BRASILIA, Brazil, May 25 - The recent death of a Honduran woman of AIDS from lack of medication has turned Latin American activists against Brazil, for years the region's champion in the global fight to guarantee AIDS drugs for all.

Activists say Ibel Martinez, a 36-year-old mother of four who died last month, could have been saved by anti-retroviral AIDS drugs like those given free to 115,000 Brazilians in a program that has become a model for the developing world.

Brazil's denial of a last-minute plea to sell or donate drugs to Martinez -- which experts said came too late anyway -- has led some nongovernmental organizations to accuse Brazil of being all talk and no action in the push to ensure universal access to AIDS treatment.

While not blaming Brazil for the woman's death, activists plan protests at Brazilian embassies across Latin America on Monday. The NGOs want a commitment from Brazil to export or donate AIDS drugs in emergencies and to use its diplomatic clout in the world AIDS arena to pressure regional governments to urgently develop their own drug distribution programs.

"Brazil is a regional leader on HIVand it must take a firmer stance ... to equalize access to treatment in the region, not continue with just dialogue that falls on deaf ears," said Edgar Carrasco, regional secretary of the Latin American and Caribbean Council of AIDS Services Organizations.

The head of Brazil's AIDS program, Paulo Teixeira, says the country is in no position to provide drugs to other countries.

Limited capacity at the Brazilian state laboratory that produces eight of 15 AIDS drugs used locally and a tight health budget make it unfeasible for Brazil to attend the flood of pleas from dying patients from Africa to Haiti, says Teixeira.

Exporting would also contravene its international trade commitments and undermine the victories it won in slashing prices of imported drugs by threatening to break patents.

"How can a country be responsible for giving this kind of assistance? It doesn't make sense, especially for a developing country," Teixeira said earlier this week. "Every drug I take from my arsenal comes out of the Health Ministry's budget."

SHARING THE SUCCESS STORY

Brazil, an AIDS success story, has a powerful voice at international AIDS forums and played a key role in creating a global AIDS fund, and pushing for access to drugs.

When the AIDS epidemic exploded in the 1980s, Brazil's 170 million population was seen as a major casualty, running infection rates similar to South Africa. Now, HIV-AIDS infection rates in Brazil stand at 0.6 percent of the adult population versus 25 percent in South Africa.

Activists say Brazil could do more to share that success.

"We have a humanitarian problem of worldwide proportions. Anyone with the resources to help should not be inhibited by politics or trade agreements," said Richard Stern, director of Agua Buena Human Rights Association in Costa Rica.

NGOs say 10 to 15 people die daily in Latin America due to a lack of access to AIDS medicines.

Brazil says it is doing all it can to pressure the region's governments while respecting national sovereignty. And under a new program, Brazil will give 2.5 million reais ($1 million) in AIDS assistance, including donations of drugs and technological help, for AIDS programs in poor countries.

"We can't take the place of other countries' governments. We can recommend, which we've done exhaustively," said Teixeira, who believes Brazil's global victories on access to AIDS drugs will be much more effective for Latin America "than Brazil taking on a commitment that isn't ours and that we are unable to meet."

Copyright © 2002 Reuters Limited.

Though the woman wasn't due to give birth for another month, she was having contractions and hemorrhaging.

If she lived in the United States, doctors would have performed a cesarean section. But on the Haitian island of La Gonave, premature babies generally don't survive -- the island's medical facilities aren't equipped to care for them.

Doctors from Indiana, during an annual mission to the island in March, went to work on Naomi at La Gonave Wesleyan Hospital.

Members of the mission team knew they had to try to prevent a premature birth. "(When doctors) put a preemie baby here, (they) stick an oxygen tube in, and if it makes it, it does. If it doesn't, it doesn't," said Dr. Steve Foley, a member of the Indiana team.

An ultrasound helped doctors to spot the problem. Naomi was stabilized and admitted, and the birth was successfully delayed.

Childbirth is rarely easy for anyone, but it can be especially difficult in impoverished La Gonave, according to RTV6 reporter Stacia Matthews, who accompanied the doctors on their trip. With good medical equipment and facilities at a premium, quality care is hard to come by on the island.

The visiting doctors have to work with the equipment that is available to them at the facility. Epidurals aren't available, so doctors have few ways to ease the pain.

And when complications arise, the lack of supplies becomes more obvious.

A woman named Christina developed a condition that causes swelling and high blood pressure. Doctors, noting that her baby was late, decided to induce labor.

The birth would have to be visual. A heart monitor was one of the few pieces of equipment aiding the doctors.

But communication and compassion, according to Matthews, helped Christina through the process. The baby was delivered safely.

The visiting doctors operated on 42 patients during their trip, and saw four times as many people in the clinic.

Copyright © 2002 WRTV TheIndyChannel.com.

Alexander Vierme is a man of few words, but the Haitian quickly expressed his discomfort. He needed prostate surgery, and he hoped that a team of doctors visiting from Indiana could help.

The doctors knew how to treat Vierme and the dozens of patients who formed a line outside La Gonave Wesleyan Hospital. The trick was doing it with unfamiliar and outdated equipment.

"We've examined the patients. We know what they have. Our concern was we didn't have the right equipment," said Dr. Neale Moosey.

Moosey was a member of the surgical mission team from Indiana that has visited La Gonave -- an impoverished island about 20 miles from mainland Haiti -- annually for the last 12 years.

During the team's trip in March, a number of surgeries were needed, and doctors would have to try them with limited resources. Blood loss also was a concern, because the facility didn't have the capacity for blood collection.

It was a challenge that the team had to tackle if Vierme and the others were to be treated.

Vierme needed his operation desperately. His son said Vierme has had trouble urinating since 1983.

So the operation began. During the procedure, a machine sending oxygen to Vierme began to malfunction.

Doctors rushed to make adjustments, buying enough time to remove part of Vierme's prostate. Vierme came through just fine.

Such adjustments are nothing new to the team.

"We're dealing and using equipment that probably was modern in the 1960s," one of the doctors told RTV6 Staying Healthy reporter Stacia Matthews, who went on the March trip. "We're not using the equipment we're used to using, and we have to adapt ourselves.

Copyright © 2002 WRTV TheIndyChannel.com.  

                                                                                                                                               Medical team travels to Haiti

By WRTVTheIndyChannel.com, May 20, 2002

A surgical mission team from Indianapolis is striving to make a difference in a remote area of Haiti -- a country that is short on jobs, short on hope and short on medical care.

RTV6 Staying Healthy reporter Stacia Matthews accompanied the group last March when it visited Gonave, a remote island about 20 miles from the mainland.

"We love the people. We love coming here. And the other opportunity is to see God at work," Dr. Steve Foley said.

The team has made the trip for 12 years and word of its arrival spread quickly across the island.

Patients already were waiting to be seen as the team arrived at the overflowing 33-bed hospital. Beds were set up outside, but some patients had to be turned away, Matthews said.

Five-month-old Waneide Pheunaud was among the most seriously ill. The infant was passing a lot of blood in her stool, so the team consulted a Cuban surgeon who was in Gonave for a two-year tenure

The surgeon was worried about an abscess and that the child had typhoid, Dr. Diane Foley said. Foley also said diagnosis was difficult since there was no X-ray equipment. The surgeon eventually operated and the prognosis wasn't good, Matthews said.

"It's very hard," nurse Susan Stalder said. "When you know you can't do something that's so successful in the states, it's very hard."

But several days later, Waneide made a dramatic change for the better, answering the prayers of her family and the team.

"This is much better than I thought she would be," Foley said. "This is exciting just to see her eyes open."

Copyright © 2002 WRTV TheIndyChannel.com.

                                                                                                                                                                                          Posted at 2:38 p.m., Monday, May 20, 2002

Haiti begins vaccination campaign against polio  

By Michael Norton, Associated Press Writer

PORT-AU-PRINCE, Haiti, May 20 - Shaken by an outbreak of polio last year, volunteers in this Caribbean country on Monday placed drops of polio vaccine on children's tongues for the start of a nine-week immunization campaign that will reach the Dominican Republic.

"Two drops of polio serum on the tongue and we can save a life," said Solange Alex, a 59-year-old nurse participating in the campaign. "We're very happy to help eradicate this paralyzing illness."

Last year's outbreak in Haiti and the neighboring Dominican Republic was the first in the Americas since 1991. The Dominican Republic will begin its part of the immunization campaign on May 31.

Twenty-one children on the island of Hispaniola came down with the paralyzing disease between July 2000 to July 2001 — 13 in the Dominican Republic and eight in Haiti, where two died. Researchers later found that the cases had originated from the polio virus that, used in oral vaccine and usually given on sugar cubes, had mutated.

Patients given the vaccine develop a mild form of polio that results in immunity. Researchers found that the outbreak resulted from nonimmunized children coming in contact with children who had received the oral vaccine in 1998-1999.

"It is inadmissible that children continue dying for avoidable causes," said Sylvana Nzirorera, a spokeswoman for UNICEF, which is helping to fund the campaign, along with the World Health Organization (news - web sites), and the Pan American Health Organization.

The polio vaccine all but eliminated the disease from most countries decades ago.

One Haitian boy, 3-year-old Dmitri Dusse, smiled after receiving the vaccine and said "I don't have to be afraid of fever."

In the campaign's first ten days, 70 volunteers in Port-au-Prince alone are to visit 700 public and private schools, inoculating children against polio. Other volunteers will visit schools nationwide.

Then, from June 1 to July 31, volunteers will trek door-to-door in an effort to inoculate children against both polio and measles in Haiti's slums and rural villages. The campaign against polio and measles will inoculate 2 million Haitian children under 10. The vaccines and other supplies will cost some dlrs 700,000.

Health officials say collaboration between Haitian and the Dominican Republic is essential because of frequent crossing of people between the two nations that share the Caribbean island of Hispaniola.

Volunteers administered the vaccine to students at the Jul Nord school in Cite l'Eternel, a seaside slum where rain brings floods, dry weather brings swirling dust, and disease is commonplace.

"I'm happy polio won't paralyze my kids now," said Emmanuela Pierre, an unemployed mother whose two children received the vaccine. "But look at us. Here in Haiti, life is paralyzed."

Due to extreme poverty and an ill-equipped health system, average life expectancy for Haiti's 8.2 million people stood at 53 last year, the lowest in the Americas.

Vaccination of children in Haiti had been irregular and spotty, especially during the 1991-94 period of military-backed rule, said Claude Surena a top official in the health ministry.

Public health officials here already have mounted campaigns to prevent new outbreaks of polio. Haiti conducted two rounds of mass vaccination in February and March 2001, and then a nationwide campaign last May to July.

No new polio cases have been reported on the island since last year.

Copyright © 2002 The Associated Press.

                                                                                                                                                                                        Posted at 12:58 a.m., Saturday, May 11, 2002  

Youngest Crucial to Anti-HIV Efforts: UNAIDS Chief  

By Alan Mozes, Reuters Writer

NEW YORK, May 10 (Reuters Health) - Global efforts to fight HIV (news - web sites) and AIDS must focus on children, the chief of the United Nations' office on the disease told world leaders Friday on the final day of the UN Special Session on Children.

"Young people must be at the center of the response to AIDS," said Dr. Peter Piot, executive director of the Joint United Nations Programme on HIV/AIDS (UNAIDS, at a press conference following his UN address. "Growing up today is totally different from what it was when I was young and what it was 20 years ago--because of AIDS."

Sitting on a panel with UNICEF Executive Director Carol Bellamy and three young AIDS activists from Kenya, Haiti and Macedonia, Piot said that governments around the world must recognize that AIDS is now essentially a "young epidemic"--noting that about half of all new infections globally strike people younger than 24.

UNAIDS statistics indicate that every day 6,000 boys and girls between the ages of 15 and 24 and 2,000 children under age 15 become infected with HIV. Every day, 1,600 children die of AIDS.

"And every day, 6,000 children are left orphaned by AIDS," Piot added. He noted that one third of these orphans are younger than 5, while two-thirds must fend for themselves and their families as stigmatized "heads of the household."

Before the UN General Assembly, Piot demanded that announcements and documents outlining public health goals be backed up with real action. He recommended scaling up mother-to-child transmission prevention programs, which currently reach only 5% of women in sub-Saharan Africa; ensuring AIDS orphans access to school, food and jobs; and expanding HIV education programs so children can obtain prevention information while being spared the social stigma that often accompanies the disease.

"HIV/AIDS is virtually reversing the (health) progress made among kids around the world," added Bellamy. She noted that working on AIDS prevention, education and treatment is now a "very important, very key component" of UNICEF's overall mission to focus on children's health issues.

Bellamy seconded Piot's contention that controlling AIDS among young people is the key to controlling HIV in the wider population and minimizing the impact of AIDS on international efforts to address other health concerns. "UNICEF has been long involved in child survival...(so) for us, fighting HIV/AIDS is a high, high, high priority."

Inviolata Mmbwavi--a 28-year-old Kenyan AIDS counsellor and member of her country's National AIDS Control Council--told Reuters Health that she was optimistic the UN conference would raise awareness about AIDS and make a difference. Mmbwavi, who was infected with HIV during her first sexual encounter at age 19, stressed that everyone concerned about children's health and welfare must pay attention to AIDS. The disease affects children living in the relative comfort of North America as well as those living in poorer parts of the world, she said.

"We live in a global village now," she added. "And if those who are not infected take care of themselves then there is a chance of them taking care of those infected. And it's not just a health issue. It's a security issue, it's an economic issue."

Piot concluded by expressing hope that if government leaders strengthen their focus on HIV and its youngest victims, AIDS can be stopped in its tracks. "In every single country where AIDS had been brought under control it has begun with young people," he said. He noted that Cambodia, Brazil and Uganda have made progress in cutting AIDS infection rates by zeroing in on people who are just becoming sexually active. "So success is possible," he said. "This is a problem with a solution. And we know it works."

Copyright © 2002 Reuters Limited