The European Parliament on Thursday adopted a resolution that calls on the Council of Ministers and the European Commission to formulate an HIV/AIDS strategy promoting early detection of the disease, Xinhua/People's Daily reports. The resolution passed with a vote of 480 to four. It says that barriers to anonymous HIV testing should be reduced and that authorities from the council and the commission should work together to communicate the benefits of earlier care for people living with HIV/AIDS, according to Xinhua/People's Daily.The parliament asked for continued HIV/AIDS monitoring and surveillance by the European Centre for Disease Prevention and Control and called for improved estimates of undiagnosed HIV/AIDS cases. The resolution also included a call for member states to initiate efforts to help end discrimination against people living with HIV/AIDS, including current restrictions on their freedom of movement, Xinhua/People's Daily reports. The parliament also asked states to increase available HIV/AIDS education and information on prevention, testing and treatment. According to Xinhua/People's Daily, 11% of new HIV cases in the European Union occur in people under age 25 (Xinhua/People's Daily, 11/20).

The number of registered HIV cases in Russia is increasing by 10% annually despite increased federal funding for HIV/AIDS efforts, Vadim Pokrovsky, head of the government-funded Federal AIDS Center, said on Friday, the AP/Google.com reports. According to Pokrovsky, Russia's rising HIV prevalence likely stems from the government's focus on HIV/AIDS treatment instead of prevention.Pokrovsky estimates that more than one million people in Russia -- or almost 1% of the country's population of 142 million people -- are HIV-positive. However, Russia officially has registered only 470,000 HIV cases, Pokrovsky said, adding that the country registers about 130 new HIV cases each day. According to experts, a large number of HIV-positive people in Russia are injection drug users. In addition, many people are unaware of HIV risk factors because of denial, insufficient information and social stigmas, the AP/Google.com reports. According to Pokrovsky, many regional governors in Russia "have simply refused to acknowledge the problem" of HIV/AIDS, while others have chosen to increase funding for the disease rather than promote awareness about the issue. Pokrovsky said that Russia appears to have "no national policy" on HIV/AIDS and is "running in place" while the disease spreads.Pokrovsky encouraged the government to develop a clear strategy for publicizing HIV/AIDS-related issues and spend money wisely to maximize results. "Everyone needs to understand that [HIV] is a threat to the nation, and it's necessary to mobilize as one would for war," he said. According to the AP/Google.com, Russia's government said it allocated about $445 million for HIV/AIDS-related efforts last year, which was 50 times more funding than in 2005. Pokrovsky said the government will spend about $270 million for HIV/AIDS programs this year, which includes $193 million for treating 30,000 HIV-positive people and $7.6 million for prevention efforts. Pokrovsky said that HIV prevention funding is inadequate and is "the weakest point" in Russia's HIV/AIDS efforts. "We are doing practically nothing" to prevent new HIV cases, he added.The government reduced HIV/AIDS funding because of the financial crisis, and Pokrovsky said that future funds also could be at risk. He also expressed concern that prevention funding could be misspent, citing an example of a $3.6 million HIV/AIDS awareness television program that aired at 8:30 a.m., a time when many high-risk populations were unlikely to view the show (Gutterman, AP/Google.com, 11/21).

The Washington Post on Saturday examined the "ballooning number of people in Chile who were not told they had tested positive for HIV and therefore were denied potentially lifesaving treatment." Officials earlier this month announced that about 512 people nationwide have not been informed by the public health system that they tested HIV-positive and that more than 1,000 people have not been told by private sector services that they carry the virus. The situation has led to the resignation of former Health Minister Maria Soledad Barria, plans to reform the country's notification system and a "recent warning that the government could declare a 'health emergency' if the hundreds of people who still do not know that they have the virus are not found and told quickly," according to the Post. In addition, the situation has "prompted a vigorous debate about public health, sexuality and the politics of HIV," the Post reports. "Who is responsible for this situation?" Teresa Valdes, a sociologist and board member of a women's organization, wrote in an opinion piece posted to the El Mostrador Web site. She added, "Is it the official of the laboratory that delivered the result, the health center where the test took place ... or a society that denies sexual diversity, that has discriminated for years against homosexuals and that drapes a cloak of silence over the sexuality of its members."Marcela Contreras, a hematologist, told the Cooperativa radio network that the situation was "out of proportion" and could affect a quality blood service system in the country. "There is a responsibility of the patients that went to take the HIV test because many of them did not give their correct addresses or telephone numbers," Contreras said. According to the Post, other people have said that the lack of timely notifications is a failure of Chile's health system. In addition, an editorial in La Nacion said that the stigma surrounding HIV/AIDS in the country contributed to the situation. "Sexual promiscuity is a reality that must be acknowledged, regardless of philosophical or religious views," the editorial said, adding, "Thus, prevention campaigns must be more explicit than they currently are when it comes to the risks and alternatives for protecting yourself against AIDS." As the government "rushed to notify" those affected by the situation, its response "has also come under criticism," the Post reports. Some people have said that government workers arrived at their jobs and told them they were HIV-positive in front of their colleagues. In response to the situation, the government has named Anibal Hurtado as the new coordinator for the National AIDS Commission, and there are talks about introducing legislation to improve the HIV notification system. Hurtado also has suggested that police databases could be used to find and notify HIV-positive people. "It's always difficult to take responsibility," Hurtado said, adding, "But I want to take it" (Partlow, Washington Post, 11/22).

Summaries of several recent developments related to health care overhaul efforts appear below.Congressional players: Congressional Democrats who hope to pass health care reform legislation next year will have to "walk a fine line as they seek to work together on what promises to be a historic legislative endeavor," as many of the "key players in the debate" have a "storied history of attempting to elbow others out of the way," Roll Call reports. Some of the important players include former Senate Majority Leader Tom Daschle (D-S.D.), whom President-elect Barack Obama reportedly plans to nominate as HHS secretary; Senate Finance Committee Chair Max Baucus (D-Mont.); Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-Mass.); and Sens. Hillary Rodham Clinton (D-N.Y.) and Ron Wyden (D-Ore.). According to Roll Call, despite certain tendencies, "most of the power players and their aides say everyone is mindful of the need to play nice to avoid the pitfalls of the Clinton administration's failed universal health care plan, when Democratic infighting allowed Republican opponents to define the issue and sink the proposal" (Pierce, Roll Call, 11/21).Kennedy: Kennedy, despite his recent diagnosis of incurable brain cancer, has returned to Capitol Hill "on a mission that so far has proved impossible: enactment of comprehensive health care legislation that would provide coverage for the nation's estimated 47 million people who don't have health insurance," USA Today reports. According to USA Today, "Kennedy's reappearance" after a seizure and subsequent brain surgery "sets up a potentially dramatic race against time as he seeks to cajole the notoriously slow-moving Senate into delivering the capstone of his four-decade legislative career." Congressional Democrats "are approaching health care reform cautiously," with some "urging a go-slow approach," but increases in health care costs and the number of residents without health insurance are "creating momentum for action," according to USA Today (Kiely, USA Today, 11/21).Peter Orszag: Former Congressional Budget Office staffers on Thursday appeared divided over whether agency director Orszag's potential move to head the Office of Management and Budget "would move the ball forward on overhauling health care or push it back," CQ HealthBeat reports. But they "agreed that the appointment would be a strong addition" to "Obama's inner circle as it confronts the twin challenges of a faltering economy and a dysfunctional health care system" and that "Orszag could prove to be a forceful advocate for controlling Medicare spending," according to CQ HealthBeat. CQ HealthBeat reports that Orszag, whom Obama reportedly plans to name as OMB director, could have a role in health care overhaul efforts and "could be a big player" on efforts to link spending and quality of care under Medicare (Reichard, CQ HealthBeat, 11/20).Pay-go rules: Pay-go rules should not delay efforts by congressional Democrats to pass comprehensive health care overhaul legislation next year, House Ways and Means Committee Chair Charles Rangel (D-N.Y.) said on Thursday, CQ Today reports. According to Rangel, the passage of health care overhaul legislation is more important than concerns about the effect of such legislation on the federal budget deficit. His position "suggests that Democrats will see a major overhaul of health care laws as important enough to circumvent" pay-go rules, but some Republicans have "expressed concern" about that prospect, according to CQ Today (Wayne, CQ Today, 11/20).Technology companies: Expectations for health care overhaul next year and a "desire of governments worldwide to drive costs of national health systems" have prompted more tech companies to "bet on health care and what many of them see as a lucrative -- but relatively untapped -- market," an "opportunity that tech companies underestimate at their own peril," Reuters reports. According to Reuters, a number of tech companies that previously had limited or no connection to health care have begun to develop tools to reduce health care costs and improve patient care. Andrew Rocklin, an analyst at Diamond Management & Technology Consultants , said, "Health care is a $2.5 trillion market in the United States alone," adding, "Anybody who chooses not to participate could be giving up a potentially large amount of revenue" (Kahn, Reuters, 11/21).Town hall meetings: PricewaterhouseCoopers and the National Association of Children's Hospitals and Related Institutions on Thursday hosted a series of town hall meetings in a dozen locations nationwide to discuss the top priorities for health care overhaul, the San Francisco Chronicle reports. According to meeting participants, the "central challenge" is the development of proposals to "fix a monumentally complex and costly health system amid a nose-diving economy," the Chronicle reports. The meetings coincided with the release of a survey by the groups that found U.S. residents cite efforts to reduce costs as their top health care priority, while health industry leaders prioritize expanded access to coverage, according to the Chronicle. The survey included 1,800 respondents, including 800 policymakers and health industry executives (Fernandez, San Francisco Chronicle, 11/21).

Opinion Pieces Summaries of several recent opinion pieces related to health care overhaul appear below.Gerald Seib, Wall Street Journal : The "opportunities for the Obama administration to drive through its agenda" on health care and other issues "actually are getting better" as the "economic signs grow ever more grim," Journal columnist Seib writes. He writes, "The thing about a crisis ... is that it creates a sense of urgency." According to Seib, as a result of the current economic downturn, thousands of U.S. residents will lose their jobs and employer-sponsored health insurance and "swell the ranks of the nation's uninsured." He adds, "That will add a bit of rocket fuel to the Obama call for universal health coverage" (Seib, Wall Street Journal, 11/21).David Sirota, San Francisco Chronicle : "Based on advertisements, Obama identified no more important priority than guaranteeing health care for all citizens," Sirota, a fellow at the Campaign for America's Future and a board member of the Progressive States Network , writes in a Chronicle opinion piece. He writes, "The moral case for universal health care is obvious," adding, "In the world's richest country, ... 18,000 people die each year because they lack health insurance." According to Sirota, "We permit this annual massacre while our wasteful system exacerbates our debt and saps our economic competitiveness by forcing us to spend more money per capita on health care than any other nation." He writes, "That said, if morality alone prompted solutions, this problem would have been addressed long ago." Sirota adds, "While some claim the deficit should preclude bold health care legislation, it's the other way around," and "as with everything in Washington, a political motive is needed for action -- and even conservatives acknowledge Democrats have such a motive when it comes to health care" (Sirota, San Francisco Chronicle, 11/21).William Snyder, Wall Street Journal : Obama as president "will almost certainly move quickly toward some form of government-provided -- and possibly government-mandated -- health insurance," Snyder, a policy adviser to the Heartland Institute , writes in a Journal opinion piece. He adds, "A principal reason for this is the oft-cited figure of 46 million uninsured U.S. residents," but the "notion that there are 46 million Americans who can't get the health care they need for lack of money or public assistance is a myth." Snyder writes that the "other two common misperceptions are that the uninsured don't get health care and that when they do they're 'free riders,' i.e., they don't pay for the care they get." According to Snyder, "Perhaps we should look for ways to encourage the millions of people who are currently eligible for existing government programs to enroll before we expand programs to include people that may not need assistance" (Snyder, Wall Street Journal, 11/21).

Broadcast Coverage PBS' "NewsHour with Jim Lehrer " on Thursday examined the obstacles that Obama might face in health care overhaul efforts. The segment includes comments from Uwe Reinhardt of Princeton University , Stuart Butler of the Heritage Foundation , Karen Ignagni of America' Health Insurance Plans and Chris Jennings, a former White House health care adviser (Woodruff, "NewsHour with Jim Lehrer," PBS, 11/20).

About 35% of women in India's Karnataka state know that condoms can prevent HIV transmission, according to India's National Family Health Survey , the Times of India reports. The survey indicated a need for increased access to HIV prevention and education and expanded access to female condoms, according to the Times. The NFHS survey also found that 12.3% of women and 32.6% of men in the state have comprehensive knowledge about HIV.According to the Times, Karnataka has not been included in a National AIDS Control Organization condom distribution program despite the state's high HIV prevalence, which is twice as high as the national HIV prevalence. Other states with a high HIV prevalence, such as Manipur, also are not included in the NACO program, the Times reports. State HIV/AIDS control organizations last year supplied Karnataka with about 250 million male condoms, and a portion of NACO's annual budget has been allocated to distribute condoms in areas that have an increased risk of HIV, according to the Times. NACO is scaling up efforts to introduce female condoms across the country. About 1.5 million female condoms were distributed in four states -- Andhra Pradesh, Maharashtra, Tamil Nadu and West Bengel -- and placed in government medical stores, Pritpal Marjara, team leader for technical support of NACO, said. Marjara added that the agency plans to obtain an additional 1.5 million female condoms for the program, which is expected to cost four million Indian rupees, or about $700,000. The condoms will be sold through nongovernmental organizations at a "highly subsidized rate" of 3.5 Indian rupees, or about 69 cents, Marjara said. NACO aims to reach 200,000 commercial sex workers through the program, Marjara said. NACO also is increasing the number of condom vending machines in train stations and public restrooms as part of the program, Mayank Agarwal, a joint director at NACO, said (Nagaraj, Times of India, 11/19).

Uganda's Ministry of Health has started to draft a medical male circumcision policy for HIV prevention, the New Vision/AllAfrica.com reports. "Assessment of the capacity of health units to implement the policy has been conducted," Sam Zaramba, general director of health services, said. He also said that the policy "will not be a stand alone strategy" but part of the country's HIV prevention strategy that emphasizes abstinence, condom use and fidelity (Bugembe, New Vision/AllAfrica.com, 11/20).

HIV/AIDS Biggest Challenge to Ugandan Army, President Says In related news, Uganda's President Yoweri Museveni on Tuesday said that HIV/AIDS is the most significant challenge faced by the country's army, New Vision/All Africa.com reports. Museveni urged soldiers at Kaweweta military training school in Nakaseke to live responsibly in terms of HIV/AIDS prevention and care. "If you die or get sick from AIDS, you let us down," he said, adding that more soldiers have died from AIDS-related causes than in combat (Kiwanuka, New Vision/AllAfrica.com, 11/20).

A recent report by the United Kingdom's Royal College of Nursing found that 48% of the 5,000 nurses polled had been injured by a needle previously used on a patient during their careers, with about one-third fearing risk of exposure to bloodborne diseases such as HIV and hepatitis, BBC News reports (BBC News, 11/19). According to the PA/Google.com , the survey also found that although most nurses who had experienced a needle injury were provided with information about risks from their employer, 28% were not. In addition, about one-third of nurses within the National Health Service who had experienced an injury regarded the support they received from their employer as adequate (PA/Google.com, 11/19). According to BBC News, one-quarter of nurses who said they experienced needle sticks reported that their employer did not provide them with post-exposure prophylaxis. In addition, a poll of nurses in the report revealed that nearly half of the nurses do not have access to safety devices, such as shielded needles, that could protect nurses from infections like HIV and hepatitis, RCN said. RCN General Secretary Peter Carter said, "It is clear that needle injuries are an everyday threat for nurses" (BBC News, 11/19). Currently, 94% of employers have a policy that covers prevention and reporting of needle stick injuries, but only 55% of the nurses surveyed had received training from their employer on safe needle use. Ninety-six percent of nurses said they use needles as part of their jobs, according to the PA/Google.com. Carter said, "Government and employers in the NHS need to start taking this issue seriously by introducing needle policies and investing in safer alternatives to traditional needles so that these accidents don't happen in the first place" (PA/Google.com, 11/19). An NHS Employers spokesperson said the agency acknowledges the RCN report and takes the "issue of needle stick injuries very seriously" (BBC News, 11/19). The report is available online .

In the face of increasing HIV cases in the Philippines, lawmakers are debating a reproductive health bill that could have a significant impact on reversing the upward trend in new cases through HIV prevention, care and support services, IRIN/PlusNews reports (IRIN/PlusNews, 11/19). The bill would increase HIV services in the country, as well as require government hospitals to include contraceptives in the supplies they purchase and make reproductive health education mandatory in schools (Kaiser Daily HIV/AIDS Report , 11/14).According to a recent report from the Department of Health's National Epidemiology Center, 57 new HIV cases were recorded in September -- a 128% increase in the number of reported cases compared with the same period last year. Gerard Belimac, program manager of the National AIDS and STI Prevention and Control Program , said, "While the Philippines is still considered a low-incidence country, the epidemic level could come in three years," adding, "More and more people are resorting to risky behavior." Belimac said that although HIV has not reached epidemic levels in the country, UNAIDS has estimated that about 8,300 people are HIV-positive. He added that new HIV cases are primarily found in high-risk groups such as commercial sex workers and men who have sex with men. Ferchito Avelino, national coordinator of the Philippine National AIDS Council , said that although Filipinos may be aware of the risk of HIV/AIDS, such knowledge is not translating into behavior change. In addition, he said that misconceptions about the virus have created a false sense of security, adding that although the country has a relatively low number of HIV cases compared with other nations, "there is no room for complacency." Avelino also called for an aggressive HIV prevention campaign, noting that the median age bracket in which Filipinos first engage in sexual activity is becoming younger. According to Belimac, it is crucial that the government approves the bill because HIV programs are achieving 30% coverage overall and only sex workers are fully covered by the programs. Belimac said, "In order to reverse the trend, we must have 80% coverage," adding that a "lack of political will" is the main obstacle to preventing HIV transmission. For example, he said most local governments do not have budgets for HIV intervention programs, which indicates lack of commitment. "HIV prevention takes a back seat and, with their limited funds for health services, the local government units are not entirely to blame; HIV prevention competes with other health services," Belimac said (IRIN/PlusNews, 11/19).

Catholic Bishops Introduce Version of Bill In related news, Catholic bishops in the country are drafting their own version of the reproductive health bill because of the fact that it promotes the use of contraceptives and condoms, Reuters reports. The Rev. Melvin Castro of the Episcopal Commission on Family and Life said that the bishops have been working with lawmakers to draft an alternative to the measure, given that they consider it unconstitutional and an infringement on the religious beliefs of Filipinos. About 85% of the nearly 90 million people in the Philippines are Catholic. Castro said, "We would not allow a legislation that would allocate money from a majority of the taxpayers who are Catholics to be allocated to a program which is against their beliefs." According to Reuters, some bishops have threatened to refuse Holy Communion and other sacraments to politicians who support the bill (Reuters, 11/20).

More than 1,000 HIV-positive people and HIV/AIDS advocates gathered near the White House on Thursday to urge President-elect Barack Obama to improve both domestic and global HIV/AIDS initiatives, VOA News reports. The rally was coordinated by Africa Action . Michael Swigert, associate director of Africa Action, said that Obama's first 100 days in office will be "a critical period" for setting HIV/AIDS priorities, including appointing the next U.S. global AIDS coordinator and other global health positions. Swigert said that it is "important that Obama fill those positions with qualified individuals who support comprehensive prevention programs." According to Swigert, President Bush's HIV/AIDS work is "probably his most popular foreign policy" and has generated "good will for us abroad." Under the next administration, the U.S. should "continue to be a leader" in these efforts, he said.According to Swigert, HIV/AIDS funding should be a priority for the next president as well as the next Congress. He acknowledged that current economic conditions will pose challenges for the next administration to fund expanded HIV/AIDS initiatives but said that the U.S. "need[s] to provide $59 billion over five years" through the President's Emergency Plan for AIDS Relief "to fight not just HIV but also malaria and tuberculosis." Swigert added that the U.S. will need to set "hard treatment targets" and increase the availability of generic drugs to meet the goal of achieving universal treatment access by 2010. Although PEPFAR has done "an increasingly better job" of not relying on brand-name medications, the program "still could do better in stretching taxpayer dollars further to save lives in Africa," Swigert said. According to Swigert, there is a "big push" in the U.S. development community to "consolidate development assistance" and "harmonize" the funding of development programs in Africa. Therefore, it is "really important" for Obama to build on his "incredible popularity" by enlisting U.S. allies in Europe to address issues like HIV/AIDS "that really affect Europeans, Americans as much as Africans," Swigert said. According to VOA News, Obama during the U.S. presidential campaign committed to guarantee treatment and care for HIV-positive people in the U.S., provide housing for people living with HIV, end the federal ban on needle-exchange programs and redirect abstinence-only education into broader HIV prevention programs. In addition, Vice President-elect Joe Biden in July helped pass a bill to reauthorize PEPFAR in Congress, VOA News reports (Lesser, VOA News, 11/20). An audio discussion with Swigert is available online .

A bipartisan group of 55 senators has signed a letter asking the Department of Defense to reconsider a proposed rule for the military's Tricare health insurance program that would require hospitals that treat Tricare beneficiaries to use the same reimbursement system for hospital outpatient services as Medicare, CQ HealthBeat reports. The letter will be sent to U.S. Defense Secretary Robert Gates and Office of Management and Budget Director Jim Nussle.In the letter, proposed by Sen. Ben Nelson (D-Neb.), the senators offered their support for the basic premise of the proposed rule but voiced concern that the current proposal "lacks a broad, effective transition" that would prevent any inconvenience to program beneficiaries during the policy transition. The senators wrote, "Sudden and severe shifts in payments as have been proposed by DOD could jeopardize providers' ability to care for Tricare patients," adding, "To prevent such disruptions to quality of and access to care, it is crucial that such new payment policies be implemented with a meaningful transition period."Sens. James Inhofe (R-Okla.), John Cornyn (R-Texas), Edward Kennedy (D-Mass.), Chuck Schumer (D-N.Y.), Lindsay Graham (R-S.C.) and Jim Webb (D-Va.) are among those who already have signed the letter (Weyl, CQ HealthBeat, 11/20).