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�CLINTON LIBRARY PHOTOCOPY
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�PRINT DOC REQUESTED: NOVEMBER 30, 1999
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CLIENT:
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PILE: NYT
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AIDS AND ORPHANS AND AFRICA AND DATE IS SEPT 1998
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I.ST STORY of Level 1 p r i n t e d i n FULL format.
Copyright
1998 The New York Times Company
The New York Times
September 18,
SECTION: S e c t i o n A;
1998,
F r i d a y , Late E d i t i o n - F i n a l
Page 1; Column 1; Foreign Desk
LENGTH: 2 3 90 words
HEADLINE: I n Zambia, the Abandoned
Generation
SERIES: DEAD ZONES: C h i l d r e n o I: the Plague
BYLINE:
By SUZANNE DALEY
DATELINE: LUSAKA, Zambia
BODY:
I t was o n l y two weeks a f t e r t h e i r mother d i e d from AIDS t h a t t h e i r aunt took
them t o the bus s t a t i o n . She s a i d she d i d not want t o take care of them anymore.
She t o l d thein t o go t o Lusaka, f i n d a p o l i c e s t a t i o n and ask f o r an orphanage.
The c h i l d r e n , C a l v i n Katoya and Jackson Kabaso, who would l i k e t o be soccer
s t a r s someday, d i d as they were t o l d , r i d i n g the bus an hour from the s m a l l town
of Kabwe, then a s k i n g s t r a n g e r s where t o go. But the p o l i c e c o u l d not h e l p them.
As the days went by, the boys, 12 and 15, s l e p t i n the r u s t i n g , abandoned cars
nearby. They had no money or food.
E d i t h and K h u z i n i Banda l i v e d w i t h t h e i r aunt f o r about year a f t e r t h e i r
mother di.ed i n 1994. But then the aunt s a i d her home was too crowded. She sent
the g i r l s
then 13 and I'l years o l d -- t o l i v e alone i n t h e i r mother's house.
The g i r l s make do by r e n t i n g out h a l f the two-room house f o r $15 a month, and
begging from the neighbors when food runs o u t .
The two young women keep t h e i r c i n d e r - b l o c k room t i d y , decorated w i t h
magazine l a y o u t s of models and Hollywood s t a r s . They hope the headmaster w i l l
l e n i e n t about t h e i r school fees, which are e i g h t months overdue.
Sometimes, says E d i t h Banda, she i s j e a l o u s o f those who s t i l l
" I t would n i c e t o have someone who cares about us," she s a i d .
be
have p a r e n t s .
The AIDS epidemic has been r a g i n g i n Zambia f o r n e a r l y two decades, and
thg^*)eaths p i l e up, so do the orphaned c h i l d r e n .
as
/
I t i s much the same i n many o t h e r p a r t s of A f r i c a . I n r u r a l areas o f East
' A f r i c a , 4 o f every 10 c h i l d r e n who have l o s t one parent by age 15 have l o s t t h a t
parent t o AIDS, a c c o r d i n g t o U n i t e d Nations f i g u r e s . I n 1997 alone, the disease
orphaned '\ .1 m i l l i o n c h i l d r e n , more than 90 percent of them i n A f r i c a south o f
' the Sahara .
,
But i t i s Zambia, a county t h a t has never embraced b i r t h c o n t r o l , t h a t has
the h i g h e s t p r o p o r t i o n o f orphaned c h i l d r e n i n the w o r l d , the U n i t e d Nations
says. Here, an e s t i m a t e d 23 percent o f a l l c h i l d r e n under 15 are m i s s i n g one
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COLLECTION:
Clinton Presidential Records
First Lady's Office
June Shih (Speechwriting)
OA/Box Number: 17214
FOLDER TITLE:
UN World AIDS Day 12/1 [1]
2006-0810-F
dbl833
RESTRICTION CODES
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Freedom of Information Act -15 U.S.C. 552(b)|
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b(2) Release would disclose internal personnel rules and practices of
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b(3) Release would violate a Federal statute |(bX3) of the K O I A j
b(4) Release would disclose trade secrets or confidential or financial
information |(bX4) of the F O I A j
b(6) Release would constitute a clearly unwarranted invasion of
personal privacy 1(b)(6) of the FOIA]
b(7) Release would disclose information compiled for law enforcement
purposes 1(b)(7) of the F O I A j
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C. Closed in accordance with restrictions contained in donor's deed
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RR. Document will be reviewed upon request.
�6 fff) -epjl^fc
CL.
A
/jtlM My/7/
1/
/!-^&
/-^
Clinton Library Photocopy
�PAGE
The
3
New York Times, September 18, 1998
or both p a r e n t s , many o f them from AIDS, and t h e numbers a r e expected
to rise.
For now, most o f t h e c h i l d r e n have been absorbed i n t o extended f a m i l i e s .
Almost 75 percent o f a l l households a r e t a k i n g care o f a t l e a s t one orphan. But
i n t h i s c o u n t r y , where h a l f o f a l l households are l i v i n g i n extreme p o v e r t y , t h e
s t r a i n o f c a r i n g f o r e x t r a c h i l d r e n i s b e g i n n i n g t o take i t s t o l l . Many c h i l d r e n
are being squeezed o u t . I n 1991 Lusaka had 35,000 c h i l d r e n l i v i n g on t h e s t r e e t ;
today t h e r e a r e more than 90,000.
Zambian o f f i c i a l s b e l i e v e t h e number o f a d u l t s i n f e c t e d w i t h H.I.V., t h e
v i r u s t h a t causes AIDS, w i l l not d e c l i n e b e f o r e 2010, which means t h a t t h e
orphan p o p u l a t i o n w i l l not peak u n t i l 2020. Recent U n i t e d Nations r e p o r t s
e s t i m a t e t h a t t h e r e were n e a r l y h a l f a m i l l i o n orphaned by the disease i n Zambia
today. That number i s expected a t l e a s t t o double i n t h e coming decade, f u r t h e r
s t r a i n i n g t h e c o u n t r y ' s meager resources.
The Orphans
Even W i t h i n F a m i l i e s , Many Are Outcasts
Already t h e orphans a r e s u f f e r i n g . When t h e r e i s not enough t o e a t , orphans
o f t e n g e t l e s s than t h e o t h e r c h i l d r e n i n t h e household. They a r e o f t e n t h e l a s t
to g e t shoes, t h e l a s t t o go t o s c h o o l . I n t h e r u r a l areas, g i r l s a r e m a r r i e d
o f f a t 12 or 13, f a r younger than t h e usual age o f 18. The reason: t h e f a m i l y no
longer has t o feed t h e g i r l , and can c l a i m a b r i d e p r i c e .
Advocates f o r t h e c h i l d r e n say t h e orphans a r e more l i k e l y t o s u f f e r
b e a t i n g s and sexual abuse.
from
"When you s t a r t t a l k i n g about t h e r i s i n g number o f orphans, you a r e q u i c k l y
t a l k i n g about a r i s e i n a l l these r e l a t e d issues -- c h i l d l a b o r , c h i l d abuse and
sexual abuse," s a i d Stephan Dahlgren, a p r o j e c t o f f i c e r w i t h Unicef based i n
Zambia. "The more v u l n e r a b l e c h i l d r e n you have, the more t h e problems e s c a l a t e . "
Despite t h e huge number o f people i n f e c t e d w i t h H.I.V. i n Zambia, t h e r e i s
l i t t l e p l a n n i n g f o r death. Most people are never t e s t e d f o r AIDS and do n o t
admit t o i t even i f they f i n d they a r e i n f e c t e d . Only among t h e e l i t e i s t h i s
b e g i n n i n g t o change.
"Everybody knows about AIDS," Mr. Dahlgren s a i d . " I f you go i n t o a s m a l l
v i l l a g e and ask a c h i e f about AIDS, he knows a l l about i t . But when i t comes
down t o 'What i s t h i s disease t h a t so and so d i e d from?' then i t ' s t u b e r c u l o s i s
or m a l a r i a . "
Since few p r e c a u t i o n s have been taken, many orphans are l o s i n g b o t h t h e i r
parents and a l l t h e i r i n h e r i t a n c e a t t h e same t i m e . R e l a t i v e s q u i c k l y swoop i n
and grab p r o p e r t y , be i t cooking pots o r farm l a n d . I n t h e o r y t h e c h i l d r e n c o u l d
appeal t o t h e c o u r t s , b u t few have the money t o do so.
Florence and Veronica P h i r i once l i v e d c o m f o r t a b l y w i t h t h e i r p a r e n t s i n t h e
modest house they owned. T h e i r f a t h e r was an e l e c t r i c i a n . But i n 1994 both
parents d.i.ed w i t h i n months o f each o t h e r . The g i r l s were 8 and 6.
W i t h i n weeks, t h e i r f a t h e r ' s f a m i l y took over t h e house and sent t h e g i r l s t o
l i v e w i t h an aunt i n a r u r a l v i l l a g e . There, the g i r l s s a i d , they were beaten
and had t o work long hours f e t c h i n g water and c o l l e c t i n g wood.
�PAGE
The New
York Times, September 18,
4
1998
Two years l a t e r , t h e i r mother's r e l a t i v e s i n t e r v e n e d and brought the g i r l s
back to Lusaka t o l i v e w i t h t h e i r maternal grandmother, who s e l l s vegetables i n
the market. Florence and Veronica and f o u r cousins who are a l s o orphans spend
most days p l a y i n g i n the d u s t y s t r e e t s i n f r o n t of her grandmother's d i l a p i d a t e d
house.
Florence and
not expect they
i s no food. But
she s a i d , s h y l y
Veronica have n o t h i n g t h a t ever belonged t o t h e i r p a r e n t s and do
ever w i l l . With her grandmother, Florence says, some days t h e r e
she i s s t i l l g l a d t o be here. " I t i s much b e t t e r than b e f o r e , "
a d j u s t i n g her ragged c l o t h e s .
This year a community group donated money f o r her school fees, a school
u n i f o r m and shoes. But Veronica w i l l have t o w a i t ; t h e r e was not enough money
f o r her.
The S h e l t e r s
Help f o r C h i l d r e n Hardened by
Life
Zambian h e a l t h a u t h o r i t i e s b e l i e v e t h a t H.I.V. prevalence here w i l l peak t h i s
year because r e c e n t surveys r e p o r t s i g n i f i c a n t b e h a v i o r a l changes. But even t h i s
seems Like b i t t e r news: The i n f e c t i o n r a t e i n urban areas i s expected t o p l a t e a u
at 28 p e r c e n t . I n r u r a l areas, e x p e r t s c a l c u l a t e , i t w i l l be a t 22 p e r c e n t r a t e ,
g i v i n g Zambia one of the w o r l d ' s h i g h e s t i n f e c t i o n r a t e s .
As w i t h o t h e r A f r i c a n s , the vast m a j o r i t y of i n f e c t e d Zambians are between
the ages o f 15 and 40, meaning t h a t they are d y i n g when they should be i n t h e i r
most p r o d u c t i v e years. T h i s , combined w i t h w i d e - s c a l e l a y o f f s as the Government
t r i e s t o r e t o o l a s o c i a l i s t economy by s e l l i n g o f f state-owned businesses, has
made i t a i l the more d i f f i c u l t f o r f a m i l i e s t o absorb the growing number o f
orphans. C h i l d r e n , orphaned or not, have hard l i v e s i n Zambia. Nearly h a l f are
s t u n t e d from a l a c k o f food.
As the sun s e t s on t h i s c i t y , c a s t i n g shadows over the modern
Government-sponsored h i g h r i s e s , e n t i r e f a m i l i e s s e t t l e i n f o r the n i g h t on the
s i d e w a l k s . S c a t t e r e d among them are the ragged s t r e e t c h i l d r e n , many o f whom
make money as p r o s t i t u t e s and look f o r any means t o get h i g h .
Workers a t the Fountain of Hope, a new n o n p r o f i t o r g a n i z a t i o n t h a t works w i t h
the s t r e e t c h i l d r e n , say the c h i l d r e n have even found a way o f g e t t i n g a
p o w e r f u l h i g h from fermented human feces, a substance known as jekem.
But i n the d a y l i g h t , many i d l e the hours away k i c k i n g a soccer b a l l around
o u t s i d e the Fountain o f Hope h e a d q u a r t e r s . The o r g a n i z a t i o n i s t r y i n g t o o f f e r
them a s p e c i a l f o u r - y e a r e d u c a t i o n program t h a t w i l l ready them f o r school
exams. But the s t r e e t c h i l d r e n here are l i k e s t r e e t c h i l d r e n everywhere -hardened and focused on s u r v i v a l .
The s t o r i e s the c h i l d r e n t e l l of f e a r , r e j e c t i o n and l o n e l i n e s s are numbingly
s i m i l a r . Simon P h i r i , who i s 14 years o l d but looks about 10, can not even
remember when h i s p a r e n t s d i e d . Slumped i n a c h a i r , he peels the d i r t from h i s
palms as lie t a l k s s u l l e n l y about h i s s h o r t l i f e . For a w h i l e , he s a i d , he stayed
w i t h h i s mother's best f r i e n d . But a f t e r a w h i l e , he l e f t .
"They were always i n s u l t i n g me,"
and never saved me a n y t h i n g . "
he s a i d . "They always a t e when I went out
�PAGE
The
New York Times, September 18,
5
1998
Me says he has s l e p t many n i g h t s i n t h e a i s l e s o f t h e l o c a l market p l a c e . But
now he sleeps on t h e f l o o r o f a f r i e n d ' s o l d e r b r o t h e r ' s house. He must g e t h i s
own food though, and he has no money f o r soap. He says he earns money doing odd
jobs i n the market, but t h e counselors say t h a t he has a s e x u a l l y t r a n s m i t t e d
disease. Nearly h a l f t h e boys do.
Simon has not been t o school i n a t l e a s t f o u r years, though he hopes t o be an
accountant when he grows up. " I . would l i k e t o work i n an o f f i c e , " he s a i d ,
suddenly b r i g h t e n i n g .
F i n d i n g homes f o r t h e s t r e e t c h i l d r e n i s n o t r e a l l y a p o s s i b i l i t y , say t h e
workers a t t h e c e n t e r . There are o n l y a h a n d f u l o f very s m a l l orphanages i n
Zambia, i n c l u d i n g t h e Kabwata Orphanage; i t was t h e r e t h a t C a l v i n and Jackson,
who had been sent t o Lusaka by an aunt, ended up a f t e r t h r e e days w i t h o u t food.
E v e n t u a l l y the p o l i c e c o n t a c t e d L o r r a i n e Miyanda, who runs t h e p l a c e , and she
bent the r u l e s t o l e t t h e boys i n . U s u a l l y the orphanage w i l l not take c h i l d r e n
over the age of 10.
But Ms. Miyanda says she has l i t t l e hope t h a t anyone w i l l ever take t h e boys
i n t o a new home. I n many A f r i c a n c o u n t r i e s t h e r e i s l i t t l e t r a d i t i o n o f t a k i n g
i n c h i l d r e n who are n o t blood r e l a t i v e s and f o r m a l a d o p t i o n i s e x t r e m e l y r a r e .
C h i l d advocates say t h a t t h i s may be a p a r t i c u l a r problem i n t h e f u t u r e because
of the way AIDS tends t o d e v a s t a t e whole f a m i l i e s , p a r t i c u l a r l y i n v i l l a g e s .
"The extended f a m i l y i n A f r i c a i s f a r b e t t e r than i n t h e West about t a k i n g i n
r e l a t i v e s . , " s a i d Mark Louden, a South A f r i c a n who i s w r i t i n g a book on AIDS
orphans. "There i s no f o r m a l i t y about t a k i n g care o f c o u s i n s . They s l i p r i g h t
i n t o saying 'Mom.' I n A f r i c a you have 30 Moms. The problem i s t h a t AIDS doesn't
u s u a l l y take -just one woman i n a f a m i l y ; i t tends t o take a l l t h e wives o f t h e
b r o t h e r s because t h e b r o t h e r s tend t o behave s i m i l a r l y . "
The Caring A d u l t s
Grandmothers Help, But When They Go . . .
In t h e l a s t few years, dozens o f f l e d g l i n g o r g a n i z a t i o n s have sprung up i n
Zambia t r y i n g t o h e l p t h e c h i l d r e n . But t h e r e i s v i r t u a l l y no Government money
a v a i l a b l e and many are s t a f f e d o n l y by v o l u n t e e r s .
" I t ' s not t h a t t h e Government i n unsympathetic," says Louis Mwewa, t h e
c o o r d i n a t o r o f C h i l d r e n i n Need, an umbrella o r g a n i z a t i o n t h a t t r i e d t o
represent the groups. "But we are a poor c o u n t r y and they do n o t have money."
In Matero, one o f Lusaka's poorer neighborhoods, where s m a l l houses w i t h t i n
roofs s t r e t c h f o r m i l e s , overwhelmed grandmothers and households t h a t are headed
by young s i b l i n g s l i v i n g on t h e i r own are easy t o f i n d . I n one house Brenda
Ternbo, 52, cares f o r I'l o f her g r a n d c h i l d r e n .
On a recent a f t e r n o o n , no one i n her household had eaten y e t as t h e r e was no
food In the house. Mrs. Tembo was w a i t i n g f o r someone t o buy tomatoes from her
vegetable stand b e f o r e buying corn meal, which would feed more o f them f o r l e s s .
There are f i v e c h i l d r e n i n t h i s household who should be i n s c h o o l , b u t t h e r e i s
no money f o r t h a t .
There i s b a r e l y enough room f o r a l l t h e c h i l d r e n t o l i e down on t h e f l o o r a t
n i g h t . The homemade plywood t a b l e and the t h r e e r i c k e t y c h a i r s must be p u t
�PAGE
The
New
York Times, September 18,
6
1998
o u t s i d e when i t i s bedtime. "T am not alone l i k e t h i s . " she s a i d , p o i n t i n g
across the d i r t road a t another house. "Right over t h e r e , i t i s the same."
While the grandmothers s t r u g g l e w i t h the burden of f e e d i n g and c l o t h i n g the
c h i l d r e n , some c h i l d advocates are more w o r r i e d about those who are growing up
i n the s i b l i n g households, where chaos sometimes r e i g n s .
L i k e the Banda g i r l s , the Zulu s i b l i n g s s u r v i v e on the r e n t they r e c e i v e from
t h e i r p a r e n t s ' house i n a neighborhood c a l l e d Kuanda Square. The seven c h i l d r e n
l i v e i n the back i n a tumbledown two-room s t r u c t u r e . But r e c e n t l y the o l d e s t boy
got. m a r r i e d and set up h i s own household, l e a v i n g l e s s money f o r the r e s t of t h e
c h i l d r e n , who range i n age from 19 t o I I . The 19-year-old i s known i n the
neighborhood as a d r i n k e r who r e g u l a r l y beats the younger ones.
On a recent v i s i t , t h e r e was no food i n the dank s m e l l i n g house. Shoes and
d i r t y c l o t h e s were J.aying about. But w i t h the 19-year-old s i t t i n g s i l e n t l y
nearby, no one complained of any d i f f i c u l t i e s . A l l but the youngest appeared t o
have found some way of making money, from working as a maid t o s e l l i n g sugar
cane i n the market. But each keeps t h a t money f o r h i m s e l f or h e r s e l f , they s a i d .
The 11-year-old appears t o s u r v i v e on the g e n e r o s i t y of the o t h e r s , but i t was
c l e a r they expected her t o do most o f the housework.
"Sometimes the l a u n d r y i s d i f f i c u l t , "
her s k i r t n e r v o u s l y .
the g i r l a d m i t t e d , t w i s t i n g the hem
of
By 1991 the needs of the orphans i n the Matero neighborhood had become so
apparent t h a t some l o c a l women banded t o g e t h e r t o t r y t o h e l p . They have
r e g i s t e r e d 2,047 orphans i n the neighborhood and assigned someone t o look i n on
each household and h e l p s o l v e problems t h a t crop up. To r a i s e money f o r school
fees, they make doormats, bake bread, sew and b a t i k f a b r i c s . Six days a week,
they a l s o g i v e about 60 of the c h i l d r e n a f r e e meal, w i t h the h e l p o f the l o c a l
C a t h o l i c church.
So f a r t h i s year the group, c a l l e d Kwasha Mukwena, has promised t o pay the
school fees f o r 279 c h i l d r e n -- fees t h a t range from l e s s than $10 f o r the
younger c h i l d r e n t o about $30 f o r the o l d e s t . But they have o n l y r a i s e d the
money t o pay f o r J 32 .
As the lunch hour drew near r e c e n t l y , the orphans began a r r i v i n g i n the
c a r e f u l l y swept church y a r d . I n the back, over an open f i r e , the women had made
a v e g e t a b l e and peanut stew t o be eaten w i t h a corn p o r r i d g e . The c h i l d r e n , i n
t a t t e r e d c l o t h i n g , were p a i n f u l l y o b e d i e n t . Some, as young as f i v e , c a r e f u l l y
c a r r i e d f u l l p l a t e s t o the room where even the t o d d l e r s a t e w i t h o u t s p i l l i n g a
drop.
A dozen c h i l d r e n a l s o c a r r i e d p l a s t i c boxes -- a s i g n a l t o the workers t h a t
they were having a p a r t i c u l a r l y hard t i m e . Before e a t i n g , these c h i l d r e n put
h a l f t h e i r food i n t h e i r boxes. E i t h e r they knew they would get no supper and
were saving f o r l a t e r , or they had been t o l d t o b r i n g food home -for o t h e r
c h i l d r e n i n the household or face punishment.
" I t i s not t h a t people are so c r u e l , " s a i d P a t r i c i a Ngoma, who
w i t h the program. "But they have n o t h i n g themselves."
Dead Zones
volunteers
�PAGE
7
The New York Times, September 18, 1998
L a t e r a r t i c l e s w i l l r e p o r t on o t h e r aspects o f t h e AIDS c r i s i s i n A f r i c a ,
and then on o t h e r c o n t i n e n t s .
GRAPHIC: Photos: THOSE LEFT BEHIND -- C h i l d r e n orphaned by AIDS say a p r a y e r
b e f o r e a meal a t the C a t h o l i c church i n Matero. More than 2,000 orphans have
been i d e n t i f i e d m Matero, a neighborhood i n the Zambian c a p i t a l , but t h e
church, aided by l o c a l v o l u n t e e r s , can feed o n l y 60. THE VICTIMS OF AIDS
A
d i s t r e s s i n g l y f a m i l i a r s i g h t i n Zambia, a s u p p l i e r o f c o f f i n s w a i t s on a
roadside i n Lusaka, the c a p i t a l , f o r customers. AIDS deaths are most common i n
A f r i c a , and because s o c i e t y i.s slow t o change, t h e epidemic i s expected t o
p e r s i s t . (Photographs by Joao Silva/Sygma, f o r The New York Times)(pg. A12); A
few o f the thousands o f Zambian c h i l d r e n orphaned by AIDS i n Lusaka are f e d a t a
church. (Joao Si. 1 va/Sygma, f o r The New York Times) (pg. A l )
Chart/Map: "AT ISSUE: Swept Aside By an Epidemic"
The U.N. e s t i m a t e s t h a t i n r u r a l areas o f East A f r i c a , 40 p e r c e n t o f orphans
have l o s t one o r both p a r e n t s t o AIDS. The number o f c h i l d r e n who have become
orphans as a r e s u l t o f AIDS s i n c e the b e g i n n i n g o f the epidemic: Map/chart shows
number o f A f r i c a n c h i l d r e n under 15 who have l o s t t h e i r mother o r both p a r e n t s
t o AIDS between 1970 and 1997, by n a t i o n . (Source: UNAIDS, Report on the G l o b a l
H.I.V./AIDS E p i d e m i c ) ( p g . A12)
LANGUAGE: ENGLISH
LOAD-DATE: September 18, 1998
�Page 2
LEVEL 3 - 9 OF 161 STORIES
C o p y r i g h t 1998 The New York Times Company
The New York Times
December 4, 1998,
F r i d a y , Late E d i t i o n - F i n a l
SECTION: S e c t i o n A; Page 1; Column 1; F o r e i g n Desk
LENGTH: 1795
words
HEADLINE: AXDS I s Everywhere, b u t A f r i c a Looks Away
SERIES: DEAD ZONES: The Burden o f Shame
BYLINE:
By SUZANNE DALEY
DATELINE: DURBAN, South A f r i c a
BODY:
Mercy Makhalemele found out she was H . I . V . - p o s i t i v e when she was pregnant
w i t h her second c h i l d . She was 23, had been m a r r i e d f o r f i v e y e a r s , and was
f a i t h f u l t o her husband. She c r i e d a l l t h e way home from t h e p r e n a t a l c l i n i c ,
b u t was t o o a f r a i d t o t e l l anyone f o r n e a r l y a year.
When she f i n a l l y did t e l l her husband, he beat her to the ground, knocking
her against a l i g h t e d stove and badly burning her w r i s t , she s a i d . Then he threw
her out of the house, r e f u s i n g to b e l i e v e that he had given her the v i r u s . The
next day, he went to the shoe s t o r e she managed. With everyone watching, he
shouted a t her to c o l l e c t a l l her things, he would have nothing to do with
someone with H.I.V., the v i r u s that causes AIDS.
Her employers d i s m i s s e d her t h a t a f t e r n o o n .
"My s t o r y , " she t o l d a women's group g a t h e r e d f o r a luncheon here r e c e n t l y ,
" i s n o t j u s t my s t o r y . I f you t a l k t o o t h e r women, you w i l l hear 90 p e r c e n t t h e
same. I t w i l l n o t be 50 d i f f e r e n t s t o r i e s . R e j e c t i n g us i s n o t g o i n g t o s o l v e j
the problem o f t h i s disease. I t ' s j u s t g o i n g t o cause s t r e s s . So p l e a s e , j u s t
accept us. "
Across sub-Saharan A f r i c a , t h e AIDS epidemic i s everywhere. I n s e v e r a l
c o u n t r i e s , one o u t o f f o u r people i s now i n f e c t e d w i t h t h e v i r u s and w i l l
p r o b a b l y d i e w i t h i n 10 y e a r s . The disease i s f l o o d i n g h o s p i t a l s , changing t h e
face o f work p l a c e s and p r o d u c i n g hundreds o f thousands o f orphans. But go t o a
v i l l a g e and ask i f anyone i s s u f f e r i n g from AIDS, and t h e answer w i l l l i k e l y be
no, t h e r e i s o n l y m a l a r i a o r t u b e r c u l o s i s o r d i a r r h e a .
I t i s h a r d t o f i n d anyone who p u b l i c l y admits t o b e i n g H . I . V . - p o s i t i v e . Many
go t o t h e i r graves w i t h t h e i r s e c r e t , so g r e a t i s t h e stigma. D i s c r i m i n a t i o n
a g a i n s t people w i t h t h e v i r u s e x i s t s t o some degree i n most c o u n t r i e s around t h e
w o r l d . But e x p e r t s say t h e problem i s p a r t i c u l a r l y severe i n A f r i c a , where
l i t t l e has been done t o s t u d y o r a t t a c k t h e stigma.
The shame t h a t people f e e l and t h e t r e a t m e n t t h e y s u f f e r a t t h e hands o f
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�Page 3
The New York Times, December 4, 1998
t h e i r conununities has far-reaching consequences f o r e f f o r t s t o f i g h t the spread
of the v i r u s and t r e a t the sick, experts say. For one t h i n g , i t keeps people
from wanting t o f i n d out whether they have AIDS, and i t encourages even those
who know they are i n f e c t e d t o act as everyone else does, and perhaps even spread
the disease. For instance, a mother who i s t r y i n g t o hide her H.I.V. status may
be u n w i l l i n g t o t r y i n f a n t formula t o help prevent transmission t o her c h i l d i f
other mothers i n her v i l l a g e are breast-feeding.
Fear of discovery can also keep people from seeking services of any s o r t . I n
South A f r i c a , f a c i l i t i e s earmarked f o r AIDS p a t i e n t s o f t e n stand v i r t u a l l y
empty, even though the help they o f f e r i s desperately needed.
In Richard's Bay, on the coast n o r t h of Durban, the town's s i x largest
employers have converted an o l d farmhouse i n t o a nine-bed AIDS hospice open t o
any of t h e i r 10,000 employees, many of whom l i v e i n shacks. The b u i l d i n g i s
surrounded by flowering gardens; services include counseling f o r f a m i l i e s , free
meals and v i s i t s w i t h t r a d i t i o n a l healers i f they are wanted. But despite a
l o c a l i n f e c t i o n rate estimated at 30 percent, the compound i s r a r e l y used.
" I t ' s such a huge disgrace t o be diagnosed w i t h H.I.V./AIDS that people w i l l
s u f f e r a l l sorts of discomforts rather than associate w i t h a f a c i l i t y t h a t i s
c l e a r l y known t o be f o r people w i t h AIDS," said Jenny Rogers, who designed the
hospice.
Those people who do come forward, even t o t e l l t h e i r f a m i l i e s , face daunting
prejudice. I n some rare cases, they have been stoned. But most o f t e n they are
simply r e j e c t e d by t h e i r f a m i l i e s or i s o l a t e d , t h e i r u t e n s i l s and bedclothes
kept separate from everyone else's, t h e i r needs suddenly l a s t on the l i s t . Some
are thrown out of t h e i r churches and hounded from t h e i r homes.
As Ms. Makhalemele was making her plea f o r tolerance, a 19-year-old boy was
alone i n a Durban h o s p i t a l s u f f e r i n g from tuberculosis. A few weeks before, she
had taken her p i t c h t o the boy's v i l l a g e and, i n s p i r e d by her courage, the young
man had t o l d h i s neighbors that he too was i n f e c t e d . Later t h a t day, h i s
neighbors had gathered around h i s house and, h i s s i n g and p o i n t i n g , had forced
him t o leave. His h o r r i f i e d family also wanted nothing t o do w i t h him, though
e f f o r t s at r e c o n c i l i a t i o n were under way.
A Sad Story of Loss, '1,200 Times Over'
Some experts also argue that the i s o l a t i o n that s u f f e r e r s experience can even
hurt t h e i r family or community economically.
"You have p e r f e c t l y normal people who cannot continue t o contribute t o
society anymore," said Jean Louis Lamboray, a p o l i c y adviser f o r the United
Nations agency t h a t deals w i t h AIDS. " I f they have a shop, they lose t h e i r
customers, they lose t h e i r suppliers and soon they are out of business. That's
the t y p i c a l story, 1,200 times over."
While the way people w i t h AIDS are treated varies from country t o country
across the continent, the d i s c r i m i n a t i o n seems t o be somewhat worse i n southern
A f r i c a , which has among the f a s t e s t r i s i n g rates of i n f e c t i o n but few e f f e c t i v e
AIDS programs.
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The New York Times, December 4, 1998
Yet even t o the n o r t h i n Uganda, which i s o f t e n held up as a model because i t
has an aggressive education and prevention campaign, secrecy remains an issue.
A 1993-4 survey of more than 700 c l i e n t s who had been i n counseling sessions
at an AIDS services group found that more than 60 percent had not t o l d t h e i r
spouse or regular partner. The c l i e n t s urged the organization t o f i n d an
out-of-the-way l o c a t i o n so people could attend without being i d e n t i f i e d . Experts
say t h a t d i s c r i m i n a t i o n continues even now.
A 1997 study i n Zimbabwe found t h a t
someone w i t h AIDS was w i l l i n g t o admit
disease. Patients themselves were only
status. S i x t y - f i v e percent had t o l d no
only one out of 10 people caring f o r
that they were nursing someone w i t h the
s l i g h t l y more l i k e l y t o reveal t h e i r
one.
I n South A f r i c a , Peter Busse, head of the National Association of People
L i v i n g With H.I.V./AIDS, estimates that fewer than 100 of the country's three
m i l l i o n H.I.V.-infected people are completely open about i t .
"When something l i k e World AIDS Day comes around, we have trouble f i n d i n g 20
people t o go on t e l e v i s i o n and r a d i o shows," he said.
Two Taboo Subjects: Sex and Death
Experts say lack of education about the disease, s u p e r s t i t i o n and
conservative r e l i g i o u s b e l i e f s a l l contribute t o the d i s c r i m i n a t i o n . But some
experts say t h a t AIDS arouses such passionate responses because i t encompasses
two subjects t h a t are h i g h l y taboo i n many parts of A f r i c a : sex and death.
"We are a c u l t u r e t h a t knows about death, but we don't discuss i t , " said
Noerine Kaleeba, who works f o r the United Nations agency helping communities
develop AIDS programs. "We don't discuss sex e i t h e r . With us, you can have sex
as long as you don't l e t us know. There i s a whole language f o r discussing sex,
but i t i s very subtle - - a c h i l d could be i n the room and would never know t h a t
i s what you are t a l k i n g about i t .
"But a person who has AIDS, every time you look at t h i s person, you must
confront sex and death. These are the things that make i t too d i f f i c u l t t o
handle."
Mrs. Kaleeba argues that t o some degree, however, the stigma i s s e l f imposed. The fear i s sometimes greater than i t should be and counseling can go a
long way toward helping f a m i l i e s accept those who are i n f e c t e d .
the
Many s u f f e r e r s complain that church groups o f t e n lead the charge i n i s o l a t i n g
infected.
Even before she was found t o have the v i r u s , Musa Njoko was asked t o leave
her church choir i n a township on the o u t s k i r t s of Durban. She had swollen
glands and asthma and people were whispering about her having "the Big A," she
said. But since she had only had two boyfriends, she d i d not believe i t was
possible. For weeks she d i d not leave the house. Church members came t o v i s i t
but would not enter her room.
Ms. Njoko says people s t i l l c a l l saying t h a t she i s b r i n g i n g shame on her
family f o r speaking out about the disease: "They say i s n ' t i t enough t h a t you
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The New York Times, December 4, 1998
have AIDS, do you have t o damage your family too?"
Ernest Saila, who has been h i r e d t o work f o r a United Nations program that
sends i n f e c t e d people t o various companies t o teach and counsel about AIDS, says
he i s o f t e n hounded when a t home w i t h h i s family near Bloomfontein. His mother
remains f u r i o u s a t him f o r going p u b l i c about h i s condition. She allows him t o
stay home, but refuses t o give him any money. "She says food i s enough f o r you,"
he said. "The r e s t belongs t o the other kids."
Shunned by Nurses A f t e r Giving B i r t h
When Mrs. Makhalemele gave b i r t h t o her daughter i n 1994, none of
midwives would sew her up. Four hours went by before an aunt, also a
the h o s p i t a l , who came by t o v i s i t , read her chart and d i d the work.
aunt d i d not know t h a t Mrs. Makhalemele s t i l l had dressing inside of
massive i n f e c t i o n followed.
the
nurse i n
But the
her, and a
Ms. Makhalemele t o l d her husband she was H.I.V.-positive l a r g e l y because her
baby daughter was so sick she f e l t she needed t o be honest w i t h him. A f t e r he
threw her out, i t was the c h i l d ' s p e d i a t r i c i a n who took her i n , g i v i n g her work
as a maid. Though g r a t e f u l , she was also humiliated.
" I d i d not want t o become a maid," Ms. Makhalemele said. " I t was not my
dream. I had t o swallow my pride. I needed money f o r formula."
A few months l a t e r her husband got sick and a blood t e s t showed he was
i n f e c t e d . Only then d i d he admit that he had i n f e c t e d her, and he wanted her
back.
Since then, both he and her daughter have died. Mrs. Makhalemele i s now
employed by the National Association of People L i v i n g With H.I.V./ AIDS t o t a l k
to people around the country i n a campaign t o promote "disclosure and
acceptance."
But she i s not advocating what she c a l l s "reckless" disclosure. When she
spoke t o the women's group recently, she was accompanied by a shy young woman
named Princess who i s also i n f e c t e d and wants t o volunteer w i t h Ms.
Makhalemele's campaign. But her boyfriend has threatened t o k i l l her i f she goes
p u b l i c . He already has a new g i r l f r i e n d and does not want her t o know h i s H.I.V.
status.
Ms. Makhalemele i s counseling Princess t o go slowly. She r e c e n t l y stopped
more than a dozen young people from taking p a r t i n an AIDS awareness t e l e v i s i o n
show because she f e l t they d i d not t r u l y understand the consequences of going
public.
" I t i s not f o r everyone," she said. " I t i s a very serious t h i n g t o do."
Dead Zones
Later a r t i c l e s w i l l report on other aspects of AIDS i n A f r i c a and other
continents. Previous a r t i c l e s described the g a l l o p i n g spread of the disease
(Aug. 6 ) , the transmission of the v i r u s through breast milk (Aug. 19), the
orphans l e f t behind (Sept. 18), e t h i c a l problems i n t e s t i n g vaccines (Oct. 1)
and the economic e f f e c t s of the epidemic (Nov. 15).
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�Page 6
The New York Times, December 4, 1998
GRAPHIC: Photos: AIDS i s flooding hospitals i n A f r i c a and producing hundreds of
thousands of orphans, but the stigma attached t o the disease keeps many
sufferers s i l e n t . At a meeting i n KwaZulu/Natal, i n f e c t e d people joined i n
prayer. (Joao Silva/Sygma, f o r The New York Times)(pg. A l ) ; Two of those w i t h
the AIDS v i r u s a t the KwaZulu/Natal meeting. Mercy Makhalemele, who works f o r
the National Association of People L i v i n g With H.I.V./AIDS and who i s
H.I.V.-positive h e r s e l f , dramatizes the problem a t a school meeting i n r u r a l
KwaZulu/Natal. (Photographs by Joao Silva/Sygma, f o r The New York Times)(pg.
A16)
Map of South A f r i c a showing l o c a t i o n of Durban: Accept us, pleaded an H.I.V.
s u f f e r e r i n Durban. But A f r i c a won't, (pg. A16)
LANGUAGE: ENGLISH
LOAD-DATE: December 4, 1998
-
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�Page 39
LEVEL 3 - 79 OF 161 STORIES
The A s s o c i a t e d Press S t a t e & L o c a l Wire
The m a t e r i a l s i n t h e AP f i l e were compiled by The A s s o c i a t e d Press. These
m a t e r i a l s may n o t be r e p u b l i s h e d w i t h o u t t h e express w r i t t e n consent o f The
A s s o c i a t e d Press.
December 1, 1998, Tuesday, PM
cycle
SECTION: S t a t e and R e g i o n a l
LENGTH: 543 words
HEADLINE: AIDS e d u c a t o r t o embark on 1,800-mile j o u r n e y t o r a i s e awareness
BYLINE:
ALEXIS CHIU, A s s o c i a t e d Press W r i t e r
DATELINE: BOSTON
BODY:
As people around t h e g l o b e mark World AIDS Day t o d a y w i t h r a l l i e s and
remembrances, a Boston man w i l l be i r o n i n g o u t t h e d e t a i l s o f h i s own
i n t e r n a t i o n a l e f f o r t t o r a i s e awareness about t h e d e a d l y d i s e a s e .
I n a t r i p to begin e a r l y next year, John C h i t t i c k w i l l t r a v e l the world h i t t i n g p l a c e s such as Bosnia, Hong Kong and Las Vegas - to educate teen-agers
about HIV and AIDS.
His m i s s i o n , he says, i s t o use e d u c a t i o n t o t r y t o stem t h e t i d e o f new
i n f e c t i o n s among young p e o p l e .
"Teen AIDS i s becoming a g l o b a l pandemic o f major p r o p o r t i o n s , " s a i d
C h i t t i c k , 50. The e x e c u t i v e d i r e c t o r o f Boston's n o n p r o f i t TeenAIDS-PeerCorps
p l a n s t o embark on t h e 1 5 - c o u n t r y , 1,800-mile t r e k i n January.
" I want t o l e a v e i n each c o u n t r y a network o f young people who've been
t r a i n e d ... t o be peer t e a c h e r s , who u n d e r s t a n d t h a t b e s t way t o s t o p t h e
HIV/AIDS epidemic i s t o t a l k t o each o t h e r , " he s a i d .
An e s t i m a t e d h a l f o f a l l new HIV i n f e c t i o n s i n t h e U n i t e d S t a t e s a r e among
people under 25, a c c o r d i n g t o t h e Centers f o r Disease C o n t r o l and P r e v e n t i o n .
A r e c e n t r e p o r t by t h e J o i n t U n i t e d N a t i o n s Program on HIV/AIDS and t h e World
H e a l t h O r g a n i z a t i o n found t h a t g l o b a l HIV i n f e c t i o n s i n c r e a s e d 10 p e r c e n t i n
1998, and t h a t t h e numbers f o r young people around t h e w o r l d m i r r o r those i n t h e
United States.
O r g a n i z e r s o f World AIDS Day have named t h i s y e a r ' s campaign "Young People,
Force f o r Change" because new i n f e c t i o n s a r e i n c r e a s i n g l y c o n c e n t r a t e d i n
younger age groups, e s p e c i a l l y i n e a s t e r n Europe, A s i a and A f r i c a .
"The whole i d e a i s t o g e t young people t o be aware o f t h e r i s k s o f AIDS. They
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The Associated Press State & Local Wire
are a force f o r change," said Bryna Brennan, a spokeswoman f o r the Pan American
Health Organization, the regional o f f i c e of WHO. " I t ' s w i t h the youth t h a t we
have a chance t o end the disease."
That's something C h i t t i c k says he's known since he began researching
adolescents and AIDS while working toward h i s doctorate a t Harvard 10 years ago.
"Teen-agers need p o s i t i v e peer pressure; i t ' s the negative peer pressure
that's g e t t i n g them i n t o t r o u b l e , " he said. "When I t a l k t o young people, I
never t e l l them t o go out and save the world. I say, ' I f you love a f r i e n d ,
c e r t a i n l y you want t o save them from dying prematurely."'
C h i t t i c k plans t o use some of the same techniques on h i s t r e k t h a t he does
w i t h teen-agers i n l o c a l schools - t r a d i t i o n a l lessons, t h e a t r i c a l performances
and i n t e r a c t i v e exercises.
As he walks through southeast Asia, eastern Europe and American communities
that include Miami and an American Indian reservation i n New Mexico, C h i t t i c k
plans t o sleep and eat i n the homes o f l o c a l s . He hopes t o meet teen-agers
w i l l i n g t o be peer teachers i n t h e i r communities and then give them the basic
medical and psychological t r a i n i n g needed f o r the task.
Updates on C h i t t i c k ' s t r a v e l s w i l l be a v a i l a b l e on an I n t e r n e t web s i t e f o r
teen-agers, and he plans t o d e t a i l h i s e f f o r t s a t the 13th World AIDS Conference
i n South A f r i c a i n 2000.
"This i s teens reaching out t o other teens," he said. "Parents can s t i l l
provide moral guidance, but kids need t o t e l l other kids about the medical
f a c t s . This i s the way w e ' l l save t h a t generation."
Eds: The web s i t e t h a t w i l l carry updates on C h i t t i c k ' s t r i p i s
www.teenaids.org.
LANGUAGE: ENGLISH
LOAD-DATE: December 1, 1998
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Copyright 1999 FT Asia Intelligence Wire
All Rights Reserved
Copyright 1999 BANGKOK POST
July 17, 1999
SECTION: News
LENGTH: 936 words
HEADLINE: Spreading the safe sex message
BODY:
Plem Suraphongchai
SEX EDUCATION: A doctor has just spent 17 days walking through Thailand as part of a global effort
to warn youngsters of the dangers of HIV and Aids
Picture yourself at a coffee shop in Sogo Department Store. Snuggled in your armchair, cappuccino on
hand, you are ready to swap stories with pals about your latest sexploits.
Then there's a tap on your shoulder. It's John Chittick, a doctor who is on a mission to bring you back
to reality. He's spreading the word about HIV and Aids.
He has been in Thailand to remind teenagers of the deadly virus - and hopefully to help save them from
it.
Dr Chittick randomly approaches teenagers in shopping centres and on the street. He asks them if they
speak English, then he asks them to pass on the information he is about to give them to other young
people. The information is about Aids.
Dr Chittick is on a 2,800-kilometre mission to educate young people around the world about HIV. In 18
months, he plans to walk across five continents to spread information which he hopes will help young
people make intelligent decisions about their sex lives.
He won't save the world; but he hopes his actions might save up to 25,000 lives.
Dr Chittick spent 17 days in Thailand, walking through Chiang Rai, Chiang Mai, Chon Buri, Pattaya,
Samae Sam, and Bangkok. He talked to about 1,500 young people.
A Harvard professor, Dr Chittick diminishes intimidation with his bright Hawaiian shirts and a big
smile. "I'm not here to lecture," he said. "Just to tell them some facts they probably want to know."
These facts include the reality, "No sex, no Aids." But Dr Chittick knows that "is a ridiculous
expectation". "Sex is natural," he said. "Obviously there has to be sex. Unfortunately there is also this
insidious virus that comes with it. If you and your friend choose to have sex, use condoms. "But
condoms can break so there are no guarantees."
During his sessions, Dr Chittick also explains how to use condoms more effectively. He provides
straightforward medical information and explains the different risks associated with different types of
sex.
He says the information is most effective when it is passed from young person to young person.
"When I first meet youngsters, I give them a card. It has my name on it in Thai and a message saying,
'You must save yourself and your friends from Aids'. "When I leave, I emphasise it's their responsibility
to tell theirfriendsabout what they've just learned.
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"I'm sure everyone has friends who are in danger of contracting this virus." If the 1,500 Thai kids that Dr
Chittick talks to tell two of theirfriends,that makes 4,500 young people who knows more about Aids.
Dr Chittick prefers small group discussions to speeches. He believes children should be able to
"challenge their teachers".
"Teenagers are trying to find their own identities. They are prime rebels. They don't want to follow
orders." Dr Chittick spoke of a conversation with a boy in Chon Buri.
"He said parents talk to children about Aids just because they don't want them to have sex. When I asked
him if he really believed that, he replied with a confident 'yes'.
"That's why I don't generalise when I talk to them. When I talk about drugs, I only talk about getting
Aids through needle exchange. Most adults want me to sum it up with "drugs are bad", but once young
people start doubting parts of the information, they won't believe any of it. They will revolt."
And after 17 days in the Kingdom, he has discovered disturbing trends.
"While many youngsters know about Aids, many are not having safe sex," said Dr Chittick. "My fear is,
there is a sense of burnout among these youngsters." The Aids hype 10 to 20 years ago sparked a
powerful, but short-lived interest among the Thai public. Billboards promoting safe sex, common two
decades ago are now a rarity, the doctor said. "This is a very, very dangerous trend." Also the concept of
"life is grand - let's party" endures. This live-for-today philosophy makes Aids something that happens
to other people in the minds of many teens. And many view Aids as something that only happens to bad
people. "The sense of invincibility among teens is very prevalent," said the doctor.
But, half of new HIV/Aids cases around the world are among the under-24s. The doctor says the Thai
government needs to do more to stop children becoming sex workers and to educate youngsters about
HIV.
"When I was walking down a street near the night bazaar in Chiang Mai, 200 metres from a police
station, there were middle-aged men lining up outside a bar to pick up 12-year-old boys," Dr Chittick
said.
"When I talked to the boys, they had no concept of what Aids is. For an extra 200 or 300 baht some sex
workers will agree not to use a condom.
"You have to question that - and the fact the police are letting bars get away with this." Dr Chittick also
says some serious research is needed on the topic. He said: "There needs to be a direct line of
communication. The government cannot have an effective campaign without understanding teenagers."
Dr Chittick recently returned to the US to raise funds and prepare for his Eastern Europe trip.
"No one is too young for this kind of education. These children are the generation that will be sexually
active the longest so they have every right to know what choices they are making and the consequences."
* You can check out Dr Chittick's non-profit organisation, Teenaids Peercorp Inc, at
http:/www.teenaids.org.
Copyright 1999: Bangkok Post. All Rights Reserved.
LANGUAGE: English
LOAD-DATE: July 19, 1999
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Copyright 1999 FT Asia Intelligence Wire
All Rights Reserved
Copyright 1999 THE JAKARTA POST
June 23,1999
SECTION: News
LENGTH: 916 words
HEADLINE: Activist steps out to spread word about deadly disease AIDS
BODY:
JAKARTA (JP): Dr. John Chittick is an unlikely foot soldier in the global war on AIDS. Literally. A
short, roly-poly figure with a mop of graying hair, he bears more resemblance to an overgrown
schoolboy than a man whose declared mission is to spread the word about the disease. His fighting
fatigues are gaudy Hawaiian shirts which lend him a benign, almost comical appearance and, he
believes, puts those he meets immediately at ease during his "information" walks in far-flung cities of
the world. His battle cry, a softly delivered but fervent warning on the dangers of the epidemic, includes
the directive "No sex. No AIDS". And his target is the world's teenagers, who he contends are at the
greatest risk of contracting the disease as they venture into experimentation with drugs and sex. "This is
a mission which is important both professionally and personally to me," Chittick said during a visit last
week to Jakarta. " I have known many people who have died of the disease — and many more who will
die." His mission grew out of his doctoral research at Harvard University, published in 1994 as
Adolescents and AIDS: The Third Wave. During this time, he became acquainted with Dr. Jonathan
Mann — he describes him as a "mentor" — who was at the forefront in raising awareness about the deadly
new disease in the early 1980s. Mann's death in the SwissAir plane crash off Nova Scotia in September
1998 gave Chittick the impetus to establish TeenAIDS-PeerCorps, a non- profit organization which also
maintains an information site on the web (www.teenaids.org). " I was at my family's home when it came
on CNN about the SwissAir crash. And although I didn't know Dr. Mann was aboard the flight, that
whole night I couldn't sleep thinking about how I needed to do something to get the message out about
AIDS. And when I heard Dr. Mann was killed, I decided to do this." Chittick's "Global Walk to Prevent
Teen HIV/AIDS", which is dedicated to Mann's memory, will cover 15 developing countries and U.S.
cities and suburbs. It began in Vietnam in January and will wind up at the XIII International AIDS
Conference in Durban, South Africa, in July. He contends the major problem today is ending the myth
that AIDS does not touch young heterosexuals. "At least 50 percent of new HIV/AIDS cases around the
world are in people 24 and under. But a lot of people don't want to see it as a problem — if it is, they
think it must be of gay teens." Chittick said he came across the denial among teens hanging out in Blok
M Mall, male hustlers selling themselves at Lapangan Banteng in the heart of Jakarta and prostitutes in
the Kramat Tunggak red-light area. "In the past, Indonesia did not tell the truth about its AIDS problem.
There was the attitude that this is a foreigners' disease and that we are invulnerable to this." Despite his
unabashed confession that "I've tried nearly everything at one time or another", Chittick knows he runs
the risk of being called the ultimate party pooper by those who argue they can take a tab of Ecstasy, hit
the disco and still behave responsibly in bed. " I know I get a lot of people riled up when I say 'No sex.
No AIDS'," he said of the message, which is also stamped in Indonesian on his name card. "But that is
what it comes down to. Sure, you can use condoms, but condoms are not foolproof. They can leak."
During his Indonesia trip, Chittick conducted information seminars for staff at Le Meridien, where he
stayed in Jakarta. "Separate talks were held for male and female staff, and Dr. John put the problem in
terms we could really understand," said the hotel's public relations manager Aprilisa Madewa. " I went to
both sessions and, of course, he was more polite when he talked with the women. "But what he said
really made us think about the problem." Chittick consciously distances himself from "those who say
'No, No, No' to teens and cut off all dialog. With this kind of problem, there needs to be
communication". Chittick also condemns religious conservatives who champion AIDS as divine
retribution for the world's sinners. "When I was in Malaysia, there was a seminar on AIDS and Islam,
which is a great idea because you are putting it in terms for people to understand. And there is no holy
book from any religion which says its OK to let people die from not knowing about HIV." He contends
that today's worldly teenagers are far different from even 20-somethings. "Teens are part of that global,
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live-for-today MTV reality. Traditions are breaking down like never before in our history. The problem
is that teens cannot separate what say Ricky Martin or Madonna is doing, the entertainment, from
reality." Educating teens about the disease, he adds, is best done by those who know them best - their
peers. "Part of being a teenager is breaking away and being oneself, separating themselves from adults
and becoming part of a peer group. But young people also want to be told they have a responsibility. I
tell them they have the responsibility to save their own and a friend's life by learning about AIDS."
Through his travels around the world, Chittick hopes to be able to meet and talk to at least 25,000 young
people. "With every young person I meet, I talk to them, touch them and use humor," Chittick said as he
prepared to return to the U.S. for a walk through America's heartland. " I look them in the eyes and tell
them to tell their friends that AIDS is here."
Copyright 1999: The Jakarta Post. All Rights Reserved.
LANGUAGE: English
LOAD-DATE: June 30, 1999
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�Page 55
LEVEL 3 - 14 9 OF 161 STORIES
Copyright 1998 M2 Communications Ltd.
M2 PRESSWIRE
November 25,
1998
LENGTH: 575 words
HEADLINE: UN
World AIDS Day, Secretary-General says emergency p e r s i s t s i n many regions,
despite medical advances
BODY:
- High Cost of Treatment Noted, w i t h 95 Per Cent of I n f e c t i o n s I n Poorer
Countries; T r i b u t e Paid t o UN Pioneers Who Died i n Plane Crash
This i s the t e x t of a message from Secretary-General K o f i Annan t o mark the
observance of World AIDS Day on 1 December:
Today, we mark World AIDS Day i n memory of those who have died, and i n
recognition of those who l i v e and work on the f r o n t l i n e s of the struggle
against the epidemic.
Among them, we pay t r i b u t e t o Jonathan Mann, f i r s t Director of the World
Health Organization's (WHO) Global Programme on AIDS, and h i s w i f e Mary-Lou, the
pioneering AIDS researcher, who died along w i t h several United Nations
colleagues i n a plane crash less than three months ago.
Some would have us believe t h a t because b e t t e r medicines have been found,
the AIDS emergency i s over. The f a c t s t e l l us otherwise. There i s s t i l l no cure.
The advance of HIV has not been stopped i n any country. Even i n Western Europe
and North America, around 75,000 people were i n f e c t e d l a s t year.
By the end of t h i s month, the number of adults and c h i l d r e n l i v i n g w i t h HIV
w i l l exceed 33 m i l l i o n - 10 per cent more than a year ago. AIDS has already
taken 14 m i l l i o n l i v e s . At least 95 per cent of a l l i n f e c t i o n s and deaths occur
i n the developing world, where the c o s t l y new medicines t h a t can help prolong
l i v e s are scarcely available or affordable.
So the t r u t h i s t h a t AIDS i s s t i l l an emerging epidemic - one t h a t i s
k i l l i n g more people every year than malaria. Because the v i c t i m s are mostly
young adults, who would otherwise be r a i s i n g f a m i l i e s and supporting the
economy, the repercussions are reaching c r i s i s l e v e l . Nowhere i s t h i s t r u e r than
i n sub-Saharan A f r i c a , where 34 m i l l i o n people have been i n f e c t e d and 11.5
m i l l i o n have died since the epidemic began.
This t i d a l wave r i s k s wiping out the hard-won gains of poorer nations. I n
Botswana, a c h i l d born e a r l y i n the next decade can expect t o l i v e j u s t past 40
- instead of t o age 70 i n the absence of AIDS. Zimbabwe estimates t h a t by the
year 2005, i t w i l l have more than 900,000 AIDS orphans under 15. A major company
i n the United Republic of Tanzania says i t s costs due t o AIDS exceeded i t s t o t a l
p r o f i t s f o r the year.
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M2 PRESSWIRE November 25, 1998
That i s why the broad-based struggle against the epidemic c a r r i e d out by the
J o i n t United Nations Programme on HIV/AIDS i s v i t a l . Perhaps, the most important
message the United Nations system can convey i s that we are not powerless
against the epidemic. Many countries, including a handful i n the developing
world, have slowed the spread of HIV by t a l k i n g openly about AIDS and sexual
behaviour; by showing s o l i d a r i t y w i t h those already i n f e c t e d ; and by making
information about prevention and support available t o a l l c i t i z e n s .
Experience t e l l s us t h a t prevention e f f o r t s are e s p e c i a l l y l i k e l y t o pay o f f
among young people, by teaching them t o adopt safe behaviour from the s t a r t .
Around h a l f of a l l HIV i n f e c t i o n s occur i n young people aged 15-24. Through the
1998 "Force f o r Change" campaign, the United Nations and i t s partners have
h i g h l i g h t e d the r o l e that young people can play i n changing the course of the
epidemic.
Young people are a powerful influence f o r education and understanding i n
t h e i r f a m i l i e s , t h e i r peer groups, t h e i r schools, t h e i r communities and t h e i r
countries. On t h i s World AIDS Day, l e t us recommit t o our investment i n young
people everywhere - f o r they hold the key t o a safer f u t u r e .
LANGUAGE: English
LOAD-DATE: November 25, 1998
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LEVEL 3 - 9 5
OF 161 STORIES
C o p y r i g h t 1998 F e d e r a l Document C l e a r i n g House, I n c .
FDCH Federal Department and Agency Documents
December 1, 1998; Tuesday
LENGTH: 367 words
AGENCY: DEPARTMENT OF HEALTH AND HUMAN SERVICES
SIC-MAJOR-GROUP: 02 - Food, Drug and H e a l t h
HEADLINE: SECRETARY SHALALA'S STATEMENT ON WORLD AIDS DAY
CONTACT: (202) 690-6343
BODY:
HHS S e c r e t a r y Donna E. S h a l a l a i s s u e d t h e f o l l o w i n g statement as she
a r r i v e d today a t Ben
Gurion A i r p o r t , I s r a e l , where she w i l l a t t e n d an i n t e r n a t i o n a l conference
on women's h e a l t h :
"As we commemorate World AIDS Day, we acknowledge t h e i n c r e a s i n g l y t r a g i c
t o l l AIDS i s
t a k i n g across t h e g l o b e . T h i s disease knows no c o u n t r y , crosses e v e r y
b o r d e r , and s t r i k e s men,
women and c h i l d r e n o f every n a t i o n , every age, every c u l t u r e .
"This i s a day t o pause and r e f l e c t on t h e p r o g r e s s we've made, and on t h e
l o n g road we must s t i l l
t r a v e l . I t i s a day t o r e d e d i c a t e o u r s e l v e s t o p r e v e n t i n g new i n f e c t i o n s ,
improving treatment f o r the
s i c k , and t o one day f i n d a v a c c i n e and c u r e .
"Just days ago, t h e U n i t e d N a t i o n s e s t i m a t e d t h a t more t h a n 33 m i l l i o n
people worldwide a r e l i v i n g
w i t h t h e AIDS v i r u s , t h e h i g h e s t e s t i m a t e ever. While we have l e a r n e d much
about d r u g t h e r a p i e s
t h a t can a r r e s t t h e p r o g r e s s o f t h e disease and p r e v e n t t r a n s m i s s i o n from
mother t o i n f a n t , these l i f e s a v i n g drugs a r e n o t w i d e l y a v a i l a b l e around t h e w o r l d .
"AIDS i s t a k i n g men and women i n t h e prime o f l i f e , t o o o f t e n l e a v i n g
orphaned c h i l d r e n i n t h e care
of over-burdened r e l a t i v e s and f r i e n d s around t h e g l o b e . Today i n
Washington D.C,
President
C l i n t o n w i l l announce an h i s t o r i c i n c r e a s e i n f u n d i n g a t t h e N a t i o n a l
I n s t i t u t e s o f Health t o prevent
and t r e a t HIV-AIDS around t h e w o r l d , i n c l u d i n g a 33 p e r c e n t i n c r e a s e over
l a s t year's f u n d i n g t o
search f o r an AIDS v a c c i n e .
And, he w i l l announce an emergency g r a n t
program from USAID t o
h e l p s u p p o r t AIDS orphans around t h e w o r l d .
" P r e s i d e n t C l i n t o n has committed unprecedented resources t o f i g h t i n g t h i s
epidemic a t home and
abroad. Funding f o r a l l AIDS programs has r i s e n 110 p e r c e n t s i n c e he t o o k
o f f i c e , and HHS w i l l
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Federal Department and Agency Documents, December 1, 1998
spend nearly $7.7 b i l l i o n i n 1999 f o r HIV/AIDS prevention, treatment and
research. Nearly 20
years a f t e r the world f i r s t heard the name of t h i s t e r r i b l e disease, we are
locked i n a struggle t o
defeat i t . We pledge t o you on t h i s World AIDS Day that we w i l l not give up
the f i g h t . "
REGION: 4th U.S. C i r c u i t Court of Appeals - V i r g i n i a , West V i r g i n i a , North
Carolina, South Carolina, Washington, D.C.
INDUSTRY-CODE: Health services
LANGUAGE: ENGLISH
LOAD-DATE: December 11, 1998
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White House Convening on AIDS in Africa
Welcoming Remarks by First Lady Hillary Rodham Clinton
The White House
September 7,1999
I want to start by thanking all of you for being here. You may recall that back in July the
Vice President announced the Administration's request for $100 million on behalf of our
government's efforts to combat the pandemic of AIDS. We also announced a series of
meetings, of which this is one. There will be a number of others as well.
We are joined today by leaders from the Administration, international organizations,
foundations, businesses, and grassroots AIDS activists. The people around this table are
a testament to the impact of the AIDS pandemic and the effect it has on every sector of
society and every (inaudible) .... Also, the responsibility...(inaudible)
It is my hope that this meeting will lead to new initiatives, new resources, new thinking,
and new partnerships to fight - and ultimately win - the war against HIV/AIDS in Africa
and around the world.
Every day, we are reminded of the breakthroughs that we've had in this fight- from drug
therapies that are improving life to education campaigns that are empowering people to
prevent this disease. We know what works. But, we also know that far too many people
are still being left behind.
Just a week ago in Atlanta, we heard that the rate of HIV infections is no longer declining
in the United States. And, each and every day, AIDS claims the lives of more than 5,500
men, women, and children in Africa. In the next few years, that number will more than
double. The AIDS epidemic in Africa is a crisis of biblical proportions. We are facing an
emergency. And what we see in Africa today, we will likely see one day in India, in
Southeast Asia, and the Newly Independent States if we do not act now.
In Uganda, I saw firsthand what can be accomplished when the governments and citizens
join forces to beat this disease. I went to the AIDS Information Center and saw countless
billboards educating people to protect themselves against AIDS. I remember a song that
had been sung in the information center: The song's theme is that Ugandans are fighting
to ensure that AIDS cannot win. And this entire government citizens' campaign is
working. From 1992 to 1998, the percentage of sexually active teenage girls who were
HIV positive declined by almost two thirds.
That example was on the minds of the African health ministers who came together last
week at a W.H.O. meeting in Namibia. They declared war on HIV/AIDS and made a
commitment to stop the devastation plaguing their citizens and countries. And I hope and
pray that the United States will work hand in hand with these governments and citizens.
�Because AIDS is not somebody else's problem. Our work against this deadly disease
must be part of all our development efforts - especially those affecting women and
children. Because, as we speak, the AIDS epidemic is turning back the clock on the
development we have seen taking place in Africa. It is undermining entire economies,
trade, civil society, and the stability that was so hard fought for by those nations. It is
decreasing life expectancy by up to 20 years in some countries and turning millions and
millions of children into orphans.
I know that the people around this table and in this room have worked tirelessly to make
great progress in the battle against AIDS. But, we have a lot more that we need to do
today.
That is why I am pleased to be joined by leaders of the United States including the
Secretary of Health and Human Services, Donna Shalala; the Secretary of the Treasury
Larry Summers; our new USAID Administrator Brady Anderson; our Surgeon General,
Dr. David Satcher; the Undersecretary of State, Frank Loy; Leon Fuerth, the Assistant to
the Vice President for National Security Affairs; and Sandy Thurman, the Director of the
White House Office of National AIDS Policy.
/The Administration starting with the Vice President's call more than a month ago has
' asked for an additional $100 million next year to fight the global battle against AIDS.
This new initiative represents the largest increase ever in the international AIDS budget.
And it would allow us to more than double our efforts in sub-Saharan Africa.
We can also take heart in the recent Cologne Agreement, which will more than double
the debt relief provided to countries that would help the countries that need it the most.
This means that eligible nations such as Uganda and Tanzania will now be allowed to use
theirfreedup resources on social sector spending - including, for the first time, activities
to prevent HIV/AIDS. We will work with the International Monetary Fund, the World
Bank, and UNAIDS to encourage Uganda, Tanzania, and other eligible countries to
^ / develop HIV/AIDS pilot projects.
I am very pleased that we are joined by key representatives from multilateral
organizations, including Jim Wolfenson and Jan Piercy from the World Bank and Peter
Piot from UNAIDS. And we will hear from him about the work that UN agencies are
doing to combat AIDS around the world, and that reminded me of yet one more reason
why the United States should pay our dues to the United Nations.
We are also very fortunate to have with us the National Association of People with AIDS
and the Global AIDS Action Network - two non-governmental organizations that are on
the frontlines.
In addition there are representatives of foundations here that have provided great
leadership in the fight against HIV/AIDS. I want to thank the Rockefeller Foundation,
the Gates Foundation, and the Open Society Institute for their generous contributions. I
also want to thank the Kaiser Family Foundation, which comes here today with a new
�commitment to match funding dedicated to preventing AIDS among adolescents in South
Africa. And I want to thank the MacArthur Foundation, which will be bringing
foundations together at the end of this year to discuss even more ways that they help meet
this challenge.
I am also pleased to be joined by representatives of the private sector. Robert Johnson
from Black Entertainment Television who will use his network to (inaudible) and Bristol
Myers Squibb, who are making great contributions - but also reminding us of critical role
that businesses has to play...??.
Because just imagine what we could accomplish if, over the next few years, we could
bring to this table every business, government leader, foundation, NGO, multilateral
organization, and citizen who wants to be part of meeting the challenge ... by
HIV/AIDS(inaudible)
We can never give up until we finally meet our ultimate goal - and find a cure that
reaches every single man, woman, and child. But, until then, we must do all we can in
our power to prevent HIV and heal those it strikes in Africa and all over the world. It is
my great pleasure to have you here and to be part of this discussion and more than that to
be part of this (inaudible) We hope that the United States ???????
And I hope that over the next hour or so we will think creatively about the ways that we
can work together to do just that.
�.6,
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Elizabeth Glaser Pediatric A I D S Foundation Awards
Remarks by First Lady Hillary Rodham Clinton
Washington Press Club
January 28,1999
Thank you all. Thank you. Well, it is my honor to be here, once again, for one of the most important
events that I think goes on in Washington every year, as we take the energy and the generosity of
individuals, corporations, and foundations in a great show of philanthropic spirit and put that to work on
behalf of the extraordinary, groundbreaking work that these scientists and their colleagues are doing. I
am grateful to be here with all of you and to have a chance, once again, to thank those of you who
support the foundation and the work that Elizabeth started so many years ago.
I want to thank my friend Paul, whom I appreciate for not embarrassing me. But more than that I want to
thank him for his courage, commitment, and his support and friendship. I'm honored to be with him
once again as we recognize the outstanding work that the Elizabeth Glaser Pediatric AIDS Foundation,
and these scientists, are doing to push the frontiers of science even further.
I want to thank the remarkable leaders of this foundation, who have helped to build it into what it is
today. I know that Suzie Zeegan is often very modest about her contributions, but she has been a
stalwart, steadfast voice and heart of this organization for so many years. I'm glad that she is joined by
Kate Carr and Janis Spire, and all of you who are on the board and involved in the work of the
foundation.
And I want to say a personal word of appreciation and gratitude to Mary Fisher. Her tireless work, her
eloquent powerful voice has meant a lot to many of us, and I know that she will not rest until we do all
that we can on behalf of the work that she so well represents.
None of us would be here today—not Suzie, not Paul, not me, not Mary—none of us, were it not for the
inspirational life and work of our friend Elizabeth Glaser. Her spirit animates this gathering, as it does
any time we come together. No one fought harder—or more—to bring attention and resources to the
issue of pediatric AIDS. No one who ever heard her speak or met her will ever forget that fabulous laugh
and that very persistent effort that she put into making it clear to all she met that this was an issue that
was not just confined to those who were suffering from the tragedy of HIV and AIDS—and particularly
as it affected children—but for every human being. And that work that she started and that spirit that is
still with us has brought hope to millions and millions of children and adults who suffer from this
disease. She transformed literally the way this country responds to HIV and AIDS.
It was something that started very simply, sitting around a kitchen table with Suzie and Susan, and
deciding to undertake what must, at that time, have seemed like an impossible task. But once again, one
person and a small group of people have made a tremendous difference. And as Margaret Mead
famously once said, "It is only a small group of people who ever make a difference in changing the
direction of the world."
So here we are to celebrate the 10th anniversary, a "decade of progress, a decade of promise," and to go
forward into this upcoming decade with the same level of commitment, motivation, and dedication. And
there is no group that has done more than this foundation to make it possible for us to say that we are
looking at a decade of promise.
Ten years ago, almost no one knew about AIDS, let alone that it could be transmitted from mother to
child. There was ignorance; there was fear. And we have come a very long way indeed. We've come to
the point where we can say that there is a pediatric AIDS research agenda and that we can point to the
progress that all of us have seen made because of the dedication of scientists.
We can look back at the decade of breakthroughs that have dramatically reduced mother-to-child
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transmission and greatly improved the quality of life and life expectancy of infected children. There are
also more drugs—once only available to adults—that are now benefiting children.
I want to underscore something Paul said and thank all of you who joined us in our fight to make
pediatric labeling a reality. It was a long struggle, but it was one that we could not have achieved
without the support of this foundation and many of you here today. Now we have a regulation in place
assuring that prescription drugs are tested for safety and efficacy in children. This regulation will ensure
that doctors know which drugs to prescribe and how much to give to their youngest patients. We believe
this initiative has the potential for saving countless lives, and we could not have done it without you.
In the past several months, the Clinton Administration has also launched new initiatives to address AIDS
in minority communities, to strengthen our efforts to find a vaccine, and to boost our international
efforts to care for children orphaned by AIDS. Those are three very important initiatives, and let me just
briefly address them.
As I look around this room, I see that there are not many representatives of minority communities, which
are the hardest hit part of the American population. And certainly if we look abroad and we see what
HIV/AIDS is doing in Africa and Asia, it makes that emphasis even more urgent.
The effort to find a vaccine, which these scientists to some extent are focusing their work on, is
something that the United States is even more committed to. And working with partners around the
world, we hope we will see progress.
And finally, international efforts to care for children orphaned by AIDS are extremely important. I've
seen varying statistics, but I keep seeing the number: 40 million orphans from AIDS in the next ten
years.
So we've come together to celebrate what we've achieved, but also to look towards the future. And we
have a lot to be thankful for when we look at the health care of our children. In the last six years,
because of the leadership of this President and the Administration and the supporters in Congress and
elsewhere, we've seen improvements in the health of America's children. Immunization rates are at an
all time high, infant mortality at an all time low. And thanks to the President's program for children's
health insurance called "CHIP," millions more children are eligible for coverage, and we have to make
sure that we reach the 5 million children who are eligible but not currently enrolled.
I'm also pleased to announce today that the President's fiscal year 2000 budget includes a new $40
million grant program to support graduate medical education. This is something that has worried me for
quite sometime. Some of you may know that graduate medical education—how we fund the training of
our physicians, our research scientists, our hospitals, and our medical centers—is funded by Medicare.
And what we have found over the last several years is that the funding for those who work with children
and are being trained to work with children is grossly disproportionate to the need. I can't remember the
exactfigures,but something like over $9,000 a year is spent out of Medicare to fund the training and
work of physicians who work with adults, and about $400 a year for those physicians working with
children. We have worked for quite sometime to change that, and I am very proud that the President's
budget will make a start on that.
There is no way we could talk about treating children with HIV or AIDS or any chronic or acute
condition if we don't have the doctors and the trained staff ready and able to treat them throughout our
country. So we need to do more to train doctors who care for our children and provide vital health
services for the poorest, the sickest, and the most vulnerable among our children.
Too long children's hospitals have been trying to carry this responsibility without adequate resources. I
ran into Senator Kennedy as I got off the elevator. Senator Kennedy and others have introduced a
bipartisan piece of legislation to make permanent the funding of those who work for children's health
and I hope, in addition to the grant, we will see a permanent solution to this problem.
But we have a lot of work ahead of us. Here, and around the world especially, new HIV infections are
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increasing, and women of color and young people are among the most vulnerable. Every hour of every
day, two more American adolescents are infected with HIV. And around the world, 1,600 children are
infected every single day.
As we all know, the ravages of pediatric AIDS are the most severe in the developing countries, where
over 90 percent of new infections now occur. By the end of this year, 40 million people will be living
with HIV or AIDS. And by the end of the next decade, AIDS will have orphaned over 40 million
children.
Now when you're confronted with statistics like these, it is sometimes difficult not to feel overwhelmed.
But the founders of this foundation and this effort, and Elizabeth herself, would not accept that as an
excuse at all. The legacy that Elizabeth leaves us is one that is driven by and shaped by hope, not
despair; one that chooses action over inaction; one that is determined, regardless of the odds, to find
effective treatments, a vaccine, and eventually a cure.
Now we know that that can only happen if we have the kind of support and dedication of the scientists
that we honor today, and I am very proud to ask them to stand and receive their individual awards. These
gifted individuals represent some of the brightest investigators from the international research
community. While they work at separate research institutions, they all share a deep commitment to not
only furthering their own work, but collaborating with those who are their partners here and around the
world.
The first recipient is Dr. Robert Doms from the University of Pennsylvania. Dr. Doms, will you please
come forward? Dr. Doms is investigating how a cell gets infected with HIV. And I told Dr. Doms and
the other scientists that I read the summary of their work, and as a lay person, I have to confess I wasn't
quite sure what CCR5 was, what it did or what it didn't do, but I know how important the work is that
each of them is engaged in. Dr. Doms is attempting to discover how we can block the infection by
learning how the cell gets infected in the first place—which would then lead to the development of an
effective vaccine. And so on behalf of all us, and literally on behalf of millions of people who will
maybe never know your name, Dr. Doms, but will benefit from your work, congratulations! [The First
Lady presents the award.]
Dr. Philip Goulder from Massachusetts General Hospital is investigating the immune response of
AIDS-infected children in the United States and Africa to bring us closer to the discovery of an AIDS
vaccine. I want, particularly, to thank Dr. Goulder and those who work with him for partnering with
scientists and physicians in Africa where the need is so acute, and where we have an opportunity to
make a tremendous difference. Because, as so many of you know, the progress that we've made in
extending life expectancy and quality of life for many people living with HIV/AIDS is dependent upon a
very expensive drug regiment which is out of the reach of people in most of the rest of the world. So the
work that is being done by Dr. Goulder and others is critical to bringing hope to people in parts of the
world that now don't have an opportunity to benefit from what has already been achieved. Dr.
Goulder—congratulations. [The First Lady presents the award.]
Next is Dr. Jule Overbaugh from Seattle's Fred Hutchinson Cancer Research Center. She is
collaborating with other researchers to further reduce mother-child HIV transmission—particularly
during breastfeeding. You know, we spent years persuading women in developing countries to breast
feed. This was one of the great causes of the 1970's and early 80's, to persuade them that their breast
milk was more effective for their children to build up their child's immune system, and not to be
persuaded by advertisements promoting the use of formula when they didn't even have clean water that
they could mix with the formula. But, of course, now we are trying tofigureout what we do with that
success, because the breast feeding, which is very important for many reasons, is one of the ways that
HIV is transmitted. As part of the work that Dr. Overbaugh is doing, she is studying HIV-infected
infants and mothers in Nairobi, Kenya. And I want to thank her also for helping to focus on the issue in
Africa. Congratulations. [The First Lady presents the award.]
Dr. Paul Johnson from Harvard Medical School is researching new ways to help boost the immune
system's response to HIV infection in children. And that is something else that we are so hopeful about,
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to learn more about what can be done to fend off HIV once it enters into a child's system, to prolong life
and really do everything we can to diminish the impact of HIV and postpone or eliminate the
development of AIDS. Thank you, Dr. Johnson for your important work. [The First Lady presents the
award.]
You know, I feel, as 1 hand out these awards to these scientists, the way I felt when I first went to a
doctor younger than myself. These four incredible scientists are so young, and for all of us we think of
that as a very hopeful sign that the research that is going on is engaging the attention and the intelligence
and expertise of our young scientists and researchers. And certainly by evidence of them today and the
work that they are doing, we have every reason to be hopeful. So let me on behalf of the foundation
thank all of you who have been part of this work, who have been involved in carving out this very
unique contribution that the foundation is making to furthering scientific endeavor and to highlighting
the work that these four scientists are doing.
It is a pleasure and an honor for me to be part of this presentation once again, and to do all that I can
along with all of you to make it possible for us to move forward against this disease, and do everything
we can to protect our children from it, and to help those who already suffer from it to lead lives of
quality as they try to fulfill their entire God-given promise.
Thank you very much.
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LEVEL 3 - 17 OF 161 STORIES
Copyright 1998 M2 Communications L t d .
M2 PRESSWIRE
December 3, 1998
LENGTH: 1447 words
HEADLINE: THE WHITE HOUSE
Remarks by the President a t World AIDS Day event
HIGHLIGHT:
Room 450, Old Executive O f f i c e B u i l d i n g
BODY:
THE PRESIDENT: Thank you. Amy, f o r your magnificent remarks and the power of
your example. Thank you, Cynthia, f o r coming t o t h i s b i g , scary crowd.
(Laughter.) She was nervous. I said, w e l l , look a t the b r i g h t side - a t least
you got out of school f o r a day. (Laughter.)
I thank the other c h i l d r e n who are here w i t h us. And I want t o thank a l l the
members of our a d m i n i s t r a t i o n who have helped so much i n t h i s cause - Secretary
A l b r i g h t ; Brian Atwood; Dr. Satcher; our AIDS Policy D i r e c t o r , Sandy Thurman;
members of the Council on HIV and AIDS. We're glad t o have Nafis Sadik here, the
Director of the U.N. Population Fund. Richard Socaridies from the White House, I
thank you and a l l the other members of the administration. And I , too, want t o
j o i n i n expressing my appreciation t o the members of Congress who Brian
mentioned f o r t h e i r support f o r AIDS funding.
But I e s p e c i a l l y want t o thank Amy f o r being here and reminding us of what
t h i s i s a l l about. When she was speaking my mind wandered back t o an incident
that occurred when I was running f o r President i n 1992. Some of you have heard
me say t h i s before, but I was i n Cedar Rapids, Iowa, a place l a r g e l y known f o r
i t s enormous percentage of Czech and Slovak c i t i z e n s . And there was i n the crowd
at t h i s r a l l y where I was speaking a woman who was e i t h e r Czech or Slovak,
probably, holding an A f r i c a n American baby. And I said, whose baby i s t h i s ? She
said, t h i s i s my baby. And I said, where i s t h i s baby from? She said, F l o r i d a , I
got her from Florida. (Laughter.)
And i t was October i n Cedar Rapids and she should have been i n F l o r i d a ,
probably. (Laughter.) She said, t h i s baby was born w i t h AIDS and abandoned and
no one would take t h i s baby. This woman had her marriage had dissolved, she was
r a i s i n g her own c h i l d r e n alone. But because she heard about c h i l d r e n l i k e t h i s
wonderful l i t t l e g i r l , she adopted t h i s baby.
And every year since, about once a year, I see t h i s young c h i l d . I've
watched her grow up now and I'm happy t o t e l l you that s i x years l a t e r she's
s t i l l a l i v e and doing p r e t t y w e l l . She comes t o the NIH f o r regular check-ups
and she comes by the White House t o see her f r i e n d . And every time I see Jimiya
I am reminded of what t h i s whole t h i n g i s about.
And I t h i n k I should t e l l you one other t h i n g . When Amy was standing up here
w i t h me and I was t e l l i n g her what a f i n e j o b she d i d , she said, I'm so glad
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t h a t Cynthia could be here, and that I could say Carla's name i n your presence.
This i s , I t h i n k , very important f o r people who have not been touched i n
some personal way - who have never been at the bedside of a dying f r i e n d , who
have never looked i n t o the eyes of a c h i l d orphaned by AIDS or i n f e c t e d w i t h HIV
- t o understand. And I believe, always, that i f somehow we could reach t o the
heart of people, we would always do b e t t e r i n dealing w i t h problems, f o r our
mind always conjures a m i l l i o n excuses i n dealing w i t h any great d i f f i c u l t y .
Let me begin, even i n t h i s traumatic moment, t o say we have a l o t t o
celebrate on t h i s AIDS Day. We celebrate the example of Amy and Cynthia. Just
t h i n k , a decade ago people r e a l l y believed t h a t AIDS was unstoppable; the
diagnosis was a v i r t u a l death sentence; there was an enormous amount of
ignorance and prejudice and fear about HIV transmission. Most of us knew people
who couldn't get i n t o apartment houses or were being kicked out or otherwise t h e i r c h i l d r e n couldn't be i n school because of fears that people had about i t .
Every day, f o r people who had HIV or AIDS and t h e i r f a m i l i e s - every day was
a struggle a decade ago. A struggle f o r basic information, f o r treatment, f o r
funding, and a l l too o f t e n , f o r simple compassion.
For s i x years, thanks t o many of you, we have worked hard t o change t h i s
p i c t u r e - and so have tens of thousands of other people across our country and
across the globe. We've worked hard t o draw a t t e n t i o n t o AIDS and t o b e t t e r
d i r e c t our resources by creating the O f f i c e of National AIDS Policy and the
President's Council on HIV and AIDS. We had the f i r s t ever White House
conference on AIDS. We helped t o ensure t h a t people w i t h HIV and AIDS cannot be
denied health benefits f o r p r e e x i s t i n g conditions. We accelerated the approval
of more than a dozen new AIDS drugs, helping hundreds of thousands of people
w i t h AIDS t o l i v e longer and more productive l i v e s .
Working together with members of both parties i n the Congress, we increased
our investment in AIDS research to an h i s t o r i c $1.8 b i l l i o n . This year we
secured $262 million i n new funding for the Ryan White CARE Act, providing
medical treatment, medication, even transportation to families coping with
AIDs. This October we declared that AIDS had reached c r i s i s proportions i n the
African American, Hispanic American and other minority communities, and fought
for $156 million i n i t i a t i v e to address that. Today the Vice President i s
announcing $200 million in new grants for communities around the country to
provide housing for people with AIDS.
The results of these and other efforts have been remarkable. For the f i r s t
time since the epidemic began, the number of Americans diagnosed with AIDS has
begun to decline. For the f i r s t time, deaths due to AIDS i n the United States
have declined. For the f i r s t time, therefore, there i s hope that we can actually
defeat AIDS.
But a l l around us there i s , as we have heard from a l l the previous speakers,
fresh evidence t h a t the epidemic i s f a r from over, our work i s f a r from
f i n i s h e d , t h a t there are r i s i n g numbers of AIDS i n countries l i k e Zimbabwe,
where 11 men, women, and c h i l d r e n become i n f e c t e d every minute of every day.
There are s t i l l too many c h i l d r e n orphaned by AIDS, tens of thousands here i n
America, tens of m i l l i o n s i n developing nations around the world.
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And when so many people are s u f f e r i n g , and w i t h HIV transmission
d i s p r o p o r t i o n a t e l y high, s t i l l , among our own young people here i n America, i t ' s
a l l r i g h t t o celebrate our progress, but we cannot rest u n t i l we have a c t u a l l y
put a stop t o AIDS. I believe we can do i t - by developing a vaccine, by
increasing our investment i n other forms of research, by improving our care f o r
those who are i n f e c t e d and our support f o r t h e i r f a m i l i e s .
Last year a t Morgan State U n i v e r s i t y , I declared that we should redouble our
e f f o r t s t o develop an AIDS vaccine w i t h i n a decade. Today I am pleased t o
announce a $200 m i l l i o n investment i n c u t t i n g edge research at the NIH t o
develop a vaccine. That's a 33 percent increase over l a s t year. With t h i s
h i s t o r i c investment, we are one step closer t o p u t t i n g an end t o the epidemic
f o r a l l people.
I'm also pleased t o say that there w i l l be more than $160 m i l l i o n f o r other
new research c r i t i c a l t o f i g h t i n g AIDS around the world, from new s t r a t e g i e s t o
prevent and t r e a t AIDS i n c h i l d r e n , t o new c l i n i c a l t r i a l s t o reduce
transmission.
And as hard as we are working t o stop the spread of AIDS we cannot forget
our profound o b l i g a t i o n f o r the heartbreaking youngest v i c t i m s of the disease the orphaned c h i l d r e n l e f t i n i t s wake. Around the world, as we have heard,
m i l l i o n s of c h i l d r e n have l o s t t h e i r parents. Their number i s expected t o r i s e
t o 40 m i l l i o n over the next 10 t o 15 years. Some of them are free of AIDS,
others are not. But sick or w e l l , too many are l e f t without parents t o p r o t e c t
them, t o teach them r i g h t from wrong, t o guide them through l i f e and make them
believe t h a t they can l i v e t h e i r l i v e s t o the f u l l e s t .
We cannot restore t o them a l l they have l o s t , but we can give them a f u t u r e
- a f o s t e r family, enough food t o eat, medical care, a chance t o make the most
of t h e i r l i v e s by helping them t o stay i n school. Today, through Mr. Atwood's
agency, we are committing another $10 m i l l i o n i n emergency r e l i e f t h a t w i l l ,
though seemingly a small amount, a c t u a l l y make a huge d i f f e r e n c e f o r many
thousands of c h i l d r e n i n need around the world.
I'm also d i r e c t i n g Sandy Thurman t o lead a f a c t - f i n d i n g mission t o A f r i c a ,
where 90 percent of the AIDS orphans l i v e . Following the mission she w i l l report
back t o me w i t h recommendations on what more we can do t o help these c h i l d r e n
and give them something not only t o l i v e f o r , but t o hope f o r .
Eleven years ago, on the f i r s t World AIDS Day, we vowed t o put an end t o the
AIDS epidemic. Eleven years from now, I hope we can say t h a t the steps we took
today made that end come about. I f i t happens, i t w i l l be i n no small measure
because of people l i k e you i n t h i s room, by your u n f a i l i n g , passionate devotion
to t h i s cause - a cause we see most c l e a r l y expressed i n the two people s i t t i n g
r i g h t behind me.
Thank you a l l , and God bless you. (Applause.)
LANGUAGE: English
LOAD-DATE: December 4, 1998
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�MEMORANDUM
To:
Fr:
Re:
Da:
HRC
June
AIDS speech
Dec. 1, 1999
1 talked to Sandy Thurman who recommnded that we add the Sept. AIDS convening and future
meetings we plan to hold with business and religious leaders about the AIDS epidemic, (page 5)
She also said we could say that the President is sending her to India on a fact finding mission.
We also beefed up the language about the U.S. commitment, (page 8)
��THE WHITE HOUSE
WASHINGTON
Office of the First Lady
Ph: (202) 456-6266
Fax: (202) 456-6244
To:
Phone Number:
Fax Number:
From:
Number of pages (including cover):
Comments:
�In this section you need to make clear the difference in how the violent and mentally ill should
be treated, and how those without those problems or with lesser problems should be treated. The
phrase "continuum of care" is too liberal compared to saying that we have to attack this problem
from all sides. So it should go something like...
Make no mistake, for those who are violent or dangerous, we must take them off the streets.
But one solution will not work for every homeless case.
For those who pose no real danger, studies show we can have the kind of success getting people
off the streets that we are having getting people off of welfare...
Now, make no mistake,of couree if someone who is violent or dangerous,-tk©y shouldn't be
wandering our streets., a danger to themselves and everyone else. But the larger story is that we
have deinstitutionalized so many people without providing them with the proper services, a
policy that just hasn't worked. In addition to efforts to require people take their medication
through Kendra's law, we also have to provide the right kind of mental health services. We need
to provide a continuum of care, so that we get people back on their feet, productive and working
-not turn our back on them.
A homeless person with a mental illness desperately needs transitional housing, job training, and
mental health services. If outreach to these individuals is coupled with appropriate medical
treatment and connects them to housing and other supportive services, one study reported a 45
percent reduction in the number of days of homelessness after three months of this type of
treatment. Over a year, clients had a 70 percent increase in the number of days worked,
demonstrating that homeless persons with mental illnesses can make substantial improvements in
the overall quality of their lives. We need to provide a continuum of care, so that we get people
back on their feet, productive and working -not turn our back on them. Shelter Plus Care, a
federal program recognizes that homeless people with disabilities, including mental illness, need
more than just shelter. The program works through not-for-profits in the private sector to
coordinate housing with other supportive services for those who need it. I think this is a valuable
program, and it ought to be expanded. And I believe we should better target the considerable
federal investment in mental health services towards these kinds of initiatives to address
homelessness.
The strength of America is its many voices, and you know better than anyone, sometimes those
voices rise up in protest. This is our strength and our virtue, not our weakness. When voices rise
up in protest, you can listen and respond, or you can stop up your ears and fight back. I look
forward to serving this great state as Senator, and I look forward to serving with your
considerable help -listening to all the voices of this great State, and working together to solve its
problems. That's my promise.
�Thank you very much.
�,
J-6ant tell you how much 1 look forward to the possibility of serving the people of this state.
Atid 1 hope 1 am guided, every single day 1 am in office, by the leesonc I've learned from you.
You know better than anyone, you have to listen to someone when they are in trouble. In New
York there are mothers looking for child care eo they can go to work; there are people on welfare
looking for job training; there are children in need of health care. The problems you are asked to
solve are as diverse as the people you serve, and if I'm elected to the Senate, every Mew Yorker
-ever)' single one •• will have a voice in determining how we can bring dignity and freedom to all
its citiaens.
Now, a minister doesn't serve just some of his or her flock; and political leaders shouldn't serve
just their political friends, should they? I'm counting on a lot of people to come together and
help me in this race. But if 1 were lucky enough to win, I would serve the entire state, not my
political friends, not just my supporters, and not just the people who agree with me. This is
another lesson you've taught me; inclusion means real inclusion, it means serving all the people
you've been called to serve, not just some of them. And it means finding a way to talk and listen
to-people who have fought with you sometimes fought with you bitterly without becoming
petty, and without retaliating.
4-believe it makes a huge difference in the policies you adopt, whether or not you have allowed
U^c spirit of cooperation to survive and thrive. [New York City's public schools are suffering
while our leaders bicker and second guess one another. In an atmosphere of upheaval and in
lighting, schools in Mew York City have not been able to move forward and students, in the end,
always pay the price.—could do much more of this]
As we enter the holiday seasons, we are called upon to think of the lives of the less fortunate.
And as_the weather gets colder, the less fortunate should be on our minds more, not less.
Homelessness is a terrible problem for many Americans. Political leaders are given an enormous
trust because they're elected to serve everyone -they don't get to pick and choose. And I think
they ought to be judged not just on how they treat the fortunate, but how they treat everyone,
including the least among us. Do they treat them with decency, with honesty, with caring, do
they offer a way so that helping hand so each and every constituent can live up to their Godgiven potential? Or are they using the problems of the least fortunate to divide us? Or do they
show them a closed hand, a closed door?
Breaking up families that are homeless is wrong.[ and yet the Mayor has made this policyCriminalizing the homeless with mass arrests for those whose only offense is that they have no
home is wrong.[and yet the mayor has made this policy.] Locking people up for a day won't take
a single homeless person off the streets for good. These are not actions that will solve the
problems of the homeless, but are nothing more than political bandaids put on for the political
season.
They punish poverty rather than lift people out of it. And despite the national economic recovery,
poverty in this city has been on the increase, rising [fill in figures...]. I believe that we must
strike a basic bargain - those who work 40 hours should have a decent wage, access to
healthcare, and live out of poverty. That's why I have long supported the Earned Income Tax
credit and support an increase in the minimum wage.
�When the Mayor responds to the problems of homeleesncss by breaking up families, taking
children away from their parents because they lack shelter, it's not only wrong, it's
unconscionable. And when the Mayor criminalizes the homeless by arresting those on the street,
it's wrong. The real tragedy of these actions is that they don't really solve the problem at all they just punish poverty.
Real problems require us to go beyond headlines and myths, beyond politics and retaliation they require real leadership that is on the side of people, not against them, and real solutions. It
seems like a bad dream now, but we had a Republican once who came to Washington singing the
virtues of orphanages, telling us some parents who were poor simply shouldn't be parents. We
told them they were wrong. We must never take a U-turn back to those policies.
Now, homelessness is a serious problem. There are right now 85,000 New Yorkers using the
city's shelter system, and sadly, that number is on the rise. The number of homeless families
sleeping in the municipal shelter system has risen by 8 percent since 1998 alone. And shelter
providers report that street bound homeless have increased over the last few years.
It's been proven over and over again, emergency assistance alone will not solve the problem of
homelessness. We need comprehensive and long-term approaches that will help homeless
people become self-sufficient. And we have to keep our eye on the ultimate goal, which should
be no different for the homeless than for anyone else: work that promotes that self-sufficiency.
We clearly must break the cycle of dependency, but we will only do that if we provide people
with real opportunities. That means work - learning the virtues of work. But it also means
providing people with the tools so they can work - safe, reliable child care, health care benefits
and job training. We must not ask for self-sufficiency from the homeless at the same time we
pursue policies that cripple their chances for it. That's part of leadership — responding with
patience and foresight to a problem when it arises.
It will take federal, state and local governments acting intelligently and humanely together to
help solve homelessness -not headlines. And the most critical component is housing. As we all
know, rents are skyrocketing in New York. That's why Section 8 housing vouchers - which rely
on the market place to provide subsidized housing - are such an important tool to combat
homelessness. Over the last two years, the Administration has proposed 150,000 new housing
vouchers for Section 8 housing, but Congress has only approved 110,000. Even this is still a
drop in the bucket, when 215,000 households in New York City are on the waiting list for
housing vouchers. According to HUD, the average waiting period in New York City is 8 years.
I believe we need to triple new housing vouchers and target them to areas of the country with the
highest homeless rates.[check w/ HRC]
And we have to take special steps to address the problem of mental illness that many of the
homeless face. Today, mental health advocates say that 14,000 mentally ill people are homeless
or in shelters and it is estimated that close to half of all people in the shelters suffer from a
mental illness. One-third of homeless Americans suffer from an untreated mental illness.
�Thank you so much, it is wonderful to be here today.
New York, in all its diversity, truly stands as a microcosm for the entire world. And I think you,
who as ministers act so often as beacons of hope in people's lives, understand this better than
anyone: the problems that you are asked to help solve are as diverse as the people that you serve.
And 1 think one of the most important things you've taught me over the years, is that a minister
is not a minister to some of his or her flock. Well, as a political leader you may be elected by
some of the people, but you serve them all. If I am elected Senator I will make sure my office
doors are always wide, wide, wide open.
I think that a Senator must believe in three important values - opportunity, responsibility and
community. And in the last 7 years, under the leadership of President Clinton, we have seen a
tremendous growth in opportunity, with an economy that has created over 18 million new jobs as
a result of policies that restored fiscal responsibility and that invested in people. And we have
seen a growth in responsibility - I supported welfare reform, and it is working across America
with X millions now off welfare and back in the workforce. We still have more to do to move
millions more off of welfare, but we have made progress.
But as we approach the holiday season, we cannot abandon the value of community, the value
that sets us apart, (good place for quotes and elaboration)...
Whether it is a senior citizen who has paid into Medicare and is now struggling to pay for their
prescription drugs that are rising so fast in price.
Whether it's a mother who is working and playing by the rules and needs childcare to lift her out
of poverty.
Whether it's a young person growing up in the poorest areas who is working hard in school and
needs a modern school to learn.
Whether it's someone with AIDS who needs the help to survive one of the most dreaded
diseases ever to strike the world.
And whether it's is someone who has lost their way in life and is left homeless with their
families on the streets of New York.
We cannot forget any of these peopleThere are no easy answers to these problems. Creating a government program for every problem
does not work. But neither does letting people fend for themselves, especially those least able to
do that.
�Meeting the Needs of Children Orphaned bv AIDS
(and other children in distress)
V Children orphaned bv AIDS are at serious risk of not receiving the essential
supports that all children need to grow and develop into productive adults.
These essential supports include:
* Family security
-- shelter, food, clothing (income, protection against property grabbing)
-- identity, sense of belonging (in/formal adoption/foster care, migration)
— protection from exploitation (abuse, neglect, child labor)
* Educational security
— formal schooling
-- getting into school (particularly girls)
- staying in school (many drop out to care for parents w/AIDs)
— returning to school (orphans often do not return because of
discrimination, absence of needed fees, need to work)
-- youth development activities (to avoid crime, drugs, early & commercial sex)
~ structured recreation
- life skill training
— vocational training and apprenticeships
« Health/mental health security
-- counseling and support (dealing with death, isolation, stigma)
— nutrition (vitamin supplementation)
-- immunization & basic care (ORT)
-- HIV prevention (orphans are at very serious risk)
V Supporting children orphaned bv AIDS means strengthening families.
communities, and youth themselves. Solutions must be low-cost, sustainable, and
replicable/expandable to a scale responsive to the magnitude of the projected
devastation. Successes to date seem to build on development efforts designed to
enhance the ability of families, extended families, and vi lages (communities) to cope
with and meet the needs of their children. These solutions require the active buy-in and
participation of individuals and committees at the village level. NGOs, donors,
governments and others can help to create an enabling environment for effective action
(beyond discrimination, denial, and hopelessness) and to support locally defined and
executed programs including microenterprise and income generating activities.
V Focusing attention on children orphaned bv AIDS can be a catalyst for a more
vigorous response to HIV generally. The only way to slow the number of children
orphaned by AIDS is to reduce the transmission of HIV. Until there is an available
vaccine, this means more aggressive prevention efforts. In addition, the delivery of low
cost treatments for opportunistic infections, STDs, and TB to parents with AIDS can help
them to live longer and better lives and enable them to plan for the care of their children
when they are no longer able.
�GUAM
vvww.visilguaiii.org
Ap5
<>
�ROUNDTABLE ON HIV/AIDS
Following her speech at Chiang Mai University, the F i r s t
Lady i s invited to participate in a roundtable discussion on
HIV/AIDS at the campus.
^
There are a number of very worthwhile projects ongoing in
the North in the search for a vaccine against AIDS and,
ultimately, a cure for the disease. The Armed Forces Reseach
I n s t i t u t e of Medical Sciences (AFRIMS), the Centers for Disease
Control (CDC), and possibly Johns Hopkins and other private
universities are cooperating in t h i s regard with local drug
companies and with the Thai Ministry of Health and other Thai
organizations in a number of labs, c l i n i c s , and other settings.
/
A short (thirty-minute) roundtable briefing by
/representatives of these organizations w i l l offer the F i r s t
/Lady a briefing on efforts underway and progress to date. I t s
jparticipants, who w i l l have attended the F i r s t Lady's speech,
[ w i l l gather immediately after the speech in a nearby room.
11/7/96
�Suggested Speech to be given by Hillary Clinton at the Inauguration of the new AIDS
Information Centre Building, Kampala, Uganda:
It is a special pleasure for me to join you today as you inaugurate this beautiful new building. The
work you are doing here is of great importance in responding to the tragedy of the global AIDS
epidemic. I have learned much from Mary Grace Alwano-Edyegu, the director, about the services
you offer to yqur clients and to the community. And I have learned much about the courage and
s
bravery which you have shown in responding to the AIDS epidemic.
I would like to commend the bravery of the many Ugandan citizens who come to the AIDS
Information Centre for HIV counseling and testing. It is never easy to have a medical test done.
No matter what the test is, it is natural to be fearful of the results. In the case of an HIV test, many
people say to themselves, "What if I get bad results? It is better not to know such things. Ignorance
is bliss." But in the case of HIV infection, we know that ignorance is mil bliss. In fact, it is only
with information and behavior change that we can stop this epidemic. Those of you who have come
for HIV testing have shown great courage. You have chosen noi to be ignorant. You have been
willing to undergo a difficult and fearful experience so you can protect others and plan for your
family's future. I congratulate you, the clients of the AIDS Information Centre, for your courage in
the face of this disease which is so frightening to all of us. You are living examples of the AIC
slogan: Knowledge is power.
I would also like to commend the courage and bravery of the counselors and staff of the AIDS
Information Centre. The work you are doing is not easy. Every day you must inspire your clients
to adopt behaviors which will promote health. That sounds easy, but in fact we know from research
around the world that it isn't. And every day, you face the extremely painful task of telling some
of your clients that they have already contracted HIV, a deadly infection. I can only imagine how
stressful and emotionally exhausting this must be for each of you, and how much courage you need
when you walk into these counseling rooms with positive test results. The work you are doing is
extremely important, and I thank you, and the world thanks you for your courage, dedication, and
compassion as you counsel your clients.
�Lastly, I would like to congratulate President Museveni for his openness and courage in dealing with
this epidemic. This has empowered public health leaders in Uganda to pioneer many different
approaches to AIDS prevention. It is not by chance that Uganda is the only country in Africa where
so many people come voluntarily for HTV counseling and testing. Uganda can be proud of the AIDS
Information Centre; TASO, and so many other innovative and pioneering ADDS prevention projects.
Because of your commitment and your tireless efforts, there is good reason to believe that new
cases of HTV infection in Uganda are declining, especially in young people. This is wonderful news
with global implications, and shows.what can be accomplished when the government, public health
leaders, and the citizens work together with commitment and courage. Because of your efforts,
today we have more hope that young families in Uganda can stay healthy and contribute to the
development of your beautiful country.
Congratulations to AIC on your new building! I am so proud and happy that the people of the
United States have helped you finance this building, and I am pleased that your partners from
USAID and the US Public Health Service are helping you continually evaluate and improve the
services you offer. I am also so impressed that the fees paid by your clients have also made a big
contribution to the building. This really shows how much they value your services.
The
government and people of Japan and Germany have also helped construct this building, and I think
this makes it a symbol of the international commitment and solidarity we need to combat the AIDS
epidemic. I hope that this new building will enable you to serve even more people- and to serve
them well.
It seems unfair that the AIDS epidemic hit Uganda just when you were emerging from a decade of
civil war. At a time when talented young people are needed to rebuild your country, you must deal
with a disease which has killed so many people in their most productive years of life. But you have
responded with compassion and a commitment to service.
Thank you for your bravery, courage and hard work. Thank you especially for the love and
dedication you bring to your work. Your smiles, songs, and dances today tell me that for each of
you, in spite of the difficult times and experiences you each have, serving others has brought joy and
meaning to your lives— and to theirs.
�Strategic Objective 4 : Increase Service Utilization and Change Behaviors Related to Reproductive,
Maternal and Child Health to Reduce Fertility, the Transmission of HIV and Maternal and Child
Mortality
Problem
* Fertility and mortality rates in Uganda remain high. The average woman has 6.8 children and
about one child in seven dies before age five.
* Maternal mortality is also high at an estimated 5 0 6 d e a t h s / 1 0 0 , 0 0 0 births .
* Only about 8 % of w o m e n are using modern family planning. Spacing children at least t w o years
apart reduces fertility, maternal mortality and childhood death. Expectant mothers using improved
maternal health services have substantially reduced maternal and infant mortality.
* HIV/AIDS remains a very serious problem, w i t h upwards of 1 5 % of the adult population in some
urban areas infected.
* HIV is also a significant factor in child mortality.
* Infants of infected mothers w h o do not become infected themselves have a substantially
increased risk of death during childhood.
* Resource constraints severely limit the government's ability to improve basic services. Annual
GOU recurrent health expenditures are about $ 3 . 6 0 per capita per year, a large portion of which is
allocated to hospital-based, curative care instead of primary, preventive care which is cheaper and
more effective.
2
Program Description
* USAID's major, continuing initiatives include upgrading the skills of health care providers in
family planning and maternal health, mass-media communications, community education,
contraceptive social marketing, and HIV testing and counselling.
* Recently, USAID has increased its emphasis on sexually transmitted diseases (STDs), a major
factor in HIV transmission, and health-care financing.
* USAID's efforts have played a significant role in declining rates of fertility, mortality, and HIV
transmission.
* Fertility has declined from 7.3 (1989) to 6.8 in the t w o thirds of the country where comparative
data exist, and infant and child mortality have declined by about 2 0 % and 1 7 % respectively.
* New cases of HIV among 15-19 year-old women may have declined by as much as 5 0 % in some
urban areas since 1 9 9 2 , probably due to reductions in high-risk sexual behavior.
Planned Assistance
* Increase the availability and quality of health services related to family planning, HIV and other
STDs, and care of mothers and infants in 13 districts.
* Encourage the adoption of behaviors which will reduce the risk of acquiring HIV, of unwanted
pregnancy, and of maternal and child death.
* Enhance financial sustainabilitv of maternal and child health services by increasing revenue,
generation at public facilities and increasing the private-sector provision of care.
* Increase Contraceptive Prevalence from 1 2 . 5 % to 1 5 % ( 1 9 9 8 ) .
* Increase condom sales from 5 million/yr (95) to 15 million/yr (97).
* Increase HIV testing/counselling from 5 5 , 0 0 0 people/yr to 7 5 , 0 0 0 people/yr (1998).
Focus
USAID-funded programs are active in 13 of Uganda's 39 districts (35% of the population).
Special concerns
1. Instability in the North will prevent improved health services to that region.
2. Salaries of health workers must be increased to improve their motivation.
In the USA there are less than 10 maternal deaths per 100,000
�HIV/AIDS Profile:
Uganda
Demographic Indicators
iiiiiiiiii^il^
||||||lfi||i
46,120
Sources: U.S. Bureau of tbe Ceosus, United Nations, World Health Organization.
Epidemiological Data
The HIV epidemic in Uganda is one of the older epidemics in Africa. Although
recent trends in HIV infection in women attending several antenatal clinics in
Uganda show significant declines in HIV prevalence, new infections remain high,
especially in young people.
•
Those with sexually transmitted
diseases continue to be at high risk for
infection. The combination of high-risk
behavior and increased susceptibility
contributed to their high levels of
infection. Data from Mugalo Hospital in
Kampala show females with a higher
level of HIV infection than males from
1989 through 1995.
HIV Seroprevalence for STD Patients
Kampala, Uganda: 1989-1995
HIVSwoprevalBncaCX)
1989
1M0
1991
1995
Source: International Programs Center, Population Division. U.S. Bureau of the Census, HIV/AIDS Surveillance Data Base, June 1996.
�Uganda
•
Sentinel surveillance data from
Nsambya Missionary Hospital in
Kampala indicate a decline in HIV
infection among pregnant women since
1992. A similar trend is occuring at
Rubaga Missionary Hospital, Kampala.
HIV Seroprevalence by Site for Pregnant
Women in Kampala, Uganda: 1985-1995
HrvSeropravalencefK)
1964
•
In cities throughout Uganda, HIV
infection levels among pregnant women
increased over the 1989-92 time
period. Since 1992, sentinel
surveillance reporting from these cities
indicates either a decline or a leveling
off of HIV infection levels.
1968
1990
1992
1994
1996
HIV Seroprevalence for Pregnant Women
Selected Cities in Uganda: 1989-1995
so
mvSaropr«valeoc«(%)
I^Tororo — Moyo -a-Mbaram *Jln]a •"•Mlembe -»-Mutolara
40
1988
•
HIV seroprevalence levels among
pregnant women in Kabarole District
follow the same patterns as for all
adults with the HIV prevalence levels
higher in urban areas than rural. Data
from 1991 to 1994 show infection
levels remaining relatively steady in all
three areas.
1986
1989
1990
1991
1992
1993
1994
1995
1996
HIV Seroprevalence for Pregnant Women
Kabarole District, Uganda: 1991-1994
50
HIV Seroprevalence {%)
• Urban
.*.Sen)lurt)an
40 -
-Rural
30 20 to -
1991
1992
1993
1994
1995
Source: International Proorams Center, Population Division, U.S. Bureau of the Census, HIV/AIDS Surveillance Data Base, June 1996.
�Uganda
•
Data for pregnant women in
Mbale, capital of Eastern Region, and
Palisa are consistent with a pattern of
declining or of stabilizing HIV
prevalence seen in other areas of
Uganda.
HIV Seroprevalence for Pregnant Women
Two Rural Areas in Eastern Region
Uganda: 1989-1995
30
HfVSeroprevalencoC*)
1968
1989
1991
1992
1993
1994
1995
1966
HIV Seroprevalence by Age and Sex
Adults in Rakai District, Uganda
1994-1995
•
A study conducted among adults
living in 58 rural communities in Rakai
District found a higher level of HIV
infection among females (21 percent)
than among males (16 percent). Peak
prevalence occurred in the 20-29 year
age group for females and among men
30-39 years of age.
HIV Seroprevalence (%)
15-19
•
In a study of 15 rural villages of
Masaka District, located in southwest
Uganda, HIV infection levels among
adults hovered around 8 percent from
1989 to 1995.
1990
20-29
30-39
40-49
50-58
All
HIV Seroprevalence for Adults
Rural Area in Masaka District,
Uganda: 1989-1995
15
M V Saroprevalenca (%)
T
10
8.4
Mini
198940
1991
1992
1993
1994
1995
Source: International Programs Center, Population Division, U.S. Bureau of the Census, HIV/AIDS Surveillance Data Base, June 1996.
�Uganda
•
In the rural villages of Masaka
District, peak prevalence of HIV
infection occurs among women in the
age group 25-29 years and men in the
30-34 years age group.
HIV Seroprevalence by Age and Sex
Adults in 15 Rural Villages
Masaka District, Uganda: 1995
30
HIVSaroprevaJencs(%)
•Female
..19..
20
15 14.8
14
m
us:
10
2S
OA
13-19
•
Available studies tend to show a
large differential in HIV infection levels
between urban and rural areas. Data
from a study of adults 20-35 years of
age in Kabarole District in Uganda
demonstrate the urban/rural
differentiation in infection levels.
20-24
1
25-29
15.5 ^ H .
H
5
3 2.5
30-34
35-39
4044
46-54
55+
HIV Seroprevalence by Type of Residence
Adults in Kabarole District
Uganda: 1991-1994
50
HlVS«rapravalonc8(%)
Semlurban
Urban
•
Sentinel surveillance in Kabarole
District, Western Uganda, found HIV
seroprevalence levels less than 10
percent among the general population
(5 years and older) in 1993. Data from
the semiurban site, Rwimi, document
higher HIV levels among both males
and females than in the rural site,
Nyabani. Infection levels among
females were higher than among males
in both Rwimi and Nyabani.
93
Rural
HIV Seroprevalence for General
Population in Nyabani and Rwimi, Uganda:
1993
30
HIV Sen
r>ce(%)
•Male
•Female
•Both
20
10
Nyabani
Rwimi
S o u r c e : I n t e r n a t i o n a l P r o g r a m s C e n t e r , P o p u l a t i o n D i v i s i o n , U . S . Bureau of t h e C e n s u s , H I V / A I D S Surveillance D a t a Base, J u n e 1 9 9 6 .
�Uganda
•
In sentinel surveillance studies,
HIV infection levels in blood donors
vary among the different hospital sites
in Kampala. Nakasero, the only site for
which ISSO's data are available, shows
a decline in HIV infection.
HIV Seroprevalence for Blood Donors
Selected Sites in Kampala.Uganda:
1986-1993
HIVS«repravalenc»(%)
l—Mmaao *Nalaa«ro -"-Maambya -»-nubaga[
1988 1988 1987 1988 1989 1990 1991 1992 1993 1994
Source: International Programs Center, Population Division, U.S. Bureau of the Census, HIV/AIDS Surveillance Data Base, June 1996.
�PAGE
6
33RD STORY o f Level 1 p r i n t e d i n FULL format.
Copyright 1996 The Washington Post
The Washington Post
December 16, 1996, Monday, F i n a l E d i t i o n
SECTION: A SECTION; Pg. A04
LENGTH: 1157
words
HEADLINE: Lessons From A f r i c a i n AIDS Prevention; Addressing Other S e x u a l l y
Transmitted Diseases Helps Curb HIV I n f e c t i o n
BYLINE: Susan Okie, Washington Post S t a f f W r i t e r
BODY:
Some p u b l i c h e a l t h experts say the United States could l e a r n a l o t about how
t o stem the spread of AIDS by s t u d y i n g p r e v e n t i o n programs i n several A f r i c a n
nations.
Recent work t h e r e has shown t h a t r a t e s o f HIV i n f e c t i o n can be cut s h a r p l y i f
an i n t e n s i v e e f f o r t i s made t o t r e a t and prevent o t h e r s e x u a l l y t r a n s m i t t e d
diseases such as s y p h i l i s , gonorrhea and chlamydia.
E f f o r t s t o take advantage o f t h i s new understanding, and apply i t i n the
U n i t e d S t a t e s , have been hindered by l a c k of cooperation between s e x u a l l y
t r a n s m i t t e d disease programs and HIV p r e v e n t i o n programs, which t r a d i t i o n a l l y
have been separate i n t h i s c o u n t r y and compete f o r f e d e r a l funding.
Even a t the n a t i o n a l l e v e l , AIDS p r e v e n t i o n e f f o r t s have not focused on
•;ing s e x u a l l y t r a n s m i t t e d diseases. Helene Gayle o f the f e d e r a l Centers f o r
iSe C o n t r o l and Prevention acknowledged t h a t the agency has neglected t o
emphasize the r o l e o f s e x u a l l y t r a n s m i t t e d diseases i n i n c r e a s i n g the spread o f
HIV.
"Everyone knows about AIDS, which i s r e l a t i v e l y less l i k e l y f o r the
p o p u l a t i o n t o encounter, and nobody knows about STDs [ s e x u a l l y t r a n s m i t t e d
d i s e a s e s ] , " she s a i d . "There's something wrong i n our messages t h a t we d i d not
l i n k those."
Researchers have known f o r some time t h a t many STDs increase a person's r i s k
of becoming i n f e c t e d w i t h HIV. I n a d d i t i o n , an H I V - i n f e c t e d person who a l s o has
an STD t h a t causes an u l c e r o r sores, such as s y p h i l i s or herpes, i s f a r more
l i k e l y than someone w i t h o u t such a disease t o t r a n s m i t the deadly v i r u s t o
others.
\ | An i n t e n s i v e program t o diagnose and t r e a t STDs i n the town of Mwanza,
i Tanzania, reduced r a t e s o f HIV t r a n s m i s s i o n by more than 40 percent, according
'ito a study p u b l i s h e d l a s t year. I n Uganda, e n t i r e communities are being t r e a t e d
w i t h m u l t i p l e a n t i b i o t i c s as p a r t o f a f o u r - y e a r study t o see whether mass
treatment f o r STDs can reduce the spread of AIDS.
U.S. r a t e s o f s e x u a l l y t r a n s m i t t e d diseases are the h i g h e s t o f any developed
country, w i t h p a r t i c u l a r l y h i g h frequencies among teenagers, poor people and
minorities.
�PAGE
7
The Washington Post, December 16, 1996
I n Uganda, p r e v e n t i o n e f f o r t s have helped t o produce "a tremendous increase
i n the use o f condoms and s i g n i f i c a n t postponement o f the age o f f i r s t sexual
^rcourse," s a i d Peter P i o t , executive d i r e c t o r o f the United Nations Program
IV/AIDS.
" I f t h i s i s p o s s i b l e i n one o f the poorest c o u n t r i e s i n the w o r l d , why i s i t
not p o s s i b l e i n one o f the r i c h e s t c o u n t r i e s i n the world?" P i o t asked
p a r t i c i p a n t s a t a conference on STDs i n Tampa l a s t week, j o i n t l y sponsored by
the CDC and the American S o c i a l Health A s s o c i a t i o n .
Approximately 12 m i l l i o n Americans become i n f e c t e d w i t h STDs every year, w i t h
one-quarter o f the i n f e c t i o n s o c c u r r i n g i n teenagers. The N a t i o n a l Academy o f
Sciences' I n s t i t u t e o f Medicine concluded i n a r e p o r t l a s t month t h a t " p u b l i c
awareness and knowledge r e g a r d i n g STDs are dangerously low" and t h a t "an
e f f e c t i v e n a t i o n a l system f o r STD p r e v e n t i o n c u r r e n t l y does not e x i s t . "
Gayle, d i r e c t o r o f the CDCs N a t i o n a l Center f o r HIV, STD and TB Prevention,
s a i d more e f f e c t i v e treatment o f STDs would "have a major impact f o r some p a r t s
of the HIV epidemic" i n the U n i t e d States. But she questioned whether an
i n t e n s i v e treatment e f f o r t l i k e the Tanzanian one would be e q u a l l y s u c c e s s f u l i n
t h i s c o u n t r y , where -- i n c o n t r a s t t o A f r i c a - - a m i n o r i t y of H I V - i n f e c t e d
people a c q u i r e the v i r u s through heterosexual i n t e r c o u r s e .
"The r e a l i t y i s t h a t t h i s i s not A f r i c a or Asia, and w h i l e we have the
h i g h e s t r a t e s o f STDs i n the Western world, i t i s s t i l l not the same d r i v i n g
f o r c e f o r the epidemic across the n a t i o n as i t i s i n much o f the developing
w o r l d , " Gayle s a i d . " I f we d i d the Mwanza experiment here, would we have the
same e f f e c t ? "
i the Mwanza study, which i n c l u d e d more than 8,000 s u b j e c t s , a new c l i n i c
; s t a b l i s h e d t o t r e a t STDs i n a d u l t s i n s i x r u r a l communities. A f t e r two
years, the r a t e o f new HIV i n f e c t i o n s i n those communities was compared w i t h
t h a t i n s i x s i m i l a r communities where people were not t r e a t e d a t a s p e c i a l STD
c l i n i c . The research team, l e d by Heiner Grosskurth o f the A f r i c a n Medical and
Research Foundation, found t h a t 1.2 percent o f p r e v i o u s l y u n i n f e c t e d study
p a r t i c i p a n t s i n the communities w i t h the STD c l i n i c had acquired HIV, compared
w i t h 1.9 percent o f those i n the comparison communities, which i s considered a
significant difference.
Encouraged by these r e s u l t s , o t h e r researchers from Columbia U n i v e r s i t y ,
Johns Hopkins U n i v e r s i t y and the Ugandan M i n i s t r y o f H e a l t h are conducting a
f o u r - y e a r study of mass a n t i b i o t i c treatment f o r STDs i n more than 9,000 people
i n Uganda's Rakai d i s t r i c t , a r e g i o n w i t h n o t o r i o u s l y h i g h AIDS r a t e s . H a l f the
p a r t i c i p a n t s p e r i o d i c a l l y r e c e i v e doses o f t h r e e a n t i b i o t i c s , intended t o t r e a t
any n o n - v i r a l STDs they may have. The o t h e r h a l f get v i t a m i n s and p i l l s f o r
i n t e s t i n a l p a r a s i t e s , but not a n t i b i o t i c s .
Midway through the study, the frequency o f s e v e r a l STDs i s lower i n the
a n t i b i o t i c - t r e a t e d communities, but researchers w i l l not know the e f f e c t on HIV
t r a n s m i s s i o n f o r two more years, s a i d Maria Wawer o f Columbia U n i v e r s i t y .
Reports o f the A f r i c a n research were greeted e n t h u s i a s t i c a l l y by p u b l i c
h e a l t h o f f i c i a l s who have long been f r u s t r a t e d a t U.S. r a t e s o f STDs many times
h i g h e r than those found i n Western Europe. For example, l a s t year i n the U n i t e d
States, t h e r e were 150 cases o f gonorrhea per 100,000 people. (Among b l a c k
�PAGE
8
The Washington Post, December 16, 1996
teenage males i n i n n e r c i t i e s , t h e r a t e was 2,000 cases per 100,000 people.) I n
Sweden, t h e r e were 3 cases per 100,000 people.
i o t suggested European STD r a t e s are lower because t h e r e i s g r e a t e r p u b l i c
W i i i i n g n e s s t o discuss sexual matters, as w e l l as broader access t o sex
education, condoms and medical treatment. P i o t s a i d t h a t l a s t year, t w o - t h i r d s
of French teenagers r e p o r t e d u s i n g condoms the f i r s t time they had sexual
i n t e r c o u r s e . I n t h e U n i t e d States, o n l y 2.2 percent o f p u b l i c h i g h schools make
condoms a v a i l a b l e t o students and o n l y h a l f o f h e a l t h departments provide STD
treatment.
J u d i t h Wasserheit, d i r e c t o r o f the CDCs d i v i s i o n o f STD p r e v e n t i o n , s a i d she
hoped the conference and t h e recent I n s t i t u t e o f Medicine r e p o r t would provoke
"much more p u b l i c s c r u t i n y -- because we have t h e t o o l s [ t o prevent these
diseases] and we a r e n ' t u s i n g them."
AIDS p r e v e n t i o n programs, n a t i o n a l l y and a t the s t a t e and l o c a l l e v e l s , a r e
more p o l i t i c a l l y p o w e r f u l and f a r more generously funded than programs t o
c o n t r o l STDs. The f e d e r a l budget f o r f i s c a l 1996 i n c l u d e d $ 583 m i l l i o n f o r AIDS
s u r v e i l l a n c e and p r e v e n t i o n and $ 1.4 b i l l i o n f o r AIDS research, compared w i t h $
105 m i l l i o n f o r STD p r e v e n t i o n and $ 110 m i l l i o n f o r STD research.
Gayle s a i d advocacy groups "are very passionate about AIDS as an issue and
have b e n e f i t e d t o a c e r t a i n e x t e n t by the s p o t l i g h t . " STD p r e v e n t i o n , however,
"has n o t been something people have been w i l l i n g t o go and p i c k e t on C a p i t o l
H i l l about."
LANGUAGE: ENGLISH
-DATE: December 16, 1996
�EVENT SCENARIO
EVENT:
Site v i s i t
DATE:
F r i d a y , March 28, 1997
TIME:
10:30 a.m.
LOCATION:
The AIDS I n f o r m a t i o n Centre - K i s e n y i
PARTICIPANTS:
FLOTUS and d e l e g a t i o n , Mrs. Museveni,
M i n i s t e r o f H e a l t h Dr. C r i s p u s Kiyonga,
D i r e c t o r o f t h e AIDS I n f o r m a t i o n Centre Mary
Grace Alwano-Edyegu, Ambassador and Mrs.
Southwick, o t h e r GOU and l o c a l o f f i c i a l s ,
o t h e r U.S. M i s s i o n p e r s o n n e l . (See a t t a c h e d
f o r l a r g e r guest l i s t and f o r sample
invitation.)
OBJECTIVE:
To h i g h l i g h t t h e g l o b a l t h r e a t o f t h e AIDS
epidemic, and t h e USG e f f o r t s t o a s s i s t t h e
Government and people o f Uganda i n r e s p o n d i n g
t o t h e epidemic. To emphasize t h e importance
of e d u c a t i o n i n c o m b a t t i n g t h e spread o f AIDS
and i n d e a l i n g w i t h t h e consequences o f AIDS.
OVERVIEW:
FLOTUS a r r i v e s a t t h e AIDS I n f o r m a t i o n Centre
and proceeds t o D i r e c t o r ' s o f f i c e f o r
b r i e f i n g and t e s t i m o n i a l s . FLOTUS t a k e s t o u r
of AIC b u i l d i n g ending i n h a l l where TASO
drama group p e r f o r m s . FLOTUS moves o u t s i d e
h a l l and c u t s r i b b o n t o i n a u g u r a t e AIC
b u i l d i n g and makes b r i e f remarks. FLOTUS
departs.
BACKGROUND:
See a t t a c h e d .
TALKING POINTS
See a t t a c h e d .
Speech."
PROTOCOL:
TBD
PRESS:
Open
PHOTO-OP:
Yes
TRANSLATION:
No
GIFT:
Presented i n advance.
ADVANCE:
- The AIDS I n f o r m a t i o n Centre
A l s o see a t t a c h e d "Suggested
, White House Advance Team
�SITE OFFICER:
, White House Advance Team
Dr. Elizabeth Marum, U.S. Mission - Kampala
�GUEST LIST - THE AIDS INFORMATION CENTRE:
Janet Museveni, F i r s t Lady o f Uganda
Mary Grace Alwano-Edyegu, D i r e c t o r , AIDS I n f o r m a t i o n Centre
Sophia Mukasa-Monico, D i r e c t o r , The AIDS Support O r g a n i z a t i o n
Dr. E l i z a b e t h Madraa, Program Manager, STD/AIDS C o n t r o l Program,
M i n i s t r y of Health
Dr. C r i s p u s Kiyonga, M i n i s t e r o f H e a l t h
Ambassador Shinsuke, Japanese Ambassador
P r o f e s s o r James Sengengo, Chairman, AIC Board o f D i r e c t o r s and
Dean o f F a c u l t y o f S o c i a l Sciences, Makerere U n i v e r s i t y
C h r i s t o p h e r Iga, Mayor o f Kampala
Monica Uzamukunda, AIC c l i e n t who w i l l t e l l h e r s t o r y
R i c h a r d Ongom, AIC c l i e n t , Chairman o f post t e s t c l u b drama group
Grace Nakaunde, l e a d s i n g e r i n t h e TASO drama group
Dr. E l i z a b e t h Marum, T e c h n i c a l A d v i s o r i n HIV/AIDS, USAID/Uganda
Ambassador and Mrs. Southwick
�AIDS
INFORMATION
CENTTRE
The Executive Board and Management of
AIDS INFORMATION CENTRE
to tke Inauguration Ceremony oftkeir flew Office* Lj. Mrs. Hillary Rodham Clinton,
aif
of tke presiclent
of the Irfniled ^talei
vife of tke f-^reiuLnl
1 1\30
of tke ^epuLiic
of^Ameruxu, in tke company,
of Uganda.,
am at-^$-$2^^\3nformalion
on 28tk
Iffjarck
of Mrs. Janet Museveni.
1 997
Centre ^J4earl^itarleri
from
10.30
am to
^Kiienyi
R.S.V.P (REQUIRED)
Exscutiva Director
AIDS Information Centre
P. O. Box 10446 T«L: 271433
KAMPALA! UGANDA
PLEASE BRING THIS CARD TO OBTAIN ENTRANCE
�BACKGROUND:
The AIDS I n f o r m a t i o n Centre (AIC) i s a non-governmental
o r g a n i z a t i o n ( p r i v a t e n o n - p r o f i t ) which p r o v i d e s v o l u n t a r y and
anonymous HIV t e s t i n g and c o u n s e l i n g . AIC r e c e i v e s f u n d i n g from
USAID and t e c h n i c a l a s s i s t a n c e from t h e U.S. Centers f o r Disease
C o n t r o l and P r e v e n t i o n .
The AIDS I n f o r m a t i o n Centre was e s t a b l i s h e d i n 1990 by a
c o n s o r t i u m o f Ugandan and e x p a t r i a t e p r o f e s s i o n a l s t o respond t o
the growing demand from Ugandans t o l e a r n whether o r n o t t h e y a r e
i n f e c t e d w i t h t h e AIDS v i r u s . Since 1990, AIC has served over
320,000 Ugandans, and now operates i n Kampala, J i n j a , Mbarara,
and Mbale.
I n a d d i t i o n t o HIV t e s t i n g and c o u n s e l i n g , AIC o f f e r s l o n g term
support t h r o u g h t h e " p o s t - t e s t c l u b , " whose members a r e a c t i v e i n
community e d u c a t i o n and o u t r e a c h s e r v i c e s . The AIDS I n f o r m a t i o n
Centre r e c e n t l y moved i n t o a new b u i l d i n g c o n s t r u c t e d f o r AIC i n
a h e a v i l y p o p u l a t e d slum area o f Kampala; p r e v i o u s AIC work i n
t h i s area documented v e r y h i g h r a t e s o f HIV i n f e c t i o n i n t h i s
community. The USG c o n t r i b u t e d about h a l f o f t h e t o t a l funds
r e q u i r e d f o r t h e b u i l d i n g ; about 3 0 p e r c e n t came from t h e fees
which AIC c l i e n t s pay t o r e c e i v e t h e c o u n s e l i n g and t e s t i n g ; and
the remainder i s from t h e Government o f Japan.
The r a t e o f new HIV i n f e c t i o n i n Uganda i s d e c r e a s i n g .
Behavior
change r e s u l t i n g from p u b l i c e d u c a t i o n i n c l u d i n g r e d u c t i o n i n
c a s u a l p a r t n e r s , d e l a y i n g o f f i r s t sex by teenagers, and condom
use a l l appear t o be c o n t r i b u t i n g t o t h e d e c l i n e .
The AIDS I n f o r m a t i o n Centre and i t s s i s t e r o r g a n i z a t i o n . The AIDS
Support O r g a n i z a t i o n (TASO) b o t h support "drama groups" which,
drawing on t h e o r a l t r a d i t i o n s o f Ugandan c u l t u r e , p r e s e n t songs
and s m a l l s k i t s t o community groups, churches and s c h o o l s as a
v e h i c l e f o r education/community o u t r e a c h . Both drama groups w i l l
p r o v i d e b r i e f performances.
The TASO drama group members a r e
a l r e a d y i n f e c t e d w i t h HIV. The group's motto i s " l i v i n g
p o s i t i v e l y w i t h AIDS" and i t emphasizes AIDS e d u c a t i o n , how t o
a v o i d HIV i n f e c t i o n , and t h e need t o p r o v i d e compassionate care
t o people l i v i n g w i t h AIDS.
Note: AIC and TASO use t h e term " c l i e n t s " f o r t h e i r
b e n e f i c i a r i e s . Terms such as "AIDS people," " p a t i e n t s , " "AIDS
p a t i e n t s , " e t c . , s h o u l d be avoided i n f a v o r o f terms such as
"people l i v i n g w i t h AIDS" o r "people l i v i n g w i t h HIV i n f e c t i o n . "
�TALKING POINTS:
- - I am d e l i g h t e d t o j o i n you t o inaugurate t h i s new b u i l d i n g . I
am glad t h a t the United States was able t o a s s i s t i n funding
construction of the f a c i l i t y . The f a c t t h a t user fees also paid
f o r a p o r t i o n of the b u i l d i n g demonstrates the p o t e n t i a l f o r t h i s
a c t i v i t y t o be s e l f - s u s t a i n i n g .
--The AIDS epidemic i s an issue the world over, e s p e c i a l l y i n the
United States. I t i s encouraging t o meet so many people coping
c o n s t r u c t i v e l y w i t h the disease. You are an example t o us i n the
United States, and t o other countries i n A f r i c a and throughout
the world s t r u g g l i n g w i t h the epidemic.
I commend the
imagination and energy which has gone i n t o the musical and
dramatic productions which are used t o spread information about
AIDS.
- - E f f o r t s i n the b a t t l e against AIDS are beginning t o have some
e f f e c t . The r a t e of new i n f e c t i o n s of HIV i n Uganda i s
decreasing. This holds out the promise that over time, t h i s
disease can be overcome.
- - I appreciated the t e s t i m o n i a l s by the two i n d i v i d u a l s who have
shared w i t h us t h e i r personal experience w i t h AIDS. Their
s t o r i e s were both moving and i n s p i r a t i o n a l .
�Uganda:
V i s i t to AIDS Information Center
Context
The AIDS Information Center (AIC) i s a non-governmental
organization which provides voluntary and anonymous HIV t e s t i n g
and counseling. AIC receives funding from USAID and t e c h n i c a l
assistance from the U.S. Centers f o r Disease Control and
Prevention.
The AIDS Information Center was established i n 1990 by a
consortium of Ugandan and e x p a t r i a t e professionals t o respond to
the growing demand from Ugandans to l e a r n whether or not they had
been i n f e c t e d w i t h the AIDS v i r u s . Since 1990, AIC has served
over 320,000 Ugandans, and now operates i n Kampala, J i n j a ,
Mbarara, and Mbale.
In a d d i t i o n to HIV t e s t i n g and counseling, AIC o f f e r s long term
support through the "Post-Test Club," whose members are a c t i v e i n
community education and outreach services. The AIDS I n f o r m a t i o n
Center r e c e n t l y moved i n t o a new b u i l d i n g constructed i n a
heavily-populated slum area of Kampala; previous AIC work i n t h i s
area documented very high rates of HIV i n f e c t i o n i n the
community. The United States c o n t r i b u t e d about h a l f of the t o t a l
funds r e q u i r e d f o r the b u i l d i n g ; about 30 percent came from fees
which AIC c l i e n t s pay to receive the counseling and t e s t i n g ; and
the remainder came from the Government of Japan.
The r a t e of new HIV i n f e c t i o n i n Uganda i s decreasing.
Behavior
change r e s u l t i n g from p u b l i c education, i n c l u d i n g r e d u c t i o n i n
casual partners, delaying of f i r s t sex by teenagers, and condom
use a l l appear t o be c o n t r i b u t i n g to t h i s d e c l i n e .
P r i o r t o the ceremony which w i l l take place at the Center during
your v i s i t , you w i l l be b r i e f e d on AIC services by i t s D i r e c t o r ,
tour the f a c i l i t i e s , and speak w i t h several men and women who
have b e n e f i t t e d d i r e c t l y from the p r o j e c t . You w i l l then cut a
ribbon to inaugurate the new AIC b u i l d i n g . During the ceremony,
one woman and one man w i l l give personal " t e s t i m o n i a l s " about
t h e i r experience l e a r n i n g about AIDS through the AIC.
The AIDS I n f o r m a t i o n Center and i t s s i s t e r o r g a n i z a t i o n , the AIDS
Support Organization (TASO), both support "drama groups" which,
drawing on the o r a l t r a d i t i o n s of Ugandan c u l t u r e , present songs
and small s k i t s t o community groups, churches and schools as a
v e h i c l e f o r education/community outreach. Both drama groups w i l l
provide b r i e f performances. The TASO drama group members are
i n f e c t e d w i t h HIV. The group's motto i s " l i v i n g p o s i t i v e l y w i t h
AIDS" and i t emphasizes AIDS education, how to avoid HIV
i n f e c t i o n , and the need to provide compassionate care t o people
l i v i n g w i t h AIDS.
�Note: AIC and TASO use the term " c l i e n t s " f o r t h e i r
b e n e f i c i a r i e s . Terms such as "AIDS people," " p a t i e n t s , "AIDS
p a t i e n t s , " etc., should be avoided i n favor of terms such as
"people l i v i n g w i t h AIDS" or "people l i v i n g w i t h HIV i n f e c t i o n . "
11
Objectives
o
To h i g h l i g h t the global t h r e a t of the AIDS epidemic, and U.S.
e f f o r t s t o a s s i s t Ugandan's i n responding t o the epidemic.
o
To emphasize the importance of education i n combatting the
spread of AIDS and i n dealing w i t h the consequences of AIDS.
Talking Points
—
I am d e l i g h t e d t o j o i n you to inaugurate t h i s new b u i l d i n g .
I am glad t h a t the United States was able t o a s s i s t i n paying
f o r the construction of the f a c i l i t y . The f a c t t h a t user
fees also paid f o r a p a r t of i t demonstrates the p o t e n t i a l
f o r t h i s a c t i v i t y t o be s e l f - s u s t a i n i n g .
The AIDS epidemic i s an issue the world over, i n c l u d i n g i n
the United States. I t i s encouraging t o meet so many people
coping c o n s t r u c t i v e l y w i t h the disease. You are an example
to us i n the United States, and t o other countries i n A f r i c a
and throughout the world s t r u g g l i n g w i t h the epidemic. I
commend the imagination and energy which has gone i n t o the
musical and dramatic productions which are used t o spread
information about AIDS.
E f f o r t s i n the b a t t l e against AIDS are beginning t o have some
e f f e c t . The r a t e of new i n f e c t i o n s of HIV i n t h i s country i s
decreasing. This holds out the promise t h a t over time, w i t h
a great deal of e f f o r t on a l l of our p a r t s , t h i s disease can
be overcome.
I appreciated the testimonials by. the two i n d i v i d u a l s who
have shared w i t h us t h e i r personal experience w i t h AIDS.
Their s t o r i e s were both moving and i n s p i r a t i o n a l .
�Participants
Those attending the ceremony w i l l include the s t a f f of the
Kampala AIDS Information Centre and some s t a f f members
representing the other branches located i n Mbarara, J i n j a , and
Mbale. C l i e n t s of AIC w i l l also be i n v i t e d , e s p e c i a l l y members
of the Post-Test Club. I n a d d i t i o n , o f f i c i a l s from the M i n i s t r y
of Health and the Kampala C i t y Council are l i k e l y t o attend.
The f o l l o w i n g i n d i v i d u a l s are expected to take p a r t i n the
activity:
Janet Museveni, F i r s t Lady of Uganda
L^fary Grace Alwano-Edyegu, D i r e c t o r , AIDS Information Centre
Sophia Mukasa-Monico, D i r e c t o r , the AIDS Support Organization
LJ>r. E l i z a b e t h Madraa, Program Manager, STD/AIDS Control
Program, M i n i s t r y of Health
uEr. Crispus Kiyonga, M i n i s t e r of Health, Government of Uganda
Ambassador Shinsuke, Japanese Ambassador (from Nairobi)
Professor James Sengengo, Chairman, AIC Board of D i r e c t o r s , and
Dean of the Faculty of Social Sciences, Makerere U n i v e r s i t y
Christopher Iga, Mayor of Kampala
Monica Uzamukunda, AIC c l i e n t who w i l l t e l l her s t o r y
Richard Ongom, AIC c l i e n t , Chairman of the Post-Test Club Drama
Group
Grace Nakaunde, lead singer i n the TASO Drama Group
D^.. E l i z a b e t h Marum, t e c h n i c a l advisor i n HIV/AIDS,
USAID/Uganda (on assignment from the U.S. Centers f o r Disease
Control and Prevention)
Ambassador and Mrs. Michael Southwick
L
�• NOV 01 '96
10:23Rf1 CBS hEWS
-
n 8. BRAQLEYt
Decades after the last U.S.G.I. took leave from Vletnaa
for "R and R" In places like Thailand and the Philippines,
Anerican and aany other foreigners continue to flock to
Southeast Asia for prostitutes— prostitutes who year by
year sees to be getting younger and younger.
And with this Increasing focus on young girls, the sex
trade in Asia has become so profitable that i t "is now"
spilling over into the less-developed countries of the
region.
In Caabodia alone there are now sone 20,000 underage
prostitutes, nany as young as twelve and thirteen years
old.
P
'
2
�P.3
NOV 01 '96
10:23flM CBS NEWS
60 MINUTES
"R
& R IN SOUTHEAST ASIA"
VOL. XXIX, NO. 7
OCTOBER 2 1 , 1996
ED BRADLEY:
In Phnom Penh, Cambodia's Capital, brothels dot the streets of
many poor neighborhoods. Laurence Gray, of the humanitarian
group,
World Vision,
runs
a program
for disadvantaged
children.
His research revealed a wide open trade in
prostituted
children,
including
the marketing
of young
virgins, who bring a premium price for the pimps.
LAURENCE GRAY:
W were offered a girl two weeks ago for $1,000. And we asked
e
i f we could-- you know, for that money we would want to take
her
away. And we were told for that money, we could take her
away, and k i l l her i f we wanted to.
ED BRADLEY:
And k i l l her?
LAURENCE GRAY:
And k i l l her.
ED BRADLEY:
What are the ages of these girls?
LAURENCE GRAY:
The ages that we're aware of, they range from nine years of
age.
�P.4
NOV 01 '96 10:24RM CBS N W
ES
-2-
-
ED BRADLEY:
Nine?
.i
LAURENCE GRAY:
Yes.
Nine.
ED BRADLEY:
And, i s i t uncommon to find twelve, thirteen-year-olds?
LAURENCE GRAY:
I t ' s - - disturbingly, i t i s not uncommon. I t i s quite easy to
locate twelve or thirteen-year-old girls in the brothel areas.
ED BRADLEY:
So, one Sunday afternoon, we went with an interpreter and a
hidden camera to a neighborhood on the outskirts of Phnom
Penh, where there are dozens of brothels, most of them
offering a selection of young girls for sale.
Within minutes
of entering one brothel, the owner displayed several young
girls, including these two.
INTERPRETER:
Thirteen, fourteen.
ED BRADLEY:
So, she's thirteen years old, and she's fourteen?
INTERPRETER:
Yes.
�P.6
•
NOV 01
'96
10:24An CBS fCWS
-3- " - .
ED BRADLEY:
How much are they?
INTERPRETER:
I t ' s $400 dollars.
ED BRADLEY:
Four hundred dollars?
INTERPRETER:
Yes.
ED BRADLEY:
The market for prostituted children i s being fueled in part by
what have come to be known as sex tourists - - and the sex tour
promoters who send them to Asia, many of whom now shop their
services on the Internet.
60 MINUTES Associate Producer
Jon Wells, posed as a sex
tourist, and contacted several U.S.-based sex tour operators.
All of them indicated they would arrange a sex tour to Asia
for him.
He sent a check to one tour operator, who publishes
this book on Asian prostitutes; a book that begins with a
warning, that traveling overseas for the purpose of having sex
with a child, i s a crime, but goes on to explain exactly ho*
to do i t .
I t even devotes a section to underage g i r l s .
The
company arranged to provide this woman as a tour guide foi
Wells' trip to Thailand. We provided the hidden camera.
�P.7
NOV 0 1 ' 9 6
10:24PM CBS NEWS
-4-"-.
ED BRADLEY:
The guide introduced Wells to Bangkok's thriving commercial
sex industry; go-go bars, nightclubs arid massage parlors, a l l
in reality, brothels of one form or another that cater to
Western men; many of them, American.
..
—
II II i i T i i i n r i m m
i nr mi
•
When the tour guide took us to a beach resort 100 miles south
of Bangkok, she said she had taken many American sex tourists
there, who were looking for underage g i r l s .
JON WELLS:
"And, how old i s the g i r l with the blue T-shirt?"
TOUR GUIDE:
"Fifteen."
JON WELLS:
"She's fifteen.
She's afraid."
TOUR GUIDE:
"Very afraid.
JON WELLS:
" h i s she afraid?"
Wy
TOUR GUIDE:
"She's children.
A child."
ED BRADLEY:
She said the g i r l i s afraid because she's a child.
said the price was $20 dollars.
Her pimp
But when he delivered the
g i r l to the lobby of our hotel, Wells called off the deal.
�P.8
NOV 0 1 ' 9 6
10:25AM CBS rEWS
-5-
^ .
JON WELLS:
" I changed my mind.
He can keep the-- he can keep his money.
I t ' s alright."
ED BRADLEY:
At that moment the young g i r l ' s r e l i e f was obvious.
The President of the outfit we hired for t h i s tour goes by the
name of Mac Horn, a pen name he used to author h i s e x p l i c i t
"how-to" sex tour book.
He didn't know we'd hired him weeks
e a r l i e r to arrange that tour for our Associate Producer, and
a photographer with a hidden camera.
Do you arrange sex tours to Asia for American men?
MAC HORN:
No.
ED BRADLEY:
You don't?
MAC HORN:
Not personally.
I - - I - - what I re-- I've never taken anyone
on a sex tour, person
ED BRADLEY:
But you arrange for them to go?
MAC HORN:
Well, I have, reluctantly, sent a few.
five men.
Not very many, four or
�NOV 01 '96
P
10:25tt1 CBS NEWS
*
9
-S- ' - .
ED BRADLEY:
You introduce men to women, to girls, through your guide.
MAC HORN:
No.
ED BRADLEY:
You don't?
MAC HORN:
What-- not-- well, my guide takes them-- for example, my guide
will take them to-- to
ED BRADLEY:
To a place where they
(OVERLAPPING)
MAC HORN:
To a place where they can
ED BRADLEY:
can meet underage women.
MAC HORN:
Well-- well, no. No. M guide does not take them places
y
where they can meet underage women.
ED BRADLEY:
W wanted to find out what your business was a l l about. So,
e
we hired you to arrange a sex tour for "60 MINUTES." Did you
know that?
M C HORN:
A
No.
�P. 10
NOV 01 '96 10:25fn CBS rCWS
-7-
-.
ED BRADLEY:
I'd
like to-- you to take a look at a section of this
videotape
M C HORN:
A
Sure.
ED BRADLEY:
I t shows our Associate Producer at a Thai brothel. being
offered a g i r l , who said she was 15 years old. This was a l l
arranged by the tour guide we paid you to provide for us.
Alright?
JON WELLS: (ON TAPE)
" o old i s the g i r l i n the blue T-shirt?"
Hw
W M N (ON TAPE)
OA:
"Fifteen."
JON WELLS; (ON TAPE)
"She's fifteen?
She's afraid?
Why i s she afraid?"
W M N (ON TAPE)
OA:
"Look, she's children.
A child."
M C HORN:
A
That's a very unusual situation.
ED BRADLEY:
Why i s i t unusual?
M C HORN:
A
Well, i t ' s unusual because you-- you don't encounter that age
factor.
That's very rare.
�NOV 01 '96
P
10:25AM CBS rEWS
-8-
*
1 1
-
ED BRADLEY:
No, i t ' s not very rare!
You don't have to look very hard or
very far to find underage prostitutes. " This g i r l was just 12
years old when she took a job in, what she thought was a
restaurant i n a Thai beach resort, but turned out to be a
brothel, catering to foreign sex tourists. She says the owner
forced her into prostitution.
You were there for over a year, in-- in a typical night, how
many men did you have sex with?
GIRL: (BY TRANSLATOR)
On a regular night, i t was 12 or 13 men.
But i f i t was a
holiday, i c was 20 to 30.
ED BRADLEY:
And,
she says she was paid less than a dollar a day.
Three
months after she began working, she says the owner told her
that she'd tested HIV-Positive, and then threatened her with
beatings so she would not t e l l the customers.
So, after you tested Positive, for the next year you continued
to have sex most nights with ten, twelve men?
GIRL:
Yes.
(BY TRANSLATOR)
I just continued working.
And I didn't t e l l the
customers, because I was afraid of the owner.
�P 12
NOV 81 '96
10:25flM CBS r<EWS
-9- ' ED BRADLEY:
And she told us very few of her customers used condoms.
.i
In Thailand, like many countries in this region, the supply of
young girls continues to answer the demand of sex tourism
because prostitution i s seen by many as an answer to poverty.
Catholic Missionary Father Joe Maier, an American whose been
in Bangkok for 25 years, sees examples a l l too often; examples
Tike this woman. She left the slums of Bangkok for the local
sex districts, catering to foreigners; not to s e l l herself,
but to s e l l her daughter, who, at the time, was 11 years old.
FATHER JOE MAIER:
So, the neighbors were down selling their kids, and she said,
" I ' l l s e l l mine."
ED BRADLEY
Sell for prostitution.
FATHER JOE MAIER:
Well, for-- yeah.
Sell directly for prostitution.
ED BRADLEY:
Why would she s e l l her children?
FATHER JOE MAIER:
She wants some money. And her old man beats her.
He drinks.
She says i t ' s - - you know, "what do I do? Do I s e l l my kid, or
have him beat me and scream at me, and I don't give him
Whiskey money?" So she s e l l s - - s e l l the kid i s the easiest
thing to do.
I t ' s the easiest way out.
�NOV 01
'96
P. 13
10:26tt1 CBS FEWS
-10-
-,
ED BRADLEY:
This i s big business here?
FATHER JOE MAIER:
Oh, i t ' s
ED BRADLEY:
Sex tourism?
'•
FATHER—JQ]3 MAIER:
Totally big business.
7
And--
-—
ED BRADLEY:
and-- the-- the prostitutes are getting younger?
FATHER JOE MAIER:
Oh, yeah.
They're getting much younger.
Becauae they got
this crazy idea that-- well-- well-- well, i f we get younger
ones, then they've never been used sexually. And-and-- and therefore, we won't get AIDS.
and--
So, yeah. I t ' s going
younger.
ED BRADLEY:
The poverty that leads some parents to s e l l their children
into prostitution, i s not confined to the slums of Bangkok.
Many of the young g i r l s who end up in brothels, come from the
H i l l Tribe country, 500 miles to the North.
Here, in this area, known as the Golden Triangle near the
boarder with Burma, middlemen often come to villages, looking
for young girls to buy, offering a couple hundred dollars for
a virgin.
And up here, that's a lot of money.
$250 dollars
i s enough to feed a family of five for six months.
�P. 14
NOV 01 '96
W-ZSPH CBS fCWS
-11- " - .
ED BRADLEY:
American Baptist Missionary, Lauren Bethal, runs a program
that works with many g i r l s who've been sold into prostitution
by their parents.
Do you see a difference in the-- the prostitutes you would see
in this country compared to prostitutes in the United States?
LAUREN BETHAL:
Prostitutes in Thailand are coming from situations where they
are desperate to help their mothers and fathers and brothers
and sisters. And so, they w i l l sacrifice themselves for their
families, even as-- working as prostitutes.
I don't think
prostitutes in the west are generally sending money back home
to M m and Dad.
o
ED BRADLEY:
This young girl, Bunong, now 18 years old, was just 13 when
she came to Bethel's attention.
She had been rescued from a
brothel for the second time, by Thai police. Both times she'd
been sold by her father, who wanted money to support his opium
habit.
*
LAUREN BETHAL:
He also has explained to me that he feels that his l i f e i s
more important than theirs. And that, whatever they can do to
help him to live longer i s - - i s really what should happen.
�NOV 01 '96
P. 15
10:26flM CBS rOJS
-12-'
- .
ED BRADLEY:
H w does she feel about what hap-- what's happened to her?
o
BUNONG: (BY TRANSLATOR)
She said, " I wondered why my father would do something like
that.
And I feel very bad."
ED BRADLEY:
Is she angry at him?
BUNONG:
(ANSWERS IN FOREIGN LANGUAGE
BEGINS TO CRY)
ED BRADLEY:
But yet, she comes back home to help him.
BUNONG:
Yeah.
ED BRADLEY:
Concerned that the same fate awaits Bunong's two younger
sisters, Lauren Bethal -- after months of trying -- finally
convinced the father to give up the two youngest daughters to
her care.
LAUREN BETHAL:
They're learning how to read and write, and become literate.
ED BRADLEY:
The g i r l s will eventually end up here, in the city of Chaing
Mai,
where Bethal runs three shelters that provide food,
housing, education and vocational training for over 200 young
g i r l s ; some of them, former prostitutes.
�NOV 01 '96
P
10:26flM CBS NEWS
LS
''
-13-"-.
ED BRADLEY:
Others are from impoverished
or broken homes, what Bethal
calls high-risk situations that, too often, push young.girls
into prostitution to help their families.
The education and
vocational training gives them new career choices; choices
that can keep them out of the reach of sex tourists and sex
tourism promoters, like Mac Horn.
Do you think that these-- these young Asian g i r l s have made a
career choice to be a prostitute?
MAC HORN:
Some of them, yes, and some of them, no.
Most of them are in
the prostitution because of their-- in order to support their
family.
And so, you do have parent-- parental consent.
And, I'm
ED BRADLEY:
So, that's okay that the parents have sold their children. . . .
MAC HORN:
Well, i t ' s apparently okay with them.
ED BRADLEY:
Do you feel any culpability in aiding and abetting that?
MAC HORN:
Absolutely not.
�NOV 01 '96
P
10:27AM CBS rCWS
'
1
7
-14-" - .
ED BRADLEY:
In your book you recommend people go to Cambodia, i f under 16
.i
i s your thing.
M C HORN:
A
I
ED BRADLEY:
You have pictures of 14-year-olds from Vietnam.
You say, in
your book, you t e l l people how to avoid getting picked up by
Thai police.
M C HORN:
A
Yeah.
ED BRADLEY:
So, you're telling someone else who wouldn't know how to do
i t , H W TO D IT!
O
O
M C HORN:
A
Well, I'm telling them how to do i t because I'm telling them
how others have done i t .
ED BRADLEY:
And you're telling them how to do i t , Mac. There's no way
around i t !
M C HORN:
A
Well, I'm-- okay.
I mean, i f - - i f they're gonna use i t that
way, then that's fine.
�P 18
NOV 01 '96
10:27AM CBS rEWS
-15- • - .
ED BRADLEY:
So, what other reason would you put i t in the book
,
<
M C HORN:
A
Well
ED BRADLEY:
i f you weren't going to t e l l them how to get around i t ?
M C HORN:
A
Because I'm ex-- I'm explaining my-- I've met-- you know, I ' l l
be honest with you, I've met guys who have-- do have sex with
underage girls.
I've met them, and I know how they operate.
That doesn't mean that's how I do i t , and that doesn't mean
that's how I'm gonna set up a tour so you can do the same
thing.
ED BRADLEY:
If you're the kind of person who wants to go to Thailand and
have sex
M C HORN:
A
If.
ED BRADLEY:
with an underage g i r l , Mac here, i s gonna t e l l you how
to do i t .
M C HORN:
A
I'm gonna t e l l you-- I'm gonna t e l l you how to-- how to do i t ,
yes.
I'm gonna t e l l you how others have done i t .
�P. 19
.'• N V 01 '96 10:27flM CBS NEWS
O
-16-"-.
ED BRADLEY:
You don't have a problem with that?
M C HORN:
A
No.
I don't have a problem with that at a l l .
I'm not--
because I don't feel like I'm advocating or promoting people
to go out there and have sex.
ED BRADLEY:
Through your book, through your travel brochure, through your
company, you're making i t possible for Westerners to go to
Asia, and have sex with underage g i r l s .
There's some people
who would c a l l you nothing more than a pimp. You're making
money off of i t .
M C HORN:
A
Well, I'm not making-- I'm-- I'm-- I don't consider myself a
pimp, by any stretch of the imagination.
ED BRADLEY:
The fact i s , i t doesn't take any stretch of the imagination.
�1996.07.09 : 11th International Co... Plenary Speech, Vancouver,lfltpiJWtaaisgate.hhs.gov/cgi-bin/wa...l513010+32+0+0&WAISaction=retrieve
REMARKS BY:
PLACE:
DATE:
DONNA E. SHALALA, SECRETARY OF HEALTH AND HUMAN
SERVICES
11th I n t e r n a t i o n a l Conference on AIDS, Vancouver, Canada
J u l y 9, 1996
Plenary Address, 11th International Conference on AIDS
Dr. Rekart, Secretary de la Fuente, distinguished guests:
We come here today from different countries, with different languages, different cultures, and different
religions. But, a common bond unites us — our commitment to protecting the health of women, men, and
children the world over.
It is that commitment that I have come here this morning to discuss with you. Because, in just fifteen
years — the time it takes to raise a child from birth to adolescence — a wave of human destruction has
swept over our planet.
In that time, HIV has claimed the lives of more than six million people. And, we expect that more than 5
million children under age 10 will be orphaned because of this insidious virus.
We know that women constitute more than 40 percent of adult HIV infections around the globe. By the
end of the century, experts predict that most new HIV infections will be among women. We know that
biologically and socially women are more vulnerable to HIV infection. We know that HIV expresses
itself differently in women than it does in men.
And, as we approach the dawn of the 21st century, we know that the real faces of AIDS include our
mothers and our sisters, our children and our nieces, our neighbors and our friends.
But, they are not alone. Because, in the face of this tragedy, there are also glimmers of hope.
In just three years, we have traveled from the despair of Berlin to the hope of Vancouver. Not false hope.
But, hope grounded in science.
Under the leadership of President Clinton, the United States has dramatically increased its commitment
to combatting HIV and AIDS around the world — planting the seeds of today's and tomorrow's victories
by re-focusing and re-energizing our research agenda.
By creatingfrankand honest public education campaigns.
By directly involving non-governmental organizations and people living with HIV in the planning and
implementation of our AIDS strategy.
By forging partnerships with our pharmaceutical industry, experts from academia, and members of the
AIDS community to remove bureaucratic roadblocks and speed the development of AIDS- related
vaccines and drugs - including protease inhibitors.
And, by continuing to support international efforts - especially the extraordinary work of the new
United Nations AIDS program - and its visionary leader, Dr. Peter Piot.
Like anything worth doing, the seeds of these investments have taken time to root. Yet, planted in the
memory of those we could not save, and nourished with love and vision their flowers have now started
to bloom, bearing the sweetest fruit of all for women and children around the world — results.
What do I mean by results?
I mean that, thanks to the brilliant work of scientists worldwide, thanks to the wonderful leadership of
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Dr. Bill Paul and Dr. Tony Fauci at the National Institutes of Health and our steady investment in basic
science, we know that the use of AZT can reduce the risk of perinatal transmission of HIV by as much as
two-thirds.
We now know that sexually transmitted diseases increase a woman's risk of HIV infection.
And, thanks to nearly a decade of hard work, we now have a powerful weapon in our battle to help those
living with HIV and AIDS - the new class of drugs called protease inhibitors.
The development, approval times, and promise of these new drugs have been nothing less than
remarkable. Three new drugs in one year - each one in record time.
Clearly, we still need more information about these drugs - information about their long-term effects,
how to best combine them, when to administer them, and how to avoid resistance.
But, in the dark shadows of Berlin, who would have ever imagined that we'd be talking about
suppressing HIV in the bloodstream?
We must do more than imagine now.
i
We must work to ensure that our greatest breakthroughs are placed firmly within the grasp of every
citizen.
No citizen of the world — no matter where they live or how little money they have — should be
sentenced to misery while their brothers and sisters are reaping the benefits of our sustained investment
in science.
But, even as we work to improve the length and quality of life of all citizens living in the shadow of HIV
and AIDS, we must remember that our battle against HIV and AIDS is far from over.
We must remember that there is only one clear road to victory, only one way to stop this disease from
touching the lives of any more families, any more children.
We must prevent the transmission of HIV - before it ever happens.
That's why we will never give up our fight to develop a vaccine and find a cure.
That's why we're sending clear messages to our citizens: encouraging them to abstain from sex and drugs
or insist that their partners use latex condoms consistently and correctly.
And, that's why, until there is a cure, our first priority has been - and must always be - prevention.
Today I am pleased to announce a new comprehensive, integrated research strategy for AIDS prevention
led by the National Institutes of Health and the Centers for Disease Control and Prevention.
We're increasing our investment in research designed to prevent the transmission of HIV — research into
vaccines, into human behavior, and into new forms of prevention. And, as a central part of this strategy,
we're stepping up our efforts to develop topical microbicides for women.
Today, too often, women must rely solely on their male partner for protection from HIV. And, in too
many cases, that means no protection at all.
We all know this must change.
All women must have the tools they need to protect themselves and their children — free from the fear of
abuse or condemnation.
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With a safe and effective topical microbicide, women all over the world will be educated and
empowered to prevent HIV.
I am proud of the fact that, in the past three years, we have nearly tripled our investment in microbicide
research. And, I am asking NIH and CDC to continue to increase that investment over the next four
years.
These two agencies plan to spend a cumulative total of more than $100 million in microbicide research
over the next four years. That's a real investment in women's health and women's lives.
Today, we ask our partners — from the pharmaceutical industry to the leaders of other nations, from
researchers to those living with HIV -- to join with us in this - and every other -- fight.
Let me be clear: Any breach in international solidarity is a victory for the virus.
As Ghandi said, "We must become the change we want to see."
So, together, let us challenge ourselves to continue to support biomedical research, uncovering great
scientific discoveries that educate and empower women to protect themselves against HIV and other
sexually transmitted diseases.
Let us educate men — especially our young men ~ to respect women and to protect their families by
taking personal responsibility for preventing the spread of disease.
And, let us never forget the underlying socioeconomic factors that prevent women from protecting
themselves and their families.
Because, our battle against HIV and AIDS is also a battle against racism, sexism, poverty, and
homophobia. And, as citizens of the world, we must continue to confront these battles - individually
and collectively - if we are to win the war against AIDS.
Because, if we are to conquer HIV ~ and I firmly believe that we will — it will take more than passionate
speeches.
It will take education and action. It will take loud voices and bold visions. It will take the courage and
commitment of scientists and advocates alike.
But, it must be done. It will be done.
In the names of those who have been affected by HIV and AIDS throughout the globe ~ citizens we
have lost and those fighting to survive — all of us must join hands, now and forever, in the fight to reach
our common goal, in the fight to save our planet.
Thank you.
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�98.12.01:Rotavirus Colloquium, New Delhi, India
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DONNA E. SHALALA, SECRETARY OF HEALTH AND HUMAN SERVICES
R o t a v i r u s Colloquium, New D e l h i , I n d i a
December 1, 1998
Making Vaccines Avaulable, Affordable and Effective
I'm honored to join you today as we mark the tenth anniversary of the Indo-U.S. Vaccine Action
Program, and recommit ourselves to combating infectious disease all over the world.
The Pali Canon, a sacred Indian text written over 2,000 years ago, notes simply-yet eloquently-"disease
is sorrow." And in 1918-1919, no one would have doubted that statement. Seventy-nine years ago, the
worst virus the world has ever known sent a wave of death crashing around the globe. In just eleven months, the Spanish flu pandemic claimed 40 million victims worldwide-possibly half in India-and
infected the majority of humanity. Never had a disease been so global in scope.it respected no national
border.no national flag.and no family or community.
In cities and towns around the world, the pandemic produced scenes from a Gothic horror novel-but it
was all too real. The dead were left in gutters-while death carts roamed the streets in a surreal scene from
Medieval times. And as the death toll mounted, orderly life began to break down. Schools and churches
closed; farms and factories shut down; homeless children wandered the streets, their parents vanished!
The acting U.S. Army Surgeon General calculated that if the pandemic continued its mathematical rate
of acceleration-it soon could spell the end of humankind.
But then, as silently, as mysteriously, as quickly as it came, the vims vanished. When the pandemic
eventually waned, it was soon pushed off the front pages.and out of the public imagination. Today, it's
largely forgotten.
But as we confront a growing number of emerging and re-emerging infectious diseases-from dengue in
India to hantavirus in the U.S.-we must not forget the lessons of our century's first plague. Perhaps more
than any other epidemic, the Spanish flu episode illustrates that diseases spread across borders of
culture, language and territory. We aren't protected, in the words of Indian poet Rabindranath Tagore,
"by narrow domestic walls." Diseases can destabilize governments, and destroy fragile communities and
economies. Above all, the Spanish flu taught us that there can be no international security without
international health security. They are-and always will be-one and the same.
Because infectious diseases recognize no borders, in our fight against them, neither can we. The only
way that we can get infectious diseases to exit the world stage is if governments, world health
organizations, the private sector and academia work together to attack them with a global strategy.
Because we all share a common future, we must stand on common ground.
And because, as we've seen time and time again, when we do work together-we win. In 1977, we
eradicated smallpox from every nation on earth-and we removed one of history's deadliest killers from
the medical books, and consigned it to the history books. We're now doing the same with measles,
hoping to write the final chapter on this childhood scourge. By 1996, measles reached record low levels
in the Americas, and transmission of the disease has been interrupted in many other countries. And
polio, which once attacked Presidents and poor children alike, may soon join smallpox in the history
books. Since 1988, when the World Health Organization launched its campaign to eradicate polio,
there's been an 80 percent reduction in reported cases, worldwide. My department is supporting the
international assignment of 30 long-term epidemiologists, technical officers, virologists and data
managers to help the WHO and various countries combat the disease. And I know that India, which
shoulders 60 percent of the world's polio burden, is undertaking a range of polio fighting
initiatives-including national immunization days.
We need a similar global strategy-a similar global commitment-if we also want to put an end to the
second great plague of the twentieth century-AIDS. As we mark World AIDS Day, we must make it
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clear that any breach in international solidarity is a victory for the virus. We must remember that AIDS
is destroying millions of lives-attacking the body and assaulting the spirit. And because this disease is
surrounded by fear and ignorance, those afflicted by it-perhaps as many as 900,000 in the U.S. and at
least one million in India- too often face social isolation and the loss of community support. As the
nation dealing with more AIDS cases than any other, India must be an important partner in the global
effort to develop, evaluate, produce and introduce vaccines to prevent the spread of HIV, and to reduce
AIDS deaths in India and around the world.
That's just one of the reasons why I was proud to join Minster Alagh, the Minister of State for Science
and Technology, last Friday to sign a joint statement that extends the Indo-U.S. Vaccine Action Program
for five more years. One of our most successful partnerships, for 10 years this jointly funded program
has sustained a broad spectrum of immunization related activities that benefit both our countries-and the
world. It's supported U.S.-Indian vaccine research on cholera, malaria, AIDS, typhoid and other diseases
of priority for India. It's improved our understanding of infectious diseases. And it's helping to fill the
Indian-and the global-need for new and more effective infectious disease vaccines and diagnostics.
The very existence of the Vaccine Action Program also recognizes that preventive vaccines are among
the most cost effective health technologies. And that their widespread use is key to controlling,
preventing and one day eradicating many infectious diseases. That day may now be dawning for
rotavirus-the most common cause of severe childhood diarrhea. As many of you know, rotavirus
globally affects 130 million children under the age of 5 every year. Resulting in possibly 800,000
deaths-That's 800,000 children who will never have the chance to reach adulthood.never have the chance
to reach their dreams. And almost 25 percent of these deaths occur in India. In fact, more children die in
a single day.every day.every year.from rotavirus.than all the people who have died from Ebola,
hantavirus and Lassa Fever, combined, in world history.
But we may now be able to offer these children a lifeline. Because clinical trials have shown that the
new, "first generation" vaccine is safe.80 percent protective against severe rotavirus.and capable of
preventing the dehydration that actually leads to death. And although tests in Brazil and Peru were
inconclusive about the vaccine's effectiveness in developing countries, you may be aware that the latest
study from Venezuela shows that the vaccine holds as much promise for the developing world as it does
for the U.S. and elsewhere. Routine childhood immunizations for rotavirus could immediately bring the
curtain down on a major public health problem.and help lift up the world's children.
The "first generation" rotavirus vaccine is certainly a scientific success story. But we now need to focus
our attention on the development and testing of the next generation, vaccines that are being developed to
specifically attack the strains of rotavirus found in India.and the first candidate vaccines to ever result
from Vaccine Action Program research. These vaccines are promising, but they won't be able to save
one child.or spare one family grief.or stop one epidemic.unless we make them available.affordable.and
effective. Notice 1 said "we." In this world without borders, these are challenges that government cannot
meet alone. Challenges which require the leadership of the pharmaceutical industry. Challenges that we
must meet, not only for rotavirus-but for all new vaccines. And challenges which I want to address
today.
Our first challenge is to make vaccines available. This requires an ongoing public-private partnership as
we move a new vaccine from development to delivery. We saw that with rotavirus. Only joint publicprivate research and testing enabled us to reach the point where the "first generation" rotavirus vaccine is
ready. The vaccine was originally developed in a lab at the United States' National Institute of Allergy
and Infectious Disease, after years of academic and government collaboration. But it couldn't prevent a
single illness.it couldn't protect a single child, if it remained sitting on a laboratory shelf. Wyeth Lederle
eventually entered into an agreement with the lab to commercially develop it. And both parties
contributed personnel, equipment and supplies to the effort-with the government lab also providing
funding. When the vaccine was judged ready, Wyeth sponsored the necessary clinical trials which
showed it to be safe and effective. And now it's up to the private sector to move the vaccine into
marketing...move it from the halls of science into the hands of those who need it.and make it available to
the world. Without the private sector's involvement in commercial development and marketing, new
vaccines may remain unavailable, and unable to make their appearance on the world's stage.
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But once a vaccine is available, then what? That brings us to our second challenge. We need to ensure
that vaccines are not only available, but affordable. Although many infectious diseases are democraticstriking the rich and poor without discrimination-it's particularly the developing world that bears the
brunt of their attacks. So we must work together to make sure that the price of a new vaccine doesn't put
it beyond the reach of those populations that need it most. Tiered pricing arrangements for new vaccines,
or other strategies, may need to be instituted for the developing world. I'm reminded that over 2,200
years ago the great Indian leader Asoka-the first universal Emperor of India-was also the world's very
first ruler to preach a new, radical notion of government-one based on social compassion. That idea is
certainly still relevant for all of us here, as we struggle with the problem of making vaccines affordable
for those who need them most.
Our final challenge is to make sure that vaccines are effective-everywhere. For example, I know that in
the case of the rotavirus, the "first generation" vaccine is effective against the four most common strains
of the disease-which predominate in the developed world. But in some countries-especially India-the
diversity of strains is extensive. That's why we may need to develop a second generation vaccine to fight
these additional strains. The same is true for any new vaccine-we must ensure that we develop vaccines
that will effectively attack every strain of a disease, in every country. And when we're developing them,
we also need to study specific regional factors-such as nutrition and sanitation level-which, if not taken
into account, can affect the success of many vaccines and our ability to fight infectious diseases.
Think about it-when our century's first pandemic, the Spanish flu, engulfed the world some 80 years ago,
we didn't have this ability to fight it. Today, we have the ability to develop weapons to fight infectious
diseases-we just need the will.If we're willing to work together, we can meet the challenges of
availability, affordability and effectiveness..If we're willing to work together, one day our children will
have to turn to the dictionary-and not the newspaper headlines-to find the word "pandemic." And if we're
willing to work together, we can guarantee that our children-and their children-will remember the 21st
century as a time of health and hope.a time of promise and possibility.a time of medical miracles and
scientific marvels. I've no doubt that we can do it.that we must do it.that we will do it.
UM
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�1996.11.11 : Aaron Diamond Center Dedication Ceremony, New York, N.Y.
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DONNA E. SHALALA, SECRETARY OF HEALTH AND HUMAN SERVICES
Aaron Diamond Center D e d i c a t i o n Ceremony, New York, N.Y.
November 11, 1996
Confronting HIV/AIDS
We're here to celebrate a great private sector initiative in the battle against AIDS. But first, I want to say
something about Irene Diamond, who, like her late husband Aaron, is a real New York gem.
I actually first met Irene when I was the President of Hunter College and she was just starting the
Diamond Foundation. But I want to let you in on a little secret: Irene wasn't always such a
dyed-in-the-wool New Yorker.
In fact, before she came to New York and married Aaron, Irene was one of the leading story editors in
Hollywood, where she helped bring the great Bette Davis movies to the screen.
She even green-lighted an obscure little picture that nobody thought had much of a chance. Perhaps
you've heard of it: Casablanca.
I say this to make the point that Irene Diamond is no stranger to giving great things to the world. Irene
and Aaron gave us the Diamond Foundation to enrich New York, a city that had so enriched them.
The new, state-of-the art laboratory space that we dedicate today has already achieved that goal. But the
Diamond Center's impact will be felt far beyond the borders of this extraordinary city.
If past is prologue, the research of Dr. Ho and his brilliant colleagues could help satisfy a waiting world's
hunger for a vaccine and a cure.
Already, the scientists of the Diamond Center have given us new insight into how HIV does its dirty
work, and how to help tip the balance in favor of infected individuals.
Already, Diamond Center scientists have eliminated all detectable virus from the bloodstream and
launched studies to determine if we can eradicate HIV from those infected with it.
So I think I'm on solid ground when I speak of my high hopes for the Diamond Center. And that's what
I've come to talk about today: hope.
Vaclav Havel, the Czech prisoner-tumed-President, calls hope "a state of mind, not a state of the world."
Hope, he says, is "a dimension of the soul, an orientation of the heart."
Three years ago, I came before the AIDS community and suggested that the time had come to re-orient
our hearts toward hope.
It was a risky proposition, but in the wake of the Berlin conference, I was convinced that the pendulum
had swung too far toward despair.
I am, by nature, an optimist. And my feelings about AIDS had been reinforced by that heroic long-term
survivor, Michael Callen, who said: " I don't say hope will guarantee you'll beat AIDS - but you've got to
have hope to be in the running."
How I wish that Michael could have lived to see this day. A day when our hope rests upon the strongest
foundation of all: results.
Results, to be frank, whose seeds were planted before the White House became fully engaged in this
struggle in 1993.
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For we all know that as this terrible epidemic unfolded in the 1980s, the executive branch - with a few
courageous exceptions — did not lead.
It was the activists and the scientists and the foundations and some Members of Congress who pushed
ahead and set the course.
Now, for the first time, under President Clinton's leadership, you have an Administration that is a true
partner in this struggle - a Federal government on your side, pulling its weight, doing its part.
For the first time, you have an Administration that is really listening to the scientists and the other
experts, listening not only to your encouragement, but also to your frustrations.
And, it's paying off.
Four years ago, when the first Clinton Administration took office, there were few good treatment options
for people living with HIV and AIDS.
Today, we've approved - in record time — three new protease inhibitors that are extending and improving
the lives of people with HIV and AIDS. And more promising drugs are on the way.
When the Clinton Administration took office, the boldest federal AIDS prevention public service
announcement featured -1 kid you not - a man pulling up a sock.
Today, the CDCs "Respect Yourself, Protect Yourself campaign speaks frankly to young adults about
the importance of abstinence and the correct and consistent use of latex condoms.
When the Clinton Administration took office, the government's HIV/AIDS strategy wasn't adequately
addressing the needs of women, even though they account for 40% of cases worldwide.
Today, we are helping pregnant women to prevent the perinatal transmission of HIV to their babies.
We are focusing on the unique HIV/AIDS concerns of lesbians.
And earlier this year, I went to Vancouver to announce this Administration's commitment to spend $100
million on topical microbicide research over the next four years.
When the Clinton Administration took office, we were spending $385 million a year providing treatment
and services under the Ryan White CARE Act.
Today, that sum has grown to one billion dollars - including a tripling this past year of resources
dedicated to getting expensive new drugs to citizens in need.
Finally, when the Clinton Administration took office, we had no coordinated AIDS strategy.
Today, with the all-star team of Patsy Fleming in the White House; Helene Gayle at CDC; Joe O'Neill at
HRSA; and, of course, Bill Paul at the NIH, we have a coordinated plan of attack, and we are moving
forward on all fronts.
Since we are here to dedicate a research facility, I want to pay special tribute to Dr. Paul, who couldn't
be with us today, for the great work he has done to strengthen the Office of AIDS Research.
President Clinton and I fought hard during the last Congress and won significant authority for the OAR
to direct and guide the research agenda, including the ability to shift funds to meet emerging scientific
opportunities.
I want to thank the scientists and activists who stood with us in this fight. Throughout the years, you've
told us how important it is to focus on basic science and investigator-initiated research.
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And I'm proud that, at the OAR, that's exactly what we've done.
Since 1994, the Office of AIDS Research has increased investigator-initiated research by 40% and is
reorganizing our critical vaccine-research efforts. This commitment will continue as we implement the
Levine report.
Why? Because we know that we must nurture innovative research if we are going to fight - and win - the
battle against HIV.
And I know we can.
Just four years ago, who would have imagined that we'd join here today with new strategies, new
leadership, new resources and - most important - new results?
But this is a record to build on, not rest on. And as we dedicate this facility, we must rededicate
ourselves to finishing the job.
As President Clinton has said, "Our common goal must ultimately be a cure, a cure for all those who are
living with HIV, and a vaccine to protect all of us from the virus.
Listen very carefully to these words: a cure for all of those who are living with HIV - not just those
fortunate enough to have insurance or to live in the developed world.
For even as scientists work to achieve breakthroughs, those of us in policy-making positions must work
to ensure that those breakthroughs are placed firmly in the grasp of every citizen who needs them.
And, until there is a cure, we must ensure that our first priority continues to be prevention.
In that respect, I want to take a moment to commend Dr. Piot, the visionary leader of the Joint United
Nations Program on HIV/AIDS, for his initiatives to prevent TB and PCP in the developing world.
The Joint Program is built upon an idea, an idea that says we must all work together to defeat the
multi-headed monster that we call AIDS.
It is the same idea we must bring to all of our AIDS- related endeavors.
And it is the same idea that lies at the very foundation of the Diamond Center, a public-private
partnership in the truest sense of the word.
Today, I call upon this nation's great philanthropies and corporations to follow the Diamond
Foundation's example and to join with all of us in the fight against AIDS.
As you do, never forget that the battle against HIV and AIDS is also a battle against racism, sexism,
ignorance, poverty and homophobia.
And as you do, know that your federal government will stand with you, just as we are standing with the
Diamond Center today.
As Humphrey Bogart said in Casablanca: " I think this is the beginning of a beautiful friendship."
Thank you.
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DONNA E. SHALALA, SECRETARY OF HEALTH AND HUMAN SERVICES
White House, C o n g r e s s i o n a l Black Caucus Event on HIV/AIDS, Washington
October 28, 1998
Responding to the Crisis
Today, October 28, is an auspicious day for this occasion. Because today — exactly 200 years ago — was
the birthday of Levi Coffin, founder of the Underground Railroad. If Mr. Coffin were alive today, he
would see we've come a long and winding road since those days of shame. But I imagine he'd be
troubled by the crisis of HIV/AIDS in the African-American community, which has been kept
underground for far too long.
As the President has made clear, this Administration has been committed from the start to attack the
HIV/AIDS epidemic in America with every tool at our disposal. With the support of Congress, we've
boosted overall funding for AIDS-related programs by more than 90 percent since 1993. And we've
nearly tripled funding for the Ryan White CARE Act. At NIH, we launched a new vaccine research
center and challenged science to develop an AIDS vaccine in 10 years. At the FDA, our quicker AIDS
drug-approval process has brought forth 9 new AIDS drugs, 20 new drugs for AIDS-related conditions,
and three new diagnostic tests.
As today's announcement demonstrates, as the face of AIDS has changed, so have our strategies to
address it. A substantial portion of our federal AIDS dollars goes to serving racial and ethnic minorities.
Sixty-three percent of participants in AIDS clinical trials sponsored by NIH are minorities - 40 percent
are African-American. Forty-two percent of clients served by Title I of the Ryan White Act are AfricanAmericans. And last month, we made a down payment on boosting the ability of communities of color
to fight this health crisis, a down payment on the significant investment the President has announced
today.
Today is an important milestone. But we have miles to go before we complete the journey that Levi
Coffin began, and secure health equality for all Americans. But this milestone today signifies more than
a new push against HIV/AIDS. It signifies that when it really counts, Washington can pull together to
respond to the real needs of real people. It signifies that we have a creative, responsive federal
government. It signifies that democracy works - that a devoted group of lawmakers, community leaders
and activists can join forces, raise their voices, demand action, and hold our feet to the fire. Finally, this
day signifies that still have real, fire-in-the-belly leaders in Congress giving voice to the voiceless in
America — extraordinary leaders like Louis Stokes and Maxine Waters.
Dr. King was right when said, "Every step toward the goal of justice requires sacrifice, suffering and
struggle, the tireless exertions and passionate concern of dedicated individuals." Today we take a giant
step toward justice. And it's my honor to introduce a man whose leadership and concern made this day
possible — Congressman Louis Stokes. I have known Congressman Stokes since I was a teenager. He
was a law school classmate of my mother's. He leaves Congress with our highest praise, affection and
admiration - in particular for his outstanding leadership on minority health. The Congressman from
Cleveland, my dear friend, the Honorable Louis Stokes.
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�1999.02.25: National Conference on African Americans and AIDS
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DONNA E. SHALALA, SECRETARY OF HEALTH AND HUMAN SERVICES
N a t i o n a l Conference on A f r i c a n Americans and AIDS
February 25, 1999
Fighting AIDS in the African American Community
Thank you Phi 1 for your gracious introduction.
1
I've had the privilege of knowing Phill for many years. He has what George Bernard Shaw once called
the Life Force. That's the spirit that makes all things seem new again for everyone he touches. Last week
I was thinking about someone else with the Life Force.
Time magazine asked if I had any suggestions for their Person of the Century. Now there are some
questions I have to think long and hard about. But when it came to giving Time magazine a name, I
didn't have to think at all. I simply said: Nelson Mandela.
President Mandela is one of those rare people who, when the hammer of oppression strikes, the hammer
cracks. He never cracked. I mention President Mandela because as he closes out his remarkable political
career, the one thing he's been talking about a lot lately is another kind of oppression: AIDS.
Our nation does not face the magnitude of the HIV/AIDS catastrophe that now confronts Africa.
Nevertheless, as I'll discuss shortly, the burden of HIV/AIDS falls unequally on the African American
community.
President Mandela's warning that "silence fuels this epidemic" reminds us that shame, rumor,
misunderstanding - and, yes, silence, still shroud HIV/AIDS in our country, including the African
American community. That is why this conference is so important. You have not been silent. But many
of you have been left to wage this fight against HIV/AIDS quietly and alone. All that changes today.
Medical historians will someday write that this was the place - and black history month was the time when African American doctors, nurses, health professionals and advocates, and their sisters and
brothers in other countries, came to the forefront of the battle against HIV and AIDS. Now you are
united. Now you speak with one voice. Now you act with one purpose. So let me congratulate each of
you for making history today.
During the next two days, you'll be joining some of our nation's leading experts in discussing the causes,
prevention, care and treatment of HIV in the African American community. You'll be hearing from a
number of my colleagues: Dr. Eric Goosby, Dr. Earl Fox and Dr. Joe O'Neill.
But I want to talk with you as a partner - and I hope as a sister. Because this is a battle none of us government, practitioner or individual human being - can win alone. We must work together. Our
success depends on it. And so do the lives and futures of thousands of African Americans.
I'm not going to throw a lot of numbers at you. But there are at least two numbers that can't be ignored.
African Americans make up 13 percent of our nation's population. They also make up 45 percent of all
new AIDS cases. Compared with other racial and ethnic groups, African Americans have the highest
rates of HIV infection, the highest AIDS mortality rate, and the highest number of productive years lost.
These trends come on top of the disproportionate rates of cancer, heart disease, and stroke suffered by
African Americans. So as you know better than anyone, HIV/AIDS has come like an ill wind pushing
what was already a crisis in African American life expectancy even closer to the brink. A recent study by
Dr. David Kindig and his colleagues at the University of Wisconsin Medical School notes that HIV is
now one of the leading contributors to the gap in life expectancy between African Americans and whites.
If you're an African American male, you're almost 8 times more likely to have AIDS than a white male.
And if you're an African American woman you're almost 20 times - let me repeat that - 20 times more
likely to have AIDS than a white woman standing next to you. In fact AIDS - a preventable disease - is
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now the second leading cause of death for African American women in their most productive years of
life, and the leading cause for African American men the same age.
But there is another side - a more hopeful side - to this troubling picture. We're no longer in the early
days of this disease when our understanding of HIV was negligible - and our ability to fight AIDS was
non-existent. Today, because of the skill and caring of African American doctors, nurses, advocates and
all other medical professionals, the idea of people living with AIDS is neither a slogan nor a dream.
Working together, we've cut the overall death rate from AIDS almost in half in just one year - knocking
AIDS out of the top ten causes of death for the first time since the late 1980s. Perinatal transmission of
AIDS is down almost three-quarters. Combination drug therapies are not only extending life - they're
allowing people with AIDS to return to work - and to the lives - they led and loved. We've nearly tripled
funding for the Ryan White Care Act. This year we will spend nearly 8 billion dollars on HIV/AIDS.
But we're not just focusing on treating and preventing AIDS. We want to wipe this disease off the face
of the earth. That's why two years ago, the President issued a national call to arms to find a vaccine for
AIDS within ten years. You know how important these steps are. All of them are bringing us closer to
the day when we can join hands and celebrate the end of this dreaded disease.
But none of this progress means anything if AIDS simply passes from being a crisis for our nation to a
crisis sitting in the lap of the African American community. I believe that is morally unacceptable.
So let me be clear: Victory measured by any standard other than the total elimination of AIDS is no
victory at all. We must eliminate HIV/AIDS. That's why last year, President Clinton specifically called
for the elimination of racial health disparities in six critical areas - including HIV/AIDS. This
commitment to closing the gap in health between whites and minorities comes on top of our all out
assault on HIV/AIDS in the African American community.
That assault has been guided by three basic principles: Be comprehensive. Be inclusive. And, most
important, be unwavering until victory.
Let me talk briefly about all three.
Principle One: Have a comprehensive strategy.
We've learned from some of you that the only way to beat HIV/AIDS in the African American
community is to attack this disease from every direction. That's exactly what we must do - and do
together. Put out good prevention messages that are funded nationally - but designed locally.
Together - expand research that takes into account the needs of people living in urban communities.
Together - fund faith-based services.
Together - train health professionals at historically black colleges and universities.
Together - leave no stone unturned in the fight to prevent and treat HIV/AIDS.
The fact is, we're teaming up with advocates, scientists, health professionals, social organizations,
business and labor leaders, and people living with HIV/AIDS to beat this disease. Forty percent of the
participants in AIDS clinical trials are now African American. We're helping low income African
Americans without private insurance or Medicaid purchase the lifesaving drugs they need.
We've created HIV/AIDS treatment guidelines - that are regularly updated - and you can download from
the Web to help you treat your patients using the most up-to-date information.
We're working to break the link between substance abuse and AIDS - by funding comprehensive
substance abuse treatment programs at the local level - and specifically targeted to African Americans.
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Our Office on Women's Health and our Office of HIV/AIDS Policy are meeting with each other - and
with grassroots women's organizations - to come up with specific strategies for fighting HIV/AIDS in
African American women.
When I talk about a comprehensive approach to fighting AIDS -1 don't just mean programs. I mean
leaders too. I'm extremely proud of the team we've put together - starting with Dr. David Satcher, our
new Surgeon General. Dr. Satcher has made fighting HIV in the African American community a central
part of his life's work. He understands what this disease is doing to minority communities - and frankly
to Africa from where he just returned. Dr. Satcher has both the skill and the moral authority to lead us
toward an end to this epidemic.
Another member of our team is Dr. Margaret Hamburg. Dr. Hamburg was formally Commissioner of
Health in New York City. Today, her many duties include making sure that the President's goal - and
your goal - of eliminating health disparities is met.
And with me this morning is Dr. Marsha Martin - my special advisor on HIV/AIDS and homelessness.
When Marsha talks, I listen.
Principle Two: Be inclusive when decisions are made.
We don't want to impose programs and ideas on the African American community. We want to listen,
learn, and fight as a team.
So, our strategy is not top down. It's bottom up. It's about helping you fund your projects. Implement
your ideas. Support your prevention and treatment programs. That's the strategy we built on as we've
worked with the Congressional Black Caucus. The Caucus is very concerned that African American are
not benefiting equally from the available treatment and good prevention strategies that have brought
down the mortality rate - and rate of new infections - for other communities. Frankly, they have a point.
One recent study concluded that among HIV infected adults living with an advanced stage of the disease
- a disproportionate number are male, African American and poor. We also know that African
Americans are less likely to be tested for HIV; have less access to the newest treatment regimens; and
have experienced a less sharp decline in death rates following the introduction of new anti-retroviral
therapies.
So last October, the President teamed up with the CBC and announced an additional 156 million dollars
to enhance the federal response to HIV/AIDS in racial and ethnic minority communities. These funds
will support leaders on the front line. Leaders like you. And their purpose is to build on progress already
made by hundreds of community based organizations in the African American community - where the
real work of fighting AIDS is taking place. I should add, we're asking for even more funds next year to
address disparities in HIV/AIDS. A full 171 million dollars.
We also have Crisis Response Teams that are targeting minority communities with a high concentration
of HIV. The teams will only come in at the request of political and health leaders at the community level
- and will include experts trained to meet the specific needs of each community. Finally, our Office of
Minority Health, works closely with African American communities across the United States - as a
resource for information and referral, and as a vehicle for receiving policy guidance from advocates and
health professionals.
Principle Three: Be absolutely unwavering in our determination to bring this epidemic to an end.
Churchill said it best: Never, never give up.
That's the attitude you have about HIV/AIDS. My colleagues in the Administration and I share it every
waking minute. Still, I'm not here to tell you we can win this battle today, this month or even this year.
But I am here to tell you: Together, we will win, and we won't quit until we do.
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With your strong voices - and help from Congress - we've increased funding for AIDS-related programs
by more than 90 percent since 1993. Our budget request for next year is close to 4.5 billion dollars,
including an additional 100 million dollars for Ryan White, money that will boost the areas most
important to the African American community. That means prevention. Encouraging people to know
their status. Early intervention. Access to quality care. And purchasing drugs that fight HIV.
But, again, this fight is not just about programs or money. It's about heart. And it's about character.
I can tell you, the President, the Vice President and the First Lady have all spoken passionately and
eloquently about how we cannot turn a blind eye to what HIV/AIDS is doing to African Americans. The
fact is, at the end of our lives, we will all be judged by our commitment to ending this terrible epidemic.
We absolutely must not fail.
I've come full circle, because as I said at the beginning of my remarks, the way to make sure we don't
fail is to continue to work as partners. You are the leaders of this battle. We know that - and we need you
to stay involved.
For that reason, I urge you to learn as much as you can about identifying, preventing and treating
HIV/AIDS in the African American community. Download our treatment guidelines. You can find them
at www.hivatis.org. Encourage your patients to get tested and know their HIV status. That includes
pregnant women. Ask questions - and be on the look out for risky behaviors that can lead to HIV
infection.
Work with your local communities - in schools, civic organizations, businesses and homes. Also work
with our Health Resources and Services Administration. We can help you with referrals; finding
community based services; and funding. Use your skills, training and knowledge of the African
American community to first close the gap in who gets AIDS, and then to close the door on AIDS.
After seeing the AIDS Quilt, a student in Virginia Beach recently wrote this about AIDS: " I lost my
uncle to this disease a few years ago. It frightens me to think that some people could have been spared
for this disease if only they had been educated."
Another student, this one from Wellsville, Missouri wrote: " I don't think the kids at my school actually
realize how many people have died from AIDS, and how many die each year. Everybody thinks it can't
happen to them - but it can." That's the real reason we're here today.
To teach. To prevent. To stop the fear. To make sure it doesn't happen to anyone anymore.
This conference - and your leadership - will bring that day, if not within sight, certainly within reach.
Thank you.
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�t
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REMARKS BY:
PLACE:
DATE:
http://waisgate.hhs.gov/cgi-bin/wa...9513265+43+0+0&WAISaction=retneve
DONNA E. SHALALA, SECRETARY OF HEALTH AND HUMAN
SERVICES
World Health O r g a n i z a t i o n
B e i j i n g , China
September 5, 1995
Women's Health Day
GOOD EVENING:
[Thanks and acknowledgements]
I am honored to join all of you tonight and to represent the United States government at this important
conference on the health of women.
Together, we are joining hands across continents and cultures to improve the health of women from Peru
to Paris - from Lebanon to Los Angeles -- from Senegal to Singapore.
In just fourteen years — the time it takes to raise a child from birth to adolescence ~ a wave of human
destruction has swept over our planet. In that time, HIV has claimed the lives of more than six million
men, women, and children. And today, more than 18 million citizens of the world are living with this
insidious virus.
We know that women constitute more than 40 percent of adult HIV infections around the globe - and,
tragically, that number is growing.
In my own country, last year more than 14,000 women were diagnosed with AIDS, representing nearly
one-quarter of all cases among women reported since 1981.
We know that — biologically and socially — women are more vulnerable to HIV infection.
We know that HIV expresses itself differently in women than it does in men.
And, as we approach the dawn the 21st century, we know that the real faces of AIDS include our
mothers and our daughters, our sisters and our aunts, our neighbors and our friends.
The face of AIDS is the 30 year-old woman in Zimbabwe who is struggling to survive with her partner,
who is also infected with HIV.
The face of AIDS is the 24 year-old woman in London who exchanges sex for food and shelter and is
now living with AIDS.
The face of AIDS is the 42 year-old woman in Los Angeles who, having unknowingly infected her
children, must watch her family disintegrate before her eyes.
And, the face of AIDS is the 11 year-old girl in the Philippines forced to raise herself because both of
her parents were stolen away by this cruel pandemic.
But, these women are not alone.
Because, in the face of this tragedy, there are also glimmers of hope — women, from around the world,
using their minds and bodies and souls, researching vaccines and cures, raising money and raising
awareness, holding families together, and fighting for policies that will help stop this disease ~ and heal
those it strikes.
And, that's exactly why we are here.
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We meet today to demonstrate our solidarity against HIV and AIDS, our determination to conquer it,
and our commitment - now and always - to compassionately support those members of our global
family who have been affected by it.
Let me be clear: Any breach in international solidarity is a victory for the virus.
Because AIDS does not discriminate.
It knows no boundaries of geography or gender; ethnicity or employment;
It makes no distinctions based on age, nationality, or sexual orientation.
And, our efforts must be just as universal in scope.
In the United States, we have significantly increased the resources devoted to combatting HIV and AIDS
at home and around the world.
We have re-focused and re-energized our research agenda and developed frank and honest public
education campaigns.
We have — as a matter of national policy - directly involved non-governmental organizations in the
planning and implementation of our AIDS strategy.
And, through it all, we are working tirelessly to empower women to protect themselves against HIV and
other sexually- transmitted diseases.
I'm talking about not only developing and approving the female condom - but giving women the skills
they need to negotiate sexual interactions and protect themselves.
I'm talking about doubling our research commitment to develop a topical microbicide that prevents HIV
infection and allows women ~ privately - to protect themselves from HIV and other sexually
transmitted diseases.
I'm talking about capitalizing on the landmark results of AIDS Clinical Trials Group 076. The evidence
that we can block perinatal transmission of HIV with a drug has created a bright ray of hope for
countless women and their children.
And I'm talking about providing appropriate and compassionate care to all those who are living with
HIV and AIDS. We can make their lives better, if not longer, but it will require greater will and greater
resources.
But it is clearly not enough.
To meet this challenge, all of us must encircle the globe, creating an international front to stop the spread
of this disease and the pain and suffering it causes.
As members of the global family, the people of the United States remain committed to the international
partnership against HIV and AIDS.
The President's budget includes $121 million for direct assistance to international AIDS activities —
demonstrating the United States continued commitment to these efforts as the lead bilateral contributor.
We are also firmly supporting the new United Nations AIDS Program and its visionary director, Dr.
Peter Piot, who, in just a few short months, have made tremendous gains.
The success of UNAIDS - and the success of every other international effort - w i l l depend upon all
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nations committing their hearts, their minds, and their resources to get the job done.
So, before we leave here tonight, let us challenge ourselves to improve and expand education programs
that teach women about their own bodies - so that they can protect their own lives.
Let us educate our men — especially our young men — to respect women and take personal responsibility
for preventing the spread of disease.
Let us continue to support biomedical research - uncovering great scientific discoveries that empower
women to protect themselves against HIV and other sexually transmitted diseases.
Let us make treatment for sexually transmitted diseases available to men and women - so that we can
reduce - and one day eradicate - this critical co-factor to HIV infection.
And, above all, let us never forget the underlying socioeconomic factors that prevent women from
protecting themselves and their families. Because, our battle against HIV and AIDS is also a battle
against racism, sexism, poverty, and homophobia.
And, we must continue to confront these battles — individually and collectively — if we are to win the
war against AIDS.
As citizens of the world, it is our responsibility to stand up for the rights of people with HIV and AIDS
— it is our responsibility to wipe out discrimination as we work to wipe out this deadly disease.
Because, if we are to conquer HIV — and I firmly believe that we will - it will take an unprecedented
level of international cooperation and collective action.
It will take courage and creativity;
It will take passion and perseverance;
It will take loud voices and bold visions.
But, it must be done.
It will be done.
In the names of those who have been affected by HIV and AIDS throughout the globe — citizens we
have lost and those we may lose ~ All of us must join hands — now and forever — to fight to reach our
common goal.
Thank you.
###
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REMARKS BY:
PLACE:
DATE:
DONNA E. SHALALA, SECRETARY OF HEALTH AND
HUMAN SERVICES
"Respect Y o u r s e l f , P r o t e c t Y o u r s e l f " Press
Conference
November 30, 1995
Respect Yourself, Protect Yourself
GOOD MORNING:
Thank you for joining us.
Last week, our country-reached another sad milestone in our fifteen year battle with AIDS. The Centers
for Disease Control and Prevention reported that more than half a million men, women, and children
have now been diagnosed with AIDS, and more than 300,000 Americans have lost their lives to this
relentless killer.
This epidemic is taking a particularly heavy toll on young Americans. In 1993, AIDS became the
leading cause of death among Americans between the ages of 25 and 44. And between 1993 and 1994,
the number of AIDS-related deaths in that age group rose 8 percent.
We know that AIDS is only the final stage of a long-term illness that begins with an infection that can
occur 10 or more years before diagnosis. That means that many of the Americans who are dying in their
20s, 30s, and 40s, were infected in their teenage years and their 20s.
The November 24 issue of "Science" includes a new study prepared by Dr. Philip Rosenberg of the
National Cancer Institute giving us even greater cause for alarm about our young adult population. The
study shows that cases of AIDS have increased much more rapidly among individuals bom in 1960 or
later.
As you can see by the chart behind me, new cases of AIDS are rising rapidly among young adults and
peaking as they reach their late 20s and early 30s.
What we have is a generation in jeopardy, and it is up to us to take action now to reverse these tragic
trends before a new generation of leadership for this country begins to be wiped out by the AIDS
epidemic.
The new public service campaign we are launching today ~ "Respect Yourself, Protect Yourself «
offers young adults the information they need to stay healthy. The NIH study shows that as each
generation of Americans reach their late teens and early 20s, they enter a danger period with very high
levels of HIV infection.
These public service announcements are specifically designed to reach adults between the ages of 18 and
25 with a balanced message of abstinence, prevention, and responsibility. They use the words and
experience of young adults themselves to urge this generation to exercise their personal responsibility to
protect themselves from HIV.
We know that prevention efforts work to slow the rate of HIV infection in targeted population groups.
We have seen some remarkable success, for example, among older gay white men, where infection rates
were at their highest when this epidemic began and have come down considerably in recent years.
The key to successful prevention efforts is that they must be targeted. And they must be sustained over a
period of years and even generations. We cannot start and stop because if we do that, this epidemic will
just keep going and going.
Two years ago, our country took an important step forward when we launched the Prevention Marketing
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Initiative, aimed at young adults 18 to 25. We offered young adults the accurate information they need to
protect themselves from HIV. We told them that abstinence is the best way to avoid sexual transmission
of HIV. And we told those who are sexually active that they must use latex condoms consistently and
correctly to significantly reduce their risk of infection.
This campaign is beginning to work. We have seen signs of greater understanding of and use of
condoms and we have seen promising signs of a greater degree of sexual abstinence in young people and
a growing movement toward what is called "secondary virginity." For those who have begun to have sex
early in their lives to choose to abstain is a sign of increasing personal responsibility.
But we cannot stop here. The latest trends show that we have a great deal of work to do, so we are
rolling up our sleeves and getting to work. I'd like to ask Dr. David Satcher, the director of the Centers
for Disease Control and Prevention, to join me and describe this exciting new campaign.
###
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�3/28/97
FIRST LADY HILLARY RODHAM CLINTON
REMARKS TO THE PEOPLE OF UGANDA
NILE CONFERENCE CENTER
KAMPALA, UGANDA
MARCH 28,1997
�Acknowledgments: Mrs. Museveni; Vice President Kazibwe [Kah-Zee-Bway]; Deputy
Speaker Okwir [Oh-Kwee]; Minister Mukwaya [Moo-Kwy-yah; Minister of Gender and
Community Development]
It seems fitting that we gather on Good Friday - a day that marks the passage from
sorrow and despair to hope and renewal.
For that is the journey that Uganda and so many of the countries of Africa have taken in
the last 10 years.
Just over two weeks ago, I stood at a podium in the State Department and spoke about
why I was coming to Africa. I wanted to come to Africa to highlight Africa's economic and
democratic renewal. To remind Americans of the importance of our partnership with Africa. To
underscore how our modest contribution in foreign aid yields enormous results ~ helping
countries to invest in their people, providing a framework for Africa's growth and increasing
trade between our countries, and strengthening democracies and democratic institutions.
I also knew that Africa had a positive story to tell - one that Americans could learn from.
All across Africa, individuals and communities are coming together, forging bold and creative
solutions at the grassroots level and at the highest reaches of government.
�Today, I can say that this trip has exceeded my most optimistic expectations. In Senegal,
in South Africa, in Zimbabwe, in Tanzania, and now in Uganda, I have been privileged to see
Africa's renewal firsthand.
Nowhere has Africa's progress been more impressive than in the building of democracy.
Until recently, there were only 5 democracies on this continent. In the last 6 years, that number
has jumped to 23.
But democracy is not just about one election, it is about free and fair elections that are
repeated successfully. It is also about other essential processes and institutions: a functioning
parliament and an independent judiciary. It is about political parties, a free press, and the basic
rights of assembly and association.
Now that we have seen democracy emerge strongly on this continent, the questions for all
of us who care about the future of democracy in Africa are: What can be done to sustain and
deepen this democratic transformation? What is needed to ensure that these new democracies
take root and prosper? How can we spur other nations to make the transition to sustainable
democracy?
To thrive, a democracy depends on other essential elements. It should be too obvious to
point out -- but, too often, it isn't -- that the health of a democracy depends on empowering and
enabling average citizens to participate fully in the decisions that touch their lives.
3
�It depends, in short, on what you are doing here in Uganda. The efforts I have seen here and all across Africa ~ are essential to building a vibrant democracy.
A vibrant democracy requires that all women become full participants in their
society. For too long, in too many places, both in Africa and around the world, women have
lived on the outskirts of opportunity. Yet we know we cannot build the kind of future we want
without the contributions of women. Over the last two weeks, I have been privileged to see
women shaping their own destinies, and the destinies of their countries - building homes on a
worn patch of land in Cape Town...learning to manage a health clinic in a village in Senegal..and
working to reform the laws affecting property ownership and inheritance rights in Zimbabwe and
Tanzania.
Women are playing a greater role than ever in Uganda. Women's rights are now
enshrined in your constitution. Women in Uganda have been welcomed into the government. As
President Museveni has rightly said, "Women form more than half of our society, so you'd be
hurting yourself if you left behind six of every 10 people."
�To your wise President I would add: "You wouldn't just be hurting yourself -- you
wouldn't be living in a democracy." A democracy without women's full participation is a
contradiction in terms. Only when women's rights - the fullness of human rights -- are
respected, can women begin to experience the authority over themselves that is the bedrock of
the democratic experience. Only then can they begin to experience the consciousness of full
citizenship, and the action it inspires.
Moreover, women will not flourish — and neither will democracy — if they continue to be
undervalued in and outside the home. Women constitute 70 percent of the world's poor. Women
must be assured the opportunity to earn a decent income and become economically selfsufficient. This means investing in the great untapped reservoir of human potential that women
represent.
If half the citizens on this Earth are underpaid, uneducated, under represented, fed less,
fed worse, not heard, threatened by violence in their own homes ~ we cannot sustain the
democratic values and way of life we have all come to cherish.
A vibrant democracy requires investing in people through education and health
care. What I saw at the Seguku School this morning, and what I saw in visiting with students in
Senegal, South Africa, and Tanzania, is a commitment to education, and thus, a commitment to
the future.
�At Seguku, I heard how teachers, as part of a national effort, are getting better training. I
saw new and creative learning materials in the hands of children. And, in an energy-filled
classroom, 1 saw the results of your government's promise of free and expanded primary
education.
While this commitment has put tremendous pressure on your schools, it has provided
infinite hope for your people. Two million new students nationwide have registered for school.
Since last year, the enrollment at Seguku has nearly doubled, to almost 1,200 children.
There was something else I saw at Seguku that is crucial to cultivating a democracy:
Seguku values the education of girls. In fact, more girls graduate from Seguku than boys.
Through this commitment, Uganda is building a solid foundation for its people. The
single most important investment any nation can make is in the education of girls and women. In
country after country, the benefits of educating women go far beyond the classroom and the
schoolhouse. They turn up in stronger families, better nutrition, higher wages.
They also result in a real democracy. By telling girls that if they work hard and make the
grade, they can have a rightful place in society, you are supporting the most democratic of ideals:
The belief that every citizen, regardless of where they come from or who they are, is entitled to
his or her rightful share of personal, political, economic, and civic power.
�Just as teaching people to read and to write is essential to strengthening democracy, so,
too, is investing in health and addressing public health challenges. In every country I have
visited, I have seen progress in providing access to a full spectrum of low-cost, high-yield healthcare services.
Uganda's world-leading efforts to educate its people against HIV and AIDS is a clear
demonstration of this kind of commitment. I saw this firsthand today at the AIDS Information
Center. The center has served 320,000 Ugandans. It has taught people about the dangers of HIV.
And it has given hope to those infected with the virus.
The center is part of a broader campaign to slow the spread of AIDS - one in which the
government has assumed an important responsibility, but where non-governmental organizations
are also playing a critical role. Since I have been in your country, I must have passed a dozen
billboards with AIDS prevention messages. It is clear that Uganda has made an all-out
commitment to stopping AIDS. And as a result, Uganda is the only country in Africa where the
rate of new HIV infections is actually decreasing. As the Taso group sang to me this morning,
Ugandans are fighting to ensure that "AIDS cannot win."
�In Zimbabwe, I saw a similar commitment to building democracy through better health «
this time through family planning. Zimbabwe is giving women the knowledge they need to
determine for themselves how many children they want to have -- and when they want to have
them. As a result of Zimbabwe's cutting-edge family planning clinics, fertility rates are falling
and contraceptive use is high. Infant mortality rates are low for the simple reason that healthier
women are having healthier babies. Good family planning is resulting in stronger families and
better opportunities for women and children.
A vibrant democracy requires that all its people are given the opportunity to
participate fully in the economic life of their countries, and to raise their own standard of
living.
It is clear that democracy cannot thrive, or long survive, in an environment of poverty and
despair. It will only prosper where people have reason to hope for a better tomorrow. That is why
it is essential to continue economic reforms and to create the framework basis for self-sustaining
economies. Already, Africa has made tremendous progress to this end. Last year, 30 African
countries recorded positive economic growth.
Uganda was one of them. Uganda should be proud of its surging economy. An economy
that had been destroyed by decades of war, now registers a stunning growth rate of 8 percent a
year.
�When I visited the FINCA Village Bank, 1 sawfirsthandone way this economy is being
transformed. The bank provides modest loans to about 4,000 women, helping them to start small
businesses . In Zimbabwe and Tanzania, I visited similar programs. In each country, these
lending institutions are helping to stabilize democracy because they assure women of the
opportunity to earn a decent income and to enter the circle of expanding economic opportunity.
They help families and communities to become economically self-sufficient.
The economic reforms carried out by the government have also encouraged Ugandan
farmers to increase their agricultural production. Hundreds of new farmers have not only
bolstered your economy through exports, they have brought you food security. In the last 5 years,
child malnutrition rates have dropped by 20 percent.
It's clear that these continent-wide efforts to improve economic performance have done
much to reinforce democracy. When you widen economic opportunity, you give people a stake in
their nations and their economies. When you spark broad-based economic growth, you reduce
income disparity, and create stability.
It's important to add that farsighted countries — like Uganda ~ reinvest their new
revenues in better health and education for their people. This, in turn, encourages further foreign
investment, for a well-educated, healthy population attracts outside capital. Properly cared for,
this cycle of hope repeats itself, enriching successive generations.
�A vibrant democracy requires citizens to take personal and collective responsibility
for creating a civil society.
What do I mean by a civil society? I mean one that calls on all its elements - individuals,
community groups, houses of worship, businesses, government - to take responsibility for the
common good.
That's what I have seen across the continent. In Senegal, villagers acted out a drama
about the rights and responsibilities of citizens in a democracy. There and in Tanzania, in a
village outside of Arusha, I saw community groups coming together to improve the education
and health in their communities.
I also met a remarkable group of Rwandan women working to rebuild their country. I met
with them just a couple of hours ago, an^ was privileged tohegr-how they are working to heal
their country fromige terrible genocide^lo ease the great suffering of its women and children,
and the refugee crisis it has endured. They described to me how they had joined together in
associations to better their lives. I was moved by what they told me, and I assured them of our
commitment in supporting their reconciliation and rebuilding of their society.
10
�We know from our own experience in the United States that democracy requires patience,
hard work, flexibility, and the acceptance of inherent imperfections. Not only does democracy
ask each of us to take responsibility and to do our share, it asks us to count on others — people
whose views we may never agree with, whose ideas we may never understand — to do the same.
With democracy, there is no day off, for it depends on the internalization of these values in
people's hearts and minds.
Finally, wc also believe that a vital democracy requires Africa's friends and
partners to make a contribution to Africa's democratic transformation. The United States
intends to continue its partnership with Africa in its efforts to deepen and strengthen democracy.
We can do this by supporting efforts such as the ones I saw today: Efforts to allow women to
take their rightful place at the table; efforts to educate all Africa's people, efforts to see to it that
everyone can get good health care, efforts to ensure that women as well as men have access to
credit, so that they can participate in Africa's growing economy. These are the tools of
opportunity. They will help sustain democracy.
I am proud of the role America has played in Africa's renewal. I wish the American
people could see what is happening in Africa today. They would see that a modest contribution
in United States aid to Africa - less than 1/1 Oth of 1% of our budget -- yields extraordinary
returns. Aid from the United States trains teachers, supports AIDS prevention, sparks
microenterprise development, keeps family planning centers open, and helps strengthen
democratic institutions.
11
�I am also proud that American assistance creates the conditions for self-sustaining
economic growth. Assistance goes hand-in-hand with private investment. Over the course of my
trip, I have had the opportunity to see American companies doing well for themselves and doing
well for the countries of this continent. I know the President is eager to work with Congress to
find new and effective ways to support Africa through a balanced approach that involves a
continuing development partnership and an expanding role for trade and investment. We believe
this approach will enable African countries to achieve their goal of greater self-reliance and full
integration into the global economy. As President Museveni told me last evening, he looks
forward to the time when America's relationship with Uganda is based on "investment, trade,
and tourism."
I am mindful that there are other threats to Africa's fragile democracies that require our
concern and vigilance. That is why the United States attaches such high importance to its
collaboration with regional leaders and organizations in seeking to resolve conflicts that threaten
economic and democratic progress. That is why we are eager to support African efforts to
enhance their capacity to respond to crises, such as the African Crisis Response Force. And that
is why we seek to strengthen measures to protect us all from the new threats to the security and
welfare of democracies everywhere, such as crime, narcotics trafficking, and international
terrorism.
And my husband asked me to make clear his commitment on another issue: He asked me
to tell you that he will come to Africa during his second term as President.
12
�I have had a remarkable trip to Africa. There is so much that I have been privileged to
learn. And as I prepare to return home, it is with the hope that this trip may reflect the growing
consciousness in the minds of the people of Africa and America that, despite the wide ocean
between us, we are neighbors on this shared Earth. We cannot live without each other. We have
much to learn from one another. In our relationship, there must no longer be an "us" or a "them,"
but only a "we."
For as I saw yesterday, as I walked the dusty floor of the Olduvai Gorge in Tanzania, we
are a "we." We come from the same place. We share a common home. We are part of a larger
family. The message, embedded in that rock, is that we must never let respect for any human
being be eroded; we must make the dignity of every single person our governing principle.
Tomorrow, I will end my trip to Africa in a place that is just beginning. Eritrea. A new
country founded on timeless ideals. May its story, like that of Africa, be one of constant renewal.
13
�
Dublin Core
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Title
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Health Care Reform
Identifier
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2006-0810-F
Description
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<p>This collection consists of records related to Hillary Rodham Clinton's Health Care Reform Files, 1993-1996. First Lady Hillary Rodham Clinton served as the Chair of the President's Task Force on National Health Care Reform. The files contain reports, memoranda, correspondence, schedules, and news clippings. These materials discuss topics such as the proposed health care plan, the need for health care reform, benefits packages, Medicare, Medicaid, events in support of the Administration's plan, and other health care reform proposals. Furthermore, this material includes draft reports from the White House Health Care Interdepartmental Working Group, formed to advise the Health Care Task Force on the reform plan.</p>
<p>This collection is divided into two seperate segments. Click here for records from:<br /><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0810-F+Segment+1"><strong>Segment One</strong></a> <br /><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0810-F+Segment+2"><strong>Segment Two</strong></a></p>
Provenance
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Clinton Presidential Records
Publisher
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William J. Clinton Presidential Library & Museum
Text
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Paper
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Title
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UN World AIDS Day 12/1 [1]
Creator
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First Lady's Office
Speechwriting Office
June Shih
Source
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10487574
42-t-7431950-20060810F-Seg2-044-031-2015
Identifier
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2006-0810-F Segment 2
Is Part Of
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Box 44
<a href="http://clinton.presidentiallibraries.us/items/show/36145" target="_blank">Collection Finding Aid</a>
<a href="https://catalog.archives.gov/id/10487574" target="_blank">National Archives Catalog Description</a>
Provenance
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Clinton Presidential Records: White House Staff and Office Files
Publisher
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William J. Clinton Presidential Library & Museum
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Adobe Acrobat Document
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Preservation-Reproduction-Reference
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5/27/2015