Subject: CDC Summary Date: 5/26/93 (258 lines) From: National AIDS Info Clearinghouse Copyright 1993, Information, Inc., Bethesda, MD AIDS Daily Summary May 26, 1993 The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold. Copyright 1993, Information, Inc., Bethesda, MD "FDA Issues Warning About AIDS Drugs From 'Buyers Clubs'" Washington Post (05/26/93), P. A3 (Schwartz, John) Some AIDS drugs not approved by the Food and Drug Administration and sold through "buyers' clubs" may be unsafe, the FDA wrote in a letter sent yesterday to about a dozen of the clubs. The agency has long permitted HIV-positive persons to import unapproved treatments under a "personal use" policy. Consequently, the underground buyers clubs have emerged to satisfy that demand and to act as information clearinghouses for treatment alternatives. Drugs available in the buyers clubs are usually obtained from foreign countries. These drugs include DDC, Immunex, and hard-to-find herbal medicines such as Chinese bitter melon. The FDA's letter did not specify drugs or treatments that the agency believes are hazardous, but outlined three areas of concern: the lack of physician's involvement in some of the groups; "the sale of injectable products of unknown purity, sterility, and strength"; and the promotion and commercialization of "unproven and potentially dangerous products." The letter did not impose regulatory action on the clubs but noted that "illegal importations are subject to enforcement action under the Federal Food, Drug, and Cosmetic Act. FDA will continue to evaluate closely the activities of 'buyers' clubs' and others who import drug products." Since the buyers' clubs first started selling imported treatments from Israel more than 10 years ago, the FDA and the underground operations have maintained a civil relationship. But last year the federal agency began investigating the clubs as a result of concerns about unfounded product claims, promotion, and drug bootlegging. Related Stories: New York Times (05/26) P. A18; Los Angeles Times--Washington Edition (05/26) P. A5. "U.S. Blacks, Africans Cite Grim AIDS Data" Philadelphia Inquirer (05/26/93), P. A10 (Fritz, Mark) A summit of black Americans and Africans was held yesterday in Libreville, Gabon, where stories of AIDS ravaging through communities were told. At the summit, AIDS was cited as the leading killer of New York women between the ages of 14 and 55, and Africa was identified as the world's leader in the number of HIV-positive people. Debra Fraser-Howze, director of New York's Black Leadership Commission on AIDS, said, "Multiple generations are being simultaneously wiped out by AIDS on two continents. We have a lot in common with our brothers and sisters here on the continent." Fraser-Howze said she had to fight to get a special workshop to be conducted at the conference, even though she told of the alarming statistic of AIDS among New York women. According to Betty Adams, a member of the commission, many black men still consider AIDS a disease of homosexuals. But even American AIDS activists were surprised at the poor health profile in Africa, which has an estimated 8 million of the world's 13 million people with HIV. Experts at the summit said that the Uganda railroad has a 15 percent annual turnover in employees because of death and sickness caused by AIDS. AIDS patients account for 70 percent of the hospital beds in the Tanzanian city of Bujumbura, and some villages have a 90 percent infection rate. The focus on the devastation by AIDS in Africa has largely overshadowed the extensive spread of tuberculosis, to which AIDS patients are especially susceptible. "House Passes Research Bill That Bans Immigrants With HIV" Philadelphia Inquirer (05/26/93), P. A11 (Ball, Karen) The House of Representatives yesterday approved a medical research bill that bans HIV-positive foreigners and permits fetal tissue research. With a 290-130 vote, the House returned to the Senate a bill that authorizes $6 billion for the National Institutes of Health and directs new research money for breast and ovarian cancer, contraception, and fertility. Some of the legislators who opposed the AIDS ban ended up voting for the bill, claiming women's health research was too important to be neglected any longer. Although President Clinton promised to lift the ban on HIV-infected foreigners in his campaign, he is likely to sign the measure. The Senate is expected to send it to him later this week. The original bill was sidetracked in the Senate in February, when legislators upset with Clinton's plans to lift the immigration ban tacked the ban onto the fetal tissue research bill. The House overwhelmingly voted to accept the Senate language when the bill went to conference before the House-Senate team that works out differences between the two chambers. The vote yesterday was on the negotiated version of the bill. The HIV-positive ban was the only significant difference. Legislators who supported the ban on HIV-positive immigrants noted that it could cost $100,000 a year to care for an AIDS patient, and that America's health care system is already overwhelmed. Related Story: Washington Post (05/26) P. A3; Baltimore Sun (05/26) P. 16A. "Peace Corps Workers Are Infected With AIDS Virus Abroad" New York Times (05/26/93), P. A13 (Holmes, Steven A.) An increasing number of Peace Corps volunteers have been found to have contracted HIV during their tours of duty even though they received thorough AIDS education, according to a study released at a Paris conference sponsored by the Society for International Travel Medicine. The study, conducted for the Peace Corps by Dr. Thomas Eng, an epidemiologist from the Centers for Disease Control, indicated that 29 volunteers had been found to be infected with HIV since 1987, when the Corps began testing applicants for the virus and turning away applicants who were HIV-positive. The report said that among the 29, eight had definitely become infected while volunteering in the Corps, and four of them within the last year. A total of seven of the eight had been assigned to Africa, which has the highest rate of HIV infection in the world--estimated at 14 million HIV-positive people. Six of the eight infected volunteers were in their mid-20s, the study said. It also said the volunteers "indicated that they were most likely infected as a result of having unprotected sex with host-country nationals and did not perceive themselves to be at risk." Although the number of people who became infected is a small percentage of the nearly 6,000 current volunteers and the more than 18,000 people who have entered the Corps since 1987, some Peace Corps officials say they were surprised that four volunteers were found to have become infected last year. What was most alarming to Peace Corps officials was the low rate of condom use among volunteers even in countries where the prevalence of AIDS is high. "AIDS Quilt Ceremony to Recall, Honor 3" Boston Globe (05/25/93), P. 22 (Kong, Dolores) Three employees of the Massachusetts Department of Health who died of AIDS were expected to be honored this week at an AIDS quilt ceremony. The three employees are Sidney W. Borum Jr., an AIDS educator who died last year of the disease; Duane Draper, director of the state's AIDS bureau, who died in 1991; and Phil Carrozza, who worked with the state bureau of substance abuse services. Because of the three employees' commitment to AIDS when they were living, scores of co-workers, Lt. Gov. Paul Cellucci, Secretary of Health and Human Services Charles Baker, friends, and family members are expected to attend a ceremony at the department to remember the contributions of the three men. Two AIDS quilts in memory of Borum and Draper will be revealed and displayed alongside a quilt that already stands in the lobby of the department in memory of Carroza. The quilts will serve as a reminder of the men's dedication to AIDS issues and the work that remains to be done, according to organizers of the ceremony. "Canada Recommends Inquiry Into Blood System" Reuters (05/25/93) Ottawa, Canada--The Canadian government requested Tuesday that its provinces examine their blood supply procedures, after discovering that more than 1,000 Canadians contracted HIV through tainted blood transfusions. A parliamentary subcommittee previously issued a report calling for an investigation into the country's blood supply system after finding that more than 1,000 people contracted HIV in the 1980s after receiving blood transfusions and blood products. In 1990, the federal government began compensating each of the 1,000 infected Canadians with about $95,000, said Janice Hopkins of Health and Welfare Canada. However, hemophiliacs and others are pressing for an inquiry into the extent of infection among recipients of blood and blood products, and for additional compensation from the provinces, which share with Ottawa the responsibility of ensuring a safe blood supply. Health Minister Benoit Bouchard said provincial health ministers must be consulted before a public inquiry is implemented, but once specifics are determined it should take about six to nine months. The country's blood distribution system is funded by the provinces, regulated by the federal government, and managed by the Canadian Red Cross Society. "Va. Student Hands Out 300 Condoms: Safe-Sex Crusade Draws a Suspension" Washington Post (05/25/93), P. C5 (Brown, DeNeen L.) A student from a Fairfax County, Va., high school who distributed more than 300 condoms to fellow students was suspended last week as a result. Nathan Hurto, a junior at Edison High School, said he handed out the condoms during school last Thursday "to let people know if they are going to do something that puts them at risk, they need to minimize that risk." Hurto said he was not a member of any AIDS service organization. He said that at the end of the day on Thursday he was told that he was suspended for five days for "disrupting the educational process." Under school regulations, no student is permitted to distribute anything that is not first approved by the principal. Hurto said he believed he would be punished for deviating from school norms, but could not understand why he was suspended for five days. "Five days is what you get for having drugs at school. Whether you agree with me or not for handing them out, they are equating something potentially lifesaving, in the instance of HIV, to something that could destroy your life, like alcohol or another drug." The only school systems throughout the Washington, D.C., area that allow the distribution of condoms are those within the city limits. In Fairfax County, condoms are addressed in sex education classes in grades seven through 12. Hurto said he did not force anyone to take the condoms, "I just said, 'Here's a condom; do you want it?" He added, "Most people just said thanks and just took them and put them in their pocket." "CDC Chokes on AIDS Treatment Proposal" Science (05/14/93) Vol. 260, No. 5110, P. 883 (Stone, Richard) Although celebrated physician Henry Heimlich claims that malaria may be a potential treatment for AIDS, the Centers for Disease Control strongly disagrees. Dr. Heimlich, inventor of the lifesaving Heimlich maneuver, has been giving malaria therapy to sufferers of cancer and Lyme disease for years. Patients are injected with the malaria parasite which is intended to stimulate an immune reaction that kills other foreign organisms. However, Heimlich's findings on the malaria treatment remain unpublished. On April 29, the CDC responded to several inquiries from the scientific community and the media regarding Heimlich's work. The agency criticized Heimlich's proposal to inject malaria parasites into 10 HIV-positive volunteers. The CDC said that "the use of induced malaria infection in HIV-1 infected individuals cannot be justified." Heimlich said that his proposal was an "inhouse draft" that "by no means was to be circulated." Heimlich also said that the CDC reneged on an agreement to assist his work. Heimlich mentioned a September 1986 letter from Robert Kaiser, head of CDC's parasitic diseases division, who wrote that CDC "would make available certain strains" of malaria parasite for use in Heimlich's malaria therapy for cancer. But Kieser referred inquiries to Carlos Campbell, head of the CDC's malaria branch, who rejected Heimlich's claims. "We weren't prepared to offer him parasites until we saw some evidence that there was an approved protocol," said Campbell. Heimlich says he has no established timetable for proceeding with the research. "WHO: Combined Forces Against AIDS" Lancet (05/22/93) Vol. 341, No. 8856, P. 1336 (McGregor, Alan) United Nations agencies will coordinate efforts in a more aggressive global fight against AIDS to be headed by the World Health Organization. The move stems from a resolution sponsored by some 40 countries and adopted unanimously by the World Health Assembly at the end of its two-week session in Geneva. Under the auspices of the Inter-Agency Advisory Group on AIDS and the Task Force on AIDS Coordination--whose leaders are based within WHO--the first goal is to have a study ready for the January meeting of WHO's executive board. It will concentrate on expected growth and consequences of the epidemic over the next two decades. The study will highlight the potential level of available resources in the next 10 years, and how the new program will be organized and managed. Moreover, it will focus on "the need to have global leadership for a coordinated international response to the pandemic." At a recent newsconference, Dr. Michael Merson, director of the WHO AIDS division, dispelled the published contentions that the spread of HIV in Africa was to some extent a myth. "This is a terrible epidemic, no myth. No one country is spared," Merson said. He added that about $2.9 billion a year will be needed for all possible preventive measures proposed. However, WHO's budget for 1994-95 is only $1.8 billion.