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"Effect of Breastfeeding on Infant and Child Mortality Due to
Infectious Diseases in Less Developed Countries: A Pooled
Analysis"
Lancet (02/05/00) Vol. 355, No. 9202, P. 451
An analysis of several studies from six different countries
included information on the deaths of 1,223 children under age
two. The studies included babies that were breastfed into their
second year. By studying the extent that breastfeeding can
protect infants against child mortality, researchers found ways
to shape policies regarding HIV-positive mothers breastfeeding
their children. The six studies used show that acute respiratory
infections and diarrhea were the chief causes of death from
infectious diseases in three of the studies. In the African
subjects, almost all the children were breastfed, while the
greatest protection provided by breastfeeding was seen in
Pakistan. Overall, protection provided by breastmilk decreased
with age during infancy, and is a consideration for new policies.
The question of replacing breastmilk of HIV-positive mothers must
also be weighed against the cost and availability of milk
substitutes. The authors, from the World Health Organization
Collaborative Study Team on the Role of Breastfeeding on the
Prevention of Infant Mortality, note "there is a wide agreement
that the final decision on whether or not to breastfeed if a
woman is HIV-positive should reside with the mother and the
family."
Lancet (02/05/00) Vol. 355, No. 9202, P. 496; Ricci, E.; Parazzini,
F.; Pardi, G.
In a letter to the editor, Italian researchers report the
completion of a study on caesarean section versus vaginal
delivery in relation to the risk of passing HIV to a child. The
final results, which follow the March 1999 publication in The
Lancet of the European Mode of Delivery Collaboration Trial,
include the infection status of another 15 children and indicate
that only one infant, who was delivered vaginally, was infected
with HIV-1. Of 414 women taking part, 10.6 percent gave birth to
HIV-infected babies during vaginal delivery, and 1.7 percent
during caesarean section. All mothers received zidovudine during
pregnancy, and the researchers note that the overall complication
rate was low.
Washington Times (02/17/00) P. A15; Kurlantzick, Joshua
A United Nations trade conference in Bangkok has attracted
protesters, who want industrialized nations to allow low-cost
generic versions of AIDS drugs to be available to the developing
world. Protesters chanted slogans and focused on the plight of
those with HIV, who need expensive drugs to stay alive. The U.N.
Conference on Trade and Development, which meets only every four
years, was founded to help foster cooperation between wealthy and
developing nations. AIDS activists want to discuss the 1994
Trade Related Aspects of Intellectual Property agreement that
gives drug companies sole worldwide patent rights to their drugs.
These companies charge retail prices for AIDS drugs that are far
above the budgets of people in developing countries; less than 2
percent of Thais with HIV can afford didanosine, and few Africans
can at all. Thailand was threatened with sanctions on its
products last year after it briefly considered producing cheap
forms of didanosine.
"Africa Conference's Huge Task: Turning Interest Into Action"
Washington Post (02/17/00) P. A2; Fletcher, Michael A.; Mufson,
Steven
Rep. Alcee Hastings (D-Fla.) says that some African Americans in
his district have shown very little concern about Africa's many
problems because they have their own survival to carve out.
"[Some people in] my district are as interested in day-to-day
survival as the people in the Sudan are," he notes. Hastings, a
member of the House International Relations subcommittee on
Africa, is meeting with thousands of activists, business people,
and others for a conference in Washington to try to change
America's attitude towards Africa. Political leaders know they
face an immense task, since few people in America strongly
support specific African countries. The need for support for
Africa is great, as AIDS ravages the continent, diseases orphan
children by the thousands, and civil wars continue to rage.
Washington Post (02/17/00) P. E3; Gillis, Justin
Human Genome Sciences has won patent rights for the CCR5 receptor
protein, a key pathway that HIV uses to enter cells. Research
has shown that people with defective CCR5 can remain immune to
HIV for years. Currently, several pharmaceutical
companies--including Human Genome--are investigating drugs that
would block the gene in people with normal copies of it. News of
the patent caused Human Genome's stock to soar on Wednesday, up
21 percent to $188.
Reuters (02/16/00)
Seattle-based Targeted Genetics Corp. is joining the
International AIDS Vaccine Initiative (IAVI) and the Children's
Research Institute in Ohio to develop an AIDS vaccine. The
vaccine will be made by using viral vector technology to put HIV
genes into humans in order to generate a protective immune
response. IAVI will invest over $6 million during the first
three years of the collaboration. Targeted Genetics will receive
exclusive rights to sell the vaccine, under certain conditions
for selling it at a reasonable price.
"Isles Better Already Good Role on Needle Exchange"
Honolulu Star-Bulletin Online (02/15/00); Altonn, Helen
Hawaii's syringe exchange program has improved in two areas,
according to Don Des Jarlais, research director of the Chemical
Dependency Institute at Beth Israel Medical Center in New York.
The total number of syringes exchanged rose to an all-time high
in 1999, and injection risk behavior dropped, with just 21
percent of those surveyed reporting that they shared needles in
recent months. In his annual evaluation of the program, Des
Jarlais found that syringe exchange clients in Hawaii are aging,
with an average age of 42. He noted that 17 percent of AIDS
cases in Hawaii stem from injection drug use and that heroin was
the primary drug injected. While the expert praised Hawaii's
syringe exchange program, he said the state must do more to
address hepatitis B and C, "which, in Hawaii, are undoubtedly
going to cause more illness and death than HIV." Des Jarlais
recommended increasing hepatitis B vaccinations and putting more
emphasis on the risks involved in sharing injection drug
paraphernalia.
Reuters (02/16/00)
The American Foundation for AIDS Research (AmFAR) is using
$875,000 in new grants to test compounds for preventing HIV
infection. The money will be used to research microbicides, gels
that can prevent sexually transmitted diseases like HIV and
syphilis. The gels would give women a way to protect themselves
other than condoms, which men may refuse to wear. Researchers
from Montreal, Cornell University, and Belgium will examine using
compounds in saliva, coconut oil, or shampoo to protect against
HIV.
Reuters (02/17/00); Swindells, Steven
Crack cocaine is rapidly taking hold in South Africa and could
have serious consequences on the country's crime and AIDS rates.
Quick action is needed to prevent a deadly crack scourge, which
started among sex workers who then get their clients addicted. Heroin
is also becoming more common, but crack is about to replace
mandrax (methaqualone) as the No. 1 drug. Health workers note
that crack and heroin could have devastating effects on South
Africa's HIV rates; however, with prostitutes more willing to
have unprotected sex in order to obtain more money to buy crack,
the cycle is unlikely to end immediately.
Reuters (02/16/00); Baxter, Barry
President Festus Mogae of Botswana urged his citizens Wednesday
to alter their sexual behavior to stop HIV's spread. AIDS
threatens the economic success of the country, as the average
life expectancy in Botswana has dropped to 45 years from 69 in
the past decade. Speaking at a conference co-sponsored by the
Harvard AIDS Institute, Mogae also noted that the stigma of AIDS
often causes family members to shun each other and society.