Say Anything

The laws have been signed and they are now effective ... We can't watch our people die, and their patents have been here for so long.
Thailand's Minister of Health, Mongkol na Songkhla, quoted in a January 25, 2007, Reuters report entitled, "Thailand Stuns Drug Firms with Generic Licenses," in which he announced the government is issuing compulsory licenses to allow the production of generic versions of the two patented drugs: Kaletra (lopinavir) and Plavix (clopidogrel bisulfate). The government issued its first compulsory license, for Stocrin (efavirenz), in November 2006. That country's Pharmaceutical Research and Manufacturers Association (PReMA) wrote to Prime Minister Surayud Chulanont to ask that no further compulsory licenses be issued. But Mongkol moved forward, claiming that the industry is "reaping colossal benefit from us." He added that generic copies from Chinese or Indian firms would be up to 90% less expensive than the patented versions. Brand-name pharmaceutical companies protested that they had not been informed in advance of the decision, which they said could cause some companies to leave Thailand.

One of the strongest predictors of whether or not the teens disclosed their sexual orientation was whether the physician had discussed sex with them at all. Very few physicians were regularly discussing sexuality, even though sex is one of the major developmental challenges and health risks at that age.
Gareth D. Meckler of Portland's Oregon Health and Sciences University and coauthor of a recent US survey that found the majority of openly gay teens are not apt to freely discuss their sexuality their physician, according to a January 3, 2007, Reuters report. In the study, researchers from the RAND Corporation and the University of California, Los Angeles (UCLA) surveyed 131 lesbian, gay, and bisexual teens ages 14-18 attending the "Models of Pride Youth Conference." Ninety percent had seen their physician within the previous two years, and two-thirds had visited their physician within the past year. Among those surveyed, 70% reported being "out" to everyone or nearly everyone they knew. But while 66% acknowledged it was important for their physician to know about their sexual orientation, only 35% said their own physician knows they are gay, lesbian, or bisexual. In cases where the teens had disclosed to their physician, the physician brought up the issue only 21% of the time. When asked what physicians could do to facilitate a discussion about sexuality, 64% of teens said, "Just ask me." The full report, "Nondisclosure of Sexual Orientation to a Physician Among a Sample of Gay, Lesbian, and Bisexual Youth," was published in a recent issue of the Archives of Pediatrics & Adolescent Medicine [2006;160(12):1248-1254].

I haven't seen this overall realization, like "Houston, we have a problem."
US Rep. Donald M. Payne (D-NJ), Co-Chair of the Congressional Caribbean Caucus, quoted in a January 21, 2007, Associated Press report about the one-day Caribbean Summit on HIV/AIDS held in St. Croix, during which health officials said widespread ignorance about HIV disease and discrimination against those living with HIV/AIDS are hampering regional control efforts. Excluding Cuba, the Caribbean has the second-highest rate of infection after sub-Saharan Africa. An estimated 500,000 people in the region, or 2.4% of the total population, are infected. In 2005, around 24,000 people in the Caribbean died of AIDS-related illnesses, making it the leading cause of death among people ages 15 to 44. Payne called on the 15-member Caribbean Community (Caricom) to do more to secure international funding for controlling the spread of HIV disease, lest predictions from economists at the University of the West Indies showing that failing to slow HIV/AIDS will have a major impact on Caribbean economies, come true.

It's not just enrolling people on therapy. It's people who will die -- they're gone.
Mark Dybul, US Global AIDS Coordinator and in charge of the US President's Emergency Plan for AIDS Relief (PEPFAR), quoted in a January 12, 2007, San Francisco Chronicle article about the implications of how an impasse over budget priorities left the Republican-controlled 109th US Congress to adjourn in December 2006 with budget resolutions freezing most federal programs, including PEPFAR, at 2006 funding levels through September 2007. Unless the Democratic-controlled 110th US Congress revisits PEPFAR funding by mid-February 2007, PEPFAR will be unable to fulfill the planned expansion of antiretroviral therapy access or programs to prevent mother-to-child transmission (MTCT) of HIV. According to Dybul, PEPFAR was to enroll 350,000 more patients on antiretroviral therapy this year, at 50,000 new patients per month. Most of the new patients to be treated are Africans. Dybul stated that from 110,000 to 175,000 patients will die without antiretroviral therapy, and that an estimated 23,000 children would become infected if Congress does not fully fund PEPFAR, as MTCT services "will pretty much have to halt."