion center including inadequate screening of donors, 
mislabeling of blood units, sloppy record keeping, and poor 
quarantine methods for untested plasma.
      
"Africans Try to Break Silence on AIDS Even as Ailment Consumes Their Continent"
Los Angeles Times (09/11/94) P. A20;  Dadson, Amba
     In Africa, where 10 million of the world's 16 million HIV 
infection cases have occurred, silence is helping the disease to 
spread.  Many Africans cannot bring themselves to discuss AIDS 
because of powerful social forces, such as modesty and shame, 
which also keeps them from seeing their doctors.  Now, in Ivory 
Coast, an almost unheard support group called "The Friends Club" 
has formed to break the silence and to offer hope to those 
infected with HIV.  The meetings, drawing 35 to 40 people, are 
upbeat and positive and include honest conversations on all 
aspects of the disease.  Ivory Coast is West Africa's most 
affected country, with over 18,000 documented cases of AIDS.
      
"Women Suffer Most From AIDS, Conference Told"
Reuters (09/09/94);  Eltahawy, Mona
     AIDS activists accused the U.N. population conference on Friday 
of ignoring the increasingly devastating effect the disease is 
having on women around the globe.  Women activists also told a 
non-governmental organizations panel discussion that family 
planning programs do not adequately inform women about ways to 
protect themselves from sexually transmitted diseases.  
International health organizations report that HIV is spreading 
faster among women than men, so far infecting over 7 million 
women worldwide.  Elizabeth Reid, director of the HIV and 
Development Program of the United Nations Development Program, 
said than women in many traditional societies are unable to 
protect themselves from infection because they don't have the 
power to demand that their husbands practice safe sex.  Simone 
Diniz, co-founder of a women's health collective in Brazil, said 
that family planning programs, "need to redefine their role, 
permitting themselves to further women's awareness and 
empowerment based on the understanding of who decides how, why, 
and when to have sexual intercourse."  Diniz said many women 
partaking in family planning programs use the pill or 
implants--as opposed to condoms--because such choices don't 
involve the husbands' role in the decision.
      
"Vatican Takes Low-Key Position on Contraceptives"
Reuters (09/11/94);  Pullella, Philip
     Although the Vatican assumed a low-key position on contraceptives
at the U.N. population conference in Cairo, the Catholic Church 
says this does not indicate a change in its position prohibiting 
them.  Vatican observers were surprised that, in pre-conference 
meetings, language that promoted condoms was not modified or 
formally contested.  Holy See delegates said that their position 
had not changed, but that they had agreed to not block discussion
by contesting the language.  The delegates also said that they 
were putting contraceptive issues aside so that they could focus 
on its fight against abortion.
      
"Bob Nelson Appointed Director of Public Policy and Advocacy for Catholic Charities"
Business Wire (09/09/94)
     Catholic Charities of the Archdiocese of San Francisco announced 
the appointment of Bob Nelson as director of Public Policy and 
Advocacy in San Mateo, Marin, and San Francisco counties.  Nelson
has been at Catholic Charities for over seven years, most 
recently as manager of HIV Direct Services.  He also sits on the 
Ryan White CARE Council, the Mayor and Board of Supervisors' 
Joint Task Force on HIV, and the National HIV Housing Coalition 
Board of Directors.
      
"AIDS: $35 Million in Carrots and Sticks"
U.S. News & World Report (09/12/94) Vol. 117, No. 10, P. 25
     Although the U.S. government has put billions of dollars into 
AIDS research during the past decade, some critics claim these 
research dollars were imprudently spent.  Last week, NIH, the 
nation's largest funder of AIDS research, announced a program 
that would fund research on highly experimental treatments.  By 
1998, NIH will give $35 million in grants to scientists and 
researchers under the condition that within two years of 
obtaining the grant, they start testing a new treatment in 
patients.  If this provision is not met, the recipient will lose 
the grant.  The NIH program has been well received by both 
industry representatives and AIDS activists.
      
"HIV, TB Present Deadly Combination"
American Medical News (09/05/94) Vol. 37, No. 33, P. 33;  
Pinkney, Deborah Shelton
     Experts at the 10th International Conference on AIDS warned that 
AIDS and TB could kill up to 15 million people during the next 
few years.  Asia, which accounts for two-thirds of the world's TB
cases,  has an even bleaker outlook because it has experienced a 
large increase in HIV cases in the past year.  Almost a third of 
the world's population is already infected with the TB bacilli, 
though most will never become sick, explained Arata Kochi of the 
World Health Organization."  HIV-infected persons, however, are 
more likely to get sick with TB than individuals who are not 
HIV-infected.  Those who go untreated can spread TB to 10 or 20 
others within a year.  "With over 50 percent of the adults 
infected with TB in many Asian countries, there is no end in 
sight for how bad the co-epidemic can get in Asia," said Kochi.
      
"Directly Observed Therapy for Tuberculosis in New York City"
Journal of the American Medical Association (08/10/94) Vol. 272, 
No. 6, P. 435;  Klein, Susan J.;  DiFerdinando Jr., George T.;  
Naizby, Brenda E. et. al.
     In a letter to the editors of the Journal of the American Medical
Association, Drs. Klein, DeFerdinando, and Naizby address a 
previously published study conducted by Bloch et al. on 
drug-resistant tuberculosis and the current TB epidemic in New 
York City.   Klein et al. call to attention the New York State 
Department of Health's directly observed therapy (DOT) treatment 
for TB patients, which involves offering anti-TB medications at 
various locations across New York City, minimizing access 
barriers to those infected.  Bloch et al. respond by 
congratulating New York City's public and private health care 
providers and their success with TB patients over the last two 
years with the DOT program.  "The use of DOT in NYC was not the 
only intervention," they caution.  Bloch and his colleagues 
stress that DOT was part of an individualized patient treatment 
plan that also provided "accessible services, a reliable source 
of medication, treatment in a variety of settings, and social 
services, and an integrated system of follow-up."  They summarize
that "available evidence supports the recommendation that DOT be 
considered ... as part of optimal TB patient treatment."
      
