[hivaids-twg] Fwd: Today's News (2009.11.13ex)

[HIV-TWG Moderator]

---------- Forwarded message ----------
From: Diaz, Clara <diazc at unaids.org>
Date: Fri, Nov 13, 2009 at 8:14 PM
Subject: Today's News (2009.11.13ex)
To:


 Please find attached the following AIDS-related articles compiled by UNAIDS







*UNAIDS*

1. JAIDS - *Progress in Global Blood Safety for HIV*

2. JAIDS - *Estimating The Level of HIV Prevention Coverage, Knowledge and
Protective Behavior Among Injecting Drug Users: What Does The 2008 UNGASS
Reporting Round Tell Us? *

3. JAIDS - *Estimating Levels of HIV Testing, HIV Prevention Coverage, HIV
Knowledge, and Condom Use Among Men Who Have Sex With Men (MSM) in
Low-Income and Middle-Income Countries*

4. JAIDS - *Measuring the Impact of the Global Response to the AIDS
Epidemic: Challenges and Future Directions *



*AFRICA** AND MIDDLE EAST*

1. Mmegi, Botswana - *More Come for HIV Testing - Report  *

2. IRIN/PlusNews - *Battle** Won For HIV-Positive Soldiers  *

3. Health-e, SA - *Lack of Political Will Threatens Aids Funding *

4. IRIN/PlusNews - *GLOBAL: Disabled should claim rights in UN convention *



*ASIA** AND PACIFIC*

1. China Daily - *HIV/AIDS sufferers must tell partners *

2. Daily Express, Malaysia - *Awareness on impact of HIV, AIDS still low *

3. Times of India - *15 HIV positive children put on ART every month*



*EUROPE***

1. The Lancet, UK - *Lessons and myths in the HIV/AIDS response
(Correspondence)*

2. The Lancet, UK - *Lessons and myths in the HIV/AIDS response — Authors'
reply *

3. The Lancet, UK - *Lessons and myths in the HIV/AIDS response
(Correspondence) *

4. LeFigaro.fr - *2 ans ferme pour avoir transmis le VIH *

5. El País, Spain - *Más de la mitad de la población mundial infectada con
el virus del VIH son mujeres *



*LATIN AMERICA AND CARIBBEAN*

1. Unisivión - *ONU: 200 millones de niños raquíticos en países pobres*

2. Infobae.com - *El 30% de los travestis argentinos tiene sida *

3. O Estado de S. Paulo, Brazil - *Visitas íntimas a presos homossexuais  *



*NORTH AMERICA*

1. Washington Post - *Study in D.C. to test whether HIV treatment can
prevent spread*

2. TIME - *Rape and the Plight of the Female Migrant Worker*

3. IPS Terra Viva - *Human Rights, Health: Twin Issues for Climate Change *

4. GlobalPost - *Opinion: Gay rights go global *



*UNAIDS WEB.SITE*

1. UNAIDS - Global Fund approves US$2.4 billion in new grants





===========================



*UNAIDS*



===========================



*Progress in Global Blood Safety for HIV**
**JAIDS Journal of Acquired Immune Deficiency Syndromes*

12/2009



Volume 52 - Issue - pp S127-S131

doi: 10.1097/QAI.0b013e3181baf0ac

Supplement Article



Takei, Teiji MD; Amin, Noryati Abu MD; Schmid, George MD; Dhingra-Kumar,
Neelam MBBS, MD, CTM; Rugg, Deborah PhD



Abstract

Objective: To assess progress toward ensuring a globally safe blood supply.



Design and Methods: We examined 2 global databases for blood safety: (1)
that of the United Nations General Assembly Special Session on HIV/AIDS
(UNGASS) blood safety indicator; and (2) that of the Global Database on
Blood Safety (GDBS), a database developed by the World Health Organization.
The UNGASS data were collected through the Ministry of Health based on the
GDBS data, followed by a reconciliation and cross-checking of the data by
World Health Organization and United Nations Programme on AIDS (UNAIDS).



Results: The proportion of United Nations member countries reporting UNGASS
data for blood safety is among the highest of all UNGASS indicators: 147 of
192 United Nations Member States participated in UNGASS reporting in 2008
and 125 of them (85%) submitted data on blood safety. Ninety-one of the 125
countries (73%) reported that 100% of collected blood units were screened in
a quality assured manner, but 34 countries did not screen all collected
blood units in accordance with minimum quality standards. GDBS data showed
that 80.7 million blood units were collected globally in 167 countries
during 2004-2005, of which 77.3 million were tested for HIV and at least 0.6
million of the remaining 3.4 million donations went untested.



Conclusions: Progress has been made toward eliminating blood transfusion as
a significant cause of HIV infection globally. Screening all donated blood
for HIV in accordance with minimum quality standards remains vital, however,
as health care systems should, at a minimum, do no harm. This goal is
achievable and would assist in reaching Millennium Development Goals by
2015.



Author Information

>From the *UNAIDS, Geneva, Switzerland; and †WHO, Geneva, Switzerland.

Conflict of interest: none.

The authors of this paper declare no conflicts of interest.



Correspondence to: Teiji Takei, Senior Adviser, EMP/EVA/MOE, UNAIDS, 20
Avenue Appia, CH-1211 Geneva 27, Switzerland (e-mail: takeit at unaids.org).



*Full article:
http://journals.lww.com/jaids/Fulltext/2009/12012/Progress_in_Global_Blood_Safety_for_HIV.8.aspx
*



*4*

*Estimating The Level of HIV Prevention Coverage, Knowledge and Protective
Behavior Among Injecting Drug Users: What Does The 2008 UNGASS Reporting
Round Tell Us?**
**JAIDS Journal of Acquired Immune Deficiency Syndromes*

12/2009



Volume 52 - Issue - pp S132-S142

doi: 10.1097/QAI.0b013e3181baf0c5

Supplement Article



Mathers, Bradley M MBChB; Degenhardt, Louisa PhD; Adam, Philippe PhD;
Toskin, Igor MD, PhD; Nashkhoev, Magomed MD, PhD; Lyerla, Rob PhD; Rugg,
Deborah PhD



Abstract

Objectives: The 2001 Declaration of Commitment from the United Nations
General Assembly Special Session on HIV/AIDS (UNGASS) set the prevention of
HIV infection among injecting drug users (IDUs) as an important priority in
the global fight against HIV/AIDS. This article examines data gathered to
monitor the fulfillment of this commitment in low-income and middle-income
countries (LMICs) where resources to develop an effective response to HIV
are limited and where injecting drug use is reported to occur in 99 (of 147)
countries, home to 75% of the estimated 15.9 million global IDU population.



Methods: Data relating to injecting drug use submitted by LMICs to the Joint
United Nations Programme on HIV/AIDS (UNAIDS) in the 2008 reporting round
for monitoring the Declaration of Commitment on HIV/AIDS were reviewed. The
quality of the data reported was assessed and country data were aggregated
and compared to determine progress in HIV prevention efforts. For each
indicator, the mean value weighted for the size of each country's IDU
population was determined; regional estimates were also made.



Results: Reporting was inconsistent between countries. Forty percent of LMIC
(40/99), where injecting occurs, reported data for 1 or more of the 5
indicators pertinent to HIV prevention among IDUs. Many of the data reported
were excluded from this analysis because the indicators used by countries
were not consistent with those defined by UNAIDS Monitoring and Evaluation
Reference Group and could not be compared. Data from 32 of 99 countries met
our inclusion criteria. These 32 countries account for approximately
two-thirds (68%) of the total estimated IDU population in all LMICs.



The IDU population weighted means are as follows: 36% of IDUs tested for HIV
in the last year; 26% of IDUs reached with HIV prevention programs in the
last year; 45% of IDUs with correct HIV prevention knowledge; 37% of IDUs
used a condom at last sexual intercourse; and 63% of IDUs used a clean
syringe at last injection. Marked variance was observed in the data reported
between different regions.



Conclusions: Data from the 2008 United Nations General Assembly Special
Session reporting round provide a baseline against which future progress
might be measured. The data indicate a wide variation in HIV service
coverage for IDUs and a wide divergence in HIV knowledge and risk behaviors
among IDUs in different countries. Countries should be encouraged and
assisted in monitoring and reporting on HIV prevention for IDUs.



Author Information

>From the *National Drug and Alcohol Research Centre, University of New South
Wales, Sydney, Australia; †Joint United Nations program on HIV/AIDS, Geneva,
Switzerland; ‡Institute for Prevention and Social Research, Utrecht, The
Netherlands; and §National Centre in HIV Social Research, University of New
South Wales, Sydney, Australia.



The authors of this paper declare no conflicts of interest.



Correspondence to: Bradley M. Mathers, MBChB, National Drug and Alcohol
Research Centre, University of New South Wales, Sydney, New South Wales
2052, Australia (e-mail: b.mathers at unsw.edu.au).



*Full article:
http://journals.lww.com/jaids/Fulltext/2009/12012/Estimating_The_Level_of_HIV_Prevention_Coverage,.9.aspx
*



*5*

*Estimating Levels of HIV Testing, HIV Prevention Coverage, HIV Knowledge,
and Condom Use Among Men Who Have Sex With Men (MSM) in Low-Income and
Middle-Income Countries**
**JAIDS Journal of Acquired Immune Deficiency Syndromes*

12/2009



Volume 52 - Issue - pp S143-S151

doi: 10.1097/QAI.0b013e3181baf111

Supplement Article



Adam, Philippe C G PhD; de Wit, John B F PhD; Toskin, Igor MD, PhD; Mathers,
Bradley M MBChB; Nashkhoev, Magomed MD, PhD; Zablotska, Iryna MD, PhD;
Lyerla, Rob PhD; Rugg, Deborah PhD



Abstract

Background: HIV prevalence data suggest that men who have sex with men (MSM)
in low-income and middle-income countries (LMIC) are at increased risk of
HIV. The aim of this article is to present global estimates on key HIV
prevention needs and responses among MSM in LMIC.



Methods: Data on HIV testing, HIV prevention coverage, HIV knowledge and
condom use among MSM were derived from UNGASS country progress reports
submitted in 2008. Eligible country estimates were used to calculate global
and regional estimates, weighted for the size of MSM populations.



Results: Of 147 LMIC, 45% reported at least 1 indicator that reflects the
HIV prevention needs and responses in MSM. Global weighted estimates
indicate that on average 31% of MSM in LMIC were tested for HIV; 33% were
reached by HIV prevention programs; 44% had correct HIV knowledge; and 54%
used condoms the last time they had anal sex with a man.



Conclusions: The 2008 UNGASS country reports represent the largest
harmonized data set to date of HIV prevention needs and responses among MSM
in LMIC. Although reporting is incomplete and does not always conform to
requirements, findings confirm that, in many LMIC, HIV prevention responses
in MSM need substantial strengthening.



Author Information

>From the *National Centre in HIV Social Research, University of New South
Wales, Sydney, Australia; †Institute for Prevention and Social Research,
Utrecht, The Netherlands; ‡Department of Social and Organizational
Psychology, Utrecht University, Utrecht, The Netherlands; §Joint United
Nations programme on HIV/AIDS, Geneva, Switzerland; and ∥National Drug and
Alcohol Research Centre, University of New South Wales, Sydney, Australia.



The authors declare that they have no conflicts of interest.



Correspondence to: Philippe C. G. Adam, PhD, National Centre in HIV Social
Research, University of New South Wales, Sydney, New South Wales 2052,
Australia (e-mail: philippe.adam at unsw.edu.au).



*Full article:
http://journals.lww.com/jaids/Fulltext/2009/12012/Estimating_Levels_of_HIV_Testing,_HIV_Prevention.10.aspx
*



*6*

*Measuring the Impact of the Global Response to the AIDS Epidemic:
Challenges and Future Directions**
**JAIDS Journal of Acquired Immune Deficiency Syndromes*

12/2009



Volume 52 - Issue - pp S152-S159

doi: 10.1097/QAI.0b013e3181baf128

Supplement Article



Mahy, Mary ScD, MHSc; Warner-Smith, Matthew MPH; Stanecki, Karen A MPH;
Ghys, Peter D MD, PhD, MSc



Abstract

Objectives: In the Declaration of Commitment of the 2001 United Nations
General Assembly Special Session on AIDS, all Member States agreed to a
series of actions to address HIV. This article examines the availability of
data to measure progress toward reducing HIV incidence and AIDS mortality
and discusses the extent to which changes can be attributed to programs.



Methods: Lacking a method to directly measure HIV incidence, trends in HIV
prevalence among 15-year to 24-year olds and groups with high-risk behaviors
are used as a proxy measure for incidence trends among adults in generalized
and concentrated/low-level epidemics, respectively. Although there is
limited empirical data on trends in new infections among children, progress
in the treatment area is tracked through indicators for the percentage of
people who remain on antiretroviral treatment 12 months after initiation and
the coverage of antiretroviral treatment. Successive iterations of
epidemiological models using surveillance data from pregnant women and
groups with high-risk behavior and data from national household surveys,
demographic data and epidemiological assumptions have produced increasingly
robust estimates of HIV prevalence, incidence and mortality.



Results: Globally, incidence has decreased among adults (accompanied by
evidence of changes in behavior in several countries) and children over the
past decade. The decline in AIDS mortality is more recent. On the basis of
the underlying logical framework and mathematical models, it is concluded
that programs have contributed to a reduction in HIV incidence and AIDS
mortality.



Conclusions: More data are needed to reliably inform trends in HIV incidence
and AIDS mortality in many countries to allow an assessment of progress
against national and global targets. In addition, impact evaluation studies
are needed to assess the relationship between changes in incidence and
mortality and the HIV response and to determine the extent to which these
changes can be attributed to specific programmatic interventions.



Author Information

>From the UNAIDS, Geneva, Switzerland.



The authors of this paper declare no conflicts of interest.



Correspondence to: Matthew Warner-Smith, MPH, UNAIDS, 20 Ave Appia, CH-1211
Geneva 27, Switzerland (e-mail: warnersmithm at unaids.org).



*Full article:
http://journals.lww.com/jaids/Fulltext/2009/12012/Measuring_the_Impact_of_the_Global_Response_to_the.11.aspx
*



===========================



*AFRICA** AND MIDDLE EAST*



===========================



*More Come for HIV Testing - Report  **
**Mmegi, Botswana*

12/11/2009



Isaiah Morewagae



Tebelopele is working round the clock to contribute to the National Strategy
Framework (NFS) and United Nations (UN) universal access target of having 95
percent of Batswana know their HIV status by 2013.



The Tebelopele Voluntary Counselling and Testing Centre annual report for
2008/2009 says the organisation's clients uptake has increased from a total
of 3783 in 2000 to over 650 000 as at March 31 this year. Tebelopele says
the growth is largely due to the continued support it has enjoyed from the
government, other partners and the commitment and dedication of its staff.



"For this reporting period, 160 188 clients were counselled and tested," the
report says, adding that Tebelopele aims to be a source of information,
support and testing for all of its clients. Out of a total of the 163 095
people seen in 2008/2009, 98.2 percent received counselling and testing
while a mere 1.8 percent received counselling only, the report says.



This trend has been observed over the last few years and is attributed to
people not having adequate time for either counselling or testing during
their visit. "They were coming to seek information only or supportive
counselling," says the report.



To achieve its goal, Tebelopele is continuously trying to reach more
first-time testers through mobilisation, outreach and ward-based testing
efforts. "The proportion of Tebelopele clients who received voluntary
counselling and testing services outside of a Tebelopele stand-alone centre
rose from less than one percent in 2000/2001 to more than 44.4 percent (7
2324) in 2008/2009," the report says



The number of repeat testers increased from 5.2 percent in 2000 to 35.7
percent in 2008/2009 mainly due to the ongoing campaign to encourage people
to test themselves as part of a healthy lifestyle, as well as other
promotions that attract large numbers of people, including those previously
tested.



The report on HIV prevalence says: "Between 2000 and 2006, the highest
prevalence was recorded among sexually active adults in the 35 to 39 years
age group, followed by the 30 to 34 years age group." By comparison, the
lowest prevalence was recorded among the 15 to 19 years age group.



The report notes that Botswana law currently prohibits HIV testing for all
individuals under the age of 21, thus the number of people seen under the
age of 21 is lower compared to all other age groups.



*2*

*Battle Won For HIV-Positive Soldiers  **
**IRIN/PlusNews*

11/11/2009



Johannesburg — The South African cabinet has approved a new policy
prohibiting discrimination against soldiers and would-be recruits on the
basis of their HIV status.



Previously, HIV-positive members of the South African National Defence Force
(SANDF) could be excluded from recruitment, international deployment, and
promotion, but a 2008 high court decision declared such policies
unconstitutional and gave the SANDF six months to amend them.



The high court case was brought by the AIDS Law Project (ALP) on behalf of
the South African Security Forces Union (SASFU) and two HIV-positive men.
One man was an SANDF member who had not been allowed to join his unit on
foreign deployments; the other had been denied employment in the SANDF,
based on his status.



The ALP expressed disappointment about the length of time the SANDF took to
comply with the court order and the persistence of unfair discrimination
against HIV-positive soldiers and recruits, but in October one of the men,
Sergeant Sipho Mthethwa, became the first known HIV-positive soldier to be
deployed on international service.



The SANDF had argued that people living with HIV were unfit to withstand the
stress and physical demands of foreign deployments. An estimated 25 percent
of SANDF employees are HIV positive, higher than the national adult
prevalence of 18 percent.

*[This report does not necessarily reflect the views of the United Nations]*



*3*

*Lack of Political Will Threatens Aids Funding**
**Health-e, SA*

12/11/2009



Khopotso Bodibe



Universal access to antiretrovirals in poor countries is under threat as
donors reduce funding for AIDS programmes, warns Medecins Sans Frontieres
(MSF).



According to the MSF's recent report, titled "Punishing Success? Early Signs
of a Retreat from Commitment to HIV/AIDS Care and Treatment", funders'
commitment to supporting AIDS treatment for people in poor countries is
waning. The report largely focuses on two of the world's foremost programmes
that support AIDS treatment. They are the Global Fund to Fight AIDS, TB and
Malaria and the US President's Emergency Plan for AIDS Relief (PEPFAR).



"Last year, in 2008, the Global Fund approved Round 8 Proposals.
Unfortunately, because of lack of funding the Global Fund had to cut already
approved proposals by $1.5 billion", said Sharonann Lynch, policy adviser
for MSF's Campaign for Access to Essential Medicines.



"Another case in point (is) PEPFAR. In Uganda, currently, PEPFAR-supported
facilities have been told that they must suspend treatment for new patients
in need. Some are doing what they can and, at least, putting pregnant women
on treatment or the very sick on treatment or people who have TB-HIV
co-infection. Others have been told that they can only put new people on
treatment if someone dies that is currently on ARVs, thus freeing up a
space, a slot if you will, or if someone is lost to follow-up. None of that
is good news", Lynch continued.



"In South Africa, PEPFAR-supported facilities are - from what we understand
- referring patients in need of treatment that have yet to be started on
ARVs to other facilities", she said, speaking of the devastation already
being caused by the reduction of funding.



The Global Fund relies heavily on individual governments and business for
its funding. At its board meeting this week, it has to decide whether it has
sufficient money to support proposals for Round 9 of applications. Already
there is talk that funding for this round will be reduced by $1 billion. The
board may not call for new rounds of applications next year. If it decides
not to due to lack of funding, it will be a historic event. It will be the
first time that it has not provided financial support in a given year.
PEPFAR, on the other hand, is a programme funded by the United States's
government.



According to the United Nations' AIDS agency, UNAIDS, the Global Fund and
PEPFAR have put a combined total of 2. 95 million people around the world on
ARVs by the end of last year. But they are not the only ones going back on
their commitments.



"The UK had led the charge for there to be unanimous support for universal
access to treatment within the Group of 8 wealthy countries, which was then
endorsed by the UN General Assembly in 2005 and 2006. Now the UK is
switching gears, shifting its funds elsewhere and their political spotlight
elsewhere. The Netherlands, which has been one of the strongest supporters
for funding HIV/AIDS treatment, are considering a 30% reduction next year in
their funds. France as well is considering a reduction in HIV funding", said
Lynch.



This reduction of funding will negatively affect the more than five million
people in developing countries estimated to need ARV treatment, but who
cannot afford it and whose governments do not have the capacity to provide
it to them.



In 2005, the international community committed itself to universal access to
treatment by the year 2010. This commitment was preceded by the formation of
the Global Fund in 2002 and PEPFAR in 2003. It's immoral that these
commitments are now not being stuck to, said Dr Tido von Schoen- Angerer,
Director of the MSF's Campaign for Access to Essential Medicines.



"There's a dirty secret here, I think. It is that the donors are getting
cold feet about commitment for a long term a chronic disease. As a medical
humanitarian organisation, we see that there is today a betrayal of
commitments that were only made a few years ago. Slowing down what is
finally starting to work would be really punishing success. We need the
sustained increased funding for HIV/AIDS and it's possible to plan it. We
know we will be faced with the AIDS epidemic, at least, for another 30
years", von Schoen-Angerer said.



While the world is facing tough economic times, he argues that money is not
the real issue why AIDS funding is being reduced.



"Many economists actually think it will be possible to fund global health at
adequate levels. It's of course at a time of a financial crisis that the
poorest countries are hit the most - and not only at country level, but also
individuals. Actually, more support is needed for the poorest at times of
crisis. It has to be put in perspective: In the European Union, $1 billion
is spent a day on agricultural subsidies, and you're telling us there is no
money to fund global health where people are dying? This is an excuse. I
think the funding is possible. It's an issue of political will", von
Schoen-Angerer said.



*5*

*GLOBAL: Disabled should claim rights in UN convention **
**IRIN/PlusNews*

12/11/2009



NAIROBI, 12 November 2009 (PlusNews) - The United Nations Convention on the
Rights of Persons with Disabilities (CRPD) should be used as a tool to
improve access to HIV services for disabled people, who are often
marginalized in national HIV policies, says a new report.



"PWDs experience all the risk factors associated with HIV, and are often at
increased risk because of poverty, severely limited access to education and
health care, lack of information and resources to facilitate 'safer sex',
lack of legal protection, increased risk of violence and rape, vulnerability
to substance abuse, and stigma," the authors noted in HIV/AIDS and
Disability: Final Report of the 4th International Policy Dialogue.



HIV/AIDS was implicitly included in the CRPD under article 25a, where "State
Parties shall provide PWDs with the same range, quality and standard of
free, affordable health care and programmes as provided to other persons,
including in the area of sexual and reproductive health and population-based
public health programmes," the authors noted.



"There is usually little national data on the numbers of people with
disabilities affected and infected with HIV, and communications campaigns
around HIV are not designed with PWDs in mind," said Phitalis Were, of
Leonard Cheshire International, a global organisation working with the
disabled.



"Condoms have expiry dates that blind people cannot read, so how are they to
know that a condom is past its sell-by date?" Were also noted that disabled
people could not claim their right to health services unless they were
educated about these rights.



The CRPD came into force in 2008, and has 143 signatories and 71 parties.
Were said that if the CRPD was to be effective, governments needed to act on
the commitments they made by ratifying it.



"Many of our laws are so outmoded and offensive to PWDs, and must be changed
urgently; in Kenya, for instance, certain sections of statutory law still
refer to people with mental disabilities as imbeciles and idiots."



*=======================*

* *

*ASIA** AND PACIFIC*

* *

*=======================***



*HIV/AIDS sufferers must tell partners **
**China Daily*

13/11/2009



By Shan Juan



A new regional regulation requiring people who test positive for HIV to
inform sex partners of their condition within a month is widely considered
well-intentioned but unrealistic.



For the first time in China, health authorities began to clearly regulate
HIV status disclosure on the part of sufferers, who number 700,000 by
official estimates.



The regulation, now still a draft, issued by the Gansu health department on
Monday, stipulates that upon getting the HIV confirmation from the clinics,
the sufferer must tell his or her partners within a month about the
infection, or face a lawsuit.



"The requirement featuring a one-month time limit is not human-oriented as
sufferers who first learn of their HIV status need time to accept the harsh
reality, let alone informing others of their condition," said He Tiantian,
who heads the Women's Network against AIDS - China, a civil society
supporting females living with HIV/AIDS.



She is also HIV positive.



However, she said the regulation was good in that it stipulated sufferers
must disclose their newly confirmed HIV positive status to sex partners on
their own.



In China's voluntary HIV/AIDS consulting and testing clinics across the
country, a person can get free HIV screening by providing their own
identification and personal information.



"Some give fake documents to protect their privacy," said Professor Jing Jun
with Tsinghua University.



Among the 700,000 HIV/AIDS sufferers in China, only 270,000 can be tracked,
he said.



Regional surveys in the country showed that only one-third of the newly
diagnosed HIV sufferers would disclose their infection to their partners.



"The Gansu regulation is good in intention while unrealistic in practice,"
he noted.



Those most likely to tell their partners are those who have been married for
a long time.



Other sufferers, especially prostitutes, often fail to inform their partners
about the infection, he said.



*2*

*Awareness on impact of HIV, AIDS still low**
**Daily Express, Malaysia*

13/11/2009



Kota Kinabalu: Public awareness on the impact of HIV and AIDS is still low
in Malaysia, said World Vision Malaysia Chief Executive Officer Liew Tong
Ngan.



He said there were still a lot of people including in Malaysia still
oblivious on issues related to HIV/AIDS.



"According to UNAIDS in 2007, an estimated 4.9 million people in Asia were
living with HIV.



"Even in Malaysia, officially, an average of 16 HIV cases are reported
daily. Many of those affected are women and children - married women with
normal heterosexual relationships and children who contracted the disease
from their parents," he said.



Liew said this to reporters at the launching of One Life Revolution (OLR) by
an international award-winning actress, Lee Sinje here on Thursday.



World Vision Malaysia is organising the OLR exhibition, themed 'One Life Do
Something', a life-sized experiential exhibition that will offer visitors a
completely new perspective on the issue of HIV/AIDS and child trafficking,
at the 1Borneo hypermall until this Sunday from 10am to 10pm. Admission is
free.



Through a series of captivating audio tours and powerful imageries, visitors
will get to experience the impact of HIV/AIDS and child trafficking by
stepping into the lives of three real children.



Lee Sinje, who supports World Vision Malaysia through its international
Child Sponsorship Programme, is currently sponsoring nine children under
World Vision's Child Sponsorship Programme.



World Vision is an international humanitarian organisation devoted to
tackling the causes of poverty.



"HIV/AIDS and child trafficking are taboo subjects among the majority of
Malaysians," said Liew, adding, " for individuals, families and communities
whose lives had been impacted, they often grieve in silence."



"HIV/AIDS is as much a Malaysian problem as it may be in Africa. It is not
someone's else problem but it is a collective problem. And it is not an
African or poor nations' problem. Nor is it a disease of drug addicts,
homosexualsand prostitutes brought about their own doing," he said.



Hence, Liew said the organisation has taken the initiative to create the OLR
exhibition that began in 2002 to urge the public to look at the issues of
HIV/AIDS closely from a different perspective. He said the exhibition is
being brought to Sabah for the first time to enable people to step into the
shoes of those who have been affected and learn more about the effects of
AIDS and how they can help.



"People can help by participating in our Child Sponsorship Programme by
sponsoring an underprivileged child with RM50 a month. The sponsorship can
provide better education for the child, basic amenities like water, basic
healthcare and improved nutrition.



"We are not giving the money directly to the children but we will liaise
with the leaders of the communities or the government leaders in providing
assistance to ensure the sponsored child benefits as well.



"The ultimate aim of the programme is to ensure the sponsored child stays
healthy, educated for life, protected and participating in communities
activities," he said.



Liew said the money would also be used to help the child's poor parents to
improve their living standard through agricultural activities that generate
income so that some parents in poor communities would not have to sell the
children for money.



He said Malaysians have sponsored a total of 33,000 children all over the
world in 97 countries and that 3.5 million children, who are orphans and
HIV/AIDS patients, are sponsored globally.



Those interested to sponsor a child can contact World Visio Malaysia at
03-78806414, or email admin at worldvision.com.my, or call toll free at
1-800-88-2505. The website is www.worldvision.com.my.



*3*

*15 HIV positive children put on ART every month**
**Times of India*

13/11/2009



Umesh Isalkar, TNN



PUNE: The analysis of spread of HIV infection among children has revealed
that there are 14,148 HIV positive children in the state. Of them, 4,457 are
on the life-saving antiretroviral treatment (ART) and every month 15
children are put on ART.



"HIV infection progresses more aggressively in infants than in adults. In
children, the immune system is underdeveloped and acquiring HIV infection
thwarts their further growth," said Kananika Tripathy, a UNICEF consultant
attached to the Maharashtra State Aids Control Society (MSACS).



Infectious disease expert Sanjay Pujari said, "It is recommended that HIV
positive infant, less than one year old, should be put on ART. Kids born to
HIV infected mothers have to go through a DNA test so that ART can be
started. Unfortunately, this test cannot be offered routinely due to high
costs. The test is available in private hospitals but not at government
set-ups. That's one of the limitations in starting ART in infants less than
one year old when the benefit is maximum. For children between one and six
years of age, the ART is recommended when the CD4 count drops below 25."



As per the National AIDS Control Society (NACO), India is home to 1,00,000
HIV infected children of which 40,000 urgently require ART to survive.
However, only 10,000 such children are getting the treatment,



About patterns of the infection in the country, Tripathy said, "About 35 per
cent of the 2.6 million estimated HIV cases in India are women. Around 15%
to 35% of the children get the infection from their mothers. Majority of the
children living with HIV can be saved by timely administration of paediatric
ART."



The paediatric HIV drugs are being made available in all the 42 ART centres
in Maharashtra so that children get equal importance against adults as far
as treatment for the deadly disease is concerned, added Tripathy.



"Treatment within the first few months of life can dramatically improve the
survival rate among children. That's why the DNA tests will be vital in
India's fight against HIV," said Madhu Oswal, founder member of Mukta
HIV/AIDS helpline.



*========================*



*EUROPE***



*========================*



*Lessons and myths in the HIV/AIDS response (Correspondence)**
**The Lancet, UK*

14/11/2009



Volume 374, Issue 9702, Pages 1674 – 1675

Ann M Starrs a



Peter Piot and colleagues' Viewpoint1 offers a succinct and well reasoned
analysis of what has been achieved and what remains to be done to address
the global HIV and AIDS pandemic. There is one element of their argument,
however, that is incomplete. They note that the Global Fund, the US
President's Emergency Plan for AIDS Relief (PEPFAR), and the GAVI Alliance
are major investors in health systems, and argue that these investments have
led to hiring more health workers, refurbishing health centres, purchasing
essential equipment, and expanding laboratory capacity.



This is true. However, what is mainly being strengthened is the capacity of
health systems to provide care and treatment specifically for HIV/AIDS, but
not necessarily to deal with other urgent health needs, such as managing
obstetric emergencies or childhood illnesses. This exclusion is
understandable, since reducing maternal and child mortality writ large has
not been part of the Global Fund's or GAVI's mandate. It is becoming
increasingly clear that if progress is going to be made on all the
health-related Millennium Development Goals (MDGs), and health more
holistically, then general funding for health as well as AIDS specifically
must increase significantly. The way funding is allocated and its effect
measured must reflect the full scope of critical health needs and effective
health interventions.



This is the central point of the Declaration of Solidarity for a Unified
Movement for the Right to Health.2 Momentum is building for major changes in
the global health field; next year we will have only 5 years left until the
MDG deadline. The time for change is now.



I declare that I have no conflicts of interest.



References

1 Piot P, Kazatchkine M, Dybul M, Lob-Levyt J. AIDS: lessons learnt and
myths dispelled. Lancet 2009; 374: 260-263. Full Text | PDF(120KB) |
CrossRef | PubMed

2 Partners in Health. Declaration of solidarity for a unified movement for
the right to health. http://act.pih.org/page/s/declaration. (accessed Oct
28, 2009).



a Family Care International, New York, NY 10012, USA



*4*

*Lessons and myths in the HIV/AIDS response — Authors' reply**
**The Lancet, UK*

14/11/2009



Volume 374, Issue 9702, Pages 1675 – 1676

P Piot a, M Kazatchkine b, M Dybul c, J Lob-Levyt d



We agree with Ann Starrs that many important causes of ill health in
low-income and middle-income countries are seriously underfunded, and that
“general funding for health as well as specifically for AIDS must increase
significantly”. The momentum created by the global AIDS response has already
led to increased funding for health, but clearly not enough. Additionally,
efficiency gains can be made in HIV interventions, and we should do as much
as we can to ensure that the synergies between the AIDS response and other
health programmes are optimised.



We also support the proposal by Charles Wiysonge and colleagues for more
investment in evidence-informed policy making—the AIDS field has clearly had
its share of difficulties in translating evidence into policies and
practices, particularly when it comes to prevention.



Jon Rohde raises the issue of the use of classic measures for communicable
disease control such as contact tracing. Whereas such measures have indeed
proven effective in the control of some outbreaks, the effectiveness of some
of the components of outbreak control in stopping the spread of HIV is
unproven. Whereas epidemiological surveillance for HIV is probably more
advanced than for most other public health problems in low-income and
middle-income countries, and has been an important technique in programme
planning and implementation, traditional contact tracing has indeed been
used less in most democratic countries, and there is no evidence that it has
contributed to limiting the spread of HIV. Most countries are now
emphasising broad access to HIV testing, counselling, and education, and
informing the partners of those found HIV positive. Confidentiality, not
secrecy, is a general ethical obligation in medical practice, although
specific exceptions are accepted in most societies.



We declare that we have no conflicts of interest.



a Institute for Global Health, Imperial College London, London SW7 1NA, UK

b Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland

c O'Neill Institute for National and Global Health Law, Georgetown
University Law Center, Washington, DC, USA

d GAVI Alliance, Geneva, Switzerland



*5*

*Lessons and myths in the HIV/AIDS response (Correspondence)**
**The Lancet, UK*

14/11/2009



Volume 374, Issue 9702, Page 1674,

Roger England a



Although it is good to see HIV industry leaders admit to getting so much
wrong in the past (July 18, p 260),1 it is alarming to see that they still
are.



Parroting that HIV is “the biggest killer in Africa” is misleading. HIV is
unevenly distributed, disproportionately affecting some southern African
countries. South Africa alone accounts for 23% of HIV deaths, and setting
aside the three countries with the most HIV deaths, HIV causes 7·4% of
deaths for the rest of Africa—well below those for respiratory infections,
cardiovascular diseases, malaria, maternal and perinatal disorders, and
accidents and injuries.2



Piot and colleagues identify a myth that prevention is not working. But no
one actually argues that. They also claim that promoting just one solution
is irresponsible. But no one is. The actual arguments are that interventions
should be more focused3, 4 and that billions have been wasted on
“preventing” general epidemics that could never happen.5 And Piot and
colleagues' claim of seeing “a return on the investments of the past decade
in the form of falling rates and fewer deaths” is untenable: incidence in
Africa peaked a decade ago, before the investments started, and declines are
due more to the natural course of the epidemic.



Piot and colleagues claim that “mobilisation around AIDS” has “contributed
to an increase in global funding for health”, and that HIV funding has not
been “at the expense of health systems”. These statements are presented
without evidence and are untrue. Data from the Organisation for Economic
Co-operation and Development show that, from 1999 to 2006, health aid as a
proportion of total development assistance continued increasing at its trend
over previous years, but that the non-HIV component declined (figure)—ie,
HIV aid displaced other health aid.2 Over this period, US$10 billion that
would have gone to non-HIV health went to HIV.



Not only has HIV displaced other health spending, it is delivered in ways
that harm country health systems by bypassing their planning and budgeting
mechanisms, creating huge administrative burdens, and being unaligned with
countries' own health priorities.2



Finally we must ask whether the declaration of “no conflict of interest” is
being taken seriously here. All but one of these authors are part of the
powerful HIV lobby and have benefited from the disproportionate funding for
this disease.



I was an applicant for the post of Executive Director of UNAIDS on the
platform of closing it down.



References

1 Piot P, Kazatchkine M, Dybul M, Lob-Levyt J. AIDS: lessons learnt and
myths dispelled. Lancet 2009; 374: 260-263. Full Text | PDF(120KB) |
CrossRef | PubMed

2 England R. The fight against AIDS in the larger context: the end of ‘AIDS
exceptionalism’. UNU-Cornell Africa Series Symposium: the social and
economic dimensions of HIV/AIDS in Africa. New York, NY, USA; Sept 9, 2008.

3 Potts M, Halperin DT, Kirby D, et al. Reassessing HIV prevention. Science
2008; 320: 749-750. CrossRef | PubMed

4 Wilson D, Halperin D. “Know your epidemic, know your response”: a useful
approach if we get it right. Lancet 2008; 372: 423-426. Full Text |
PDF(62KB) | CrossRef | PubMed

5 Chin J. The myth of a general AIDS pandemic; the campaign for fighting
diseases. London: International Policy Press, 2008.
http://www.fightingdiseases.org/pdf/Jim_chin_AIDS.pdf. (accessed Oct 19,
2009).



a Health Systems Workshop, Box 1350, Grande Anse, St George's, Grenada



*6*

*2 ans ferme pour avoir transmis le VIH**
**LeFigaro.fr*

12/11/2009



Un homme de 31 ans a été condamné par le tribunal correctionnel de Perpignan
à 5 ans de prison, dont 3 ans et demi avec sursis, pour avoir transmis le
sida, alors qu'il se savait atteint, à ses deux compagnes successives et à
l'enfant qu'il avait eu avec l'une d'elle. Poursuivi pour "transmission de
substance nuisible ayant entraîné une infirmité permanente", le prévenu a
expliqué à la barre qu'il n'avait pas informé les deux femmes de sa maladie
par crainte d'une éventuelle rupture.



Une peine de quatre ans de prison avait été requise par le procureur. Le
prévenu, également condamné au versement d'indemnités provisionnelles de
quelque 50.000 euros, encourait dix ans d'emprisonnement. Ayant déjà
effectué près de quatre mois de détention fin 2006-début 2007, il n'a pas
été immédiatement placé sous mandat de dépôt à l'issue de l'audience.



Se sachant atteint de la maladie, il avait transmis le virus du sida en 2006
à son ancienne compagne, et à sa petite fille, née de leur relation et
placée sous tri thérapie dès la naissance, puis à sa compagne actuelle.
Selon l'avocate de son ancienne compagne, "il savait qu'il était contaminé
et il savait comment les protéger", ce qu'il s'est abstenu de faire (AFP).



*7*

*Más de la mitad de la población mundial infectada con el virus del VIH son
mujeres **
**El País, Spain*

13/11/2009



EP – Colonia - Las mujeres representan más de la mitad de los 33 millones de
casos de VIH/Sida que existen en todo el mundo, con 17 millones de
infectadas, procedentes en su mayoría de Europa Occidental y países en vías
de desarrollo, y con edades comprendidas entre los 15 y 49 años, según
explicó la directora del Centro de Estudio de Salud Sexual y VIH del
Hospital Universitario de Homerton (Reino Unido), Jane Anderson, con motivo
de su presencia en la XII Conferencia Europea sobre Sida, que se celebra
esta semana en la ciudad alemana de Colonia.



En el marco del encuentro Perspectiva de género, organizado en colaboación
con Bristol-Myers Squibb, Anderson señaló que más del 30 por ciento de los
infectados en 2007 fueron mujeres -con especial incidencia entre las féminas
de Africa Subsahariana, Oriente Medio, Africa del Norte y el Caribe-
mientras que el porcentaje de afectadas de entre 15 y 24 años representa el
60 por ciento de los casos, con una prevalencia mayor en Africa Subsahariana
y Norteamérica.



Un reciente informe de la Organización Mundial de la Salud (OMS) señala que
las mujeres son más vulnerables al contagio que los hombres por las
características de sus órganos sexuales, especialmente en el caso de las
jóvenes, que carecen de células protectoras en la vagina. Además, la
probabilidad de que un hombre transmita el virus es dos veces mayor que a la
inversa, y el hecho de que oculte conductas de riesgo también aumenta el
riesgo, así como otros factores relacionados con las creencias, las
tradiciones, la dependencia económica, la falta de acceso a la educación, la
explotación sexual o los malos tratos.



"Las mujeres son más vulnerables al contagio debido a, entre otras, causas
fisiológicas, sociales y de vulnerabilidad económica", añadió Anderson, que
apostó por las políticas de prevención para evitar "este grupo específico de
población" sufra más contagios, producidos en su mayoría por las relaciones
sexuales (80% de los casos). Por su parte, la transmisión del virus de
madres a hijos durante el periodo de embarazo o la lactancia, así como el
uso compartido de jeringuillas entre usuarios de drogas por vía parenteral
representa entre el 5 y el 10% de las infecciones.



"Apenas hay estudios realizados bajo una perspectiva de género, hasta el
punto de que en los años 90 la propia FDA elaboró un documento cuyo objetivo
era que se reclutaran más mujeres en los ensayos clínicos", lamentó por su
parte la doctora de la Unidad de Enfermedades Infecciosas del Hospital
Universitario Clínico de Valencia, María José Galindo, que señaló que la
mayoría de trabajos existentes se han centrado en el embarazo y en la
transmisión materno-infantil.



En este sentido, el doctor del Departamento de Enfermedades Infecciosas del
Hospital Pitie Salpetriere Pitie de París (Francia), Roland Tubiana,
presentó los resultados de un subanálisis de género realizado en el marco
del estudio Castle, un ensayo para determinar la eficacia del antiviral
Reyataz, de BMS, en el que apenas se registraron efectos secundarios entre
las pacientes tratadas. "Las mujeres responden mejor a la terapia
antiviral", aseveró Tubiana, que insistió en la importancia de conocer las
consecuencias del virus entre las féminas, con especial hincapié en aspectos
como la carga viral, las repercusiones en su salud mental, las consecuencias
sobre la redistribución de la grasa o las interacciones farmacológicas,
entre otras.



Evolución del virus

Las mujeres infectadas también evolucionan de un modo diferente que los
varones aunque la doctora Anderson lamentó que no exista "información
suficiente para orientar la toma de decisiones a la hora de aplicar un
tratamiento o seleccionar una dosis". En esta línea, Galindo apostó por "el
seguimiento concreto" de las infectadas, basado principalmente en el control
ginecológico "para evitar el cáncer de cervix o cuello uterino, uno de los
más frecuentes en estos casos".



El acto también contó con la presencia de Ophelia Haanyama Orum, nativa de
Zamba aunque actualmente reside en Suecia, que aportó a los presentes su
testimonio como "mujer y madre afectada por el VIH", e insistió en la
importancia de educar a los más pequeños en salud sexual para evitar que se
repitan casos como el de Sudáfrica, donde hay más de 13 millones de niños
huérfanos tras la muerte de sus madres a causa del virus, cifra que se prevé
alcanzará los 42 millones de menores en el año 2010. "Ojalá que un
entendimiento mejor del SIDA en la mujer pueda traducirse en una menor
mortalidad y en una mayor esperanza de vida para las millones de afectadas",
concluyó Haanyama.



*========================*

* *

*LATIN AMERICA AND CARIBBEAN*

* *

*========================*



*ONU: 200 millones de niños raquíticos en países pobres**
**Univisión*

11/11/2009



LONDRES (AP) - Casi 200 millones de niños de países pobres están en estado
raquítico debido a la falta de alimentación, señaló el miércoles un estudio
realizado por UNICEF.



La gran mayoría de casos de desnutrición ocurren en Asia y en Africa: más
del 90% de niños que padecen de raquitismo viven en esos dos continentes.



"A menos que se preste atención para abordar las causas de la desnutrición
materno-infantil actual, los costos serán considerables mañana", destacó Ann
M. Veneman, directora ejecutiva del Fondo de las Naciones Unidas para la
Infancia (UNICEF), en una declaración.



Más de un tercio de las muertes entre la población infantil menor de cinco
años está relacionada con la desnutrición, afirmó la UNICEF. Los niños con
deficiencias nutricionales a menudo carecen de un organismo fuerte para
poder combatir las enfermedades y complicaciones.



Pero se ha destinado muy poco dinero para garantizar que los niños del mundo
en desarrollo reciban suficientes alimentos, si se compara con otros
problemas graves como el sida. Aunque el sida es la causa del 2% de las
muertes infantiles, recibe más de 20 centavos por cada dólar en el gasto de
salud pública.



La UNICEF no logró decir cuánto gasta en nutrición. Pero el año pasado, una
agencia paralela, la Organización Mundial de la Salud (OMS) gastó seis veces
más en el sida en Africa que en nutrición.



Aunque se ha logrado progreso en Asia, el índice de raquitismo bajó del 44%
de 1990 al 30% el año pasado, no se ha logrado mucho en el Africa. En ese
continente se registró un 38% de casos de raquitismo en 1990, con respecto a
un 34% el año pasado.



La agencia instó a que se apliquen más estrategias para dar suplementos de
vitamina A y que se amplíe la campaña de lactancia materna. Eso podría
reducir el índice de mortalidad infantil en hasta el 15%, dijo la UNICEF.



Pero no todos coinciden con el planteamiento del UNICEF.



"No es realista creer que la desnutrición pueda ser controlada aplicando
planes verticales de la ONU", destacó Philip Stevens, de la Red de Política
Internacional, un centro de estudios londinense. "El progreso del informe de
la UNICEF señala una mejoría en la nutrición que con toda certeza es un
resultado de un crecimiento económico, y no de las estrategias de la ONU",
agregó.



La UNICEF insistió que se necesitaba más dinero a fin de resolver el
problema. "Con más de 1.000 millones de personas que padecen de desnutrición
y hambre, es necesaria la urgente acción y un liderazgo internacional",
destacó Veneman en el informe.



*3*

*El 30% de los travestis argentinos tiene sida**
**Infobae.com*

13/11/2009



Según un estudio realizado por el Hospital Ramos Mejía de la ciudad de
Buenos Aires, la mayoría se contagia por vía sexual. Su expectativa de vida
es de 32 años



vestigación relevó el comportamiento de riesgo y la prevalencia de
enfermedades de riesgo entre 4.118 pacientes que consultaron durante 4 años.




Entre ellos, 105 eran travestis y brindaban servicios sexuales. Los análisis
revelaron que la prevalencia de la infección por VIH tipo 1, de la sífilis y
de otras ITS (hepatitis B, herpes genital, úlceras genitales y verrugas
causadas por el virus del papiloma humano) superaba enormemente las cifras
en el resto de los pacientes.



En los travestis, la infección por el virus del sida alcanzó 27,5%, a
diferencia de 6,2% en el grupo no transgénero. En la Argentina, la
prevalencia de esta infección entre las mujeres trabajadoras sexuales no
supera un 4,5 por ciento.



Y mientras un 42% de los travestis tenía sífilis, la prevalencia de esa
enfermedad curable no superó el 18% en el resto de los pacientes atendidos.



Estas causas determinan que la expectativa de vida de un transexual que vive
en la Argentina es de 32 años aproximadamente, menos que en Sudáfrica, donde
es de 37.



La vía de contagio es mayoritariamente sexual, ya que ninguno de los
pacientes estudiados consumía drogas inyectables. Aun así, la proporción de
uso correcto del preservativo fue igualmente baja tanto en los travestis
(13,5%) como en los pacientes no transgénero (18%).



*4*

*Visitas íntimas a presos homossexuais  **
**O Estado de S. Paulo, Brazil*

12/11/2009



Em decisão inédita no Brasil, a Justiça do Pará liberou a visita íntima à
população HOMOSSEXUAL carcerária. Detentos que quiserem receber seus
parceiros devem solicitar esse direito à Superintendência do Sistema
Penitenciário do Estado. A Comissão de Direitos Humanos da OAB-PA e os
movimentos de Lésbicas, Gays, Bissexuais e Transgêneros do Estado
comemoraram a decisão. "É um avanço importante", diz o coordenador do
movimento Marcelo Larrat.



*========================*



*NORTH AMERICA*



*========================*



*Study in D.C. to test whether HIV treatment can prevent spread**
**Washington Post*

13/11/2009



By Darryl Fears, Washington Post Staff Writer



The National Institutes of Health and the D.C. Health Department are
preparing to launch a study in the District with an ambitious goal: to
determine whether aggressive treatment of every adult with HIV could
eliminate AIDS.



As part of the study, the NIH will provide the Health Department with
experts who will help modernize patient record-keeping at clinics to better
track HIV-infected people. Experts will also show social workers how to
monitor patients to ensure they take their medication, even when they feel
well.



"The purpose is to get the . . . level [of HIV in the blood] down so that
people will not infect anyone because their viral load is so low," said
Anthony S. Fauci, director of the National Institute of Allergy and
Infectious Diseases. "When you follow couples -- one who's infected, the
other who's not -- the probability of infection diminishes when the viral
load is very low. The philosophy is if you could test everybody, and treat
everybody who has HIV, you could use treatment as prevention."



Fauci declined to say how much money and other resources would be devoted to
the study before the project begins next month. He and city officials also
would not to say which areas of the city would be included in the study,
aside from Anacostia.



In the District and other cities, about half of the people who are tested
and receive an HIV diagnosis wait an average of six months before getting
treatment. During that time, many carry on as if there was no diagnosis,
using illegal drugs and having unsafe sex, spreading the virus and sometimes
re-infecting themselves with a deadlier strain of the disease.



Fauci said the premise for the study is based on a mathematical theory put
forward by doctors at the World Health Organization last year. They
concluded that global universal treatment with antiretroviral drugs would
reduce HIV to 1 case in 1,000 by 2016 and reduce the prevalence rate --
which includes an estimation of the number of people with HIV who have not
been tested -- to 1 percent in 50 years



The report energized U.S. doctors and scientists who study AIDS because it
was the first to look at aggressive treatment as prevention, a way to arrest
the spread of the disease in a community, such as Anacostia. A similar study
is being conducted in the Bronx in New York.



But the WHO theory is so untested that its supporters doubt it will live up
to expectations. "It's so far in the hypothetical stage that I wouldn't even
rank it" among the methods that work, such as condoms and needle exchange,
Fauci said.



The study, scheduled to be launched by the White House on or around World
AIDS Day, Dec. 1, has major challenges. Researchers must first determine
whether testing every adult for HIV is feasible. Then they must determine
whether people who test positive will opt for treatment.



"They might say, 'I don't want to go on medication, I feel fine,' " Fauci
said. "What happens when you treat people? Will the benefit equal a benefit
to society? Will aggressive treatment have the unintended consequence of
inducing drug resistance? Will it lead to behavior changes with people
running around doing what they want, assuming they're disease-free? We might
find that this is not workable."



If the theory is proved, Fauci said, it could lead to a nationwide testing
and treatment program for adults 18 to 49 that would cost hundreds of
millions, "if not billions," of dollars.



Some doctors have said the study's premise is shaky because the WHO theory
is not valid. Elimination of HIV is theoretically possible, "but it would
take at least 70 years" based on the WHO model, said scholar Bradley G.
Wagner and Prof. Sally Blower at the David Geffen School of Medicine at the
University of California at Los Angeles.



"Even under optimistic assumptions, we find elimination to be unlikely," the
authors wrote in a study of the WHO theory. But Wagner and Blower, who have
said they were among the first to suggest treatment as a prevention method
10 years ago, said the WHO model is useful, with lower expectations.



Doctors at the University of North Carolina were also skeptical, calling the
WHO theory plausible but unproved. However, Prof. Myron S. Cohen and two
colleagues wrote, "The WHO model challenges us to marry treatment and
prevention."



At the Family and Medical Counseling Service, a primary care clinic in
Anacostia, deputy director Angela Fulwood Wood embraced the WHO theory and
the NIH study that aims to prove it. "We're missing opportunities to deal
with HIV as early as possible," she said.



The clinic caters to African Americans in a high-risk area for HIV
contraction and could use the tools offered by the NIH -- electronic patient
records and personnel who could follow up when people test positive.



Follow-up requires persistence and personnel, the latter a resource the
clinic does not have in abundance, Wood said. The clinic needs trained
counselors to overcome an anti-medical establishment mind-set in Anacostia.
"As African Americans, we are very proud to not take medicine, especially if
we don't feel sick."



Corrie Franks, 55, said he waited five years to get treatment after his HIV
diagnosis at a New York prison in 1990.



Released from prison four months later, he behaved no differently, smoking
crack and having sex. He moved to the District in 1995, entered a drug
rehabilitation facility, heard a presentation from the counseling service
and got treatment.



"I went from a high viral load to an undetectable viral load," he said.

© 2009 The Washington Post Company



*2*

*Rape and the Plight of the Female Migrant Worker**
**TIME Magazine*

12/11/2009



By Mark Schliebs / Jakarta



No one knows if 1-year-old Yunus will ever see his mother again. Like 6
million other Indonesians, she traveled far from home to find employment.
She was hired by a wealthy family in Saudi Arabia. But one day, while on her
boss's property, she went to check on some goats and, according to what is
known of her tale, was raped by two men. Yunus was conceived of that
assault.



The two women raising the boy hope he never learns about his mother — let
alone his real father. The stigma of such a birth is so heinous that Yunus'
mother gave him up to Normawati, 50, and her close friend Ibu Herlina, 53,
who describe themselves as Yunus' adoptive grandmother and mother,
respectively. However, the child's situation is not unique, and Normawati
(who like many Indonesians goes by a single name) is not unused to it.
Indeed, the campaigner for migrant-worker rights and her daughter are
raising several children of half-foreign parentage who were abandoned by
raped migrant mothers. There are dozens of children of similar backgrounds
in Jakarta and its environs



While globalization has turned much of the world into a wide-open labor
market, it has also created complex human and societal dramas. Women account
for up to 50% of the world's 100 million–strong migrant-worker population —
and there is no effective entity to protect their rights and dignity. In
2008, Indonesians working abroad, commonly as domestic staff in the Middle
East and parts of Asia, contributed about $6.8 billion to their national
economy via remittances, according to the World Bank. And while statistics
are difficult to come by, there are increasing reports of many who are
physically abused, raped and — in some cases — killed by their employers.
While cases of death at the hands of overseas employers are relatively rare,
Normawati says she has seen countless pregnant Indonesians coming through
the gates of Jakarta's Soekarno-Hatta International Airport after working
abroad. She says the most disturbing of experiences can be heard again and
again from the lips of different women: "The boss tells the woman, 'You must
be with me.' Then rape."



The story behind Yunus' conception isn't even exclusive in his new home,
which is not far from the airport. His adopted sister Nadia, who celebrated
her first birthday on Nov. 1, was born following the rape of her mother in
Kuwait. Both children were born in Jakarta and were almost immediately
placed into Ibu Herlina's care. Their adopted mother points out that the
children share "Arab" facial features, in contrast to most of their
siblings, who have "Asian looks." Her home, consisting of a modest house and
a dormitory-like shelter, is filled with 10 children who were abandoned by
migrant workers. Only a few of the biological mothers have made contact with
their children. The abuse of Indonesian workers in some countries has become
so notorious that Jakarta is considering placing bans on labor migration to
specific destinations. Manpower and Transmigration Minister Muhaimin
Iskander says workers may soon be prevented from entering Saudi Arabia and
Jordan if a "thorough review" shows that those governments are providing
insufficient protections for Indonesian workers.



In many cases, Normawati explains, female migrant workers are raped and then
dumped on the streets by their employers, who refuse to give them their
passports after discovering that the women are pregnant. The women are then
arrested by police and placed in jail. Sometimes they are deported before
the child is born. Herlina claims that airport officials have called her to
ask what to do with the babies who are left behind by mothers.



Normawati says there are dozens of children who were abandoned by migrant
workers in homes throughout Jakarta and surrounding areas. "I'm in my house
one or two days a week," she says. "I travel to see my grandchildren" — as
she calls the abandoned infants. Normawati and Herlina sustain their wards
by way of donations as well as assistance from the families of some of the
children, who are nevertheless too ashamed to raise the children themselves.



While the abandonment of the children depresses her, Herlina thinks it is
better that they stay in her care. Their biological mothers are often
married and have other children, she says, and the husbands who stay in
Indonesia while the women work abroad are often not the type to welcome
another man's offspring. It is rare for a biological mother to contact
Herlina after giving away her child. Normawati agrees that many men are
"sensitive" about such issues. "If the migrant worker takes her baby [to
raise herself], three things could happen," she says. The first is the most
common: "The husband gets angry and wants a divorce. The second one is [the
woman] doesn't go home," abandoning what was once a stable home to go off on
her own with her child. The third thing that could happen? It is the rarest:
"The husband will accept the child."



*3*

*Human Rights, Health: Twin Issues for Climate Change**
**IPS Terra Viva*

13/11/2009



Helen Clark



HANOI, Nov 12 (IPS) - Vietnam will be one of five nations most affected by
climate change. Worst-case scenarios see large parts of the low-lying and
flood-prone Mekong Delta area, which produces much of the nation's rice
crop, flooded. A one-metre rise in sea level, predicted by 2100 will affect
10 percent of Vietnam's population (which now stands at 86 million) and 10
percent of GDP lost.



The government could not have been more right when it released these
scenarios in August. Many international organisations concur. As millions
are displaced and the potential for vector-borne diseases such as malaria
and dengue to spread grows, health and human rights have become concerns
closely related to climate change.



The links between health, human rights and climate change was the focus of
the 260-delegate-strong conference held in Hanoi from October 26 to 29. One
hundred million people, out of a total of 150 million worldwide, will have
to migrate thanks to climate change effects in Asia, said Daniel Tarantola,
professor of Health and Human Rights at the University of New South Wales,
in his opening address at the &apos;International Conference on Realising
the Rights to Health and Development for All&apos;.



"Forced migration moves people away from the basic infrastructure on which
good health absolutely depends like sanitation and clean water, making them
vulnerable to communicable diseases in crowded, under serviced temporary
settlements," added Tarantola, who was also one the organisers of the
conference.



Rapid urbanisation and its associated health problems are another issue.



Tarantola said 60 percent of people worldwide will live in cities in 2030,
up from 14 percent in 1900. "Urbanisation is exposing hundreds of millions
of people to poor air quality and inadequate sanitation and services,
particularly in Asia."



Though nearly three-quarters of Vietnam&apos;s population is still rural,
the nation is struggling with rapid urbanisation; Ho Chi Minh City (HCMC),
the southern hub and commercial centre, recently passed the seven million
mark.



"Rural townships will become cities (as a result of climate change)," he
told IPS in an interview, referring to Vietnam. "And the cities are not
equipped for these people. For example, HCMC, how can it be protected?"



The ADB estimates that two-thirds of HCMC, which is close to the Mekong
Delta, will be flooded by 2050.



Another keynote speaker, regional climate change expert Gurmit Singh of
Malaysia, said that Asia&apos;s response to climate change so far has to
been to blame more industrialised nations rather than take its own
mitigating action.



Tarantola, who is more optimistic than Singh, says that Vietnam&apos;s
communist government has "done a lot of sophisticated policy adaptation.
There is awareness that tomorrow will not be like yesterday."



It is "not earth-shattering or sophisticated," Koos Neefjes, a policy
advisor on climate change at the United Nations Development Programme
(UNDP), told IPS via email, but Vietnam has at least made strides in
"implementing improvements on disaster management."



The government&apos;s swift efforts last month saved many lives when Typhoon
Ketsana hit the central coast, killing 163. Increasing inclement weather
events are also forecast to increase in Vietnam.



Ugo Blanco of the UNDP&apos;s disaster management arm told IPS after Ketsana
hit: "Vietnam suffers 6.4 typhoons per year-this is already typhoon number
nine, and we have one or two months until the end of the season. I would say
climate change will impact negatively."



At the Hanoi a climate change conference, Deputy Prime Minister Hoang Trung
Hai said, "Vietnam will be affected much more by climate change" in times to
come.



According to local news the government has approved a 12- to 14-million U.S.
dollar major project, which will run in two stages from this year until 2020
and will include 36 projects in total. Increasing community understanding of
climate change is one focus.



The government has also approved the National Target Programme to respond to
climate change. Neefjes says that "Vietnam is to be commended for having
pulled this off so soon after the world woke up to climate change in about
2007." . The issue of human rights does play into solutions such as
adaptation and mitigation, says Tarantola. People facing flooding and
destruction of lands and crops often have two options: stay or go.



"(And) to what extent do people who are concerned take part in that choice?
Relocation poses human rights issues. There&apos;s hardly any arable land
(in Vietnam). The economic, social and cultural environment (where they
relocate) will be different."



"You look at the disadvantage-the reduced coping capacity," he told IPS
"Children drowning-how can they be protected from floods? Then you look at
women from a social and economic perspective. You look at basic rights and
look to meet those."



"Different professional/development communities are coming together
increasingly, including health and environment communities, and more of that
needs to happen," said Neefjes. "(But) we seem to be mainstreaming
everything into everything. I don&apos;t see climate change as a
&apos;framework&apos; but as a set of pressures."



*4*

*Opinion: Gay rights go global**
**GlobalPost*

11/11/2009



By Peter Tatchell — Special to GlobalPost



LONDON, U.K. — A new bill before the Ugandan parliament proposes the death
penalty for “aggravated homosexuality” and “serial offenders.” A sentence of
life imprisonment will be imposed for touching a person with homosexual
intent. Membership in gay organizations, advocacy of gay human rights and
the provision of condoms or safer sex advice to gay people will result in
seven years jail for “promoting” homosexuality. Failing to report violators
to the police within 24 hours would incur three years behind bars. The new
legislation will also apply to Ugandans who commit these "crimes" while
living abroad, in countries where such behavior is not a criminal offense.



Over the last few years, Uganda has stepped up its victimization of lesbian,
gay, bisexual and transgender (LGBT) people, often at the behest of
Christian leaders who are aided and funded by right-wing evangelical
churches in the U.S.



Typical is the fate of gay rights activist Kizza Musinguzi. He was jailed in
2004 and subjected to four months of forced labor, water torture, beatings
and rape. Any Ugandan who speaks out against anti-gay violence faces dire
consequences. A heterosexual Anglican bishop, Christopher Ssenyonjo, was
expelled from the Church of Uganda for defending the human rights of LGBT
people. In recent years, the Ugandan government has passed a law banning
same-sex marriage, fined Radio Simba for broadcasting a discussion of LGBT
issues and expelled a UNAIDS agency director for meeting with gay
campaigners.



Similar homophobic persecution is happening elsewhere in Africa, from
Nigeria to Cameroon, Burundi, Rwanda and Gambia, where President Yahya
Jammeh has called for sexual cleansing. He has promised "stricter laws than
Iran" on homosexuality, and has begun his witch-hunt by ordering LGBT people
to leave the country and threatening to "cut off the head" of any homosexual
who remains.



One hindrance to LGBT rights is that no international human rights
convention specifically acknowledges sexual rights as human rights. None
explicitly guarantee equality and non-discrimination to LGBT people. The
right to love a person of one’s choice is wholly absent from global
humanitarian statutes. Relationships between partners of the same sex is not
specifically recognized in any international law. There is nothing in any of
the many U.N. conventions that explicitly prohibits homophobic
discrimination and protects LGBT people.



Of the 192 member states of the U.N., only a handful come close to giving
full equality and protection against discrimination to LGBT people: the
Netherlands, Belgium, Spain, France, Germany, Denmark, Sweden, Norway,
Finland, Canada, New Zealand and the U.K.



In much of the world, homophobia is still rampant. About 80 countries
continue to outlaw homosexuality, with penalties ranging from one year’s
jail to life imprisonment. More than half of these countries were former
British colonies. Their anti-gay laws were originally imposed by the British
in the 19th century, during the period of colonial rule. These homophobic
laws, which were retained after independence, are wrecking the lives of LGBT
people.



Six Islamist states impose the death penalty, including Saudi Arabia, Iran,
Mauritania and Sudan. In some provinces of other countries, such as Nigeria
and Pakistan, Islamic Shariah law is enforced and lesbians and gays can be
stoned to death. Hundreds of millions of LGBT people worldwide are forced to
hide their sexuality fearing ostracism, harassment, discrimination,
imprisonment, torture and even murder. Some of this violence is perpetrated
by vigilantes, including right-wing death squads in countries like Mexico
and Brazil. They justify the killing of queers as "social cleansing." Other
homophobic persecution is encouraged and enforced by governments, police,
courts, media and religious leaders, as these examples illustrate:



In the new post-Saddam Hussein “democratic” Iraq, people who murder LGBTs to
defend the “honor” of their family invariably escape punishment. The rise of
Islamist fundamentalism has led to the creeping, de facto imposition of
Shariah law, with deadly consequences for LGBTs and for women who refuse to
be veiled. The U.S. and U.K.-backed Grand Ayatollah Ali al-Sistani has
issued a fatwa calling for the execution of lesbians and gays in the “worst,
most severe way possible.” Islamist death squads of the Badr and Sadr
militias are assassinating LGBT people with impunity.



Russian religious leaders have united to orchestrate hatred against the LGBT
community. The Orthodox Church has denounced homosexuality as a "sin which
destroys human beings and condemns them to a spiritual death." The Chief
Mufti of Russia 's Muslims, Talgat Tajuddin, says gay campaigners “should be
bashed … . Sexual minorities have no rights, because they have crossed the
line. Alternative sexuality is a crime against God.” Russian Chief Rabbi,
Berl Lazar, has condemned gay pride parades as “a blow for morality," adding
that there is no right to “sexual perversions."



The Iranian persecution of LGBTs continues unabated. Twenty-two-year-old
Amir was entrapped via a gay dating website. The person he arranged to meet
turned out to be a member of the morality police. Amir was jailed, tortured
and sentenced to 100 lashes, which caused him to lose consciousness and left
his whole back covered in huge bloody welts.



The Western-backed regime in Saudi Arabia retains the death penalty (usually
beheading) for homosexuality. In early 2006, its neighbor, the United Arab
Emirates, imposed six years jail on 11 gay men arrested at a private party.
They were not imprisoned for sexual acts, but merely for being gay and
attending a gay social gathering.



Despite this oppression, LGBT people have made huge gains in many parts of
the world. A mere four decades ago, LGBTs were almost universally seen as
mad, bad and sad. Same-sex relations were a sin, a crime and a sickness
nearly everywhere. It was only in 1991 that the World Health Organization
declassified homosexuality as an illness and that Amnesty International
agreed to campaign for LGBT human rights.



Last December, something truly historic happened. Sixty-six countries signed
a United Nations’ statement calling for the universal decriminalization of
homosexuality and condemning homophobic discrimination and violence. This
was the first time the U.N. General Assembly had ever considered the issue
of LGBT human rights. Previously, all attempts to get the U.N. to endorse
gay equality had been blocked by an unholy alliance of the Vatican and
Islamic states.



Now, at last, in almost every country on earth, there are LGBT freedom
movements — some open, others clandestine. For the first time ever,
countries like the Philippines, Estonia, Lebanon, Columbia, Russia, Sri
Lanka and China are hosting LGBT conferences and Pride

celebrations. Via the internet and pop culture, LGBT people in small towns
in Ghana, Peru, Uzbekistan, Kuwait, Vietnam, St Lucia, Palestine, Fiji and
Kenya are connecting with the worldwide LGBT community. The struggle for
LGBT liberation has gone global. We’ve begun to roll back the homophobia of
centuries. Bravo!



Peter Tatchell has campaigned for LGBT human rights for 40 years. For more
information about his campaigns: www.petertatchell.net.

Copyright 2009 GlobalPost – International News



*========================*



*UNAIDS WEB.SITE*



*========================*



Global Fund approves US$2.4 billion in new grants

*UNAIDS*

12/11/2009



The Global Fund to Fight AIDS, Tuberculosis and Malaria’s Board of Directors
has approved new grants with a two-year commitment of US$2.4 billion. The
Global Fund Board concluded its 20th meeting in Addis Ababa, Ethiopia on 11
November. High on the agenda were discussions on the implications of the
global financial crisis for a fully funded AIDS response.



The Global Fund Board also announced the launch its next round of grants in
May 2010. This round of funding will be considered for approval at a Board
meeting to be held some time between November 2010 and January 2011.



“We are seeing a tremendous demand for funding,” said Michel Kazatchkine,
the Executive Director of the Global Fund. “Countries are showing that they
are able to effectively turn large amounts of money from donors into
prevention, care and treatment of AIDS, TB and malaria, which in turn will
save millions of lives.”



Addressing the Global Fund Board earlier in the week UNAIDS Executive
Director, Mr Michel Sidibé congratulated Dr Kazatchkine on the excellent
progress made over the last year.



Mr Sidibé expressed concern that because overall resource demand is higher
than anticipated in the funding scenario of the replenishment meeting in
Berlin in 2007, the Global Fund risks facing a resource gap for the period
2009-2010. He reiterated his call to donor countries to ensure that the
Global Fund is fully funded. He also called for appropriate prevention
investments that match the nature of the epidemic, for example in Eastern
Europe where HIV is mainly transmitted via injecting drug use.



Speaking on the potential impact of the financial crisis on the AIDS
response, Mr Sidibé called for innovative approaches and the need to
establish new partnerships in the AIDS response.



With its key approaches – country ownership, inclusiveness, accountability
and performance-based funding – the Global Fund is setting the standard in
development financing and is strongly aligned with aid effectiveness
principles. Praising this approach, Mr Sidibé encouraged even greater
engagement with implementing countries and communities in decision-making
processes.



Mr Sidibé also committed to scaling up technical support from the UN system
and that UNAIDS programme at the country and regional level would expand its
support to the Global Fund.



“A strengthened partnership at country level will lead to greater
cohesiveness and sustainability of the response,” said Mr Sidibé.



The Global Fund Board also approved a new grant architecture to simplify
grant management and reporting by countries and facilitate their strategic,
long-term planning.



The Global Fund was created in 2002 with a mandate to dramatically increase
resources to fight three of the world's most devastating diseases – HIV, TB
and Malaria, and to direct resources to areas of greatest need. It has since
approved a total funding of US$18.4 billion for 144 countries. It’s a global
public/private partnership between governments, civil society, the private
sector and affected communities the Global Fund represents a new approach to
international health financing
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