ARMS Email System Page I of 9

RECORD TYPE: PRESIDENTIAL (RECONSTRUCTED EMAIL)

CREATOR: Carter Wilkie WILKIE C ) (WHO)

CREATION DATE/TIME:06-APR-1993 19:21:00.00

SUBJECT: News Calendar for Wednesday

TO: Dawn A. Alexander ALEXANDER DA ) (WHO) READ: UNKNOWN

TO: S. Collier Andress ANDRESS S ) (WHO) READ: UNKNOWN

TO: John C. Angell ANGELL J ) ( OMB) READ: UNKNOWN

TO: Joan Baggett BAGGETT J ) (WHO) READ: UNKNOWN

TO: Lavora R. Barnes BARNES L ) (WHO) READ: UNKNOWN

TO: Heather Beckel BECKEL H ) (WHO) READ: UNKNOWN

TO: FAX (6527,Begala,Dreyer,Prince) TLXAlMAIL_\F:6527\C:BEGaLA,DREyer,PrincE\ READ: UNKNOWN

TO: Eric Berman BERMAN E ) (WHO) READ: UNKNOWN

TO: Elizabeth A. Bernstein BERNSTEIN E ) (WHO) READ: UNKNOWN

TO: Robert 0. Boorstin BOORSTIN R ) (WHO) READ: UNKNOWN

TO: Liz Bowyer BOWYER L ) (WHO) READ: UNKNOWN

TO: Ken Chitester CHITESTER K ) (WHO) READ: UNKNOWN

TO: Nestor M. Davidson DAVIDSON N ) (WHO) READ: UNKNOWN

TO: Jeffrey L. Eller ELLER J (WHO) READ: UNKNOWN

TO: Rahm Emanuel EMANUEL R ) (WHO) READ: UNKNOWN

TO: Patricia A. Enright ENRIGHT P ) (WHO) READ: UNKNOWN

TO: Deborah L. Fine FINE D ) (WHO) READ: UNKNOWN

TO: William Galston GALSTON W ) (OPD) ARMS Email System Page 2of9

READ: UNKNOWN

TO: Mark Gearan GEARAN M (WHO) READ: UNKNOWN

TO: Ernest D. Gibble GIBBLE E (WHO) READ: UNKNOWN

TO: Jonathan P. Gill GILL J (WHO) READ: UNKNOWN

TO: Marcia L. Hale HALE M ) (WHO) READ: UNKNOWN

TO: Alexis Herman HERMAN A (WHO) READ: UNKNOWN

TO: Steven M. Hilton HILTON S ) (WHO) READ: UNKNOWN

TO: Dwight Holton HOLTON D ) (WHO) READ: UNKNOWN

TO: Julie Hopper HOPPER J (WHO) READ: UNKNOWN

TO: Kimberly S. Hopper HOPPER K (WHO) READ: UNKNOWN

TO: Sharon Kennedy KENNEDY SM ) (WHO) READ: UNKNOWN

TO: FAX (2560,Kristie Kenney) TLXAlMAIL \F: 2560\C: KRIStie Kenney\\ ) (D READ: UNKNOWN

TO: David Leavy LEAVY D (WHO) READ: UNKNOWN

TO: Carola McGiffert MCGIFFERT C ) (WHO) READ: UNKNOWN

TO: Regina T. Montoya MONTOYA R (WHO) READ: UNKNOWN

TO: Lisa Mortman MORTMAN L ) (WHO) READ: UNKNOWN

TO: Dee Dee Myers MYERS D (WHO) READ: UNKNOWN

TO: Kathleen L. O'Neill ONEILL K (WHO) READ: UNKNOWN

TO: Eric w. Payne PAYNE E (WHO) READ: UNKNOWN

TO: John Podesta PODESTA J ) (WHO) READ: UNKNOWN

TO: Meeghan E. Prunty PRUNTY M (WHO) ARMS Email System Page 3of9

READ: UNKNOWN

TO: Bruce Reed REED B ) (OPD) READ: UNKNOWN

TO: Marla Romash ROMASH M ) ( VPO) READ: UNKNOWN

TO: Ricki Seidman SEIDMAN R (WHO) READ: UNKNOWN

TO: David Seldin SELDIN D ) (WHO) READ: UNKNOWN

TO: Stephen B. Silverman SILVERMAN S ) (WHO) READ: UNKNOWN

TO: Patti Solis SOLIS P ) (WHO) READ: UNKNOWN

TO: Jason M. Solomon SOLOMON J ) (WHO) READ: UNKNOWN

TO: Gene Sperling SPERLING G ) (OPD) READ: UNKNOWN

TO: Todd Stern STERN T ) (WHO) READ: UNKNOWN

TO: Richard Strauss STRAUSS R ) (WHO) READ: UNKNOWN

TO: Stephanie Streett STREETT S ) (WHO) READ: UNKNOWN

TO: Kimberly Tilley TILLEY K ) (WHO) READ: UNKNOWN

TO: Maria M. Tio TIO M ) (WHO) READ: UNKNOWN

TO: Stuart E. Trevelyan TREVELYAN S ) (WHO) READ: UNKNOWN

TO: Christine A. Varney VARNEY C (WHO) READ: UNKNOWN

TO: A. Victoria Rivas-Vazquez RIVASVAZQU_A ) (WHO) READ: UNKNOWN

TO: Lorraine A. Voles VOLES L (WHO) READ: UNKNOWN

TO: Michael Waldman WALDMAN M ) (WHO) READ: UNKNOWN

TO: Ann F. Walker WALKER A ) (WHO) READ: UNKNOWN

TO: Anne Walley WALLEY A ) (WHO) ARMS Email System Page 4 of9

READ: UNKNOWN

TO: Carter Wilkie WILKIE C (WHO) READ: UNKNOWN

TO: FAX (1121,Marilyn Yager) TLXAlMAIL \F: 1121 \C:MARilyn Yager\\ ) (DE READ: UNKNOWN

TO: Kathy McKiernan MCKIERNAN K (WHO) READ: UNKNOWN

TO: David B. Anderson ANDERSON D (WHO) READ: UNKNOWN

TO: Jess Sarmiento SARMIENTO J (WHO) READ: UNKNOWN

TO: Andre C. Oliver OLIVER A (WHO) READ: UNKNOWN

TO: Kelly A. Crawford CRAWFORD K (WHO) READ: UNKNOWN

TO: Deborah L. Coyle COYLE D (WHO) READ: UNKNOWN

TO: Betty W Currie CURRIE B (WHO) READ: UNKNOWN

TEXT: PRINTER FONT 12 POINT COURIER NEWS CALENDAR, Edition: Wednesday, April 7, 1993 This calendar lists all relevant news expected over the next six weeks. Some of this information is tentative; it is intended for planning purposes only, not for general distribution. Please send your additions or corrections to this calendar to: Eric Payne, Communications Research, OEOB 197 456-7845, FAX: 456-2239. Current week's calendar is also available on OASIS anytime: goto Info Mangement menu, type "PROT" return, then type "NC" return. WED 4/7 President: Airline Commission bill signing, 10:30 am. VP & Espy, Reinventing Government at USDA, 9:30 am. McLarty: "Today" on NBC. Reich: briefing on the 1994 budget, 9:30 am. Babbitt: Interior's Nat'l Biological Survey, Colorado. Shalala: Larry King Live, TIME editorial board. Christopher: Australian FM Evans. NIH: AIDS Program Advisory Committee meeting. Demographic state of the nation, population survey, DoC. Mfg., mining, whole., & retail, fourth qtr, 10 am. Consumer credit February, tentative. Auction of three-month and six-month Treasury bills, 2 pm. Chief economist of Merrill Lynch on Clinton plan. Reform Superfund: Coalition of 18 Fortune 500 Companies. Common Cause's Clean-up D.C. Day (campaign finance reform). Nat'l Student Hunger Strike protests refugees at Guantanamo Police Foundation: "Civil Disorder, How Should We Prepare?" U.S. Marines: first-hand accounts on Somalia, 9 am. "Not in My Army" (gays in military) on CBS' "48 Hours" Cambodian electoral campaign begins. ARMS Email System Page 5of9

UN World Health Day. THU 4/8 FY94 budget release. WH officials on morning news shows. VP attends Braves season opener, Atlanta. Shalala: HHS budget for FY94. Riley: DoEd budget for FY94. DoEd's Nat'l Trial State Assessments in Math: NPressClub. Producer prices. Plant & equip. expenditures, IV qtr 1992. Blue Chip Ee. Forecast, tentative. ABC's "Prime Time Live" features govt waste. Wilhelm: Ohio University Alumni Association. Latvian FM Andrejevs visits Washington. Cherry blossoms predicted at peak in D.C. Ryan White death anniversary. Birthday of the Buddha. 17th amend. to US Constitution ratifed. Federal Govt seizure of steel mills anniversary. FRI 4/9 Trial of LAPD officers could go to jury this weekend. Shalala: satellite tour on health care reform.

Consumer prices. Real earning, lO am. Good Friday. Lee surrendered to Grant at Appamattox Courthouse. SAT 4/10 UN Sec encl review of Libyan compliance w/ anti-terrorism. Bataan Death March Anniversary, 5,200 Americans died. SUN 4/11 Easter Sunday Pope says Mass broadcast worldwide from St. Peter's. 40th anniversary of HHS. Civil Rights Act of 1968, 25th anniversary. MON 4/12 White House Easter Egg Roll, South Lawn. Transprtn report out on nation's highways and bridges. Browner: "Close-Up" Q&A session (CSPAN). World ag. supply/demand estimates, 3 pm. Crop production, 3 pm. TUE 4/13 Major Labor/Ed Depts. symposium on summer jobs program. (Includes satellite town hall meetings) Gorbachev attends Th. Jeffersonis 250th at Monticello. OPEC ministers meet. Advance retail sales. State and area employ. & unemploy. February, 10 am. World ag. production, 3 pm. "Frontline" segment on illegal high-tech exports to Iran. Pulitzer Prizes awarded in NY. California Congressional District 17 Primary. Mississippi Congressional District 02 Runoff. Birthday: Eudora Welty. WED 4/14 Major Labor/Ed Depts. symposium on summer jobs program. Bob Dole tests campaign waters in New Hampshire. Mfg. and trade inventories & sales February, 10 am. 10 day auto sales, 4 pm. G-7 Finance and Foreign Ministers mtg, Tokyo. ARMS Email System Page 6of9

Pena: ISTEA, Kalispell, Montana. Riley: H Appropriations. Browner: Wilderness Society's Env. Women of Action Awards. FEMA: Nat'l Hurricane Conference, Orlando, FL. Stock market: H Telecommunications Finance Subc. Nat'l Conference of Black Mayors, NY, thru 4/18. Italy's parliament: immunity of former PM Andreotti. Pan American Day & Week, Presidential Proclamation. Lincoln assassinated at Ford's theater. THU 4/15 Tax filing deadline. Bob Dole tests campaign waters in New Hampshire. GAO report due on DoD base closure recommendations. Shalala: Grand Forks and Minot, North Dakota. Expected indictment of Clark Clifford & Robert Altman. Texas Senate debate live on C-Span, pm. FRI 4/16 President meets with Japan PM Miazawa at WH.

Optical Fibre to link Australia/New Zealand/US. Mdse. exports & imports-February. Industrial production & capacity util., 9:15 am. Consumer sentiment for April, U Mich, pre-release. Riley: Education writers conference, Boston. Kemp, Oprah, et al, get Horatio Alger Ass'n award. Vermont Maple Festival (Apr. 16-18). SAT 4/17 VP and Mrs Gore in Orlando, Florida. Tyson: Business Week Forum of 100 CEO's, Florida. Dept. of Energy: National Science Bowl. SUN 4/18 VP in New York Mrs. Gore in New Orleans. Orthodox Easter Sunday. Holocaust Day, Allied troops liberated Buchenwald. National Volunteer Week. Grange Week. National Library Week. MON 4/19 Congress returns from recess. Trade negotiations w/ EC Trade Minister Brittan in DC. Shalala: Women's Econ Roundtable, NY. Nat'l Ass'n of Broadcasters Convention, Las Vegas, NV Radio/TV news dir. Ass'n Convention, Mimai, FL Nat'l Ass'n of Agricultural Journalists, Wash., D.C. Boston Marathon. Monthly Treasury statement. Warsaw Ghetto Revolt: 50th Anniversary. TUE 4/20 Senate resumes votes on stimulus package. Czech President Havel in DC. Trade negotiations w/ EC Trade Minister Brittan in DC. Proposed date for Middle East Peace talks. Los Angeles Mayoral Primary. Sustainable development assistance, S Appropriations. Development Assistance, Foreign Op subc: S Appropriations. Eleventh ASEAN-US Dialogue. National Youth Service Day. Anniversary of LA Conservation Corps. Public Allies Awards Day. ARMS Email System Page 7of9

WED 4/21 Czech President Havel in DC. Kindergarten Day. National Convention of American Mothers Inc. Eleventh ASEAN-US Dialogue. Professional Secretaries Day & Week. Birthdays: Queen Elizabeth II, former Gov. Tom Kean. THU 4/22 Earth Day. President: Holocaust Memorial Museum Opening Ceremonies. (includes Presidents of Austria, Romania, and German FM) Shalala: Nat'l Min AIDS encl, D.C.

FHA meeting yields. Birthday: Jack Nicholson. FRI 4/23 Journalists begin evaluations of Clinton's first 100 days. Senate Democrats' scheduled health care retreat. State & area employment and unemployment for January. Read Me Day: celebrities/volunteers read in classrooms. Wm Shakespeare's birth and death Anniversary. SAT 4/24 Homosexual veterans to stage event in Arlington Cemetery. Senate Democrats' scheduled health care retreat. Advance durable shipments and orders. Revised housing permits (for latest month) 10-day auto sales. Immunization Week. Armenian Martyrs Day. SUN 4/25 Referendum in Russia. Nat'l March on Washington for Gay & Lesbian Rights. Abortion first legalized anniversary. "Earth Day USA" proposes "We're All in This Together Week." Existing home sales (NARealtors) . Big Brothers/Big Sisters Appreciation Week. National Crime Victims Rights Week. National Science and Technology Week. Birthday: William J. Brennan, Jr. MON 4/26 President meets with Italy PM Giuliano. Shalala: Council of Jewish Fed., D.C. GDP-IV (revised). Corporate profits-IV (preliminary). Import & export price indexes. Newspaper Ass'n of America Publisher's Convention, Boston. Holocaust Memorial Museum opens to public. Israel Independence Day. Chernobyl Nuclear Reactor Disaster Anniversary. TUE 4/27 Foreign aid, population, health and drugs, S Approp. Newspaper Ass'n of America Publisher's Convention, Boston. Birthday: Coretta Scott King. WED 4/28 Workers' Memorial Day, (for injured or killed workers). Hearings on OSHA reform. Spain's King Juan Carlos and Queen Sophia visit Phila., PA. Newspaper Association of America Annual Convention. Birthday: James A. Baker, III. THU ARMS Email System Page 8of9

4/29 Technically lOOth day of President's term. FDR's First 100 Days: author Patrick Maney, Nat'l Archives. One year anniversary of L.A. riots. FRI 4/30 State Dept. annual report: Patterns of Global Terrorism. USTR: report on foreign discrimination in gov procurement. USTR: intellectual property rights protection report.

National Arbor Day (proposed), Presidential Proclamation. 1st Presidential Inauguration Anniversary. SAT 5/1 WH Correspondents Association Dinner. Kentucky Derby. Senate election in Texas. Transition date set for Somalia Operations by UN Sec Gen. Breaux Bridge Crawfish Festival, LA, 200,000 attendees. Law Day, Presidential Proclamation. Loyalty Day, Presidential Proclamation. American Lung Association Clean Air Campaign 1993. National Allergy/Asthma Awareness Month. National Arthritis Month. Older Americans Month. Mental Health Month. Steelmark Month. May Day. SUN 5/2 Gov. 's Bay Bridge Run and Bayfest, Chesapeake Bay Bridge. 2nd Annual Nat'l River and Trail Cleanup Weak. MON 5/3 National Nurses Week. Nat'l Mtg of Obstetricians & Gynecologists (HRC invited) National Public Radio: 1st Broadcast anniversary. Public Service Recognition Week. TUE 5/4 National Teacher Day. Birthday: George F. Will. WED 5/5 Cinco De Mayo: fetes in Hispanic communities nationwide. Hoagie Day in Philadelphia. THU 5/6 National Day of Prayer, Presidential Proclamation. FRI 5/7 U.S.-EC summit. WH hosts European encl Pres. Rasmussen and EC Pres. Delors. International Bar-B-Q Festival, Owensboro, KY. Battle of Dien Bien Phu ends French rule in Indochina 1954. Birthday: Sen. Pete V. Domenici. SAT 5/8 V-E Day, Surrender of Germany to Allied Forces. Birthday: Sen. Dennis DeConcini, Harry S Truman. SUN 5/9 Mother's Day: Presidential Proclamation. National Historic Preservation Week. Police Week: Presidential Proclamation. Small Business Week. Russia Victory Day honors 20 million who died in WWII. "Vast Wasteland" speech anniversary, Newton Minow, 1961. 5/10 Mrs. Gore (tentative): Mental Health Speech, Chicago. First mtg of Non-Proliferation Treaty (NPT) Prep Comm, NY. Basketball Hall of Fame Enshrinement Ceremonies. ARMS Email System Page 9of9

Birthday: T. Berry Brazleton.

5/13 WH News Photographers Ass'n Dinner. 5/15 Nat'l Peace (Police) Officers Memorial Service. 5/17 Proposed Mid-East talks on arms control/regional security. 5/18 Education Dept's satellite town mtg on education reform. 5/22 Riddick Bowe, heavyweight champion defends title at RFK. 5/23 Elections for the Cambodian Constituent Assembly. US-Mexico Three-City Program under NAFTA. 5/24 Mrs. Gore: American Psychiatric Ass'n, S. Francisco. 5/25 Mrs. Gore: Anti-Defamation League, California. Tentative: Mrs. Gore w/Magic Johnson in South Central, LA. 5/29 Memorial Day weekend. 5/31 Memorial Day. 6/1 Deadline for DoD to publish changes to base closings list. Start of hurricane season. 6/2 Forest policy proposal due (60 days after 4/2 conference). 6/TBD US/EC Ministerial, Sec of State mtg w/EC Commissioners. 6/3 Deadline for President to announce China's MFN status. 6/5 World Environment Day, Global 500, Nairobi. Robert F. Kennedy shot in Los Angeles, 25th anniversary. 6/14 UN World Conference on Human Rights, Vienna. 6/28 Trial of former Reagan HUD official: Debroah Gore Dean. 7/15 Deadline for President to approve/reject base closing list. Deadline for report on homosexuals in the military. ARMS Email System Page 1 of 2

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Julie E. Demeo ( DEMEO J ) (OPD)

CREATION DATE/TIME: l-SEP-1995 14:31:59.43

SUBJECT: Daily DPC Report

TO: Adam R. Kreisel KREISEL A (WHO) READ: l-SEP-1995 14:36:26.42

TEXT: see attached. Is this the last one? ======ATTACHMENT 1 ======ATT CREATION TIME/DATE: l-SEP-1995 14:30:00.00

ATT BODYPART TYPE:p

ATT CREATOR: Julie E. Demeo

TEXT:

PRINTER FONT 12 POINT COURIER September 1, 1995

DAILY BRIEFING MEMORANDUM FOR THE PRESIDENT FROM: DOMESTIC POLICY COUNCIL SUBJECT: Daily Briefing on DPC Issues

Background and Update on Zero Tolerance As you know, on June 10, 1995, you gave a Radio Address on Zero Tolerance. In this address, you called on Congress to make Zero Tolerance "the law of the land" by calling on the states to adopt Zero Tolerance laws for teenagers caught drinking and driving with a blood alcohol content of more than .02 percent, or the equivalent of one beer, one wine cooler, or one shot of alcohol. You were joined at this address by members of Mothers Against Drunk Driving, Students Against Drunk Driving, AAA, and the National Safety Council, who all expressed strong support for this effort. On June 21, you sent a letter to Senator Byrd, commending his efforts on the Zero Tolerance issue and urging the Senate to pass Senator Byrd's Zero Tolerance amendment to the National Highway System Designation Act, which would achieve your objective of making Zero Tolerance "the law of the land." Later that evening, the amendment passed by a margin of 64 D -34. The House has not yet acted on the Highway System Designation Act, but is planning on taking it up by mid September. Currently there have been no Zero Tolerance Amendments offered in committee, but Representative Flake (D D -NY) is planning on offering an amendment similar to Senator Byrd's when the bill comes to the floor. Since the June 10 Radio Address, the Department of Transportation and the White House has been communicating with a number of safety groups on the issue of Zero Tolerance, including MADD, SADD, and the National Safety Council. Last week, SADD sent out ARMS Email System Page 2of2

its Fall newsletter to over 25,000 schools across the country. This newsletter focused on the issue of Zero Tolerance, and contained a message from you on Zero Tolerance on the front page. We plan on continuing to work with these groups to promote the Zero Tolerance issue and its inclusion in the House version of the National Highway Bill in September.

Medicare and Medicaid

We have scheduled a series of meetings with possible "validators" on Medicare and Medicaid. Early next week, Laura Tyson will meet with Robert Reischauer. HIV/AIDS Discrimination Several recent examples of AIDS D -related discrimination have been in the news. In South Carolina, a judge has ruled that the state can deny coverage in its high D -risk insurance pool to people with AIDS or HIV. The case is expected to be appealed. A woman with HIV who had been deported from Egypt was barred from a flight to her home in Ethiopia because of her infection. In Romania, an eight [] -year old boy with AIDS was stoned by villagers seeking to evict him and his family from their home. [More than 90 percent of AIDS cases in Romania are among children] . In China, workers at the World Health Organization's Fourth World Conference on Women were warned to cover their bodies with bug spray because flies might transmit HIV carried by lesbian attendees.

Housing As part of HUD's nationwide effort to crack down on owners of federally assisted housing who do not meet their contractual obligations, Sec. Cisneros yesterday served a notice of mortgage default on the owners of Clifton Terrace Apartments, a troubled 258 0 -unit federally subsidized development in Washington, D.C. Increasing problems of crime, poor maintenance, and mismanagement preceded HUD's action at Clifton Terrace. HUD is seeking to have the landlord voluntarily transfer possession of the property to HUD; if this does not occur, HUD will seek legal actions to take control. Sec. Cisneros' press conference was covered by the local evening news.

======END ATTACHMENT 1 ======ARMS Email System Page I of 4

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Jeffrey Levi ( LEVI_J (WHO)

CREATION DATE/TIME:23-APR-1996 19:03:22.28

SUBJECT: conference listings

TO: Ursula Sanville SANVILLE U (OPD) READ:30-APR-1996 17:44:49.47

TO: Lahoma Romocki ROMOCKI L (OPD) READ:24-APR-1996 13:28:10.65

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE:23-APR-1996 03:26:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsnews

ATT SUBJECT: New Conference Listings 04/23/96

ATT TO: levi j levi_j@Al@CD )

TEXT: CDC National AIDS Clearinghouse Conference Calendar Database

NEW CONFERENCE LISTINGS April 23, 1996

The Clearinghouse's Conference Calendar Database contains information about upcoming conferences related to HIV and AIDS.

NAC ONLINE users can search this database by selecting "Clearinghouse Databases" from the NAC ONLINE main menu. When asked to enter a database name, specify "CONF" to search the Calendar.

To access the NAC ONLINE BBS, set your communications software to dial (800) 851-7245, and set the options for 8 data bits, N parity, 1 stop bit, full duplex, and complete a new user questionnaire. Only non-profit organizations, government agencies, educational institutions, and health departments are given full access to NAC ONLINE and the NAC databases.

Overnight, 7 new listings were loaded to the Conference Calendar Database. Their records follow:

TITLE: Social Marketing in Public Health DATE: June 19-22, 1996 LOCATION: Clearwater Beach, FL SPONSOR ( S) : Department of Community and Family Health, College of Public Health, University of South Florida CONTACT: Ginger Phillips, College of Public Health - MDC 56, USF Health ARMS Email System Page 2 of 4

Sciences Center, 12901 Bruce B. Downs Blvd., Tampa, FL 33612-4799, (813) 974-4867, FAX: (813) 974-5172, Internet email: [email protected] EVENT TYPE: Conference TOPICS: Adolescents. Condom use. Sexually transmitted diseases (STDs). Research programs. Social factors. Community health. Schools. Education. Media. Advocacy. NOTES: Fee: Preconference: Before May 20, $140; After May 20, $160; Main conference: Before May 20, $190; After May 20, $210. One day registrations available. Discounts for students. Additional fees for dinner, late registration (after June 10), and CHES accreditation fee. Accommodations, (813) 595-1611. Travel, (800) 940-1901. Continuing education credits available. For poster session information, see the contact person.

TITLE: New Perspectives in the Management of HIV Disease DATE: May 4, 1996 LOCATION: Bethesda, MD SPONSOR (S): World Health CME; Glaxo Wellcome, Inc. CONTACT: World Health CME, World Health Communications, Inc., 41 Madison Ave., New York, NY 10010-2202, (800) 433-4584, (800) 521- 1177 (within New York state only), FAX: (212) 481-8534, Internet email: [email protected] EVENT TYPE: Conference TOPICS: Case management. Treatment. Therapies. Virology. NOTES: Continuing education credits available.

TITLE: Embracing change: Challenges and Opportunities; Health Care for the Homeless Conference; 7th Annual DATE: June 6-8, 1996 LOCATION: Washington, DC SPONSOR(S): U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Primary Health Care, Division of Programs for Special Populations CONTACT: Maggie Castoires, HCH Conference Registrar, John Snow, Inc., 44 Farnsworth St., Boston, MA 02210, (617) 482-9485, FAX: (617) 482-0617 EVENT TYPE: Conference TOPICS: Homeless persons. Community health. Women. Children. Families. NOTES: Fee: Before May 10, $185; After May 10, $200.

TITLE: The ADA: A Road Map to Opportunity; North Carolina statewide Americans with Disabilities Act Conference DATE: May 15-17, 1996 LOCATION: Research Park, NC SPONSOR(S): National Association of ADA (Americans with Disabilities Act) Coordinators CONTACT: National Association of ADA (Americans with Disabilities Act) Coordinators, One World Trade Center, Ste. 800, Long Beach, CA 90831-0800, (800) 722-D-ADA, FAX: (800) 9-FAX-ADA EVENT TYPE: Conference. TOPICS: Workplaces. Americans with Disabilities Act (ADA). Reasonable accommodations. Legislation or regulation. Legal issues. Schools. Information resources. NOTES: Fee: Member, $120; Non-member, $150. Additional fees for keynote luncheon and pre- and post-conference workshops. Continuing ARMS Email System Page 3 of 4

education credits available.

TITLE: National Wellness Conference DATE: July 15-19, 1996 LOCATION: Stevens Point, WI SPONSOR (S): National Wellness Institute, Inc. CONTACT: National Wellness Institute, Inc., 1045 Clark St., Ste. 210, P.O. Box 827, Stevens Point, WI 54481-0827, (800) 243-8694, FAX: (715) 342-2979, Internet email: [email protected] EVENT TYPE: Conference TOPICS: Health promotion. Spirituality. Community health. Emotions. Women. Information dissemination. Cultural factors. Children. NOTES: Fee: National Wellness Association Member, $419; Non- member, $459. Additional fees for preconference seminars, conference meals, and housing.

TITLE: Emerging Trends in HIV Disease DATE: June 1, 1996 LOCATION: Queens, NY SPONSOR (S) : HIV Clinical Education Initiative at SUNY Brooklyn CONTACT: (718) 270-4752 EVENT TYPE: Conference TOPICS: Pregnancy. Virology. Treatment. Therapies. Neurological diseases or disorders. NOTES: Fee: $10. Continuing education credits available.

TITLE: Building Service Skills for HIV DATE: May 21, 1996 LOCATION: Brooklyn, NY SPONSOR (S) : AIDS Education and Training Center at SUNY: Health Science Center at Brooklyn (HSCB); the HIV Clinical Education Initiative at SUNY:HSCB; HIV Clinical Educat·ion Initiative at Woodhull Hospital; Bedford-Stuyvesant HIV Care Network; East New York/Brownsville HIV Care Network; Fort Green HIV Project; Williamsburg/Greenpoint/Bushwick HIV Care Network; and Brooklyn AIDS Task Force CONTACT: Miriam Gross, (718) 270-3796 EVENT TYPE: Conference TOPICS: Medicare. Medicaid. Treatment. Women. Case management. Substance abuse. Cultural factors. Alternative therapies. NOTES: Fee: $15; students, $10 (must show student ID).

Information about additional conferences is welcome. Please send E-Mail to Flynn McLean (through NAC ONLINE, or [email protected] via the Internet) at the CDC National AIDS Clearinghouse; include the title, dates, site, sponsoring agency, contact information, registration fee, and topics to be discussed at the conference.

======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE:23-APR-1996 12:26:00.00

ATT BODYPART TYPE:D ARMS Email System Page 4of4

TEXT: RFC-822-headers: Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for levi [email protected]; Tue, 23 Apr 1996 12:24:38 -0400 (EDT) Received: from aspensys (aspensys.aspensys.com) by STORM.EOP.GOV (PMDF V5.0-6 #6879) id <[email protected]> for [email protected]; Tue, 23 Apr 1996 12:24:58 -0700 (MST) Received: by aspensys (5.0/SMI-SVR4) id AA06806; Tue, 23 Apr 1996 12:26:13 +0500 Errors-to: [email protected] Precedence: bulk Originator: [email protected] X-Comment: CDC National AIDS Clearinghouse X-Listprocessor-version: 6.0c -- ListProcessor by Anastasios Kotsikonas ======END ATTACHMENT 2 ======ARMS Email System Page 1 of 5

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Jeffrey Levi ( LEVI J (WHO)

CREATION DATE/TIME:29-APR-1996 09:09:47.59

SUBJECT: daily news

TO: Patsy Fleming FLEMING P (WHO) READ:29-APR-1996 10:51:07.40

TO: Ursula Sanville SANVILLE U (OPD) READ: 2-MAY-1996 12:25:21.45

TO: Lahoma Romocki ROMOCKI L (OPD) READ:NOT READ

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE:25-APR-1996 11:51:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsnews

ATT SUBJECT: CDC AIDS Daily Summary, 04/25/96

ATT TO: levi_j levi j@Al@CD

TEXT:

AIDS Daily Summary April 25, 1996

The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

************************************************************ "Mandate That HIV Troops Be Discharged Is Set for Repeal" "Abbott Laboratories: FDA Approves New Test for Detecting AIDS Virus" "AIDS and the City" "Distrust Distorts True Blood Picture" "Don't Abandon Infected Babies" "Immune Activation Impaired in Lungs of HIV-Positive TB Patients" "African Armies Weakened by HIV and AIDS" "Risk Factors for Symptomatic CMV in HIV-Positive Children Identified" "Viral Load: Inconclusive FDA Hearing" "Peripheral-Blood-Based PCR Assay to Identify Patients With Active Pulmonary Tuberculosis" ************************************************************ ARMS Email System Page 2 of 5

"Mandate That HIV Troops Be Discharged Is Set for Repeal" New York Times (04/25/96) P. Bl3; Shenon, Philip Leaders of the House and Senate agreed on Wednesday to repeal legislation that would have forced the discharge of all HIV-positive military members. The repeal was included in a major budget bill that will soon be forwarded to both houses of Congress and is expected to pass easily. Sen. Mark 0. Hatfield (R-Ore.) led the fight for the repeal, which was supported by the White House and the Pentagon. The discharge provision was part of a Defense Department spending bill that was passed two months ago. Rep. Robert K. Dornan (R-Calif.), who sponsored the measure, vowed to reintroduce legislation for the ban in the 1997 Defense appropriation bill. Related Stories: USA Today (04/25) P. 9A; Washington Times (04/25) P. A4

"Abbott Laboratories: FDA Approves New Test for Detecting AIDS Virus" Wall Street Journal (04/25/96) P. B2 The Food and Drug Administration has given approval to Abbott Laboratories' new test for HIV, to be called Hivag-1 Monoclonal. The new test, which detects the p24 antigen of the virus, will be used to treat HIV-infected patients and will be sold to blood banks and plasma-collection centers for HIV screening in the United States. The test is designed to detect HIV infection sooner than tests that detect antibodies to the virus.

"AIDS and the City" Washington Post (04/25/96) P. A30 An editorial in the Washington Post points out that while Washington, D.C., was recently said to have the highest number of AIDS cases in the nation, the Centers for Disease Control and Prevention statistics compared the city to other states. Because AIDS cases are concentrated in urban areas, the editors contend, it would be expected that the rate appears high when compared with states, even those that have major cities. A more telling analysis, however, would compare metropolitan areas that include large cities and some surrounding counties. By this comparison, Washington would rank fourth behind San Francisco, New York, and Baltimore, respectively. The editors also note that although the CDC report shows the number of new AIDS cases dropping, this decline is a result of a new, broader definition of AIDS being adopted in 1994.

"Distrust Distorts True Blood Picture" Toronto Globe and Mail (04/24/96) P. AS; Picard, Andre In a news analysis in the Toronto Globe and Mail, Andre Picard writes that the low public confidence in Canada's blood supply is reasonable in light of Canada's tainted-blood tragedy, but points out that the public should also recognize improvements that have been made in the system. The Canadian Red Cross and public health officials insist that the blood system is safe, yet Picard notes that public distrust of the blood system will remain until an explanation is given for the distribution of tainted blood products. The infections happened more than ten years ago; however, news of the public inquiry into the incident has raised fears about AIDS and hepatitis. Moreover, the threat of becoming infected from a blood transfusion is now greatly reduced, yet a new poll found that people fear transfusions more than they fear ARMS Email System Page 3 of 5

dying from surgery. In conclusion, Picard asserts that giving blood will help save lives and notes that although transfusions are safe, they should not be given unless necessary.

"Don't Abandon Infected Babies" Wall Street Journal (04/24/96) P. AlS; Mayersohn, Nettie In a letter to the editor of the Wall Street Journal, Nettie Mayersohn, a New York state legislator, responds to a previous letter that opposed federal legislation to require newborns to be tested for HIV if their mothers' HIV status had not been determined during pregnancy. Mayersohn writes that she has introduced similar, necessary legislation in the New York State Assembly because many HIV-infected women do not receive prenatal care and thus cannot take advantage of treatment during pregnancy that would reduce the chance of transmission of HIV to their children. She points out that 75 percent of children born with HIV are not really infected and that if their mothers were counseled to avoid breastfeeding, they might not contract the virus. By passing the Ackerman-Coburn Amendment, Mayersohn notes, policy makers could help stem the spread of the epidemic.

"Immune Activation Impaired in Lungs of HIV-Positive TB Patients" Reuters (04/24/96) HIV-positive patients with tuberculosis (TB) have a significant reduction in CD4 cell proliferation in lung tissue, New York University researchers report. This contrasts with the normal host response in HIV-negative individuals, marked by a proliferation of CD4 cells. Dr. Kevin F. Law and colleagues tested the cellular response in lung segments of 28 TB patients. Seventeen were HIV-positive. Both HIV-positive and HIV-negative patients had significantly increased numbers of total cells. HIV-positive patients with TB had a lower proportion of CD4 cells and a higher proportion of CDS cells in the lung segments than HIV-negative patients with TB.

"African Armies Weakened by HIV and AIDS" Reuters (04/24/96) Half the soldiers in some African countries are infected with HIV, participants in an AIDS conference for military officers were told Wednesday. The prevalence of HIV in the armies of developing countries, especially in Africa, are exceptionally high, Malawian Defense Minister Justin Malewezi reported. Ebrahim Samba, the World Health Organization director for Africa, said soldiers are a high-risk group because they are young, sexually active, and away from home for long periods of time. These men may pay prostitutes for sex or have sex with women from the local community, and do not usually use condoms, he added.

"Risk Factors for Symptomatic CMV in HIV-Positive Children Identified" Reuters (04/23/96) New York University researchers report in the Pediatric Infectious Diseases Journal that HIV-positive children with cytomegalovirus (CMV) infection and low CD4 cell counts are more likely to develop symptoms of CMV infection. Children with elevated levels of HIV p24 antigen are also at greater risk for the disease. Dr. Sulachni Chandwani and colleagues studied three groups of children: some who were HIV-positive, some who were seroreverters born to HIV-positive women, and some who were born ARMS Email System Page 4 of 5

to HIV-negative women. Seven of the 40 HIV-positive children with CMV developed symptoms of the infection. They also had significantly lower CD4 T cell counts and greater HIV p24 concentrations.

"Viral Load: Inconclusive FDA Hearing" AIDS Treatment News (04/05/96) No. 244, P. 5; James, John S. The Food and Drug Administration met in March to consider the first viral load testing kit, Hoffmann-La Roche's Amplicor HIV Monitor, to be submitted for formal FDA approval. While the agency is likely to approve viral load tests, it may approve them for prognosis only--which could result in managed care and insurance companies paying for only one or two tests in a patient's lifetime. Many doctors, however, would want to use the tests to determine what treatment strategy is best for a patient and to monitor the effectiveness of drug therapies. Some activists are now worried that the FDA's approval might discourage this use of viral load testing.

"Peripheral-Blood-Based PCR Assay to Identify Patients With Active Pulmonary Tuberculosis" Lancet (04/20/96) Vol. 347, No. 9008, P. 1082; Condos, Rany; Mcclune, Amy; Rom, William N.; et al. Dr. Neil W. Schluger and colleagues at the Bellevue Hospital in New York report that they used a polymerase chain reaction (PCR) assay, which detects circulating mycobacterial DNA, to test peripheral blood from 88 patients admitted to a chest ward with suspected pulmonary tuberculosis (TB) . The researchers compared the PCR results to the final clinical diagnosis and found that the PCR assay correctly identified 39 of the 41 patients with proven TB. Of that number, 63 percent were sputum-smear negative. HIV infection was common among the patients. Overall, the sensitivity and specificity of the PCR assay were 95 percent and 89 percent, respectively. Based on these findings, Schluger et al. believe that peripheral-blood-based PCR detection for the diagnosis of TB is technically feasible and has a potentially important role in TB diagnosis.

======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE:25-APR-1996 11:51:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for [email protected]; Thu, 25 Apr 1996 11:49:21 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF V5.0-6 #6879) id <[email protected]> for [email protected]; Thu, 25 Apr 1996 11:49:40 -0700 (MST) Received: by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id LAA11137; Thu, 25 Apr 1996 11:51:11 -0400 Errors-to: [email protected] X-Mailer: Microsoft Mail V3.0 Precedence: bulk Originator: [email protected] X-Comment: CDC National AIDS Clearinghouse ARMS Email System Page 5 of 5

X-Listprocessor-version: 6.0c -- ListProcessor by Anastasios Kotsikonas ======END ATTACHMENT 2 ======ARMS Email System Page 1 of 7

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Jeffrey Levi ( LEVI J (WHO)

CREATION DATE/TIME:29-APR-1996 09:14:26.28

SUBJECT: mmwr

TO: Ursula Sanville SANVILLE U (OPD) READ:30-APR-1996 09:39:04.42

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE:26-APR-1996 17:11:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsnews

ATT SUBJECT: MMWR 04/26/96

ATT TO: levi j ( levi_j@Al@CD )

TEXT: MORBIDITY AND MORTALITY WEEKLY REPORT ****************************************** Centers for Disease Control and Prevention April 26, 1996 Vol. 45, No. 16

* Update: Influenza Activity_ United States and Worldwide, 1995 96 Season, and Composition of the 1996 97 Influenza Vaccine

* Multidrug-Resistant Tuberculosis Outbreak on an HIV Ward Madrid, Spain, 1991 1995

Update: Influenza Activity United States and Worldwide, 1995 96 Season, and Composition of the 1996 97 Influenza Vaccine To monitor influenza activity and to detect antigenic changes in the circulating strains of influenza viruses, CDC conducts surveillance in collaboration with the World Health Organization (WHO) and its international network of collaborating laboratories and with state and local health departments in the United States. This report summarizes surveillance for influenza in the United States and worldwide during the 1995 96 season and describes the composition of the 1996 97 influenza vaccine.

United States Influenza activity began in November 1995 and peaked during late December 1995 and early January 1996. In many parts of the country, influenza activity declined steadily during January and February; of the 34 states that reported levels of influenza-like illness for the week ending April 13, a total of 16 states reported sporadic* levels of influenza-like illness, and 18 states reported no activity. Of the 4132 influenza virus isolates reported to CDC from WHO collaborating laboratories in the United States from October 1, 1995, through March 30, 1996, a total of 3786 (92%) were ARMS Email System Page 2of7

influenza type A and 346 (8%) influenza type B. Of the 2416 type A isolates that were subtyped, 1427 (59%) were type A(HlNl), and 989 (41%) were type A(H3N2). Influenza type A(H3N2) predominated in the Mountain, New England, and Pacific regions, accounting for 70%, 56%, and 55% of subtyped influenza A isolates, respectively. Influenza type A(HlNl) predominated in the other six regions, accounting for 55%_82% of subtyped influenza A isolates. During February, although the total number of isolates decreased, the number and proportion of influenza type B isolates began to increase, and during March 1996, 50% 72% of all isolates reported were type B. The proportion of all deaths reported by the vital statistics offices of 121 U.S. cities that were attributed to pneumonia and influenza (P&I) only slightly exceeded the epidemic threshold ** during 3 of the 8 weeks from October 29 through December 23, 1995. During the 6 weeks from December 24, 1995, through February 3, 1996, the proportion of P&I deaths remained above the epidemic threshold, peaking at 8.2% of all deaths during the week ending January 20. However, since February 10, percentages of P&I deaths have been below the epidemic threshold.

Worldwide Influenza activity occurred at moderate to severe levels during October 1995_ March 1996. Epidemics associated with influenza A(H3N2) and A(HlNl) viruses were reported in countries in Europe, Asia, and North America, while influenza B viruses circulated at low levels. School outbreaks caused by influenza A(H3N2) viruses were reported in England beginning in September and October. During November and December, epidemic activity associated primarily with A(H3N2) viruses was reported by countries throughout Europe, including Belarus, Bulgaria, Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Latvia, Netherlands, Norway, Slovakia, Spain, Sweden, and the United Kingdom. During January, influenza A(H3N2) viruses were associated with outbreaks in Beijing and with high levels of influenza-like illness in six northern provinces of China. Isolation of influenza A(H3N2) viruses also was reported in North America (Canada and the United States), Europe (Belgium, Iceland, Ireland, Italy, Poland, Portugal, the Russian Federation, and Switzerland), Asia (Guam, Hong Kong, Japan, and Singapore), and Oceania (Australia and New Zealand) . For the first time sincethe 1991 92 influenza season, A(HlNl) viruses were associated with epidemics in several regions of the world. Epidemic activity associated with influenza A(HlNl) viruses was reported and predominated in Belgium, Canada, Japan, southern France, Switzerland, and the United States. Influenza A(HlNl) viruses were isolated in association with sporadic activity in Europe (Finland, Germany, Italy, Latvia, Netherlands, Poland, Romania, Russian Federation, Spain, Sweden, and the United Kingdom) and Asia (China, Hong Kong, Israel, and Thailand)

In comparison to type A influenza viruses, type B viruses have been isolated later in the season and less frequently worldwide. Influenza B viruses were isolated primarily in association with sporadic activity in North America (Canada and the United States), Asia (China, Hong Kong, Israel, Japan, and Singapore), Europe (Belarus, Finland, France, Germany, Greece, Hungary, Netherlands, Poland, Romania, Russian Federation, Sweden, Switzerland, and the United Kingdom), and Oceania (Australia and New Zealand) . ARMS Email System Page 3of7

Composition of the 1996_97 Vaccine The Food and Drug Administration Vaccines and Related Biological Products Advisory Committee (VRBPAC) has recommended that the 1996 97 trivalent influenza vaccine for the United States contain A/Wuhan/359/95-like(H3N2), A/Texas/36/91-like (HlNl), and B/Beijing/184/93-like viruses. This recommendation was based on the antigenic analysis of recently isolated influenza viruses and the antibody responses of persons vaccinated with the 1995 96 vaccine. Although most of the influenza type A(H3N2) viruses that have been antigenically characterized are similar to the A/Johannesburg/33/95 strain, increasing numbers of recently isolated A(H3N2) strains from Asia, Europe, and North America are more similar to the antigenic variant A/Wuhan/359/95 (Table 1). Vaccines containing the A/Johannesburg/33/94 (H3N2)-like virus induced a good antibody response to the vaccine strain but induced lower and less frequent antibody responses to recent type A(H3N2) strains such as A/Wuhan/359/95 (1). Therefore, VRBPAC recommended changing the influenza type A(H3N2) vaccine component to an A/Wuhan/359/95-likestrain for the 1996_97 season. The strain that will be used by U.S. vaccine manufacturers because of its growth properties will be the antigenically equivalent A/Nanchang/ 933/95 virus. Virtually all (98%) influenza A(HlNl) viruses that have been antigenically characterized are similar to the reference strains A/Taiwan/01/86 and A/Texas/36/91. Because vaccines containing the A/Texas/36/91 strain induced antibodies with similar frequency and titer to both the vaccine virus and to recent type A(HlNl) strains (1), VRBPAC recommended retaining an A/Texas/36/91-like strain in the 1996 97 vaccine. Antigenically characterized influenza B viruses isolated recently in Asia, Europe, and the United States have been similar to the reference strains B/Beijing/184/93 and B/Harbin/07/94. Vaccines containing the B/Harbin/07/94 strain induced antibodies with similar frequency and titer to the vaccine virus and to recently isolated influenza B strains (1). Therefore, VRBPAC recommended retaining B/Harbin/07/94-like strain in the 1996 97 vaccine.

Reported by: Participating state and territorial health dept epidemiologists and state public health laboratory directors. M Zambon, PhD, Central Public Health Laboratory, A Hay, PhD, National Institute for Medical Research, London; G Schild, DSc, J Wood, PhD, National Institute for Biological Standards and Control, Hertfordshire, England. I Gust, MD, A Hampson, Commonwealth Serum Laboratories, Parkville, Australia. L Canas, Armstrong Laboratory, Brooks Air Force Base, Texas. Y Guo, Institute of Virology, National Center for Preventive Medicine, Beijing, People's Republic of China. World Health Organization National Influenza Centers, Div of Emerging and other Communicable Diseases Surveillance and Control, Geneva. Div of Virology, Center for Biologics Evaluation and Research, Food and Drug Administration. Influenza Br, Div of Viral and Rickettsial Diseases, National Center for Infectious Diseases, CDC.

Editorial Note: During the 1995_96 season, the impact of influenza in many parts of the United States and in some other countries in the Northern Hemisphere was more severe than during the previous season (2). In the United States, influenza type ARMS Email System Page 4of7

A(HlNl) viruses predominated for the first time since the 1986 87 season; although this subtype has not been associated with excess mortality in recent decades, the incidence of infection with type A(HlNl) has been high, especially among school-aged children. Influenza type A(H3N2) was not the predominant strain but circulated throughout the season and was associated with outbreaks among all age groups. Continued circulation of influenza type A(H3N2) and type A(HlNl) is anticipated during the 1996_97 season. Influenza B activity increased late in the 1995_96 influenza season, suggesting that type B viruses may circulate more widely next winter. Strains to be included in the influenza vaccine usually are selected during the preceding January through March because of scheduling requirements for production, quality control, packaging, and distribution of vaccine for administration before onset of the next influenza season. Recommendations of the Advisory Committee on Immunization Practices for the use of vaccine and antiviral agents for prevention and control of influenza will be published in an MMWR Recommendations and Reports on May 3, 1996.

References 1. World Health Organization. Recommended composition of influenza virus vaccines for use in the 1996 1997 flu season. Wkly Epidemiol Rec 1996;71:57 61. 2. CDC. Update: influenza activity_United States and worldwide, 1994_95 season, and composition of the 1995 96 influenza vaccine. MMWR 1995;44:292 5.

*Levels of activity are 1) sporadic sporadically occurring influenza-like illness (ILI) or culture-confirmed influenza with no outbreaks detected; 2) regional_outbreaks of ILI or culture­ confirmed influenza in counties with a combined population of <50% of the state's total population; and 3) widespread_outbreaks of ILI or culture-confirmed influenza in counties with a combined population of =>50% of the state's total population.

** The epidemic threshold is 1.645 standard deviations above the seasonal baseline calculated using a periodic regression model applied to observed percentages since 1983. The baseline was calculated using a robust regression procedure.

Multidrug-Resistant Tuberculosis Outbreak on an HIV Ward Madrid, Spain, 1991_1995 Beginning in 1990, outbreaks of multidrug-resistant tuberculosis (MOR-TB) have been reported in hospitals and prisons in the eastern United States (1). During June 199l_January 1995, MDR-TB was diagnosed in 47 patients and one health-care worker at a 120-bed, infectious disease referral hospital in urban Madrid; on April 19, 1995, the Spanish Field Epidemiology Training Program was asked to investigate this outbreak. This report summarizes the findings of this investigation, which suggested that nosocomial transmission of MDR-TB occurred on a hospital ward for patients with human immunodeficiency virus (HIV) infection. A case of MDR-TB was defined as culture-confirmed TB that was resistant to at least rifampin and isoniazid in a patient hospitalized on the ward for HIV-infected persons during June 199l_January 1995 and with no previous history of TB treatment. Case finding was coordinated by the mycobacteriology laboratory ARMS Email System Page 5of7

director and an infectious disease specialist, who reviewed medical records and laboratory results for persons with suspected MDR-TB. In addition to drug-susceptibility testing, analysis of resistant strains included DNA fingerprinting with restriction fragment-length poly-morphism (RFLP). Because the hospital did not have in place a ventilation system that recirculated or removed air, the acid-fast bacilli (AFB) isolation capacity (negative pressure and number of air interchanges per hour) could not be assessed on the HIV ward. MDR-TB was identified in 47 HIV-positive patients who had been hospitalized on the HIV ward during June 1991_January 1995. The mean age of case-patients was 34 years (range: 25_54 years); 39 (81%) were male, and 32 (67%) were injecting-drug users. The one health-care worker was HIV-positive and had worked on the HIV ward during 1990 1994. A total of 47 (98%) patients, including the health-care worker, had died at the time of the investigation; the mean interval from diagnosis of MDR-TB to death was 78 days. An analysis of isolates from TB cases throughout the hospital during 1991_June 1995 identified 104 that were drug-susceptible; 12 that were resistant to one drug; and 66 that were resistant to isoniazid, streptomycin, ethambutol, and rifampin (HSER) (Figure 1) . The proportion of Mycobacterium tuberculosis strains identified that were MDR-TB increased from 10% in 1991 to 53% in 1993 to 65% in June 1995. Beginning in 1993, the resistance pattern identified consistently in isolates was HSER: of the 26 cases diagnosed during October 1993_June 1995, this pattern was present in 24 (92%). Of the 12 isolates available for DNA fingerprinting, the same band patterns were present in 11 (Figure 2). For comparison, TB isolates were obtained from the two patients with different antibiograms; their RFLP analyses were distinct from those of isolates from the other patients. A case-control study was conducted to identify potential risk factors for MDR-TB among HIV-infected patients who had been hospitalized on the HIV ward during September 15, 1991_December 31, 1994, and in whom TB was diagnosed in 1994, Cases included patients with isolates with the HSER resistance pattern (n=18); controls were patients with isolates sensitive to rifampin, isoniazid, streptomycin, and ethambutol (n=17). The category _potentially infective_ for TB patients was defined as the period from 2 weeks before a positive sputum smear or TB culture confirmation until sputumcultures were negative or until death. _Possibly exposed_ for patients without TB was defined as hospitalization on the HIV ward concurrent with the hospitalization of a potentially infectious patient during the period until 2 weeks before TB was diagnosed in the potentially infectious patient. Case- and control-patients were similar in age, sex, HIV risk group, interval of time between HIV diagnosis and TB diagnosis, and CD4+ T-lymphocyte count at the time of TB diagnosis. However, before the hospitalization during which MDR­ TB was diagnosed, 13 (72%) of the case-patients had been hospitalized on the HIV ward, compared with five (29%) control patients (odds ratio=6.2; 95% confidence interval=l.2_36.7). Of all patients with TB diagnosed in 1994 who were hospitalized on the HIV ward, 5% had MDR-TB. Case patients were more likely to have been possibly exposed to potentially infective wardmates and to have more days of exposure (13 [72%) for a median of 26 days) than control patients (seven (41%) for a median of 8 days) (for duration of exposure, chi square for linear trend=7.0; p=0.03). ARMS Email System Page 6of7

Reported by: D Herrera, R Cano, P Godoy, EF Peiro, J Castell, C Ibanez, F Martinez Navarro, Field Epidemiology Training Program; V Moreno, A Ortega, L Sanchez, R Duran, F Pozo, Carlos III Health Institute, Ministry of Health and Consumer Affairs, Spain. Div of Bacterial and Mycotic Diseases, National Center for Infectious Diseases; International Br, Div of Field Epidemiology, Epidemiology Program Office, CDC.

Editorial Note: The findings in this report document the first outbreak of nosocomial MDR-TB to be investigated in Spain. Characteristics of this outbreak that are similar to previously reported outbreaks include MDR-TB among patients hospitalized in an HIV-dedicated ward, a high death rate within 3 months of onset, and the role of mycobacteriology laboratory-based surveillance in recognizing similar resistance patterns with confirmation through RFLP fingerprinting (2). Measures to control this outbreak have included 1) isolating all MDR-TB patients in a separate area of the hospital and the on-site provision of all clinical and diagnostic services; 2) notifying family, community members, and wardmates of patients whose MDR-TB had been diagnosed during January_June 1995 about their exposure, scheduling follow-up evaluation, and offering isoniazid preventive therapy (although isoniazid resistance had been identified in isolates from the outbreak, this resistance was low); 3) informing all hospital staff about the outbreak, and establishing a TB screening clinic that was attended by 565 (96%) of 591 employees; 4) purchasing personal respiratory protection devices that fulfilled recommended sealage and filtering criteria (3) and distributing these devices to staff exposed to TB patients; and 5) developing plans to improve the capacity of the hospital's mycobacteriology laboratory and to install 11 AFB isolation rooms. To prevent nosocomial transmission of M. tuberculosis, hospital staff should monitor surveillance for and rapidly diagnose, isolate, and treat persons with suspected TB and ensure timely laboratory confirmation with identification of drug­ susceptibility patterns. Because immunocompromised persons, such as those on HIV wards, are at increased risk for TB, surveillance and rapid confirmation are especially important to prevent M. tuberculosis transmission. In addition, hospitals and other health-care facilities should conduct regular employee TB screening clinics (graded by occupational risk category) that closely monitor tuberculin skin test conversions; such clinics can assist in surveillance for nosocomial transmission of TB.

References 1. Kent JH. The epidemiology of multidrug-resistant tuberculosis in the United States. Med Clin North Am 1993;77:1391 409. 2. CDC. Nosocomial transmission of multidrug-resistant tuberculosis among HIV-infected persons Florida and New York, 1988 1991. MMWR 1991;40:585 91. 3. CDC. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care facilities, 1994. MMWR 19 9 4 ; 4 3 (no . RR - 13 ) .

======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE:26-APR-1996 17:12:00.00 ARMS Email System Page 7of7

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for levi [email protected]; Fri, 26 Apr 1996 17:09:53 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF V5.0-6 #6879) id <[email protected]> for levi [email protected]; Fri, 26 Apr 1996 17:10:13 -0700 (MST) Received: by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id RAA09302; Fri, 26 Apr 1996 17:11:52 -0400 Errors-to: [email protected] Precedence: bulk Originator: [email protected] X-Comment: CDC National AIDS Clearinghouse X-Listprocessor-version: 6.0c -- ListProcessor by Anastasios Kotsikonas ======END ATTACHMENT 2 ======ARMS Email System Page 1 of 5

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Jeffrey Levi ( LEVI_J (WHO)

CREATION DATE/TIME:29-APR-1996 09:13:34.91

SUBJECT: daily news

TO: Patsy Fleming FLEMING P (WHO) READ:29-APR-1996 11:01:39.57

TO: Ursula Sanville SANVILLE U (OPD) READ: 2-MAY-1996 12:31:47.34

TO: Lahoma Romocki ROMOCKI L (OPD) READ:NOT READ

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE:26-APR-1996 10:33:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsnews

ATT SUBJECT: CDC AIDS Daily Summary 4/26/96

ATT TO: levi j ( levi_j@Al@CD )

TEXT: AIDS Daily Summary April 26, 1996

The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

************************************************************ "Reversal on Military HIV Issue Is Rare Hill Victory for Gay Rights Activists" "Historic Budget Battle Ends With a Whimper, As Congress Approves Funding Deal for 1996" "House Panel Backs Discharge of Military Personnel With HIV" "Blood-Supply Issue Tops Agenda" "Merck's AIDS Drug Is Discounted" "Women Policy Center Urges Focus on Women With ... " "New Virulent Tuberculosis Strain Hits Denmark" "Kenyan Government Supports Controversy ... " "AZT, ddI, and ddC Combinations at FDA Advisory Hearing" "Quebec Challenges Blood Inquiry" ************************************************************

"Reversal on Military HIV Issue Is Rare Hill Victory for Gay ARMS Email System Page 2 of 5

Rights Activists" Washington Post (04/26/96) P. A9; Mintz, John Wednesday's agreement between the White House and congressional leaders to reverse a ban on HIV-infected people serving in the military was a victory for gay rights activists. Ultimately, Senate and House leaders decided to reverse the policy because the entire command structure of the U.S. military opposed it. Rep. Robert K. Dornan (R-Calif.) added the provision to the 1996 defense spending bill, which President Clinton signed though he noted that the amendment was unconstitutional and ordered government lawyers to support legal challenges to it. On Thursday, Dornan accused his GOP colleagues of "caving in" to gay rights lobbyists. Related Story: Miami Herald (04/25) P. 13A

"Historic Budget Battle Ends With a Whimper, As Congress Approves Funding Deal for 1996" Wall Street Journal (04/26/96) P. Al4; Calmes, Jackie; Rogers, David The House and Senate agreed on Thursday on a spending bill, which was presented by White House and congressional leaders, to finance the remaining five months of 1996. Nondefense government programs funded by annual appropriations were cut by $20 million, or about 9 percent from last year's level. Programs that were not touched included Social Security, Medicare, Medicaid, welfare, and veterans benefits. The National Institutes of Health received an almost 6 percent, or $654 million, increase in spending for medical research. The Ryan White AIDS program received an estimated $105 million increase over last year's level of funding.

"House Panel Backs Discharge of Military Personnel With HIV" Washington Times (04/26/96) P. AB On the same day that Congress voted to repeal a provision to ban HIV-positive service members, the House National Security personnel subcommittee voted to support it and to reestablish the ban on gays serving in the military. Both proposals in the subcommittee were introduced by chairman Rep. Robert K. Dornan (R-Calif.), who had added the original ban on HIV-positive service personnel to the 1996 defense spending bill. The subcommittee voted to add the proposals to the personnel part of the 1997 defense budget. Dornan held that the ban on HIV-positive soldiers was not an attack on gays but rather on those who contract HIV in brothels. The revised measure includes a provision allowing HIV-positive service members to keep their jobs "if the service secretary deems their retention necessary." Dornan's earlier attempt to institute the ban was widely opposed by homosexual rights activists, President Clinton, the military, and veterans groups.

"Blood-Supply Issue Tops Agenda" Toronto Globe and Mail (04/25/96) P. A4 As health ministers from Canada's provinces and territories met on Wednesday, restoring public confidence in the country's blood system was a central topic. The ministers agreed that the public's confidence must be restored immediately, however they did not reveal details of how that might be accomplished. The officials were preparing for a meeting with federal health minister David Dingell, and were expected to ask for his approval for a study of directed donations, in which blood is donated exclusively for a family member to use. Only a few provinces now allow such ARMS Email System Page 3 of 5

donations.

"Merck's AIDS Drug Is Discounted" Knight-Ridder (04/26/96) The retail cost of Merck & Co. 's new AIDS drug Crixivan was cut by 19.5 percent after the activist group ACT-UP threatened to boycott the product. Stadtlanders, the Pittsburgh based mail-order company that distributes the drug, said Crixivan would be sold to buyer's club members for $398 a month and to non-members for $495 a month.

"Women Policy Center Urges Focus on Women With ... " U.S. Newswire (04/25/96) The Center for Women Policy Studies released two reports on Thursday to advocate AIDS prevention programs, policies, messages that are appropriate for women's diverse needs, and new Medicaid managed care systems that can provide comprehensive services to women with HIV and AIDS. According to the Centers for Disease Control and Prevention, women make up 19 percent of all reported AIDS cases, more than triple the amount in 1985. The AIDS epidemic among women has received little attention, however. The "Medicaid Managed Care" report notes that as Medicaid programs shift to managed care, "the needs of women with HIV/AIDS are rarely considered as policy makers mandate changes on the state and local level." In the second report, titled "Ten Principles," the researchers suggest women-centered AIDS prevention, including research on woman-controlled prevention methods, gender-based behavioral research, and increased funding for HIV prevention outreach. Copies of the reports are available from the Center for Women Policy Studies, 2000 P Street N.W., Suite 508, Washington, D.C. 20036.

"New Virulent Tuberculosis Strain Hits Denmark" Reuters (04/25/96); Follett, Christopher A new virulent strain of drug-resistant tuberculosis has invaded Denmark, a Danish hospital announced Thursday. The disease requires long, complex treatment and the isolation of patients for months. Although the strain accounts for less than 1 percent of all TB cases in the country, health experts have imposed strict precautions to keep the disease from spreading. The World Health Organization has urged governments and the pharmaceutical industry to spend $500 million a year to stop the current resurgence of TB. Most of the nine people infected with the new strain in Denmark were either foreigners or Danes who had been to developing countries.

"Kenyan Government Supports Controversy ... " Xinhua News Service (04/25/96) Although the Kenyan government claims the controversial AIDS drug Pearl Omega works, it also said that more clinical trials are needed before the protease inhibitor can be widely used. The government said that it supported the trials being conducted in accordance with World Health Organization standards. The creator of the drug, Prof. Arthur Obel, claims that he has cured about 500 HIV-infected individuals with Pearl Omega. Obel was earlier condemned, but is now supported by Kenya's government.

"AZT, ddI, and ddC Combinations at FDA Advisory Hearing" AIDS Treatment News (04/05/96) No. 244, P. 6; James, John S. A recent meeting of the Food and Drug Administration (FDA) ARMS Email System Page 4of5

Antiviral Drugs Advisory Committee focused on whether new results from ACTG 175, the Delta trials, CPCRA 007, and an overview of several studies of AZT and ddI should change the standard use of AZT, ddI, and ddC, especially in combination. Overall, the combinations of AZT with ddI and AZT with ddC were found to be better than AZT alone in reducing the risk of death. AZT with ddI was also found to be better at reducing the risk of death than AZT with ddC. The benefits of AZT and ddI were similar overall in patients who had not taken antiretrovirals before. In sum, the committee voted to recommend approval of ddI for initial treatment of HIV infection, as well as to recommend approval of the combination of AZT with ddC for antiretroviral-naive patients. The FDA panel, however, voted against approval of the therapy for patients with antiretroviral experience. Moreover, the committee agreed that although there was no proof that ddI and AZT are better than ddI alone, it was uncomfortable with the decision, because while the evidence did not show that the combination was necessarily better than the single drug, combination therapy is generally thought to be better than monotherapy.

"Quebec Challenges Blood Inquiry" Nature (04/18/96) Vol. 380, No. 6575, P. 572; Spurgeon, David Quebec's government has taken legal action against the Canadian government, claiming that the federal inquiry into the sale of tainted blood products to hemophiliacs in the mid-1980s is unconstitutional. A lawyer representing the province said that the federal commission of inquiry, led by Justice Horace Krever, did not have the authority to issue more than 300 preliminary notices of wrongdoing. Robert Martin, a professor of constitutional law at the University of Western Ontario, disagrees, adding that the Canadian constitution divides only law-making authority between the federal government and the provinces, so the federal government can investigate conflicts at any level. Quebec's action is more far-reaching than previous efforts to thwart the inquiry, in that it could limit the federal government's broad involvement in setting standards in such areas as health care. The head of the Quebec branch of the Canadian Hemophilia Association responded to the province's action by noting that those infected by the contaminated blood are beginning to lose hope that the truth behind the tragedy will ever be revealed.

======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE:26-APR-1996 10:33:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for [email protected]; Fri, 26 Apr 1996 10:31:41 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF V5.0-6 #6879) id <[email protected]> for [email protected]; Fri, 26 Apr 1996 10:32:00 -0700 (MST) Received: by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id KAA15079; Fri, ARMS Email System Page 5 of 5

26 Apr 1996 10:33:40 -0400 Errors-to: [email protected] Precedence: bulk Originator: [email protected] X-Comment: CDC National AIDS Clearinghouse X-Listprocessor-version: 6.0c -- ListProcessor by Anastasios Kotsikonas ======END ATTACHMENT 2 ======ARMS Email System Page 1 of 5

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Jeffrey Levi ( LEVI J (WHO)

CREATION DATE/TIME: l-MAY-1996 16:05:15.40

SUBJECT: daily news

TO: Patsy Fleming FLEMING P (WHO) READ: l-MAY-1996 17:01:27.52

TO: Ursula Sanville SANVILLE U (OPD) READ: 3-MAY-1996 15:33:04.39

TO: Lahoma Romocki ROMOCKI L (OPD) READ:NOT READ

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE: l-MAY-1996 11:24:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsnews

ATT SUBJECT: CDC AIDS Daily Summary 05/01/96

ATT TO: levi j levi j@Al@CD

TEXT: AIDS Daily Summary May 1, 1996

The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

************************************************************ "Bill Would Order AIDS-Virus Testing to Protect Babies" "AIDS Fight Is Skewed by Federal Campaign Exaggerating Risks" "Scientists Hone Knowledge of How Virus Spreads" "AIDS Acrimony" "Spread of AIDS Alarms Chinese" "Gay Rights Group Lauds AMA Call for Sexual History Queries" "Don't Play Catch-Up With TB" "B.C. to Pay for New AIDS Drug" "Hit Hard Early or Delay? New Drugs Cloud Options" "Homemade Tattoos Transmitting HIV" ************************************************************

"Bill Would Order AIDS-Virus Testing to Protect Babies" New York Times (05/01/96) P. Al; Fisher, Ian Congressional leaders have tentatively agreed on a provision ARMS Email System Page 2 of 5

that would make mandatory HIV testing of newborns a stipulation for states to receive federal AIDS funding under the Ryan White CARE Act if health officials cannot reduce the number of infected babies by other means. Under the act, health care providers would be required to advise pregnant women to be tested for HIV. It would call for states to take a series of steps toward mandatory testing of infants, but only of those born to women whose HIV status is not known. Testing would become mandatory for the children of those women if the number of infected children was not reduced by counseling by the year 2000. AIDS activists have opposed the mandatory testing of infants, but are expected to support the overall bill and try to repeal the testing measure later. Mandatory testing of newborns has been controversial, raising fears of discrimination. New York, like other states, has routinely tested newborns anonymously, but new regulations there will allow mothers to learn their infant's test result. Related Story: Baltimore Sun (05/01) P. 4A

"AIDS Fight Is Skewed by Federal Campaign Exaggerating Risks" Wall Street Journal (05/01/96) P. Al; Bennett, Amanda; Sharpe, Anita Although the nine-year-old federal America Responds to AIDS campaign warns that anyone can get AIDS, the effort is having a potentially detrimental impact on funding for AIDS prevention. While 83 percent of all reported AIDS cases are among homosexuals and injection drug users, no federal funding is specifically allocated for these groups. Needle exchange programs, seen as effective against the spread of HIV, are denied federal funding. Moreover, much of the Centers for Disease Control and Prevention's $584 million AIDS-prevention funding is directed at heterosexual women, college students, and others who face a relatively low risk of infection. Experts argue that more money is needed for prevention among high-risk groups. The CDC's Helene Gayle notes that "increasingly, it's important to shift strategies to meet the epidemic," and reports that the agency is giving communities more say in how to spend federal AIDS money. Political and social forces that shaped the policy made in 1987 are still making it difficult for the government to alter its prevention efforts.

"Scientists Hone Knowledge of How Virus Spreads" Wall Street Journal (05/01/96) P. A6 While AIDS experts once thought the disease would become an epidemic among non-drug-using heterosexuals, there is now consensus that this is unlikely. Lyle Petersen, former chief of the Centers for Disease Control and Prevention's branch that estimates the prevalence of HIV, says that "over 90 percent of the population is heterosexual, and most people at zilcho or very low risk." HIV is not transmitted heterosexually as easily as it is transmitted through anal sex or through shared needles. For both men and women, it is much easier to transmit other serious sexually transmitted diseases than to pass on HIV. People with venereal diseases, however, are more likely to become infected with HIV if exposed. Sexual contact with a large number of people in a short period, as occurred in gay bathhouses early in the epidemic, seems to be necessary for widespread transmission. AIDS has spread more rapidly among the heterosexual population in Africa and Asia, due to more widely practiced prostitution. Some scientists say the United States may be vulnerable to strains of HIV that are more easily spread through heterosexual contact. ARMS Email System Page 3 of 5

"AIDS Acrimony" Los Angeles Times--Washington Edition (05/01/96) P. Bl; Boxall, Bettina; Meyer, Josh The gap in federal AIDS funding for San Francisco and Los Angeles has spurred a political debate and lobby to change the formula such funding is based on. The Ryan White Care Act has favored regions hardest hit in the early years of the epidemic, sending more money to San Francisco and New York than to Los Angeles, even though there are now several thousand more people with AIDS in Los Angeles County than in San Francisco. Reauthorization of the funding act may include provisions helpful to Los Angeles. Rep. Henry A. Waxman (D-Calif.) organized a formal protest in Congress, but noted "I can't just represent Los Angeles alone. I have to stand for what's fair."

"Spread of AIDS Alarms Chinese" Washington Post (05/01/96) P. A21; Mufson, Steven The number of reported HIV infections in China is relatively small, with 2,594 people known to be infected and 80 known AIDS cases. But health experts say the virus is spreading rapidly, and estimate that the actual number of cases is as high as 100,000. Two-thirds of the reported cases are in the southern province of Yunnan, where drug use has brought HIV across the borders from Burma, Laos, and Thailand. China recently committed $60 million to set up six border check-points along the Yunnan border. Reasons for the rapid spread of the virus in China include ignorance, as well as the government's reluctance to talk about sex or promote condom use. Poor blood screening and unhygienic procedures at hospitals are also to blame. China's economic reforms have also contributed to the virus' spread, with foreign trade increasing and prostitution resurging. The government seems to be dealing with AIDS more openly, and last year hosted a major conference on AIDS awareness day.

"Gay Rights Group Lauds AMA Call for Sexual History Queries" Washington Times (05/01/96) P. AS The Gay and Lesbian Medical Association applauded the American Medical Association's recommendation Tuesday that all doctors ask their patients for a detailed sexual history, saying the move would help stop discrimination. The AMA report points out specific health problems experienced by homosexuals, including HIV, adolescent suicide, and ovarian cancer.

"Don't Play Catch-Up With TB" Los Angeles Times--Washington Edition (05/01/96) P. AlO In an editorial in the Los Angeles Times Washington Edition, the authors urge the United States to take action to fight tuberculosis, which was declared a global emergency by the World Health Organization three years ago. According to the editors, U.S. public health officials must not be complacent about the disease, which resurged in the mid-1980s.

"B.C. to Pay for New AIDS Drug" Toronto Globe and Mail (04/30/96) P. AlO; Coutts, Jane British Columbia will be the first Canadian province to pay for the protease inhibitor saquinavir, and will spend up to $5 million in the coming year to buy the drug for about 500 people who have HIV but not AIDS. A U.S. study has questioned the clinical benefits of the drug, the first protease inhibitor to be ARMS Email System Page 4 of 5

approved in Canada.

"Hit Hard Early or Delay? New Drugs Cloud Options" AIDS Alert (04/96) Vol. 11, No. 4, P. 40 The development of protease inhibitors and new knowledge of the dynamics of HIV infection have prompted the call for early treatment, although researchers say more data is needed. "Now that we know the virus is constantly reproducing itself--unlike what we thought in the old days ... it makes sense to hit hard and hit early," said Michael Sheran, an AIDS doctor at Saint Vincent's Hospital in New York. Doctors are concerned, however, that people will develop resistance to the drugs. John Mellors, of the University of Pittsburgh, favors early treatment to delay disease progression. In making treatment decisions, clinicians consider a patient's CD4 cell count, viral load, and quality of life while on the drug. Melanie Thompson, of the AIDS Research Consortium in Atlanta, says more research is needed on protease inhibitors to advocate early or delayed treatment and that cases should be evaluated individually. Patients seem more willing to take protease inhibitors than they were to take nucleoside analogues, though some are waiting for new drugs and more information before starting treatment.

"Homemade Tattoos Transmitting HIV" POZ (04/96) No. 13, P. 24 A recent report on deaths in Florida prisons revealed that AIDS is the leading killer among inmates and that AIDS-related deaths rose from 34.7 percent to 52.3 percent between 1987 and 1992. In 1995 the figure was 58 percent. While rape is portrayed in television as the main risky behavior of inmates, a Florida Corrections Department expert said that intravenous drugs and homemade tattoo needles pose the same amount of risk. In Florida, inmates are educated about AIDS, and educational videos are shown in waiting rooms. Those participating in high risk behaviors are encouraged to get tested.

======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE: 1-MAY-1996 11:25:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for [email protected]; Wed, 01 May 1996 11:22:45 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF V5.0-6 #6879) id <[email protected]> for [email protected]; Wed, 01 May 1996 11:23:01 -0700 (MST) Received: by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id LAA20939; Wed, 01 May 1996 11:24:49 -0400 Errors-to: [email protected] Precedence: bulk Originator: [email protected] X-Comment: CDC National AIDS Clearinghouse X-Listprocessor-version: 6.0c -- ListProcessor by Anastasios Kotsikonas ARMS Email System Page 5 of 5

======END ATTACHMENT 2 ======ARMS Email System Page 1 of 4

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Patsy Fleming ( FLEMING_P ) (WHO)

CREATION DATE/TIME:20-MAY-1996 14:21:01.78

SUBJECT: promising gely

TO: Ursula Sanville SANVILLE U (OPD) READ:20-MAY-1996 16:06:30.02

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE:20-MAY-1996 13:01:00.00

ATT BODYPART TYPE:B

ATT CREATOR: Jeffrey Levi

ATT SUBJECT: daily news

ATT TO: Patsy Fleming FLEMING P )

ATT TO: Ursula Sanville SANVILLE_U )

ATT TO: Lahoma Romocki ROMOCKI L

TEXT:

======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE:20-MAY-1996 11:51:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsinfo

ATT SUBJECT: - no subject (01I4XEPLSJ8200QC7G) -

ATT TO: LEVI J LEVI J@Al@CD

TEXT: AIDS Daily Summary May 20, 1996

The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

************************************************************ " 'Promising' Gel Could Prevent HIV Infection in Women" "Infectious Diseases Resistant, Study Finds" ARMS Email System Page 2of4

"Old in Africa" "Obituary: Howard Shapiro, 40, A Writer With AIDS" "Teens Teach Peers About AIDS" "AIDS Victim Jailed for Biting" "First Spanish Conference on AIDS Set Here" "Roundup: Thailand's Prenatal HIV Transmission" "HIV-1 Entry Cofactor: Functional cDNA Cloning of a Seven-Transmembrane, G Protein-Coupled Receptor" "Judge Freezes Accounts of Firm Touting AIDS Treatment" ************************************************************

'Promising' Gel Could Prevent HIV Infection in Women" USA Today (05/20/96) P. lA; Painter, Kim A vaginal gel has been shown to protect monkeys from simian immunodeficiency virus (SIV), suggesting that it could protect women from HIV. The study, led by Roberta Black of the National Institute of Allergy and Infectious Diseases, demonstrates the most promising lead yet for a chemical that women can use to protect themselves from the virus. The vaginal gel, containing a drug called PMPA, was applied to five monkeys that were then exposed to SIV, along with two other untreated monkeys. The monkeys who received the gel did not become infected, but the researchers note that further study is needed to determine whether the gel will work as well in women. Related Story: Baltimore Sun (05/20) P. 2A

"Infectious Diseases Resistant, Study Finds" New York Times (05/20/96) P. A3 In its annual report, the World Health Organization (WHO) warns that infectious diseases are becoming more resistant to antibiotic drugs. The agency says that more money must be spent to fight malaria, cholera, and tuberculosis. These three diseases are becoming more prevalent even though they are preventable or easily treatable. WHO also notes that some 30 new infectious diseases have emerged in the last 20 years, including AIDS and the Ebola virus. According to WHO's report, infectious diseases caused more than one-third of all deaths worldwide last year, and resistance to antibiotics is increasing due to misuse.

"Old in Africa" Washington Post (05/19/96) P. Al; Buckley, Stephen In sub-Saharan Africa, where AIDS has orphaned many children, elderly grandparents are often called upon to serve as full-time parents. The elderly, however, also suffer from a lack of family or government financial support, and increasingly need to work to support themselves. Africa's elderly were historically respected for their wisdom and power, and cared for by their children. But now, as younger Africans struggle to support themselves, and AIDS hits the 20- to 30-year-old age group particularly hard, the elderly have become the primary caregivers for many children.

"Obituary: Howard Shapiro, 40, A Writer With AIDS" New York Times (05/20/96) P. Bl4 Howard Aaron Shapiro, who started writing humorous newspaper and magazine articles about living with HIV when he found out he was infected, died Saturday at the age of 40. His writing gave readers insight to his life with the disease and his struggle to get assistance to survive. Mr. Shapiro's work has been published in the New York Press and in the gay publication Body Positive, in ARMS Email System Page 3 of 4

which his last column, written while in the hospital, will appear.

"Teens Teach Peers About AIDS" St. Louis Post-Dispatch (05/17/96) P. Bl; Librach, Phyllis Brasch Students from St. Louis-area schools attended the Youth Forum on HIV and AIDS Thursday, educating their peers about how HIV is transmitted and how to prevent its spread. The program, which has been held since 1991, has trained about 175 teens, who in turn have taught 10,000 students about AIDS. The peer teachers, who advocate abstinence, are thought to be able to communicate better with teens than adults would.

"AIDS Victim Jailed for Biting" Toronto Globe and Mail (05/17/96) P. AlO A man with AIDS was given a maximum reformatory sentence of nearly two years for biting an undercover police officer because the judge said he knew he was threatening the officer's health. After biting the officer, Robert Thissen told him that "the joke's on you. I've got AIDS." Thissen, a transvestite prostitute, had offered his sexual services to the undercover officer but a struggle ensued when the officer tried to arrest him. The officer has tested negative for HIV.

"First Spanish Conference on AIDS Set Here" Houston Chronicle (05/17/96) P. 28A; Zuniga, Jo Ann The first all-Spanish AIDS conference in Houston began on May 18. Conference organizers intended to reach the growing population of minorities with AIDS. Workers from Amigos Volunteers in Education and Services (AVES) and the Houston Health Department have visited apartments, cantinas, and other sites to conduct HIV tests. Each year, AVES reaches about 250 to 300 HIV or AIDS patients, of whom about 80 percent are Latinos.

"Roundup: Thailand's Prenatal HIV Transmission" Xinhua News Agency (05/20/96) The number of children infected with HIV born in Thailand is increasing rapidly, posing future social problems for the country. One quarter of all infants born to HIV-positive women in Thailand carry the virus, and even if they do not, their parents are likely to die before they are old enough to take care of themselves. The number of orphans born to women with HIV is expected to rise to 20,000 per year by the year 2000. The government is increasing spending on HIV/AIDS prevention and advanced research on remedies from tropical plants.

"HIV-1 Entry Cofactor: Functional cDNA Cloning of a Seven-Transmembrane, G Protein-Coupled Receptor" Science (05/10/96) Vol. 272, No. 5263, P. 872; Feng, Yu; Broder, Christopher C.; Kennedy, Edward A.; et al. To infect a human cell, HIV-1 requires a CD4 receptor and another cofactor specific to human cells. This cofactor is needed for the virus to fuse to the cell membrane and enter the cell. Edward A. Berger and colleagues at the National Institute of Allergy and Infectious Diseases identified this cofactor, which they called fusin. The researchers said the identification of fusin would provide new insight into how HIV infects target cells and would allow the creation of transgenic lab animals that would serve as more effective models HIV-1 infection in humans. ARMS Email System Page 4of4

"Judge Freezes Accounts of Firm Touting AIDS Treatment" American Medical News (05/13/96) Vol. 39, No. 18, P. 11 A Pennsylvania company accused of fraudulently promoting an ozone treatment as an AIDS cure has been ordered to provide a full financial report and has had its accounts frozen. The Securities and Exchange Commission (SEC) has accused Lazare Industries of Marshalls Creek, Pa., and Richard J. Harley, the company's chief executive, with scheming to defraud 72 investors in the sale of $1.4 million of stock. In a lawsuit, the SEC charged that Lazare and Harley misled investors or failed to give them information about the company's ozone therapy. The SEC claims that they wrongly said that the treatment, consisting of "ozone-oxygen enemas," was patented and that it had undergone extensive testing which showed it was effective against AIDS. In actuality, one clinical test of the therapy was stopped by the Food and Drug Administration after two months. The treatment was advertised on the Internet, radio, and through direct mail. Harley asked people seeking treatment at his clinic to invest in the company, promising huge returns as the business grew.

======END ATTACHMENT 2 ======

======ATTACHMENT 3 ======ATT CREATION TIME/DATE:20-MAY-1996 11:52:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for [email protected]; Mon, 20 May 1996 11:49:26 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF V5.0-7 #6879) id <[email protected]> for [email protected]; Mon, 20 May 1996 11:52:32 -0700 (MST) Received: by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id LAA29530; Mon, 20 May 1996 11:51:37 -0400 Apparently-to: [email protected] ======END ATTACHMENT 3 ======ARMS Email System Page I of 4

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Jeffrey Levi ( LEVI J (WHO)

CREATION DATE/TIME:21-MAY-1996 11:22:19.23

SUBJECT: daily news

TO: Patsy Fleming FLEMING P (WHO) READ:29-MAY-1996 12:21:49.63

TO: Ursula Sanville SANVILLE U (OPD) READ:l2-JUN-1996 10:18:21.15

TO: Lahoma Romocki ROMOCKI L (OPD) READ:NOT READ

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE:21-MAY-1996 11:03:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsnews-request

ATT SUBJECT: CDC AIDS Daily Summary 05/21/96

ATT TO: aidsnews [email protected]@INET@EO

ATT CC: aidsinfo [email protected]@INET@EO

TEXT: AIDS Daily Summary May 21, 1996

The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

************************************************************ "Clinton Signs Law Renewing Assistance for AIDS Patients" "The Democratization of AIDS" "Fanfare: Boxing" "Malaria, AIDS Are Killing Worldwide, Report Finds" "Across the USA: Florida" "Dialing Up an AIDS Cure" "Cyclists Bring Power on Wheels for AIDS Fight" "Agouron Cites Positive Viracept Data" "Drugstore Cowboys" "Sitting Priddy" ************************************************************

"Clinton Signs Law Renewing Assistance for AIDS Patients" ARMS Email System Page 2of4

Philadelphia Inquirer (05/21/96) P. A6; Ross, Sonya President Clinton signed a law Monday that will extend the Ryan White CARE Act for five years, providing funds to communities for home care, transportation, counseling, hospice care, and other support for people with HIV and AIDS. Since the law was passed six years ago, it has provided care for more than 300,000 people. The law allocates $738 million to AIDS services for fiscal 1996, up from $632 million last year. The law includes a provision calling for $10 million to be used to urge pregnant women to voluntarily seek counseling and HIV testing. States will receive $52 million to provide new AIDS drugs to patients who cannot afford them.

"The Democratization of AIDS" Wall Street Journal (05/21/96) P. A23; Satcher, David; Gayle, Helene D.; Koop, C. Everett; et al. In a series of letters to the editor of the Wall Street Journal, health officials and others respond to a recent article which reported that a Centers for Disease Control and Prevention public education campaign exaggerates the risk of AIDS to the general public. Dr. David Satcher, director of the Centers for Disease Control and Prevention, and Dr. Helene Gayle, director of its National Center for HIV, STD, and TB Prevention, write in a joint letter that the article was unbalanced and incomplete. They argue that the broad public education campaign was important in curbing the spread of HIV, noting the decline in the rate of AIDS in some groups. Dr. C. Everett Koop, former Surgeon General, also objects to the "seriously flawed article." Koop writes that the government made the best decision it could--to educate the general public--because there was evidence that HIV would not be contained in high-risk groups, saying "it was the right thing to do in 1987. It is still the right thing to do." Meanwhile, William, M. London, of the American Council on Science and Health, applauds the article, adding that he has tried to spread the same message and has been criticized for it.

"Fanfare: Boxing" Washington Post (05/21/96) P. E2 The California State Assembly passed a bill that requires boxers to test HIV-negative in order to be licensed in the state. The bill came in response to the announcement that former heavyweight Tommy Morrison has HIV. Seven states and Puerto Rico required yearly HIV tests before Morrison's announcement, and other states have since implemented the requirement.

"Malaria, AIDS Are Killing Worldwide, Report Finds" St. Louis Post-Dispatch (05/20/96) P. 7A Malaria and AIDS claimed 17 million lives worldwide last year, including 9 million children, the World Health Organization (WHO) reported Monday. Bacterial, viral, and parasitic diseases, when grouped together, are the world's leading cause of death, responsible for one-third of all deaths. Tuberculosis was the deadliest infectious disease in 1995, claiming 3.1 million lives, up 400,000 from 1993. The agency says that a mix of international populations and disease organisms are partly responsible for the increases. The WHO report also contained some good news, however. Globally, life expectancy is longer, babies are healthier, and some infectious diseases have become controlled. Use of the tetanus vaccine prevented 700,000 deaths from the disease last year, and poliomyelitis has almost been wiped out. ARMS Email System Page 3of4

"Across the USA: Florida" USA Today (05/21/96) P. 9A In Apopka, Fla., health officials are suggesting HIV tests for up to 40 people who may have been exposed to the virus by a man who calls himself a "male slut." The man's 16-year-old girlfriend tested positive for HIV.

"Dialing Up an AIDS Cure" Washington Post--Washington Business (05/20/96) P. 3; Rohn, Daniel T.; Patton, Scott; Ginsberg, Steven Bell Atlantic customers in Maryland, Virginia, and the District of Columbia now have the option of donating 1 percent of their monthly bill to support AIDS research at the Whitman-Walker Clinic. For the project, part of the company's Community Threads program, donations are paid by Bell Atlantic, based on the Bell Atlantic portion of the bill, and do not add to the cost to the customer. The project was started in April 1995 on a trial basis and made official in November.

"Cyclists Bring Power on Wheels for AIDS Fight" Miami Herald (05/20/96) P. lB; Cauvin, Henri E. The first-ever Florida AIDS ride ended on Sunday on Miami's South Beach, as 757 cyclists rode into Flamingo Park to celebrate the end of their three-day ride from Orlando and the $1.5 million they had raised for several AIDS organizations in the state. Riders had to raise at least $1,400 to participate in the event, which ended with much emotion and celebration.

"Agouron Cites Positive Viracept Data" Reuters (05/20/96) Two pilot Phase II clinical trials of Agouron's drug Viracept have demonstrated its ability to reduce the level of HIV in infected patients, the company said. In the study, 36 HIV-positive patients received either Viracept in combination with Bristol Myers Squibb's drug Zerit or Zerit alone. HIV was reduced by more than 98 percent in three groups who received differing doses of Viracept with Zerit, and by a mean of 82 percent in those who received Zerit alone. CD4 T-cell counts rose more in the patients receiving both drugs than in those taking Zerit alone.

"Drugstore Cowboys" Advocate (05/14/96) No. 707, P. 37; McAleavy, Teresa M. A black market for prescription drugs has been on the decline but may now resurge as demand for protease inhibitors rises. The AIDS drug black market, in which people who receive the drugs free from clinics sell them for a profit, is generally unprosecuted, since drug enforcement efforts are often focused elsewhere. David Gilden, of Gay Men's Health Crisis, notes that the black market for AIDS drugs has declined on its own in recent years, as the price of AZT has fallen. The new protease inhibitors, as well as cutbacks in funding for Medicaid and other programs that pay for AIDS drugs, may help to raise demand again, however. In addition, some small pharmacies are buying black-market drugs and selling them at retail prices to compete with larger stores. Drugs bought on the black market may not be safe due to improper storage. Furthermore, since most people buying black-market drugs are taking them without medical care, any side effects could go untreated. Thomas Staffa, assistant attorney general in the New York Medicaid Fraud Control Unit, says ARMS Email System Page 4 of 4

that AIDS drugs account for just a small portion of the black market for prescription drugs, claiming that it is "the high-priced drugs, like those for cancer, or Prozac, that command the most money."

"Sitting Priddy" POZ (05/96) No. 14, P. 34; Grau, Rawley Laurie Priddy, who was fired from her job in 1991 after disclosing that she had HIV, says the anger she felt from the experience gave her the impetus to speak out as an AIDS activist. She now educates professional basketball players and their partners about HIV and AIDS through the NBA Players Association (NBPA) AIDS program. The program was organized through the Johns Hopkins School of Public Health, following Magic Johnson's disclosure. She has also worked on the curriculum and training for the NBA's Winning Against AIDS program, in which NBA players educate inner-city kids about HIV at basketball camps. She frequently shocks people in her sessions, and helps them to see that anyone is vulnerable to the virus, by telling them she has HIV. She regrets the way gender and race have divided the activist community, fearing that the fight for funding and rights for people with HIV will suffer. Priddy's husband, whom she met after she was found to have HIV, is HIV-negative. They live in Baltimore, and when not working to fight discrimination, Priddy enjoys fishing and crabbing along the Chesapeake, and riding her motorcycle in rural Maryland. ======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE:21-MAY-1996 11:01:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for [email protected]; Tue, 21 May 1996 10:58:40 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF VS.0-7 #6879) id <[email protected]> for [email protected]; Tue, 21 May 1996 11:01:46 -0700 (MST) Received: from inetdev.aspensys.com by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id LAA04330; Tue, 21 May 1996 11:00:32 -0400 Received: from sparc20.aspensys.com (198.77.71.44) by inetdev.aspensys.com (EMWAC SMTPRS 0.80) with SMTP id ; Tue, 21 May 1996 11:07:43 -0400 Resent-date: Tue, 21 May 1996 11:00:32 -0400 Resent-from: [email protected] Resent-message-id: Organization: CDC National AIDS Clearinghouse X-Mailer: Mozilla 2.0 (Win95; I) ======END ATTACHMENT 2 ======ARMS Email System Page 1 of 4

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Jeffrey Levi ( LEVI J (WHO)

CREATION DATE/TIME:24-JUN-1996 10:47:09.84

SUBJECT: daily news

TO: Patsy Fleming FLEMING P (WHO) READ:24-JUN-1996 14:00:13.97

TO: Ursula Sanville SANVILLE U (OPD) READ:25-JUN-1996 14:50:53.19

TO: Lahoma Romocki ROMOCKI L (OPD) READ: 2-JUL-1996 12:44:05.55

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE:24-JUN-1996 10:41:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsnews

ATT SUBJECT: CDC AIDS Daily Summary 06/24/96

ATT TO: levi_j ( levi_j@Al@CD )

TEXT: AIDS Daily Summary June 24, 1996

The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

****************************************************** "Green Cross Corp." "Ride to Remember: 1,901 Cyclists Join AIDS Fund-Raiser" "In Night Ministry, Cookies and Condoms Carry the Message" "Adamant About Animal Rights" "Doctor Charged in Man's Suicide" "Hands Reach Out to Family Hit by AIDS" "Rare Food Parasite Eyed in Illnesses" "Hollywood Marks 'Day of Compassion'" "Returning Home: Reflections on the USA's Response to the HIV/AIDS Epidemic" "Anti-AIDS Ads Back Gay Community" ******************************************************

"Green Cross Corp." Wall Street Journal (06/24/96) P. B9A ARMS Email System Page2of4

Japan's Green Cross Corp. has announced that it will face a one-time charge of at least $42.5 million in the fiscal year ending March 1997 as a result of litigation by HIV-infected hemophiliacs who allege that the company supplied them with unheated blood products potentially contaminated with HIV. The number of plaintiffs has increased from 401 in March to its present 806.

"Ride to Remember: 1,901 Cyclists Join AIDS Fund-Raiser" Washington Post (06/24/96) P. Bl; Argetsinger, Amy The Philadelphia-to-Washington D.C., bicycle ride that ended Sunday was one of five AIDS rides across the country that together are expected to raise $25 million for AIDS organizations. The 1,901 riders that ended their trip from Philadelphia near the Washington Monument raised $4.5 million for Washington's Whitman-Walker Clinic, Food & Friends, and other AIDS service organizations. Many of the participants, who were required to raise a minimum of $1,400 each, rode in support or memory of friends with AIDS.

"In Night Ministry, Cookies and Condoms Carry the Message" New York Times (~6/24/96) P. AlO; Terry, Don The Night Ministry, a nondenominational group of clergy and volunteers, provides outreach to pimps, prostitutes, teenage runaways, and homeless people on the streets of Chicago. Volunteers go out in the group's van five nights a week, delivering cookies, condoms, medication, conversation, and religion. When the ministry was founded 20 years ago, it was based on listening and counseling, but with the onset of the AIDS epidemic, the group started providing condoms as well. Rev. Thomas Behrens, who helped found the ministry, noted that the group provides condoms because "we can't continue to build relationships with people if they're dead."

"Adamant About Animal Rights" Washington Post (06/24/96) P. B3; Lipton, Eric Animal rights activists gathered in Washington, D.C., on Sunday for the March for the Animals, representing circus animals, dolphins, and animals used for fur, medical research, and cosmetic testing. Some factions of the demonstrators were urging peaceful rallies, while others advocated noisy, disruptive protests. AIDS activists have criticized the animal rights movement for putting animals before humans. Animal rights groups argued, however, that research on animals does little to advance the search for new AIDS treatments.

"Doctor Charged in Man's Suicide" Toronto Globe and Mail (06/21/96) P. Al; Coutts, Jane; Hess, Henry An AIDS specialist in Toronto was charged Thursday with helping one of his patients kill himself. Dr. Maurice Genereux is believed to be the first doctor in Canada to be charged with assisted suicide. He was released on bail with permission to continue practicing medicine but not to prescribe controlled drugs. The case involves the death of Aaron McGinn, a 31-year-old AIDS patient who died at his home in early April. McGinn's death was attributed to AIDS, but three weeks ago, the Toronto coroner's office received a call that AIDS was not the real cause of death. After researching the case, the coroner and police investigators concluded that McGinn had committed suicide ARMS Email System Page 3 of 4

with an overdose of Seconal, a drug Genereux had prescribed for him several months before. Steve Minuk, McGinn's close friend and former lover, said he had known of McGinn's desire to take his own life and had promised not to interfere.

"Hands Reach Out to Family Hit by AIDS" Philadelphia Inquirer (06/22/96) P. Bl; Shaw, Donna Following the death of her only son, Mark, to AIDS in 1992, Judith Trullinger became suicidal and could not work. She now owes about $35,000 on her mortgage and as much as $145,000 in back taxes, and thus was about to lose her home in a sheriff's sale Friday. Delaware County Judge Joseph F. Battle, however, gave Trullinger a three-month reprieve on her mortgage. Sen. Rick Santorum's (R-Pa.) office offered her free legal assistance in the case and may help her with the taxes she owes as well. Since the Philadelphia Inquirer reported on Trullinger's dire needs on Thursday, many people have offered to help by providing money, housing, tax preparation, and other services. Moreover, the Delaware Chapter of the National Hemophilia Foundation plans to set up a fund for Trullinger, whose son, a hemophiliac, contracted HIV from tainted blood products. Trullinger also could be eligible to receive at least $100,000 under a nationwide settlement between four pharmaceutical companies and the lawyers for HIV-infected hemophiliacs.

"Rare Food Parasite Eyed in Illnesses" Boston Globe (06/21/96) P. l; Miles, Katrina; Knox, Richard A. After confirming 28 cases in Massachusetts of persistent diarrheal illness linked to a food-borne parasite, state health officials are considering warning doctors to watch for more cases involving the unusual microbe. The infection has been reported in several hundred people in North America. The Massachusetts health department is not advising people to avoid any fruits or vegetables, but is recommending that people with compromised immunity--like those infected with HIV or who are undergoing cancer treatment--consider eating only cooked, peeled, or locally grown produce. The illness--caused by a one-celled organism called Cyclospora cayetanenis-- can lead to severe dehydration if left untreated.

"Hollywood Marks 'Day of Compassion'" United Press International (06/21/96) HIV and AIDS were common themes on Friday's soap operas and television talk shows as Hollywood marked the fourth annual Day of Compassion to remember people who died of AIDS and to raise public awareness about HIV and AIDS. Soaps, including ABC's "All My Children" and "General Hospital," remembered fictional characters and real people who died of AIDS. Such talk show hosts as Maury Povich, Sally Jessy Raphael, and Oprah Winfrey discussed AIDS issues including children with AIDS, AIDS charities, and teenage mothers with AIDS.

"Returning Home: Reflections on the USA's Response to the HIV/AIDS Epidemic" Lancet (06/15/96) Vol. 347, No. 9016, P. 1673; Merson, Michael H. In an essay in the British medical journal the Lancet, Dr. Michael Merson of the Yale University medical school, comments on the United States' response to AIDS and how it can be improved. Merson worked for the World Health Organization for 18 years--for five years as director of the agency's Global Program on AIDS. ARMS Email System Page 4of4

He says he was surprised when he returned to the United States at the ignorance he encountered among many Americans about how HIV is spread, and the fear among school systems about teaching HIV prevention. Merson suggests that condoms should be more readily available and advertised in the media. He also criticizes the government's policy of not allowing federal funds to be used for syringe exchange programs and recommends that states address the financial needs of AIDS patients in their Medicaid plans. Merson says the United States' poor response to AIDS is due in part to the reluctance to discuss sexual behavior and to the stigmatization associated with AIDS. He advises community-based organizations to implement AIDS prevention programs and says AIDS services need to be available to all segments of the population. Removing the stigma of HIV is important, Merson concludes, as is minimizing debates about AIDS education and prevention campaigns.

"Anti-AIDS Ads Back Gay Community" Advertising Age (06/17/96) Vol. 67, No. 25; P. 38 In a new public service campaign geared to the gay community, AIDS Project Los Angeles (APLA) and BBDO West remind young men that "There's life after sex." The campaign is designed to encourage young gay men not to throw their lives away with unsafe sex. Allen Carrier, APLA communications director, said that some stations or viewers may object to the campaign because it endorses the gay community.

======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE:24-JUN-1996 10:42:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for [email protected]; Mon, 24 Jun 1996 10:39:48 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF V5.0-7 #6879) id <[email protected]> for levi [email protected]; Mon, 24 Jun 1996 10:42:14 -0700 (MST) Received: by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id KAA06810; Mon, 24 Jun 1996 10:41:28 -0400 Errors-to: [email protected] Precedence: bulk Originator: [email protected] X-Comment: CDC National AIDS Clearinghouse X-Listprocessor-version: 6.0c -- ListProcessor by Anastasios Kotsikonas ======END ATTACHMENT 2 ======ARMS Email System Page I of 5

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Jeffrey Levi ( LEVI_J (WHO)

CREATION DATE/TIME:l2-JUL-1996 11:35:21.15

SUBJECT: daily news

TO: Patsy Fleming FLEMING P (WHO) READ:l5-JUL-1996 10:15:09.08

TO: Ursula Sanville SANVILLE U (OPD) READ:NOT READ

TO: Lahoma Romocki ROMOCKI L (OPD) READ:l2-JUL-1996 17:22:58.10

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE:l2-JUL-1996 11:33:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsnews

ATT SUBJECT: CDC AIDS Daily Summary 07/12/96

ATT TO: levi_j levi j@Al@CD

TEXT: AIDS Daily Summary July 12, 1996

The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

****************************************************** "AIDS Conferees Debate How Early to Offer New Drugs" "AIDS Therapy Faces a Turning Point" "Scientists Display Substantial Gains in AIDS Treatment" "Health Plans to Cover New AIDS Drugs But Issues of Cost, Treatment Remain" "Many See Hope in AIDS Meeting; Marketers Also See Opportunity" "Many AIDS Patients Opt for Suicide" "Firm Fired HIV Positive Employee Over Illness, Suit Charges" "AIDS Activists Disrupt Meeting of Researchers" "A Shot in the Dark" "Progress Report: Prophylaxis and Therapy for MAC" *********************************..4*******************

"AIDS Conferees Debate How Early to Offer New Drugs" Wall Street Journal (07/12/96) P. Bl; Waldholz, Michael ARMS Email System Page 2 of 5

Throughout the 11th International Conference on AIDS this week, researchers discussed how soon newly-infected HIV patients should be treated with protease inhibitors, costly new drugs that have been able to reduce the amount of virus to undetectable levels. Treating the estimated 800,000 Americans with HIV could cost at least $5 billion a year and increase the risk of HIV developing resistance to the drugs, but Aaron Diamond AIDS Center scientist David Ho says that his studies support treatment at the first sign of infection. In a current study, 12 patients were treated early and have no detectable virus after a year. Ho wants to remove the therapy and see if the virus comes back or if it is still hiding in certain tissues of the body. Doctors who treat poor patients say the debate over early treatment is meaningless for them because their patients cannot afford the costly drugs.

"AIDS Therapy Faces a Turning Point" Washington Post (07/12/96) P. Al; Brown, David As the 11th International Conference on AIDS ended Thursday, researchers tempered the positive news about promising new drugs with caution that a cure is still not in sight. Studies presented at the meeting demonstrated the ability of protease inhibitors, combined with other drugs, to reduce the amount of HIV in the bloodstream to undetectable levels for up to two years. Scientists are considering whether drug therapy could be stopped in patients who have no detectable HIV. However, before stopping treatment, doctors would offer to biopsy a patient's lymph node, where the virus may still be growing. If a cure is not found, infected people may be able to live longer lives through long-term virus suppression. Survival may depend on how soon treatment is started, however.

"Scientists Display Substantial Gains in AIDS Treatment" New York Times (07/12/96) P. Al; Altman, Lawrence K. Data from several studies of new AIDS treatments were released on Thursday at the 11th International Conference on AIDS. The researchers who conducted the trials, however, cautioned that the findings could not be deemed a cure. Two studies involved combinations of drugs, including AZT, 3TC and the protease inhibitor ritonavir; in both trials, patients' viral loads were reduced to undetectable levels for long periods of time. While the new treatments are extremely promising, experts note that the virus could develop resistance to the new drugs--just as it has to older ones--or patients could prove to be unable to tolerate the harmful effects of the drugs over an extended period.

"Health Plans to Cover New AIDS Drugs But Issues of Cost, Treatment Remain" Wall Street Journal (07/12/96) P. A3; Winslow, Ron While health insurers and managed care plans say they will pay for the costly new protease inhibitors for patients with HIV, the potential cost for the drugs could vary widely. Researchers are debating how soon patients should be treated with the drugs, a factor that could affect cost dramatically. The drugs cost at least $12,000 a year, and a test to monitor patients costs another $1,000. Moreover, early treatment would increase both the number of patients being treated and the cost to insurers. Concerns may be exaggerated, though, considering that the drugs help improve the health of seriously ill patients and thus save money on hospital stays and antibiotics. Tim Westmoreland of the ARMS Email System Page 3 of 5

Georgetown University Law Center noted that protease inhibitors may actually save money for health plans that pay for both prescription-drug benefits and hospital care.

"Many See Hope in AIDS Meeting; Marketers Also See Opportunity" Wall Street Journal (07/12/96) P. Bl; Tanouye, Elyse The 11th International Conference on AIDS held in Vancouver, British Columbia, this week was sponsored by drug makers and other companies eager to display their products. According to Graeme White, the conference's corporate relations manager, pharmaceutical firms and other sponsors contributed nearly a third of the $11 million cost of holding the event. While many conference attendees merely picked up their free Abbott Laboratories' tote bags and eagerly stood in line at the Gilead Sciences booth to get a free water bottle, some AIDS activists protested the commercial hype of the event, marching through the aisles while chanting, "We die. You make money," and putting down roach motels at the Roche Holding booth while waving signs that said "Greed Infestation." According to one drug company executive, however, the commercial hubbub was "extraordinarily subdued," compared with meetings of such groups as the American Heart Association, where celebrities often pitch products.

"Many AIDS Patients Opt for Suicide" Miami Herald (07/11/96) P. 9A; Haney, Daniel Q. People with AIDS commonly attempt suicide and doctors seem increasingly willing to assist them, according to survey results presented Wednesday. Failed suicides are frequent, because physician-assisted suicide is illegal in most places, but surveys show that doctors and nurses are more willing to bend or break the rules to help patients end their pain. Thomas Mitchell of the University of California at San Francisco reported that 53 percent of 114 San Francisco-area AIDS specialists surveyed said they had helped patients end their lives by writing prescriptions for narcotic overdoses. Five years ago, 28 percent of doctors said they would probably help in a suicide.

"Firm Fired HIV Positive Employee Over Illness, Suit Charges" Chicago Tribune (07/11/96) P. 1-7; O'Connor, Matt Robert Viola, who served as a board member of AIDS Care, a residence for homeless AIDS patients in Chicago, was sued by a former employee for firing him because he thought the man had developed AIDS. Patrick N. Martinez says he told Viola previously that he had HIV and that Viola wrongly believed a case of bronchitis indicated that Martinez had developed full-blown AIDS. When Martinez returned to work after being ill, Viola confronted Martinez with the information and tried to force him to quit. Viola fired him the next month. Martinez says he believes Viola was concerned about the potentially high health care costs to his company. Jim Flosi, founder and president of AIDS Care, said that such allegations are completely out of character for Viola, noting that he has volunteered many hours and offered the services of his marketing, communications, and graphics design firm to the cause.

"AIDS Activists Disrupt Meeting of Researchers" Boston Globe (07/11/96) P. 8; Knox, Richard A. A small group of AIDS activists from ACT-UP San Francisco disrupted a meeting at the 11th International Conference on AIDS Wednesday, throwing red liquid that broke glassware and soaked ARMS Email System Page 4 of 5

the clothes of participants. The protest was one of many at the conference, but the first violent disruption. The protesters were apparently upset about the toxicity of AZT.

"A Shot in the Dark" Discover (06/96) Vol. 17, No. 6, P. 66; Cohen, Jon Thailand, a country particularly hard-hit by AIDS, is preparing for the world's first large clinical trial of an HIV vaccine. The country began experiencing an explosive HIV epidemic in 1988, and unlike the epidemic in the United States and Europe, 90 percent of the people infected were heterosexuals. Researchers found a new strain of HIV, subtype E, in northern Thailand and suspected it was more easily transmitted through heterosexual sex than the more common subtype B. A panel at the National Institute of Allergy and Infectious Diseases recommended in 1994 that efficacy trials of the Biocine and Genentech vaccines begin, but the trials were delayed indefinitely. That same year, a World Health Organization panel approved beginning vaccine trials in hard-hit developing countries. Genentech had a large supply of vaccine, but it was designed for subtype B. The company began testing the vaccine in a small number of Thai drug users who were infected with subtype B. Even as this trial was being prepared, though, subtype E was spreading rapidly among drug users. Biocine hopes to start a trial of a subtype E vaccine this fall and is working on a vaccine for both subtypes that may enter a trial by the end of 1997.

"Progress Report: Prophylaxis and Therapy for MAC" AIDS Clinical Care (06/96) Vol. 8, No. 6; P. 45; Currier, Judith Several studies in the past year have reported advances in the prophylaxis and treatment of disseminated Mycobacterium avium complex (MAC), a common cause of morbidity and mortality in patients with advanced HIV infection. Rifabutin was the first agent shown to reduce the incidence of disseminated MAC, but further analysis of favorable studies showed no survival benefit. Clarithromycin has been shown to improve survival by 33.1 percent, although resistance was also found to develop to the drug. Studies showed that both daily clarithromycin and weekly azithromycin are better than rifabutin for MAC prophylaxis, but the relative effect of the two is difficult to determine. Clarithromycin appears to be slightly more effective, although resistance was more commonly associated with it than with azithromycin. To treat MAC, therapy with a macrolide and at least one other agent is currently recommended, although some studies have suggested that a three-drug combination may be more beneficial.

======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE:12-JUL-1996 11:34:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF VS.0-4 #6879) id <[email protected]> for ARMS Email System Page 5 of 5

[email protected]; Fri, 12 Jul 1996 11:33:28 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF VS.0-7 #6879) id <[email protected]> for [email protected]; Fri, 12 Jul 1996 11:33:24 -0700 (MST) Received: by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id LAA10710; Fri, 12 Jul 1996 11:33:19 -0400 Errors-to: [email protected] Precedence: bulk Originator: [email protected] X-Comment: CDC National AIDS Clearinghouse X-Listprocessor-version: 6.0c -- ListProcessor by Anastasios Kotsikonas ======END ATTACHMENT 2 ======ARMS Email System Page I of 4

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Jeffrey Levi ( LEVI_J (WHO)

CREATION DATE/TIME:28-JUL-1996 14:46:04.95

SUBJECT: daily news

TO: Patsy Fleming FLEMING P (WHO) READ:29-JUL-1996 09:27:12.87

TO: Ursula Sanville SANVILLE U (OPD) READ:NOT READ

TO: Lahoma Romocki ROMOCKI L (OPD) READ:l3-AUG-1996 15:47:18.93

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE:26-JUL-1996 10:34:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsnews

ATT SUBJECT: CDC AIDS Daily Summary 07/26/96

ATT TO: levi_j ( levi_j@Al@CD )

TEXT: AIDS Daily Summary July 26, 1996

The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

****************************************************** "Pa. Program Offers 2 More AIDS Drugs for Working Poor" "Poor TB Care Worse Than None" "Courts Tough on Those Who May Expose Others to AIDS, Study Says" "The FDA Can Work Better" "Report Blasts FDA's Blood Regulation" "AIDS and Elderly: Age Is No Escape" "Tuberculosis on Rise in Kenya" "Venezuela Registers Nearly 3,500 Deaths from AIDS" "Serum HIV-1 RNA Levels and Time to Development of AIDS in the Multicenter Hemophilia Cohort Study" ******************************************************

"Pa. Program Offers 2 More AIDS Drugs for Working Poor" Philadelphia Inquirer (07/26/96) P. B2; Collins, Huntly Two more powerful new protease inhibitors will be provided ARMS Email System Page 2of4

at no cost to low-income, uninsured AIDS patients in Pennsylvania, the state Welfare Department announced Thursday. Crixivan and Norvir will be added to the list of 58 AIDS drugs, including the protease inhibitor Invirase, now provided by the $5.7 million program. To be eligible for the free drugs, HIV-infected patients must earn less than $30,000 a year. Each patient may receive just one of the protease inhibitors, which, when combined with older AIDS drugs, are able to suppress the level of HIV in the bloodstream. The drugs are covered by private insurers and Medicaid, but the uninsured are not covered in many states.

"Poor TB Care Worse Than None" USA Today (07/26/96) P. 2D; Manning, Anita Tuberculosis (TB) programs that are not managed well do more harm than good, researchers at the University of California San Francisco and Stanford University Medical Center report today in the journal Science. UCSF's Sally Blower and Philip C. Hopewell, and Stanford's Peter Small, evaluated the World Health Organization's TB control programs and report that the number of TB cases could be reduced by 80-90 percent by 2000 if WHO meets its goals of identifying 70 percent of cases worldwide and curing 85 percent of those identified. In their report, the researchers warn that unless TB patients are treated with a full six-month drug regimen, they can develop and spread drug-resistant strains. Small called the report a vehicle to raise awareness about the need for increased resources.

"Courts Tough on Those Who May Expose Others to AIDS, Study Says" Houston Chronicle (07/25/96) P. 21A; Epstein, Aaron The courts of the 1990s are ruling against HIV-positive individuals who expose others to the virus, even if the risk is remote, a new legal study says. Lawrence Gostin, a Georgetown University law professor, based his findings on 310 AIDS cases since January 1991. Judges have not discriminated against people with AIDS in schools, workplaces, and housing projects, but Gostin says they increasingly rule against HIV-positive individuals in insurance disputes and in health-care settings where exposure to blood is possible. For example, several courts have held that HIV-positive surgeons could be kept from operating despite a low risk of transmitting the virus to patients. At a briefing on the study on Wednesday, Gostin said that lawmakers and judges need to be educated about the risks of transmission. The study noted that in criminal cases, people with HIV have been convicted for spitting, biting, hitting, and other behaviors which did not carry significant risk of transmission. Moreover, Gostin said, insurance disputes involving access to care, ceilings on coverage, and other issues are generally decided in favor of the insurance company.

"The FDA Can Work Better" Washington Post (07/26/96) P. A27; Mikulski, Barbara; Kassebaum, Nancy In a commentary in the Washington Post, Senators Barbara Mikulski (D-Md.) and Nancy Kassebaum (R-Kan.) object to a July 17 Post editorial that criticized their year-long efforts to reform the Food and Drug Administration. They argue that the legislation developed by the Senate Labor and Human Resources Committee has not been rushed to the Senate floor, as the editorial suggested, but is the result of careful consideration. ARMS Email System Page 3 of 4

They also note that the FDA's success in speeding-up approval of AIDS drugs, in response to pressure from the AIDS community, was a basis for further improvement. Objecting to the editorial's suggestion that the bill would put too much regulatory power in the private sector, the authors say it would only encourage cooperation throughout the approval process, thus avoiding costly delays.

"Report Blasts FDA's Blood Regulation" Philadelphia Inquirer (07/26/96) P. A3; Shaw, Donna A new Congressional report criticizes the Food and Drug Administration for not regulating the blood-products industry effectively and not adequately protecting Americans from tainted blood. The report said that 15 years after AIDS was first identified, the agency still does not have an effective recall system for contaminated blood products. It recommended that a fund be created to help people who "suffer adverse consequences" from tainted blood- and plasma-based therapies, but fails to mention the estimated 10,000 hemophiliacs infected with HIV in the 1980s from blood-clotting products. Moreover, Corey Dubin, president of the Committee of Ten Thousand, an activist group for HIV-infected hemophiliacs, denounced the report for its exclusion of people already infected. Legislation is pending to provide $1 billion to compensate HIV-infected hemophiliacs, but the bill is said to have poor chances.

"AIDS and Elderly: Age Is No Escape" Chicago Tribune (07/25/96) P. 1-1; Lade, Diane C. In Florida, at least 3,991 people over age 50 have contracted HIV from unprotected sex and died of AIDS. Sexual contact is the most common way people over age 50 are infected with HIV, accounting for 60 percent of cases in Florida since 1981. Heterosexual sex is the most common mode of transmission among those 65 or older and was responsible for 24.6 percent of all cases documented in Florida since 1981. While people aged 30-39 comprise 45 percent of the state's AIDS cases, the disease is spreading in the senior population at a rapid rate. Nationally, the percentage of AIDS cases in people over 50 increased 11 percent from 1993 to 1994. E. Bentley Lipscomb, secretary of Florida's Department of Elder Affairs, says the problem stems from lack of education as well as a neglect to target HIV programs to the elderly population.

"Tuberculosis on Rise in Kenya" Xinhua News Agency (07/25/96) In Kenya, tuberculosis cases increased to 4,000 in 1995, up from 400 10 years earlier, a government official said Thursday. The Kenyan Minister for Health attributed the rise to the spread of HIV. An estimated 1 million Kenyans have the virus, which is often associated with TB. The minister was speaking at the opening of a new TB clinic.

"Venezuela Registers Nearly 3,500 Deaths of AIDS" Xinhua News Agency (07/25/96) Out of 5,796 AIDS cases in Venezuela, 3,496 people have died, a health official announced Thursday. Alejandro Villarroel, medical director of the International Foundation of Combat Against AIDS in Venezuela, urged the public to be aware of the threat of the disease. ARMS Email System Page 4of4

"Serum HIV-1 RNA Levels and Time to Development of AIDS in the Multicenter Hemophilia Cohort Study" Journal of the American Medical Association (07/10/96) Vol. 276, No. 2, P. 105; O'Brien, Thomas R.; Blattner, William A.; Waters, David; et al. Research suggests that HIV-infected individuals with higher levels of viral RNA may develop AIDS more quickly than those with lower viral levels, but the time from infection to AIDS has not been quantified for various HIV-1 RNA levels. The link between the amount of HIV-1 RNA during early chronic HIV-1 infection and future disease progression is important to understand the pathogenesis of HIV-1. Dr. Thomas R. O'Brien of the National Cancer Institute and colleagues evaluated HIV-1 RNA levels and disease progression in 165 patients enrolled in the Multicenter Hemophilia Cohort Study. The patients' ages at time of seroconversion ranged from 1 year to 66 years. The viral levels were similar for patients younger than 17 and for those aged 18 to 34, but they were higher for individuals aged 35 or older. At 10 years after seroconversion, 72 percent of patients with the highest initial viral load had progressed to AIDS, while none of the patients with the lowest viral loads had developed the disease. The authors conclude that the HIV-1 RNA level during early chronic HIV-1 infection is a strong, age-independent predictor of disease progression.

======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE:26-JUL-1996 10:35:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for levi [email protected]; Fri, 26 Jul 1996 10:34:44 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF V5.0-7 #6879) id <[email protected]> for [email protected]; Fri, 26 Jul 1996 10:34:25 -0700 (MST) Received: by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id KAA05768; Fri, 26 Jul 1996 10:34:47 -0400 Errors-to: [email protected] Precedence: bulk Originator: [email protected] X-Comment: CDC National AIDS Clearinghouse X-Listprocessor-version: 6.0c -- ListProcessor by Anastasios Kotsikonas ======END ATTACHMENT 2 ======ARMS Email System Page 1 of 5

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Jeffrey Levi ( LEVI_J (WHO)

CREATION DATE/TIME: 5-AUG-1996 10:46:48.21

SUBJECT: daily news

TO: Patsy Fleming FLEMING P (WHO) READ: 5-AUG-1996 12:56:12.22

TO: Ursula Sanville SANVILLE U (OPD) READ:NOT READ

TO: Lahoma Romocki ROMOCKI L (OPD) READ:l3-AUG-1996 15:00:37.12

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE: 5-AUG-1996 10:41:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsnews

ATT SUBJECT: CDC AIDS Daily Summary 08/05/96

ATT TO: levi j levi j@Al@CD

TEXT: AIDS Daily Summary August 5, 1996

The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

****************************************************** "Groups Unite on New AIDS Drug Therapies" "Progress on AIDS Intensifies the Battle to Make Insurers Reveal Medical Data" "States Run Low on AIDS Funds" "Breakthrough for HIV-Positive Babies" "In Search of A Cure--and A New Image" "Agents Crack Down on Marijuana Buying Club" "TB Returns With A Vengeance" "AIDS Ride Fund-Raisers Shift Into High Gear in Third Year" "Foreign HIV Surfaces in the Bronx" "Difficulties and Strategies of HIV Diagnosis" ******************************************************

"Groups Unite on New AIDS Drug Therapies" Wall Street Journal (08/05/96) P. B3; Waldholz, Michael ARMS Email System Page 2 of 5

A group of representatives from 40 organizations, including the White House, government health agencies, pharmaceutical companies, research centers, private and government health insurers, and patient-advocacy groups, have formed a coalition to organize research to help clear the confusion surrounding the use of new AIDS drugs. Linda Distlerath, an official at Merck, said the group will try to "facilitate and coordinate" several clinical trials in the next few years. The group's goal is to determine which drug combinations are most effective, at what point therapy should begin, and what can be done to avoid the development of drug resistance. The group, to be called the Forum for Collaborative HIV Research, has met five times and announced the partnership on Friday after a meeting with Vice President Gore.

"Progress on AIDS Intensifies the Battle to Make Insurers Reveal Medical Data" Wall Street Journal (08/05/96) P. A7A; Scism, Leslie Some large life and health insurance companies do not reveal the results of tests to applicants, a practice that takes on special significance for HIV tests. Jody Deramus of Vienna, Va., has filed a lawsuit in federal court against Jackson National Life Insurance Co., a unit of Prudential, charging that the company failed to notify her husband that he had tested positive for HIV. Mr. Deramus had applied to increase his life insurance coverage in 1988 and was refused additional coverage but not told why. Moreover, when he became ill, HIV was not suspected, and the couple only learned that Deramus was infected in October 1989. Jackson National revealed its test results days before Deramus died in June 1991. In addition to her other claims, Mrs. Deramus charges that the company exposed her to harm by not warning her of her husband's condition. She has not tested positive for the virus. The company holds that it acted within the law and that informing the patient would not have prolonged his life.

"States Run Low on AIDS Funds" Washington Times (08/05/96) P. AS As states are already facing shortages in funds that provide AIDS drugs to their poor residents, many are cutting the share of drugs they can afford to offer each patient. Still more cuts are pending as more patients seek treatment because of promising new drugs. Washington has become the latest state to cut its AIDS drug assistance program to avoid bankruptcy. The program was shut down temporarily after a 76 percent increase in AIDS patients between January and June. The programs, which supply drugs for patients who are uninsured or who do not qualify for Medicaid, are in danger largely because of costly new protease inhibitors that are powerful, but must be taken on a strict regimen.

"Breakthrough for HIV-Positive Babies" Washington Post (08/05/96) P. Al9; Hentoff, Nat In a Washington Post commentary, Nat Hentoff applauds the New York law passed in June that requires the HIV testing of all newborns and the disclosure of the results to the mothers. Hentoff points out that while some mothers in New York complained for years that they should have been informed that their children were infected with HIV, the state's confidentiality law prevented such disclosure. Nettie Mayersohn, a New York state assemblywoman, sponsored the bill and fought for three years to ARMS Email System Page 3 of 5

get it passed. Hentoff notes that she was opposed by the National Organization of Women, gay groups, AIDS activists, some medical organizations, and the American Civil Liberties Union. The groups argued that mandatory testing is a violation of privacy, and that counseling and voluntary testing is a better method. After the New York law passed, Hentoff further notes, the American Medical Association announced their support for mandatory testing of all newborns and pregnant women.

"In Search of A Cure--and A New Image" Washington Post--Washington Business (08/05/96) P. 5; Day, Kathleen While early tests of an AIDS vaccine being developed by Cel-Sci, a small biotechnology company in Alexandria, Va., are promising, Wall Street analysts have raised doubts about the company. Jim Mccamant, associate editor of Medical Technology Stock Letter, says Cel-Sci's promotion of the vaccine has been very positive, even though their research has been slow and inconclusive. In addition, Angus MacDonald, a biotech analyst with Fahnestock & Co., criticized the company for conducting research on the vaccine without approval by the Food and Drug Administration. Cel-Sci CEO Geert Kersten admits that while the company has some problems, it will ultimately win the confidence of investors.

"Agents Crack Down on Marijuana Buying Club" New York Times (08/05/96) P. AS; Golden, Tim California drug agents raided the largest above-board marijuana provider in the country Sunday, after tolerating the operation for more than two years. Activists say the Cannabis Buyers' Club of San Francisco provides marijuana to thousands of people seeking relief from illnesses like AIDS and cancer. The operation was not closed down immediately, but more than 40 pounds of marijuana was seized and will probably be used to arrest people, officials said. Organizers of the club objected to the crackdown, arguing that it would hurt AIDS and cancer patients.

"TB Returns With A Vengeance" Washington Post (08/03/96) P. Al8 Last year, almost 3 million people died of tuberculosis, a figure greater than that reported during the worst years of the epidemic around 1900, the World Health Organization said. Nearly 15 million people have the disease today, and 50 million are expected to be afflicted worldwide during the last decade of this century. WHO predicts that 17.9 million cases will occur in South and Southeast Asia, 10.4 million in East Asia, and 9.2 million in sub-Saharan Africa.

"AIDS Ride Fund-Raisers Shift Into High Gear in Third Year" Los Angeles Times (08/04/96) P. Bl; Sancetta, Amy Dan Pallotta, the creator and producer of the American AIDS Rides, says the five rides this year will raise $23 million. The rides, which will involve 11,000 riders and thousands of volunteers, will benefit 28 AIDS organizations across the country. Moreover, the riders bond on the challenging courses and share the commitment to helping AIDS patients. Pallotta has helped raise $27.8 million since the first ride in 1994.

"Foreign HIV Surfaces in the Bronx" ARMS Email System Page 4of5

Science News (07/20/96) Vol. 150, No. 3, P. 40; Sternberg, Steve In a surprising and disturbing find, AIDS researchers have identified rare strains of HIV in long-time Bronx, N.Y., residents. At Bronx-Lebanon Hospital Center, 828 people who visited the facility participated in voluntary HIV testing and counseling. Of the 43 people found to be HIV-positive, 35 were infected with subtype B, the most common strain in North America. Eight had geno types of HIV-1, including subtypes A, C, and a Thai strain of type B, never before found in people living in the United States. Kathleen Irwin, a medical epidemiologist at the Centers for Disease Control and Prevention, said the diversity of the strains was "far greater" than researchers had expected to find in the United States. The Bronx is a common destination for immigrants from countries where HIV is more common. Intravenous drug use and high-risk heterosexual sex are also common in the area. The discovery could have implications for vaccine development, because although researchers are now focusing on a vaccine for the B strain of HIV, the newly identified cases could spur research for a vaccine to protect against strains previously thought to exist only in developing countries.

"Difficulties and Strategies of HIV Diagnosis" Lancet (07/20/96) Vol. 348, No. 9021, P. 176; Gurtler, Lutz In a review of current HIV testing methods, Lutz Gurtler, of the World Health Organization's Collaborating Center for Reference and Research on AIDS, describes the strengths and weaknesses of existing testing technologies. Antibodies to HIV are diagnosed initially by enzyme-linked immunosorbent assays (ELISA) and agglutination assays and confirmed by either Western Blot or more specific tests like competitive ELISA. Nucleic-acid-based tests and p24-antigen tests, meanwhile, detect the virus itself. Such tests are used for HIV detection in newborn infants, characterization of individual strains for subtyping and forensic identification, and therapeutic monitoring. Moreover, nucleic-acid-based assays can detect HIV in a shorter time period after infection than tests for antibodies, which are not detectable until six to eight weeks after infection. When quantified, nucleic acid tests can also indicate clinical status. The limits of existing HIV tests are recognized when new strains are identified. New assays are needed to detect all HIV strains, Gurtler concludes, to reduce the risk of transmission and to make diagnosis more reliable.

======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE: 5-AUG-1996 10:42:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for [email protected]; Mon, 05 Aug 1996 10:41:14 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF V5.0-7 #6879) id <[email protected]> for [email protected]; Mon, 05 Aug 1996 10:40:44 -0700 (MST) ARMS Email System Page 5 of 5

Received: by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id KAA17938; Mon, 05 Aug 1996 10:41:22 -0400 Errors-to: [email protected] Precedence: bulk Originator: [email protected] X-Comment: CDC National AIDS Clearinghouse X-Listprocessor-version: 6.0c -- ListProcessor by Anastasios Kotsikonas ======END ATTACHMENT 2 ======ARMS Email System Page 1 of 4

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Jeffrey Levi ( LEVI J (WHO)

CREATION DATE/TIME: 9-AUG-1996 11:23:25.80

SUBJECT: daily news

TO: Patsy Fleming FLEMING P (WHO) READ: 9-AUG-1996 16:41:19.67

TO: Ursula Sanville SANVILLE U (OPD) READ: 9-AUG-1996 17:42:52.07

TO: Lahoma Romocki ROMOCKI L (OPD) READ:13-AUG-1996 09:51:34.61

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE: 9-AUG-1996 11:10:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsnews

ATT SUBJECT: CDC AIDS Daily Summary 08/09/96

ATT TO: levi j ( levi_j@Al@CD )

TEXT: AIDS Daily Summary August 9, 1996

The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

****************************************************** "An Inborn Barrier to the AIDS Virus Is Found in Study" "Nature Deals Blow to Viatical Insurers" "Pharmacia & Upjohn in Marketing Pact with Gilead" "Free Test Shows Advancement of AIDS Virus" "Task Force to Advise on Blood Supply" "Across the USA: Wisconsin" "Nevirapine Now Available Commercially" "Glaxo's Epivir AIDS Drug Gets European License" "HIV and the Pediatrician as the Child's Advocate" "Control Strategies for Tuberculosis Epidemics: New Models for Old Problems" ******************************************************

"An Inborn Barrier to the AIDS Virus Is Found in Study" Wall Street Journal (08/09/96) P. BS; Waldholz, Michael ARMS Email System Page 2 of 4

AIDS researchers report that some people have a rare gene that protects them from HIV infection. The Aaron Diamond AIDS Research Center's Richard Koup and colleagues report in today's issue of the journal Cell that the gene makes a protein which does not allow HIV to enter cells. The protein, CKR-5, was identified in June by five different research groups--including the Aaron Diamond Laboratory--as being critical for HIV's entry into the cell. The researchers say that only about 1 percent of people of Western European heritage carry the gene but note that the findings can be used for drug development.

"Nature Deals Blow to Viatical Insurers" Journal of Commerce (08/09/96) P. SA; Macleod, Helen R. Although companies that buy life insurance policies from the terminally ill were hurt by the news this month about advances in AIDS care, they were also encouraged about the passage of a health insurance bill that includes a provision making viatical settlements free from federal income tax. The new policy adds a substantial amount to the settlement a terminally ill policyholder can expect to receive, while also apparently granting approval to the viatical settlement industry. Improving the survival of AIDS patients is good news, of course, but for viatical settlement companies longer life means less profit. Dignity Partners, for example, recently announced that it would no longer buy policies from AIDS patients.

"Pharmacia & Upjohn in Marketing Pact with Gilead" New York Times (08/09/96) P. D3 Pharmacia & Upjohn has brokered a deal with Gilead Sciences in which it will pay Gilead $60 million for the overseas marketing rights to Gilead's Vistide, a drug for fighting blindness in AIDS patients. Pharmacia said it would pay Gilead $10 million initially and another $10 million after the drug is cleared for marketing in Europe. The company would then acquire $40 million on newly issued Gilead preferred shares. Gilead shares close at 19.125, up $1.50 in Nasdaq trading.

"Free Test Shows Advancement of AIDS Virus" Miami Herald (08/08/96) P. 3B; Rafinski, Karen Roche Molecular Systems is offering a free test to HIV-infected individuals to help them assess the amount of virus in their blood. The test, which helps doctors determine how far progressed the disease is, will be free until August 17. The Amplicor HIV-1 Monitor test, while not approved by the Food and Drug Administration for this use, is an especially important tool for doctors to monitor the use of protease inhibitors. The test usually costs about $123.

"Task Force to Advise on Blood Supply" Toronto Globe and Mail (08/08/96) P. A4 Canada's health ministers will be advised by a federal-provincial task force this fall on how to keep the blood supply safe, despite concerns by Justice Horace Krever that the task force is a pre-emptive move against the findings of his inquiry. The task force, created in April, includes representatives from the federal government, five provinces, and experts in transfusion medicine.

"Across the USA: Wisconsin" USA Today (08/09/96) P. 6A ARMS Email System Page 3 of 4

Donald Hawks, an HIV-positive man who had unprotected sex with three women, has been issued a six-year prison sentence. Hawks pleaded no contest to reckless endangerment. None of the women have tested positive for HIV.

"Nevirapine Now Available Commercially" Reuters (08/08/96) Viramune (nevirapine), a non-nucleoside reverse transcriptase inhibitor for the treatment of HIV infection, became commercially available on Wednesday. According to Roxane Laboratories, the new drug has a wholesale price of $6.88 for one standard daily maintenance dose. "This price, when compared to the currently approved protease inhibitors, which range from $12-$18 per day, is significantly lower," notes Roxane's Ed Tupa. An Expanded Access Program has provided AIDS patients with Viramune since March.

"Glaxo's Epivir AIDS Drug Gets European License" Reuters (08/08/96) Glaxo Wellcome announced on Thursday that its Epivir, a drug for the treatment of HIV infection, has been approved by the European Commission for use in the 15 member states of the European Union. When used in combination with other drugs, Epivir has demonstrated effectiveness in reducing the mortality rate of AIDS patients. The drug is also marketed as 3TC.

"HIV and the Pediatrician as the Child's Advocate" Lancet (07/27/96) Vol. 348, No. 9022, P. 247; Duke, Christopher; Kovar, Ilya z. In a review of the laws applying to HIV testing of pregnant women and their unborn children, Christopher Duke and Ilya Z. Kovar of the Chelsea and Westminster Hospital in London cite the details of the law that may be used in doctors' favor to protect infants from perinatal infection. Opponents of mandatory HIV testing for pregnant women say it violates their rights, for example, yet without it, the rights of the child are abandoned, because recognizing and treating vertically transmitted HIV can dramatically improve a child's health and survival. Moreover, while confidentiality rules prohibit a doctor from revealing a patient's HIV status, confidentiality in the United Kingdom may be breached to protect another person's health. The authors claim that this would allow a doctor to disclose that a woman has HIV if it would protect her child's health. Similarly, the British law allows disclosure of confidential information if it is in the public interest, which would likely include the protection of a child's health, they say. However, if a mother's HIV status is disclosed without her consent, disclosure must be restricted to only the medical staff who need to know to protect the child.

"Control Strategies for Tuberculosis Epidemics: New Models for Old Problems" Science (07/26/96) Vol. 273, No. 5274, P. 497; Blower, S.M.; Small, P.M.; Hopewell, P.C. S.M. Blower, of the University of California at San Francisco, and colleagues, present a theoretical framework for designing effective tuberculosis (TB) control strategies and determining treatment levels to eradicate the disease. Using a mathematical model that estimates the disease's pathogenesis, and incorporating the population level effects of chemoprophylaxis ARMS Email System Page 4of4

and treatment, they conclude that treatment failure rates must be lower in developing countries than in developed countries to control TB. They also contend that the World Health Organization's global TB treatment goals for the year 2000 would probably not lead to global eradication but would significantly reduce morbidity and mortality. Furthermore, they estimate how suboptimal control programs contribute to the evolution of drug resistance and suggest that higher standards for treatment should be required for programs in developing countries compared to those in developed countries.

======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE: 9-AUG-1996 11:12:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF VS.0-4 #6879) id <[email protected]> for [email protected]; Fri, 09 Aug 1996 11:10:46 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF VS.0-7 #6879) id <[email protected]> for [email protected]; Fri, 09 Aug 1996 11:09:54 -0700 (MST) Received: by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id LAA24010; Fri, 09 Aug 1996 11:10:41 -0400 Errors-to: [email protected] Precedence: bulk Originator: [email protected] X-Comment: CDC National AIDS Clearinghouse X-Listprocessor-version: 6.0c -- ListProcessor by Anastasios Kotsikonas ======END ATTACHMENT 2 ======ARMS Email System Page 1 of 4

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Jeffrey Levi ( LEVI_J (WHO)

CREATION DATE/TIME:13-AUG-1996 10:56:14.63

SUBJECT: daily news

TO: Patsy Fleming FLEMING P (WHO) READ:13-AUG-1996 12:17:11.94

TO: Ursula Sanville SANVILLE U (OPD) READ:13-AUG-1996 12:29:31.98

TO: Lahoma Romocki ROMOCKI L (OPD) READ:13-AUG-1996 11:11:13.51

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE:13-AUG-1996 10:52:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsnews

ATT SUBJECT: CDC AIDS Daily Summary 08/13/96

ATT TO: levi_j levi j@Al@CD

TEXT: AIDS Daily Summary August 13, 1996

The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

****************************************************** "Chilean Politician Says Prison Medics Infected Inmates With

H.I.V. II "The Reliable Source: A Sobering Interlude" "Business World: What Else Is Lost in Dr. Kessler's Fog?" "Husbands Can Spread Cervical Cancer" "Patients to Test Drug in Effort to Stop AIDS" "Lifetime Costs of HIV Infection: Lower in U.S. Versus Australia" "Burma Headed for Health Crisis--UK Rights Group" "Gay Men Show Moderate Interest in Participating in HIV Vaccine Trials" "Study Urges Easing of Syringe Laws" "HIV Mutations Block Interactions Between Protease and Inhibitors" ****************************************************** ARMS Email System Page 2of4

"Chilean Politician Says Prison Medics Infected Inmates With H. I. V." New York Times (08/13/96) P. A4 An opposition political leader has accused paramedics in a prison in Santiago, Chile, of infecting inmates with HIV by using contaminated needles to draw blood for tests. Thomas Hirsch, president of the Humanist Alliance party, a left-wing group, said the medical workers used the same needles to draw blood from inmates known to have the virus and from those who were not infected. The inmates said 10 syringes were used indiscriminately to draw blood from the prisoners. The head of the prison employees' office denied the charges and said he would sue Hirsch for slander. Hirsch said his charges were based on a paramedic's report, adding that he plans to file court charges to force an investigation.

"The Reliable Source: A Sobering Interlude" Washington Post (08/13/96) P. B3; Greer, Annie; Gerhart, Ann At the Republican National Convention Monday night, HIV-positive AIDS activist Mary Fisher repeated the call for AIDS compassion that she made at the 1992 convention in Houston. She was joined by 12-year-old Hydeia Broadbent of Las Vegas, who was born to an infected drug user and adopted by Patricia Broadbent when she was six weeks old. The girl read a poem she had written, saying "I have a bright future and no one can take that away from me. I am the future."

"Business World: What Else Is Lost in Dr. Kessler's Fog?" Wall Street Journal (08/13/96) P. Al3; Jenkins Jr., Holman W. In a commentary on the relationships between drug companies and the Food and Drug Administration, Holman W. Jenkins Jr. points to the events surrounding the approval of Johnson & Johnson's home HIV test. The test, developed by Elliott Millenson and his wife Wendy Strongin, was bought by J&J after the FDA rejected it, and David Kessler, the agency's head, said he would never approve home-testing for HIV. Millenson then sold his company to J&J in an attempt to gain J&J's "participation in the approval process and eventual marketing of the [HIV home testing] product." Millenson became head of J&J's Direct Access Diagnostics division and was given a budget for lobbying and contributions. When the FDA eventually approved the test in May, however, Millenson had already been fired by J&J amid questions about lobbying contributions he had made and negative publicity. An arbitrator has ordered the company to return the test and related assets to Millenson. Jenkins contends that the example illustrates the problems associated with allowing politics to influence the approval of drugs and devices by the FDA.

"Husbands Can Spread Cervical Cancer" Washington Post--Health (08/13/96) P. 7; Auerbach, Stuart Husbands who have extramarital sex can infect their wives with a human papillomavirus, which has been linked to cervical cancer, researchers reported last week. F. Xavier Bosch of Barcelona and Nubia Munoz of the International Agency for Research on Cancer in Lyon, France, led the study of 183 Spanish women, published in the Journal of the National Cancer Institute. Health problems related to sexually transmitted diseases (STDs) are more common and more serious in women and can be passed on to children during pregnancy or at childbirth. The Centers for Disease Control and Prevention estimates that at least 12 million ARMS Email System Page 3 of 4

Americans are infected with some form of STD each year.

"Patients to Test Drug in Effort to Stop AIDS" Richmond Times-Dispatch (08/12/96) P. B4 A total of 2,500 patients at 50 clinical trial sites nationwide will receive a new treatment for HIV infection, aimed at preventing the progression to AIDS. Remune, developed by the late Dr. Jonas Salk, is designed to boost the immune system to control HIV. The treatment is made from HIV that has been inactivated with radiation and has had a protein removed. The treatment, developed by Immune Response Corp., has shown some evidence of boosting the immune system.

"Lifetime Costs of HIV Infection: Lower in U.S. Versus Australia" Reuters (08/12/96) The lifetime costs of treating patients with HIV seem to be higher in Australia than in the United States, researchers at the University of Melbourne reported. Susan F. Hurley and colleagues found that the average lifetime cost to a HIV-infected patient in Australia was $93,000, 49 percent of which was spent on drugs and 32 percent on hospital care. In the United States, the comparable costs were about 17 percent lower. Hurley said the lower costs in the United States seemed to be due to lower rates of hospitalization and drug prescribing, possibly because of reduced access to health services.

"Burma Headed for Health Crisis--UK Rights Group" Reuters (08/13/96) Political isolation, ethnic conflict, and censorship in Burma has led to a health crisis and increased the spread of HIV, the London-based International Center Against Censorship reports. The group said accurate statistics concerning public health in the country are rare or non-existent. It also noted that HIV has spread rapidly over the past decade due to drug abuse and prostitution. Burma's military government has been criticized for its authoritarian policies and alleged human rights abuses. The World Health Organization estimates that half a million people in the country of 46 million were infected with HIV in 1995, although official statistics say only 9,885 people carry the virus.

"Gay Men Show Moderate Interest in Participating in HIV Vaccine Trials" Reuters (08/12/96) About half of the homosexual or bisexual men living in the greater Boston area said they would be "somewhat" interested in participating in clinical trials of HIV vaccines, researchers say. Michael Gross of Abt Associates and colleagues surveyed 630 men in two age groups and found that 34 percent were "not at all" interested and 16 percent were "very" interested. Older men were significantly more likely than younger men to show interest.

"Study Urges Easing of Syringe Laws" AIDS Alert (07/96) Vol. 11, No. 7; P. 83 Most states still enforce laws written 30 years ago to make the sale, distribution, and possession of syringes illegal without a prescription, Georgetown law professor Lawrence Gostin recently reported to the U.S. Centers for Disease Control and Prevention. Gostin told the agency, which does not endorse needle exchange programs, that such laws have contributed to the spread of HIV among injection drug users. While CDC officials ARMS Email System Page 4 of 4

recognize the benefit of needle exchange programs for reducing HIV infection, they say they require more evidence that legalizing syringes would not increase drug use. "The states need to look and see if the laws still·make sense, but we are not making any federal recommendations," said the CDC's Dr. Helene Gayle. Federal funds may not be used for needle exchange programs in the United States unless the surgeon general concludes that they reduce HIV infection and do not lead to increased drug use. An AIDS advisory council to the governor of New Jersey has recommended that the state law be changed to support needle exchanges, having found that such programs are as useful in reducing HIV transmission as drug abuse treatment programs in the state.

"HIV Mutations Block Interactions Between Protease and Inhibitors" Chemical & Engineering News (07/29/96) Vol. 74, No. 31, P. 44 By changing enough to prevent a drug from binding to it, HIV protease can become drug-resistant after a patient has been taking it for only a few weeks. Researchers are studying ways to make drugs less vulnerable to HIV's changes; however, they first need to understand how the virus affects drug binding. Paul Ala and colleagues at DuPont/Merck Pharmaceutical recently presented their work on HIV's resistance to their protease inhibitor DMP323 at the 11th International Conference on AIDS. Although problems with DMP323 took it out of consideration for use in humans, the scientists noted that it is a valuable tool to help in the understanding of how HIV mutates to prevent the drug from binding. The research could also be important for understanding resistance to protease inhibitors in general.

======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE:13-AUG-1996 10:53:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for [email protected]; Tue, 13 Aug 1996 10:52:51 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF V5.0-7 #6879) id <[email protected]> for levi [email protected]; Tue, 13 Aug 1996 10:51:51 -0700 (MST) Received: by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id KAA01072; Tue, 13 Aug 1996 10:52:42 -0400 Errors-to: [email protected] Precedence: bulk Originator: [email protected] X-Comment: CDC National AIDS Clearinghouse X-Listprocessor-version: 6.0c -- ListProcessor by Anastasios Kotsikonas ======END ATTACHMENT 2 ======ARMS Email System Page 1 of 5

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Jeffrey Levi ( LEVI_J (WHO)

CREATION DATE/TIME:30-AUG-1996 13:24:08.73

SUBJECT: daily news

TO: Patsy Fleming FLEMING P (WHO) READ: 3-SEP-1996 10:34:59.44

TO: Ursula Sanville SANVILLE U (OPD) READ: 4-SEP-1996 13:32:31.37

TO: Lahoma Romocki ROMOCKI L (OPD) READ:27-SEP-1996 14:57:53.88

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE:30-AUG-1996 11:20:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsnews

ATT SUBJECT: CDC AIDS Daily Summary 08/30/96

ATT TO: levi j levi j@Al@CD

TEXT: AIDS Daily Summary August 30, 1996

The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

****************************************************** "Japan Arrests Doctor in Case of Bad Blood" "Widow Asks Full Court to Review AIDS Case" "Baxter Sets Aside $68M for Immuno's HIV Costs" " 'Hope Is Back in America' " "AIDS Fears Prompt Brothel Raids" "Risks and Rewards of One-Product Stocks" "Testing for TB" "HIV Testing Among Women Aged 18-44 Years--United States, 1991 and 1993" "Pneumocystis Pneumonia--Los Angeles" "Blood Safety Issues Working Group Convened" ******************************************************

"Japan Arrests Doctor in Case of Bad Blood" New York Times (08/30/96) P. A9; Pollack, Andrew ARMS Email System Page 2 of 5

A Japanese doctor and hemophilia expert was arrested Thursday on charges that he prescribed blood products to a patient knowing they carried the risk of HIV infection. Dr. Takeshi Abe, the head of a government panel on AIDS in the 1980s, has been accused with other officials of delaying the approval of heat-treated blood products even though evidence had suggested that they could prevent the spread of HIV. Law enforcement officials also raided the offices of the Ministry of Health and Welfare Thursday, and had previously raided the Green Cross Corp., a drug company involved in the distribution of tainted blood products. The activity suggests that criminal charges may be filed against current or former officials.

"Widow Asks Full Court to Review AIDS Case" Journal of Commerce (08/30/96) P. BA The widow of a man who died of AIDS in 1991 is asking a federal appeals court to reconsider the lawsuit she filed against a life insurance company that did not tell her husband he had HIV. A federal judge and a three-judge panel of an appeals court has already ruled in favor of the insurer, Jackson National Insurance. The company had refused to disclose why they found Frank Deramus medically unsuitable for increased coverage after he took a blood test in 1988. Jackson National said it was not legally responsible to advise Deramus of his results. Jody Deramus said she would seek a review from the Supreme Court if the full 5th U.S. Circuit Court of Appeals refuses to hear her case.

"Baxter Sets Aside $68M for Immuno's HIV Costs" Financial Times (08/30/96) P. l; Green, Daniel To cover the potential costs of lawsuits brought by hemophiliacs against Immuno International, a company being acquired by Baxter International, the new parent is setting aside $68.5 million. Immuno makes blood products in Europe, as Baxter does in the United States. Both companies have been among the firms to face lawsuits by hemophiliacs infected with HIV. Settlements have been reached in the United States and Japan, but not in Europe.

"'Hope Is Back in America'" Washington Post (08/30/96) P. A36 In President Clinton's acceptance speech Thursday night to the Democratic National Convention, he pointed to progress made in various areas of American society during his administration. Among them, he mentioned that "more rapid development of drugs to deal with HIV and AIDS and moving them to the market quicker have almost doubled life expectancy in only four years--and we are looking at no limit in sight to that. We'll keep going until normal life is returned to people who deal with this," he said.

"AIDS Fears Prompt Brothel Raids" Toronto Globe and Mail (08/29/96) P. Al2; Stackhouse, John In the capital of Nepal, and seven other Indian cities, 456 prostitutes including more than 100 children have been held in poor conditions for six months and have been subjected to HIV tests. The women and girls were taken from Bombay brothels during a raid ordered by the state court to clear the city of HIV-infected prostitutes. In response to a public outcry, the government allowed 124 Nepalese women and four of their children to return home, however. About 100 other Nepalese women refused ARMS Email System Page 3of5

to leave Bombay, saying they would return to their brothels.

"Risks and Rewards of One-Product Stocks" Investor's Business Daily (08/30/96) P. Al; Gessel, Chris Dignity Partners, a San Francisco company that bought life insurance policies from people with HIV, was the first viatical settlement company to go public. Its stock peaked at 14.5 just after its IPO in February. After the approval of protease inhibitors, however, Dignity said it would no longer buy policies from AIDS patients, and its stock dropped 77 percent in one day. The company's experience illustrates the risks of investing in a company that relies on only one product.

"Testing for TB" Financial Times (08/30/96) P. 16; Graham, Jill A new tuberculosis (TB) test, developed by the British company Biotec Laboratories, could have important implications for diagnosing the disease. The World Health Organization has declared TB a "global emergency," and accurate diagnosis is especially critical to treating the disease. The new test is a simple microbiological assay which a relatively unskilled person can perform. Moreover, it can detect TB within 10 hours. The test will be evaluated in feasibility studies in British labs and in third world countries.

"HIV Testing Among Women Aged 18-44 Years--United States, 1991 and 1993" Morbidity and Mortality Weekly Report (08/30/96) Vol. 45, No. 34, P. 6 HIV testing and counseling is important for women so they can seek early treatment for themselves and reduce the risk of transmission to others, including their children. A report from the Centers for Disease Control and Prevention provides information about HIV testing in women aged 18-44 based on interviews in 1991 and 1993 of women selected at random from the U.S. population. During those years, the proportion of women who said they had been tested for HIV rose from 18.8 percent to 31.8 percent, an increase of 60 percent. In both 1991 and 1993, higher percentages of black and Hispanic women, compared to white women, had been tested. Moreover, women with less than 12 years of education were more likely to be tested than more educated women, as were women living in poverty compared to those living at or above the poverty level. In 1991, women who had given birth in the past five years were more likely than others to be tested for HIV. Among them, Hispanics and blacks, women with less than 12 years of education, and those living in poverty were again more likely to be tested. The rate of testing was about double in never-married women who had given birth in the past five years, compared to all married women in the age group.

"Pneumocystis Pneumonia--Los Angeles" Morbidity and Mortality Weekly Report (08/30/96) Vol. 45, No. 34, P. 1; Gottlieb, M.S.; Schanker, H.M.; Fan, P.T.; et al. The first published report of what later became known as AIDS was published by researchers from the Centers for Disease Control and Prevention in Morbidity and Mortality Weekly Report on June 4, 1981, and reprinted today. Dr. M.S. Gottlieb and colleagues reported that between October 1980 and May 1981, five homosexual men were treated for Pneumocystis carinii pneumonia (PCP) at three Los Angeles hospitals. Two of them died. All ARMS Email System Page 4of5

five had evidence of cytomegalovirus infection and candidal mucosal infection. Diagnosis of PCP was confirmed in all five. The men did not know each other or know of sexual partners who had similar illnesses. Two of the men reported having frequent homosexual contacts with various partners. Three of the men had very low in vitro proliferative responses to mitogens and antigens. In a new editorial note, the authors point out that PCP in previously health men with no other apparent underlying immunodeficiency is very rare. They suggest there may be a link between the disease and some aspect of the homosexual lifestyle. They concluded that the evidence points to the possibility of a cellular-immune dysfunction related to a common exposure that predisposes an individual to opportunistic infections.

"Blood Safety Issues Working Group Convened" Lancet (08/24/96) Vol. 348, No. 9026, P. 540; Bayer, Ronald A meeting held in Italy in July launched a two-year inquiry into the tainted-blood tragedies in several countries that resulted in people becoming infected with HIV through contaminated blood products. Doctors, social scientists, and blood safety experts attended the meeting, sponsored by both the Japan Foundation's Center for Global Partnership and the Toyota Foundation. The group explored the policy responses of 12 countries to evidence presented in the 1980s that HIV posed a threat to the blood supply. Some countries developed safeguards more quickly than others during the period before HIV-antibody tests were available. These precautions included excluding high-risk donors, conducting surrogate testing for hepatitis B antibody, heat treating clotting factors, and recalling potentially contaminated blood products. Meeting participants also considered the emergence of advocacy groups calling for compensation of HIV-infected hemophiliacs, and they tried to determine why some efforts were more successful than others. At future meetings, the group plans to discuss the legal, ethical, and political factors that account for the differing national responses to the threat of HIV in the blood supply.

The AIDS Daily Summary will not be published on Monday, September 2, 1996, in observance of Labor Day. Publication will resume on Tuesday, September 3.

======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE:30-AUG-1996 11:21:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for [email protected]; Fri, 30 Aug 1996 11:20:50 -0400 (EDT) Received: from aspen3.aspensys.com (198.77.70.84) by STORM.EOP.GOV (PMDF V5.0-7 #6879) id <[email protected]> for [email protected]; Fri, 30 Aug 1996 11:19:32 -0700 (MST) Received: by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id LAA17320; Fri, 30 Aug 1996 11:20:59 -0400 Errors-to: [email protected] ARMS Email System Page 5 of 5

Precedence: bulk Originator: [email protected] X-Comment: CDC National AIDS Clearinghouse X-Listprocessor-version: 6.0c -- ListProcessor by Anastasios Kotsikonas ======END ATTACHMENT 2 ======ARMS Email System Page 1 of 4

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Jeffrey Levi ( LEVI_J (WHO)

CREATION DATE/TIME:l6-SEP-1996 14:14:48.21

SUBJECT: daily news

TO: Patsy Fleming FLEMING P (WHO) READ:l6-SEP-1996 15:46:04.66

TO: Ursula Sanville SANVILLE U (OPD) READ:24-SEP-1996 17:01:27.35

TO: Lahoma Romocki ROMOCKI L (OPD) READ:27-SEP-1996 16:32:04.47

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE:l6-SEP-1996 10:59:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsnews

ATT SUBJECT: CDC AIDS Daily Summary 09/16/96

ATT TO: levi_j ( levi_j@Al@CD )

TEXT: AIDS Daily Summary September 16, 1996

The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

****************************************************** "Agouron Pharmaceuticals to Give Away Experimental AIDS Drug to Some People" "HIV Home Test Kit Picks up on Market" "In Changing Face of Illness, an Optimistic Prognosis Emerges" "Drug War Isn't About Marijuana as Medicine" "AIDS Patients Slipping Through Safety Net" "AIDS Claims Five Each Day in Northern Thailand" "White House Releases Clinton Health Information" "Botswana Faces Serious Threat of AIDS" "Frequent Infection of Peripheral Blood CDS-Positive T-Lymphocytes With HIV-1" "Drug Therapy: Ganciclovir" ******************************************************

"Agouron Pharmaceuticals to Give Away Experimental AIDS Drug to ARMS Email System Page 2 of 4

Some People" Wall Street Journal (09/16/96) P. B6; Rundle, Rhonda L. Patients in the advanced stages of AIDS will be eligible to receive the experimental protease inhibitor Viracept (nelfinavir) free of charge under an expanded-access program to be announced today. Agouron Pharmaceuticals will offer the drug, which has not been approved by the Food and Drug Administration, to AIDS patients who have stopped using the three commercially available protease inhibitors. The number of patients expected to enroll in the program is estimated to be between several hundred and several thousand. Patients and doctors should call 1-800-621-7111 for information about the program.

"HIV Horne Test Kit Picks up on Market" USA Today (09/16/96) P. 4B; Wells, Melanie While Johnson & Johnson's home HIV test kit, Confide, is now becoming available at stores outside of Texas, its introduction has not been widely advertised due to a conflict in the company. J&J has been ordered to relinquish its rights to the test to its creator, Elliott Millenson, who was fired by the company in 1993. In the meantime, the company has filed a lawsuit, but has limited advertising of the test since it does not have much of an incentive to kick off a huge carnpaign--one which some say could have cost $20 million. Some commercials have appeared, and J&J says more national advertising is corning soon.

"In Changing Face of Illness, an Optimistic Prognosis Emerges" Washington Post (09/16/96) P. A3; Brown, David Deaths from infectious diseases will continue to decline between now and 2020, while deaths from noncommunicable diseases and accidents will rise, according to a new report from the World Health Organization. Although the rate of AIDS has not yet peaked in some countries, the fraction of deaths caused by infection, childbirth, and malnutrition, is expected to drop by more than half by 2020. The authors of the study assumed that the AIDS epidemic will reach a plateau in 25 years, with regional death rates attributed to the disease about half of what they are now. The trend is expected due to changes in demographics, economics, and technology.

"Drug War Isn't About Marijuana as Medicine" New York Times (09/16/96) P. Al4; Szasz, Thomas Financier George Soros' support for the medical use of marijuana appears inconsistent with his efforts to support the war on drugs, claims Dr. Thomas Szasz, a psychiatrist at the State University of New York. In a letter to the editor of the New York Times, Szasz says that legalizing marijuana for medical use would shift the responsibility to the physician who would prescribe it. Marijuana would simply become another "dangerous drug" controlled by the government, he concludes.

"AIDS Patients Slipping Through Safety Net" New York Times (09/15/96) P. 24; Kolata, Gina Due to increased demand for new AIDS drugs, and the high cost of the treatments, government programs designed to provide the drugs free to needy patients are failing. The AIDS Drug Assistance Program was established by Congress to give states money to provide the drugs to uninsured or underinsured people. Recently, however, states have been forced to limit the drugs they provide, or make applicants wait for treatment. Nearly half of ARMS Email System Page 3of4

all states are limiting, or are expected to limit, access to the new protease inhibitors. A lobbying group for AIDS patients estimates that the $190 million appropriated for the program in the 1996 budget is less than half of what is needed.

"AIDS Claims Five Each Day in Northern Thailand" Xinhua News Agency (09/15/96) In northern Thailand, five AIDS patients die each day, and 100,000 people in the country contract HIV each year, the Population and Community Development Association reports. The two provinces hardest hit by the disease are Chiang Mai, with 6,370 patients, and Chiang Rai, with 4,S02. An estimated 900,000 people in Thailand have AIDS, 70 percent of whom are between the ages of 15 and 24.

"White House Releases Clinton Health Information" Reuters (09/13/96) In response to challenges from Republican presidential candidate Bob Dole, the White House released on Friday President Clinton's medical records. The documents included a report that Clinton, as part of an insurance physical, tested negative for HIV in 1990. The medical summary also said Clinton "has no history of hypertension, diabetes, tuberculosis, sexually transmitted disease, cancer, stroke, or heart disease."

"Botswana Faces Serious Threat of AIDS" Xinhua News Agency (09/13/96) Botswana's growing AIDS rate has prompted the government to urge people to change their sexual attitudes and habits. Last year, an estimated 12 percent of the country's 2 million people were thought to have AIDS. Doctors are struggling to handle the increase in demand from the disease; some 40 percent of the hospital beds in the country are occupied by AIDS patients, according to Botswana President Ketumile Marire.

"Frequent Infection of Peripheral Blood CDS-Positive T-Lymphocytes With HIV-1" Lancet (09/07/96) Vol. 34S, No. 902S, P. 649; Livingstone, W.J.; Moore, M.; Innes, D.; et al. Patients infected with HIV-1 suffer the loss of CD4 T-cells, which are critical to the body's immune system. However, while CD4 cells have been identified as the main target for HIV-1, the extent of infection of other immune cell types remains unknown. Scottish researchers, along with the Edinburgh Heterosexual Transmission Study Group, studied both the types of cells infected in 16 HIV-infected individuals and the relation of viral load to disease progression. In seven of the eight patients who were asymptomatic for AIDS, CD4 T-cells were the main reservoir of HIV. In five of the eight patients with AIDS, infection of CDS cells accounted for 66 percent to 97 percent of the total proviral load. This finding contradicts previous studies which found that CDS cells remain uninfected. The authors say their results provide evidence that HIV-1 more broadly infects different cell types in vivo than described in laboratory tests. They suggest that the decline in CDS cells may be attributed to HIV's impact as AIDS develops.

"Drug Therapy: Ganciclovir" New England Journal of Medicine (09/05/96) Vol. 335, No. 10, P. 721; Crumpacker, Clyde S. ARMS Email System Page 4of4

In the New England Journal of Medicine, Dr. Clyde S. Crumpacker, of Beth Israel Hospital in Boston, Mass., discusses ganciclovir, the first antiviral drug effective against cytomegalovirus (CMV) disease. CMV retinitis is a common and potentially blinding infection in AIDS patients. In a study of 157 AIDS patients, CMV retinitis was the initial AIDS-defining opportunistic infection in 3 percent, and it developed later in an additional 26 percent. The disease progressed from unilateral to bilateral in 60 percent of patients who did not receive ganciclovir. Among 18 patients with unilateral disease, none progressed to bilateral disease while taking the drug. Studies with AIDS patients with CMV retinitis have found that ganciclovir and foscarnet are equally effective, and that a combination of the two drugs is superior against the disease, but neither therapy offered a clear survival benefit. Oral and intravenous ganciclovir were found to be similarly effective for maintenance therapy. Moreover, those AIDS patients in whom disseminated CMV infection is associated with weight loss have gained weight while taking ganciclovir. Oral ganciclovir has also shown promise in preventing CMV disease in AIDS patients.

======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE:l6-SEP-1996 11:00:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from conversion.pmdf.eop.gov by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for [email protected]; Mon, 16 Sep 1996 10:59:24 -0400 (EDT) Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for [email protected]; Mon, 16 Sep 1996 10:59:17 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF V5.0-7 #6879) id <[email protected]> for [email protected]; Mon, 16 Sep 1996 10:57:12 -0700 (MST) Received: by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id KAA25428; Mon, 16 Sep 1996 10:59:03 -0400 Errors-to: [email protected] Precedence: bulk Originator: [email protected] X-Comment: CDC National AIDS Clearinghouse X-Listprocessor-version: 6.0c -- ListProcessor by Anastasios Kotsikonas ======END ATTACHMENT 2 ======ARMS Email System Page 1 of 4

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Jeffrey Levi ( LEVI J (WHO)

CREATION DATE/TIME:l8-SEP-1996 10:59:35.83

SUBJECT: daily news

TO: Patsy Fleming FLEMING P (WHO) READ:18-SEP-1996 12:24:55.26

TO: Ursula Sanville SANVILLE U (OPD) READ:19-SEP-1996 13:46:09.30

TO: Lahoma Romocki ROMOCKI L (OPD) READ:20-SEP-1996 10:06:05.94

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE:18-SEP-1996 10:22:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsnews

ATT SUBJECT: CDC AIDS Daily Summary 09/18/96

ATT TO: levi j levi j@Al@CD

TEXT: AIDS Daily Summary September 18, 1996

The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

****************************************************** "More Germs Elude Drugs" "Three TV Stations to Run Condom Ads" "Researcher Cites Genetic Factor in HIV Resistance" "Denver Extends Health Coverage to Partners of Gay City Employees" "Brudnoy, Feeling Healthier, Launches AIDS Research Drive" "New Needs of Society Bring Back a Medical Dinosaur: House Calls" "AIDS Cases Seen Decreasing in France" "6,800 Sri Lankans Suspected to be AIDS Carriers" "Flirting With Suicide" "No End of Plagues" ******************************************************

"More Germs Elude Drugs" USA Today (09/18/96) P. lD; Manning, Anita ARMS Email System Page 2 of 4

The rise of drug-resistant microbes is making common infections more difficult to treat, scientists said at a recent meeting of the American Society for Microbiology. For example, the increasing use of antifungal drugs, especially for patients with AIDS or those receiving chemotherapy, has led to resistance. Development of new drugs to treat fungal infections is underway, but will take a long time.

"Three TV Stations to Run Condom Ads" Washington Times (09/18/96) P. All Three NBC affiliate television stations, in Houston, Seattle, and Chico, Calif., will run paid advertising for condoms, marking the first time that such commercials have been accepted by a major network station. The 60-second ad has been run by MTV and Comedy Central for a year, but was rejected by the major networks and about 40 TV stations.

"Researcher Cites Genetic Factor in HIV Resistance" Boston Globe (09/17/96) P. AS Genetic protection from HIV infection is more common in Caucasians than in people of African descent, a researcher reported at the annual meeting of the Institute of Human Virology last week. Steven O'Brien of the National Cancer Institute studied more than 1,900 American men and women who have been exposed to HIV repeatedly and have either not become infected or have been HIV-positive for a long time. The gene, CKR-5, slows progression of HIV infection and allows individuals to live an average of two years longer than infected individuals without the gene. People who inherit the gene from both parents have absolute protection from HIV, while the protection is partial in people who inherit the gene from one parent. No individuals of African descent have been identified as having any genetic protection.

"Denver Extends Health Coverage to Partners of Gay City Employees" New York Times (09/18/97) P. Al7; Brooke, James Gay partners of workers employed by the city of Denver will receive health insurance coverage under an ordinance to be signed today. The decision is part of a trend in companies and local governments to offer health benefits to gay partners of employees. Lantz Trantham, a businessman who opposed the ordinance, called it "financially irresponsible, not just with AIDS, but with the multitude of sexually transmitted diseases." An atmosphere of tolerance exists in the city, where a record 10,000 people participated in the annual AIDS walk last week. The event raised $1.2 million for state AIDS services.

"Brudnoy, Feeling Healthier, Launches AIDS Research Drive" Boston Globe (09/17/96) P. BS; Knox, Richard A. Boston radio talk show host David Brudnoy, who nearly died of AIDS two years ago, is feeling healthier lately due to a new combination of drugs. He launched a campaign for AIDS research Tuesday, aiming to raise $10 million for research at Massachusetts General and Brigham and Women's hospitals. The funds would boost the AIDS clinical research budget at the hospitals by about 40 percent. Brudnoy explains that he created the AIDS research fund to help "carry us from where we are now--optimism, but guarded--to optimism with confidence."

"New Needs of Society Bring Back a Medical Dinosaur: House Calls" ARMS Email System Page 3of4

New York Times (09/18/96) P. Cll; Gilbert, Susan The demand for doctors to make house calls is rising, due to a growing number of people--including the elderly, AIDS patients, and those disabled by violence--who want to stay home for care. At an American Medical Association symposium last week, it was reported that the number of house calls charged to Medicare rose from 37 million in 1988 to 218 million in 1994. However, only about three million of the visits each year are made by physicians; nurses, social workers, and home health aides make the rest. Currently, new tools--including a video telephone system and digital stethoscopes and blood pressure monitors--are being developed to help doctors recognize which patients need to be visited in person.

"AIDS Cases Seen Decreasing in France" Reuters (09/17/96) The number of full-blown AIDS cases in France decreased in the first half of 1996, leading officials to expect a continuing annual decline. The health ministry reported Tuesday that 2,507 new AIDS cases were reported between January and June, which would amount to 5,014 cases for the year if the trend continues. Last year, 5,469 cases were reported, down from 5,789 in 1994.

"6,800 Sri Lankans Suspected to be AIDS Carriers" Xinhua News Agency (09/18/96) Health officials in Sri Lanka say that an estimated 6,800 people in the country have AIDS. The first AIDS case in Sri Lanka was identified in 1986 in a man who became infected in London. By 2005, more than 80,000 Sri Lankans are expected to have with HIV. The economic impact of each AIDS case is expected to reach $19,000.

"Flirting With Suicide" New York Times Magazine (09/15/96) P. 39; Green, Jesse Since 1981, HIV prevention campaigns targeted at the gay community have contained the same message--that "a condom every time" is the only way to be protected. Although the average number of unsafe sex contacts for gay men in New York City declined from more than 11 per year in 1980 to one per year in 1991, many gay men are no longer heeding safer sex warnings. As it became known that AIDS would not be cured quickly, and that safety precautions could not be temporary, the gay community began giving up the battle. By 1991, men who had been safe for at least six years were becoming less cautious, and men who had never been safe saw it as futile to start. By 1990, the weaknesses in AIDS education became apparent. Black and Latino men had not been reached, and young homosexuals were also at high risk. HIV rates among older, white, gay men who had heard the message even started rising. Berkeley psychologist Walt Odets criticizes HIV prevention campaigns targeted at gay men for being coercive and dishonest. He advocates messages that include information about relative risk and that encourage communication between partners to determine risk.

"No End of Plagues" Economist--Sub-Saharan Africa Survey (09/07/96) Vol. 340, No. 7982, P. 15 Africa faces several disease threats, but the most serious is that of AIDS. The disease was initially thought to affect only the white homosexual community, and even as it spread to the ARMS Email System Page 4of4

general population, it was not considered a serious problem. Now, however, the threat is recognized and complacency is gone. The World Health Organization estimates that about 24 million people in sub-Saharan Africa will be HIV-positive by the year 2000. AIDS is spreading quickly throughout the region, and young military men--who spend a lot of time traveling--are especially vulnerable to HIV. Still, anti-AIDS drugs, including older drugs like AZT, are not affordable in Africa. To combat the disease, South Africa has taken several measures, including implementing sexual education programs for young people; providing treatment for sexually transmitted diseases; promoting safer sex on billboards, taxis, music tapes, and calendars; and increasing condom distribution.

======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE:l8-SEP-1996 10:24:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from conversion.pmdf.eop.gov by PMDF.EOP.GOV (PMDF V5.0-4 #?§79) levi ; @);a_.::-----~-:-get. ... r ;--s-TC:d ,.-- - id <[email protected]> for ___ ..-~- 18 Sep 1996 10:23:11 -0400 (EDT) Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for levi [email protected]; Wed, 18 Sep 1996 10:23:03 -0400 (EDT) Recei;ed: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF V5.0-7 #6879) id <[email protected]> for levi [email protected]; Wed, 18 Sep 1996 10:20:54 -0700 (MST) Recei;ed: by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id KAA07492; Wed, 18 Sep 1996 10:22:51 -0400 Errors-to: [email protected] Precedence: bulk Originator: [email protected] X-Comment: CDC National AIDS Clearinghouse X-Listprocessor-version: 6.0c -- ListProcessor by Anastasios Kotsikonas ======END ATTACHMENT 2 ======ARMS Email System Page 1 of 5

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Jeffrey Levi ( LEVI_J (WHO)

CREATION DATE/TIME:lO-OCT-1996 08:29:50.04

SUBJECT: daily news

TO: Patsy Fleming FLEMING P (WHO) READ:lO-OCT-1996 13:27:34.71

TO: Ursula Sanville SANVILLE U (OPD) READ:l6-0CT-1996 12:46:52.77

TO: Lahoma Romocki ROMOCKI L (OPD) READ:lO-OCT-1996 17:05:47.08

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE: 9-0CT-1996 17:30:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsnews

ATT SUBJECT: CDC AIDS Daily Summary, 10/09/96

ATT TO: levi_j levi j@Al@CD

TEXT:

AIDS Daily Summary Wednesday, October 9, 1996

The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC Clearinghouse should be cited as the source of this information. Copyright 1995, Information, Inc., Bethesda, MD

****************************************************** "Japan AIDS Scandal Raises Fear That Safety Came Second to Trade" "Morrison Receives Offers to Fight" "Prisoner's Cry of 'Rape' Is Heard" "No Stone Turns Up" "Seven Office-Mates at a Dying Bank Ask: Who Will Survive?" "Digest: Digene and Cytyc" "Blood Banks Look at New Draws as Donations Dry Up" "Health: World Health Group Details Progress on 10 [Killer Diseases] " "Genetic Restriction of HIV-1 Infection and Progression to AIDS by a Deletion Allele of the CKR5 Structural Gene" "Pharmaceutical Industry Sues to Stop Discount Pricing to Clinics" ******************************************************

"Japan AIDS Scandal Raises Fear That Safety Came Second to Trade" ARMS Email System Page 2 of 5

Wall Street Journal (10/09/96) P. Al; Hamilton, David P. Although U.S. drug companies had safe, heat-treated blood products available between 1983 and 1985, the Japanese government did not allow them to be imported in order to protect domestic companies. During that time, more than 1,800 Japanese hemophiliacs contracted HIV. Some 400 have already died. Many Japanese see the scandal as an example of the conflicts-of-interest that link bureaucrats and industry executives, and often put business interests before public safety. A former government official, two former drug industry executives, and one leading hemophilia researcher have been arrested on charges related to the tainted-blood scandal. Earlier this year, current Health Minister Naoto Kan forced the government to both investigate the scandal and to reveal incriminating internal documents.

"Morrison Receives Offers to Fight" New York Times (10/09/96) P. BlO George Foreman has said he will fight heavyweight Tommy Morrison, who announced that he wants to return to the ring despite the fact that he has HIV. Foreman is scheduled to fight Crawford Grimsley this November and has invited Morrison to fight on that undercard and reiterated his offer to fight Morrison next year. Morrison's manager Tony Holden said a Morrison may meet Foreman, but not in November.

"Prisoner's Cry of 'Rape' Is Heard" New York Times (10/09/96) P. Bl; Lorch, Donatella Maurice J. Mathie was awaiting trial in a Suffolk County jail in New York when he claims he was raped by the chief of security. While serving 10 to 15 years in a state prison on manslaughter charges, Mathie told his story to legislators, judges, and prisoners rights groups through hundreds of letters. In August, he was awarded $750,000 by a federal judge. The security guard, Sgt. Roy Fries, is now retired with a full pension, and he is appealing the decision. While rape is widely known to be part of prison life, there are no national statistics on sexual assault in prisons, and most inmates do not speak publicly about it. AIDS is a serious threat in prisons, where condoms are not available and the rate of HIV infection is high. One activist, Stephen Donaldson, a former president of Stop Prisoner Rape, said he was gang-raped while incarcerated and contracted HIV as a result. Donaldson recently died of AIDS.

"No Stone Turns Up" Washington Post (10/09/96) P. C3; Gerhart, Ann; Groer, Annie Despite publicity that Sharon Stone would appear in Washington, D.C., this weekend for events related to the displaying of the AIDS memorial quilt, she will not be involved. Fellow AIDS activist and AmFAR founder Elizabeth Taylor will be present and will lead a candlelight march on Saturday night. Taylor founded the American Foundation for AIDS Research, which Stone serves as fund-raising chairman.

"Seven Office-Mates at a Dying Bank Ask: Who Will Survive?" Wall Street Journal (10/09/96) P. Al; King, Ralph T., Jr. With Wells Fargo's recent takeover of First Interstate Bank, seven people at the bank's Los Angeles headquarters' Corporate Insurance Department were left wondering if their jobs would survive the expected layoffs. The off ice consisted of three vice ARMS Email System Page 3 of 5

presidents, three administrative assistants, and their boss. One of the administrative assistants, Mark Clotfelter, is infected with HIV and was worried about retaining his health benefits. Although his position was terminated, Clotfelter later was employed at Wells Fargo's capital-markets operation.

"Digest: Digene and Cytyc" Washington Post (10/09/96) P. Bl2 Biotechnology companies Digene, based in Maryland, and Cytyc, of Massachusetts, have agreed to cooperate on the development and sale of tests to detect and monitor cervical cancer and certain sexually transmitted diseases.

"Blood Banks Look at New Draws as Donations Dry Up" USA Today (10/09/96) P. 4A; Norman-Culp, Sheila Blood donations in the United States have been dwindling for more than the past decade, due to the fear of AIDS, the aging of reliable donors, and the rise in body-piercing, tattooing, and other short-term factors that prevent willing donors to give blood. In 1982, a Montclair, N.J. blood bank collected 1,816 pints of blood a year. By 1989, donations had declined to 1,447 pints. Last year, only 831 pints were collected at that site. People with new tattoos or body piercings, and those who have spent more than 72 hours in jail, cannot give blood for a year. People who have had surgery, dental work, or any immunization, been diagnosed with gonorrhea, or been exposed to hepatitis, measles, mumps, or chicken pox must also wait. Members of the American Association of Blood Banks will discuss new ways to attract donors at the group's annual meeting this weekend in Orlando, Fla.

"Health: World Health Group Details Progress on 10 [Killer Diseases] " IPS Wire (10/07/96) The World Health Organization notes in its latest report on the State of the World's Vaccines and Immunization that significant progress is being made in the development of vaccines against 10 major deadly diseases, comprising HIV/AIDS, malaria, pneumococcal disease, meningococcal meningitis, rotavirus, respiratory syncytial virus, dysentery, enterotoxigenic Escherichia coli, schistosomiasis, and dengue. According to the WHO, the drive for profit in the developed world's pharmaceutical industries is behind the improvement, even if those companies have Western tourists and soldiers in mind rather than residents of developing countries when pursuing their research. "Ironically," said the report, "a vaccine against pneumococcal pneumonia and meningitis--diseases which kill over a million children a year in developing countries--was developed largely to prevent the incidences of inner ear infections among children in the United States." The report noted, however, that some drug makers have halted vaccine research vital to developing countries--into the virus that causes AIDS for instance--because the need for such products has declined in the industrialized world.

"Genetic Restriction of HIV-1 Infection and Progression to AIDS by a Deletion Allele of the CKR5 Structural Gene" Science (09/27/96) Vol. 273, No. 5283, P. 1856; Dean, Michael; Carrington, Mary; Winkler, Cheryl; et al. Recent research has shown that the chemokine receptor CKR5 serves as a critical co-receptor for certain strains of HIV-1. Further ARMS Email System Page 4 of 5

studies have suggested that a defect in co-receptors may protect some individuals from HIV-1 infection. Stephen J. O'Brien, of the National Cancer Institute, and colleagues, mapped the location of the CKR5 structural gene and determined the frequency of the defect in the population. From a total of 1,955 patients at high risk for HIV, who were involved in large AIDS studies, 17 people, who had all been exposed to HIV-1 but tested negative for viral antibodies, were found to have two copies of the defective gene. In individuals who had survived with HIV for more than 10 years, the presence of one copy of the defective gene was much more common. An analysis of the frequency of the defect and survival time showed that disease progression is slower in people with one copy of the defective gene than in individuals without the defect.

"Pharmaceutical Industry Sues to Stop Discount Pricing to Clinics" AIDS Treatment News (10/04/96) No. 256, P. 4; James, John S. The Pharmaceutical Research and Manufacturers Association (PhRMA), an organization representing drug companies, filed a lawsuit in July to protest a federal law that requires pharmaceutical companies to of fer discounts to certain government-supported medical programs for the poor. Most public medical clinics and AIDS-drug assistance programs are eligible for the discount, while Medicaid and other programs large enough to have their own pharmacies are not. The PhMRA lawsuit is an attempt to stop the government-funded programs from contracting with outside pharmacies. This would limit the discount program, and increase the financial hardship of many poor and uninsured patients. Only about 12 of the state ADAP programs currently use the discount, but many are eligible for the program. If successful, the PhRMA lawsuit would prevent most ADAP's from getting the discounted rates. Several AIDS organizations are sponsoring a demonstration on October 11 to protest PhRMA's action. ======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE: 9-0CT-1996 17:31:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from conversion.pmdf.eop.gov by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for [email protected]; Wed, 09 Oct 1996 17:31:19 -0400 (EDT) Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for [email protected]; Wed, 09 Oct 1996 17:30:31 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF V5.0-7 #6879) id <[email protected]> for levi [email protected]; Wed, 09 Oct 1996 17:27:31 -0700 (MST) Received: by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id RAA09291; Wed, 09 Oct 1996 17:30:16 -0400 Errors-to: [email protected] X-Mailer: Microsoft Mail V3.0 Precedence: bulk Originator: [email protected] X-Comment: CDC National AIDS Clearinghouse ARMS Email System Page 5 of 5

X-Listprocessor-version: 6.0c -- ListProcessor by Anastasios Kotsikonas ======END ATTACHMENT 2 ======ARMS Email System Page 1 of 5

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Jeffrey Levi ( LEVI_J (WHO)

CREATION DATE/TIME:ll-OCT-1996 15:45:12.06

SUBJECT: daily news

TO: Patsy Fleming FLEMING P (WHO) READ:ll-OCT-1996 17:55:08.11

TO: Ursula Sanville SANVILLE U (OPD) READ:l5-0CT-1996 09:39:39.04

TO: Lahoma Romocki ROMOCKI L (OPD) READ:l5-0CT-1996 15:59:10.29

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE:ll-OCT-1996 13:20:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsnews

ATT SUBJECT: CDC AIDS Daily Summary, 10/11/96

ATT TO: levi j levi_j@Al@CD )

TEXT:

AIDS Daily Summary Friday October 11, 1996

The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may ot be sold, and the CDC Clearinghouse should be cited as the source of this information. Copyright 1995, Information, Inc., Bethesda, MD

******************************************************

"L.A. Plan Allowing Drug Users in HUD Housing Raises GOP Ire" "Fla. Employee Fired Over AIDS List" "Japanese Aide Gains Favor by Fighting the Bureaucrats" "New Drugs Boost Results at Biogen, Biochem, Which Are Closely Watched" "AIDS Is Becoming a Black Disease" "Drug Combinations Found More Effective Against AIDS" "Florida Mother Who Fed HIV Baby Sues Hospital" "Varied Events Expected to Draw a Million Visitors to D.C." "Pediatric HIV Infection" "NCF Builds on AIDS Catalog's Success" ARMS Email System Page 2 of 5

******************************************************

"L.A. Plan Allowing Drug Users in HUD Housing Raises GOP Ire" Washington Post (10/11/96) P. A3; Schwartz, John; Evans, Judith

A pilot program in Los Angeles that will provide federally funded housing for AIDS patients, but will not evict those who use illicit drugs, even in the residence itself, is being attacked by Congressional Republicans who contend that the program conflicts with Department of Housing and Urban Development (HUD) policies. The general HUD rule is that of "zero tolerance," and tenants are permitted to be thrown out for substance abuse. According to Fred Eggan, Los Angeles city AIDS coordinator, however, the program is not a "glorified crack house," but it is intended to offer a compassionate way of dealing with the complexities of AIDS patients who are addicted to drugs. The program will not condone drug use, he says, but will provide drug treatment, intensive therapy, and other services. Those who repeatedly abuse drugs, however, will be referred to other substance abuse centers.

"Fla. Employee Fired Over AIDS List" Philadelphia Inquirer (10/11/96) P. A2; Perez, Evan

William Calvert, a public health worker in Miami, was fired Wednesday for using a confidential list of almost 4,000 people with HIV and AIDS to check the status of potential dates. Calvert allegedly took the computer disks to a gay bar and offered to look up names for his friends. Calvert was turned in anonymously when someone sent copies of the disk and a letter to two Tampa Bay area newspapers and the Pinellas County Health Department. An employee of the Florida Department of Health and Rehabilitative Services since 1988, Calvert admitted to using the database on a laptop at his home, bypassing password protection used to keep the files confidential, but he claims he did nothing wrong. The incident has raised questions about the security of such records, and AIDS patient advocates assert that it is evidence of the risks involved in keeping a list of the names of HIV and AIDS patients.

"Japanese Aide Gains Favor by Fighting the Bureaucrats" New York Times (10/11/96) P. Al2; WuDunn, Sheryl

Naoto Kan, Japan's Health Minister, is popular among many of his countrymen for his role in taking on the Japanese bureaucracy and launching an investigation into the tainted-blood scandal. At least 400 Japanese, the majority of them hemophiliacs, have died of AIDS as a result of having contracted HIV from contaminated blood supplies. Kan's probe into the decade-old affair revealed that health authorities knew about the risk of the blood's contamination for several years before they banned its import. Several senior bureaucrats, pharmaceutical company executives, and a leading AIDS expert have been arrested for their alleged involvement in the scandal.

"New Drugs Boost Results at Biogen, Biochem, Which Are Closely Watched" ARMS Email System Page 3 of 5

Wall Street Journal (10/11/96) P. BSA; Eisinger, Jesse

Several small biotechnology firms performed well in the last quarter, due largely to new products, while some of the bigger biotechnology companies posted mixed results. Biogen, Centocor, and Biochem Pharma produced strong results, driven by the introduction of new drugs, including Biogen's multiple sclerosis treatment Avonex; Centocor's ReoPro, a platelet blocker; and Biochem Pharma's 3TC, an anti-AIDS treatment that is becoming a key component of the cocktail of medications used to treat AIDS, analysts say. Amgen and Genzyme, two more established firms, also had solid quarters, analysts believe, while Chiron is expected to report weaker third-quarter results.

"AIDS Is Becoming a Black Disease" Washington Post (10/11/96) P. A25; Raspberry, William

In a commentary in the Washington Post, columnist William Raspberry notes the growing incidence of AIDS and HIV among young African Americans as pointed out by Mario Cooper, a member of the Harvard AIDS Institute who is black, gay, and HIV-positive. Cooper cited statistics from the Centers for Disease Control and Prevention that showed that AIDS has become the No. 1 killer of blacks between the ages of 25 and 44, and he also pointed out that of the 700,000 to 900,000 HIV-positive Americans, 50 percent to 60 percent are non-whites. He further noted that both the medical community and the African American community are acting as though AIDS was still predominantly affecting white gays and drug users. Cooper stated that the disease is hitting blacks and Hispanics the hardest just as evidence is becoming available that prevention works. Because AIDS is portrayed as a disease that can affect homosexuals and heterosexuals, more funding has become available, but Cooper fears that the education necessary for prevention is still not as widely available for the most vulnerable parts of the population. To remedy the situation, he is working on a major conference on Oct. 22 sponsored by the Harvard AIDS Institute, the National Minority AIDS Council, and the Balm in Gilead organization. He hopes that the conference will spur "a forthright acknowledgment by our political and community leaders--including the NAACP and the Urban League--that this disease has the potential to devastate our community in the next decade."

"Drug Combinations Found More Effective Against AIDS" Reuters (10/09/96); Emery, Gene

Adding either of two AIDS drugs, ddI (didanosine) or ddC (zalcitabine), to AZT therapy is better than the AZT alone for slowing the progression of AIDS, researchers at Harvard Medical school said Wednesday. Led by Dr. Scott Hammer, the researchers reported that the combination therapy slowed disease progression by more than 37 percent. In a related study, scientists at St. John Hospital in Detroit found that the additional drugs offered no benefit for patients whose immune systems were already damaged by HIV. An editorial published with both studies in the New England Journal of Medicine says the studies suggest that all HIV-infected individuals should receive drug therapy, especially after their CD4 cell count falls below 500. The studies also ARMS Email System Page 4 of 5

indicate that a viral load test, which measures the amount of virus in the blood, is the best way to evaluate the progress of HIV infection and to determine how well treatment is working.

"Florida Mother Who Fed HIV Baby Sues Hospital" Reuters (10/10/96)

A woman who was mistakenly given the child of an HIV-positive woman at a Florida hospital in place of her own to nurse has filed a lawsuit against the hospital. She claims that she has been unable to breast-feed her own daughter for fear that she contracted HIV and could pass it along, and has consequently suffered both fear and anxiety. The incident occurred in mid-April, when a nurse's aide brought the newborn to the woman while she was sleeping. She had already begun nursing before she realized the error, at which time her own baby was brought to her. She was not informed until the next day that the baby she had nursed was born to a woman with HIV, and the hospital suggested at that time that she stop breast-feeding her own child just to be safe. A lawyer for the hospital said the suit was frivolous because neither the mother nor the daughter were injured; but the woman's lawyer noted that the deprivation of a woman's right to nurse created a severe emotional impact.

"Varied Events Expected to Draw a Million Visitors to D.C." Washington Post (10/11/96) P. B4; Wheeler, Linda

More than 1 million people are expected to visit Washington, D.C., this weekend, as they come to the city to participate in any one of a number of events. Starting today, the AIDS Memorial Quilt will be on display, unfolding its mile-long quilt on the Mall. Along with the quilt will be a nine-member demonstration group that opposes the "homosexual agenda, following the quilt around the country and protesting at its various displays. Two other protest activities, a Latino March and ACT-UP's demonstration will also take place this weekend, potentially drawing thousands of participants alone. Other events taking place in the District this weekend include the Taste of D.C. festival and Whitman-Walker clinic's candlelight march on Saturday to commemorate those who have died of AIDS.

"Pediatric HIV Infection" Lancet (09/28/96) Vol. 348, No. 9031, P. 863; Scarlatti, Gabriella

About 1.5 million children had been infected with HIV by late 1994, according to the World Health Organization, with over 75 percent of them in sub-Saharan Africa and developing countries in the Americas. Moreover, almost half of all adults with HIV are women of child-bearing age, making the need for programs to prevent mother-to-child transmission especially urgent. The rate of mother-to-child transmission varies from 13 percent to 42 percent, and is twice as high in Africa as in Europe. Studies of the timing of HIV transmission from mother-to-child have yielded evidence for both early and late in-utero transmission. Evidence has also been reported for postnatal transmission via breastfeeding, but mothers in some developing countries need to ARMS Email System Page 5 of 5

breastfeed to protect their children from other endemic diseases. Temporary HIV infection has been observed in newborns with a frequency ranging from 2.7 percent to 6.4 percent. This suggests that infants can clear the virus, which has implications for interrupting transmission and disease progression. While zidovudine therapy is useful to reduce the rate of mother-to-child transmission, a simpler method of treatment is necessary.

"NCF Builds on AIDS Catalog's Success" DM News (09/30/96) Vol. 18, No. 36, P. 8; Asato, Cathy

The National Catalog Foundation, which has met great success with its National AIDS Awareness Catalog, is planning to publish a National Lesbian and Gay Pride Catalog for the 1996 holiday season. The circulation of the 2-year-old AIDS catalog is now 600,000. The NCF donates 100 percent of its profits to nonprofit organizations. The two catalogs will contain the same items but have different covers and different target audiences. The AIDS catalog is geared to anyone interested in fighting the disease, homosexual or heterosexual. The New-York-based NCF is hoping to raise $1 million in capital over the next two years and has made its list of 12,000 buyers and requesters available for rent. ======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE:ll-OCT-1996 13:20:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from conversion.pmdf.eop.gov by PMDF.EOP.GOV (PMDF VS.0-4 #6879) id <[email protected]> for [email protected]; Fri, 11 Oct 1996 13:20:30 -0400 (EDT) Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF VS.0-4 #6879) id <[email protected]> for [email protected]; Fri, 11 Oct 1996 13:20:23 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF VS.0-7 #6879) id <[email protected]> for [email protected]; Fri, 11 Oct 1996 13:17:22 -0700 (MST) Received: by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id NAA15565; Fri, 11 Oct 1996 13:20:11 -0400 Errors-to: [email protected] X-Mailer: Microsoft Mail V3.0 Precedence: bulk Originator: [email protected] X-Comment: CDC National AIDS Clearinghouse X-Listprocessor-version: 6.0c -- ListProcessor by Anastasios Kotsikonas ======END ATTACHMENT 2 ======ARMS Email System Page 1 of 6

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Sandra L. Bublick-Max ( BUBLICKMAX S ) (OPD)

CREATION DATE/TIME:l5-0CT-1996 11:30:51.66

SUBJECT: attached achievements document

TO: William White WHITE WI ) (WHO) READ:l5-0CT-1996 14:42:09.43

CC: Barbara D. Woolley WOOLLEY B ) (WHO) READ:l5-0CT-1996 12:03:15.11

TEXT:

Bill, Attached please find the updated achievements for distribution. Sandy ======ATTACHMENT 1 ======ATT CREATION TIME/DATE:l5-0CT-1996 11:29:00.00

ATT BODYPART TYPE:p

ATT CREATOR: Sandra L. Bublick-Max

TEXT: PRINTER FONT 24 POINT ROMAN

PRESIDENT CLINTON'S FIRST TERM

HEALTH REFORM RECORD:

ACHIEVEMENTS AND CURRENT PROPOSALS PRINTER FONT 12 POINT ROMAN

PRINTER FONT 10 POINT ROMAN Updated: October 12, 1996 D PRINTER FONT 12 POINT ROMAN PRESIDENT CLINTON'S HEALTH CARE ACHIEVEMENTS

? Enacted the Kennedy ARMS Email System Page 2of6

D -Kassebaum health insurance reforms that will benefit as many as 25 million Americans. This law will enable individuals to keep their health insurance coverage when they change jobs. Workers will no longer fear losing their health insurance if they or a family member have a pre D -existing condition. Many of the provisions in this law were included in the President's balanced budget proposal and the Health Security Act. The law also includes several other key provisions that will: Guarantee renewability of coverage; Guarantee access to health insurance for small businesses; Eliminate the discriminatory tax treatment of the self D -employed; Established penalty D -free withdrawals from IRAs for some medical expenses; Strengthen efforts to combat health care fraud, waste and abuse; Provide consumer protections and tax incentives for private long D -term care insurance; and Simplify the health care system and reduce paperwork.

? Established protections for mothers and their newborns. Today, some health plans refuse to pay for anything more than a 24 D -hour hospital stay, and some recommend releasing mothers as few as 8 hours after delivery. The President signed into law common sense legislation that requires health plans to allow new mothers to remain in the hospital for at least 48 hours following most normal deliveries and 96 hours after a Caesarean section. ? Signed into law mental health parity provisions. The President signed into law legislation to prohibit health plans from establishing separate lifetime and annual limits for mental health coverage. ? Strengthened Medicare Trust Fund. The President's 1993 economic package included policy and structural changes that extended the life of the Trust Fund by three years which were enacted without one Republican vote. The President's balanced budget proposal will extend the life of the trust fund by 10 years from today. ? Protected the Medicaid guarantee for children, elderly, pregnant women and people with disabilities. The President vetoed the Republicans' proposal to block grant the Medicaid program, guaranteeing health care coverage or benefits to 37 million beneficiaries. The President also presided over the approval of 12 Medicaid waivers to cover 2.2 million previously uninsured Americans. ? Protected kids from tobacco products and advertising. The ARMS Email System Page 3 of 6

President issued guidelines to eliminate easy access to tobacco products by children and to prohibit companies from advertising tobacco to kids. The goal is to reduce smoking by children by 50 percent within seven years. ? Increased childhood immunizations to an historic high. The President's childhood immunization initiative includes community D -based educational efforts, more affordability and better detection. In 1995, 75 percent of two D -year olds were fully immunized -- an historic high. 0 ? Made women's health a priority. Helped develop technology to detect cancer and other diseases earlier and with greater accuracy. Since 1993, funding for breast cancer research at NIH has increased by 79 percent. Launched the Women's Health Initiative -- the largest clinical study ever on diseases that affect older women. Included women of diverse racial/ethnic backgrounds in research and evaluation of drugs and medical devices. ? Enacted laws to reduce violence against women. The President enacted the Violence Against Women Act -- the first national effort to reduce violence against women. This Act has already devoted $156 million to give law enforcement tools to punish criminals who prey on women and children. Created a nationwide 24 0 -hour Domestic Violence Hotline, (which has already received 50, 000 calls), to provide immediate crisis intervention, counseling and referrals.

? Enacted laws to prevent and punish handgun violence. Fought for the Brady bill, which has already prevented more than 60,000 fugitives, felons and criminals from buying handguns. The President expanded this bill to prevent individuals who commit acts of domestic violence from buying guns. Banned 19 of the deadliest assault weapons and stopped efforts to repeal the assault weapons ban. Every year at least 39,000 people die and 100,000 are treated in emergency rooms from gun violence.

? Expedited the FDA review and approval of new drug products. Under the President's watch, U.S. drug approvals are now as fast or faster than any other industrialized nation. Average drug approval times have dropped since the beginning of the Administration from almost three years to just over one year. In 1997, virtually all breakthrough drugs will be approved within 6 months without compromising safety standards. ? Increased funding for AIDS research, prevention, housing and treatment. In the President's first term, he has presided over a 56 percent increase in spending on programs for people living with AIDS including: the Ryan White Care Act, research, State AIDS drug assistance programs that help patients buy new protease inhibitor drugs, and Housing Opportunities for Persons with AIDS that provides housing assistance for over 65,000 people. ARMS Email System Page 4of6

? Increased funding for the veterans' health. An increase of nearly one billion dollars will provide resources for the health care of 43,000 more veterans.

? Helped Vietnam veterans whose children are born with spina bifida. The President signed legislation to provide health care and rehabilitative training for children of Vietnam veterans who are born with spina bifida. This legislation will help thousands of children whose birth defects may be a result of their fathers' or mothers' service to our country.

? Improved funding for the Indian Health Service. Increased Medicare and Medicaid reimbursement rates for the Indian Health Service will result in an additional $65 million to provide quality health care for American Indians and Alaskan Natives. ? Reduced regulations. The Vice President's reinventing government initiative has resulted in the elimination of 1,600 pages of regulations in the Department of Health and Human Services, a 23 percent reduction. D PRESIDENT CLINTON'S HEALTH CARE PROPOSALS*

? Extending the life of the Medicare Trust Fund until 2006. The President's Medicare savings (of $116 billion scored by the Congressional Budget Office) and structural changes will extend the Hospital Insurance Trust Fund for approximately ten years from today. ? Modernizing Medicare and providing for more choices. The President's Medicare plan will increase the choice of plans for beneficiaries by adding a Medicare Preferred Provider Organization option, a Provider Sponsored Organization alternative, and a HMO with a point D -of D -service option. It also includes "competitive D -bidding" initiatives that will make Medicare a more prudent and effective purchaser of health care services. Lastly, it enhances funding for academic health centers by redirecting funds for medical education to managed care plans. ? Adding new preventive benefits for Medicare beneficiaries. The President's Medicare proposal will add preventive benefits by providing for: full coverage of mammography screenings, a colorectal screening benefit, diabetes case management, and preventive injections for pneumonia, influenza and hepatitis B. ? Taking a first step toward coverage of long D -term care. The President's Medicare proposal will establish a respite benefit for families of Medicare beneficiaries with Alzheimer's Disease. ? Liberating states to have more flexibility to administer Medicaid. The President's Medicaid proposal will eliminate ARMS Email System Page 5of6

the burdensome waiver process for both managed care and home and community D -based care alternatives to institutionalization. It will preserve the Federal guarantee of health coverage and also make it easier for states to expand coverage.

? Providing for a "Workers' Transition Insurance" benefit. This proposal will build on Kennedy D -Kassebaum by helping to assure that previously insured people who are looking for a new job can afford to keep their health insurance and thus retain their portability protections. It will cost about $2 billion a year and will help approximately 3 million Americans a year retain insurance coverage, including 700,000 children. ? Empowering small businesses to access and purchase more affordable insurance. This will be accomplished through the use of voluntary health purchasing cooperatives (HPCs) by providing access to Federal Employees Health Benefit Plans, overriding restrictive state laws and giving grants for the establishment and operation of HPCs. ? Prohibiting health plans from restricting medical communications. Currently, some health plans require doctors to sign contracts that may inappropriately limit their ability to give patients information about referrals and alternative treatment. The President's ?anti D -gag? initiative will encourage physicians to discuss a full range of treatment options with patients. ? Creating an Advisory Commission on Consumer Protection and Quality in the Health Care Industry. The President signed an Executive Order to create a bi D -partisan Advisory Commission to review changes occurring in the health care system and, where appropriate, make recommendations on how best to promote and assure consumer protection and health care quality. ? Protecting health care benefits of workers and retirees. Helped tens of thousands of workers and retirees get promised benefits from their private health plans by developing a project to resolve cases quickly and by submitting amicus briefs in critical cases. ? Expanding health care options for older veterans. The President proposed the "Veterans Medicare Reimbursement Project of 1996," legislation to open the VA system to Medicare D -eligible veterans in a number of cities. This measure will allow the VA to receive reimbursement from Medicare, improving access to care for older veterans while lowering costs to the VA system. ? Contributing to the World Health Organization's initiative to eradicate global polio by the year 2000. This proposal will increase spending on global polio eradication efforts ARMS Email System Page 6of6

by $20 million. If successful, the United States alone could save more than $230 million per year after polio eradication is achieved.

* Where Federal funding is required for these proposals, it is included in the context of the President's balanced budget. ======END ATTACHMENT 1 ======ARMS Email System Page I of 5

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Jeffrey Levi ( LEVI J (WHO)

CREATION DATE/TIME:l5-0CT-1996 10:33:00.11

SUBJECT: daily news

TO: Patsy Fleming FLEMING P (WHO) READ:l5-0CT-1996 16:11:06.01

TO: Ursula Sanville SANVILLE U (OPD) READ:21-0CT-1996 10:40:20.73

TO: Lahoma Romocki ROMOCKI L (OPD) READ:l5-0CT-1996 10:45:43.90

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE:l5-0CT-1996 10:16:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsnews

ATT SUBJECT: CDC AIDS Daily Summary 10/15/96

ATT TO: levi j ( levi_j@Al@CD )

TEXT: AIDS Daily Summary October 15, 1996

The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

****************************************************** "At-Home Kits Test Medical Policies" "Shoo Flu, Don't Bother Me" "Condoms a Safer Sell in South Korea" "South Africa Slow to Battle Spread of Tuberculosis" "Judge Finds D.C. Medicaid in Violation" "Culture, et cetera: Sex Club Mission" "Animal Research Key to Progress" "China Sounds Alarm on AIDS" "The Changing Epidemiology of Acquired Drug-Resistant Tuberculosis in San Francisco, USA" "HIV Blocked by Chemokine Antagonist" ******************************************************

"At-Home Kits Test Medical Policies" Richmond Times-Dispatch (10/15/96) P. Al ARMS Email System Page 2 of 5

As the number of Americans using home health test kits increases, questions are being raised about the lack of government guidelines for such tests. Americans spent more than $1 billion on home tests in 1995, a 13 percent increase over the previous year. The Food and Drug Administration only approved the first home HIV test this year after six years of debate and only after phone counseling was added as a requirement. Although the agency regulates such tests for effectiveness, it has not established a policy on how to determine whether a test is appropriate for society. The FDA has recently been forced to deal with the question again after an Atlanta mother developed and marketed a home drug-use detection kit to other parents. The FDA said she violated federal law, but the product has been allowed to stay on the market while the case is under further consideration.

"Shoo Flu, Don't Bother Me" Washington Post--Health (10/15/96) P. 7; Squires, Sally The Centers for Disease Control and Prevention (CDC) predicts that this year's influenza season is likely to be a bad one, with the advent of at least one strain of flu virus that has been linked to severe symptoms. The CDC therefore recommends that people in high-risk groups--including the elderly; people infected with HIV; those receiving cancer therapy; and children and adults with chronic health conditions--become vaccinated against the virus. This year's flu vaccine contains three strains of killed virus, as have vaccines in past years, but researchers are also working on several ways to improve the vaccine, including using live influenza virus administered by a nasal spray, and developing new ways of streamlining production of vaccines so the protection can be more widely distributed. High-risk people who cannot be vaccinated, such as those with allergies to eggs, may be protected against influenza A varieties with antiviral drugs such as amantadine and rimantadine.

"Condoms a Safer Sell in South Korea" Chicago Tribune (10/14/96) P. 4-5 Since talking about sex in public is taboo in South Korea, stores are therefore reluctant to display condoms and consumers are embarrassed to be seen buying them. As an alternative, entrepreneur Paek Myong-ju has packaged condoms in trinkets including cigar boxes, compact discs, wedding bouquets, and walnuts. The camouflaged condoms are sold in convenience stores, department stores, and through mail order. Paek, who sold 100,000 walnut condoms alone in January, reports that most of his customers are female.

"South Africa Slow to Battle Spread of Tuberculosis" New York Times (10/13/96) P. 12; McNeil, Donald Jr. Although the World Health Organization has called South Africa's tuberculosis (TB) problem the worst in the world, the country's government has been slow to respond to the emergency. South Africa has the highest reported infection rate--about 350 cases per 100,000 people--and an increasing rate of drug-resistant TB, which kills 54 percent of patients it infects. The problem is partly attributed to a rise in drug use and the spread of HIV, which can increase susceptibility to TB. Moreover, a government plan to train nurses in the latest treatment methods, establish a case register, and build 200 mini-laboratories to facilitate rapid diagnosis is facing ARMS Email System Page 3 of 5

bureaucratic barriers.

"Judge Finds D.C. Medicaid in Violation" Washington Post (10/12/96) P. Al; Locy, Toni A federal judge has ruled that Washington, D.C. 's Medicaid program is failing to reach thousands of poor residents--and is threatening their health and violating their constitutional rights. U. S. District Judge Gladys Kessler said the program's problems range from failing to process Medicaid applications on time to inefficiently assigning doctors to recipients. Kessler pointed to examples of patients who are suffering as a result, including Karl Von Faust, who has AIDS and had to enroll in drug trials to pay for his medicine. The judge set a hearing date in November at which time she will decide how to remedy the program's problems.

"Culture, et cetera: Sex Club Mission" Washington Times (10/15/96) P. A2 A safe-sex club has opened in San Francisco, according to an article in the October 7 issue of U.S. News & World Report. Eros, the Center for Safe Sex, provides free condoms and other safe-sex supplies, offers a massage studio and sauna, as well as safe-sex lessons. Gay sex clubs have returned, and city officials and AIDS activists cannot decide if they are a public health threat or benefit. Some activists say the clubs will contribute to the increased spread of HIV in the gay community, but others hope they will offer HIV education for those most at-risk.

"Animal Research Key to Progress" USA Today (10/15/96) P. 14A; Paris, Susan E. The award of the Nobel Prize in medicine for work in immunology serves as a reminder that animals are vital to medical progress, notes Susan E. Paris, president of Americans for Medical Progress, in a letter to the editor in USA Today. Paris points out that the research that won the prize involved the study of laboratory mice and resulted in the knowledge of how the immune system targets viruses. She argues that animal rights activists would have liked to derail such research 20 years ago, and that continued efforts by activists could deny progress against AIDS, cancer, and other diseases.

"China Sounds Alarm on AIDS" United Press International (10/15/96) Chinese health officials report that AIDS is spreading rapidly throughout the country, adding that government AIDS campaigns were not effective. The State AIDS Supervision Station said AIDS awareness was low among members of high-risk groups and that most HIV infections are attributed to intravenous drug use. By the end of 1995, China had 3,341 documented HIV cases. In that year, 1,567 cases were added, compared to 502 new cases in 1994. The Ministry of Health estimates that close to 10,000 people are infected with HIV, and independent activists and experts say the number is closer to 100,000. The government has appropriated $1.8 billion for national AIDS work this year.

"The Changing Epidemiology of Acquired Drug-Resistant Tuberculosis in San Francisco, USA" Lancet (10/05/96) Vol. 348, No. 9032, P. 928; Bradford, Williamson Z.; Martin, Jeffrey N.; Reingold, Arthur L. ARMS Email System Page 4of5

The emergence of drug-resistant Mycobacterium tuberculosis in recent years has created a serious global health threat. To effectively control tuberculosis (TB) and determine what the best treatment options are, the factors that contribute to drug-resistance must be defined. Dr. Peter M. Small, of Stanford Medical School, and colleagues studied the trend of drug-resistance in San Francisco, a city that has had an effective TB control program. The researchers considered all reported TB cases in San Francisco between 1985 and 1994. They found evidence that 14 patients who were infected with susceptible M. tuberculosis later developed drug-resistance. Among these cases, two occurred between 1985 and 1989, and the remainder were reported between 1990 and 1994. Acquired drug­ resistance was associated with AIDS, non-compliance with therapy, and gastrointestinal symptoms. The authors conclude that the increasing prevalence of HIV/TB co-infection can be attributed to the increase in acquired drug resistance in San Francisco. They also suggest that conventional TB control measures may not be adequate in communities with high rates of HIV infection.

"HIV Blocked by Chemokine Antagonist" Nature (10/03/96) Vol. 383, No. 6599, P. 400; Arenzana-Seisdedos, Fernando; Virelizier, Jean-Louis; Rousset, Dominique; et al. Recent research has shown that HIV-1 depends on chemokine receptors to act as cell surface co-receptors to enter and infect cells. Scientists from the Pasteur Institute, the University of British Columbia, and the University of Bern report that a modified version of the chemokine RANTES can block HIV-1 without prompting the adverse effects the original compound causes. The findings suggest that "receptor signaling and cell activation is probably not required for the anti-HIV effect of chemokines," and that therapeutic agents could be developed as a result, the authors conclude.

======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE:l5-0CT-1996 10:20:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from conversion.pmdf.eop.gov by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for levi [email protected]; Tue, 15 Oct 1996 10:19:28 -0400 (EDT) Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for [email protected]; Tue, 15 Oct 1996 10:19:16 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF V5.0-7 #6879) id <[email protected]> for levi [email protected]; Tue, 15 Oct 1996 10:13:58 -0700 (MST) Received: by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id KAA28642; Tue, 15 Oct 1996 10:16:56 -0400 Errors-to: [email protected] Precedence: bulk Originator: [email protected] X-Comment: CDC National AIDS Clearinghouse ARMS Email System Page 5of5

X-Listprocessor-version: 6.0c -- ListProcessor by Anastasios Kotsikonas ======END ATTACHMENT 2 ======ARMS Email System Page 1 of 4

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Patsy Fleming ( FLEMING_P ) (WHO)

CREATION DATE/TIME: 8-NOV-1996 13:17:22.14

SUBJECT: AIDS news

TO: Ursula Sanville SANVILLE U (OPD) READ: 8-NOV-1996 13:19:11.68

TEXT:

======ATTACHMENT 1 ======ATT CREATION TIME/DATE: 8-NOV-1996 13:53:00.00

ATT BODYPART TYPE:E

ATT CREATOR: aidsnews

ATT SUBJECT: CDC AIDS Daily Summary 11/08/96

ATT TO: fleming_p ( fleming_p@Al@CD )

TEXT: AIDS Daily Summary November 8, 1996

The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

****************************************************** "One Man's AIDS Tale Shows How Quickly Epidemic Has Turned" "Blue Dye Is Found to Kill HIV" "Abbott AIDS Drug Called Safe for Kids" "New Tests Measure HIV Level in Tonsils" "Italian Study Finds HIV Does Not Increase Risk of Miscarriage" "Medical Marijuana Law in Legal Limbo" "New Class of Drug Offers New Hope Against AIDS" "AIDS Researchers Predict Shortage of Participants for Pediatric Trials" "Opening an Electronic Pharmacy to the World" "Health Centers Vie for Gays" ******************************************************

"One Man's AIDS Tale Shows How Quickly Epidemic Has Turned" Wall Street Journal (11/08/96) P. Al; Sanford, David In the Wall Street Journal, editor David Sanford recounts to readers how he has lived with HIV for more than 10 years and how advances in treatment over the last year have given him new hope of surviving. Sanford says he was probably infected at a Manhattan bath house in 1982. At the time, the new infectious disease prevalent in the homosexual community was referred to as ARMS Email System Page 2of4

Gay Related Immune Deficiency, or GRID. Sanford said he had symptoms of infection within weeks, but did not seek an HIV test until 1989, at which time he tested positive. His doctor did not recommend treatment as the time due to his relatively high T-cell count. After seeing a friend die of AIDS, however, Sanford started preparing for his own decline. He was diagnosed with AIDS in 1991, and started taking AZT and Dapsone, a drug for leprosy. Then, as his immunity started to fail, Sanford began taking the antiretroviral drug Videx (ddI). Sanford told his employers, friends, and relatives he had AIDS in 1995. A friend then referred him to Dr. Jerry Groopman, an AIDS practitioner in Boston, who prescribed the protease inhibitor Invirase, along with Bactrim, to fight off a bacterial infection; as well as Diflucan; AZT; and Epivir. Sanford reports that he is now well and planning for the future.

"Blue Dye Is Found to Kill HIV" Washington Times (11/08/96) P. All; Klinka, Karen A patented new use for Methylene Blue could virtually eliminate the threat of AIDS from blood transfusions, researchers at the Oklahoma Medical Research Foundation report. Biochemist Robert Floyd said that the drug, used to treat the bilrubin buildup that causes "blue baby" syndrome, can inactivate HIV in stored human blood and may eventually be used in patients. The foundation received a patent on the procedure Tuesday and hopes to conduct clinical trials soon.

"Abbott AIDS Drug Called Safe for Kids" Chicago Tribune (11/07/96) P. 3-1; Hutchcraft, Chuck New research suggests that a combination of AIDS drugs including a protease inhibitor will soon be available for children with the disease. "One of the issues with AIDS drugs in particular, and with drugs in general, is that new drugs come along and are ultimately approved for adults way in advance of children," says Dr. John Leonard, of Abbott Laboratories. A recent study at the National Institutes of Health found that Abbott's protease inhibitor Norvir is safe for children. The study, presented Wednesday at the Third International Congress on Drug Therapy for HIV Infection, was the first evaluation of a protease inhibitor in children. Some children experienced the same side effects as adults, said researcher Dr. Brigitta U. Mueller, of the National Cancer Institute, but the same positive results were also reported. The study may facilitate regulatory approval of protease inhibitors in children.

"New Tests Measure HIV Level in Tonsils" Reuters (11/07/96) A new testing method will improve the monitoring of HIV levels in immune system cells in the tonsils, researchers said Thursday. Ashley Haase of the University of Minnesota and colleagues report in the journal Science that they have developed a test to determine the level of HIV in the tonsils' lymphoid tissue, where HIV is known to hide. Tests currently measure the level of HIV in the bloodstream, but the new method can evaluate the level of HIV in two types of cells, those on the surface of the cells that store the virus and inside the cells that make new virus particles.

"Italian Study Finds HIV Does Not Increase Risk of Miscarriage" Reuters (11/07/96) ARMS Email System Page 3of4

New research indicates that, contrary to previous findings, HIV infection does not heighten the risk of miscarriage. Dr. Augusto E. Semprini of the University of Milan and colleagues studied the miscarriage rate in HIV-infected women compared to HIV-negative women, and concluded that "HIV does not significantly influence the course of early gestation." There was also no significant difference in the miscarriage rate between women taking AZT and those not taking the drug.

"Medical Marijuana Law in Legal Limbo" United Press International (11/07/96) The new California law legalizing the use of marijuana for medical purposes has left prosecutors in the need of guidelines for enforcement. "The priority is to delineate what the responsibilities are of the federal authorities versus the local authorities," said Larry Brown of the California District Attorneys Association. Other issues to be considered include the illegal purchase of marijuana seeds to grow plants for medicinal use, and the need to clarify which illnesses and how much of the drug will be allowed under the new law.

"New Class of Drug Offers New Hope Against AIDS" Reuters (11/06/96); Fox, Maggie Researchers at the Third International Congress on Drug Therapy in HIV Infection presented evidence that a new class of drugs, known as non-nucleoside reverse transcriptase inhibitors (NNRTis), work as well as protease inhibitors and offer new choices to AIDS patients. Mark Wainburg and colleagues at Montreal's McGill University AIDS Center found that a combination of AZT, Bristol-Myers Squibb's ddI, and Boehringer Ingelheim's NNRTI nevirapine "led to non-detectable levels of virus in plasma in over 75 percent of patients who were previously drug-naive." Another group of researchers, led by Joep Lange of Amsterdam's Academic Medical Center, found similar results, concluding that "nevirapine provides new opportunities for combination treatment." The NNRTis and the protease inhibitors interfere with one another, however, making it necessary for pharmaceutical firms to work to overcome this, notes David Ho of the Aaron Diamond AIDS Research Center at New York's Rockefeller University.

"AIDS Researchers Predict Shortage of Participants for Pediatric Trials" Reuters (11/06/96) Studies by the Pediatric AIDS Clinical Trials Group (PACTG) may be hindered by a lack of participants, said Dr. Deborah Cotton of the Harvard Medical School last week in a report to the Office of AIDS Research Advisory Council. One of the group's objectives is to reduce the rate of HIV perinatal infection by 2 percent. Cotton was responding to a report by PACTG Director Dr. Stephen Spector, who noted that while the rate of perinatal transmission is declining, the rate of HIV-positive women becoming pregnant is also increasing.

"Opening an Electronic Pharmacy to the World" Nature Medicine (10/96) Vol. 2, No. 10, P. 1064; Steele, Fintan R. In an effort to make powerful new AIDS drugs more widely available around the world, a group of pharmacists in Raleigh, N.C., has founded a company that sells the drugs globally via the ARMS Email System Page 4of4

World Wide Web. The company, AIDSRx, was created to give physicians around the world access to AIDS drugs at a 5 percent discount off the average price charged by U.S. pharmacies. Founded in July, the company has had some difficulty exporting the drugs to many countries due to their strict trade restrictions, but the business is growing nonetheless. The company also has plans to offer the drugs at a discount to U.S. patients who are uninsured. AIDSRx is a for-profit venture, but its founders note that it is not intended as a money-making opportunity. Moreover, 10 percent of the profit from each order will be invested in AIDS education efforts in the country from which the order was received.

"Health Centers Vie for Gays" Crain's New York Business (10/28/96) Vol. 12, No. 44, P. 6 Two new health centers targeting gays are set to open in New York City next year. One clinic, being built by Community Health Project, is expected to open in November 1997 and handle about 60,000 visits a year from predominantly gay clients. The Gay Men's Health Crisis is also planning to open a primary care clinic next year, but it expects to serve only HIV-positive patients. Various other AIDS service organizations serve New York's gay community, including Village Center for Care/Rivington House and AIDS Day Services Association of New York State.

The AIDS Daily Summary will not publish on Monday, November 11, 1996, in observance of Veterans Day. Publication will resume on Tuesday, November 12.

======END ATTACHMENT 1 ======

======ATTACHMENT 2 ======ATT CREATION TIME/DATE: 8-NOV-1996 12:54:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for [email protected]; Fri, 08 Nov 1996 12:53:24 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF V5.0-7 #6879) id <[email protected]> for [email protected]; Fri, 08 Nov 1996 12:53:12 -0700 (MST) Received: by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id MAA28274; Fri, 08 Nov 1996 12:53:11 -0500 Errors-to: [email protected] Precedence: bulk Originator: [email protected] X-Comment: CDC National AIDS Clearinghouse X-Listprocessor-version: 6.0c -- ListProcessor by Anastasios Kotsikonas ======END ATTACHMENT 2 ======ARMS Email System Page 1 of 4

RECORD TYPE: PRESIDENTIAL (EXTERNAL MAIL)

CREATOR: [email protected]@INET@EOPMRX

CREATION DATE/TIME: 8-NOV-1996 12:53:00.00

SUBJECT: CDC AIDS Daily Summary 11/08/96

TO: sanville u sanville u@Al@CD (OPD) READ:l5-NOV-1996 12:44:06.21

TEXT: AIDS Daily Summary November 8, 1996

The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

****************************************************** "One Man's AIDS Tale Shows How Quickly Epidemic Has Turned" "Blue Dye Is Found to Kill HIV" "Abbott AIDS Drug Called Safe for Kids" "New Tests Measure HIV Level in Tonsils" "Italian Study Finds HIV Does Not Increase Risk of Miscarriage" "Medical Marijuana Law in Legal Limbo" "New Class of Drug Offers New Hope Against AIDS" "AIDS Researchers Predict Shortage of Participants for Pediatric Trials" "Opening an Electronic Pharmacy to the World" "Health Centers Vie for Gays" ******************************************************

"One Man's AIDS Tale Shows How Quickly Epidemic Has Turned" Wall Street Journal (11/08/96) P. Al; Sanford, David In the Wall Street Journal, editor David Sanford recounts to readers how he has lived with HIV for more than 10 years and how advances in treatment over the last year have given him new hope of surviving. Sanford says he was probably infected at a Manhattan bath house in 1982. At the time, the new infectious disease prevalent in the homosexual community was referred to as Gay Related Immune Deficiency, or GRID. Sanford said he had symptoms of infection within weeks, but did not seek an HIV test until 1989, at which time he tested positive. His doctor did not recommend treatment as the time due to his relatively high T-cell count. After seeing a friend die of AIDS, however, Sanford started preparing for his own decline. He was diagnosed with AIDS in 1991, and started taking AZT and Dapsone, a drug for leprosy. Then, as his immunity started to fail, Sanford began taking the antiretroviral drug Videx (ddI) . Sanford told his employers, friends, and relatives he had AIDS in 1995. A friend then referred him to Dr. Jerry Groopman, an AIDS practitioner in Boston, who prescribed the protease inhibitor Invirase, along with Bactrim, to fight off a bacterial infection; as well as ARMS Email System Page 2 of 4

Diflucan; AZT; and Epivir. Sanford reports that he is now well and planning for the future.

"Blue Dye Is Found to Kill HIV" Washington Times (11/08/96) P. All; Klinka, Karen A patented new use for Methylene Blue could virtually eliminate the threat of AIDS from blood transfusions, researchers at the Oklahoma Medical Research Foundation report. Biochemist Robert Floyd said that the drug, used to treat the bilrubin buildup that causes "blue baby" syndrome, can inactivate HIV in stored human blood and may eventually be used in patients. The foundation received a patent on the procedure Tuesday and hopes to conduct clinical trials soon.

"Abbott AIDS Drug Called Safe for Kids" Chicago Tribune (11/07/96) P. 3-1; Hutchcraft, Chuck New research suggests that a combination of AIDS drugs including a protease inhibitor will soon be available for children with the disease. "One of the issues with AIDS drugs in particular, and with drugs in general, is that new drugs come along and are ultimately approved for adults way in advance of children," says Dr. John Leonard, of Abbott Laboratories. A recent study at the National Institutes of Health found that Abbott's protease inhibitor Norvir is safe for children. The study, presented Wednesday at the Third International Congress on Drug Therapy for HIV Infection, was the first evaluation of a protease inhibitor in children. Some children experienced the same side effects as adults, said researcher Dr. Brigitta U. Mueller, of the National Cancer Institute, but the same positive results were also reported. The study may facilitate regulatory approval of protease inhibitors in children.

"New Tests Measure HIV Level in Tonsils" Reuters (11/07/96) A new testing method will improve the monitoring of HIV levels in immune system cells in the tonsils, researchers said Thursday. Ashley Haase of the University of Minnesota and colleagues report in the journal Science that they have developed a test to determine the level of HIV in the tonsils' lymphoid tissue, where HIV is known to hide. Tests currently measure the level of HIV in the bloodstream, but the new method can evaluate the level of HIV in two types of cells, those on the surface of the cells that store the virus and inside the cells that make new virus particles.

"Italian Study Finds HIV Does Not Increase Risk of Miscarriage" Reuters (11/07/96) New research indicates that, contrary to previous findings, HIV infection does not heighten the risk of miscarriage. Dr. Augusto E. Semprini of the University of Milan and colleagues studied the miscarriage rate in HIV-infected women compared to HIV-negative women, and concluded that "HIV does not iignificantly influence the course of early gestation." There was also no significant difference in the miscarriage rate between women taking AZT and those not taking the drug.

"Medical Marijuana Law in Legal Limbo" United Press International (11/07/96) The new California law legalizing the use of marijuana for medical purposes has left prosecutors in the need of guidelines ARMS Email System Page 3of4

for enforcement. "The priority is to delineate what the responsibilities are of the federal authorities versus the local authorities," said Larry Brown of the California District Attorneys Association. Other issues to be considered include the illegal purchase of marijuana seeds to grow plants for medicinal use, and the need to clarify which illnesses and how much of the drug will be allowed under the new law.

"New Class of Drug Offers New Hope Against AIDS" Reuters (11/06/96); Fox, Maggie Researchers at the Third International Congress on Drug Therapy in HIV Infection presented evidence that a new class of drugs, known as non-nucleoside reverse transcriptase inhibitors (NNRTis), work as well as protease inhibitors and offer new choices to AIDS patients. Mark Wainburg and colleagues at Montreal's McGill University AIDS Center found that a combination of AZT, Bristol-Myers Squibb's ddI, and Boehringer Ingelheim's NNRTI nevirapine "led to non-detectable levels of virus in plasma in over 75 percent of patients who were previously drug-naive." Another group of researchers, led by Jeep Lange of Amsterdam's Academic Medical Center, found similar results, concluding that "nevirapine provides new opportunities for combination treatment." The NNRTis and the protease inhibitors interfere with one another, however, making it necessary for pharmaceutical firms to work to overcome this, notes David Ho of the Aaron Diamond AIDS Research Center at New York's Rockefeller University.

"AIDS Researchers Predict Shortage of Participants for Pediatric Trials" Reuters (11/06/96) Studies by the Pediatric AIDS Clinical Trials Group (PACTG) may be hindered by a lack of participants, said Dr. Deborah Cotton of the Harvard Medical School last week in a report to the Office of AIDS Research Advisory Council. One of the group's objectives is to reduce the rate of HIV perinatal infection by 2 percent. Cotton was responding to a report by PACTG Director Dr. Stephen Spector, who noted that while the rate of perinatal transmission is declining, the rate of HIV-positive women becoming pregnant is also increasing.

"Opening an Electronic Pharmacy to the World" Nature Medicine (10/96) Vol. 2, No. 10, P. 1064; Steele, Fintan R. In an effort to make powerful new AIDS drugs more widely available around the world, a group of pharmacists in Raleigh, N.C., has founded a company that sells the drugs globally via the World Wide Web. The company, AIDSRx, was created to give physicians around the world access to AIDS drugs at a 5 percent discount off the average price charged by U.S. pharmacies. Founded in July, the company has had some difficulty exporting the drugs to many countries due to their strict trade restrictions, but the business is growing nonetheless. The company also has plans to offer the drugs at a discount to U.S. patients who are uninsured. AIDSRx is a for-profit venture, but its founders note that it is not intended as a money-making opportunity. Moreover, 10 percent of the profit from each order will be invested in AIDS education efforts in the country from which the order was received. ARMS Email System Page 4of4

"Health Centers Vie for Gays" Crain's New York Business (10/28/96) Vol. 12, No. 44, P. 6 Two new health centers targeting gays are set to open in New York City next year. One clinic, being built by Community Health Project, is expected to open in November 1997 and handle about 60,000 visits a year from predominantly gay clients. The Gay Men's Health Crisis is also planning to open a primary care clinic next year, but it expects to serve only HIV-positive patients. Various other AIDS service organizations serve New York's gay community, including Village Center for Care/Rivington House and AIDS Day Services Association of New York State.

The AIDS Daily Summary will not publish on Monday, November 11, 1996, in observance of Veterans Day. Publication will resume on Tuesday, November 12.

======ATTACHMENT 1 ======ATT CREATION TIME/DATE: 8-NOV-1996 12:53:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for [email protected]; Fri, 08 Nov 1996 12:53:19 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF V5.0-7 #6879) id <[email protected]> for [email protected]; Fri, 08 Nov 1996 12:53:13 -0700 (MST) Received: by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id MAA28277; Fri, 08 Nov 1996 12:53:12 -0500 Errors-to: [email protected] Precedence: bulk Originator: [email protected] X-Comment: CDC National AIDS Clearinghouse X-Listprocessor-version: 6.0c -- ListProcessor by Anastasios Kotsikonas ======END ATTACHMENT 1 ======Clinton Presidential Records Automated Records Management System [EMAIL] and Tape Restoration Project [Email]

This is not a presidential record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff.

This marker identifies a responsive email, already made available within another FOIA request.

FOIA: 2007-1550-F

Bucket: OPD

Creation Date: 1996-11-14

Subject: CDC AIDS Daily Summary 11/14/96

Creator: [email protected]@INET@EOPMRX ARMS Email System Page 1 of 3

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Ursula Sanville ( SANVILLE_U ) (OPD)

CREATION DATE/TIME: 2-DEC-1996 17:24:43.94

SUBJECT: draft of briefing memo

TO: Jeremy D. Benami BENAMI J (WHO) READ:NOT READ

TO: Patsy Fleming FLEMING P (WHO) READ:NOT READ

TEXT: Jeremy Attached is the World AIDS Day briefing memo for the President I drafted. Let me know if you have changes and what the next steps are. Thanks -- Jane ======ATTACHMENT 1 ======ATT CREATION TIME/DATE: 2-DEC-1996 17:22:00.00

ATT BODYPART TYPE:p

ATT CREATOR: Ursula Sanville

TEXT:

PRINTER FONT 12 POINT COURIER DRAFT December 2, 1996

MEMORANDUM FOR THE PRESIDENT FROM: Patricia S. Fleming, National AIDS Policy Director THRU: Carol H. Rasco, Assistant to the President for Domestic Policy SUBJECT: Preparation for briefing on World AIDS Day In preparation for the December 3rd World AIDS Day briefing by HHS officials, the following briefing is on the status of the epidemic and the key aspects of the Federal response. I. State of the Epidemic As of September 30, 1996, there were 566,002 reported AIDS cases and over 343,000 deaths. AIDS is now the leading cause of death among Americans aged 25 to 44. CDC estimates that between 40,000 and 60,000 Americans are becoming newly infected with HIV each year, and that between 650,000 and 900,000 Americans are currently living with HIV. The highest rates of increase in new AIDS cases are among adolescents, injecting drug users, women, and people of color. CDC estimates that one 0 -quarter of new HIV infections in the U.S. occur among young people under age 21. CDC also estimates that over 36 percent of new AIDS cases are associated with injection drug use. Women now comprise 14 percent of cumulatively reported AIDS cases. As of December 1995, African 0 -Americans and Hispanics ARMS Email System Page 2of3

comprised 52 percent of cumulative AIDS cases. The HIV epidemic continues to spread into suburban and rural areas, with dramatic increases in certain regions of the South and Midwest. While most cases are still reported from urban areas, the rate of reported cases in non D -metropolitan areas is increasing more rapidly than in urban areas. The U.S. epidemic is part of a global pandemic. Globally, the toll of the epidemic is much greater and threatens to reverse decades of economic and public health progress in developing countries. The World Health Organization estimates that 27.9 million people have been infected with HIV.

II. The Federal Response Your Administration has been credited with making tremendous progress in the fight against AIDS. Progress since you took office includes: ? A 40 percent increase in NIH IJ -supported AIDS research. ? A 158 percent increase in Ryan White AIDS Treatment grants. ? A 24 percent increase in CDC HIV prevention activities. ? A 96 percent increase for HUD's Housing Opportunities for People with AIDS program. ? As a result of Public Health Service guidelines recommending the use of AZT by HIV D -positive pregnant women and their newborns, a 17 percent drop in the number of infants with perinatally D -acquired HIV infection (from 1994 to 1995). ? Responding rapidly to FDA approval of a new class of AIDS therapies called protease inhibitors with increases in funding for State AIDS Drug Assistance Programs. ? Easing of Social Security disability rules to speed approval of eligibility. ? Strengthening the Office of AIDS Research at the National Institutes of Health. ? Fulfilling your promise of developing the first D -ever National AIDS Strategy. ? Creating the Office of National AIDS Policy at the White House and the Presidential Advisory Council on HIV/AIDS.

III. Research Developments & Opportunities for Progress A. THERAPEUTICS Implications of Viral Levels NIH [[ -sponsored research indicates that decreasing the amount of HIV in the blood can significantly slow how quickly a person becomes ill, and can also decrease the chance of transmission from mother to child. This finding has tremendous implications for therapy. Studies indicate that combination therapy (i.e., use of one or more ARMS Email System Page 3 of 3

anti [I -retroviral drugs), especially where a protease inhibitor (the

newest class of anti D -retroviral drugs) is used, provides the greatest benefit for the patients. However, this approach is new and we still do not know the best time to start therapy, to stop therapy, to change therapy, and how long these effects will last. More research is needed. [See section on contributions of the Vice President.] Discovery of New Receptors The breakthrough discovery of new chemokine receptors (CCRS and CXCR4 or fusin are receptors on the cell where HIV binds) has offered exciting new avenues of for drug and vaccine development. Research indicates that people who have defective or missing receptors are much more resistant to becoming infected.

B. PREVENTION In response to the recommendations from the Report of the NIH AIDS Research Program Evaluation Task Force, NIH is developing a comprehensive HIV prevention science agenda. Areas of focus will include: ? Vaccines. We desperately need a vaccine that will control new infections both in the U.S. and abroad. New generations of vaccines, including DNA vaccines, are now in early development. Research efforts in the HIV vaccine arena will have important implications for developing vaccines for other diseases such as Tuberculosis. ? Other Prevention Efforts. Preventing HIV infection through behavioral modification and/or a microbicide (a mechanical or chemical barrier method that blocks infection) also offers tremendous hope. Secretary Shalala has promised $100 million over the next four years for microbicide research and development. IV. Role of the Vice President The Vice President has been intimately involved in developing the Forum for Collaborative HIV Research. This new public D -private group is designed to catalyze collaborations among government researchers, pharmaceutical companies, third D -party payors, and the community to capitalize on recent scientific advances and learn how to optimally use available treatment regimens. The Vice President has also expressed interest in continuing efforts to expedite vaccine and microbicide research. ======END ATTACHMENT 1 ======ARMS Email System Page I of 3

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Ursula Sanville ( SANVILLE_U ) (OPD)

CREATION DATE/TIME: 2-DEC-1996 18:46:13.67

SUBJECT: again

TO: Dorothy K. Craft CRAFT D (OPD) READ: 2-DEC-1996 18:50:06.70

TEXT:

PRINTER FONT 12 POINT COURIER DRAFT December 2, 1996

MEMORANDUM FOR THE PRESIDENT FROM: Patricia S. Fleming, National AIDS Policy Director THRU: Carol H. Rasco, Assistant to the President for Domestic Policy SUBJECT: Preparation for briefing on World AIDS Day In preparation for the December 3rd World AIDS Day briefing by HHS officials, the following briefing is on the status of the epidemic and the key aspects of the Federal response. I. State of the Epidemic As of September 30, 1996, there were 566,002 reported AIDS cases and over 343,000 deaths. AIDS is now the leading cause of death among Americans aged 25 to 44. CDC estimates that between 40,000 and 60,000 Americans are becoming newly infected with HIV each year, and that between 650,000 and 900,000 Americans are currently living with HIV. The highest rates of increase in new AIDS cases are among adolescents, injecting drug users, women, and people of color. CDC estimates that one D -quarter of new HIV infections in the U.S. occur among young people under age 21. CDC also estimates that over 36 percent of new AIDS cases are associated with injection drug use. Women now comprise 14 percent of cumulatively reported AIDS cases. As of December 1995, African D -Americans and Hispanics comprised 52 percent of cumulative AIDS cases. The HIV epidemic continues to spread into suburban and rural areas, with dramatic increases in certain regions of the South and Midwest. While most cases are still reported from urban areas, the rate of reported cases in non D -metropolitan areas is increasing more rapidly than in urban areas. The U.S. epidemic is part of a global pandemic. Globally, the toll of the epidemic is much greater and threatens to reverse decades of economic and public health progress in developing countries. The World Health Organization estimates that 27.9 million people have been infected with HIV.

II. The Federal Response ARMS Email System Page 2of3

Your Administration has been credited with making tremendous progress in the fight against AIDS. Progress since you took office includes: ? A 40 percent increase in NIH D -supported AIDS research. ? A 158 percent increase in Ryan White AIDS Treatment grants. ? A 24 percent increase in CDC HIV prevention activities. ? A 96 percent increase for HUD's Housing Opportunities for People with AIDS program. ? Strengthening the Office of AIDS Research at the National Institutes of Health. ? As a result of Public Health Service guidelines recommending the use of AZT by HIV D -positive pregnant women and their newborns, a 17 percent drop in the number of infants with perinatally D -acquired HIV infection (from 1994 to 1995). ? Responding rapidly to FDA approval of a new class of AIDS therapies called protease inhibitors with increases in funding for State AIDS Drug Assistance Programs. ? Easing of Social Security disability rules to speed approval of eligibility. ? Creating the Off ice of National AIDS Policy at the White House and the Presidential Advisory Council on HIV/AIDS.

III. Research Developments & Opportunities for Progress A. THERAPEUTICS Implications of Viral Levels NIH D -sponsored research indicates that decreasing the amount of HIV in the blood can significantly slow how quickly a person becomes ill, and can also decrease the chance of transmission from mother to child. This finding has tremendous implications for therapy. Studies indicate that combination therapy (i.e., use of one or more anti 0 -retroviral drugs), especially where a protease inhibitor (the newest class of anti D -retroviral drugs) is used, provides the greatest benefit for the patients.

However, this approach is new and we still do not know the best time to start therapy, to stop therapy, to change therapy, and how long these effects will last. More research is needed. [See section on contributions of the Vice President.] Discovery of New Receptors The breakthrough discovery of new chemokine receptors (CCR5 and CXCR4 or fusin are receptors on the cell where HIV binds) has offered exciting new avenues of for drug and vaccine development. Research indicates that people who have defective or missing receptors are much more resistant to becoming infected.

B. PREVENTION ARMS Email System Page 3of3

In response to the recommendations from the Report of the NIH AIDS Research Program Evaluation Task Force, NIH is developing a comprehensive HIV prevention science agenda. Areas of focus will include: ? Vaccines. We desperately need a vaccine that will control new infections both in the U.S. and abroad. New generations of vaccines, including DNA vaccines, are now in early development. Research efforts in the HIV vaccine arena will have important implications for developing vaccines for other diseases such as Tuberculosis. ? Other Prevention Efforts. Preventing HIV infection through behavioral modification and/or a microbicide (a mechanical or chemical barrier method that blocks infection) also offers tremendous hope. Secretary Shalala has promised $100 million over the next four years for microbicide research and development. IV. Role of the Vice President The Vice President has been intimately involved in developing the Forum for Collaborative HIV Research. This new public 0 -private group is designed to catalyze collaborations among government researchers, pharmaceutical companies, third 0 -party payors, and the community to capitalize on recent scientific advances and learn how to optimally use available treatment regimens. The Vice President has also expressed interest in continuing efforts to expedite vaccine and microbicide research. ARMS Email System Page 1of3

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Ursula Sanville ( SANVILLE U ) (OPD)

CREATION DATE/TIME: 3-DEC-1996 09:58:18.94

SUBJECT: Briefing memo

TO: Patsy Fleming FLEMING P (WHO) READ: 3-DEC-1996 13:49:36.91

TO: Remote Addressee ( [email protected]@INET ) READ:NOT READ

TEXT: Patsy Below is a copy of the briefing memo in final format. There's also a hard copy on your chair. Let me know if you need anything else. Jane

PRINTER FONT 12 POINT ROMAN December 2, 1996

MEMORANDUM TO THE PRESIDENT From: Carol H. Rasco Patricia S. Fleming SUBJECT: Background Information on AIDS This memo provides the latest information on the AIDS epidemic and the key aspects of the Federal response. I. State of the Epidemic As of September 30, 1996, there were 566,002 reported AIDS cases and over 343,000 deaths. AIDS is now the leading cause of death among Americans aged 25 to 44. CDC estimates that between 40,000 and 60,000 Americans are becoming newly infected with HIV each year, and that between 650,000 and 900,000 Americans are currently living with HIV. The highest rates of increase in new AIDS cases are among adolescents, injecting drug users, women, and people of color. CDC estimates that one D -quarter of new HIV infections in the U.S. occur among young people under age 21. CDC also estimates that more than 36 percent of new AIDS cases are associated with injection drug use. Women now comprise 14 percent of cumulatively reported AIDS cases. As of December 1995, African D -Americans and Hispanics comprised 52 percent of cumulative AIDS cases. The HIV epidemic continues to spread into suburban and rural areas, with dramatic increases in certain regions of the South and Midwest. While most cases are still reported from urban areas, the rate of reported cases in non D -metropolitan areas is increasing more rapidly than in urban areas. The U.S. epidemic is part of a global pandemic. Globally, the toll of the epidemic is much greater and threatens to reverse ARMS Email System Page 2of3

decades of economic and public health progress in developing countries. The World Health Organization estimates that 27.9 million people have been infected with HIV. D II. The Federal Response Your Administration has been credited with making tremendous progress in the fight against AIDS. Progress since you took office includes: ? A 40 percent increase in NIH D -supported AIDS research. ? A 158 percent increase in Ryan White AIDS Treatment grants. ? A 24 percent increase in CDC HIV prevention activities. ? A 96 percent increase for HUD's Housing Opportunities for People with AIDS program. ? Strengthening the Office of AIDS Research at the National Institutes of Health. ? As a result of Public Health Service guidelines recommending the use of AZT by HIV D -positive pregnant women and their newborns, a 17 percent drop in the number of infants with perinatally D -acquired HIV infection (from 1994 to 1995). ? Responding rapidly to FDA approval of a new class of AIDS therapies called protease inhibitors with increases in funding for State AIDS Drug Assistance Programs. ? Easing of Social Security disability rules to speed approval of eligibility. ? Creating the Office of National AIDS Policy at the White House and the Presidential Advisory Council on HIV/AIDS. III. Research Developments & Opp6rtunities for Progress A. THERAPEUTICS Implications of Viral Levels NIH D -sponsored research indicates that decreasing the amount of HIV in the blood can significantly slow how quickly a person becomes ill, and can also decrease the chance of transmission from mother to child. This finding has tremendous implications for therapy. Studies indicate that combination therapy (i.e., use of one or more anti D -retroviral drugs), especially where a protease inhibitor (the newest class of anti IJ -retroviral drugs) is used, provides the greatest benefit for the patients. However, this approach is new and we still do not know the best time to start therapy, to stop therapy, to change therapy, and how long these effects will last. More research is needed. D

Discovery of New Receptors The breakthrough discovery of new chemokine receptors (CCR5 and CXCR4 or fusin are receptors on the cell where HIV binds) has offered exciting new avenues for drug and vaccine development. Research indicates that people who have defective or missing receptors are much more resistant to becoming infected. ARMS Email System Page 3of3

B. PREVENTION In response to the recommendations from the Report of the NIH AIDS Research Program Evaluation Task Force, NIH is developing a comprehensive HIV prevention science agenda. Areas of focus will include: Vaccines. We desperately need a vaccine that will control new infections both in the U.S. and abroad. New generations of vaccines, including DNA vaccines, are now in early development. Research efforts in the HIV vaccine arena will have important implications for developing vaccines for other diseases such as Tuberculosis. Other Prevention Efforts. Preventing HIV infection through behavioral modification and/or a microbicide (a mechanical or chemical barrier method that blocks infection) also offers tremendous hope. Secretary Shalala has promised $100 million over the next four years for microbicide research and development. IV. Role of the Vice President The Vice President has been intimately involved in developing the Forum for Collaborative HIV Research. This new public 0 -private group is designed to catalyze collaborations among government researchers, pharmaceutical companies, third 0 -party payors, and the community to capitalize on recent scientific advances and learn how to optimally use available treatment regimens. The Vice President also has expressed interest in continuing efforts to expedite vaccine and microbicide research. ARMS Email System Page I of 3

RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)

CREATOR: Ursula Sanville ( SANVILLE_U ) (OPD)

CREATION DATE/TIME:l5-DEC-1996 20:49:52.71

SUBJECT: POTUS BRIEFING MEMO

TO: Jeremy D. Benami BENAMI J (WHO) READ:l6-DEC-1996 09:26:46.54

CC: Patsy Fleming FLEMING P (WHO) READ:l7-DEC-1996 15:10:06.90

TEXT: Jeremy Attached is the draft briefing memo for the President. It's also on the I:\ drive under I:\dpc\data\potusbrf.196. I think the document is a little a the long side, but use your judgement about what you think is appropriate. If you need anything else let me know. I'll be at Advisory Council meeting at the Capitol Hill Hyatt. Jane

PRINTER FONT 12 POINT COURIER DRAFT December 13, 1996

MEMORANDUM FOR THE PRESIDENT FROM: Patricia S. Fleming, Director of the Office of National AIDS Policy THRU: Carol H. Rasco, Assistant to the President for Domestic Policy SUBJECT: Presentation of the National AIDS Strategy In preparation for the December 16 or 17 presentation of the National AIDS Strategy the following is a briefing on (1) the status of the epidemic, (2) the Federal response, and (3) an overview of the National AIDS Strategy. I. State of the Epidemic As of September 30, 1996, there 566,002 AIDS reported cases and over 343,000 deaths. It is now the leading cause of death among Americans aged 25 to 44. CDC estimates that between 40,000 and 60,000 Americans are becoming newly infected with HIV each year, and that between 650,000 and 900,000 Americans are currently living with HIV. The highest rates of increase in new AIDS cases are among adolescents, injecting drug users, women, and people of color. CDC estimates that one D -quarter of new HIV infections in the U.S. occur among young people under age 21. CDC also estimates that over 36 percent of new AIDS cases are associated with injection drug use. Women now comprise 14 percent of cumulatively reported AIDS cases. As of December 1995, African D -Americans and Hispanics comprised 52 percent of cumulative AIDS cases. The HIV epidemic continues to spread into suburban and rural areas, with dramatic increases in certain regions of the South and Midwest. While most cases are still reported from urban ARMS Email System Page 2of3

areas, the rate of reported cases in non [] -metropolitan areas is increasing more rapidly than in urban areas. The U.S. is part of a global epidemic. Globally, the toll of the epidemic is much greater and threatens to reverse decades of economic and public health progress in developing countries. The Joint United Programme on HIV and AIDS (UNAIDS) and the World Health Organization (WHO) estimate that 27.9 million people have been infected with HIV.

II. The Federal Response Your Administration has been credited with making tremendous progress in the fight against AIDS. These include: ? A 40 percent increase in NIH 0 -supported AIDS research. ? A 158 percent increase in Ryan White AIDS Treatment grants. ? A 24 percent increase in CDC HIV prevention activities. ? A 96 percent increase for HUD's Housing Opportunities for People with AIDS program. ? As a result of PHS guidelines recommending the use of AZT by HIV D -positive pregnant women and their newborns, the number of infants with perinatally 0 -acquired HIV infection dropped 17 percent form 1994 to 1995. ? Responding rapidly to FDA approval of a new class of AIDS therapies called protease inhibitors with increases in funding for State AIDS Drug Assistance Programs. ? Easing of Social Security disability rules to speed approval of eligibility. ? Strengthening the Office of AIDS Research at the National Institutes of Health. ? Creating the Office of National AIDS Policy at the White House and the Presidential Advisory Council on HIV/AIDS.

III. The National AIDS Strategy You asked the Office of National AIDS Policy to develop a comprehensive National AIDS Strategy that would detail the Federal government's long 0 -term approach to this epidemic. The National AIDS Strategy (NAS) has been developed to capitalize upon progress already made in fighting the epidemic and to catalyze collaborative efforts and public 0 -private partnerships among Federal Agencies, communities, State and local governments, businesses, schools, churches, families, and individuals. The NAS is a snapshot of where we are and where we need to go to end the epidemic. No previous Administration has undertaken so broad a planning effort that:

(1) sets goals for the nation; (2) involves all Federal Departments and Agencies that engage in HIV D ARMS Email System Page 3of3

-related efforts; (3) reaches out to communities and the private sector; and, (4) identifies areas where the Federal government should focus its efforts. The six national goals set forth in the National AIDS Strategy are: (1) To develop more effective treatments, a preventive vaccine to protect the uninfected, and a cure for those currently infected through strong, continuing support for HIV 0 -related research; (2) To reduce the number of new HIV infections in adults and children in the U.S. until the rate of new infections reaches zero by providing strong, continuing support for effective HIV prevention efforts; (3) To ensure that all people living with HIV have access to services, from health care to housing and supportive services, that are affordable, of high quality, and responsive to their needs; (4) To ensure that all people living with HIV are not subject to discrimination; (5) To provide strong, continuing support for international efforts to address the HIV epidemic; and, (6) To ensure that research advances are translated into improved HIV prevention programs and enhanced care for HIV- positive persons. The main messages about the NAS are: ? it sets goals for the nation, and articulates areas for further progress -- areas where the Federal government can improve its efforts in combatting the HIV epidemic; ? it calls for Federal agencies, the Presidential Advisory Council on HIV/AIDS, and the community to work together to develop solutions to our challenges; and, ? it demonstrates that the White House, through the Office of National AIDS Policy (ONAP) , is providing a cross D -cutting national focus and direction for the U.S. government's response to HIV and AIDS. ARMS Email System Page I of 4

RECORD TYPE: PRESIDENTIAL (EXTERNAL MAIL)

CREATOR: [email protected]@INET@EOPMRX

CREATION DATE/TIME:lO-JAN-1997 12:19:00.00

SUBJECT: CDC AIDS Daily Summary 01/09/97

TO: AIDSNews ( [email protected]@INET@EOPMRX ) READ:NOT READ

TO: MKarasik ( [email protected]@INET@EOPMR READ:NOT READ

TO: DAlexis ( [email protected]@INET@EOPMRX READ:NOT READ

IND TO: Ursula Sanville SANVILLE U (OPD) READ:l3-JAN-1997 15:44:00.42

TEXT: AIDS Daily Summary January 9, 1997

The CDC National Center for HIV, STD, and TB Prevention makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

****************************************************** "Panel to Review AZT Use During Pregnancy" "Don't Forsake Homosexuals Who Want Help" "High Court Hears 2 Cases Involving Assisted Suicide" "Across the USA: California" "Science & Health Bulletin: Africa-Disease [Malaria, Ebola, and AIDS Pose Serious Threats] " "Florida Will Provide Protease Inhibitors to AIDS Patients" "Zambian AIDS Scourge Worries Policy Experts" "New AIDS Drugs Cut Death Rate Sharply, Data Show" "Collaboration Needed for HIV Vaccine Success" "Culture, Media, and HIV/AIDS in Asia" ******************************************************

"Panel to Review AZT Use During Pregnancy" Washington Post (01/09/97) P. Al3 New evidence that the offspring of mice given high doses of AZT during pregnancy are at risk for cancer has raised concerns among federal health officials about the use of the drug for HIV-infected pregnant women. The National Institutes of Health will thus assemble a panel of AIDS and cancer experts next week to develop guidelines on the use of AZT during pregnancy. Health officials say that for now, pregnant women infected with HIV should continue taking the drug, which has been shown to significantly reduce the transmission of HIV to infants. High doses of the drug caused cancer in the baby mice, and pregnant women take much lower doses, said a spokesman for the National Institute of Allergy and Infectious Diseases. No cases of cancer ARMS Email System Page 2 of 4

have been found in the children of women who took AZT during pregnancy.

"Don't Forsake Homosexuals Who Want Help" Wall Street Journal (01/09/97) P. Al2; Socarides, Charles; Kaufman, Benjamin; Nicolosi, Joseph; et al. Although treatment is available for men who experience an unwanted sexual attraction to other men, it is denied to many potential patients because of political pressure, claim the writers of an Wall Street Journal commentary. Charles Socarides, a clinical professor of psychiatry at Albert Einstein College of Medicine, and colleagues, contend that, without treatment, men with unwanted homosexual inclinations become depressed and turn to unprotected sex, increasing their risk for HIV infection. The authors cite as an example a study that found that 38 percent of homosexual adolescents had engaged in unprotected sex in the previous six months. Socarides et al. conclude that the lives of many men who died of AIDS could have been saved had their attempts to seek treatment for homosexuality been successful.

"High Court Hears 2 Cases Involving Assisted Suicide" New York Times (01/09/97) P. Al; Greenhouse, Linda After hearing debates for and against the constitutional right to physician-assisted suicide on Wednesday, the Supreme Court Justices seemed reluctant to take on the issue. "Why shouldn't we conclude that as an institution, we are not in a position to make the judgment you want us to make?" Justice David H. Souter asked attorney Kathryn L. Tucker. The Seattle lawyer had argued that Washington state's law against physician-assisted suicide violates the rights of dying patients who seek a doctor's help in dying in a "humane and dignified manner." The Justices are expected to rule on the matter before the term ends in late June or early July.

"Across the USA: California" USA Today (01/09/97) P. 6A A California judge has ruled that San Francisco's Cannabis Buyers' Club was not unlawful in providing marijuana to terminally ill patients. Dennis Peron, the founder of the club, says it will reopen next week.

"Science & Health Bulletin: Africa-Disease [Malaria, Ebola, and AIDS Pose Serious Threats) " PANA Wire Service (01/08/97); Kayaya, Musengwa Malaria, Ebola, and AIDS pose serious threats in Africa, warns David Satcher, director of the U.S. Centers for Disease Control and Prevention, in the most recent issue of "Washington Line," a State Department publication. The malaria threat is especially serious, he said, because the traditional cure is not effective. Africa has been the region hardest-hit by AIDS so far, but the disease is now spreading at the most dramatic rate in Southeast Asia and India, according to the World Health Organization. The agency estimates that 40 million people worldwide will be affected by AIDS by the year 2000.

"Florida Will Provide Protease Inhibitors to AIDS Patients" Reuters (01/08/97) Protease inhibitors will be made available to Florida's low-income HIV patients in April, under the state's AIDS Drug Assistance Program. Florida expanded the program after the ARMS Email System Page 3 of 4

federal government said that it would double its $13 million allocation to the state. Florida is one of the last states in the nation to make the drugs available through the program.

"Zambian AIDS Scourge Worries Policy Experts" Africa News Online (01/08/97) The loss of intellectual minds to AIDS is a growing concern in Zambia, as an increasing number of people involved in policy-making contract HIV. Some fear that the funds used to educate young people could be wasted if they die too young to use their training. The life expectancy in Zambia is expected to decrease from 51 to 45 by 2002, due to the spread of HIV.

"New AIDS Drugs Cut Death Rate Sharply, Data Show" Reuters (01/07/97) The death rate among AIDS patients in British Columbia has decreased dramatically due to the use of new AIDS drugs. The death rate dropped from 70 individuals per 1,000 in 1994 to 23 per 1,000 at the end of 1996, officials announced. The success is attributed to new combination therapies that include protease inhibitors.

"Collaboration Needed for HIV Vaccine Success" Journal of the American Medical Association (01/01/97) Vol. 277, No. 1, P. 9; Voelker, Rebecca Cooperation between government and private industry is critical to the ·development of a safe and effective vaccine against HIV, according to a report from the AIDS Vaccine Advocacy Coalition. Government leadership is the "key ingredient" needed to advance the effort, the report said. "We were surprised to learn that, in most cases, government is the engine that drives industry and that industry research depends on government financing, government leadership, and government support," noted Chris Collins, one of the report's authors. The research, titled "Industry Investment in HIV Vaccine Research," is based on interviews with HIV vaccine researchers at 23 pharmaceutical and biotechnology firms. In the study, some researchers blamed government bureaucracy and cumbersome regulations for blocking collaborations. The report calls for increased funding for HIV vaccine research at the National Institutes of Health, as well as targeted funding toward answering scientific questions that could point to the most promising approaches. Determining the best approaches and focusing research efforts there could spur private-sector investment, the authors concluded.

"Culture, Media, and HIV/AIDS in Asia" Lancet (01/04/97) Vol. 349, No. 9044, P. 52; Wolffers, Ivan Widespread HIV education is critical in Asia, where 42 percent of the world's estimated 40 million HIV-infected people are expected to live by the year 2000. HIV is most widely transmitted in Asia via heterosexual sex, but cultural constraints limit sex education in most Asian countries. In the past three years, researchers held a series of workshops in several Asian cities to evaluate the role of the media in HIV/AIDS awareness and education. The media was found to contribute to the public's misinformation about HIV prevention, in part by including the claim that HIV can only be transmitted through contaminated blood, or that HIV usually infects only injection drug users. The Asian culture, in which frank discussions of sex are taboo, was also found to pose a major ARMS Email System Page 4of4

problem for comprehensive HIV education. Dr. Ivan Wolffers of VU-University in the Netherlands analyzed the cultural factors and media influences blocking HIV education in Asia, and has concluded that the HIV epidemic requires societal change. Wolffers suggests that the media coordinate with grass-roots groups, politicians, and religious leaders to spark this difficult, yet critical, movement. ======ATTACHMENT 1 ======ATT CREATION TIME/DATE:lO-JAN-1997 12:19:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]>; Fri, 10 Jan 1997 12:19:15 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF V5.0-7 #6879) id <[email protected]>; Fri, 10 Jan 1997 12:19:09 -0700 (MST) Received: from aspensys by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id MAA14333; Fri, 10 Jan 1997 12:18:20 -0500 Received: from smtpinet.aspensys.com by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id JAA16347; Thu, 09 Jan 1997 09:47:37 -0500 Received: from ccMail by smtpinet.aspensys.com (SMTPLINK V2.ll.Ol) id AA852831933; Thu, 09 Jan 1997 09:39:28 -0500 (EST) Precedence: bulk X-Listprocessor-version: 8.1 -- ListProcessor(tm) by CREN ======END ATTACHMENT 1 ======ARMS Email System Page 1 of 4

RECORD TYPE: PRESIDENTIAL (EXTERNAL MAIL)

CREATOR: [email protected]@INET@EOPMRX

CREATION DATE/TIME: 5-FEB-1997 10:30:00.00

SUBJECT: CDC AIDS Daily Summary 02/05/97

TO: AIDSNews ( [email protected]@INET@EOPMRX ) READ:NOT READ

TO: mkarasik ( [email protected]@INET@EOPMR READ:NOT READ

TO: dalexis ( [email protected]@INET@EOPMRX READ:NOT READ

IND TO: Patsy Fleming FLEMING P (OPD) READ: 5-FEB-1997 10:47:11.16

IND_TO: Gordon P. Agress AG RESS G ( OMB) READ: 6-FEB-1997 10:34:43.38

TEXT: AIDS Daily Summary February 5, 1997

The CDC National Center for HIV, STD, and TB Prevention makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

****************************************************** "Text of President Clinton's State of the Union Message to Congress" "Reefer Madness--Redefined" "In the Loop: Probabilities and Possibilities" "Catholic Church Resists San Francisco's Gay Agenda" "Marijuana Law Loses Support in Arizona" "Personal Health" "Reliable Source: Now You Know" "HIV Prevention and Women" "Report Charges 'Cover-up' by Canada's Blood Overseers" "February 14th National Condom Day" ******************************************************

"Text of President Clinton's State of the Union Message to Congress" New York Times (02/05/97) P. A20 Among the proposals President Clinton presented in his State of the Union address on Tuesday night were those to advance medical science and the search for an AIDS vaccine. The president pointed out that federal funding for AIDS research has increased to $1.5 billion during his administration and said the National Institutes of Health will become a leader in the effort to produce an AIDS vaccine. ARMS Email System Page 2 of 4

"Reefer Madness--Redefined" Washington Post (02/05/97) P. A27; Brookhiser Richard Brookhiser, senior contributing editor at National Review, advocates the medical use of marijuana in a Washington Post commentary and admits to using it himself to deal with the nausea caused by his chemotherapy. He points out that the drug is also beneficial to AIDS patients battling wasting syndrome because it stimulates the appetite; he feels that it is helpful for other illnesses as well. Brookhiser notes that studies of the medical benefit of the drug are rare because the government has not approved them. Moreover, he contends that opposition to laws that allow the medical use of marijuana is unfair, because it makes it difficult for average citizens to acquire the drug but does not affect access for influential lawmakers.

"In the Loop: Probabilities and Possibilities" Washington Post (02/05/97) P. A25; Kamen, Al Among possible changes cited in the Clinton administration's second term, it has been suggested that David Satcher, director of the Centers for Disease Control and Prevention, may become assistant secretary for health at the Department of Health and Human Services.

"Catholic Church Resists San Francisco's Gay Agenda" Wall Street Journal (02/05/97) P. Al9; Davis, Mark W. Archbishop William J. Levada, leader of San Francisco's 200,000 Roman Catholics, is fighting a new policy that requires companies that receive city contracts to extend the same benefits to employees' domestic partners as they do to their spouses. Levada contends that religious groups should be exempted because the policy violates the church's moral code. One such group is Catholic Charities, a nonprofit organization that receives $5.6 million in city contracts and serves 70,000 people, including AIDS patients. "We are the largest provider of HIV housing and services on the West Coast," said organization spokesman Bob Nelson. San Francisco Mayor Willie Brown has said that if the organization does not comply with the new law, it should "relinquish its funding so that other nonprofits can do their work."

"Marijuana Law Loses Support in Arizona" USA Today (02/05/97) P. 3D; Manning, Anita Most Arizona voters think a new law allowing the medical use of marijuana and other controlled drugs should be changed or reversed, according to a survey of 404 voters. The survey, sponsored by Community Anti-Drug Coalitions of America, showed that 85 percent of the respondents said the law should at least be changed, and 71 percent said it should be repealed. Marijuana and other drugs should be tested and approved like other prescription drugs, 87 percent of respondents said. Also, 34 percent were against doctors prescribing marijuana at all, but 49 percent thought it should be allowed for terminally ill patients or those experiencing severe pain.

"Personal Health" New York Times (02/05/97) P. CB; Brody, Jane E. Advancements in bone marrow transplants have improved many patients' survival times, even in older and less healthy individuals. The number of bone marrow transplants conducted in the United States each year has increased from a few hundred in ARMS Email System Page 3of4

1980 to about 4,500 now. However, more bone marrow donors are needed to increase the number of transplants, since only about 30 percent of transplant candidates have a family member who can donate. To determine just how well bone marrow recipients fare, researchers studied 798 bone marrow recipients who survived a transplant for five or more years. Of that total, 21 died of recurring cancer, 11 died of chronic graft-versus host disease, eight died of a second cancer, and five died of AIDS which they contracted from transfusions that were performed before donor blood could be tested for HIV. The remaining 743 long-term survivors were generally in good health, the researchers reported in the Annals of Internal Medicine.

"Reliable Source: Now You Know" Washington Post (02/05/97) P. C3; Gerhart, Ann; Groer, Annie Elizabeth Taylor will undergo surgery on Feb. 17 to have a benign brain tumor removed. The actress decided to put off the operation until after her Feb. 16 birthday celebration/AIDS benefit in Hollywood.

"HIV Prevention and Women" AIDS Information Exchange (01/97) Vol. 13, No. 2, P. 1 Women represent a rapidly growing segment of the HIV-positive population, accounting for more than 78,000 of the 540,806 HIV cases reported in the United States by the Centers for Disease Control and Prevention as of June 1996. Furthermore, according to estimates by the World Health Organization, the number of women with HIV worldwide will equal the number of infected men by 2000. Women accounted for 19 percent of all new adult and adolescent AIDS cases in 1995, up from 7 percent in 1985. Moreover, of the U.S. women diagnosed with AIDS in 1995, nearly 76 percent were African American or Hispanic; AIDS is the leading cause of death for African American women aged 15 to 44. Effective HIV prevention strategies for women must focus on interventions that will result in changed behavior. Empowerment can help women protect themselves from HIV and sexually transmitted diseases by giving them the tools to negotiate safer sex. Still, a variety of factors, including substance abuse, domestic violence, financial dependence, access to health care, sexual abuse, and race may affect a woman's ability to adopt safer behaviors.

"Report Charges 'Cover-up' by Canada's Blood Overseers" Lancet (02/01/97) Vol. 349, No. 9048, P. 336; Kondro, Wayne Transcripts and audiotapes of meetings of the Canadian Blood Committee held during Canada's tainted blood scandal were destroyed to protect governments and the Red Cross from public scrutiny and responsibility, according to Information Commissioner John Grace. In a report released on Jan. 22, Grace claimed that the material was destroyed two weeks after a reporter requested the documents. Grace contends that Jo Hauser, former Committee executive director, proposed the destruction of the records, which occurred at the "direction" of Committee board members. The Committee was responsible for Canada's blood system and Red Cross funding during the 1980s, when some 1,200 Canadians were infected with HIV through tainted blood and blood products.

"February 14th National Condom Day" American Health (01/97-02/97) Vol. 16, No. 1, P. 16 Valentine's Day, February 14th, is also National Condom Day. ARMS Email System Page 4of4

The Centers for Disease Control and Prevention's National STD Hotline, run by the American Social Health Association, can be reached by calling 1-800-227-8922. It offers information on using condoms to prevent the transmission of sexually transmitted diseases.

======ATTACHMENT 1 ======ATT CREATION TIME/DATE: 5-FEB-1997 10:30:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]>; Wed, 05 Feb 1997 10:30:32 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF V5.0-7 #6879) id <[email protected]>; Wed, 05 Feb 1997 10:30:30 -0700 (MST) Received: from aspensys by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id KAA19841; Wed, 05 Feb 1997 10:29:18 -0500 Received: from smtpinet.aspensys.com by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id JAA18572; Wed, 05 Feb 1997 09:58:39 -0500 Received: from ccMail by smtpinet.aspensys.com (SMTPLINK V2.ll.Ol) id AA855165264; Wed, 05 Feb 1997 09:35:47 -0500 (EST) Precedence: bulk X-Listprocessor-version: 8.1 -- ListProcessor(tm) by CREN ======END ATTACHMENT 1 ======ARMS Email System Page 1 of 4

RECORD TYPE: PRESIDENTIAL (EXTERNAL MAIL)

CREATOR: [email protected]@INET@EOPMRX

CREATION DATE/TIME:l2-FEB-1997 17:11:00.00

SUBJECT: CDC AIDS Daily Summary 02/12/97

TO: AIDSNews ( [email protected]@INET@EOPMRX ) READ:NOT READ

TO: mkarasik ( [email protected]@INET@EOPMR READ:NOT READ

TO: dalexis ( [email protected]@INET@EOPMRX READ:NOT READ

IND_TO: Patsy Fleming FLEMING P (OPD) READ:l3-FEB-1997 10:35:00.95

TEXT: AIDS Daily Summary February 12, 1997

The CDC National Center for HIV, STD, and TB Prevention makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD

****************************************************** "Family Planning and Foreign Policy Are Linked, Albright Tells House Panel" "Nationline: Fla. AIDS Patient Loses Right to Assisted Suicide" "Spread of HIV Hits Young" "Providing Access to Research Focus for Relocated AIDS Center" "Health Ministers' Inaction May Delay New Blood System" "UPI Science News: [Safe-Sex Strategies Studied at Meeting]" "Zimbabwe Takes Measures Against AIDS" "HIV Home Test Kits: Heavy Use By At-Risk Groups" "Preventing STDs and Pregnancy" "Sex Trading and Psychological Distress Among Women Recruited >From the Streets of Harlem" ******************************************************

"Family Planning and Foreign Policy Are Linked, Albright Tells House Panel" Washington Post (02/12/97) P. A20; Seelye, Katharine Q. Family planning is an important part of the United States' foreign policy, Secretary of State Madeleine K. Albright told a House committee Tuesday, urging members to support the Clinton Administration's plan and prompt the release of foreign family planning funds. The House is slated to vote on the measure on Thursday, as well as on an alternative that would prevent U.S. aid from supporting groups that perform abortions even if they use private money for that purpose. Anti-abortion groups have criticized the family planning programs, saying that they help support abortions worldwide. The administration's plan would ARMS Email System Page 2of4

release $215 million starting March l, but the amount would be reduced to $92 million if delayed until July. Dr. Inga I. Grebshva, director general of the Russian Association of Family Planning in Moscow, said Russia hoped family planning would help rebuild the population by preventing the spread of sexually transmitted diseases and reducing the need for abortions.

"Nationline: Fla. AIDS Patient Loses Right to Assisted Suicide" USA Today (02/12/97) P. 3A Charles Hall, the Florida AIDS patient who had won the right to physician-assisted suicide in a Jan. 31 ruling, lost that right when the state Supreme Court reinstated a stay in his legal case on Tuesday. The state had obtained a stay of the original ruling, which was then lifted. The Florida Supreme Court is scheduled to hear the case on May 9. Hall's lawyer notes that while his client was not planning to commit suicide immediately, he is experiencing persistent pain and is in a "pretty bleak" condition.

"Spread of HIV Hits Young" Toronto Globe and Mail (02/11/97) P. Al; Immen, Wallace Health officials in Canada report that HIV seems to be spreading at an increasing rate in the country, especially among drug users and young people, who officials say are ignoring warnings about risky behaviors. When the epidemic first hit Canada in the early 1980s, the median age at infection was 32. It has now dropped to 23, reflecting the large number of people who were infected as teenagers and are now testing HIV positive. Among older Canadians, the rate of new infections has decreased dramatically, apparently because they are taking proper precautions, reported Dr. Donald Sutherland, of Health Canada's Laboratory Center of Disease Control. Young people are more willing to take risks because they are not as aware of the consequences involved, Sutherland said. "If we are going to prevent new infections, we will have to aim at a much younger population," he noted.

"Providing Access to Research Focus for Relocated AIDS Center" Houston Chronicle (02/11/97) P. 18A; Zuniga, Jo Ann Houston's Center for AIDS, aiming to provide AIDS patients and caregivers with the most recent research and treatment information, will reopen Friday at its new, larger location. Michael Peranteau, who is HIV-positive and one of the center's three founders, said the center will help patients take control of their treatment. The Center for AIDS was established in 1995 because, "at the time there were lots of different prevention information available, but not much on treatment. And because so much of it is fast-breaking, not many people have the time or resources to read, clip, and collect," Peranteau said. The center will publish a weekly newsletter which will be sent to doctors, researchers, AIDS patients, and caregivers.

"Health Ministers' Inaction May Delay New Blood System" Toronto Globe and Mail (02/11/97) P. A6; Mcilroy, Anne Canada's health ministers announced Monday that they are delaying their decision about the Canadian Red Cross' role in a new blood system until after the final report on the tainted blood tragedy is released. The report is due on April 30, leading to speculation that the September deadline for the new blood system will not be met. "This is a serious delay in the ARMS Email System Page 3of4

implementation of the new system. I think it shows a lack of political will. There was nothing to stop them from making the hard decisions now," said Durhane Wong-Rieger, president of the Canadian Hemophilia Society.

"UPI Science News: [Safe-Sex Strategies Studied at Meeting]" United Press International (02/11/97) Researchers attending a meeting sponsored by the National Institutes of Health are evaluating safer sex programs and HIV prevention efforts, aiming to reach a consensus of the most effective strategies. Participants at the three-day meeting in Maryland will debate the best methods of intervention to reduce risky behavior. The group, hoping to develop a course of action to implement the most effective strategies, will report its conclusions Thursday afternoon.

"Zimbabwe Takes Measures Against AIDS" Xinhua News Agency (02/11/97) In an effort to increase HIV prevention, Zimbabwe will import 5 million male condoms and 420,000 female condoms for public distribution this year, the National AIDS Coordination Program Coordinator announced. The Zimbabwean government approved the female condom last year, in response to pressure from women's groups. The World Health Organization recently reported that the female condom had no side effects.

"HIV Home Test Kits: Heavy Use by At-Risk Groups" Reuters (02/11/97) Home HIV test kits are being used by those at high risk for HIV infection, according to an article in the February issue of AIDS Alert. "We have had great response among African Americans, Hispanics, and gay men ... a mirror of the groups hit hardest by the epidemic," said Arisa Cunningham, director of marketing at Direct Access Diagnostics, maker of Confide. Dr. Bernard Branson of the Centers for Disease Control and Prevention reported that the counselors employed by the test makers get "good marks." He also said that about 1 to 1.5 percent of the blood samples that have been tested are positive, a rate somewhat higher than was expected.

"Preventing STDs and Pregnancy" American Medical News (02/03/97) Vol. 40, No. 5, P. 12 Sexually transmitted diseases (STDs) are causing a "hidden epidemic," a recent Institute of Medicine report concluded, both because people are reluctant to discuss them and because many STDs are asymptomatic and difficult to diagnose. Most of the 12 million Americans infected with an STD are not aware of it. Moreover, the IOM panel said, most STD prevention efforts are inadequate and have been poorly funded. A Kaiser Family Foundation survey found that over 10 percent of American adults cannot name one STD, one in five think all STDs are incurable, and more than half are unaware that having an STD increases the risk of contracting HIV. The IOM report also said that many heterosexually transmitted HIV infections could be prevented by reducing other STDs. To combat the spread of STD, health officials are calling for more behavioral and community-based interventions, said Dr. Helene Gayle, director of the CDC's National Center for HIV, STD, and TB. The agency, she explained, is "strengthening [its] partnerships at all levels of the public sector and developing greater collaboration with academia, ARMS Email System Page 4of4

community-based organizations, and other members of the private sector." Use of effective contraceptives plays a key role in disease prevention. Although correct and consistent use of latex condoms is the most effective method -- excluding abstinence -­ condom use requires male cooperation and consent, which can be difficult to obtain. There is, therefore, a great need for female-controlled prevention methods, particularly those that offer protection against both unwanted pregnancy and STDs.

"Sex Trading and Psychological Distress Among Women Recruited >From the Streets of Harlem" American Journal of Public Health (01/97) Vol. 87, No. 1, P. 66; El-Bassel, Nabila; Schilling, Robert F.; Irwin, Kathleen L.; et al. Studies have suggested that the relationship between sex trading and psychological distress could have implications for effective HIV prevention. To better understand this link, Columbia University's Nabila El-Bassel and colleagues interviewed 346 young, drug-using women from the streets of Harlem, 176 of whom were categorized as "sex traders." The women identified as sex traders, those who reported having exchanged sex for money or drugs in the previous 30 days, scored significantly higher on the General Severity Index -- a weighted measurement of distress that combines the number of symptoms and the intensity of perceived distress -- than non sex-traders. They also scored higher on eight of the nine subscales of the Brief Symptom Inventory, another test for psychological distress. The researchers concluded that poor mental health and drug dependence may weaken the motivation and the ability of sex traders to practice safe sex. They suggest that disease prevention programs should be integrated with mental health services and drug treatment to reduce risk behavior in this population.

======ATTACHMENT 1 ======ATT CREATION TIME/DATE:l2-FEB-1997 17:12:00.00

ATT BODYPART TYPE:D

TEXT: RFC-822-headers: Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]>; Wed, 12 Feb 1997 17:11:30 -0400 (EDT) Received: from aspen3.aspensys.com (aspensys3.aspensys.com) by STORM.EOP.GOV (PMDF VS.0-7 #6879) id <[email protected]>; Wed, 12 Feb 1997 17:11:25 -0700 (MST) Received: from aspensys by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id RAA05572; Wed, 12 Feb 1997 17:07:17 -0500 Received: from smtpinet.aspensys.com by aspen3.aspensys.com (SMI-8.6/SMI-SVR4) id JAA24426; Wed, 12 Feb 1997 09:37:51 -0500 Received: from ccMail by smtpinet.aspensys.com (SMTPLINK V2.ll.Ol) id AA855768859; Wed, 12 Feb 1997 09:41:02 -0500 (EST) Precedence: bulk X-Listprocessor-version: 8.1 -- ListProcessor(tm) by CREN ======END ATTACHMENT 1 ======ARMS Email System Page I of 3

RECORD TYPE: PRESIDENTIAL (NOTES MAIL)

CREATOR: Richard Socarides ( CN=Richard Socarides/OU=WHO/O=EOP [ WHO ] )

CREATION DATE/TIME: 8-APR-1997 10:08:26.00

SUBJECT: Thurman A Strong Choice To Lead Office of National AIDS Poli

TO: Sylvia M. Mathews ( CN=Sylvia M. Mathews/OU=WHO/O=EOP @ EOP [ WHO ] READ:UNKNOWN

TO: Maria Echaveste ( CN=Maria Echaveste/OU=WHO/O=EOP @ EOP [ WHO ] ) READ:UNKNOWN

TO: Elena Kagan ( CN=Elena Kagan/OU=OPD/O=EOP @ EOP [ OPD ] ) READ:UNKNOWN

TO: Bruce N. Reed ( CN=Bruce N. Reed/OU=OPD/O=EOP@ EOP [ OPD ] ) READ:UNKNOWN

TEXT: FYI ------Forwarded by Richard Socarides/WHO/EOP on 04/08/97 10:06 AM ------

Doug.Case @ sdsu.edu 04/07/97 08:49:00 PM Record Type: Record

To: Richard Socarides cc: Subject: Thurman A Strong Choice To Lead Office of National AIDS Poli

NEWS from the Human Rights Campaign

1101 14th Street NW Washington, DC 20005 email: [email protected] WWW: http://www.hrc.org

FOR IMMEDIATE RELEASE Monday, April 7, 1997

THURMAN A STRONG CHOICE TO LEAD OFFICE OF NATIONAL AIDS POLICY, HRC SAYS

Combines Leadership Skill~, Commitment, Access

WASHINGTON The Human Rights Campaign commended the selection today of Sandra L. Thurman as the new White House "AIDS czar." ARMS Email System Page 2of3

"Sandra Thurman is a solid choice to take the Office of National AIDS Policy to the next level," said Elizabeth Birch, HRC's executive director. "She brings the right mix of leadership, political skills and commitment to the fight against HIV and AIDS."

Winnie Stachelberg, HRC's legislative director, said Thurman has the experience to design and execute the administration's programs in the changing struggle to end the HIV/AIDS epidemic.

"Thurman was intricately involved in the creation and enactment of the Ryan White CARE Act in 1990 and its reauthorization in 1995," said Stachelberg, who is a member of the executive committee of the umbrella group National Organizations Responding to AIDS. "She knows AIDS policy and politics from the inside--a critical combination of skills for this job."

Thurman becomes the third person to hold the position known informally as the national AIDS czar. She replaces Patsy Fleming, who stepped down after President Clinton's re-election.

Thurman, a native of Atlanta, is past executive director of AID Atlanta, the Southeast's first and largest AIDS service provider. Under her stewardship, AID Atlanta tripled in size, becoming a multimillion-dollar direct service agency with 90 staffers and more than 1,000 volunteers, serving thousands of individuals and families with HIV and AIDS.

Most recently, Thurman was a White House appointee to the U.S. Information Agency, responsible for cultural and professional exchange programs.

Thurman has a history of political and public service. In 1996, she held a variety of positions with the Democratic National Committee and the Clinton-Gore re-election campaign.

From 1993 to 1996, Thurman was director of advocacy programs at the Task Force for Child Survival and Development in Atlanta. The task force is sponsored by such respected organizations as UNICEF, the World Health Organization and the Rockefeller Foundation.

Thurman's AIDS-related activities include serving on the Presidential Advisory Council on HIV/AIDS; on the Georgia State AIDS Task Force; the Fulton County HIV Planning Council; and the executive committee of Cities Advocating Emergency AIDS Relief. In addition, she has served on the board of directors of the National Episcopal AIDS Coalition, Sisterlove Inc. and the Atlanta AIDS Interfaith Network. In 1995, Thurman testified ARMS Email System Page 3of3

before Congress with Elizabeth Taylor on federal AIDS programs and priorities.

Before joining AID Atlanta in 1988, Thurman was public affairs director for AmeriPlan Health Services, Georgia's largest health maintenance organization, and as a job placement specialist working with ex-offenders at the Georgia Department of Labor, Correctional Services Division. She holds a bachelor's degree in human resources administration and management from Mercer University in Georgia.

The Human Rights Campaign is the largest national lesbian and gay political organization, with members throughout the country. It effectively lobbies Congress, provides campaign support and educates the public to ensure that lesbian and gay Americans can be open, honest and safe at home, at work and in the community.

- 30 -

======ATTACHMENT 1 ======ATT CREATION TIME/DATE: 0 00:00:00.00

TEXT: RFC-822-headers: Received: from conversion.pmdf.eop.gov by PMDF.EOP.GOV (PMDF VS.0-4 #6879) id <[email protected]> for socarides [email protected]; Mon, 07 Apr 1997 20:50:56 -0400 (EDT) Received: from storm.eop.gov (storm.eop.gov) by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]> for [email protected]; Mon, 07 Apr 1997 20:50:55 -0400 (EDT) Received: from mail.sdsu.edu ( [130.191.25.3]) by STORM.EOP.GOV (PMDF V5.l-7 #6879) with ESMTP id <[email protected]> for [email protected]; Mon, 07 Apr 1997 20:50:36 -0400 (EDT) Received: from [130.191.242.121] ( [130.191.242.121]) by mail.sdsu.edu (8.8.4/8.8.4) with ESMTP id RAA18899; Mon, 07 Apr 1997 17:45:30 -0700 (PDT) X-Sender: [email protected] ======END ATTACHMENT 1 ======ARMS Email System Page 1 of I

RECORD TYPE: PRESIDENTIAL (NOTES MAIL)

CREATOR: Laura L. Efros ( CN=Laura L. Efros/OU=OSTP/O=EOP [ OSTP ]

CREATION DATE/TIME:l6-MAY-1997 11:31:25.00

SUBJECT: Re: Communique

TO: Sherman G. Boone ( CN=Sherman G. Boone/OU=OPD/O=EOP @ EOP [ OPD ] READ:UNKNOWN

TEXT: Sherman,

This is a draft (i.e. uncleared) version of the EID paragraph. The French comment is definitely out. If you can't reach me this afternoon, I'll be in tomorrow (unfortunately!)

Laura

Emerging Infectious Diseases

Infectious diseases, such as drug-resistant tuberculosis, malaria, and HIV/AIDS, pose a significant challenges to the health, security, and financial resources of the global community. In many parts of the world, infectious diseases and deaths from infectious disease have risen sharply in the last decade for a variety of reasons, including from the evolution emergence of drug-resistant microbes and to the increased and rapid movement of people and products around the world. In the coming year, our governments will plan for promote more effective coordination of international responses to outbreaks, promote the development of develop a global surveillance network, and help to build medical and institutional capacity to prevent, detect and control infectious diseases globally. Central to this work will be strengthening and linking existing activities in and among each of our countries, and in other fora, especially the World Health Organization (WHO) . ARMS Email System Page I of I

RECORD TYPE: PRESIDENTIAL (NOTES MAIL)

CREATOR: Laura L. Efros ( CN=Laura L. Efros/OU=OSTP/O=EOP [ OSTP ] )

CREATION DATE/TIME:22-MAY-1997 17:02:26.00

SUBJECT: Re: Denver Summit communique language re: emerging infectious diseases

TO: Sherman G. Boone ( CN=Sherman G. Boone/OU=OPD/O=EOP @ EOP [ OPD ] READ:UNKNOWN

TEXT: Sherman,

Here's the revised text. I will also fax you the Morgan State speech that mentioned the AIDS vaccine.

Laura

Emerging Infectious Diseases

Infectious diseases, such as drug-resistant tuberculosis, malaria, and HIV/AIDS, pose significant challenges to the health, security, and financial resources of the global community. In many parts of the world, infectious diseases and deaths from infectious disease have risen sharply in the last decade for a variety of reasons, including the emergence of drug-resistant microbes and the increased movement of people and products. In the coming year, our governments will promote more effective coordination of international responses to outbreaks; promote development of a global surveillance network; and help to build medical and institutional capacity to prevent, detect and control infectious diseases globally, including efforts to explore the use of regional stocks of essential vaccines, therapeutics, diagnostics and other materials.

Central to this work will be strengthening and linking existing activities in and among each of our countries, and in other fora, especially the World Health Organization (WHO) . We support the efforts of the WHO and endorse the recent World Health Assembly resolutions regarding the quality of biological and the certification of pharmaceutical products. ARMS Email System Page I of I

RECORD TYPE: PRESIDENTIAL (NOTES MAIL)

CREATOR: Laura L. Efros ( CN=Laura L. Efros/OU=OSTP/O=EOP [ OSTP ]

CREATION DATE/TIME:29-MAY-1997 09:41:58.00

SUBJECT: Denver Summit Communique Language

TO: Sherman G. Boone ( CN=Sherman G. Boone/OU=OPD/O=EOP @ EOP [ OPD ] READ:UNKNOWN

TEXT: Emerging Infectious Diseases

Infectious diseases, such as drug-resistant tuberculosis, malaria, and HIV/AIDS, are the worldD ,s leading cause of death and, thus, pose significant challenges to the health, security, and financial resources of the global community. In many parts of the world, infectious diseases and deaths from infectious disease have risen sharply in the last decade for a variety of reasons, including the emergence of drug-resistant microbes and the increased movement of people and products around the world. In the coming year, our governments will promote more effective coordination of international responses to outbreaks; promote the development of a global surveillance network, building upon existing national and regional surveillance systems; and help to build medical and institutional capacity to prevent, detect and control infectious diseases globally, including efforts to explore the use of regional stocks of essential vaccines, therapeutics, diagnostics and other materials.

Central to this work will be strengthening and linking existing activities in and among each of our countries, and in other fora, especially the World Health Organization (WHO) . We support the efforts of the WHO and endorse the recent World Health Assembly resolutions regarding the quality of biological and pharmaceutical products.

Rationale: On the question of enhancing research, we deferred to the Germans and removed the reference you agreed to at the sherpa meeting. Our intention is to focus the EID initiative on operational issues in which the Eight can add value. While we strongly support EID research in general, we feel that the addition of language on enhancing research dilutes the Denver Summit initiative. Furthermore, the U.S. has demonstrated its commitment to disease research by tabling the HIV/AIDS vaccine initiative.

In response to the French reference to D&availability of international standard products,Da we substituted our references to regional stocks of essential materials and to the World Health Assembly resolutions on the quality of biological and pharmaceutical products. We strongly object to the phrase D&international standard products,Da which implies the use of specific standards rather than the broad guidelines agreed to at the May 1997 World Health Assembly. Clinton Presidential Records Automated Records Management System [EMAIL] and Tape Restoration Project [Email]

This is not a presidential record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff.

This marker identifies a responsive email, already made available within another FOIA request.

FOIA: 2007-1550-F

Bucket: OPD

Creation Date: 1997-10-16

Subject: World AIDS Day Activities

Creator: Sandra Thurman CN=Sandra Thurman/OU=OPD/O=EOP [ OPD] ARMS Email System Page 1 of 1

RECORD TYPE: PRESIDENTIAL (NOTES MAIL)

CREATOR: Paul J. Yandura ( CN=Paul J. Yandura/OU=OPD/O=EOP [ OPD )

CREATION DATE/TIME:28-0CT-1997 15:18:30.00

SUBJECT: World AIDS Day request.

TO: Capricia P. Marshall ( CN=Capricia P. Marshall/OU=WHO/O=EOP @ EOP [ WHO ) READ:UNKNOWN

TO: Virginia Apuzzo ( CN=Virginia Apuzzo/OU=WHO/O=EOP @ EOP [ WHO ) READ:UNKNOWN

CC: Sandra Thurman ( CN=Sandra Thurman/OU=OPD/O=EOP @ EOP [ OPD ) READ:UNKNOWN

Paul J. Yandura ( CN=Paul J. Yandura/OU=OPD/O=EOP [ OPD ) READ:UNKNOWN

C. Wayne Skinner ( CN=C. Wayne Skinner/OU=WHO/O=EOP [ WHO ) ) READ:UNKNOWN

TEXT: I am coordinating the Administration's response to World AIDS Day through the Office of National AIDS Policy. As you may know, World AIDS Day is Monday, December 1st. The theme this year is "Give Children Hope in a World with AIDS". We are still in the preliminary planning stages and remain unsure as to what the day will ultimately look like, but, I was hoping you could help expedite a couple of specific requests:

1. As in years past, The American Association of World Health asks that the White House dim its lights (exterior) for fifteen minutes from 7:45 to 8:00 p.m. (EST) to commemorate World AIDS Day and to offer a tribute to those infected and affected by HIV/AIDS and as a visual demonstration expressing our commitment to stop the spread of HIV/AIDS.

In the past, as I understand, the White House Head Ushers Office has granted the request.

2. Also in the past, panels of the AIDS Memorial Quilt have been hung outside the OEOB. This year we would like to hang them inside the Residence (on quilt stands provided) in the East Wing, East Colonnade so that visitors could view them as they enter for the public tour.

Any help or guidance that you could provide would be greatly appreciated. ARMS Email System Page I of I

RECORD TYPE: PRESIDENTIAL (NOTES MAIL)

CREATOR: Paul J. Yandura ( CN=Paul J. Yandura/OU=OPD/O=EOP [ OPD ]

CREATION DATE/TIME:30-0CT-1997 14:22:43.00

SUBJECT: World AIDS Day Radio Address

TO: Sandra Thurman CN=Sandra Thurman/OU=OPD/O=EOP @ EOP [ OPD ] READ:UNKNOWN

Paul J. Yandura ( CN=Paul J. Yandura/OU=OPD/O=EOP [ OPD ] READ:UNKNOWN

TEXT:

Ok heres the game plan.

1. You need to email Bruce to get his concurrence so that we can than send the scheduling request to Maria and Craig.

2. After Bruce concurs we can send the scheduling request and a note from you through email.

3. After we get Maria and Craig to concur we need to send it to Ann and Stacie.

If you need help attaching the scheduling request let me know. Also, please be sure to blind cc me so I know where we are in the process.

TALKING POINTS:

World AIDS Day is sponsored by the World Health Organization.

The 1997 World AIDS Day theme is "Give Children Hope in a World with AIDS".

It serves as an annual reminder to strengthen the global effort to face the challenges of the AIDS pandemic.

It is designed to encourage public support for programs to prevent the spread of HIV infection and to provide education and awareness of issues surrounding HIV/AIDS.

======ATTACHMENT 1 ======ATT CREATION TIME/DATE: 0 00:00:00.00

TEXT: Unable to convert ARMS EXT: [ATTACH.D17]MAIL434925202.316 to ASCII, The following is a HEX DUMP:

FF57504310050000010A020100000002050000001A160000000200004DC189BE19A59647A7E3FA DECCOB2DOAA163AD6Fl8307EODOB69F9656CCA793B7703B5495D4A6F97A6FOOA68F69B9D5B5776 SCHEDULING REQUEST PROPOSAL Date: 10/30/97

_ACCEPT _REJECT PENDING

TO: Ann Lewis, Assistant to the President and Director of Communications

FROM: Bruce Reed, Assistant to the President for Domestic Policy Sandra L. Thurman, Director, Office of National AIDS Policy

REQUEST: Radio Address

PURPOSE: Commemoration of World AIDS Day

BACKGROUND: World AIDS Day is sponsored by the World Health Organization and was first observed on December 1, 1988. It serves as an annual reminder to strengthen the global effort to face the challenges of the AIDS pandemic, which continues to spread in all regions of the world. This organized effort is designed to encourage public support for programs to prevent the spread of HIV infection and to provide education and awareness of issues surrounding HIV/AIDS. The 1997 World AIDS Day theme, "Give Children Hope in a World with AIDS," challenges people around the world to contemplate the long-term repercussions of the AIDS pandemic, and not lose sight that AIDS affects everyone.

PREVIOUS PARTICIPATION: In 1993 the President spoke at Georgetown University. In 1994 the Office of National AIDS Policy arranged an Oval Office meeting with the President and HIV+ youth. In 1995 a Presidential video message was produced and the historic White House Conference on HIV I AIDS was held. In 1996 the President met with NIH, CDC and HHS representatives for a scientific research briefing in the Oval Office. Additionally, a Presidential Proclamation has been released every year.

DATE&TIME: Saturday, November 29, 1997 {World AIDS DAY is December 1, 1997)

DURATION: 30 minutes

Automated Records Management System Hex-Dump Conversion LOCATION: Roosevelt Room

PARTICIPANTS: The President Sandra Thurman, Director, Office of National AIDS Policy National AIDS Service Organization Executive Directors

OUTLINE OF EVENTS: Briefing on HIV/AIDS issues by Ms.Thurman fifteen minutes before radio address. President and Ms.Thurman enter Roosevelt Room. Introductions of Executive Directors and other guests. Ms. Thurman makes brief remarks and introduces the President. Brief remarks by the President. Radio Address. President exits.

REMARKS: Brief introductory remarks.

MEDIA: White House Photo only.

FIRST LADY: No.

VICE PRESIDENT: No.

RECOMMENDED BY: Bruce Reed and Sandra Thurman

CONTACT: Sandra Thurman or Paul Yandura (202) 632-1090

n y.mdura\wnrlddid\<;Ched rqs1