Sunday, March 3, 2013

Manitoba Conservative Party Suggests They Will Propose Changes To Anti-Bullying Bill That Requires Schools To Allow Formation Of Gay-Straight Alliances, Doctors Report That For First Time Infant Cured Of HIV Infection, Australian Defense Force Members March In Uniform For First Time At Sydney Mardi Gras

In Canada, Manitoba Opposition Leader Brian Pallister says his party will propose changes to a controversial anti-bullying bill, but he won't say whether he will support an existing clause on gay student groups. "We're obviously doing a lot of consultation. Certainly, the media coverage to date has focused on one aspect of the bill," Pallister said in recent interview. "We're concerned that the bill work for all children, not specifically concerned with a sub-set of the students of our province, but rather that it work to protect all children against bullying." The Canadian Press reports that Bill 18 has already sparked controversy in some religious quarters. It would require schools to accommodate student groups and activities that promote equality based on gender, disability, sexual orientation and gender identity. The proposed law specifically would require schools to allow students to set up "gay-straight alliance" groups if they wanted. Some groups have called the idea an attack on the freedom of religion. Pallister and other members of the Progressive Conservative Opposition have said there are two other problems with the bill — a vague definition of bullying that includes hurt feelings and a lack of any specific consequence for bullies. When asked whether his party would support the bill if those two concerns were addressed yet the allowance of gay-straight alliances remained, Pallister declined to say. "The hypothetical discussion will become a real one in a fairly short time, I hope, and then we'll be able to answer that question when we see how the NDP responds to the proposals we're making. We have already, as a caucus, had discussion on this issue ... and we'll present those ideas at the appropriate time." According to one political observer, some rural Tory legislature members are in a tight spot between supporting a bill that may be popular province-wide but unpopular in their constituency. "They're in a bind," Steven Lecce, as associate professor and head of political studies at the University of Manitoba. "One (option) is to stick to their guns and simply say 'on these moral and ethical issues, we're not willing to bend for strategic, tactical or political reasons.' That would strike me as odd in light of the last couple of years, particularly with federal Conservatives who have been incredibly astute at tapping into public opinion and navigating it." The issue played out last year in Ontario, when a similar bill led to a public spat between then-premier Dalton McGuinty and Thomas Cardinal Collins, Catholic Archbishop of Toronto. In Manitoba, some religious groups have already started letter-writing campaigns. One group, called the Campaign Life Coalition, calls the bill an example of "tyranny." The issue will come to a head in the spring when the bill goes before public hearings. Manitoba is one of the few provinces that require public hearings for all legislation.

Doctors announced on Sunday that a baby had been cured of an H.I.V. infection for the first time, a startling development that could change how infected newborns are treated and sharply reduce the number of children living with the virus that causes AIDS. The baby, born in rural Mississippi, was treated aggressively with antiretroviral drugs starting around 30 hours after birth, something that is not usually done. If further study shows this works in other babies, it will almost certainly change the way newborns of infected mothers are treated all over the world. The United Nations estimates that 330,000 babies were newly infected in 2011, the most recent year for which there is data, and that more than 3 million children globally are living with HIV. If the report is confirmed, the child born in Mississippi would be only the second well-documented case of a cure in the world, giving a boost to research aimed at a cure, something that only a few years ago was thought to be virtually impossible. The first person cured was Timothy Brown, known as the “Berlin patient,'’ a middle-aged man with leukemia who received a bone-marrow transplant from a donor genetically resistant to HIV infection. “For pediatrics, this is our Timothy Brown,'’ said Dr. Deborah Persaud, associate professor at the Johns Hopkins Children’s Center and lead author of the report on the baby. “It is proof of principle that we can cure HIV infection if we can replicate this case.'’ Dr. Persaud and other researchers spoke in advance of a presentation of the findings on Monday at the Conference on Retroviruses and Opportunistic Infections in Atlanta. Some outside experts, who have not yet heard all the details, said they needed convincing that the baby had truly been infected. If not, this would be a case of prevention, something already done for babies born to infected mothers. “The one uncertainty is really definitive evidence that the child was indeed infected,” said Dr. Daniel R. Kuritzkes, chief of infectious diseases at Brigham and Women’s Hospital. Dr. Persaud and some other outside scientists said they were certain the baby – whose name and gender were not disclosed – had been infected. There were five positive tests in the baby’s first month of life – four for viral RNA and one for DNA. And once the treatment started, the virus levels in the baby’s blood declined in the pattern characteristic of infected patients. Dr. Persaud said there was also little doubt that the child experienced what she called a “functional cure.” Now 2½, the child has been off drugs for a year with no sign of functioning virus. The mother arrived at a rural hospital in the fall of 2010 already in labor and gave birth prematurely. She had not seen a doctor during the pregnancy and did not know she had H.I.V. When a test showed the mother might be infected, the hospital transferred the baby to the University of Mississippi Medical Center, where it arrived at about 30 hours old. Dr. Hannah B. Gay, an associate professor of pediatrics, ordered two blood draws an hour apart to test for the presence of HIV, RNA, and DNA. The tests found a level of virus at about 20,000 copies per milliliter, fairly low for a baby. But since tests so early in life were positive, it suggests the infection occurred in the womb rather than during delivery, Dr. Gay said. Typically a newborn with an infected mother would be given one or two drugs as a prophylactic measure. But Dr. Gay said that based on her own experience, she almost immediately used a three-drug regimen aimed at treatment, not prophylaxis, not even waiting for the test results confirming infection. Virus levels rapidly declined with treatment and were undetectable by the time the baby was a month old. That remained the case until the baby was 18 months old, after which the mother stopped coming to the hospital. When the mother and child returned five months later, Dr. Gay expected to see high viral loads in the baby. But the tests were negative. Suspecting a laboratory error, she ordered more tests. “To my greater surprise, all of these came back negative,” Dr. Gay said. Dr. Gay contacted Dr. Katherine Luzuriaga, an immunologist at the University of Massachusetts, who was working with Dr. Persaud and others on a project to document possible pediatric cures. The researchers, sponsored by amfAR, the Foundation for AIDS Research, put the baby through a battery of sophisticated tests. They found tiny amounts of some viral genetic material but no virus able to replicate, even lying dormant in so-called reservoirs in the body. There have been scattered cases reported in the past, including one in The New England Journal of Medicine in 1995, of babies clearing the virus, even without treatment. Those reports were greeted skeptically, particularly since testing methods were not very sophisticated back then. But those reports and this new one could suggest there is something different about babies’ immune systems, said Dr. Joseph McCune of the University of California, San Francisco. One hypothesis is that the drugs killed off the virus before it could establish a hidden reservoir in the baby. One reason people cannot be cured now is that the virus hides in a dormant state, out of reach of existing drugs. When drug therapy is stopped, the virus can emerge from hiding. “That goes along with the concept that, if you treat before the virus has had an opportunity to establish a large reservoir and before it can destroy the immune system, there’s a chance you can withdraw therapy and have no virus,'’ said Dr. Anthony S. Fauci, the director of the National Institute for Allergy and Infectious Diseases. Adults, however, typically do not know they are infected right as it happens, he said. Dr. Steven Deeks, professor of medicine at the University of California, San Francisco, said if the reservoir never established itself, then he would not call it a true cure, though this was somewhat a matter of semantics. “Was there enough time for a latent reservoir, the true barrier to cure, to establish itself?'’ he said. Still, he and others said, the results could lead to a new protocol for quickly testing and treating infants. In the United States, transmission from mother to child is rare – several experts said there are only about 200 cases a year or even fewer, because infected mothers are generally treated during their pregnancies. If the mother has been treated during pregnancy, babies are typically given six weeks of prophylactic treatment with one drug, AZT, while being tested for infection. In cases like the Mississippi one, where the mother was not treated during pregnancy, standards have been changing, but typically two drugs are used. But women in many developing countries are less likely to be treated during pregnancy. And in South Africa and other African countries that lack sophisticated testing, babies born to infected mothers are often not tested until after six weeks, said Dr. Yvonne Bryson, chief of global pediatric infectious disease at the University of California, Los Angeles. Dr. Bryson, who was not involved in the Mississippi work, said she was certain the baby had been infected and called the finding “one of the most exciting things I’ve heard in a long time.'’ Studies are being planned to see if early testing and aggressive treatment can work for other babies. While the bone marrow transplant that cured Timothy Brown is an arduous and life-threatening procedure, the Mississippi treatment is not and could become a new standard of care. While it might be difficult for some poorer countries to implement, treating for only a year or two would be cost effective, “sparing the kid a lifetime of antiretroviral therapy,'’ said Rowena Johnston, director of research at amfAR.

In Australia, Australian Defence Force members marched in uniform for the first time at the Sydney Mardi Gras in front of waving crowds lining Oxford Street on Saturday night. Behind the Dykes on Bikes, who led the way, and followed by the First Australians float and one for the people who started it all 35 years ago were 120 defence personnel. According to the Sydney Morning Herald, the contingent was led by Air Commodore Tracy Smart, a director-general in Joint Health Command, and the first openly gay general in the ADF. The navy was at the front, followed by the army, led by Lieutenant Colonel Paul Morgan. They were followed by the air force and then defence family and friends. The army contingent included engaged lesbian couple Corporal Renae Fritzell-Flint and Corporal Danielle Gurkin, who are both physical trainers from Army Recruit Training Centre Kapooka. Corporal Fritzell-Flint, who has marched since 2001, said that, "To be able to wear military uniform, something we do every day, is great. We wear it with pride - and to be recognized after 20 years of being discriminated against is fine. There is a very open and accepting cultural diversity in the army. We work together in the same unit and same section and our bosses are excellent." Corporal Gurkin said it was humbling to know that Defence supported everyone, regardless of sexual orientation, gender or age. "We will march exactly as we would do anywhere else," she said before the event. "We will strictly adhere to policy - you can smile but you don't look around and if your hat blows off you don't go and get it." The ADF first had a float in the Mardi Gras parade in 2008, but there was no wearing of uniforms. Senator David Feeney, the parliamentary Secretary for Defence, said he was proud to see the ADF reflecting the community it serves. "I am pleased to see that ADF members who serve their nation with pride, who put their lives on the line, are finally able to march in the uniforms they wear day-in and day-out. This is a decision that not everyone will agree with, but it is a fair decision and it is the right decision." It is 20 years since the cancellation of the Defence Instruction on Homosexual Behaviour in the ADF, which prevented homosexual citizens from serving in the military. In 1992, then prime minister Paul Keating announced the ban on homosexuals in the ADF would be lifted. ''We've come a long way since 1978, when the pioneers of our community took to the streets wearing costumes and carrying placards calling for rights and acceptance,'' Sydney Gay and Lesbian Mardi Gras co-chairwoman Siri Kommedahl said. In 1978 the first march up Oxford Street was met by a cordon of police and participants were beaten and taken to the police station.

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