FOR IMMEDIATE RELEASE: September 5, 2000



Protesters demand candidate Bush back access to AIDS drugs for poor people with AIDS worldwide; condemn horrendous record on AIDS.

(Bethlehem, Pennsylvania, September 5, 2000) ACT UP confronted George W. Bush today, disrupting his $500-a-plate fundraiser at the Bethlehem Holiday Inn. ACT UP members disrupted the candidate's showcase from within the luncheon and outside, disrupting the presidential candidate's long-awaited speech announcing his Medicare plan.

Mark Milano, a person living with AIDS and member of ACT UP New York interrupted the candidate, holding a sign reading: "You've sold out people with AIDS to the big drug companies. Your record on AIDS in Texas is horrible,"
Milano shouted. "You have never mentioned the word AIDS. Where is your plan for AIDS drugs for poor countries."

The candidate, who did not reply, seemed dumbfounded and stood with mouth agape as the activist was dragged out, yelling, "ACT UP, fight back, fight AIDS."

Activists from ACT UP Philadelphia and ACT UP New York then disrupted the receiving line, shouting "What about AIDS!" as the candidate shook their hands, and blocked the candidate's motorcade as the entourage attempted to leave the hotel parking lot.

Activists were detained by police and released. One was held in a choke hold after stepping off a sidewalk into the street. Three citations were issued, two for littering, one for disorderly conduct.

Activists insist that a Bush presidency would be disastrous for people with AIDS in the United States and around the world, pointing to Bush's poorly-regarded record on AIDS prevention and treatment during his five years as governor of Texas, as well as his strong ties to pharmaceutical companies.

Requests for a response from the Bush campaign regarding AIDS and drug access have been denied, activists say.

Citing Bush's Medicare plan, announced today, AIDS activists charge Bush with supporting drug companies and insurance firms instead of people with AIDS.

"Bush's Medicare plan is corporate welfare, pure and simple," said Laura McTighe of ACT UP. "Rather than using the bulk purchasing power of this giant program to decrease prescription prices, Bush's plan would create a complicated scheme of reimbursement that will limit the coverage of insurance companies and permit drug companies to keep prices high while most seniors and sick people will continue to pay thousands of dollars a year."

While public criticism of domestic and international pharmaceutical company pricing practices has intensified, Bush has faced little scrutiny about conflicts of interest within his campaign's inner circle. Deborah Steelman, Bush's top health care advisor, also heads the top drug company and health industry lobbying firm Steelman Enterprises, Inc. Recent articles report that Steelman would be tapped as Secretary of Health and Human Services for a Bush Administration, making her the top public health official in the country.

"AIDS decimates countries around the globe thanks to drug company greed and government indifference," said Bob Kahn of ACT UP. "And Bush wants to make some drug company flunky the most powerful public health official in the U.S.? Clearly the lives of millions of destitute people with AIDS are inconsequential to him and his industry cronies. This kind of compassion we don't need."

Steelman opposes strategies that activists describe as sensible and cost-effective measures to increase prescription drug access, such as Medicare using its leverage as a drug purchaser to secure reasonable prescription drug prices. Steelman also objects to Third World countries eschewing drug patents in order to obtain affordable generic versions of desperately needed AIDS drugs, although this practice, called compulsory licensing, is legal according to international trade rules.

ACT UP is widely credited with forcing significant change in US trade policy on access to cheap, generic AIDS drugs after the group targeted the Clinton/Gore Administration with a series of "zaps" and major demonstrations. These actions included disruptions of the first several months of Vice President Al Gore's campaign appearances. Following confrontations with the AIDS activists, the Administration recanted, announcing a shift in domestic policy to one of flexibility on the issue of access to medication versus drug company intellectual property protection.

Most recently, on May 10, 2000, President Clinton issued an Executive Order halting the US Government's routine practice of bullying sub-Saharan countries pursuing WTO-legal options to manufacture generic versions of expensive patented medicines. "We fear that a drug-industry backed Bush Administration would reverse the executive order. With 24.5 million African lives at stake, AIDS drugs for Africa must become a campaign issue for Bush as well as Gore." stated ACT UP's Paul Davis.


Expansion of the Clinton Executive Order on AIDS drugs and sub-Saharan Africa to all least-developed and developing nations. The US Government must not use its economic power to punish poor countries that are pursuing sustainable, self-sufficient solutions to the AIDS crisis.

The US Government must facilitate access to generic AIDS drugs for poor countries by calling for the bulk manufacture and distribution of generic medicines to least developed and developing nations at cost. We demand that the US permit the manufacture and distribution by an international body such as the World Health Organization of the numerous medications which the US currently retains rights to. Donation programs, while potentially useful when not riddled with conditions, are never substitutions for sustainable solutions to the deadly lack of access to essential AIDS drugs.

The US Government must cancel the debt of the world's poorest and most AIDS-affected nations, without imposing onerous conditions.

For more information on ACT UP's campaigns to help developing nations gain access to AIDS drugs see

For more documents on intellectual property and access to medicines see the access to medication website of the Consumer Project on Technology

FYI: An April 11 2000 New York Times front page article. Bush has spoken twice about health during his entire 60 months as governor, both times to Health-trade organizations. Fully 39.1% of poor Texas children have no health care. On September 4th, Candidate Bush was overheard (off-mike but over-heard on the media) calling this NY Times Reporter an "asshole".

BUSH: "There's Adam Clymer, major league asshole from the New York Times."
CHENEY: "Oh, yeah, big time." -- September 4, uttered over an open mike, as reported by CNN

10,000 Texans have died of AIDS while Bush has been governor, and Texas has the 4th highest rate of HIV in the nation.

Finally--not mentioned in the story--Bush's telling esponse to an :AIDS Drugs for Africa" question recently posed him in an on line patient information newsletter:

Q: A presidential candidate recently announced a plan to provide significantly increased funding to southern Africa to improve their
ability to combat HIV. What are your feelings regarding AIDS in Africa?

Bush: Before we spend money, I would want to make sure that the people we're trying to help receive the help necessary. I believe we must be careful that corrupt governments do not squander the money. >> see full interview

New York Times: Section A; Page 1; Column 3; National Desk

Bush and Texas Have Not Set High Priority on Health Care

Texas has had one of the nation's worst public health records for decades. More than a quarter of its residents have no health insurance. Its Mexican border is a hotbed of contagion. The state ranks near the top in the nation in rates of AIDS, diabetes, tuberculosis and teenage pregnancy, and near the bottom in immunizations, mammograms and access to physicians.

But since George W. Bush became governor in 1995, he has not made health a priority, his aides acknowledge. He has never made a speech on the subject, his press office says. His administration opposed a patient's bill of rights in 1995 before grudgingly accepting one in 1997, and fought unsuccessfully to limit access to the new federal Children's Health Insurance Program in 1999.

Health care is near the top of the election agenda, with Vice President Al Gore already proposing a vast expansion of insurance coverage for children. Mr. Bush will begin discussing insurance and other health issues starting on Tuesday with a speech in Cleveland.

Democrats, not waiting for Mr. Bush's proposals, are already attacking him for the Texas record. But politics aside, two things are clear: Texas' health problems run far deeper than the identity of any Austin officeholder, and Mr. Bush has not tried to tackle them, despite a large state budget surplus.

The Democrats point out that Texas' lack of health insurance is among the most severe in the country. Among Texans ages 19 to 65, the percentage without coverage rose slightly under Mr. Bush and is higher than in any state but Arizona. The numbers are even worse among poor children, and hundreds of thousands of them are not enrolled in Medicaid, even though they qualify.

Governor Bush declined to be interviewed for this article, but the views expressed by the state's commissioner of health, Dr. William R. Archer III, cast a light on the Bush administration's approach to the issue.

(Dr. Archer, the son of Representative Bill Archer, Republican of Texas and the chairman of the House Ways and Means Committee, said the governor asked him to apply for the commissioner's job; he was formally chosen by the Board of Health in 1997, and took office after Mr. Bush approved the appointment.)

Almost alone among health experts in Texas, Dr. Archer minimizes the importance of the low rate of health insurance, a protection that two-fifths of the state's poor children lack. In an interview, he said he thought that while "eventually we have to insure everybody," he believed the uninsured were still getting care.

"I think insurance is important," he said. "But I don't think it's the most important thing."

Dr. Archer said he doubted that coverage made much real difference to health.

When told of that view, one of the state's leaders in public health, Dr. Ron Anderson of Parkland Hospital in Dallas, said, "Then he hasn't read the literature. Shame on him!"

Dr. Archer also accused Texas doctors of opposing preventive health care out of misplaced concern for their own billings.

"If I can prevent certain diseases upstream, and then there is no need to treat that disease, then there is nothing to charge against," he said.

And he has stirred disputes with his efforts to take his department away from the traditional services it has provided to examine the cultural causes of unhealthy behavior and lifestyles.

For example, he said Texas' high teenage pregnancy rate came about because the state's Hispanic population lacked the belief "that getting pregnant is a bad thing."

"If I were to go to a Hispanic community and say, 'Well, we need to get you into family planning,' they say, 'No, I want to be pregnant,' it doesn't work very well," he said.

According to the Alan Guttmacher Institute, Hispanic teenagers in Texas had a higher pregnancy rate than non-Hispanic whites or blacks, but the white rate was among the nation's highest, too.

The health problems of Texas go back far beyond Governor Bush and Dr. Archer. Texas ranks 25th in per capita income, just ahead of Oregon, but taxes lightly and provides a modest level of public services. Only six states collect a smaller percentage of their residents' personal income in state and local taxes than Texas does.

"The flip side of having no income tax is having a very low level of services," said Anne Dunkelberg, a senior analyst at the Center for Public Policy Priorities, a nonpartisan research institution in Austin.

Dr. Archer explained why the state tolerated having 598,000 children eligible for Medicaid, the federal-state health plan for the poor, but not enrolled in the program: "The problem is that the Legislature knows that if we are successful, and we got all those kids registered, they would not balance their budgets any more. It's not one person saying, 'Don't do this.' It's not one agency saying, 'Don't do this.' It's sort of 'Why would we all rock the boat at this point?' "

Except for Dr. Archer, most prominent health experts in Texas see the low insurance rates as the state's biggest health problem. Clair Jordan, executive director of the Texas Nurses Association, said, "Uninsured children end up in the most costly place, the emergency room."

State Representative Elliott Naishtat, a Democrat who is chairman of the House Human Services Committee, said, "The biggest health problem in Texas is the exorbitant number of people, primarily children, who have no health insurance."

Without insurance, said Jose Camacho, head of the Texas Association of Community Health Centers, children get only sporadic treatment for ear infections, asthma and diabetes.

Health insurance coverage in Texas has been stagnant for years. According to the Kaiser Commission on Medicaid and the Uninsured, among Texans 19 to 65 years old, 27.5 percent were uninsured in 1998, compared with 19.7 percent for the nation. In 1994, before Mr. Bush took office, the Texas percentage was 27.8 and the national figure 18.6 percent.

Among poor children the coverage was much worse. In 1998, 39.1 percent of Texans under 18 living at no more than twice the poverty level lacked insurance, compared with 25.7 percent nationally. In 1994, 36.7 percent of poor children in Texas and 22.8 percent of poor children nationally were uninsured.

There are many reasons for the low rates of insurance, including migratory labor, a large rural population and many low-wage workers in nonunion jobs.

But the single biggest reason is probably the state's Medicaid program, which has some of the nation's most severe limits and complicated eligibility rules and thus makes Texas "one of the most difficult states for someone to figure out how to get enrolled," said Diane Rowland, executive vice president of the Henry J. Kaiser Family Foundation, a research organization.

State Representative Garnet F. Coleman, a Democrat who is vice chairman of the House Public Health Committee, contended that the state had created an "atmosphere of fear" around applying for Medicaid.

Bertha Rochel, a homemaker interviewed at an El Paso clinic, said some of her neighbors did not seek Medicaid because "they are afraid and maybe some of their children are illegal." Some others would find their citizenship applications barred if they sought government benefits now. Mr. Camacho pointed to the Texas rule that missing an appointment meant a Medicaid applicant had to start over.

Of the 1.4 million to 1.5 million children without health insurance, the number may drop sharply in the next year when Texas finally starts enrolling children in the children's health insurance program, known as CHIP, which was enacted by Congress in 1997. Mr. Bush let the question wait until the 1999 legislative session, and fought to limit its coverage to children with family incomes up to 150 percent of the poverty line, although the federal law allowed covering children up to 200 percent of the poverty level.

The Bush approach would have excluded 200,000 of the 500,000 who became eligible when the legislature insisted on the higher level. Mr. Bush said at a Sacramento news conference on Thursday, "I signed the 200 percent bill" and would not say why he pushed for 150 percent.

The reason given at the time for the Bush position, legislators said, was a fear that a big new program would be costly by itself and turn up a "spillover" of many thousands who were already eligible for Medicaid, which has an income ceiling of 100 percent of poverty. The federal government reimburses Texas 61.5 cents out of every dollar spent for Medicaid, and will pay 75 cents on the dollar for CHIP.

Many states, like Texas, have been slow to take advantage of the CHIP program; President Clinton took the nation's governors to task over the issue in August.

But Texas now has a large effort planned for CHIP. Don Gilbert, the state commissioner of Health and Human Services, said he expected to enroll 420,000 children in CHIP and perhaps another 120,000 in Medicaid over the next year.

The worst health in Texas, with disease rates at Third World levels, is on the Mexican border. Almost a fourth of the state's population lives in 43 border counties along the 1,264 miles of the Rio Grande from El Paso to Brownsville, and as far from the river as San Antonio, about 125 miles.

A 1998 report by the state comptroller's office observed: "Health conditions in the Texas-Mexico border are among the worst in the U.S., so distressful that reports on health conditions suggest a remote country in need of medical missionaries, not a part of Texas." For example, it said, "Cases of hepatitis A, a gastrointestinal virus borne by contaminated food and water, are four times as common in the Rio Grande Valley as in the rest of Texas." Tuberculosis, diabetes and dengue fever are other high-incidence diseases.

At the border some improvement has been made in recent years, but very slowly, said Dr. Laurance N. Nickey, a retired city-county health director who now serves on the binational border health commission. Dr. Nickey said 72,000 people (about a tenth of El Paso's population) live in unincorporated colonias, or settlements, where "some of the water is safe to drink," and less than half have safe sewerage.

Dr. Archer said Governor Bush had persuaded Mexican authorities to put money into tuberculosis control, a move they had resisted because the border states in Mexico are not nearly its poorest.

El Paso alone sees about 65 million legal border crossings a year. "With this kind of a rate of crossings," Dr. Nickey said, "you don't keep measles on one side of the border and chicken pox on the other."

"We share the same air. We share the same water. We share the same pollution. We share the same hazardous waste." And because the border counties are a gateway to the rest of Texas and the rest of the country, he said, "It's not just a border issue. it involves the whole United States."

CORRECTION: April 12, 2000, Wednesday

A front-page article yesterday about health care in Texas misstated the extent of Gov. George W. Bush's public discussions on the subject. According to his presidential campaign office, Governor Bush has given at least two speeches on the subject -- on Sept. 15, 1995, to the Texas Medical Association and on June 2, 1998, to the Texas Health Care Association. His gubernatorial press office had said, and the article reported, that he had never made a speech on the subject.


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AIDS Activists Demonstrate Against Candidate Bush at Republican National Headquarters 10-13-2000


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