Optimism but no end in sight after HIV vaccine trial

Injecting drug users rehabilitation at Tien Lang-Hai Phong. There was cautious optimism in Vietnam last month when a trial HIV vaccine in Thailand appeared to provide some protection against the deadly virus.

Vietnam country director of UNAIDS Eamonn Murphy said he and his Vietnamese colleagues were confident that a fully effective vaccine could be developed in the future. However, he qualified that optimism: “I do not see an end in sight.” Released on September 24, the results of the three year trial found that the chances of catching HIV, a retrovirus that causes AIDS, were 31.2 percent less for those who had taken the vaccine. Among the heterosexual Thai volunteers, 74 people who did not get the vaccine were infected, compared to 51 percent of the vaccinated group infected. “Ultimately we still need to rely on comprehensive HIV prevention,” Murphy said. Improvements The trial was the first time in the virus’s 28 year history that a potential vaccine had shown any efficacy but the call for celebration was only momentary, as the limited effectiveness of the vaccine was a sobering reminder of the need for vigilance. "The numbers are small and the difference may have been due to chance, but this finding is the first positive news in the AIDS vaccine field for a decade," said Dr. Richard Horton, editor of the Lancet medical journal in a BBC report. Michel Sidibé, Executive Director of the Joint United Nations Program on HIV/AIDS (UNAIDS), said governments and stakeholders should “prepare today for tomorrow” when a vaccine becomes available. “We must not allow cost to deter people from access to a vaccine.” Sidibé also asked civil society to keep breaking down the social barriers to vaccine uptake. Murphy added that it was too early to talk about introducing a vaccine and many more studies needed to be done. “We have seen improvement in prevention in Vietnam and that’s what we need to focus on.” There were major challenges ahead, Sidibé said in a statement, adding that less than half the people who need treatment have access and a lot has to be done to strengthen HIV health services and make antiviral drugs and a vaccine - when it comes - affordable for everyone. Talking of those challenges, Murphy said there was a long way to go reducing stigma and discrimination in Vietnam before high risk individuals would access a vaccine. He added that governments should provide more funding to find a vaccine. Epidemic figures Murphy said official figures showed that at the end of March 2009, more than 42,000 people “that we are aware of” had died in Vietnam from HIV or AIDS related illnesses. “But this figure is probably too low because many people would not want to identify that their family members have died of AIDS due to the stigma and discrimination associated with this,” he said. “The challenge in Vietnam is that the epidemic is concentrated among groups like injecting drug users, sex workers and their partners and men who have sex with men (MSM) and you can not identify people easily in communities who may be at risk.” UNAIDS figures on the epidemic show that 30,996 people are currently living with AIDS in Vietnam and 243,000 have HIV. Every province is affected with concentrations in high risk groups in the cities. One rehab for drug addicts in HCMC reported that two-thirds of their clients were positive for the virus while an NGO working in the central provinces said one third of injecting drug users there tested positive. Between 2003 and 2006 more than 16,000 Thais from the provinces of Chonburi and Rayong volunteered to take part in the trial, which was run jointly by the Thai government and US military. The researchers tried a combination of two vaccines, ALVAC and AIDSVAX, each of which on their own had previously not worked. Reported by Michael Smith

Southern hub to test milk after children hospitalized

Ho Chi Minh City’s health department will test batches of milk suspected of sending five local children to the hospital over the past week, the local inspectorate said on Tuesday.

However, very little is known about when the inspection, proposed by HCMC’s Children’s Hospital No.2, will start. According to a report made by the hospital to the department and the city’s Preventive Health Center, from October 13-19 it admitted five children with rashes, swollen eyelids, purple lips, tiredness and respiratory difficulties. The children, who come from different districts, were all found to have consumed Vivinal GOS milk by Dutch Lady Vietnam ten minutes before developing the symptoms. Reported by Thanh Tung

Senate May Seek Greater U.S. Carbon Cuts Than House

Sept. 29 (Bloomberg) -- A Senate measure to slow global warming calls on U.S. power plants, factories and refineries to reduce greenhouse-gas emissions by 20 percent through 2020, a deeper cut than approved by the House, according to a draft.

The target is part of legislation prepared by the Senate Environment and Public Works Committee staff for release tomorrow, said a person familiar with the process who asked not to be identified before then.

Exxon Mobil Corp., the largest U.S. energy company, along with American Electric Power Co., the nation’s biggest producer of power from coal and thousands of polluters for the first time would be forced to have permits to release gases blamed for climate change. The draft doesn’t say how many free allowances, worth billions of dollars, would be granted to the companies.

“I’m surprised they didn’t mock out an allocation scheme,” said Michael McKenna, president of MWR Strategies, a Washington energy consulting firm, in an interview. The draft “is really more of a shell than anything else.”

Allocating free permits, which sparked weeks of debate in the House, would function as an economic “stimulus” to companies that receive the most, said Kevin Book, the managing director for energy analysts ClearView Energy Partners LLC.

“As long as we’re still losing jobs, there’s room for this bill to be a stimulus package,” Book said in an interview from Washington. “It’s monetary policy pure and simple: You create a new currency and then you start giving it away.”

Carbon Price Falls

Carbon permits for December in the European Union, operator of the world’s largest greenhouse-gas exchange, fell 3 percent to 13.10 euros on London’s European Climate Exchange.

Both versions of the climate legislation use 2005 as a base year for carbon-emission cuts, with the House measure approved in June mandating a 17 percent reduction in the 15-year period.

The Senate bill would cap emissions and allow trading in permits in a plan similar to the cap-and-trade system approved by the House. In the first year of trading in 2012, greenhouse gases would be capped at 6.6 billion tons, according to the draft. By lowering that figure over time, total emissions would be reduced.

In quarterly auctions starting in 2012, bids must be at $10 per ton of emissions or higher, and no buyer could purchase more than 5 percent of permits offered in any single auction, under the draft measure.

Allowances issued by states that already have established cap-and-trade programs may be exchanged for use in the federal program, under the proposal. The U.S. Commodity Futures Trading Commission would regulate the carbon market.

The bill has a 60 percent chance of being approved by the Senate this year, Book said.

E.ON, RWE Rise as Merkel Win May Extend Nuclear Life (Update2)

Sept. 28 (Bloomberg) -- E.ON AG and RWE AG, Germany’s biggest utilities, jumped in Frankfurt trading on speculation Chancellor Angela Merkel’s favored coalition government will scrap a law to phase out nuclear power in the country.

E.ON climbed 4.5 percent to 29.48 euros, while RWE advanced 4.2 percent to 64.80 euros. EnBW Energie Baden-Wuerttemberg AG, the country’s third-largest utility, gained 2.5 percent to 41 euros in Frankfurt trading.

Merkel’s Christian Democrats and the Free Democrats, her preferred allies, won enough votes to form a government in yesterday’s elections. Merkel may abolish a law that required Germany’s 17 nuclear plants to shut by 2021 after the Social Democrats thwarted earlier attempts to repeal the legislation.

“This is a very positive outcome for E.ON and RWE given that nuclear life extensions should become a reality in Germany,” Peter Crampton and Per Lekander, analysts at UBS AG, said today in a note to investors.

Merkel’s Christian Democrats and their Bavarian sister party, the Christian Social Union, won almost 34 percent in elections to the lower house of parliament, according to provisional results. The Free Democrats won almost 15 percent.

Support for the Social Democrats, or SPD, Merkel’s previous coalition partner, fell by about 11 percentage points from 2005, the biggest drop for any party in postwar history. The SPD imposed reactor-closure deadlines in 2002 when it was in power.

‘New Coalition’

“The new coalition will almost certainly now seek to extend the lifecycle of the younger atomic plants,” said Claudia Kemfert, an analyst at the Berlin-based DIW economic institute. “The nuclear bogey plainly didn’t help the SPD, for it played no role in this election.”

German businesses had expressed concerned that the cost of keeping lights on would soar if nuclear plants were turned off. Atomic-power stations run by Dusseldorf-based E.ON, RWE of Essen, Vattenfall AB and EnBW generated 23 percent of Germany’s electricity last year. Seven plants, producing 10 percent of Germany’s power, are scheduled to close by 2014.

“We’re proud of the nuclear phase-out and we will fight for its continuity in opposition,” SPD Foreign Minister Frank- Walter Steinmeier said after conceding defeat yesterday.

Solar-power companies including Q-Cells fell on concern the new government may scrap so-called feed- in tariffs used to help new technologies get off the ground.

Culture digger

Doan Ngoc Khoi (R) at an excavation site in Quang Ngai province Archaeologist Dr. Doan Ngoc Khoi has spent so much time digging in the fishing village of Sa Huynh that local residents call him a Sa Huynh “native.”

The village on the coast of the central province of Quang Ngai is so named as it is home to the country’s most significant collection of relics from the ancient Sa Huynh civilization, a likely predecessor to the Kingdom of Champa. Sa Huynh is thought to have flourished between around 1000 BC and 200 AD in central and southern Vietnam. Veil of history As a young doctoral candidate in 1988, Khoi studied the hill tribes of Ta Nung commune in the central highlands province of Lam Dong Province. It was then that he made his first major archeological discovery: several centuries’ old pieces of pottery from the graves of the Cham people, which he stumbled upon almost accidentally. After graduating university, Khoi found a job at the Quang Ngai Province Museum and became increasingly intrigued by Sa Huynh culture, especially as he would visit the fishing village personally to visit relatives. It was in Sa Huynh that the first artifacts related to the ancient culture were found by the French at the turn of the last century. As findings progressed, it came to be known that Sa Huynh lived before the Cham people in societies based around iron tools, jade and glass work and elaborate cremation and burial rituals. However, the study of the civilization was all but halted from 1945-1975 as three decades of brutal war ensued. On his visits to Sa Huynh, Khoi would often ponder the mysteries of the ancient land that Vietnamese, and indeed the world, still knew little about. “Many things in this region remain under the veil of history,” Khoi said. As he continued to work at the museum, he began riding his bike to Sa Huynh every chance he got. He eventually began excavating there and soon made his second major finding: a stele and a well from the Cham people, who inhabited the land just after the Sa Huynh civilization. Khoi presented his Sa Huynh discovery at an annual archaeology symposium in 1989 and received high praise from the experts in attendance. Based on Khoi’s findings, a team was assembled to further excavate the Sa Huynh site, a project that unearthed many valuable relics, including invaluable ceramic jars used to bury the dead. ‘Cannot escape the story’ During a 1996 visit to the section of Sa Huynh fishing village on Ly Son Island, Khoi found several broken pieces of old pottery in a pile of soil dug up by local residents. He reported the finding to the Quang Ngai Museum and an official excavation then began at Oc hamlet on Ly Son. The dig unearthed several jars containing the remains of women and jewels made from shells and fish bones. Khoi is now heading up a provincial-level study on Sa Huynh culture in Quang Ngai, and is also conducting project to preserve and promote the region’s indigenous agricultural knowledge. He has co-written a book about Quang Ngai Province as well as a book about Sa Huynh culture in the central region and a book titled Traditional Culture on Ly Son Island. “This is my passion,” he said. “It seems I cannot escape the story of the Sa Huynh culture, even in my dreams.” The archeologist also said that all he needs in life is his discoveries, not riches or fame. “This is the choice I’ve made.” After all his years of hard work and his constant visits to Ly Son, Oc hamlet residents still consider Khoi one of their own. He visits every fourth day of the Lunar New Year to celebrate Tet with them. One chief villager said that when Khoi dies, he’ll be prayed for at the communal temple dedicated to the founders of the village and other local notables. The discovery of Sa Huynh culture In 1909, French archaeologist M. Vinet dug up a group of burial jars containing stone beads and pots in the sand dunes near what is now known as Sa Huynh. Fourteen years later, the site was further investigated by Mme La Barre, the wife of a French tax official in Sa Huynh, who was fond of gems and glass jewels. Her team unearthed 240 burial jars in Phu Khuong and Thanh Duc villagers. In 1934, archaeologist Madeleine Colani conducted major excavations in neighboring areas like Phu Lu and Dong Phu (in Quang Ngai Province) and Tang Long and Phu Nhuan (in Binh Dinh Province). Hundreds of burial jars were unearthed. In 1935, Colani announced her discoveries and previous Sa Huynh finds at a conference in Manila, the Philippines, the first time Sa Huynh culture was introduced to the world. However, excavations at the site all but halted during the Vietnam War 1945-1975. After liberation and reunification in 1975, Vietnamese archaeologists began continuing excavations and studies aiming to better understand Sa Huynh. Source: Tuoi Tre

Vietnam awaits swine flu vaccine

Vietnam needs some five million doses of H1N1 influenza A vaccine for people at high risk of infection, according to National Institute of Hygiene and Epidemiology director Nguyen Tran Hien.

The people most at risk are pregnant women, the elderly, children, and those with cardiovascular disease, tuberculosis, diabetes, obesity and other chronic ailments. However, the first batches of vaccine cannot be imported until next year, according to Nguyen Ngan Quyen, director of GlaxoSmithKline (GSK) Vietnam. GSK anticipates having its first batch ready in September, and will give priority to countries that placed the first orders. Vietnam is not yet on the list, Quyen said. “But, GSK Vietnam is willing to apply to the Ministry of Health for a permit to import H1N1 vaccine into Vietnam once a source is available, which will be in 2010 at the earliest,” she said. In the meantime, Vietnam is researching its own vaccine production and hopes to bring out the first batches by 2011, said Nguyen Thu Van, director of Vaccine and Biotechnology Products Company No. 1. Margaret Chan, director general of the World Health Organization, told AFP last week that it could be months before sufficient vaccine was available to combat swine flu She put world production capacity at 900 million doses a year, for a global population of 6.8 billion. Britain and France has already received their first batches of swine flu vaccine. Australia is gearing up for a massive vaccination program set to start in October, and Turkey hopes its first supplies of the vaccine will arrive by that time. Vietnam’s health ministry on Sunday reported another 155 cases of H1N1 infection nationwide, with more schools closed down in the central and southern regions. It was the second day in succession of more than 150 new cases turning up in a single day. So far, 2,724 people have tested positive for swine flu in Vietnam since the first case in May. Two have died, while more than half have been discharged from hospital after full recovery. Worldwide, some 209,000 people have caught the virulent flu strain since it emerged in April, and 2,180 have died from the virus, according to the WHO’s latest figures. While 90 percent of severe and fatal seasonal flu cases occur in people aged above 65, most of those who die from swine flu are under the age of 50, the agency said. Source: NLD, Thanh Nien

WB HIV toolkit set for Mekong Delta infrastructure project

A national HIV awareness raising program for migrant workers on infrastructure projects is poised to start in the Mekong Delta, awaiting approval from the Transport Ministry.

The World Bank, which is funding the program, and other stakeholders met Friday at the Duxton Hotel in Ho Chi Minh City to discuss launching the toolkit, which was developed and piloted last year in China to address HIV transmission among migrant workers on large infrastructure projects around the world. The initial activity of this project is a baseline assessment and pilot of a draft toolkit full of activities which people can do to learn more about HIV and how to protect themselves, a press release about the meeting said. The other stakeholders include the HIV prevention NGO, PACT, representatives of Transport Ministry and Project Management Unit 1 (PMU1), representatives of construction companies and Ca Mau Province government officials. Hoang Anh Dung from the transport sector of the World Bank Vietnam told Thanh Nien after the meeting Friday that the PMU1 representative was waiting for confirmation from the Vice Minister of Transport before finalizing the deal with WB and PACT to launch the initial stage at an infrastructure project in Ca Mau Province. Dung said the Mekong Delta was chosen to implement the HIV prevention toolkit, because many workers in the Delta travel from place to place to work. He said, “We have to raise awareness of the relative parties - the representatives of the Transport Ministry, PMU1 and the construction contractors. In this meeting we have done that.” A six bridge construction package in the province had been chosen by the World Bank as the most appropriate site, based on the construction time line, the cost of the project and the large number of migrant workers at the site available to interview. To adapt the existing “Road to Good Health” education, communication and information toolkit to the context of Vietnam, PACT will conduct a base line assessment at the construction sites from September to December. PACT was selected by the World Bank to conduct the baseline assessment of the target groups working and living at the new bridge sites who are most at risk of getting HIV. Once the assessment is complete and the toolkit adapted, it will be applied all over Vietnam and WB will recommend that all infrastructure projects over US$10 million must factor the toolkit into the costing as a measure against HIV transmission. According to PACT, the survey, which has been funded by WB for $40,000, will entail interviews with construction managers, supervisors, construction workers, truck drivers, female sex workers and residents. The data will be used to identify information gaps in the target population and adapt the information toolkit to suit the target groups’ needs to raise HIV awareness and affect behavioral change to reduce transmission of the virus. “Most construction contractors care about safety but know little about HIV, while some workers don’t even know how HIV is transmitted,” PACT’s project manager Nguyen Anh Thuan said. “The most at risk of HIV are intravenous drug users and sex workers but research shows that migrant workers are also at high risk,” Thuan said, saying that these workers live away from home in groups and have sexual needs so they see sex workers and have an HIV impact on local residents.” Without projects and intervention like this toolkit there would be more negative impacts on residents, he said. In August 2006, six development agencies including the World Bank and Asia Development Bank signed the Joint Initiative by Development Agencies for the Infrastructure Sectors to Mitigate the Spread of HIV/AIDS. Thuan said, “This toolkit is the initial step to realize the banks’ commitment in Vietnam. It’s a great commitment.” Reported by Micheal S. Smith