[hivaids-twg] Fwd: Today's News (2009.11.23ex)

[HIV-TWG Moderator]

---------- Forwarded message ----------
From: Diaz, Clara <diazc at unaids.org>
Date: Mon, Nov 23, 2009 at 7:48 PM
Subject: Today's News (2009.11.23ex)
To:


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







*AFRICA** AND MIDDLE EAST*

1. Daily Champion, Nigeria - *N.9 Million Locals Need HIV/Aids Drugs - NACA
Boss *

2. IRIN PlusNews - *Life Expectancy Drops *

3. Sunday Standard, Botswana - *Disabled people closed out of HIV-Aids
programs – complaint*

4. Fraternité Matin, Côte d’Ivoire - *Lutte contre le sida - Les acteurs
affinent leur stratégie  *



*ASIA** AND PACIFIC*

1. The Straits Times, Singapore - *The different faces of Aids *

2. China Daily - *Coca-Cola China assists AIDS orphans*

3. Xinhua News, China - *Chinese director starts filming documentary on
reducing AIDS discrimination *



*EUROPE*

1. Le Monde - *Pays en développement : les technologies mobiles au secours
des systèmes de soins ?*

2. Le Monde - *Le Nord, le Sud et la hiérarchie des pestes, par Jean-Louis
Bianco*

3. AFP - *Sida: la transmission mère-enfant reste un défi en Amérique latine
*



*LATIN AMERICA AND CARIBBEAN*

1. Stabroek News, Guyana - *HIV infections fewer than ten years ago,
Ramsammy says*

2. Agencia Orbita, Peru - *Instan a enfrentar de manera regional el VIH  *

3. Jornal do Brasil - *Homofobia leva religião ao Senado   *



*NORTH AMERICA*

1. New York Times Magazine - *The Needle Nexus*

2. New York Times - *Medical Marijuana: No Longer Just for Adults*

3. New York Times - *How Can We Help the World’s Poor? *

4. Washington Post - *D.C. AIDS activist among new Rhodes scholars*

5. IPS Terra Viva - *U.N. in Final Push for 2015 Development Goals *

6. IPS Terra Viva - *Q&A: Maternal Mortality Rates 'One of the Saddest
Cases' in Asia  *



*UNAIDS WEB.SITE*

1. UNAIDS - Acclaimed photo exhibition by women living with HIV opens in New
York

2. UNAIDS - *Education sector: Getting to grips with an HIV monitoring and
evaluation framework *





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



*AFRICA** AND MIDDLE EAST*



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



*N.9 Million Locals Need HIV/Aids Drugs - NACA Boss **
**Daily Champion, Nigeria*

20/11/2009



Jude Opara



Abuja — OVER 900,000 Nigerians suffering from the dreaded HIV/AIDS are in
dire need of regular supply of antiretroviral drugs, the National Action
Committee Against Aids (NACA), has said.



Speaking at a press conference organiSed by the United States Embassy in
Abuja to usher the 2009 World AIDS Day slated for December 1, the Director
of Strategic Knowledge Management at NACA, Dr Kayode Ogungbemi SAID that the
country was winning the battle against AIDS.



According to Dr Ogungbemi who addressed the media jointly with the USAID
(Nigeria) Director of Investing In People, Mr. Alonzo Wind SAID that a lot
of progress had been made in the fight against the dreaded disease.



He argued that there has been a steady decline in the rate of new
infections, just as he thanked the US government for the assistance being
rendered to NACA through the US President's Emergency Plan For AIDS Relief
(PEPFAR).



Ogungbemi also said that the Federal Government in conjunction with donor
agencies was working towards a road map that would close gap on prevention
of Mother to Children (PMTC), saying that the current statistics PMTC which
stands at 20 per cent was not acceptable.



Mr. Wind promised that the US wouldcontinue to partner and assist NACA,
adding that the World AIDS Day provides opportunity to reflect on what had
been done and what needed to be done to win the battle against the killer
disease.



*2*

*Life Expectancy Drops**
**IRIN PlusNews*

21/11/2009



Johannesburg — South Africans are dying younger and in greater numbers, and
HIV/AIDS is to blame, according to a report released this week by the South
African Institute of Race Relations.



Average life expectancy declined from 62 years in 1990 to 50 years in 2007;
it is projected to fall even further by 2011, to 48 years for men and 51 for
women, according to the Institute's annual South Africa Survey.



The authors note that among 37 developed and developing countries, South
Africa is one of only six where life expectancy fell between 1990 and 2007,
with only Zimbabwe showing a steeper decline.



Of South Africa's nine provinces, those with the highest HIV prevalence
rates also had the lowest life expectancy - KwaZulu-Natal at 43 years,
followed by Free State and Mpumalanga, both at 47 years. The leading causes
of death were tuberculosis (TB), influenza and pneumonia, all common
opportunistic infections associated with HIV/AIDS.



Seventy percent of people diagnosed with TB in South Africa were co-infected
with HIV, and "it is thus reasonable to assume that at least 70 percent of
observed mortality from tuberculosis, and by extension a comparable
percentage of deaths from influenza/pneumonia, also has HIV and AIDS as an
underlying cause." Nearly half of all deaths in 2008 were thought to be
HIV/AIDS related - up from a third in 2001.



Gail Eddy, a researcher at the Institute, commented that although neither
the public health system nor the government's antiretroviral (ARV) treatment
programme were reaching all those in need, particularly in rural areas, a
slight decrease in mortality rates in the last two years may be the result
of ARVs gradually becoming more widely available.



The HIV/AIDS epidemic contributed to a 43 percent reduction in population
growth between 2001 and 2008; a fall in birth rates also played a role.



Although fewer children are being born, HIV/AIDS is creating an increasing
number of orphans: of the estimated 2.5 million children who had lost a
parent by 2007, more than half were orphaned as a result of HIV/AIDS.
According to the survey, by 2015, 32 percent of South African children will
have lost one or both parents to the virus.



Eddy noted that the government's social grants programme was not addressing
the need of orphaned children for psychosocial support. NGOs were attempting
to fill the gap created by a chronic shortage of social workers but many
were underfunded. "There's a need to strengthen government/NGO
partnerships," she said.



The report was released amid mounting controversy over mortality figures
quoted by President Jacob Zuma during a speech on 29 October. He said that
756,000 deaths had been recorded in 2008 - an astounding 30 percent increase
from the previous year.



He attributed the increase to the AIDS epidemic, an admission that the AIDS
lobby group, Treatment Action Campaign, welcomed as "the ushering in of a
new era", after a decade of government denial about the extent of AIDS by
former President Thabo Mbeki. However, a number of researchers have
questioned the figure, reportedly supplied by the Ministry of Home Affairs.



Eddy confirmed that the figure was significantly higher than the one
provided by the Actuarial Society of South Africa, on which the Institute
based its calculations.



"I think it was really a miscalculation," she said. Estimating HIV/AIDS
deaths in South Africa is particularly problematic because the disease is
not notifiable.



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



*3*

*Disabled people closed out of HIV-Aids programs – complaint**
**Sunday Standard, Botswana*

22/11/2009



by Gowenius Toka



Disabled people living with HIV-AIDS complain that they have been closed out
of government programmes aimed at helping people living with AIDS.



The complaint was raised at a workshop aimed at identifying, strengthening
societies for people with disabilities and articulating their concerns in so
far as HIV-Aids issues are concerned.

They cited the continued expulsion of people living with disabilities from
national radio and television programs, despite government’s declared
commitment to halting the spread of HIV in Botswana.



“It is against this background that the Disability HIV-Aids Trust is meeting
today in a workshop jointly organized with the National AIDS Coordinating
Agency (NACA) to facilitate the networking of Disabled Peoples Organizations
and solicit support, with a view to mainstreaming disability issues into
HIV-Aids programming” said Shirley Keoagile of The Disability HIV and Trust
(DHAT), who is also Vice President of Botswana Federation of the Disabled
People (BFDP).



She also bemoaned the lack of a ready database indicating the total number
of people with varied disabilities across the country, which she said
hampers proper planning for interventions meant to benefit the disabled.



“In the final analysis the vulnerability of PWD’s to the adverse impact of
HIV-Aids can only be meaningfully reduced if concerted efforts are ensured
to raise awareness among the affected groups,” she concluded.



*5*

*Lutte contre le sida - Les acteurs affinent leur stratégie  **
**Fraternité Matin, Côte d’Ivoire*

21/11/2009



Franck Yeo



Abidjan — Le secrétariat technique chargé de la coordination opérationnelle
(Stco) a organisé ce vendredi 20 novembre à Abidjan avec l'appui de la
banque mondiale un atelier de restitution nationale des analyses
situationnelles du Vih/sida dans quatre régions de la côte d'ivoire.



Le taux de prévalence nationale en côte d'ivoire en matière de Vih/sida est
de 4,7% selon une enquête sur les indicateurs du sida (Eis). C'est pourquoi
le gouvernement a demandé et obtenu l'appui de la banque mondiale pour le
financement d'un projet d'urgence multisectoriel de lutte contre le Vih/sida
(Pumls) exécuté dans les quatre régions à savoir les régions des Lagunes,
des savanes des montagnes et du sud comoé.



.A l'issue de ces études, il ressort que les populations les plus touchées
demeurent les jeunes et les femmes. Dans la région des lagunes, près de 26
000 professionnels du sexe vivent avec le virus et l'on dénonce également un
faible taux de dépistage. Au nord dans la région des savanes 3,2% des
personnes dépistées sont infectées. Dans la région des montagnes 2102 cas
d'Ist ont été enregistrés au cours du premier trimestre de 2009 et 358 cas
en juin 2009. cette région regorge plusieurs ong de lutte contre le sida. On
dénombre 17 à Man, 16 à Danané, 5 à Bangolo, 1 à Biankouma



Les participants ont aussi fait des recommandations. Entre autres la
multiplication des centres de dépistage, l'accroissement des prises en
charge des personnes vivant avec le Vih et sensibiliser davantage la
population sur les dangers du Sida.



Pour M. Abou Bamba, coordonnateur du Pumls « l'atelier vise à présenter aux
acteurs nationaux et les partenaires internationaux le fruit des analyses
faites dans les quatre régions. C'est un outil que nous mettons dans le
patrimoine public pour permettre à tout acteur de faire une planification »
a-t-il indiqué. Avant de demander aux acteurs et aux partenaires de prendre
appui sur ces résultats pour mieux faire leur planification.



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

* *

*ASIA** AND PACIFIC*

* *

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



*The different faces of Aids **
**The Straits Times, Singapore*

21/11/2009



Lee Siew Hua, Senior Correspondent



WE DON'T know it, but men and women with HIV live anonymously among us.



They look normal, perhaps are active in sports, raise children. They may be
anyone: a colleague or friend - even the grandmother waiting for the lift,
really. But they are walking walls of silence because Singapore society has
not yet learned to live with them.



The stigma of HIV is explored poignantly in 10 photo essays created by
patients, volunteers and caregivers. Hosted by the non-profit organisation
Action for Aids, the photo exhibition will run till Nov 29 at VivoCity.



The silence of patients, very sadly, feeds public ignorance and fear. This
fear invariably feeds more silence, with patients pulling an ever tighter
shroud of secrecy around their lives for protection. Should they speak up
then?



Medical social worker Ho Lai Peng from Tan Tock Seng Hospital says: “The
price is too high for them to pay.”



Until society or culture shifts to accommodate the marginalised sufferer, it
is may be too painful to speak up. Even with cancer - a common illness -
some patients are initially silent about their condition. Family members of
cancer patients, fearing contamination, have been known to keep separate
utensils for use at home.



Both cancer and HIV/Aids are chronic life-threatening conditions. While
there is also deep anxiety about cancer, the fear factor is conquered partly
because of the hefty resources and human sympathy focused on cancer here and
globally.



In Singapore, only two people have openly declared their HIV status. The
late Paddy Chew went public in 1998. Mr Andy Low broke his silence this
year.



Ms Ho, who has worked with patients for 14 years, has seen many of her
patients live long and fruitful lives. The pity is that these good lives are
covered up. She adds: “The discrimination is very painful because they have
to continually lie and cover up.”



Some feel guilty that they cannot be honest about their condition with a
good employer, she says.



Some forms of discrimination are obvious. People with Aids may lose their
jobs, and no specific legislation redresses this discrimination.



Subtle discrimination exists as well - even at home. A patient’s family may
have accepted his or her condition. Then when an argument breaks out, a
family member may lash out that the patient deserves his misery.



Volunteers from Action for Aids chime in with similar stories and views.
Says Mr Dan Tam, who visits HIV patients in the Communicable Disease Centre:
“They are like anyone else who is warded in hospital, just that they are
relatively more lonely and isolated. I feel upset when someone tells me that
people with Aids deserve the worst. HIV/Aids could happen to anyone.'



Photographer Tan Ngiap Heng, who helped seed the idea for the Aids photo
show at VivoCity, says: “I hope that people who see the images will also see
the humanity of the people living with HIV and be more accepting of these
people.”



Apart from stigma, photos in the exhibition also highlight the vulnerability
of HIV-positive mums and their young children. Other photos focus on the
journeys some patients make to buy cheaper generic medicine in Thailand. And
several pictures are infused with fun, hope and a sense of normalcy.



Meanwhile, the silence is still immense after years of public education and
outreach. It will take all players - the state, civil society and patients
themselves - to end the silence, the secrets and the unjustifiable stigma.



An open country like Singapore can surely focus new compassion and purpose
on an illness that has been with us a long time.



Just talking about Aids is very powerful - for Singapore society as much as
for people with Aids.



*2*

*Coca-Cola China assists AIDS orphans**
**China Daily*

23/11/2009



He is known for working to help children orphaned by AIDS in Africa, England
and China. He has been to China's rural areas numerous times to meet and
assist affected children.



He is also president of the China branch of the world's largest beverage
company.



Under the leadership of Doug Jackson, Coca-Cola China has undertaken
wide-ranging efforts to assist the orphans, some of whom carry the virus
themselves.



Recent programs include a third annual charitable golf tournament to raise
money in partnership with the Chinese Foundation for the Prevention of STD
and AIDS and the Player Foundation started by golfing legend Gary Player.



It was a small part of the Coca-Cola program to help orphans and also a
small part of the company's corporate social responsibility activities in
China.



"Over the past two years, we have provided a wide variety of support for
AIDS orphans in Yunnan, Hubei, Anhui and Xinjiang through this event. We
expect to expand support over the next year and help more affected children
live a better life," Jackson said.



"Coca-Cola strives to be responsible in its business operations and at the
same time respond to needs in the greater community," he added.



In the past two years, Coca-Cola China has been working in partnership with
the Player Foundation to raise money for the AIDS Orphans Program
administered by the Chinese Foundation for the Prevention of STD and AIDS.



The program provides financial aid, medical assistance and psychological
counseling to the children. It has collected more than 6.5 million yuan over
the past two years. And the money collected this year has already surpassed
13.5 million yuan.



"Though we are all experiencing a tough time during the economic downturn,
we have received great support from corporate donors such as Coca-Cola,"
said Ren Dequan, vice-president of the Chinese Foundation for the Prevention
of STD and AIDS.



The benefit tournament Gary Player Invitational has now assisted more than
2,000 AIDS orphans.



Player said it was a great honor for his foundation to develop the
partnership with Coca-Cola in China.



Since 2002, South African-born Player and Coca-Cola have partnered to hold
fundraising events for needy children around the world.



According to Jackson, the involvement of Coca-Cola China with HIV/AIDS
programs began in 2003 when the company supported the International Seminar
on HIV/AIDS and SARS at Tsinghua University.



In 2005, Coca-Cola and the Chinese Foundation for the Prevention of STD and
AIDS began a nationwide program to enhance awareness and prevention,
targeting women and young adults in more than 100 cities.



In 2006, Coca-Cola China began supporting a program in a Yunnan village that
helps 199 AIDS-affected orphans through education and medical help.



"Everybody can make contribution to the AIDS kids," said Jackson. "It is
hard to measure the achievements of our anti-AIDS activities, but the orphan
program will be non-stop work for Coca-Cola in China."



*4*

*Chinese director starts filming documentary on reducing AIDS discrimination
**
**Xinhua News, China*

23/11/2009



BEIJING, Nov. 22 (Xinhua) -- Established Chinese director Gu Changwei, a
cinematographer in Chen Kaige's "Farewell My Concubine" in 1993, started to
shoot a documentary on reducing people's discrimination toward HIV/AIDS
Sunday.



    The film, tentatively called "Mo Shu Xing Dong," or "Magic Move",
depicts how people infected with HIV/AIDS are leading their lives in
society. A person infected with the disease offers to work for Gu's film "Mo
Shu Shi Dai" or "Magic Age" and the change takes place.



    A survey conducted by the Chinese Center for Disease Control and
Prevention (CDC) in July showed almost half of ordinary people and 25
percent of medical workers still discriminate against HIV/AIDS sufferers in
China.



    "I hope more organizations and companies will take part in the
activities aimed to stem the spread of HIV/AIDS and eliminate the
discrimination", said Gu.



    He said, love and sincerity would bridge the gap between the public and
people infected with HIV/AIDS.



    Yin Li, vice minister of health, said the documentary was expected to
increase people's knowledge about HIV/AIDS.



    The documentary is part of China's efforts to disseminate the knowledge
of HIV/AIDS as the World AIDS Day is coming. It falls on Dec. 1 and the
theme for this year is "Universal Access and Human Rights."



    China had reported more than 290,000 HIV/AIDS cases by May this year,
including 90,000 AIDS patients.



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



*EUROPE*



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



*Pays en développement : les technologies mobiles au secours des systèmes de
soins ?**
**Le Monde*

20/11/2009



Internetactu.net



Dans les pays en développement et notamment en Afrique, les technologies
mobiles peuvent-elles combler le vide laissé par l'absence de développement
de systèmes de soins ?, s'interroge This is Africa. L'absence de personnel
soignant et de ressources en terme de santé demeure le principal problème de
la plupart des régions les plus pauvres du globe. Oui, explique Katrin
Verclas pour MobileActive : la plupart des projets de m-Santé (c'est-à-dire
de système de santé utilisant les téléphones mobiles) n'ont pas d'échelle,
de barème permettant de les comparer les uns les autres… Le manque
d'objectifs quantifiable sur leur efficacité conduit de plus en plus de
monde à s'interroger sur leur efficacité. Sans compter que le déficit
d'infrastructure et la fragmentation des expérimentations sont un frein à
toute généralisation de solutions.



"La plupart des stratégies en matière de m-Santé présument qu'en se
soustrayant au problème des infrastructures physiques, ils vont résoudre les
contraintes. Mais le plus souvent, elles créent de nouveaux problèmes
d'infrastructures", explique Bright Simons, directeur du développement de
MPedigree, une initiative mobile qui s'attaque à la contrefaçon de
médicaments en Afrique. Des problèmes d'analphabétisme, de comportement de
consommation ne sont pas correctement traités. Le plus gros risque est de
tenter d'introduire une technologie dans un environnement social qui n'y est
pas préparé. Une conclusion assez proche à celle que dessine le rapport des
Nations Unies sur le sujet qui s'inquiète du fait qu'on ne sache pas
vraiment à combien de patients ces programmes s'adressent.



Le succès des systèmes de santé via mobiles dépendra en définitive de leurs
capacités à réaliser une amélioration significative de la capacité de
prestation des soins. Or pour l’instant, ils ont parfois permis d’améliorer
la diffusion d’information de santé (au public comme aux professionnels de
santé), la consultation à distance, le diagnostic et le traitement, la
gestion des patients… Mais ont-ils eu des effets réels sur les systèmes de
soins ?



Le Centre de recherche pour le développement international (CRDI) mène une
étude pour évaluer l’impact des téléphones mobiles sur la santé, comme
l’explique Laurent Elder chef d’équipe au CRDI : "Sur la base des recherches
menées par les spécialistes en technologies de l’information et de la
communication pour le développement, il est clair que les technologies
mobiles pourraient être un système très efficace pour dispenser des services
de soins. En l’absence d’infrastructures, les mobiles peuvent être précieux
dans la lutte contre des maladies graves, comme le virus du Sida en Afrique
australe et orientale. Reste que peu de projets ont rencontré le même succès
que le réseau d’information de santé de l’Ouganda (Uganda Health Information
Network)." Les efforts pour intégrer les TIC dans la santé ont généralement
été sporadiques. La plupart des innovations dans les technologies mobiles
pour la santé et la médecine n’ont pas dépassé le stade du pilote.



Et d’appeler à prêter plus d’attention à la façon dont ces technos
améliorent et intègrent la prestation de services de base sur le terrain.
Les avantages potentiels d’améliorer l’accès, la qualité des soins, et
d’obtenir de meilleurs résultats cliniques doivent être clairement
démontrés. Pour Laurent Elder il faut mieux comprendre la viabilité
économique de ces services… Même dans le domaine de la télémédecine, il
existe encore peu d’études qui apportent des preuves convaincantes quant au
rapport coût/efficacité du téléphone mobile.

Hubert Guillaud



*5*

*Le Nord, le Sud et la hiérarchie des pestes, par Jean-Louis Bianco**
**Le Monde*

20/11/2009



Dans quinze jours commence la dernière phase de négociation sur la réduction
d'émissions des gaz à effet de serre à la suite des engagements pris à
Kyoto, engagements qui n'ont pas été tenus. Ces engagements valent jusqu'en
2012, ce qui laisse présager une prolongation de la négociation. Voilà donc
la négociation la plus dramatisée et la plus médiatisée aussi. Que l'enjeu
soit lourd et grave, je n'en doute pas. Aussi me semble-t-il utile de poser
la question : que peut penser le citoyen qui lit son journal, regarde les
journaux télévisés ? Peut-il se forger son opinion, ne pas avoir
l'impression de subir l'événement ?



Les avalanches de chiffres auxquelles nous sommes soumis sont difficiles à
comprendre, loin d'être clairs, cohérents et instructifs. Il s'agit souvent
d'injonctions, de diktats, qu'aucun savoir raisonné ne vient étayer. Je ne
veux pas dire que les savoirs n'existent pas, mais ils ne sont pas mis à la
disposition du citoyen, qui dès lors pourrait avoir le réflexe de se dire :
encore une catastrophe de plus qui nous tombe sur la tête. Encore une crise
qui nous touche, encore une peste que nous devons à cet être malfaisant,
l'homme.



Car comment s'y reconnaître entre ces 80 % de réduction d'émissions attendus
des pays développés, ces 100 milliards de dollars annuels nécessaires pour
permettre aux pays en voie de développement de s'adapter ? Et que penser de
ces taux d'émissions qui seraient de 11 % par tête d'habitant en Europe, 27
% au Etats-Unis et au Canada, face à 6 % en Chine et moins de 5 % dans les
pays en développement ? Oui mais, vous dit-on, la Chine a vu ses émissions
croître de 155 % en quinze ans ! D'où tient-on ces chiffres ? Comment
sont-ils calculés ?



Et pourquoi avoir décidé que cette peste est plus grave que la faim dans le
monde, qui a d'ores et déjà fait doubler le nombre de ses victimes en vingt
ans ? Plus grave que la crise économique qui atteint presque chaque famille
? Plus grave que l'illettrisme et l'analphabétisme qui touchent un tiers de
l'humanité ? Plus grave que le sida, la tuberculose et la malaria réunis ?
D'ailleurs y a-t-il une hiérarchie des pestes ?



Des retards graves

Pauvre Mme Michu, qui doit se débrouiller avec des informations qu'on lui
demande d'accepter sans avoir à les comprendre, mais qui est priée de
changer ses comportements alors que son gouvernement s'apprête à signer ces
nouveaux engagements, sans avoir donné le signal suffisant des économies
d'énergie ni des modifications de notre modèle de développement. Saura-t-il
trouver les fonds pour aider les pays pauvres à assumer les conséquences de
cette évolution ? Saura-t-il accompagner notre société vers des remises en
cause sans précédent ? Notre plan énergies renouvelables paraît bien modeste
face à l'ampleur de la tâche qui nous attend. N'avons-nous pas déjà pris des
retards graves dans notre préparation à ce que sera l'économie mondiale de
demain ?



Pourquoi ne pas prendre tout de suite des mesures simples et créatrices
d'emplois : plan ambitieux d'économies d'énergie par une meilleure isolation
du parc immobilier, mise en oeuvre immédiate d'un plan de bâtiments publics
à énergie neutre, c'est-à-dire qui produisent autant d'énergie qu'ils en
consommen, équipement de tous les services publics de visioconférences pour
réduire les déplacements. Toutes mesures qui génèrent des emplois durables
et non délocalisables.



Quelle peut être la crédibilité de la signature de la France à l'égard des
pays en développement quand, dès son arrivée au pouvoir, M. Sarkozy a remis
en cause la parole de la France en renonçant à l'engagement pris par son
prédécesseur d'atteindre 0,7 % de notre PNB en faveur du développement en
2012 ? Les crédits de développement devraient chuter brutalement en 2011
avec la fin de nombre de prêts bonifiés. Combien de temps pourrons-nous
encore faire semblant ? Et puis, le plus dur, le fond de toute cette
négociation est que, au bout du compte, si nous voulons en finir avec un
monde mal développé, il faudra bien apprendre à partager, à vivre sobrement
au Nord pour vivre dignement au Sud. Cela évitera sans aucun doute des
guerres mais cela se construit, ne peut être subi. Cela ne peut se faire
dans le laisser-faire et le non-dit, la simplicité volontaire est en route
et les gouvernements seront jugés à leur sens des responsabilités, de la
solidarité et de l'anticipation.



Ce que dit cette négociation, au-delà des chiffres et des effets de manches,
est qu'une nouvelle société est en train de naître, que les citoyens du
monde sauront la prendre en charge mais elle a besoin d'une vision, d'une
volonté et d'une méthode.



*Jean-Louis Bianco est ancien ministre, député et président du conseil
général des Alpes-de-Haute-Provence.*

Article paru dans l'édition du 21.11.09



*6*

*Sida: la transmission mère-enfant reste un défi en Amérique latine**
**AFP*

21/11/2009



LIMA — La transmission du VIH de la mère à l'enfant reste un défi majeur de
la lutte contre le sida en Amérique latine, où moins de 50% des femmes
enceintes séropositives reçoivent un traitement adéquat, selon
l'Organisation panaméricaine de la santé (OPS), Onusida et l'Unicef.



Chaque année, plus de 6.000 enfants en Amérique latine sont infectés par
leur mère pendant la grossesse, l'allaitement ou l'accouchement, selon un
rapport conjoint présenté vendredi par l'OPS, le Programmes des Nations
unies sur le sida (Onusida) et le Fonds des Nations unies pour l'Enfance
(Unicef).



"Le HIV est une menace pour les enfants en Amérique latine; 50% des femmes
enceintes de la région ne reçoivent pas de traitement: étendre cette
couverture de santé est un défi", a déclaré Vivian Lopez, représentante de
l'Unicef pour l'Amérique latine, à la veille d'un Forum régional sur le sida
à Lima.



Le rapport note toutefois de "fortes disparités" dans la région, et souligne
que des pays comme le Brésil, l'Argentine, le Mexique, l'Uruguay, le
Salvador, ont réussi à atteindre "un taux de traitement antirétroviral de
80% ou plus". Par contre, dans plus d'un tiers des pays, moins de 50% des
femmes enceintes séropositives sont couvertes.



Le rapport souligne aussi 450.000 cas par an de syphillis congénitale dans
la région.



L'OPS et l'Unicef ont lancé une initiative régionale visant à réduire le
taux de transmission de mère à l'enfant de 2 pour 1000 actuellement en
Amérique latine, à 0,5 pour 1000 à l'horizon 2015.



Des 33 millions de personnes affectées par le virus dans le monde en 2007,
quelque 2 millions se trouvent en Amérique latine et dans les Caraïbes,
selon les dernières données disponibles d'Onusida, qui doit publier mardi
prochain son rapport mondial sur l'état de la pandémie dans le monde.



En 2007, 60.000 personnes sont mortes du sida dans la région, qui a connu
240.000 nouvelles infections.

Copyright © 2009 AFP. Tous droits réservés



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

* *

*LATIN AMERICA AND CARIBBEAN*

* *

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



*HIV infections fewer than ten years ago, Ramsammy says**
**Stabroek News, Guyana*

22/11/2009



Posted By Iana Seales



In just under a decade, the reality of HIV has changed somewhat, but the
fight is far from over. Guyana’s Minister of Health Dr Leslie Ramsammy
points to a lower rate of infection and increased treatment and other
services, but acknowledged that there were still many undiagnosed and
untested cases in the country and that a fair section of the population
continues to ignore the messages about condom use.



Guyana has recorded successes in its HIV fight over the past eight years or
so, which Ramsammy easily rattles off with pride, including the widely
praised Prevention-of-Mother-to-Child Transmission (PMTCT) programme and the
dramatic decrease in the prevalence rate among risk groups, particularly Sex
Workers (SW). But the challenges are still very visible, and these include
the high number of unsafe commercial sex transactions across the country,
inadequate condom use, stigma and discrimination, unreported cases and
increased costs in an already overburdened healthcare system.



Estimates indicate that Guyana spends roughly $5 billion Guyana Dollars on
treatment and care of patients annually. This includes medication, medical
supplies and lab tests for people categorized as having AIDS. Every new
infection translates into additional expenses. However, these costs are
largely met by donor funds.



Stigma and discrimination continue to pose serious challenges, though it has
been pointed out that families are now more accepting of their infected
members and are increasingly opting to have them stay at home; this has been
attributed to greater awareness of the disease.



Ramsammy told Stabroek News in a recent interview that HIV is as much a
challenge now as it was when he took office, but he pointed to notable
improvements such as greater access to care and treatment, saying the impact
of actions taken years ago “is now being felt”. He said some people are
misguided on the impact of local efforts to tackle the disease, cautioning
that critics need to make assessments based on programmes implemented in
earlier strategies and the progress recorded to date.  He said also that the
prevalence among those at higher risk has declined and referred to this as
“anything but trivial”, noting that this has happened within the last
decade.



He measured the deeper involvement of civil society as a major achievement
saying that increasingly more people are getting onboard and are active.
“There should be absolutely no one who can dispute the positive impact we
have seen over the years, I am sure there are those who will want to make a
case but they will lose,” the minister added.



Rate of infection

The current rate of infection is around 1.5 per cent which represents the
findings on the ground using surveillance surveys and programmatic data;
UNAIDS estimates it at approximately 1.8 per cent. Ramsammy said the
difference in the numbers is not cause for alarm, as the numbers verify that
national data is providing an accurate picture of what is happening.



Ramsammy was asked how the rate of infection has changed over the years and
he immediately identified the risk groups including sex workers, men who
have sex with men, and the mobile population such as miners, saying the
change has been dramatic. In terms of the general infection rate, he said
that had stood at around 2.4 per cent several years ago and was even higher
at one point.



Similarly, prior to 2000 statistics indicated the rate of infection of
miners stood at  9 percent; men who have sex with men at 26 percent; sex
workers at 48 percent and infected pregnant mothers at 7 percent. Currently,
the numbers are 2.4 for miners; 20 for men who have sex with men; 18 for sex
workers and 1.1 percent for infected pregnant mothers.



“It has gone down,” the minister said of the overall prevalence rate and
according to him this is also reflected by the number of deaths. Prior to
2001 between 800-1000 AIDS-related deaths were recorded every year and today
there are between 200-300 deaths annually. The numbers aside, Ramsammy said
there have been a number of activities that are responsible for the changes
and he cited increased condom use over the years. But he acknowledged that
not everyone at high risk is following the messages about condoms.
Significantly, he said, the prison environment has also changed and pointed
out that prevalence in the prison population has also reduced over the
years. Counseling and testing are provided within the prison system and they
have had an impact, according to the minister. “We have been paying close
attention to the prisons,” he added.



He cited heightened awareness and education among the critical factors in
the visible changes saying that prior to 2000 there was a huge gap in
knowledge and the information which was accessible to the public. He said
the necessary information is now in schools and in homes, adding that not
only adults are armed with the necessary information but also children. But
he noted that “the awareness” has not translated to every citizen adjusting
his/her behaviour, stressing that many still put themselves at risk even
with all of the work the ministry and donors have done.



“Huge risk-taking still remains and it is clear that not everyone is using a
condom in risky situations, there are still too many risky engagements with
sex workers. For instance. We know that a significant number of persons
still take chances and what is troubling is that many of them are doing so
under the influence,” Ramsammy said. According to him, alcohol is playing a
critical role in impairing judgment and it is leading to new infections.



Treatment

There are about 6,000 people in Guyana who are being managed with HIV. These
are people who are living with the disease and are not on Anti-Retroviral
Drugs (ARVs) but are being treated at clinics across the country. Ramsammy
explained that persons categorized as HIV patients are considered okay
because their CD4 (a white blood cell that fights infection) count is high
and they also have no illnesses.  The goal, he said, is to ensure HIV
patients are healthy so they are constantly monitored.



There are about 3,000 persons who are on  anti retroviral drug treatment and
among them are persons who are considered AIDS patients. He said persons
considered AIDS patients are those who would have entered the system late at
an advanced stage and those with drug resistance problems. In Guyana, both a
clinical assessment and laboratory testing is done to determine whether a
patient has AIDS. The clinical assessment establishes whether a patient is
in the symptomatic stage and the laboratory testing involves checking a
patient’s CD4. Patients with low CD4 counts dipping below 200 are considered
AIDS patients.



Ramsammy said Guyana took the bold step of administering ARVs to patients
whose CD4 dips to around 350, which at the time was not in keeping with
international guidelines of using ARVs on patients with lower CD4 counts.



The point, he said, was to keep people healthy and avoid treating patients
when they fall ill.



He said statistics, prior to 2000. pointed to some 400 to 500 people
changing from living with HIV to having AIDS each year, but that the data
currently reflects only around 50 patients newly diagnosed with AIDS,
annually.



He said treatment does not remove the probability of transmission
completely, but that it does reduce it, adding that the more people on
treatment, the less chance of HIV transmission. Currently, there are 14
specialized treatment centres in the country where persons are referred to
for specialized care.



Ramsammy said there many other treatment centres and facilities across the
country where people are treated, but emphasized that specialized care is
only offered at the designated sites.



Asked about the assurances of persons in far-flung areas accessing care and
treatment, he said, there are clinics in every region and a dedicated doctor
for Regions One, Seven, Eight and Nine, who strictly covers those areas.



The doctor, according to Ramsammy, visits routinely and provides counseling,
makes diagnoses and initiates treatment since health providers in those
areas cannot initiate treatment. He said the doctor takes specimens which
are tested in the city among other things. In addition, he said a specialist
doctor visits all the communities occasionally.  He said too that people
assume HIV numbers are very high in those areas, “but this is a presumption,
it is not so”.



Previous studies have shown that between 60 to 70 per cent of people who
were HIV positive were not being detected early enough.  “I suspect right
now the number is below ten per cent,” Ramsammy added in reference to how
many infected patients might be off the register. He said that undiagnosed
patients pose serious problems including drug resistance among other issues.



*3*

*Instan a enfrentar de manera regional el VIH  **
**Agencia Orbita, Peru*

22/11/2009



Lima - Perú, (ORBITA).- El Secretario Técnico del Grupo de Cooperación
Técnico Horizontal de América Latina y El Caribe (GCTH) indicó que EL V Foro
Latinoamericano y del Caribe en VIH/ SIDA e IST representa una oportunidad
de recoger datos y hacer un análisis que permita tomar las medidas más
efectivas en materia de salud y derechos humanos, e instó a enfrentar la
pandemia a través de una respuesta regional.



“Es un honor para el Perú ser sede de foros internacionales de esta magnitud
por el intercambio que representa entre los distintos agentes de la sociedad
y niveles políticos internacionales”, resaltó José Luis Sebastián Mesones en
la realizó la primera plenaria del V Foro Latinoamericano y del Caribe en
VIH/ SIDA e IST que congregó a más de 1,500 personas.



La temática la primera sesión estuvo orientada a recoger los distintos
puntos de vista sobre el acceso universal a la atención integral, prevención
y tratamiento del VIH/SIDA en la región. La plenaria fue el punto de partida
para la presentación de los últimos alcances sobre las diversas situaciones
que afectan a las personas y grupos afectados.



JORGE CHEDIEK: “AYÚDENOS A CONVENCER”

Este primer encuentro evidenció el nivel de la problemática en la región y
sirve de soporte para que los tomadores de decisiones sepan que el problema
existe y hay que afrontarlo, afirmó Jorge Chediek, Coordinador Residente del
Sistema de Naciones Unidas en el Perú, quien enfatizó que es necesario
aportar con medidas técnicas orientadas a ofrecer una mayor atención de los
recursos y, especialmente, a tocar la sensibilidad política en la agenda de
desarrollo.



Entre los ponentes estuvieron César Núñez, Director de la Oficina Regional
ONUSIDA, Alberto Nieves, representante de la Red Latinoamericana de Personas
Viviendo con VIH/SIDA (REDLA+), Marcela Romero, representante de la Red de
Latinoamérica y el Caribe de Personas Trans (REDLACTRANS) y José Sánchez
representante de la Asociación Civil IMPACTA.



Paralelamente al V Foro Latinoamericano y del Caribe en VIH/ SIDA e ITS se
viene realizando el IV Foro Comunitario en VIH/ SIDA e ITS, con presencia de
diferentes programas nacionales sobre SIDA pertenecientes a 21 países de la
región. Este año la responsabilidad de la organización recayó sobre el Perú
en reconocimiento a sus avances en materia de atención gratuita de las
personas con VIH.



Los eventos se realizarán entre el 21 y 23 de noviembre en las instalaciones
del Museo de la Nación. Su objetivo principal es el de ser un espacio de
intercambio de experiencias con la finalidad de mejorar sus prácticas en el
ámbito científico, social y de derechos humanos aplicados al manejo de VIH/
SIDA e IST.

Además busca promover nuevos lineamientos que sirvan de impulso para la
aplicación de políticas efectivas en sus países miembros.



Durante los tres días se realizarán mesas de trabajo, divulgación de
investigaciones científicas y exposiciones sobre diversos tópicos médicos y
sociales relacionados a la epidemia de VIH.



*4*

*Homofobia leva religião ao Senado   **
**Jornal do Brasil*

22/11/2009



Luciana Abade BRASÍLIA



A Comissão de Direitos Humanos e Minoria do Senado deve votar nesta semana o
substitutivo do Projeto de Lei da Câmara (PLC) 122 de 2006 que criminaliza a
homofobia. A matéria é polêmica e tem causado discussões acaloradas entre os
parlamentares nas sucessivas reuniões a que tem sido submetida. Se aprovada,
quem "praticar, induzir, ou incitar a discriminação ou preconceito contra a
orientação sexual ou identidade de gênero" poderá ser punido com reclusão de
um a três anos, além de multa.



A polêmica se dá principalmente porque os religiosos temem uma caça às
bruxas. Afirmam que se o substitutivo for aprovado como está, padres e
pastores, para citar um exemplo, não poderão mais falar dentro das igrejas
que homossexualismo é pecado. E o direito à livre expressão será negado aos
cristãos.



Quem defende a aprovação do projeto garante que isto não ocorrerá porque a
liberdade religiosa será preservada.



- O padre e o pastor podem dizer que homossexualidade é pecado. O que não
podem é incentivar a violência contra os homossexuais, como muitos fazem -
afirma o presidente do Centro Paranaense de Cidadania, Igo Martini.



A autora do substitutivo, a senadora Fátima Cleide (PT-RO), por sua vez,
tenta explicar a diferença entre liberdade religiosa e incitação ao
preconceito: - O padre ou o pastor podem falar o que quiserem dentro da
igreja, o que não pode é eles falarem para a mãe de um HOMOSSEXUAL, quando
procurados, que o filho é uma aberração.



Fátima reconhece que a linha entre a liberdade religiosa e o combate ao
preconceito é tênue, mas garante que a aprovação do projeto tem como
principal objetivo mudar a cultura do preconceito e conseguir que os
homossexuais conquistem o mesmo respeito que os negros têm alcançado.



Presidente da Frente Parlamentar Evangélica, o deputado João Campos (
PSDB-GO) acredita que do jeito que está dificilmente o PLC será aprovado.



- Uma coisa é o preconceito, outra coisa é o direito a opinião - pondera o
deputado. - Estão dizendo que o projeto não é aprovado porque os religiosos
não deixam.



Não é verdade. Estão levando para o lado religioso para desqualificar o
debate. E estão sendo até preconceituosos com os cristão.



Para Campos, a frente não vai se opor ao projeto desde que ele se adeque não
só aos preceitos constitucionais do direito à crença, mas a liberdade de
expressão da população porque o texto não "amordaça apenas os segmentos
religiosos, mas a sociedade".



- O debate é técnico. Todos têm direito à opinião - afirma o deputado.

- Caso contrário quem fizer críticas à prostituição ou a política será preso



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



*NORTH AMERICA*



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



*The Needle Nexus**
**New York Times Magazine*

22/11/2009



By TINA ROSENBERG



Of all the mysteries posed by AIDS, perhaps the deepest and most damaging is
a human one: why have we failed so utterly to stop its transmission? Most
people with H.I.V. in the world, including a vast majority of the 22 million
who are infected in sub-Saharan Africa, caught it from a sexual partner.
Despite billions of dollars spent to slow this form of transmission, only a
few countries have had significant success — among them Thailand, Uganda and
Zimbabwe — and their achievements have been unreplicable, poorly understood
and short-lived. We know that abstinence, sexual fidelity and consistent
condom use all prevent the spread of H.I.V. But we do not yet know how to
persuade people to act accordingly.



Then there is another way that H.I.V. infects: by injection with a
hypodermic needle previously used by an infected person. Outside Africa, a
huge part of the AIDS epidemic involves people who were infected this way.
In Russia, 83 percent of infections in which the origin is known come from
needle sharing. In Ukraine, the figure is 64 percent; Kazakhstan, 74
percent; Malaysia, 72 percent; Vietnam, 52 percent; China, 44 percent.
Shared needles are also the primary transmission route for H.I.V. in parts
of Asia. In the United States, needle-sharing directly accounts for more
than 25 percent of AIDS cases.



Drug injectors don’t pass infection only among themselves. Through their sex
partners, H.I.V. is spread into the general population. In many countries,
the H.I.V. epidemic began among drug injectors. In Russia in 2000, for
example, needle-sharing was directly responsible for more than 95 percent of
all cases of H.I.V. infection. So virtually all those with H.I.V. in Russia
can trace their infection to a shared needle not many generations back.
Though it has been scorned as special treatment for a despised population,
AIDS prevention for drug users is in fact crucial to preventing a wider
epidemic.



Unlike with sexual transmission, there is a proven solution here:
needle-exchange programs, which provide drug injectors with clean needles,
usually in return for their used ones. Needle exchange is the cornerstone of
an approach known as harm reduction: making drug use less deadly. Clean
needles are both tool and lure, a way to introduce drug users to counseling,
H.I.V. tests, AIDS treatment and rehabilitation, including access to
opioid-substitution therapies like methadone.



Needle exchange is AIDS prevention that works. While no one wants to have to
put on a condom, every drug user prefers injecting with a clean needle. In
2003, an academic review of 99 cities around the world found that cities
with needle exchange saw their H.I.V. rates among injecting drug users drop
19 percent a year; cities without needle exchange had an 8 percent increase
per year. Contrary to popular fears, needle exchange has not led to more
drug use or higher crime rates. Studies have also found that drug addicts
participating in needle ­exchanges are more likely to enter rehabilitation
programs. Using needle exchange as part of a comprehensive attack on H.I.V.
is endorsed by virtually every relevant United Nations and United
States-government agency.

All over the world, however, solid evidence in support of needle exchange is
trumped by its risky politics. Harm reduction is thought by politicians to
muddy the message that drug use is bad; to have authorities handing out
needles puts an official stamp of approval on dangerous behavior. Consider
the United States. In 1988, Congress passed a ban on the use of federal
money for needle exchange; President Clinton said he supported needle
exchange but never lifted the ban, and it remains in effect. It not only
applies to programs inside the United States but also prohibits the U.S.
Agency for International Development from financing needle-exchange programs
in its AIDS prevention work anywhere in the world. The administration of
George W. Bush made the policy more aggressive, pressuring United Nations
agencies to retract their support for needle exchange and excise statements
about its efficacy from their literature. (Today, U.N. agencies again
recommend that needle exchange be part of H.I.V.-prevention services for
drug users.) Despite Barack Obama’s campaign pledge to overturn the ban, his
first budget retained it. The House of Representatives recently passed a
bill that would lift the ban — but it includes a provision that would make
using federal money for needle exchange virtually impossible in cities,
where it is needed most.



There are some parts of the world — Western Europe, Australia, New Zealand —
that do widely use harm-reduction strategies, including needle exchange. And
programs have begun even in Iran, of all places, which offers needle
exchange and methadone; its program of giving prisoners methadone is now the
world’s largest. China is now taking AIDS seriously, beginning to institute
government-sponsored harm reduction nationwide. But the overwhelming
majority of drug injectors around the world still have no such access.
Because government financing is so politically unpopular, in most of the 77
countries that offer needle exchange, the programs are run by
nongovernmental groups. As a result, these efforts are small, isolated and
often undermined by uncooperative police and health departments. The world
is casting aside the single most effective AIDS prevention strategy we know.



Russia needs needle exchange more than any other country: its H.I.V.
epidemic is large, one of the fastest-growing in the world, and perhaps the
most dominated by injecting drug use. Yet the needle-exchange efforts that
do exist are scarce, small and under siege. I traveled there recently to see
what lessons they hold. At 9 p.m. on a May night, in a tough neighborhood in
Moscow’s north, I joined two young men as they climbed the stairs from the
Metro. Arseniy and David were in their late 20s, wearing jeans and baseball
caps. They had arrived to give out clean needles and promote harm reduction
— but theirs was a guerrilla effort.



Needle exchange is legal in Russia — sort of. It must follow federal
regulations. The catch is that these regulations don’t exist: the Federal
Drug Control Service, whose top officials have called needle exchange
“nothing more than open propaganda for drugs,” has been sitting on them for
five years. As a result, no new harm-reduction programs have started during
that time. Old ones continue where local authorities tolerate them, but
Moscow’s government disapproves of needle exchange. So like their clients,
Arseniy and David avoid the police. One of their clients was Masha, who,
like every other drug user I interviewed, talked about police extortion. It
is every addict’s main fear, but avoiding police shakedowns means only more
dangerous injecting: if you fear being caught walking around with a needle,
you use the community needle your dealer provides.



Arseniy told me that he started doing harm reduction as a volunteer with an
organization working with the homeless. “Most of my clients used drugs, and
I understood we couldn’t do anything without needle exchange,” he said. So
the workers began buying needles with their own money and giving them out.
Now he, David and another pair of outreach workers get financing from
another Russian group. The city of Moscow, then, has only a handful of
people doing needle exchange. An extremely conservative estimate of Moscow’s
drug injectors puts the number at 240,000.



Moscow’s drug policy could be called harm augmentation: discourage drug use
by making it as dangerous as possible. Arseniy and David, for example, can’t
direct addicts to methadone clinics, since methadone — the global gold
standard rehabilitation method — is illegal in Russia. Nor can they bring
users into the health system: beyond the most basic health services, public
health care in Moscow is only for officially registered residents; many drug
injectors are homeless or from other cities and are unregistered in Moscow.
The only thing Arseniy and David can do is give out the card of a drop-in
center, called Yasen, across the city from the clients they were serving.



When I visited Yasen, staff members told me stories of ambulances refusing
to pick up an overdosing drug user and hospitals turning away people who
come in with the afflictions of a violent life on the streets. Russia does
have free detoxification clinics, but they use harsh, outdated methods, and
less than 10 percent of their clients stay drug-free for a year. Checking in
lands an addict on the official list of drug users — a designation that can
affect opportunities for jobs, housing and privileges like driver’s
licenses.



While the city of Moscow treats drug users purely as potential criminals,
St. Petersburg is different. The main reason is the work of Humanitarian
Action, among Russia’s first needle-exchange programs, which started its
work in 1997. The heart of Humanitarian Action is its mobile clinic, a blue
bus that visits 10 neighborhoods a week on a regular schedule. On a Friday
afternoon when I visited, the bus was parked on the side of a busy street in
front of a block of apartment towers. There was a line out the back door of
people returning bags of used needles and getting clean ones.



Lena Porechenkova, a skinny, grizzled woman with tinted glasses, was running
the bus’s needle-exchange counter. She spoke to a fresh-faced woman of 22,
also named Lena. She was planning to quit, Lena said. “But I don’t want to
get onto the state list of addicts and have problems getting a job later.”
She said she might consider buying methadone (often sold illegally by heroin
dealers) and trying to quit on her own.



“Well, it’s possible to overcome this on your own,” Porechenkova said, but
she added that it is possible to pay $200 and be anonymous. “Why don’t you
talk to our psychologist?” She called over Nikolai Yekimov, who took Lena
into a tiny office in the bus. Yekimov has a database of rehabilitation
centers. The bus also offers a case manager, who helps the client assemble
the necessary papers and test results and will even pick her up and
accompany her to the clinic. When Lena left, I asked her where she would go
for advice if the bus didn’t exist. “Nowhere,” she said.



Humanitarian Action is a model program. It has everything harm reduction
needs — save the most important thing: size. The group estimates that it has
4,000 repeat clients — a tiny proportion of St. Petersburg’s drug injectors,
who number as many as 150,000.



In a few Russian cities needle-exchange programs run by the municipal or
regional governments have kept H.I.V. rates among drug users relatively low.
But most of the country’s 75 harm-reduction programs — almost all of which
do needle exchange — are run by Russian nongovernmental groups with money
from the Global Fund to Fight AIDS, Tuberculosis and Malaria. These programs
run on $20,000 to $30,000 a year, which is far too small to have an impact.
And they are imperiled. Russia is now too rich to accept Global Fund grants
for H.I.V. prevention, so these programs will lose their financing over the
next two years. Russian officials are resisting requests from international
AIDS advocates to keep needle exchange alive.



The future of harm reduction does not reside in small programs carried out
by internationally financed groups, however stellar their quality. Such
programs have proved that harm reduction works, but they cannot make it
epidemiologically relevant. Only a government can ensure that the police and
hospitals will respect drug users’ rights to health care. Only a government
can do needle exchange on a wide scale. This is what is needed to reduce
H.I.V. rates — not just for drug users, but for us all.

*Tina Rosenberg is a contributing writer for the magazine.*

A version of this article appeared in print on November 22, 2009, on page
MM20 of the New York edition

Copyright 2009 The New York Times Company



*2*

*Medical Marijuana: No Longer Just for Adults**
**New York Times*

21/11/2009



By KATHERINE ELLISON



At the Peace in Medicine Healing Center in Sebastopol, the wares on display
include dried marijuana — featuring brands like Kryptonite, Voodoo Daddy and
Train Wreck — and medicinal cookies arrayed below a sign saying, “Keep Out
of Reach of Your Mother.”



The warning tells a story of its own: some of the center’s clients are too
young to buy themselves a beer.



Several Bay Area doctors who recommend medical marijuana for their patients
said in recent interviews that their client base had expanded to include
teenagers with psychiatric conditions including attention-deficit
hyperactivity disorder.



“It’s not everybody’s medicine, but for some, it can make a profound
difference,” said Valerie Corral, a founder of the Wo/Men’s Alliance for
Medical Marijuana, a patients’ collective in Santa Cruz that has two dozen
minors as registered clients.



Because California does not require doctors to report cases involving
medical marijuana, no reliable data exist for how many minors have been
authorized to receive it. But Dr. Jean Talleyrand, who founded MediCann, a
network in Oakland of 20 clinics who authorize patients to use the drug,
said his staff members had treated as many as 50 patients ages 14 to 18 who
had A.D.H.D. Bay Area doctors have been at the forefront of the fierce
debate about medical marijuana, winning tolerance for people with grave
illnesses like terminal cancer and AIDS. Yet as these doctors use their
discretion more liberally, such support — even here — may be harder to
muster, especially when it comes to using marijuana to treat adolescents
with A.D.H.D.



“How many ways can one say ‘one of the worst ideas of all time?’ ” asked
Stephen Hinshaw, the chairman of the psychology department at the University
of California, Berkeley. He cited studies showing that tetrahydrocannabinol,
or THC, the active ingredient in cannabis, disrupts attention, memory and
concentration — functions already compromised in people with the
attention-deficit disorder.



Advocates are just as adamant, though they are in a distinct minority. “It’s
safer than aspirin,” Dr. Talleyrand said. He and other marijuana advocates
maintain that it is also safer than methylphenidate (Ritalin), the stimulant
prescription drug most often used to treat A.D.H.D. That drug has documented
potential side effects including insomnia, depression, facial tics and
stunted growth.



In 1996, voters approved a ballot proposition making California the first
state to legalize medical marijuana. Twelve other states have followed suit
— allowing cannabis for several specified, serious conditions including
cancer and AIDS — but only California adds the grab-bag phrase “for any
other illness for which marijuana provides relief.”



This has left those doctors willing to “recommend” cannabis — in the
Alice-in-Wonderland world of medical marijuana, they cannot legally
prescribe it — with leeway that some use to a daring degree. “You can get it
for a backache,” said Keith Stroup, the founder of the National Organization
for the Reform of Marijuana Laws.



Nonetheless, expanding its use among young people is controversial even
among doctors who authorize medical marijuana.



Gene Schoenfeld, a doctor in Sausalito, said, “I wouldn’t do it for anyone
under 21, unless they have a life-threatening problem such as cancer or
AIDS.”



Dr. Schoenfeld added, “It’s detrimental to adolescents who chronically use
it, and if it’s being used medically, that implies chronic use.”



Dr. Nora D. Volkow, director of the National Institute on Drug Abuse, said
she was particularly worried about the risk of dependency — a risk she said
was already high among adolescents and people with attention-deficit
disorder.



Counterintuitive as it may seem, however, patients and doctors have been
reporting that marijuana helps alleviate some of the symptoms, particularly
the anxiety and anger that so often accompany A.D.H.D. The disorder has been
diagnosed in more than 4.5 million children in the United States, according
to the Centers for Disease Control and Prevention.



Researchers have linked the use of marijuana by adolescents to increased
risk of psychosis and schizophrenia for people genetically predisposed to
those illnesses. However, one 2008 report in the journal Schizophrenia
Research suggested that the incidence of mental health problems among
adolescents with the disorder who used marijuana was lower than that of
nonusers.



Marijuana is “a godsend” for some people with A.D.H.D., said Dr. Edward M.
Hallowell, a psychiatrist who has written several books on the disorder.
However, Dr. Hallowell said he discourages his patients from using it, both
because it is — mostly — illegal, and because his observations show that “it
can lead to a syndrome in which all the person wants to do all day is get
stoned, and they do nothing else.”



Until the age of 18, patients requesting medical marijuana must be
accompanied to the doctor’s appointment and to the dispensaries by a parent
or authorized caregiver. Some doctors interviewed said they suspected that
in at least some cases, parents were accompanying their children primarily
with the hope that medical authorization would allow the adolescents to
avoid buying drugs on the street.



A recent University of Michigan study found that more than 40 percent of
high school students had tried marijuana.



“I don’t have a problem with that, as long as we can have our medical
conversation,” Dr. Talleyrand said, adding that patients must have medical
records to be seen by his doctors.



The Medical Board of California began investigating Dr. Talleyrand in the
spring, said a board spokeswoman, Candis Cohen, after a KGO-TV report
detailed questionable practices at MediCann clinics, which, the report said,
had grossed at least $10 million in five years.



Dr. Talleyrand and his staff members are not alone in being willing to
recommend marijuana for minors. In Berkeley, Dr. Frank Lucido said he was
questioned by the medical board but ultimately not disciplined after he
authorized marijuana for a 16-year-old boy with A.D.H.D. who had tried
Ritalin unsuccessfully and was racking up a record of minor arrests.



Within a year of the new treatment, he said, the boy was getting better
grades and was even elected president of his special-education class. “He
was telling his mother: ‘My brain works. I can think,’ ” Dr. Lucido said.



“With any medication, you weigh the benefits against the risks,” he added.



Even so, MediCann patients who receive the authorization must sign a form
listing possible downsides of marijuana use, including “mental slowness,”
memory problems, nervousness, confusion, “increased talkativeness,” rapid
heartbeat, difficulty in completing complex tasks and hunger. “Some patients
can become dependent on marijuana,” the form also warns.



The White House’s recent signals of more federal tolerance for state medical
marijuana laws — which pointedly excluded sales to minors — reignited the
debate over medical marijuana.



Some advocates, like Dr. Lester Grinspoon, an associate professor emeritus
of psychiatry at Harvard University, suggest that medical marijuana’s stigma
has less to do with questions of clinical efficacy and more to do with its
association, in popular culture, with illicit pleasure and addiction.



Others, like Alberto Torrico of Fremont, the majority leader of the
California Assembly, argue for more oversight in general. “The marijuana is
a lot more powerful these days than when we were growing up, and too much is
being dispensed for nonmedical reasons,” he said in an interview last week,
bluntly adding, “Any children being given medical marijuana is
unacceptable.”



As advocates of increased acceptance try to win support, they may find their
serious arguments compromised by the dispensaries’ playful atmosphere.



OrganiCann, a dispensary in Santa Rosa, has a Web site advertisement listing
the “medible of the week” — butterscotch rock candy — invitingly
photographed in a gift box with a ribbon. OrganiCann also offers a 10
percent discount, every Friday, for customers with a valid student ID.

*A version of this article appeared in print on November 22, 2009, on page
A39A of the New York edition.*

Copyright 2009 The New York Times Company



*3*

*How Can We Help the World’s Poor?**
**New York Times*

22/11/2009



By NICHOLAS D. KRISTOF



The number of bleeding hearts has soared exponentially over the last decade.
Celebrities embraced Africa, while conservatives went from showing disdain
for humanitarian aid (“money down a rat hole”) to displaying leadership in
the fight against AIDS and malaria. Compassion became contagious and then it
became consensus



Yet all the wringing hands never quite clasped. Just as the bleeding hearts
seemed victorious, they divided in a ferocious intellectual debate about how
best to help poor people around the world. One group, led by Bono and the
indefatigable Jeffrey Sachs of Columbia University, argues that the crucial
need is for more money. After all, aid for development is quite modest: for
every $100 in national income, we Americans donate just 18 cents in
“official development assistance” to poor countries. Sweden donates five
times as much. Sachs’s book “The End of Poverty” is the bible of this camp.



The rival camp, led by William Easterly of New York University, argues that
more money doesn’t necessarily help, and may hurt. Easterly, whose powerful
and provocative book “The White Man’s Burden: Why the West’s Efforts to Aid
the Rest Have Done So Much Ill and So Little Good” appeared in 2006, is
still rocking the world of do-gooders. His book was a direct assault on
Sachs’s, and it has been influential because, frankly, much of his critique
rings true, even among aid workers.



Easterly has been joined this year by Dambisa Moyo, a Zambian economist who
wrote “Dead Aid: Why Aid Is Not Working and How There Is a Better Way for
Africa.” Moyo attracted attention in part because of the novelty of an
African denouncing aid to Africa, and her book has set off another wave of
bitter, personal feuding between the two camps. Few people fight as savagely
as humanitarians.



The Easterly/Moyo camp notes that anybody who has traveled in Africa has
seen aid projects that have failed, undermined self-reliance and
entrepreneurship, even harmed people. Economists find no correlation between
countries that received aid and those that grew quickly. Indeed, the great
economic successes in modern times (mostly in Asia) often received little
aid.



It’s also clear that doing good is harder than it looks. For example,
abundant evidence suggests that education can be transformative in a poor
country, so donors often pay for schools. But building a school is expensive
and can line the pockets of corrupt officials. And in my reporting I’ve
found that the big truancy problem in poor countries typically involves not
students but teachers: I remember one rural Indian school where the teachers
appeared only once or twice a year to administer standardized tests. To make
sure that the students didn’t do embarrassingly badly on those exams, the
teachers wrote all the answers on the blackboard. The critics can cite
similar unexpected difficulties in almost every nook of the aid universe.



If Sachs represents the Hegelian thesis and Easterly the antithesis, we now
have hope of seeing an emerging synthesis. It would acknowledge the
shortcomings of aid, but also note some grand successes. For example, the
number of children dying each year before the age of 5 has dropped by three
million worldwide since 1990, largely because of foreign aid. Yes, aid often
fails — but more than balancing the failures is quite a triumph: one child’s
life saved every 11 seconds (according to my calculations from United
Nations statistics).



Moreover, pragmatic donors are figuring out creative ways to overcome the
obstacles. Take education. Given the problems with school-building programs,
donors have turned to other strategies to increase the number of students,
and these are often much more cost-effective: (1) Deworm children. This
costs about 50 cents per child per year and reduces absenteeism from anemia,
sickness and malnutrition. A Kenya study found, in effect, that it is only
one twenty-fifth as expensive to increase school attendance by deworming
students as by constructing schools. (2) Bribe parents. One of the most
successful antipoverty initiatives is Oportunidades in Mexico, which pays
impoverished mothers a monthly stipend if their kids attend school
regularly. Oportunidades has raised high school enrollment in some rural
areas by 85 percent.



I don’t mean to imply that building brick-and-mortar schools is an outmoded
idea. My wife and I built a school in Cambodia, through American Assistance
for Cambodia, because we were able to establish that teachers do show up
there, that the bottleneck in rural Cambodia is school construction, and
that our donation would be highly leveraged. Likewise, Greg Mortenson’s
famous school-building efforts in Afghanistan and Pakistan, described in his
superb book, “Three Cups of Tea” (written with David Oliver Relin), makes a
huge difference on the ground. The point is to be relentlessly empirical.



One of the challenges with the empirical approach is that aid organizations
typically claim that every project succeeds. Failures are buried so as not
to discourage donors, and evaluations are often done by the organizations
themselves — ensuring that every intervention is above average. Yet recently
there has been a revolution in evaluation, led by economists at the Poverty
Action Lab at M.I.T. They have designed rigorous studies to see what
actually works. The idea is to introduce new aid initiatives randomly in
some areas and not in others, and to measure how much change occurred and at
what cost. This approach is expensive but gives a much clearer sense of
which interventions are most cost-effective.



The upshot is that we can now see that there are many aid programs that work
very well. We don’t need to distract ourselves with theoretical questions
about aid, so long as we can focus on deworming children and bribing
parents. The new synthesis should embrace specific interventions that all
sides agree have merit, while also borrowing from an important insight of
the aid critics: trade is usually preferable to aid.



I was recently in Liberia, a fragile African democracy struggling to
rebuild. It is chock-full of aid groups rushing around in white S.U.V.’s
doing wonderful work. But it also needs factories to employ people, build
skills and pay salaries and taxes. Americans are horrified by sweatshops,
but nothing would help Liberia more than if China moved some of its
sweatshops there, so that Liberians could make sandals and T-shirts.



Paul Collier, an Oxford University economist who exemplifies the emerging
synthesis in his brilliant book “The Bottom Billion,” has lately argued that
the best way to rescue Haiti is for America to encourage a local textile
manufacturing industry, which could export to the United States, creating
jobs and a larger tax base.



As these ideas spread, we’re seeing more aid organizations that blur the
boundary with business, pursuing what’s called a double bottom line: profits
but also a social return. For example, the New York-based Acumen Fund is a
cross between a venture capital operation and an aid group: it invests
“patient capital,” accepting below-market returns and offering management
help in a Tanzanian company that makes antimalaria bed nets, for instance,
and in a hospital company in India that offers a for-profit model to fight
maternal mortality. The founder of Acumen Fund, Jacqueline Novogratz,
recently published a memoir, “The Blue Sweater,” that argues for this kind
of approach.



In the 1960s, there were grand intellectual debates about whether capitalism
was heroic or evil; today we simply worry about how to make it work. At
last, we may be doing the same with foreign aid.



*Nicholas D. Kristof is an Op-Ed columnist at The Times and the author, with
Sheryl WuDunn, of “Half the Sky: Turning Oppression Into Opportunity for
Women Worldwide.”*

A version of this article appeared in print on November 22, 2009, on page
BR27 of the New York edition.

Copyright 2009 The New York Times Company



*4*

*D.C. AIDS activist among new Rhodes scholars**
**Washington Post*

23/11/2009



By Martin Weil



A University of Virginia graduate who runs a program that trains athletes to
be HIV/AIDS educators for youths in the District has been named a Rhodes
scholar for 2010.



According to an announcement Sunday, Tyler S. Spencer, who grew up in
Virginia and lives in the District, is one of three people from the District
and Virginia to win one of the awards, among the most prestigious in the
academic world.



The other two are Jordan D. Anderson of Roanoke, a senior at Auburn
University in Alabama, and Kira C. Allmann of Williamsburg, a senior at the
College of William and Mary.



Spencer, who grew up in Staunton and graduated from U-Va. last year, said he
hopes to return to the District after Oxford and improve and expand the
Grassroot Project, also known as Athletes United, which he founded and
heads.



"There's a lot of work that needs to be done" on HIV/AIDS, said Spencer, 23.
College athletes, he said, closer in age to the city's youths, have a
special ability to reach them and can exert "tremendous power" in stopping
the spread of the disease.



He said his organization works with the D.C. public schools and the Boys and
Girls Clubs. He has also spent summers managing a grassroots AIDS prevention
program in South Africa.



As with the 31 other American winners of the award, created in 1902, Spencer
has a background of uncommon achievement. Among other things, he was a
Morris Udall scholar and coach of the National Deaf Tennis Team.



Anderson, 21, a biomedical sciences major, has participated in a research
project at Auburn on the photochemistry of the eye.



He is captain of the swim team and an all-American whose events include the
butterfly and the backstroke. His team has twice won the national
championship. He has also been active with the Young Life Christian outreach
program.



At Oxford, he said, he expects to study global health sciences, and he views
the scholarship as "an opportunity to broaden my horizons on how I can best
serve other people."



Allmann, 22, has studied Arabic at a university in Morocco and architecture
and art history at the University of St. Andrews in Scotland.



She has been a substitute teacher in Williamsburg schools, taking
assignments in "pretty much any" academic subject but enjoying most those in
government, history and modern languages. Nonacademic interests include
tennis, yoga and volleyball.



Allmann said she plans to work for an Oxford degree in modern Middle Eastern
studies and might someday pursue a doctorate.



But after Oxford, she said, she "would like to join the Foreign Service" or
serve the U.S. government in some other capacity.



*5*

*U.N. in Final Push for 2015 Development Goals**
**IPS Terra Viva*

23/11/2009



Thalif Deen



UNITED NATIONS, Nov 22 (IPS) - A special U.N. summit of world leaders,
scheduled to take place next year, is expected to make "a final push" to
help reach the world body's widely-touted development goals by the targeted
date of 2015. "We have seen progress, but not enough - especially in
Africa," complains Secretary-General Ban Ki-moon, who has asked British
Prime Minister Gordon Brown to take a lead role in the U.N initiative.



The haphazard progress in meeting the eight Millennium Development Goals
(MDGs) has prompted the 192-member General Assembly to hold a three-day
special session next September to map out a strategy for the final five
years of the targeted date.



"Yes, it is a review of progress to date, but in order to accelerate action
from 2010-2015," Salil Shetty, director of the U.N.'s Millennium Campaign,
told IPS. The summit will specifically look at ways to remove existing
obstacles to progress in the next five years when all or most of the MDGs
are to be met.



Despite the economic crisis and the climate challenges, Shetty said, "We
believe that most of the MDGs are still achievable in most of the countries,
if leaders show the political will that is required."



"Of course, we will not achieve all the goals in all the countries, but five
years is enough time to make significant progress," he added.



The Millennium Campaign is calling for "a clear accountability and
monitoring mechanism" to be agreed at the 2010 Summit between all
governments and their citizens and between developed and developing
countries.



The MDGs include a 50-percent reduction in extreme poverty and hunger;
universal primary education; promotion of gender equality; reduction of
child mortality by two-thirds; cutbacks in maternal mortality by
three-quarters; combatting the spread of HIV/AIDS, malaria and other
diseases; ensuring environmental sustainability; and developing a
North-South global partnership for development.



A summit meeting of 189 world leaders in September 2000 pledged to meet
these goals by 2015. But their implementation has been slowed down largely
by a decline in development aid and by the recent global financial crisis.



Meanwhile, over the last few months, the secretary-general has continued to
stress that "maternal health (MDG 5) is the goal on which we lag farthest
behind".



"Every single minute, a woman dies of complications during pregnancy and
childbirth. That is unacceptable," he admits.



It is also unacceptable that 200 million women lack access to safe and
effective contraception, that women are routinely victims of sexual
violence, that girls are married off as child brides, that women are
murdered for so-called "honour" and that genital mutilation and other
harmful "traditions" still exist, Ban told a recent gathering at the
University of Washington.



At a high-level meeting on maternal health in Ethiopia last month, the
executive director of the U.N. Population Fund (UNFPA), Thoraya Ahmed Obaid,
said women are dying because for too many years, women's lives, dreams and
rights have not been given the priority attention they deserve.



Obaid, who concurs with the secretary-general that MDG 5 is "the goal
lagging the furthest behind", outlined some of the success stories on
maternal health in Africa, Asia and Latin America.



Over the past five years in Rwanda, the use of modern contraception has
nearly tripled, skilled birth attendance has increased from less than 40
percent to more than 50 percent, and deliveries in health facilities have
jumped from less than a third to nearly half of all deliveries.



"This is impressive progress towards ensuring that every pregnancy is
wanted, and every birth is safe," she told the meeting, which was sponsored
by the Dutch Ministry for Development Cooperation and UNFPA, and hosted by
the government of Ethiopia.



Ethiopia's Minister of Health Dr. Tedros Adhanom Ghebreyesus told delegates
his country has deployed more than 30,000 health extension workers and also
nearly doubled the health work force in only three years.



In Bolivia, which has one of the highest maternal death rates in Latin
America, a new midwife training programme has been set up, supported by
UNFPA, to improve care to indigenous women.



Obaid said that in Bangladesh, a decline in maternal mortality has been
attributed in large part to community engagement and mobilisation.



In Djibouti, women have organised themselves to establish a community health
fund, while in Mozambique, Tanzania and Ethiopia, mid-level health workers
are being trained to carry out higher level functions that are saving lives.



And in Cambodia, Yemen and Zambia, midwives are being deployed to make
childbirth safer.



Obaid said that life and death is a political decision. But leadership and
resources will determine "whether we fail or succeed", while solidarity and
partnership are the only way forward.



With just five years remaining in the countdown to 2015, "We need urgent
action," she declared.



Shetty told IPS the U.N. Millennium Campaign is calling for all governments
to come to next year's summit with national MDG reports that highlights what
has worked best in the first 10 years.



And on that basis, there will be a 'Breakthrough Action Plan' for 2010-2015.



Governments from developed countries should come with similar plans with
specific commitments on Goal 8, which relates to aid volume, quality, debt
cancellation and trade.



He said all climate change funding should be additional to the existing 0.7
percent commitment of gross domestic product by donor nations.



The process of preparing the national MDG reports and action plans should
have active citizen participation and the focus for the next five years
should be strongly on women and excluded groups and regions, Shetty
declared.



*6*

*Q&A: Maternal Mortality Rates 'One of the Saddest Cases' in Asia  **
**IPS Terra Viva*

23/11/2009



Marwaan Macan-Markar interviews NOELEEN HEYZER, U.N. under-secretary general
and head of UNESCAP



BANGKOK, Nov 22 (IPS) - Nearly 15 years after a landmark international
conference to advance the rights and freedoms of women, the picture in the
Asia-Pacific region is mixed, says a leading women's rights advocate and
senior United Nations official.



While educated women and those with skills "can go as far as they want," it
is a different reality for those who come from Asia's poorer millions.
"There have never been cracks in the glass ceiling for many women in poor
rural areas," says Noeleen Heyzer, head of the Economic and Social
Commission for Asia and the Pacific (ESCAP), a U.N. regional body based in
Bangkok.



A similarly mixed picture appears with the push to strengthen the cause of
women through the Convention on the Elimination of all forms of
Discrimination against Women (CEDAW), a U.N. treaty that has been ratified
by 186 countries. While lawmakers and governments have embraced this
international convention, culture and traditional beliefs have placed
roadblocks.



Most disturbing for Heyzer is the region's troubling record to slash the
maternal mortality rates, the fifth goal in a set of eight development
targets pledged by world leaders to be achieved by 2015. At a U.N. summit in
2000, the Millennium Development Goal for maternal mortality aimed to reduce
by three-fourths the maternal mortality cases in 1990 by 2015.



Today, the Asia-Pacific region accounts for close to half of the nearly
500,000 maternal deaths recorded annually across the world.



"There is no reason why so many women have to die," says Heyzer, who is also
the former head of the United Nations Development Fund for Women (UNIFEM)
before her appointment two years ago to head ESCAP. "The figures are
shocking, especially in a region where you have economic powerhouses."



Heyzer spoke with IPS after the end of a three-day regional meeting here
this week, where senior government officials, policy makers and activists
met to review progress, highlight achievements and share stories in
preparation for the 15-year review of the 1995 world conference on women
held in Beijing



IPS: You have just finished a high-level meeting to review progress in the
Asia and Pacific region nearly 15 years after the groundbreaking world
conference in Beijing to advance the rights of women. Have all countries
embraced this international policy shift and gone beyond empty promises?



NOELEEN HEYZER: Very much so. Firstly we have all the countries in this
region except four that have adopted CEDAW. What has also been very good is
that countries have gone ahead to shape their own national action plans to
combat violence against women. They are Australia, Bangladesh, Cambodia,
India, Nepal, the Philippines and Thailand. It is so different from 15 years
ago when ending violence against women was not on anyone's agenda. It was
stigmatised. There was so much silence around it.



IPS: So there is more space today to discuss issues concerning women that
you could not openly discuss in the mid-1990s?

NH: Yes. The situation of rape as a weapon of war and sexual violence during
conflicts are very much on the agenda today. But there is also recognition
and acceptance that you need to invest in women when you are looking at
peace building in post-conflict situations.



Women have to be at the peace table. It is not just about bringing warlords
to the peace table, because women help to build communities and peace at the
local level. Now women are part of the solution to help in the post-conflict
recovery process.



IPS: But reaching this point has not been easy, as many women's rights
activists have admitted. In which area in this region have there been
greater hurdles to secure the rights and greater freedoms for women-the
political or cultural and social landscape?

NH: The cultural landscape has been more challenging. There have been
excuses on violence against women, where culture is used. This is why the
(U.N.) secretary-general (Ban Ki-moon) has led the effort to launch a global
campaign to end violence against women. He is calling for men to take on a
strong role and to lead this effort.



IPS: How is this campaign playing out in Asia?

NH: There are many countries where there is growing acceptance about
redefining the role of masculinity and the role of culture. In Indonesia
there are communities where the men are emerging to talk about how they
prevent violence against women and how they increase their voices on this
issue. But until laws are implemented and until there are resources, it will
not be a full success.



IPS: But to turn your attention to politics, one of the goals that emerged
out of the Beijing conference was to increase the representation of women in
parliament. The benchmark was to have women make up 30 percent of
legislative bodies in countries. But the record is far from that, somewhere
around 18 percent. Why?

NH: This region is not doing well in this area. There are only two countries
- Nepal and New Zealand - which have parliaments where more than 30 percent
of the representatives are women. There is still a lot to be done.



Many women are not that enthusiastic in participating in the political
sphere; they prefer the economic sphere or other areas of life. And politics
is not easy in the Asia-Pacific region. It is very much tied in with money,
with networking, a demand on time.



As long as you have a division of labour where women do not have time, where
women suffer from time poverty, not just income poverty, this target will be
a challenge. And it is not so much governments but the culture of the
political system and how society has constructed itself.



IPS: One of the Millennium Development Goals seeks to slash maternal
mortality by 2015. But the figures in this region are troubling. Doesn't
this go against the spirit and hope of the Beijing women's conference?

NH: This is one of the saddest cases. There is no reason why so many women
have to die. The figures are shocking, especially in a region where you have
economic powerhouses. This is linked with the disparity in our region. This
region is still home to the largest number of poor people, especially the
rural poor.



The lack of investment in health care and in a social protection system is a
factor. And even when you do have access to a health care system it is not
easy for women to access them, because if there is insufficient income
security when some of the poorest households have to make decisions
involving the life of women, of a girl-child, it is the woman or the
girl-child who gets sacrificed. The lack of health care systems reveals how
a woman's worth is undervalued.



IPS: Is this an urban phenomenon or one that affects rural communities?

NH: The rural poor have not been a priority concern, and investment in the
agriculture sector is low. But it is not just rural communities-there are
indigenous communities, remote communities up in the mountains. The affected
women come from areas that have been marginalised.



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



*UNAIDS WEB.SITE*



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



Acclaimed photo exhibition by women living with HIV opens in New York

*UNAIDS*

20/11/2009



On 17 November UNAIDS hosted a reception for the opening of an exhibition at
the United Nations in New York entitled The House Is Small But The Welcome
Is Big, a project of the Los Angeles–based Venice Arts of over 40
extraordinary photographs made by South African women living with HIV and
Mozambican children who lost both parents to AIDS.



The exhibit, which runs until 11 December, sheds light on the hopes and
aspirations of people affected by the epidemic, as well as the
discrimination and stigma associated with HIV.

Accompanied by biographical panels, the exhibit conveys the daily lives of
15 women and 18 children who face tremendous challenges because of HIV. The
photos are simultaneously stark and hopeful, lively and compelling. Some are
difficult to look at. All of them are hard to dismiss.



Bertil Lindblad, Director of the UNAIDS New York Office, said that the
exhibit evokes the words of United Nations Secretary-General Ban Ki–moon:
“HIV is about everyone. It is not about ‘us versus them’.  There is no
‘them’ – only ‘us’, together.”  The exhibit is one of many events worldwide
commemorating World AIDS Day on 1 December



Neal Baer, M.D., Emmy-nominated writer/executive producer of the television
series Law & Order: Special Victims Unit and a co-founder of the project,
commented “These women and children have a lot to say through these images
about living on their own and raising younger siblings by themselves,” said
Baer. “That’s the harsh truth about AIDS. Millions of children are growing
up without the guidance or love of one or both parents, with many carrying
parental responsibilities.” Law & Order: Special Victims Unit star Stephanie
March joined Dr Baer at the event.



Also attending the reception was Ambassador Baso Sangqu, Permanent
Representative of South Africa to the United Nations.



The name of the exhibition comes from one of the photographs taken by 28
year-old Funeka Nceke of Cape Town. On the wall of her friend’s home hangs
an embroidered cloth that reads, “The House Is Small But the Welcome Is
Big.” Funeka lives in a shack with no electricity or running water with her
two children and two additional family members.



One beautiful photograph titled “My Memories” shows a pair of hands gently
touching old black and white photographs.  “Photographs of my parents are
displayed, which show their past. I show everyone my parents [when they
were] alive through these photos, which is a joy for me,” says Joaquim
Macamo, the 16 year-old photographer. Macamo lost both of his parents to
AIDS in 2001 and lives with his 20 year-old sister.



The exhibit has been featured at venues around the world, including New York
City; Los Angeles, Oakland, and Palo Alto, CA; Boston, MA; Colorado Springs
and Denver, CO; Tallahassee, FL; Maputo, Mozambique; Toronto, Canada; Mexico
City, Mexico; and Paris, France.



Award–winning Venice Arts has run innovative programs in documentary
photography, filmmaking, and digital media/arts since 1993. The organization
also implements participant-produced photo documentary projects with adults
and children, and co–directs the Institute for Photographic Empowerment in
collaboration with the University of Southern California Annenberg Center
for Communication Leadership.



*2*

*Education sector: Getting to grips with an HIV monitoring and evaluation
framework**
**UNAIDS*

23/11/2009



The education sector plays a critical role in national responses to the HIV
epidemic. However, this contribution is often poorly appreciated and
understood due to limited, difficult-to-measure data and the absence of
agreement on core indicators for the sector.



To assist ministries of education and their partners in measuring progress
and outcomes of related efforts, a host of international experts met in
London on 9-10 November to develop a monitoring and evaluation (M&E)
framework for education sector responses to AIDS. This framework aims to
assist ministries of education and other partners in outlining and measuring
the main programme outputs and outcomes of the education sector,
facilitating the development of effective, results-focused interventions.



Convened by the Partnership for Child Development (PCD) of Imperial College,
on behalf of the Indicators Working Group of the UNAIDS Inter-Agency Task
Team (IATT) on Education, the experts attending the meeting included
individuals with significant expertise in M&E, in education sector responses
and with a great deal of programme experience. Programme managers from
Southern Africa, Latin America and the Caribbean, and South and South-East
Asia attended.



The meeting built on a review of existing indicators used to monitor
education sector HIV responses undertaken by PCD on behalf of the UNAIDS
IATT on Education Indicators Working Group. It also contributed to an effort
underway by a wide range of partners associated with the FRESH (Focusing
Resources on Effective School Health) Initiative to develop an M&E framework
for school-based health and nutrition and HIV prevention interventions.



As well as reaching agreement on appropriate priorities for the monitoring
and evaluation of the sector’s work, the meeting also achieved consensus on
prioritising indicators that could be used.



Indicators examined included those helping the education sector address the
following questions:



1. Within the context of a national AIDS response, is there a response in
the education sector that is guided and enabled by policy, strategy and
resources?

2. Is HIV, reproductive and sexual health education a timetabled subject
delivered in schools? Is it mandatory and assessed? Are HIV-related life
skills delivered through co-curricular means?

3. Are educators receiving pre-service and in-service training about HIV
(for themselves) and about teaching HIV to students?

4. Is the education sector facilitating testing, treatment, care and support
services for learners and educators? Are measures in place to make schools
safe and protective environments?



In addition to indicators to measure these short-term outcomes, the group
also considered intermediate outcomes such as knowledge about HIV and those
of a long-term nature such as age of sexual debut.



The draft M&E framework and proposed indicators will be presented to the
UNAIDS IATT on Education at its meeting on 2-4 December 2009 in Berlin,
Germany. Anticipated next steps include field-testing the new proposed
indicators, and refining the definitions of existing ones. This will be
taken forward by members of the IATT on Education’s Indicators Working Group
in early 2010, in consultation with ministries of education and national
partners.



According to Michael Beasley, director of Partnership for Child Development
at Imperial College, “Getting things right in the education sector’s
monitoring and evaluation of its response to HIV is essential if it is to
provide a ‘social vaccine’ to the epidemic, offering knowledge and personal
skills which can prevent HIV.” He added, “It is estimated that young people
who fail to complete a basic education are more than twice as likely to
become infected as those who do. Education also reduces the vulnerability of
girls, and each year of schooling offers greater protective benefits.”



Empowering young people to protect themselves from HIV is one of the nine
priority areas for UNAIDS and its Cosponsors under the Joint Action for
Results: UNAIDS Outcome Framework 2009-2011.



Formed in 2002, the UNAIDS IATT on Education is convened by UNESCO and
brings together UNAIDS Cosponsors and other multilateral organisations,
bilateral agencies, private donors and civil society partners with the
purpose of accelerating and improving a coordinated and harmonised education
sector response to HIV.
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