A WHITAKER GROUP PUBLICATION
AFRICA HEALTH NEWS
PEPFAR
US SENATE VOTES TO
TRIPLE HIV/AIDS FUNDING
The US Senate voted overwhelmingly in July to commit $48 billion
over the next five years to the global fight against HIV/AIDS, tuber-
culosis and malaria. The legislation, which builds on the President’s
Emergency Plan for AIDS Relief (PEPFAR), is the most ambitious
foreign public health program ever launched by the United States.
Senate approval is the last major obstacle to the bill’s becoming law.
It is targeted to prevent 12 million HIV infections and treat three mil-
lion people over five years. It also seeks to address Africa’s severe health
worker shortage by supporting countries in developing long-term
health workforce plans and by funding the training of 140,000 new
health workers.
Since passage in 2003, PEPFAR has helped bring lifesaving antiret-
roviral drugs to about 1.7 million people and has supported care for
nearly 7 million, including about 2.7 million AIDS orphans and vulner-
able children. It has also provided HIV testing and counseling to about
33 million people. Before the program began, only 50,000 people in all
of sub-Saharan Africa were receiving anti-retroviral therapy.
The Senate bill differs from the version passed by the US House of
Representatives in April in several respects. In an amendment agreed to
just hours before the final vote, the Senate agreed to set aside $2 billion
of the $50 billion designated in the original bill to fund American In-
dian water, health and law enforcement programs. The bill also reverses
a 21-year-old law that bans most foreign visitors who are HIV-positive
from entering or gaining permanent residence in the US.
In a concession to conservatives who feared that money earmarked
for prevention programs would be used by abortion providers, the Sen-
ate bill requires that more than half of the program’s bilateral aid go
to AIDS treatment and care and avoids the requirement contained in
the House version that 20% of the money go to HIV prevention activi-
ties. The Senate version also does not include the clause included in the
House bill authorizing family planning groups to provide education,
testing and condoms.
The Senate bill provides $10 billion - $2 billion a year - to the Global
Fund to Fight HIV/AIDS, Tuberculosis and Malaria. About $4 billion
will be spent on fighting TB, the leading cause of death among those
suffering from AIDs, and $5 billion on combating malaria.
Eager to send the bill to President Bush for his signature, the House
Foreign Affairs Committee has said it would accept the Senate version
and the full House will take up approval of the legislation before Con-
gress goes into summer recess at the end of July.
Sen Richard Lugar (R-Ind), the top Republican on the Senate Foreign
Relations Committee, credited PEPFAR with helping to prevent insta-
bility and societal collapse in several at-risk countries. In addition, he
said, the program had “facilitated deep partnerships with a new genera-
tion of African leaders, and it has improved attitudes toward the United
States in Africa and other regions.”
JULY/AUGUST 2008
A red ribbon adorns the White House in recognition of World
AIDS Day and the US commitment to fighting AIDS globally.
REPORT
3 MILLION NOW HAVE ACCESS
TO AIDS TREATMENT
Nearly 3 million people in low- and middle-income countries were
receiving antiretroviral therapy (ART) by the end of 2007, according
to a report released in June by World Health Organization (WHO),
UNAIDS and UNICEF.
The report, Towards Universal Access: Scaling up Priority HIV/AIDS
Interventions in the Health Sector, also documented improved access
to interventions aimed at preventing mother-to-child transmission of
HIV, expanded testing and counseling, and greater country commit-
ment to male circumcision in heavily-affected regions of sub-Saharan
Africa.
“This represents a remarkable achievement for public health,” WHO
Director-General Dr. Margaret Chan said. “This proves that, with com-
mitment and determination, all obstacles can be overcome. People liv-
ing in resource-constrained settings can indeed be brought back to eco-
nomically and socially productive lives by these drugs.”
Reaching the 3 million figure represented a milestone for global
agencies fighting HIV/AIDS because that was the target sought by the
end of 2005. Although that target was not met until two years later, it
was credited with jump-starting the effort towards scaling up ART.
Meeting the target, the report stated, can be attributed to increased
availability of drugs due to price reductions, improved ART delivery
systems that are now better adapted to country contexts, and increased
demand for ART as the number of people testing positive for HIV
climbs.
The report estimated that about 31% of the estimated 9.7 million
people in need of ART received it by the end of 2007. Nearly 500,000
women were able to access ART to prevent transmission to their un-
born children - up from 350,000 in 2006. Some 200,000 children re-
ceived ART in 2007, compared to 127,000 at the end of 2006.
PAGE TWO
HIV/AIDS
PROGRAM IMPLEMENTERS TARGET
PREVENTION AT KAMPALA MEETING
While acknowledging the enormous advanc-
es made in the care and treatment of those
infected by HIV/AIDS, delegates gathered in
Kampala in June for the 2008 HIV/AIDS Im-
plementers’ Meeting called for much stron-
ger programs to prevent transmission of the
virus.
“We need to acknowledge that HIV preven-
tion is chronic disease management just as
treatment is,” US Global AIDS Coordinator
Ambassador Mark Dybul told the gathering of
1,700 HIV/AIDS program implementers from
around the world.
“We must walk with people from the time
they are very young to the time they are beyond
risk, keeping messages and methods fresh and
alive, to tackle sexual behavior like we tackled
smoking, to make it cool and a part of societal
expectations for individuals to practice socially
responsible behavior, to make gender violence
and gender inequality not only uncool but un-
acceptable,” Ambassador Dybul said.
“We need to develop combination preven-
tion to parallel the intensity, focus, and suc-
cess of combination antiretroviral treatment
integrating social and behavioral change with
proven scientific and medical methods,” he
added.
While 3 million people in low and middle
income countries are now receiving antiret-
roviral treatment, the World Health Organi-
zation (WHO) estimates that for every two
people who are newly put on treatment, five
become infected. And, Dr. Peter Piot, Execu-
tive Director of UNAIDS told delegates, while
87% of countries in the world have established
clear and ambitious goals for HIV treatment,
only about 50% have targets for key HIV pre-
vention strategies.
In addressing the theme of the meeting,
“Scaling Up Through Partnerships: Overcom-
ing Obstacles to Implementation,” speakers
pointed to the need to forge more concrete
links across the board to improve health sys-
tems generally and to place more responsibil-
ity in the hands of government and local au-
thorities.
“Moving out of a failed and flawed era of
donors and recipients, we are entering a new
era in development based on partnership be-
tween equals,” Ambassador Dybul said. “One
in which we, the international partners, must
acknowledge our role as the junior partner to
the countries we are privileged to support.”
One area highlighted by those attending
Ugandan President Yoweri Museveni
and Mrs. Janet Museveni at the meeting
the meeting was the need to understand the
dynamics of local AIDS epidemics and tailor
responses to specific situations. Dr. Piot de-
scribed this as “making the money work for
people on the ground.”
“There are still many areas where we can
strengthen local ownership, reduce unit costs
of delivery, improve coordination and increase
accountability,” he said.
Dr. Tom Kenyon, Principal Deputy and
Chief Medical Officer in the Office of the
Global AIDS Coordinators, pointed to the best
results occurring when there is good coordina-
tion at the country level between development
partners around a national plan.
“This is where our resources achieve the
greatest results, when we are led by the host
country with a shared vision and shared goals,
leadership and country ownership, transpar-
ency on both sides, and trust and mutual re-
spect,” he said.
During the five-day conference, which be-
gan on June 4, more than 200 papers were
presented by delegates from governments,
NGOs, including faith- and community-based
groups, multilateral organizations, the private
sector and groups representing people living
with HIV/AIDS.
Despite the challenges posed by the chang-
ing face of the epidemic, it was agreed that
there were many past successes upon which
to build. Addressing the opening session, Am-
bassador Dybul told the delegates, “You have
irrevocably shattered the pernicious and par-
ternalistic myth that people in resource-poor
countries could not manage complex chronic
prevention, care, and treatment programs on
a national and, in fact, continental scale. And
in so doing, you have created new models and
lessons learned for development overall.”
For transcripts from the 2008 Implement-
ers’ Meeting go to: www.kaisernetwork.org/
hivimplementers2008.
TUBERCULOSIS
PARTNERSHIP TAKES
AIM AT TB THREAT IN
SOUTH AFRICA
The Global Health Initiative of the World
Economic Forum and the Lilly MDR-TB
(multidrug-resistant tuberculosis) Partner-
ship launched a new toolkit in June to boost
the involvement of South African companies
in tackling the country’s tuberculosis (TB)
crisis.
Developed with inputs from national and
international partners including the private
sector, the toolkit provides concrete guidelines
to help South African companies rapidly in-
crease their TB control programs by adopting
a joint approach to diagnosing and treating the
growing number of TB patients who are also
HIV positive.
With 70% of TB patients also infected with
HIV, South Africa now accounts for 28% of
HIV-TB positive cases worldwide. Taken
with the emerging threat of fatal drug-resis-
tant strains of the disease, the Government of
South Africa has recognized the importance of
engaging the private sector in achieving its TB
case detection and treatment targets.
“Businesses have a fundamental responsi-
bility towards both their employees and the
wider community, and for preservation of
their long-term interests by ensuring the na-
tional development of human capital to drive
economic growth,” said Mr. Alex Azar, Eli
Lilly and Company’s Senior Vice-President for
Corporate Affairs and Communications. “Tu-
berculosis has the capacity to undermine all of
this.”
The TB toolkit aims at intercepting the pro-
gression of the disease by giving businesses
guidelines that help them leverage their exist-
ing health infrastructures and management
tools and resources to greater effect. It will
also help companies increase opportunities
and activities in the prevention, diagnosis
and treatment of TB/HIV co-infections in the
workplace.
Eli Lilly and Company launched the Lilly
MDR-TB Partnership, an alliance of 14 public
and private organizations, in 2003. It provides
comprehensive services for individuals and
families afflicted with MDR-TB - diagnosis,
treatment and surveillance of patients; train-
ing of doctors and nurses; community sup-
port, patient advocacy and anti-stigma efforts
in the workplace; and transfer of Lilly drug-
manufacturing technology to pharmaceutical
companies in high-burden MDR-TB countries
to increase local drug supplies.
 PAGE THREE

MAJOR NEW INITIATIVE

BUSINESS OPENS NEW FRONT

ON GLOBAL FIGHT AGAINST
AIDS, TB AND MALARIA
The Global Business Coalition (GBC), an alliance of more than 225
international companies, announced in June an unprecedented pack-
age of private sector initiatives aimed at “turning the corner” in the
fight against HIV/AIDS, tuberculosis and malaria.
The package includes a GBC-United Nations health-action roadmap
for optimal cross-sector coordination, a plan led by New York Stock
Exchange (NYSE) Euronext to tighten integration of business into the
malaria fight, and the deployment in Africa of a series of critical action
teams to identify ways that corporations can coordinate their skills and
resources to maximize their impact on Africa’s health challenges.
Speaking on June 9 at GBC’s 2008 Gala and Awards for Business Ex- ExxonMobil won the GBC Award for Business Excellence on Malaria
cellence in New York, Mr. John Tedstrom, Executive Director of GBC,
the private sector arm of the Global Fund to Fight AIDS, Tuberculosis
Angola, Benin, Cote d’Ivoire, Kenya, Lesotho, Liberia, Namibia, South
and Malaria, said, “The evolution of business’ role as an active partner
Africa, Swaziland, Sudan and Tanzania, and the First Ladies of Rwanda,
in the fight has reached a point at which a major, world-changing break-
Sudan and the Republic of Georgia.
through is possible.”
The aim of the new package, Mr. Tedstrom said, was to move away
Awards
from isolated partnering to globally- and nationally- coordinated part-
The GBC Awards for Business Excellence were earned by companies
nering by more effectively matching specific business infrastructure
that, in GBC’s view, had demonstrated extraordinary commitments, ac-
and skills to gaps in the fight, and by engaging business more actively
tions and results.
on the ground.
“My message: Seize the moment. The way to do this is coordination  HIV/AIDS: Leadership - Viacom for leveraging its media platforms
- smart, strong partnerships at all levels. And make those partnerships to communicate critical health messages globally.
work,” he added.
 HIV/AIDS: Community Philanthropy - Intesa Sanpaolo for
The roadmap, to be delivered to the UN Secretary-General Ban Ki-
creating Project Malawi in partnership with local government and
Moon on World AIDS Day 2009, will chart the way to a cost-effec-
NGOs.
tive, results-intensive strategy. “It will identify the gaps in technology,
resources, infrastructure, and know-how that business can, in concert  HIV/AIDS: Women & Girls - Johnson & Johnson for providing
with key partners, fill and, in so doing, make the right difference in the comprehensive services in South Africa to prevent mother-to-child
right places at the right time,” Mr. Tedstrom said. HIV transmission.
NYSE Euronext, the world’s largest exchange group and a world lead-
 HIV/AIDS: Comprehensive Workplace Programs - Standard
er for listings, cash equity trading, derivatives and the distribution of
Bank Group for its workplace policy to encourage employees and
international market data, joined GBC in April and co-hosted a World
their families to know their HIV status and to reduce the stigma
Malaria Day event with GBC and the UN Foundation that focused on
associated with HIV/AIDS.
the importance of cross-sector collaboration to achieve the goal of elim-
inating malaria mortality by 2010.  HIV/AIDS: Workplace Testing & Counseling - Telekom S.A.
Working with GBC, the UN Foundation and the NGO, Malaria No Ltd. for its Thuso HIV/AIDS Workplace program in South Africa
more, NYSE Euronext has commited to ensure that more than 10 mil- which provides education, awareness, testing and treatment.
lion insecticide-treated bed nets will be dispensed as quickly as possible
 HIV/AIDS: Expanded Community Initiatives - Xstrata Coal
to all those living in areas most affected by malaria.
South Africa for its comprehensive community program in
GBC’s first critical action team will be deployed to Kenya within the
Mpumalanga province to combat HIV/AIDs, tuberculosis and other
next three months. In June, the coalition signed a strategic partnership
opportunistic infections.
with the government of Kenya that will allow GBC, in partnership with
member companies and AMPATH (the Academic Model for the Pre-  HIV/AIDS: Core Competence - BBC World Service Trust for its
vention and Treatment of HIV/AIDS), to dramatically increase HIV HIV/AIDS media campaign in India which has reached more than
testing by going to the homes of more than 2 million Kenyans who will 250 million people.
also be screened for TB and provided with anti-malaria bed nets and
 Excellence on Tuberculosis - BD (Becton, Dickinson Company)
medications for intestinal worms.
for its initiative to improve diagnostics for tuberculosis in the
GBC’s 2008 Gala and Awards for Business Excellence brought to-
developing world.
gether private sector leaders with major partners in the fight includ-
ing UN Secretary-General Ban and other top UN officials, Global Fund  Excellence on Malaria - Exxon Mobil Corporation for its Africa
Chairman of the Board Mr. Rajat Gupta and Executive Director Michel Health Initiative which focuses on malaria research, community
Kazatchkine, Ministers of Health from a host of countries including disease control and community advocacy.
PAGE FOUR
GLOBAL HEALTH
WORLD HEALTH ASSEMBLY CHARTS NEW
COURSE FOR WHO
African health care received a major boost
in May when the World Health Assembly
passed a key resolution at its annual ses-
sion in Geneva to remove intellectual
property (IP) barriers that impede essen-
tial research and to use innovative meth-
ods to encourage research, development
and access to medicines for common dis-
eases of the developing world.
The 61st session of the Assembly, the de-
cision-making body of the World Health
Organization (WHO), was attended by
over 2,700 participants from 190 nations.
The resolution regarding IP was the result
of two years of deliberations by the WHO’s
Intergovernmental Working Group on
Public Health, Innovation and Intellectual
Property (IGWG) which brought together
stakeholders from government, the phar-
maceutical industry and NGOs.
“This is a major breakthrough for public
health that will benefit many millions of
people for many years to come,” said WHO
Director-General Dr. Margaret Chan. “This
is a contribution to fairness in health and
this is pro-active public health at its very
best.”
The Whitaker Group (TWG) participated
in both the Assembly and the IGWG where
it emphasized the role of public-private
partnerships (PPPs) in addressing Africa’s
health care needs.
At May’s Assem-
bly, TWG hosted a
luncheon on the role
of PPPs, attended by
80 African Minis-
ters of Health and
members of delega-
tions, at which Dr.
Rajiv Venkayya of
the Bill & Melinda
The Assembly called Gates Foundation
for scaling up vaccine spoke about the
programs health partnerships
the foundation has
forged in Africa, and Dr. Paul Antony of
the Pharmaceutical Researchers and Manu-
facturers of America (PhRMA) presented
an important new health tool, the website
www.globalhealthprogress.org, which al-
lows health officials to identify health pro-
grams and resources by region and issue.
TWG also distributed the first volume
of its new direc-
tory, The Whitaker
Group Guide to US
Public and Pri-
vate Resources for
Advancing Health
Care in Africa,
which provides
Dr. Margaret Chan,
background and
WHO Director-
contact information
General
on health programs
and resources available for health care ini-
tiatives in Africa.
The directory includes information on
public and private funds for a variety of
health concerns including HIV/AIDS, ma-
laria, neglected tropical diseases, water and
sanitation, health education and training,
immunization, reproductive health, capac-
ity building, health infrastructure, commu-
nity-based health solutions, research and
technology, supply chain management, eye
care and disaster management.
The Assembly endorsed a six-year ac-
tion plan to tackle what are now the lead-
ing threats to human health globally: car-
diovascular diseases, diabetes, cancers and
chronic respiratory diseases which dispro-
protionately effect low- and middle-income
countries.
Delegates also requested that WHO in-
tensify its work to curb the harmful use of
alcohol and that members commit their
own Ministries of Health to take action to
protect the health of its citizens from the
impacts of climate change.
In addition, participants reaffirmed their
commitment to eradicating polio and pre-
paring for an influenza pandemic, scaling
up immunization programs, assessing the
health aspects in migrant environments
and ending female genital mutilation.
“At this World Health Assembly, we
witnessed the interplay between the po-
litical, trade and health interests,” com-
mented the President of the Assembly, Dr.
Leslie Ramsammy, Minister of Health for
Guyana. “Child and maternal health, and
the prevention and management of non-
communicable diseases rely on the supply
chain and commodities. We are now much
closer to having an increased flow of qual-
ity health commodities that will lead to
better health.”
PREPARED AND DISTRIBUTED BY THE WHITAKER GROUP
RIVER BLINDNESS
AfDB FUNDS FINAL
PHASES OF APOC
PROGRAM
The African Development Fund (ADF), the
soft loan window of the African Development
Bank (AfDB), approved a grant of $24.5 mil-
lion in July to fund Phase II and the phasing
out stage of the Onchocerciasis (river blind-
ness) Control Program (APOC) in 19 Afri-
can countries.
The grant anticipates the successful conclu-
sion of the 34-year battle to eradicate the para-
sitic disease which at one time claimed the vi-
sion of 40,000 people each year - 99% of whom
were Africans. The APOC, the regional suc-
cessor to the Onchocerciasis Control Program
(OCP), aims at eliminating river blindness as a
public health problem in Africa by 2015.
According to the World Bank, more than
600,000 cases of blindness have so far been
prevented by the program, 25 million hectares
of formerly evacuated arable lands have been
made safe for settlement and agriculture, and
18 million children, born in now-protected ar-
eas, have been spared the risk of the disease.
In West Africa, where the program was first
instituted beginning in 1974, the Bank esti-
mated there had been a 20% economic rate of
return. Elsewhere in Africa, operations begun
in 1996 have resulted in a 17% economic rate
of return. Overall, over one million years of
productive labor have been added to the econ-
omies of participating countries.
The World Bank attributed the success of
the control program to global partnership
between multilateral institutions, bilateral do-
nors, participating governments, NGOs and
the private sector, particularly Merck and Co.
which, since 1987, has been donating Mecti-
zan® to any government making the request.
The program has also been hailed as a blue-
print for new initiatives to eradicate other
tropical diseases such as lymphatic filariasis
and schistosomiasis.
The ACOP program operates in Angola, Bu-
rundi, Cameroon, Central African Republic,
Chad, Congo, Democratic Republic of Congo,
Ethiopia, Gabon, Liberia, Malawi, Nigeria,
Tanzania, Uganda, Equatorial Guinea , Sudan,
Mozambique, Rwanda and Kenya.
The total cost of Phase II and the phas-
ing-out program is estimated at $122 million,
excluding Merck’s drug donations. The ADF
grant will meet 20% of the total cost, with
other donors contributing $75.5 million and
regional governments giving $18.8 million.