US President George W. Bush on Wednesday urged lawmakers to set aside 30 billion dollars over five years to fight AIDS worldwide, but AIDS activists said the proposal fell short of funds needed to battle the global scourge.
Bush also said that First Lady Laura Bush would visit Africa in June to assess HIV/AIDS-fighting strategies in Zambia, Mali, Senegal and Mozambique, and report back on what works and what does not in battling the deadly disease.
"She's going to meet with community leaders and visit with participants in HIV/AIDS programs during her trip to Zambia, Senegal, Mali, and Mozambique. And she's going to come back with her findings," the president said.
Bush urged the US Congress to renew and double his President's Emergency Program for AIDS Relief (PEPFAR), which has 15 billion dollars and is due to expire in September 2008.
"The generosity of the American people is one of the great untold stories of our time. Our citizens are offering comfort to millions who suffer and restoring hopes to those who feel forsaken," said Bush.
"Today, I ask Congress to demonstrate America's continuing commitment to fighting the scourge of HIV/AIDS by reauthorizing this legislation now," he said in the White House Rose Garden, surrounded by AIDS activists.
"I ask Congress to double our initial commitment and approve an additional 30 billion dollars for HIV/AIDS prevention for care and for treatment over the next five years," he said.
Bush said Washington would work with African governments, the private sector, and community groups around the world to focus the funds on treatment for some 2.5 million people, preventing some 12 million new infections, and care for 12 million more, including more than five million children.
The White House said that PEPFAR, as of March 31, had helped fund treatment for 1.1 million people in its focus countries -- Botswana, Cote dÂIvoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, Vietnam and Zambia.
The program pays for anti-retroviral treatment in the worst-hit countries, funds drugs for patients in the developing world and delivers medicine to pregnant women to prevent infections to newborns.
However, Paul Zeitz, director of the Global AIDS Alliance, said the proposal's fine print belies Bush's announcement.
"In fact, 30 billion dollars is about what the US is already on track to spend over the next five years even without the president's announcement," he said in a statement.
"The reality is that we are not even treading water as the tide of HIV/AIDS rapidly rises," Zeitz said.
He added that "the fine-print of today's proposal also shows a radical reduction in US support for HIV/AIDS treatment (domestically), even as the world is racing to meet the 2010 deadline of universal access."
Zeitz said with the United States providing treatment to 33 percent of those who need it currently, the Bush proposal would slash that funding to treat "only 2.5 million people, or about 20 percent of the 12 million people expected to need treatment in 2013."
At the end of last year, around 39.5 million people around the world were living with HIV or AIDS, according to UN figures.
Sub-saharan Africa remains by far the worst-affected region and is home to two-thirds of all people living with HIV.
May 31, 2007
US President George W. Bush on Wednesday urged lawmakers to set aside 30 billion dollars over five years to fight AIDS worldwide, but AIDS activists said the proposal fell short of funds needed to battle the global scourge.
The artificial intelligence may be used in future to predict the outcome in HIV/AIDS patients, said visiting professor, Dr Chris Tsoukas at PGI. "We are working on a research project which might ultimately result in the computer helping us to predict the outcome in our patients," said Dr Tsoukas, professor of medicine and associate director of McGill University AIDS Centre.
"PGI is one of the three centres in India that is sharing its database with us for the purpose of the research," said Dr Tsoukas. The other two are Mumbai and Ahmedabad. Emphasising that research in combating HIV/AIDS has become global, Dr Tsoukas said that various countries were combining strengths to come up with integrated data.
"When we want to access the condition of a patient, we need to see the CD4 count over a period of time. The same way, we need to remember the physical condition of the patient, the lab statistics and various other markers," said Dr Tsoukas. "While it is impossible for a doctor to compare values and arrive at a conclusion, a computer can do this and predict the outcome. So we are looking at this technology in the next 10 years."
Delivering a talk on the recent advances in the management of HIV infection, he said that more medications are available for the treatment of patients than ever before. "We have been using new combination of drugs to combat the infection," Dr Tsoukas said. "Moreover, patients who have failed the first three lines of drugs can be offered new therapies. As a result of this practice, some of my patients in Canada have been living for more than 25 years, " Dr Tsoukas said.
Voluntary HIV tests should be offered to all patients attending clinics, for whatever reason, in countries where AIDS is widespread, the World Health Organisation said on Wednesday.
Elsewhere, testing is recommended for all patients attending selected facilities, such as antenatal or sexual health clinics.
Issuing new guidance to governments, the global body said a major expansion in testing was essential if the world was to beat the HIV/AIDS pandemic, which has killed more than 25 million people in the past quarter of a century.
The AIDS virus today infects around 40 million worldwide, most of them in sub-Saharan Africa, where just 12 percent of men and 10 percent of women know their HIV status.
"This is radical in the sense that things have to change," WHO HIV/AIDS director Kevin De Cock told Reuters.
"Across the world, people with HIV are flowing through healthcare settings, not being diagnosed and not being offered the advantages of knowing their status."
Drugs can hold HIV at bay and keep patients alive, but unless people know they are infected they will not seek treatment. They are also more likely to infect others.
The WHO says less than 20 percent of HIV-positive people in low and middle-income countries know they are infected.
The situation is better in rich countries, yet even in United States an estimated 25 percent of infected people are unaware they are carrying the virus, while in Europe the rate is around one third.
Until now, most testing has been "client-initiated," with individuals having to actively seek an HIV test. But in future, the WHO wants to see "provider-initiated" schemes, with testing becoming the norm at health centers, unless a patient declines.
Universal coverage is recommended for countries gripped by a generalized epidemic, where the HIV prevalence rate in pregnant women is consistently above 1 percent -- which includes most of Africa and parts of the Caribbean -- while targeted testing is suitable for concentrated or low-level epidemics.
Some countries in Africa, such as Botswana and Kenya, have already started broad testing programs and De Cock said the price of around $1 for a simple, rapid test meant that cost should not be an insurmountable obstacle.
The Bush Administration announced today that it will seek an authorization from Congress for $30 billion over the next five years to combat HIV/ AIDS worldwide, a doubling of the current annual funding level. In 2003, President Bush proposed a five-year $15 billion effort to combat HIV/AIDS which Congress authorized until 2008.
The following is a statement by Ileana Ros-Lehtinen (news, bio, voting record), Ranking Republican, House Committee on Foreign Affairs:
The spread of HIV/AIDS has become one of the most significant moral and security challenges confronting our world today. The announcement by President Bush will allow us to continue, and even increase, our efforts to combat the human suffering caused by this deadly pandemic.
Millions of people are alive today because of ongoing U.S. efforts to prevent the spread of HIV and treat those suffering with AIDS. Yet, for all that has been accomplished, the fight has just begun.
The President's announcement is a clear recognition of the need for a long-term commitment in this struggle and an opportunity to do something truly compassionate and of significant and lasting importance for the world's most vulnerable people.
SOURCE House Committee on Foreign Affairs (Republican Office)
May 30, 2007
The HIV is spreading rapidly among Hong Kong's gay community as research indicates a rise in the number of men having unsafe sex, officials said Tuesday.
Profiling of the virus acquired by HIV sufferers has revealed a cluster of cases with similar genetic sequencing which has risen from 34 to 53 cases since October last year.
Department of Health expert Wong Ka-hing urged people with a history of unprotected sex to have HIV tests, saying the findings suggested 'rapid local HIV transmission' among gay men in the city of 6.9 million.
Hong Kong recorded 91 new cases of HIV in the first quarter of 2007, bringing the total number of infections to 3,289. Twenty new cases of AIDS were diagnosed, raising the total since 1985 to 875.
The detection of clusters of cases among gay men in Hong Kong follows regional findings that the proportion of gay men in Asia contracting HIV has risen sharply in recent years.
The trend suggests that safe-sex practices and condom use among the gay community have eased since the HIV epidemic peaked in the 1980s and early 1990s.
Cultural beliefs that women are inferior to men are spurring the rapid spread of HIV in Swaziland and Botswana, the countries most affected by AIDS, according to a report released Monday.
The report from Physicians for Human Rights showed that women's dependency on their male partners made them more vulnerable to the disease in the countries which had questionable human rights.
"The legal systems in both countries grant women lesser status than men, restricting property, inheritance and other rights," reads the report.
"Neither country has met its obligations under international human rights law, as a result women continue to be disproportionately vulnerable to HIV/AIDS."
Women subsequently had no control over sexual decisions, including using a condom, and feared testing positive would jeapordise their relationships and lead to them being stigmatised and shunned by society.
In Botswana, a country of 1.64 million people which had the highest HIV-prevalence until surpassed by Swaziland in 2004, 19 percent of community survey respondants said it was more important for a women to respect her partner than for him to respect her.
Women's lesser status in Botswana -- which has not criminalised intimate partner violence and marital rape -- meant after being infected their ability to provide for themselves was even more precarious.
Interviews with HIV-positive women revealed many engaged in risky sex with men in exchange for food for themselves and their children.
"Women are having sex because they are hungry. If you give them food, they would not need to have sex to eat," said one women.
In Swaziland, the continent's last absolute monarchy with an HIV prevalence of about 40 percent, a dual civil and customary law system denies equal rights to women.
King Mswati III practices the accepted culture of polygamy in a society which encourages multiple sexual partners for men while women are in turn blamed for spreading the virus.
"Ninety-seven percent of community survey participants held at least one gender discriminatory belief," said the report.
Zimbabwe will put 40,000 more people on life saving anti-retroviral drugs by the end of the year despite an economic crisis that has hobbled the country's health care, state media reported.
The southern African country is among the worst hit by the HIV/AIDS epidemic, killing more than 3,000 people every week and accounting for 70 per cent of hospital admissions.
But Zimbabwe, in the grips of a deep recession, has also become one of the few AIDS bright spots on the continent after its HIV prevalence rate declined to 18.1 per cent last year from 25 per cent six years ago.
Health Minister David Parirenyatwa said the number of people receiving the life-prolonging medicines has increased from 60,000 in December to 80,000 this month but that the government would add another 40,000 patients by the end of the year.
"Currently the number of people on ARVs has grown to 80,000 since December last year and we hope to achieve our target of getting 120,000 by the end of the year," Parirenyatwa told the official Herald newspaper.
Parirenyatwa said that at least 300,000 people living with HIV/AIDS were in urgent need of ARVs.
Zimbabwe's drive to increase access to ARVs has been hampered by a severe shortage of foreign currency, itself a sign of an economic crisis that has pushed inflation past 3,700 per cent and increased poverty levels.
The crisis has been particularly felt in the health sector, where basic drugs are in short supply while strikes for better pay by doctors and nurses have worsened the situation.
President Robert Mugabe - who says Zimbabwe is showing the way for Africa in the fight against HIV/AIDS - rejects charges of mismanagement and blames the West for sabotaging the economy as punishment for seizing white-owned farms to distribute to blacks.
An awareness campaign on HIV/AIDS has been initiated by the students of PAU in ten villages of the district. The campaign was arranged as part of the collaborative USAID project-Culturally Sensitive HIV/AIDS Reduction Training Project in India.
According to Director Students Welfare and Project Director Dr Tejwant Singh, the students covered two villages everyday and involved the village youth to educate people about HIV.
They distributed pamphlets and pasted posters too, and discussed the misconceptions relating to HIV/AIDS with the villagers.
Tiny tots model summer wear
LUDHIANA: The pre-primary wing of GNI Public School conducted a fashion show of 'Summer wear 2007'.
The tiny tots were dressed in soothing, colourful and trendy summer outfits. They walked the ramp with confidence. Summer Prince and Princess were selected from each class. The show was followed by a party. Director of the school P Kahlon and principal B Gulati gave the prizes to winners. Co-ordinator Abhineet Sarna and headmistress C Paul helped in making the function a success.
Brazil has offered to build a $23 million pharmaceutical plant in Mozambique that will provide drugs to treat HIV/ AIDS, malaria and other diseases, Mozambique's national newspaper said on Tuesday.
Brazil, a leading pharmaceutical manufacturer, will monitor quality and transfer technology to the proposed plant, which would produce a range of drugs, including generic antiretroviral drugs (ARVs) to fight HIV/AIDS, Noticias reported.
The plan was presented to the Mozambique government by Brazil's ambassador in the southern African nation.
Mozambique, one of the poorest nations on the continent, is struggling to find the money to rebuild its dilapidated health-care system, which was neglected during a 17-year civil war that ended in 1992.
The former Portuguese colony has been hard hit by the AIDS epidemic, with an estimated 1.6 million of its 18 million people infected with HIV. Only a fraction of those requiring ARVs are on treatment, with most of the drugs imported from India.
The offer to build the pharmaceutical plant was first raised by Brazilian President Luiz Inacio Lula da Silva during his 2004 official visit to Mozambique. Lula said he wanted drugs from the plant to be available to other African nations as well.
Brazil claims the use of generic anti-retrovirals has cut its AIDS mortality rate in half.
Mozambican Health Minister Ivo Garrido said the government would decide next month whether to approve the Brazilian proposal. "We will have to study it very carefully," he was quoted as saying by Noticias.
About one million people in need of anti-retroviral treatment for HIV/ AIDS are yet to receive it in four southern African states, according to Medicins Sans Frontieres, a global nongovernmental organisation specialising in medical services.
On the African continent, some 70 percent of people who need ARVs do not have access to the drugs.
The campaign to put pressure on governments to speed up the delivery of ARVs to millions of Africans in need of the life-prolonging drugs is gathering momentum, with MSF being the latest to add its voice to the crusade.
While the number of people receiving ARVs in Africa has increased to 1.3 million today, about 70 percent of those estimated as needing treatment in Africa are not getting it, the MSF said.
More than one million people in South Africa, Mozambique, Malawi and Lesotho need AIDS treatment but are not getting it, according to the MSF's new report, "Confronting the Health Care Worker Crisis to Expand Access to HIV/AIDS Treatment", launched in Johannesburg last week.
In Lesotho, only 17,700 people out of 58,000 have access to treatment. In Malawi, 59,900 people receive treatment as opposed to 169,000 people who do not. In Mozambique, a similarly dismal situation exists as only 44,100 people have been covered, out of 237,000.
In the more developed South Africa, only 265,000 out of 983,000 people have access.
This is happening at a time when AIDS drug prices have gone down and global funding for HIV/AIDS has increased from 2 billion US dollars in 2001 to about 8.3 billion dollars, MSF said.
"The main barrier to expanding antiretroviral therapy in these four countries today is the shortage of heath care staff to care for an increasing number of patients," Eric Goemaere, MSF head of mission in South Africa, told journalists at the launch.
This has resulted in the unnecessary loss of lives. For example, Lesotho with its population of around 1.8 million has 23,000 deaths a year due to HIV/AIDS, MSF said.
The problem is compounded by doctors being overwhelmed by AIDS cases due to the magnitude of the epidemic. Of the four countries surveyed, only Malawi and Lesotho allow nurses to deliver and manage ARVs.
"In Mozambique, nurses do not prescribe ARVs. If they are allowed to provide them, we can save many lives," Daniel Nhantumbo, MSF medical technician in Mozambique, told journalists.
His colleague, Pheelo Lethola, an MSF field doctor in Lesotho, agreed. "More people will die if we rely only on doctors, especially in rural areas and in the mountains," she said.
In the MSF report, Emily Makha, a 70-year old nurse at Kena, a rural clinic in western Lesotho, talks about providing ARVs. "As the only nurse here, I have to do the work of at least four nurses. I take blood samples, do both ante-natal and post-natal cases and handle curative care for general patients, the delivery of babies and so forth.
"If I have to go somewhere, the clinic remains closed. Most nurses have left for the United Kingdom or South Africa. As a matter of fact, if I was younger, I would also have gone now," Makha was quoted as saying in the MSF report.
"Providing HIV care in rural clinics depends on nurses, but they cannot cope with the number of patients," Lethola said. "Consultation times are too short, and sick patients suffer needlessly. When nurses suffer, patients suffer."
Presently, ARVs are the only available hope for millions of people living with HIV/AIDS. "If properly delivered, a patient should feel well and lead a relatively normal life within six months," Goemaere said.
The MSF's call for increased access to ARVs follows on a march held a month ago in South Africa's commercial hub of Johannesburg. Dozens of civil society activists participated, led by the international charity Oxfam.
They were demanding that the 53 African Union (AU) health ministers, who were meeting in Johannesburg at the time, prioritise the World Health Organisation's 2010 target for achieving universal access to prevention, treatment and support to address HIV/AIDS, tuberculosis and malaria on the continent.
Campaigners attribute the delay in providing treatment to a lack of political will. "Governments need to be pressured to address the issues around ARV delivery and distribution," Regis Mtutu of the Cape Town-based Treatment Action Campaign (TAC), told IPS in an interview at the time.
"Eight million Africans are dying from HIV/AIDS, TB and malaria every year. We want to stop this," he said
In 2001 African heads of state met in Abuja, the capital of Nigeria, and committed 15 percent of their national budgets to health as part of the African Common Position on Universal Access. "Six years down the line only two countries -- Botswana and The Gambia -- have met this promise," said Mtutu, who took part in last month's procession in Johannesburg.
In another meeting in May 2006 in Abuja, heads of states agreed to targets for ARV coverage and prevention of mother-to-child HIV transmission of at least 80 percent by 2010. Mtutu insisted that individual countries' targets should be "be equivalent or greater to the targets set" in Abuja in 2006.
Currently, most countries on the continent have less than 30 percent treatment coverage and only three countries in Africa have greater than 50 percent coverage.
A network of HIV-positive people in India has launched a national campaign against thousands of illegal backstreet clinics and quacks who cheat patients with the promise of curing AIDS.
Patients often end up going to quacks and witch doctors who use fake herbal, homeopathic and drug treatments because the government health system is widely seen as offering poor treatment while private care is costly.
Health experts say discrimination against infected patients at hospitals as well as social stigmas also force HIV-infected people to turn to quacks who advertise in newspapers and through posters, fliers and graffiti.
"The quacks are not only a stumbling block in the fight against AIDS but also they cheat unsuspecting patients, often poor and uneducated," said Shabana Patel, a representative of the Indian Network of People Living With HIV and Aids in the western state of Maharashtra.
The network of people who are HIV-positive or living with AIDS has chapters in almost every Indian state and thousands of members.
India has the world's highest number of HIV-positive cases with an estimated 5.7 million people infected, according to the United Nations. But only around 100,000 people get treatment.
Quacks step in to fill some of that gap.
Estimates vary on how much a quack charges for "curing" AIDS, but anti-quackery campaigner Nayna Raut says it could be more than $3,000 a year per patient, a fortune for India's poor.
"They don't even do a blood test. Just on the basis of some fake clinical diagnosis they prescribe their miracle cure for AIDS," Raut said.
Patel's group received more than 100 complaints in April from HIV-positive patients who said they had been cheated by quacks.
India has approved a plan that envisages spending around $2.8 billion over the next five years for AIDS prevention and increasing the number of people on first-line AIDS drugs.
May 25, 2007
Vietnam is still determined to successfully implement a national strategy in the fight against HIV/AIDS.
Nguyen Tat Thanh, Deputy Permanent Representative of Vietnam to the United Nations, made the statement at the plenary meeting of the 61st Session of the General Assembly in New York on May 22.
“Vietnam is making every efforts in implementing the National Strategy on the Prevention of and Fight against HIV/AIDS to the year 2010 and Vision 2020, which have the overall objective of keeping HIV/AIDS prevalence under 0.3 percent in 2010, achieving a zero increase rate thereafter,” Thanh said.
He also affirmed that Vietnam considers the battle against the disease as a priority target in all government agencies and local governmental bodies.
Alongside raising awareness on HIV/AIDS prevention among the population in urban, rural and mountainous areas, the country has set further targets to control the transmission from intravenous drug users and encourage widespread use of condoms. This is in addition to ensuring that people living with HIV/AIDS receive adequate care and treatment.
Other targets are to improve monitoring of the spread of the disease in all cities and provinces and prevent transmission via medical services.
The diplomat cited the Law on HIV/AIDS Prevention and Control, which was approved by the National Assembly on June 2006, as a step forward in the country’s fight against the epidemic.
“The Law spells out the rights and responsibilities of individuals, government agencies, social organisations, communities and families in the joint fight against the epidemic,” he said.
“It expressly and authoritatively prohibits stigma and discrimination against people living with HIV/AIDS and members of their families, including refusal of their employment or promotion on the basis of their HIV/AIDS status.”
“It also stipulates voluntary testing, confidentiality of test results, counselling services, access to antiretroviral (ARV) medicines and other aspects of the prevention, treatment, care and support.”
The Government is taking action now to put the law into place, he added.
According to the diplomat, while trying to increase the national budget for preventing and combating HIV/AIDS and cooperating with international donors and partners, Vietnam is also exploring ways and means to mobilise, channel and utilise resources more effectively and efficiently.
On May 7, 2007, the Prime Minister signed a decision to establish the Support Fund for the Treatment of People Living with HIV/AIDS, aimed at supporting the costs of medical examinations, treatment for people living with HIV/AIDS who are not covered by medical insurance and their spouses and children, he said.
"Vietnam will continue to scale up all efforts necessary and sufficient to achieve its national targets, MDG 6 and commitments under the Declaration of Commitments on HIV/AIDS and the Political Declaration on HIV/AIDS,” he concluded.
NILE Breweries has completed training 200 sorghum farmers as HIV/Aids peer educators. The trainees were selected from 15 core epuripursorghum growing areas in the western, northern and eastern regions.
Nile Breweries uses epuripur variety of sorghum to make Eagle Lager and Eagle Extra beer brands.
The brands are popular among the rural drinkers.
"We want farmers who grow sorghum for us to be alive, healthy and productive," Onapito-Ekomoloit, the corporate affairs manager, said in a statement.
He said the training was conducted by trainers from the Business Part, a USAID-funded project that specialises in HIV/Aids education. It started in February in Masindi and Hoima.
It ended in May in Pallisa after covering Amuria, Amolatar, Apac, Bukedea, Budaka, Dokolo, Lira, Kabermaido, Katakwi, Kumi, Oyam and Soroti.
The main message passed to the educators was for them to guide farmers to know their HIV/Aids status so as to take the necessary measures to be healthy and productive, regardless of the results.
When Lydia Matebesi was growing up in the sprawling village of Serowe in the Central District in the 1970s, little did she know that some day she would be at the heart of fighting the HIV/Aids pandemic in this southern African nation of some 1.8 million people.
A nurse by training, Lydia has been at the forefront of the fight against HIV/Aids as UNDP Botswana HIV/Aids Programme Manager for the last seven years. In this capacity she has seen it all in as far initiatives of fighting the pandemic are concerned. She is so far the longest serving HIV/Aids programme manager since it was introduced as an UNDP thematic area of development.
"It is really challenging working in an area which is forever changing," she says. First of all when HIV/Aids first emerged, it was treated as an adult diseases contracted through sexual intercourse. But it was later realised that the scourge actually hits all spheres of human development, including children, hence we at UNDP treat it as a development issue," says.
Matebesi acknowledges that there are a number of challenges organisations in the forefront of the war against HIV/Aids are faced with. Amongst these is the struggle by these organisations to find their comparative advantages. "It has always been a struggle for some of them to find a niche in such a way that they would make a marked difference."
Over the years, UNDP has played a critical role in the fight against the HIV/Aids scourge in Botswana. "In so doing, it is imperative that we work with other stakeholders in Botswana," she says. These include civil society organisations, the Government of Botswana, other United Nations agencies as well the National Aids Coordinating Agency (NACA) and the international development partners, amongst others. "Recently we've been working with government departments and ministries to mainstream HIV/Aids," she says, adding; "We work with all units in NACA."
Talking about collaboration with civil society organisations, Matebesi recall, when her UNDP worked with a British rock music group, UB40, to raise some US$75 000.00, which was distributed to some seven needy community-based organisations in the country, most of which are assisting orphans of HIV/Aids scourge. UB40 raised the funds in a series of concerts it performed marking its 20th anniversary.
From time to time, UNDP working in collaboration with other stakeholders conducts surveys and studies to assess the impact of the scourge on the Botswana society at large. Findings of a study they recently commissioned by UNDP with the government of Botswana, through NACA, to update and refine earlier estimates of the economic impact of HIV/Aids in Botswana have revealed that HIV/Aids has impacted the country so severely that this model of economic development in sub-Saharan Africa could see all the economic development dwindling in slightly over a decade from now.
"HIV/Aids continues to be a serious problem in Botswana, with a widespread social, humanitarian and economic impact. HIV prevalence rates remain amongst the highest in the world although there is some evidence that prevalence rates have peaked," states the report.
The study was commissioned to analyse the likely macroeconomic impact and make predictions of how that impact would evolve over the period to 2021.
The broad conclusion is that HIV/Aids is having a substantial negative impact on the economy of Botswana. The detailed projections show that, in the absence of widespread Anti-Retroviral Therapy (ART) provision, average real economic (GDP) growth will be reduced by 1.5 percent to 2.0 percent a year over the period 2001 - 2021, resulting in the economy being 25 percent to 35 percent smaller as a result of HIV/Aids than it would have been otherwise.
"This is really scary. 2021 is not very far," says Matebesi with an expression of serious concern on her brow.
It is very clear from these findings that the cost implications of HIV/Aids for the Botswana economy will not be going down in the next few years, she explains.
The study was also aimed at analysing sectoral, household and government budget impacts; and considers policy responses to HIV/Aids. On national budget, the study reveals that HIV/Aids will continue to have a substantial impact on the government budget, especially under the current scenario of nationwide provision of free ART. The total cost in 2006 is estimated at P1 billion approximately (US$166 112.96 million) (at 2004/05 prices), which is equivalent to approximately 6 percent of government spending. These costs include health care costs relating to in-patients, ambulatory patients and the ART programme, as well as related costs such as home-based care, prevention activities, other HIV/Aids programmes, care of orphans and vulnerable children, and additional old-age pensions. The cost of ART drugs is the largest single component of overall costs.
However, Matebesi argues that current figures on ART do not tell the whole story. "Currently people are still on first line treatment. It will get more expensive as they move on to second line treatment and so forth," she says.
To try and mitigate this, the country should now revert to generic drugs, which are cheaper than branded ones, she says.
These impact studies are carried out to gauge the cost implications, economic implications as well as demographic implications of the scourge over a number of years. Matebesi explains that so far they have carried out macro-economic study, demographic impact study, on education, on health, data review and the Botswana Aids Impact study. They are also preparing to undertake impact studies for the agriculture and transport sectors.
The dire lack of health care workers in southern Africa is threatening efforts to expand access to HIV/AIDS treatment, warned the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) in a new report issued today. The report covers four southern African countries—Lesotho, Malawi, Mozambique and South Africa—where more than one million people still need life-saving antiretroviral treatment but do not have access to it. Lack of action will result in unnecessary illness and death.
"In Thyolo district we are treating 7,000 people with HIV/AIDS. We need to increase this number to 10,000 by the end of the year, but our program is hitting a wall because there are simply not enough nurses, doctors, and medical assistants," said Veronica Chikafa, a nurse/matron working with MSF in Malawi.
Severe shortages of health staff are compromising the quality and availability of HIV/AIDS care across southern Africa. In Thyolo district in Malawi, a medical assistant can see up to 200 patients per day, far too many to ensure quality care.In Mavalane district in Mozambique, patients are forced to wait for up to two months to start treatment because of the lack of doctors and nurses, and many have died during the wait. In Lesotho there are only 89 doctors in the whole country."Providing HIV care in rural clinics depends on nurses, but they are overwhelmed by the number of patients," said Dr. Pheello Lethola, field doctor for MSF in Lesotho."Consultation times are too short, and sick patients suffer needlessly. When nurses suffer, patients suffer."
There is wide acknowledgement of the human resource crisis, but little action on the ground.MSF is urging governments to develop and implement emergency plans to retain and recruit health care workers that include measures to raise pay and improve working conditions. In most countries this will only happen if donors change their policies and start providing financial support for recurrent costs such as salaries. Ministries of finance and the International Monetary Fund (IMF) will need to find solutions to overcome "caps" on the number of health workers and level of salaries. Otherwise, governments will not be able to respond adequately to the unmet need for treatment.
Even in South Africa, which has more health care workers who are better paid compared to other southern African countries, unequal distribution and inadequate numbers of staff are causing delays to expanding treatment. "Clinics are absolutely saturated, waiting lists are growing, and it feels like we are losing the battle," said Dr. Eric Goemaere, head of MSF's program in Khayelitsha, Western Cape."For people making policies in offices far away from patients, our message is that you will be held responsible if you are not reactive or flexible enough to find solutions to the staff shortages."
To expand access to HIV care in rural settings, MSF teams havereliedon"task-shifting" from doctors to nurses, andfromnursestocommunityworkers.But these are limited measuresthatdonotremovetheneedfor additional skilled staff.
"It is incomprehensible that donors provide funds for life-long aids treatment and the building of new clinics, but refuse support for health care worker salaries on the grounds that this is 'unsustainable,'" said Sharonann Lynch, treatment literacy coordinator for MSF in Lesotho. "People living with HIV/AIDS do not only need drugs and clinics; they need trained, motivated health care workers to diagnose, monitor, and treat them."
In the four countries profiled in this report, MSF is presently providing antiretroviral treatment (ART) for nearly 30,000 people.Worldwide, MSF provides ART to over 80,000 patients in more than 30 countries.
Some 3,000 Cambodians, including 500 who are HIV-positive, took to the streets Friday to demand better HIV/AIDS care in the country, hit hardest by the disease in Southeast Asia.
"We need better access to treatment. Most HIV-positive people still lack access to even cheap... treatment," said Kong Vanny, a 42-year-old woman, who was infected by her husband.
The crowd, including Buddhist monks, university students and government officials, also lit candles to mark Cambodia's annual AIDS Memorial Day at a central park in Phnom Penh.
"We hope this event will help raise awareness of HIV/AIDS among Cambodian people," said Hor Bunleng, undersecretary of state at the National AIDS Authority, a government body tasked with tackling HIV/AIDS.
While Cambodia has made strides in battling HIV/AIDS, and has successfully slowed its once-spiralling infection rate, the country still has the highest rate of HIV in Southeast Asia.
Some 1.9 percent of the population of 13.8 million are infected with the HIV virus, and relatively few have access to treatment.
Nearly 10,000 Cambodians die of AIDS-related illnesses every year, according to the government.
May 24, 2007
The number of people suffering from HIV/AIDS in India, the country with the world's highest caseload, could be more than the official count as many cases are not reported or detected, the finance minister said on Wednesday.
India has 5.7 million people living with HIV/AIDS, according to the United Nations.
The state-run National Aids Control Organisation (NACO), which spearheads the country's fight against the deadly HIV virus, estimates 5.2 million cases.
NACO figures do not include people below 15 years and above 49 years of age.
"All reports indicate it (HIV/AIDS) is under-reported and under-detected in the country," Finance Minister Palaniappan Chidambaram told a corporate awards ceremony.
"We now recognise it is a serious problem and it is good now we are not in a state of denial anymore."
AIDS activists say a lack of awareness and widespread stigma has contributed to paranoia among many people about the virus and forced thousands of patients to hide their infection.
Many people, including some federal lawmakers, believe that a person can get HIV by shaking hands with an infected person, surveys have shown.
"Some hospitals and many families do not report HIV cases because of social stigma and this should be taken into account," said Denis Broun, UNAIDS chief in India.
Some experts say that if India's HIV epidemic does not stabilise, it could impact long-term economic prospects as many of those who are HIV-positive are in their twenties and thirties, ages seen as most productive in their jobs.
NACO estimates that out of 165,000 reported AIDS deaths so far, around 50,000 were in the 15-29 year age group.
(Additional reporting by Kamil Zaheer and Surojit Gupta)
Australian High Commissioner to India, John McCarthy, has announced additional funding for HIV/AIDS and drugs prevention in Nagaland, Meghalaya, Manipur and Mizoram.
The project, "Prevention of Drugs and HIV/AIDS in India" will be implemented by the UN Office on Drugs and Crime (UNODC) with additional funding of USD 330,000, a High Commission release said.
"The Australian Government has committed its aid program in India to preventing drug abuse and HIV/AIDS particularly in the North-East", said McCarthy.
"The main objective of this project is to strengthen the capacity of government and civil society organisations in preventing drug abuse. This will also scale-up interventions that reduce the harmful consequences of drug use, especially HIV", he added.
"The HIV/AIDS epidemic is a serious cause of concern not only in India, but across the world. With this project, Australia hopes to contribute to the efforts of organisations such as the United Nations towards preventing the epidemic," said McCarthy.
The project strategy includes engaging a community and social action to spread awareness among young people about HIV/AIDS. This includes the introduction of drug awareness programs for schools and the establishment of self-help groups for young women affected and afflicted by drug use and HIV.
The Government of Australia has supported UNODC on this project since 2005, with total Australian funding under the project being USD 854,000.
Australia's previous involvement in the North-East region through HIV/AIDS initiatives include the SHALOM project (a three-year long project initiated in Manipur between 1994-97 for the prevention and control of HIV/AIDS); the India-Australia capacity building training project (a series of teaching modules on HIV/AIDS); and the Prevention of transmission of HIV among drug users in SAARC countries project (aimed at strengthening the capacities of State governments and civil society organisations to prevent the spread of HIV/AIDS amongst injecting drug users in the SAARC region).
May 23, 2007
The Global Fund to Fight AIDS, Tuberculosis and Malaria said Tuesday it had doubled to more than one million the number of HIV victims in poor countries who receive life-saving antiretroviral treatments in a year.
Similar progress was achieved for tuberculosis and malaria, the Fund announced in a telephone news conference.
Some 2.8 million people were treated for TB via the Fund's programmes by May 1, 2007, up from 1.4 million a year earlier, and 30 million people received malaria-resistant nets, it said.
"We are clearly exceeding our targets," the Fund's executive director Michel Kazatchkine told journalists.
He said the Fund's activities had helped save around 1.8 million lives since it began its work in 2002.
The Fund is currently providing approximately two-thirds of support against malaria and TB worldwide, and around a quarter of support for HIV/AIDS, he added.
Kazatchkine urged the leaders of the G8 group of industrialised nations, who will be meeting in the German resort of Heiligendamm duing June 6-8, to live up to their commitments to help fight the diseases.
"I hope they (the G8 leaders) can be inspired by the Global Fund's success to pursue health targets they have set, including cutting malaria and tuberculosis rates in half," he said.
The Global Fund was created in January 2002 by the then UN Secretary General
Kofi Annan to channel new money into local projects in poor nations.
Joia Mukherjee, medical director for the group 'Partners in Health', which received one of the first Global Fund grants, said the Fund was vital not just in tackling the three diseases, but also in supporting public health infrastructure in developing countries.
In countries such as Rwanda, Haiti and Lesotho, the Global Fund's programmes have "huge amounts of collateral benefits for the health system in general," she told journalists.
Mukherjee called on the G8 leaders to deepen their commitment to fighting AIDS, TB and malaria, and stressed the importance of taking a long-term perspective on funding commitments, for periods of 10 to 20 years.
A 5-year-old organization that leads international efforts against three leading diseases said on Tuesday more than a million
HIV-infected people have received life-extending drugs thanks to its efforts.
The Global Fund to Fight AIDS, Tuberculosis and Malaria, launched by the Group of 8 industrialized nations and financed largely by the U.S. and European governments, said it is exceeding its targets.
The organization said as of May 1 between 1 million and 1.1 million people had received AIDS drugs through its efforts, up from 544,000 a year ago.
It said the number of tuberculosis cases treated also doubled from a year ago and the number getting insecticide-treated bed nets to protect against the bite of the mosquito that spreads malaria more than doubled.
"So far we estimate that the programs funded by the Global Fund have saved the lives 1.8 million people -- that is the lives of 3,000 people a day who would otherwise be dead from AIDS, TB and malaria," said Dr. Michel Kazatchkine, the fund's executive director.
The group devotes much of its efforts to Africa, the continent hardest hit by all three diseases.
More than 2.8 million people have been treated for TB and around 30 million families received bed nets under Global Fund fund efforts since it started its work in 2002, the group said.
Kazatchkine told reporters the fund has provided about $3.5 billion to fight the three diseases. About 30 percent of the money comes from the United States and 55 percent from EU countries, he said.
But he said much remains to be done, and that the fund is seeking $6 billion by 2010.
More than 25 million people have died of AIDS since the incurable disease, which devastates the body's immune system, was first recognized about a quarter century ago. About 40 million are now infected with the human immunodeficiency virus that causes AIDS.
Malaria kills about a million people annually, mostly young children. Tuberculosis kills an estimated 1.6 million people a year.
The Global Fund detailed its efforts in 136 countries before a meeting of G8 heads of state in Germany in June.
THE state government is spending crores of rupees on campaigns to dispel myths about HIV, but it seems to have failed to convince even the medical fraternity, and that too in the capital.
Shuttled from one hospital to another, a critically ill Ramen Adhikary (name changed) ultimately found a place in one of the premier hospitals of the city, only to be thrown out after a couple of hours by the medical staff as they learnt about his HIV positive status.
The incident took place at the Calcutta Medical College and Hospital on Tuesday, where the patient was referred to from the School of Tropical Medicine (STM). After the daylong ordeal, the 32-year-old patient, a resident of Ghatal in West Midnapore, was finally taken to a state-run hospice in Behala.
"I am yet to verify the incident. It's shocking. How can a patient be thrown out like that. We will definitely conduct an inquiry," said A N Biswas, deputy superintendent of the hospital.
"The entire incident is shocking and it highlights how HIV positive patients are neglected. We have already informed the health department and will lodge a formal complaint on Wednesday," said Tarit Chakraborty, president of the Bengal Network for Positives, an organisation of HIV positive people in West Bengal.
Adhikary had been suffering from multiple ailments for the last four months. He was diagnosed with HIV in April at the STM. His condition deteriorated meanwhile and he fell critically ill. His family members took him to Ghatal sub-divisional hospital, from where he was referred to STM again.
Accompanied by his wife, and neighbour Biswanath Jana, Ramen reported to the STM at around 9 am on Tuesday. After waiting for hours, the doctors ultimately attended to him at noon, but referred him to Calcutta Medical College citing non-availability of beds.
The trauma started for the hapless patient and his attendants the moment they reached the hospital. They were shuttled from one department to the other for hours. At 1.30 pm, the patient was finally admitted (admission order number 602/07) and placed on the floor of the male ward in the general emergency. "Around 3 pm, the Group D staff asked us about the disease of the patient and we told them it was AIDS. Suddenly, they were infuriated and told us to take him away. We argued but failed to reason with them. Some of them then picked him up from the floor, carried him out and put him on the ground in the open. It was raining and we were helpless. He (Ramen) was gasping," said the patient's wife.
Ramen lay near the hospital gate for hours in a critical condition. His relatives said they approached the doctors on duty but they all refused to help them. Ultimately, it was a group of locals who came to their aid. "We saw the man lying on the ground and he had defecated on himself. We went to the offices of the superintendent and deputy superintendent, but they had left for the day. Ultimately, we contacted Arunima Hospice, a nursing home for HIV positive patients. He was placed there late in the night," said Ajay Roy, a social worker.
South African lawmakers Tuesday passed amended legislation to broaden the definition of rape in a country with sky-high rates of sex crimes and HIV/ AIDS.
The sexual offences amendment bill, in the making for over a decade, now defines rape as any sexual penetration, including of the anus or mouth, without consent -- irrespective of the victim or perpetrator's gender.
The crime of rape is broadened beyond forced vaginal penetration to include forced oral sex and male rape, hitherto classified as indecent assault.
It also includes forced sexual penetration using an inanimate object or animal genitalia.
"The objects of the bill (include) creating offences which are intended to address the relatively high incidence of sexual offences committed in the republic," says an explanatory memorandum.
The legislation allows rape victims to obtain a court order for compulsory HIV testing of alleged offenders and for the results to be revealed to them.
It also entitles victims of sexual offences to be provided with post-exposure anti-AIDS drugs at state expense.
The bill would furthermore create a register of people convicted of sexual offences against children and the mentally handicapped to ensure they were not employed to work with such vulnerable groups or adopt children.
The amended law was supported by all political parties in the National Assembly and was passed unanimously.
About 55,000 rape cases and just under 10,000 of indecent assault were reported to South African police in the 2005/06 financial year.
Nearly half of rape victims in the country are believed to be children.
About 5.5 million in a population of 47 million are believed to be infected with the HI Virus that causes AIDS.
May 22, 2007
Each morning, Somying waits on the canal near her Bangkok slum for the iceboat that has become her lifeline.
"It's expensive but I need ice every day," the 33-year-old said of the 12 baht ($0.37) purchase that keeps her lifesaving
AIDS drug, Kaletra, from perishing in hot season temperatures nearing 40 degrees centigrade (104 F)
A version that does not need refrigeration is available in the United States and some African countries hard hit by AIDS, but not in Thailand where the army-backed government is embroiled in a patent dispute with its maker, U.S. pharmaceutical giant Abbott Laboratories.
Abbott will not register the new version, Aluvia, until Bangkok renounces its January decision to invoke a compulsory license under world trade rules which allow governments to make or buy copycat versions of drugs for public health measures.
Thailand, which has taken similar action on another AIDS drug and a heart disease medicine in what it says is a bid to widen access for its poor, wants Abbott to cut its prices more.
The company is sticking to its last offer of $1,000 per patient a year, down from $2,200, but higher than generic versions available for $695.
"The new pills would make it easier," said Somying, whose monthly ice bill eats up nearly half the 800 baht she earns at home tying ribbons for a garland maker.
"I wouldn't have to buy ice or carry around the cooler anymore," she said outside the two-room shack she shares with her two children, including a 13-year-old son with AIDS.
Still, they are among the lucky ones.
US-based William Foundation to give Rs 200 per patient TO provide regular treatment to children suffering from HIV/AIDS, a three-day medical camp will be organised by Gujarat State AIDS Control Society (GSACS) and Gujarat Network of People Living with HIV/AIDS (GNPLHA) at NHL Medical College in Ahmedabad.
Sponsored by William J Foundation (set up by former US president Bill Clinton to sponsor expensive HIV/AIDS drugs in developing and poor countries), the camp - to be organised from May 22 to 24 - is a maiden drive to help patients from 18 months to 15 years of age.
The foundation will fund Rs 200 per young patient and bear transportation expenses from anywhere in the State.
Volunteers of GNPLHA are camping in towns and villages of 24 districts to identify patients and bring them to the camp.At the end, GSACS will assess population of young patients suffering from HIV/AIDS and initiate free life-long treatment and tests.
Patients at the camp will get facility of CD4 and CD8 tests (expensive tests required for the baseline assessment of immune system) for free and will be put on medication of ARV pediatric, and others who do not require immediate medication will be registered for follow-up treatment.
"GSACS aims to begin a complete AIDS treatment programme especially for children as also a survey in 24 districts of the State is on for past 15 days,'' said additional project director GSACS Dr D M Saxena, adding, "Around 500 children are expected to attend the camp.''
Though about 2,000 patients have registered for treatment at two centres in Ahmedabad and Surat, young patients from poor financial background are left to fend for themselves. Number of patients is on steady rise in state, but free ARV drugs dose is available only at Ahmedabad and Surat centres.
Even as a third centre is proposed to come up in Rajkot, the State society, NGO and international group have joined hands to provide special facilities to children.
The world will fall far short of its 2010 target of providing universal access to HIV treatment, with India and Nigeria high in an "AIDS league of shame," a global voluntary group said on Monday.
In 2006, the U.N. General Assembly agreed to work towards universal access to treatment, care, prevention and support, following a declaration by Group of Eight countries the previous year.
In its report titled "Tackling political barriers to end AIDS," ActionAid International said India, South Africa and Nigeria -- the three nations with the highest caseloads -- have some of the lowest percentages of people receiving AIDS drugs.
"In developing countries, HIV/AIDS is a death sentence for those who don't get treatment," said Aditi Sharma, international campaign coordinator for AIDS at ActionAid.
ActionAid said only five million people around the world would be on AIDS drugs by 2010 at the current pace, which would be five million short of the target for universal access.
The group said only about two million of the estimated seven million people in need are on AIDS drugs at present.
The report says India, with the world's highest caseload, provides anti-AIDS drugs to only seven percent of HIV-positive people in need. India has 5.7 people living with HIV, according to UNAIDS.
Authorities provide only first-line AIDS drugs free in India, where the government plans to spend around 80 billion rupees ($2 billion) to combat AIDS in 2007-12.
In South Africa, which has an estimated 5.4 million people living with HIV, 18 percent of people in need of drugs are getting them.
In Nigeria, with a caseload of around 3.5 million people, just 10 percent requiring treatment get it, the group said.
Other African countries like Gambia, Ethiopia and Ghana also fare poorly, with less than 10 percent receiving treatment.
In Asia, Pakistan provides just 1.2 percent with advanced HIV with treatment, according to ActionAid.
"In country after country, progress is staggeringly slow and with just three years to go to 2010, the world is in danger of missing the target that gave hope to 40 million living with HIV and AIDS," Sharma said.
May 21, 2007
American bio-pharmaceutical major Gilead, which has entered into generic licensing deals with 10 Indian pharma firms to distribute its HIV drug Viread, is hoping to get a patent in India soon.
'We have made considerable progress in implementing our access programme and licensed Indian pharmas to manufacture Viread which originally announced a pricing of $1 a day for the pill,' Gregg Alton, senior vice president and general counsel, Gilead Sciences, told IANS.
'After much discussion, Gilead now believes that a larger number of manufacturers will intensify competition and drive down prices even further,' said Alton whose team was in Delhi last week.
Now, Gilead's application for a patent is pending before the Indian Patent office as it believes that it has a right to protect its intellectual property.
Indian pharma major Cipla has filed a pre-grant opposition against the patent application for Viread before the patents office.
But Alton said: 'We believe that protecting the intellectual property of companies who engage in drug research and development is a critical part of the treatment access equation. Intellectual property protection, when used responsibly, encourages research and discovery of newer and more effective molecules.
'Gilead respects Cipla's right to oppose the issuance of a patent for Viread or any drug. But more importantly, we reaffirm our desire to work with Cipla whether or not a patent is issued,' said Alton.
Gilead has signed generic licensing deals with 10 Indian pharma majors to distribute Viread in India and 94 other resource-limited countries.
More than 5.1 million people are believed to be infected with HIV in India - the second highest incidence of the disease after South Africa.
According to Alton, Viread (tenofovir disoproxil fumarate) is on its way to becoming the frontrunner drug across Europe for HIV/AIDS due to its low toxicity and resistance levels observed in patients.
The tablet-a-day dosage of the drug also helps in better regimen and compliance among the HIV/AIDS patients taking it.
Alton also pointed out that he expects generic versions of Gilead's anti-retrovirals to be available from several of its partners within the next few months.
When asked whether the drug would become unaffordable if Gilead was granted a patent for Viread in India, Alton assuaged fears voiced by critics and NGOs.
'The company plans to use this patent responsibly and has made its intention clear in the act of issuing non-exclusive voluntary licenses to Indian companies,' he said.
'We have also planned a direct contact programme with NGOs and this open mode of communication will enable NGOs and Gilead to work on a common platform and fight the epidemic of AIDS together.'
Currently, Gilead has signed agreements with Alkem Laboratories Ltd., Aurobindo Pharma Ltd., Emcure Pharmaceuticals, FDC Ltd., Hetero Drugs, Matrix Laboratories Ltd., Medchem International, Ranbaxy Laboratories Ltd., Shasun Chemicals & Drugs Ltd and Strides Arcolab Ltd.
Around 400 people gathered in front of Jantar Mantar to observe the 24th annual International AIDS Candlelight memorial day.
A vigil was organised on the occasion by Delhi State AIDS Control Society, BioLytical Laboratories, Oxfam, World Vision and St. John's Ambulance Brigade, on Sunday evening.
The vigil was held in memory of those who lost their lives to AIDS, as well as to reinforce the demand for new anti-retroviral drugs to be introduced by the Indian government.
Actress and social worker Nafisa Ali was the chief guest at the event.
Several HIV positive men and women joined the vigil. "I came here because many of my friends have died due to AIDS, and I want an answer to that. Why do they have to die?" asked Vidya, a sex-worker.
Tenzing, a student, came to protest. "I'm not HIV positive but I want to fight for those suffering from the syndrome."
Protestors raised slogans and carried signs "Hume jeene ke liye 2nd ARV (anti-retroviral) chaiye".
Hari Shankar Singh of the Delhi Network of Positive People said, "There are a lot of new medicines available like the 2nd line ARV, but they are not being used in India. We want them to be used here to treat HIV patients."
Addressing the rally, Nafisa Ali said, "I have asked the government to start the 2nd line ARV. It suppresses the virus."
Feroze Khan of the Positive Network of People Living with HIV/AIDS claimed, "Sixty-seven per cent of the funds granted by the World Bank for AIDS control are returned because of mismanagement. Only 33 per cent of the funds are actually utilised."
Instances from Brazil, Thailand and South Africa show that the first line ARV, which is used in India, isn't effective for many patients. However, newer first or second line drugs have not been made available by the government. Several organizations working with AIDS/HIV are calling for their introduction.
Malaysia's health ministry cannot openly promote condom use to prevent HIV/ AIDS, fearing perceptions it is advocating promiscuity in the mainly Muslim nation, reports said Monday.
The ministry's deputy director for disease control, Jalal Halil Khalil, said the government understood that condom use prevented the transmission of HIV -- cases of which are rising in Malaysia -- but could not openly support it.
"We realise that we are an Islamic country and we have to do things carefully," Jalal told the New Straits Times daily.
The health ministry earlier this year warned Malaysia could face an HIV/AIDS epidemic with the number of infected people rising fourfold to 300,000 by 2015.
Of some 75,000 people with HIV/AIDS in a population of nearly 27 million, about three-quarters are intravenous drug users, but heterosexual transmissions are growing.
Jalal admitted not being able to openly promote condoms would render prevention programmes less effective, adding the ministry was relying instead on non-government organisations (NGOs) to advocate condoms.
"It may slow down the effectiveness of prevention. It is difficult to promote the open usage of condoms," he told the Star newspaper.
"We let the NGOs do the work ... we use different ways of communicating it or else people will think we are promoting promiscuity," he said.
Sex is a taboo topic rarely discussed in public in the conservative nation, while HIV/AIDS patients suffer from social stigma.
Malaysia last year embarked on a five-year plan to curb the spread of the disease, including needle exchange programmes for drug addicts, free antiretroviral drugs and drug substitution therapy.
The walking plaza on MG Road resonated with voices of Puneites who pledged to make the city free of the stigma of HIV/AIDS. Vijay Nair, president, NGO Udaan and Founder Member of Maharashtra Network of Positive People (NMP+) was the chief guest at the candle light vigil function held on Sunday. He said that in spite of substantial awareness about HIV/AIDS, there is a lot of discrimination experienced by those affected by it. Nair also called for a concentrated effort at every level of the society to catalyse a shift in this attitude.
Several citizens lit candles and observed a minute's silence in the memory of those who died of AIDS. The event, Light Up Pune, was part of the HIV/AIDS International Candlelight Memorial designed to honour the memory of the departed souls, demonstrate support to those living with the virus and raise awareness while mobilising community involvement in the fight against the epidemic.
The day-long event included poster exhibition and quiz competition on HIV/AIDS at a multiplex in the city. Various events like street plays and so on were also held across the city as the Disha Mobile AIDS Awareness Van made rounds spreading messages on safe sex and use of condoms. Nair called upon the gathering to 'practise safe sex and be healthy' while urging members of the HIV+ Network, to take life positively, and inspire others to do so. Indian Idol Sandeep Acharya also performed during the programme.
The event was arranged by Wake Up Pune, a coalition of 32 city-based NGOs, youth groups and concerned citizens.
The number of HIV- AIDS cases is on the rise in Dane County.
According to Dane County Public Health, gay men and African Americans are two segments of the population seeing significant increases in HIV and AIDS, reported WISC-TV.
"Some people may think it's not that big of a deal anymore," said public health program manager Cheryl Robinson.
But that is wrong, according to Robinson.
In 2006, 64 new cases were reported to public health, 28 were gay men, and 13 were African American. The age group of 25-to-44-year-olds made up 51 percent of the cases reported.
"This is a virus," said MATEC site director Marge Sutinen. "It doesn't matter if you are gay or straight, young or old, black or white, rich or poor, all that matters is that you are human and it wants to get in and set up shop with you."
Sutinen works with AIDS clinics across Dane County. She said AIDS is still an epidemic. "When we have 40,000 new cases every year in this country, I still think it's a threat," said Sutinen.
Sutinen said the disease is beginning to affect new segments of the population.
"I'm seeing a lot more younger people than I did in the past," she said.
African Youth Outreach is a local organization that was initially founded to deal with AIDS problems in Africa.
"It's a public health issue that I don't think a lot of people understand," said AYO co-founder Rebecca Kendziorski. "It's over there, somewhere else, but it affects all of us."
AYO is now beginning to focus its efforts locally to help deal with the rising number of cases in the younger population.
"Kids seem to think that no one can hurt them, they are going to live forever," said Kendzioski.
Kendziorski hopes that education will help slow the trend.
To schedule an appointment for a free, anonymous HIV test, call the Madison Public Health Department at 246-4516.
May 18, 2007
Religion is hindering United Nations efforts to spread the messages needed to combat the spread of AIDS, human rights activist and High Court judge Michael Kirby said on Thursday.
Australia, under successive governments, had been far more successful in its approach to the disease, he said.
Justice Kirby was launching a new book, Civil Society, Religion and Global Governance, which includes contributions by a range of international and Australian political, legal, economic and religious figures on the role of civil society.
"We have in the world to spread the messages that are essential to stopping the spread of the (AIDS) virus," Justice Kirby said.
"Unfortunately, the only way you can do that in the absence of a drug that will do it, or the vaccine that will do it, is by the sort of measures that we have taken in Australia, that we took bravely under successive governments - the Labor government and the present government - to deal with the way in which the virus spreads.
"The difficulty that the world faces is that the United Nations seems substantially disempowered to spread those messages because of the religious impediments that exist to spreading the messages that are essential."
Those messages included the availability of condoms and the role of safer sex, the reduction of the risks of intravenous drug use, the availability of clean needles, the decriminalisation of commercial sex work and the decriminalisation of homosexual acts, Justice Kirby said.
He said these and other messages were very difficult to transmit in many countries because of the attitudes of religion.
"We have to discuss it because it affects us all and it's essential that we do it for the good of humanity," he said.
The United Nations body UNAIDS said that 39.5 million people were living with HIV/AIDS in 2006.
Banning sex education on the grounds that it offends Indian sensibilities puts young lives at risk and jeopardizes the fight against AIDS, a senior health official said.
Six states in India, which has the most people living with HIV/AIDS in the world, have banned sex education for adolescents or refused to implement the curriculum, saying the course material was too explicit or that it was against Indian culture.
Some politicians accuse educators of encouraging permissiveness among young people.
"We are not giving ideas to young people," National AIDS Control Organization (NACO) chief Sujatha Rao said. "They are already there."
"Some people are in denial that young people experiment with sex. They need to get real," she told Reuters late on Wednesday.
Rao's comments came before the cabinet approved on Thursday a plan that envisages spending 116 billion rupees ($2.8 billion) over the next five years in its most ambitious anti-AIDS project yet.
The plan for 2007-12 will focus on prevention and increasing the number of people on first-line AIDS drugs. The government plans to provide 80 billion rupees and the rest will come from foreign donors like the World Bank.
India has the world's highest caseload for HIV/AIDS with 5.7 million HIV-positive people, according to the United Nations. But sex is not spoken about openly in most parts of the country.
An India Today magazine survey last year showed one in four Indian women aged between 18 and 30 in 11 cities had sex before marriage.
Yet over 40 percent of all Indian women have not heard of AIDS, creating a dangerous combination of lack of knowledge and greater sexual activity.
"There will be a huge negative impact if you don't provide sex education, given the vulnerability of young people to the virus," Rao said earlier, addressing MPs who are also doctors.
"Are you more concerned about culture than the lives of young people?" she said.
The states of Gujarat, Maharashtra, Madhya Pradesh, Chhattisgarh and Karnataka have banned or refused to implement sex education curriculum introduced last year.
The Hindu nationalist government in Madhya Pradesh said sex education had "no place in Indian culture" and plans to introduce yoga in schools instead.
India has 165,000 reported AIDS cases of which around 50,000 are in the age group of 15-29 years.
"We are worried about our young people," Rao said.
May 16, 2007
n AIDS awareness group in male-dominated India is touting a new, colourful way to dispel chauvinistic notions about sex: comic books.
Population Council, an international voluntary group, is distributing 250,000 copies of comics among residents of shanty towns in four cities to help change social attitudes and stress the dangers of unsafe sexual practices.
"Many Indian men think it is cool to be violent and forceful with women, and that women who answer back are loose and therefore need controlling," said Vijaya Nidadavolu, Population Council's communications director.
"The idea is to make them aware of alternative gender norms that in turn might make them more equitable and thereby indulge in safer sexual practices," she told Reuters.
Domestic violence is common in India. According to U.N. figures, more than two-thirds of married females aged 15 to 49 years are victims of beating, rape or forced sex.
Experts say social attitudes and traditional ideas about masculinity make men behave in ways that open them and their partners to risk of sexual diseases.
Dispelling these chauvinistic notions is crucial in the fight against AIDS in a country which has an estimated 5.7 million HIV cases, the highest in the world.
In one comic book, a young man refuses to donate blood as he realises his past actions may have exposed him to HIV risk. Instead, he decides to get a test done.
In another, a young man turns violent towards his lover when she suggests that they use a condom because "a good girl" would not advocate protection.
The comics, the size of pocketbooks, are aimed at males aged between 15 and 24 and are designed not to look like the teaching materials normally produced by voluntary groups.
They have titles like "A Drop of Blood", "Senior Beware" and "A Packet of Love" and are available for free in Hindi, Bengali, Telugu and Urdu languages besides a limited edition in English.
They are being distributed in the slums of Delhi, Mumbai, Hyderabad and Kolkata as well as at video game parlours, Internet cafes and other youth hangouts in these cities.
"They have the advantage of visual communication combined with the written, so they have entertainment value," Nidadavolu said.
"Plus comic books are easy to carry and hide -- we find that given the stigma around HIV it is quite useful to have materials that people can conceal."
HIV screening in hospital emergency departments is cost-effective and actually welcomed by many patients, a George Washington University Medical School study finds.
More than 4,000 patients were offered the screening and almost 2,500 (60 percent) agreed to be tested. Of those, 26 patients (one percent) had a preliminary positive result for HIV infection.
HIV is the virus that causes AIDS.
The rapid screening kits were provided free of charge by the Washington, D.C., Department of Health, while researchers did the actual clinical work. While this approach would not be feasible over the long-term, it does suggest some models for a program of ongoing HIV testing in hospital emergency departments, said study author Jeremy Brown, research director in the university's department of emergency medicine.
He said the cost per preliminary positive HIV result was about $1,700, and about $4,900 per confirmed case of HIV infection.
"Washington, D.C., has one of the highest AIDS case prevalence rates in the United States, and our results suggest that ED HIV screening in this high prevalence area is well accepted by patients," Brown noted.
"The cost per case detected is low when compared with other methods for the early detection of HIV. For example, nucleic acid amplification has been used (for) early detection of HIV infection at a cost of over $17,000 per index case identified."
The study was expected to be presented May 16 at the annual meeting of the Society for Academic Emergency Medicine, in Chicago.
The most promising of the many experimental HIV vaccines in development will offer only limited immunity against the deadly virus, US government scientists said Wednesday ahead of world HIV Vaccine Awareness Day.
Unlike classical vaccines, the first-generation HIV vaccines will not enable people to fight off the virus, but may protect their immune system from the worst ravages of the virus and delay the onset of AIDS.
And because patients are at their most infectious when viral levels are high, such vaccines might also reduce the spread of the sexually-transmitted disease, making it a useful tool for public health authorities battling to contain the global HIV/AIDS pandemic.
"There is optimism that even a less-than-perfect vaccine could benefit both individual recipients and the at-risk community," said the authors in a commentary published in the New England Journal of Medicine.
It is still not clear when the first vaccines will be available.
However, stage I and II clinical trials are "well into their execution. Large numbers of people are being vaccinated," said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), and one of the authors of the paper.
Researchers around the globe have been searching for a vaccine against the human immunodeficiency virus (HIV) for two decades, but efforts have been thwarted by the virus' ability to mutate and evade clearance by the immune system.
Eventually scientists turned their attention to so-called T-cell vaccines that primarily induce a cellular immune response that reduces viral levels and preserves critical cells needed to control infection.
In animal studies, peak viral levels were reduced by a factor of 10 in primates that were inoculated with these types of vaccines and then infected with the simian counterpart of the HIV virus, according to the paper.
The inoculations also "dramatically" slowed the progression of the disease in many animals, Fauci said.
The hope is that an effective human T-cell vaccine could substantially improve the quality of life for people who contract the virus after immunization by postponing the day when they develop AIDS and have to begin treatment with a daily cocktail of drugs.
Also, by stifling the initial burst of virus and better controlling virus levels, an immunization program could potentially curb the spread of the epidemic, which is largely driven by people who have viral loads.
Computer modeling studies have suggested that even a vaccine that does not provide adequate protection against infection might alter the course of the epidemic, according to the paper, but further studies will be needed to test the hypothesis, the authors said.
Some 40 million people are HIV-positive and another 11,000 people contract the virus every day, most of them in the world's poorest nations, according to the NIAID.
The commentary was published to coincide with the 10th anniversary this Friday of HIV Vaccine Awareness Day.
Russia's AIDS epidemic is worsening with as many as 1.3 million people infected with HIV as the virus spreads further into the heterosexual population, Russia's top AIDS specialist said on Tuesday.
Russia has registered 402,000 people with HIV, of whom 17,000 have died, but the real figure is much higher, said Vadim Pokrovsky, head of Russia's federal AIDS centre.
"Not only is the number of Russians infected with HIV rising but there is an increase in the rate at which the epidemic is spreading, so a rise in the number of newly infected," Pokrovsky told reporters.
"We have an estimate of up to 1.2 million to 1.3 million infected with HIV," he said, adding that the number of those registered as infected was rising by 8 to 10 percent a year.
The United Nations estimates 65 million people worldwide have been infected with HIV and that 25 million people have been killed by AIDS since it was first recognized in 1981.
AIDS, which stands for Acquired Immune Deficiency Syndrome, is caused by the human immunodeficiency virus (HIV).
Most of those infected with HIV are unaware they are carrying the virus, according to the UN.
"ONE IN TEN MALES"
Pokrovsky said HIV was high among Russia's intravenous drug users but that many of those newly infected were not needle users. And he warned that the virus was spreading fast into the heterosexual population.
Women made up 44 percent of 39,589 registered new infections last year, he said adding that in some cities one in ten Russian males were infected with HIV.
"Evidence of the strengthening heterosexual HIV infection is the increase in the number of women among those newly registered with HIV," Pokrovsky said.
"On average for the country, one out of every fifty males is infected with HIV but in some cities it is one in ten," he said.
Russia's northern city of St Petersburg was worst affected followed by Sverdlovsk region, greater Moscow, Samara region and Moscow, though Pokrovsky said figures for Moscow were probably much higher than the data indicated.
The United Nations said in a report published on Tuesday that HIV was higher in richer regions.
"HIV prevalence is in an inverse relationship to economic development: HIV is more widespread in 'rich' regions," the UN said in a report about Russia's regions.
Pokrovsky said overall funding for fighting AIDS in Russia was rising but that just 200 million roubles ($7.75 million) would be spent on prevention in 2007 out of a total budget of 5.3 billion roubles ($205.4 million).
"The financing is sharply rising," he said. "There is now a lot of money, but the spending is not done entirely properly."
"A very small amount of that money...is directed to preventing the further spread of the epidemic; most of it is being used for treatment. That is good but you need prevention too," he said.
May 15, 2007
The Crown on Monday withdrew a charge of aggravated assault against a St. John's woman who had been accused of not informing a partner of her HIV-positive status.
Jennifer Murphy, 33, was charged in February, weeks after she had completed a one-year house arrest imposed after she pleaded guilty to the same charge, arising from an incident at an Ontario military base.
The Crown told the provincial court in St. John's that the facts of the case did not support the charge.
"I think it's a move forward - not only for me, but for the whole AIDS community in general," said Murphy, who said she used a condom during the incident that led to the charge in February.
"I've been publicly humiliated," said Murphy, who said she was shocked when the Royal Newfoundland Constabulary charged her this winter.
She described herself as an activist within the HIV-AIDS community and a campaigner for safe-sex education.
"I thought, 'You're charging me for protecting somebody?' This puts everything backwards," she said, adding that she feared the case would bring more stigma to people with HIV. "People are going to be afraid to get tested."
Murphy attracted national headlines - and what she called scandalized coverage in the Toronto area - when she was arrested in 2005 after she had sex with a soldier at Canadian Forces Base Borden.
The US ConsulGeneral today interacted with village artists involved in spreading awareness about HIV and AIDS.
Scroll-painters (potua) of West Midnapore and Howrah have been involved in a plan to educate villagers about HIV and AIDS, a method already in use in Bengal.
The programme - "Make Arts/Stop AIDS"- organised at the American Center, was attended by Consul General Henry V Jardine, David Gere from the department of world cultures, University of California at Los Angeles, and of the Make Art/Stop AIDS international initiative, and scroll-painters of the twin districts.
The scroll-painters, who use their songs and paintings to spread awareness on AIDS and HIV in their villages, displayed their artwork and sang original songs. While Swarna Chitrakar sang about how HIV virus spreads through use of same syringes, blood transfusion and unsafe sex, Gurupada Chitrakar sang about the stigma that is attached to HIV positive victims. Monimala Chitrakar talked about loving with responsibility through her song and scroll.
Speaking on the occasion, Consul General Jardine said, "It is important that the student and worker communities are involved in the project, so that policies can be implemented in their spheres. To bring the situation under control, youth of the country will have to be contacted."
According to him, the infection has reached the epidemic levels in Nagaland and Manipur. So when small pockets are discovered, it should be addressed immediately in order to prevent the pocket taking an epidemic form.
Most Chinese would refuse to work alongside a person infected with HIV/ AIDS, an academic said Monday, citing a recent survey.
"A large number of Chinese are willing to discriminate in the workplace for health reasons," Cai Dingjian, director of the Constitutionalism Research Institute of China University of Politics and Law, told reporters.
In a survey conducted by Cai and his colleagues in 10 cities covering 3,500 people, 52 percent of the respondents said they would not work with an HIV/AIDS carrier, while 49 percent said the same of Hepatitis B carriers.
More than 55 percent of the repondents said they would not hire carriers of either disease.
The survey suggested other causes of discrimination at work include physical appearance.
It showed 70.1 percent of male respondents said good looks were important for women if they wanted to get ahead in the labour market.
Although China has laws opposing work-related discrimination and promoting equality at work, the laws are not rigorously enforced, Cai said.
Failure to tackle HIV/ AIDS among drug users is hampering the global battle against the disease, the United Nations agency that coordinates the world body's fight against the disease warned Monday.
To be effective, programmes targeting the HIV virus, which precedes AIDS, need to reach around 80 percent of people who inject drugs, said
However, only eight percent of the estimated 13 million intravenous drug users worldwide, around half of whom live in Asia, have access to any kind of HIV prevention or treatment programme
The shortfall has deadly consequences, because fighting the virus among drug users is a key to stemming its spread in the wider population, said UNAIDS.
"About 10 percent of all new HIV infections worldwide are attributable to injecting drug use. If you exclude Africa, that figure rises to 30 percent," Prasada Rao, UNAIDS' regional director for Asia and the Pacific, told a conference in Warsaw.
"Evidence shows that HIV prevention programmes are particularly effective among people who inject drugs, but they are regularly denied access to information and services," he said.
UNAIDS also said that access to antiretroviral therapy, which is used to keep the disease under control in infected individuals, was "unacceptably low" among injecting drug users.
It blamed "lack of information, exclusion and widespread stigma and discrimination."
Key planks of programmes for drug users include giving them ready access to clean syringes -- reused needles are a key source of infection -- and providing less harmful substitutes, such as methadone for heroin, to help people break their drug habit under supervision.
Worldwide, HIV is predominantly spread by heterosexual sex.
Injecting drug use, however, is a major mode of HIV transmission in Southeast Asia, and the former communist bloc countries of Central Asia and Eastern Europe.
In addition, drug use is emerging as a new source of HIV infection in sub-Saharan Africa, particularly in Kenya, Nigeria, South Africa and Tanzania, UNAIDS noted.
HIV programmes for injecting drug users make a difference, said the agency, citing the example of Portugal, which scaled up programmes for drug users in 2001.
Four years later, HIV diagnoses among injecting drug users had been cut by almost a third, said UNAIDS.
"The allocation of financial resources must be used in more strategic and innovative ways to deliver more effective prevention programmes to people most at risk of HIV infection," said Rao.
Around 39.5 million people were living with HIV or AIDS at the end of last year, according to UN figures.
Sub-Saharan Africa remains by far the worst-affected region, being home to two-thirds of all people living with HIV.
May 14, 2007
A new study has found that HIV patients who drop out of care do not live as long as those who remain under a doctor's treatment.
The study was conducted by a team of researchers led by Dr. Thomas Giordano at Baylor College of Medicine and Veterans Affairs.
As part of the study, researchers looked at 2,619 men with HIV for more than four years. Most were diagnosed between 1997-1998 at a VA hospital or clinic and began treatment after Jan. 1, 1997.
Researchers divided the men into four groups based on the number of quarters they visited their HIV physicians or health care provider in the first year after starting treatment.
Sixty-four percent of them had at least one visit in all four quarters, 18 percent in three of four quarters, 11 percent in two of four quarters and 6 percent in only one quarter. The researchers then looked at how long the patients survived after that first year.
Researchers found that 16 percent of the patients died. Those who had poorer retention in care or visited the physicians less during the year after starting treatment had a greater risk of dying than those who saw the physicians at least once each quarter.
The study also found that patients with visits in one quarter had nearly twice the risk of dying compared to patients with visits in all four quarters.
"In an era when highly active therapy directed against HIV (the human immunodeficiency virus that causes AIDS) is keeping people alive, understanding the value of regular medical care is crucial," Giordano said.
"We know that adherence to medications is critically important. Patients who have trouble taking their medicines regularly will do less well. But what about those people who aren't even seeing a doctor regularly. Before this study, we had only a vague understanding of the magnitude of the problem, and we certainly didn't know whether it affected survival," Giordano added.
"The next step is to figure out how to get them to stay in care," he added.
The findings of the study were published in the June issue of Clinical Infectious Diseases and are available on line
At this rehabilitation centre in State, destitute women who are HIV+ve find shelter, a learning-cum-work place
* Ramola, a full blown AIDS patient and a worker at Swayam, died 10 days back. Gaytari was supporting her HIV positive husband and two children by working with Swayam. The organisation is now funding the studies for one of her boys.
* Lalita, from Saurashtra, is also working with Swayam for last two years. She makes an earning for her two children after her husband expired from the killer HIV/AIDS disease. Thanks to her training at Swayam she earns some extra money after work by doing needlework for her private clients in the neighbourhood.
* Meenakshi, from Mathura, was directed to Swayam as a rehabilitation effort after she acquired the virus from her HIV positive husband. Today, she says she loves the work here and is also receiving HIV/AIDS counselling through the organisation.
These women had no one to turn to. Having undergone the trauma of losing their spouses to AIDS, they carried the burden of earning a livelihood on their fragile shoulders, already bent by the knowledge of having been tested positive. But Swayam gave them the hopes to live.
The AIDS affected group received free treatment and medication from Ahmedabad-based AARAAM, an NGO run by Dr Pradeep Pethe and his colleagues. It was his exposure to the positive people and their travails that Dr Pethe (a regular visitor to the health camps and counsellor for L&T workers), drew attention to the lacuna regarding the rehabilitation for HIV positive people.
Then the idea of an organisation catering to the rehabilitation needs of this minority was born. It started with a contribution of Rs 1 lakh from A.M.Naik, CMD of L&T, for "Prayas", the Ladies Club of engineering giant. Thus Swayam _ one of the very few rehabilitation centres in India and the only one of its kind in Gujarat_ came into being two years back on May 12, 2005. It works towards rehabilitation of the destitute girls who have tested positive for AIDS.
Girls come to this centre through Gujarat State Network for the HIV Positive People (GSNHPP). Unskilled most of them, till they come to Swayam, they are trained in various skills like papercrafts, stitching, and embroidery. Experts are brought in to enable these girls to churn out beautiful handiworks, which are then marketed by "Prayas".
They work five days a week from 2 pm to 6 pm at their small shop in the Suryakiran Complex on Ghod-Dod Road. While it does get infrastructural support from the L&T management in the form of payments of the shop rental, electricity and phone bills, it is by the sheer efforts of the women at ''Prayas'' and the workmanship of these girls, that the organisation meets its own running expense.
Recently at display in the Women Entrepreneur Exhibition (WEE) 2007, the products were appreciated by visitors. Under the supervision of ''Prayas'' president Madhu Bedi, items like cushion covers, jewellery boxes, napkins, aprons, gloves, roti covers, egg cases, shoe cases etc. were designed and displayed.
"It is an organisation run by the heart and not by the head," asserts Madhu Bedi. Encouraging people to buy Swayam products, she gives this logic: "If you gift someone a bouquet of flowers worth Rs 100-Rs150, it has to be discarded in a week. If one of these articles is gifted instead, it will be remembered for its aesthetic and utilitarian worth and
cherished for a longer duration. Thus ensuring acceptability for HIV/AIDS affected people in the society, beginning from your drawing room."
As for the girls, Swayam is a shelter, a home where their persona is cared for with compassion. Says Pushpanjali Karan from Orissa: "I like coming here, learnt a lot. Earlier there was no work, was desolate, now its much better.''