From hivtwg.moderator at gmail.com Mon Jul 12 03:28:50 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:28:50 +0700 Subject: [hivaids-twg] The financial burden of HIV care, and ART in Indonesia In-Reply-To: References: Message-ID: From: Date: Sun, Jul 11, 2010 at 10:06 AM Subject: [AIDS ASIA] The financial burden of HIV care, and ART in Indonesia To: AIDS_ASIA at yahoogroups.com Cc: sigitriyarto2002 at yahoo.com The financial burden of HIV care, including antiretroviral therapy, on patients in three sites in Indonesia Sigit Riyarto,1* Budi Hidayat,2 Benjamin Johns,3 Ari Probandari,4 Yodi Mahendradhata,1 Adi Utarini,1 Laksono Trisnantoro1 and Sabine Flessenkaemper5 1Department of Public Health, School of Medicine, University of Gajah Mada, Jogjakarta, Indonesia, 2School of Public Health, University of Indonesia, Indonesia, 3Consultant, Baltimore, MD, USA, 4Department of Public Health, Medical Faculty, University of Sebelas Maret, Surakarta, Indonesia and 5Former Medical Officer, World Health Organization, Jakarta Office, Jakarta, Indonesia *Corresponding author. Department of Public Health, Medical Faculty, University of Gajah Mada, Jl. Farmako Sekip Utara, Jogjakarta, Indonesia. Tel: ?62-274-549423. Fax: ?62-274-549423. E-mail: sigitriyarto2002 at yahoo.com Accepted 23 October 2009 This paper assesses the extent of the financial burden due to out-of-pocket payments for health care incurred by people living with HIV (PLHIV) and the effect of this burden on their financial capacity. Data were collected in a cross-sectional survey of 353 PLHIV from three cities in Indonesia (Jakarta, Jogjakarta and Merauke). Respondents in Jakarta were sampled from one hospital and one non-governmental organization working with PLHIV. In Jogjakarta and Merauke, all HIV patients on antiretroviral therapy (ART) who came to selected hospitals during the interview period were asked to participate in the survey. The survey collected data on the frequency and extent of payments for HIV-related care, with answers cross-checked against medical records. Results show that PLHIV had different burdens of payments in the different geographical areas. On average, respondents in Jogjakarta spent 68%, and PLHIV on ART in Jakarta spent 96%, of monthly expenditure for HIV related care, indicating a substantial financial burden for many ART patients. These patients depended on several sources of finance to cover the costs of their care, with donations from their immediate family being the most common method, selling assets and payments from personal income being the second most common method in Jakarta and Jogjakarta, respectively. Most PLHIV in these two areas did not have insurance. In Merauke, there were little observed out-of-pocket payments because the government covers medical costs via the local budget and health insurance for the poor. The results of this study confirm previous findings that providing subsidized ART drugs alone does not ensure financial accessibility to HIV care. Thus, the government of Indonesia at central and local levels should consider covering HIV care additional to providing antiretroviral drugs free of charge. Social health insurance should also be encouraged. Keywords ART, HIV/AIDS, financial barriers, access, Indonesia Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine Health Policy and Planning 2010;25:272?282 doi:10.1093/heapol/czq004272 __._,_.___ -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/f43bb452/attachment-0010.html From hivtwg.moderator at gmail.com Mon Jul 12 03:29:35 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:29:35 +0700 Subject: [hivaids-twg] Satellite Session Announcement:: Social Media Lab for Clinicians and HCWs in HIV/AIDS In-Reply-To: References: <659420.51516.qm@web37302.mail.mud.yahoo.com> Message-ID: From: Ishdeep Kohli Date: Sun, Jul 11, 2010 at 3:26 PM Subject: [AIDS ASIA] Satellite Session Announcement:: Social Media Lab for Clinicians and HCWs in HIV/AIDS To: AIDS_ASIA at yahoogroups.com Satellite Session Announcement: Social Media Lab for Clinicians and HCWs in HIV/AIDS Swasthya India, Jodhpur School of Public Health, HIV Atlas are pleased to announce the Consortium ?Social Media Network for HIV Response?. We are organizing the Satellite Session ?Social Media Lab for Clinicians and HCWs in HIV/AIDS?, at the XVIII International AIDS Conference, to be held in Vienna, Austria, 18-23 July 2010. The Satellite Session will take place on Sunday, 18 July, 11:15 - 13:15, in Mini Room 7 ? Kohli, Ishdeep (Facilitator), Mumbai, India ? Purohit, Anil (Chairperson), Boston, United States Information and Communication Technology is seen as a vital factor in enhancing development and healthcare efforts. Internet, E-Networking, Social Media, Mobile Phones and Telemedicine can improve the efficiency of HIV/AIDS information exchange in resource-limited settings. Clinicians will be introduced to social media tools to increase their knowledge and skills in accessing and disseminating live HIV/AIDS information through the internet, mobile devices and other interactive media. An understanding of online communities and their impact on HIV clinical management will be provided. Clinicians will be presented methods of using such social media tools to gain access to target audiences including PLWHA, their support groups, as well as monitor and gauge responses from the target audience. This workshop will help clinicians and health care workers understanding the basics of how these tools can be used to influence knowledge, attitudes, behaviors and in rapidly disseminating cutting edge research and evidence-based case management approaches. Speakers: 1. Introductory Remarks on Information and Communication Technologies JVR Prasada Rao Special Advisor to Executive Director, UNAIDS India 2. Expert Sourcing for Real-Time AIDS Management by Front-Line Health Workers Shih, Ting (Click Diagnostics) Boston, United States 3. Distance Learning and HIV Clinical Seminar Series for HIV Physicians Manoharan, Gurusamy (I-TECH) Chennai, India 4. Cloud Consulting: Using Electronic Groups for Physician Communication Colby, Donn (Harvard Medical School AIDS Initiative in Vietnam (HAIVN) Vietnam 5. NGO and IT Maximization Khorakiwala, Huzaifa (Wockhardt Foundation) Mumbai, India 6. Reaching out to Communities through Mobile Technologies for Positive Health and Livelihood Outcome: Experience from India Aggarwal, Vikas (Project Concern International/ India) New Delhi, India 7. Social Media for Response to HIV Harsh, Jagdish (HIV-ATLAS) New Delhi, India 8. Scope of Internet Mediated Social Communication in HIV Response Thomas, Joe (AIDS-India, AIDS AIDS-Asia, Jodhpur School of Public Health) Melbourne, Australia Participants wishing to attend can confirm their participation to Ishdeep Kohli at ishdeepkohli at hotmail.com Ishdeep Kohli Executive Director ? Programs and Partnerships Swasthya India Mumbai, India __._,_.___ -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/4ae6d0f4/attachment-0010.html -------------- next part -------------- A non-text attachment was scrubbed... Name: winmail.dat Type: application/ms-tnef Size: 4426 bytes Desc: not available Url : http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/4ae6d0f4/attachment-0010.bin From hivtwg.moderator at gmail.com Mon Jul 12 03:30:54 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:30:54 +0700 Subject: [hivaids-twg] NAV's job opportunity: Scaling-up the Faith-Based Response to HIV and AIDS in Vietnam In-Reply-To: References: <191F5790-640A-4A58-A8C4-27A4A3542DDB@gmail.com> Message-ID: From: vern weitzel Date: Sun, Jul 11, 2010 at 9:23 PM Subject: [opportunities] Fwd: NAV's job opportunity: Scaling-up the Faith-Based Response to HIV and AIDS in Vietnam To: "[Opportunities]" Sent from the Opportunities Mailing List. If you reply, please do not CC everyone on the list. Rather, send a separate message to the individual you are replying to. Address to post a new message: opportunities at ngocentre.org.vn Avoid sending attachments, but if you must send them keep them small - 500 kilobyte maximum for each email. Please, no housing ads - only office space suitable for an NGO. To change your subscription: http://ngocentre.org.vn/mailman/listinfo/opportunities *From: *Hoang Thanh Mai *Date: *5 July 2010 4:18:34 AM PDT *Subject: **NAV's job opportunity * Dear colleagues, Nordic Assistance to Vietnam is seeking for consultant to develop a concept and training material on proposal writing and conduct training for project implementing partners. Could you please help us to post the advertisement ( see attached file) on technical website. Thank you for your support. Best wishes, Mai ____________________ Hoang Thanh Mai Nordic Assistance to Vietnam Administrator Add: 76 Hai Ba Trung Street, Hue City, Vietnam Tel/fax: + 84-54-3822613 Mob: + 84-913449448 Email: mai at navhue.org website: www.nca.no *Scope of Work* * * Project: ?Scaling-up the Faith-Based Response to HIV and AIDS in Vietnam? Topic: Development of a concept and training material on proposal writing and conduct training for project implementing partners Period of assignment: End of July to end of August Closing date: July 18th Ref. no: CB.2010.09 * * *1 **Background* Nordic Assistance to Vietnam (NAV) was established in 1994 as a consortium of three Nordic Non-Governmental Organizations. NAV?s three main program areas are community development, gender-based violence and HIV and AIDS. For the latter NAV has implemented programs since 1996 through working with self-help groups for People Living with HIV (PLHIV) and Faith-Based Organizations (FBOs) in Thua Thien Hue and Hai Phong provinces. The program is funded through the President?s Emergency Plan for AIDS Relief (PEPFAR) under the United States Agency for International Development (USAID). Project sites include Hai Phong, Quang Ninh, Hanoi, Hue, Danang and Ho Chi Minh City. The overall goal of the program is ?to enable the faith?based community to contribute towards reducing the impact of HIV and AIDS in Vietnam?. The program of NAV has the following components: 1) Prevention (abstinence and be faithful and other behavior change), 2) Palliative and home-based care, 3) Orphans and Vulnerable Children (OVC), and 4) Other policy development and systems strengthening. The latter is comprised of institutional capacity building, and reduction of stigma & discrimination. The primary partners for the program are Buddhist and Catholic FBOs as well as the Fatherland Front. Among the Catholic partners are religious orders of sisters, churches and charity clinics under the Catholic Dioceses and among the Buddhist partners selected pagodas and universities under the Buddhist Associations. *2 **Justification* Sustainability of community-based HIV and AIDS activities is dependent upon many aspects, whereof capacity building on project management and fund raising is one important component. A first resource mobilization training was held in 2009 for the partners of the program ?Scaling-up the faith-based response to HIV and AIDS in Vietnam. In order to provide more practical skills and knowledge on the full cycle from project proposal writing to management of funds and reporting, a follow-up training will be organized for key partners in August 2010. *3. **The assignment* 3.1 *Purpose of the assignment* ? *Overall objective*: Enable FBOs through capacity building to identify donors and to write funding proposals that reflect the objectives and needs of the proposed project and the requirements of the donor. 3.2 *Target groups* ? *Primary target group: *Monks, nuns, priests, sisters and lay volunteers of Buddhist and Catholic FBOs with a leading administrative role in their organization and with good written communication skills. ? *Secondary target group:* Project and field staff who are working for NAV on the program: *?Scaling up the faith-based response to HIV/AIDS in Vietnam?*. 1.3 2.3 3.3 *Main tasks for the consultant* ? Develop a concept and model for training on proposal writing ? Develop support material and tools on proposal writing ? Conduct training on proposal writing for key project partners ? Write a report from the training, which includes recommendations for future trainings ? Adjust materials and training concept in accordance with feedback from participants.** 3.4 *Key elements to be included in the material and training* ? Introduction to fundraising (potential funding sources and channels) ? Funding from institutional donors and INGOs (who are they, what are they interested in, where and how to find funding opportunities) the full cycle of fundraising from proposal writing to management of funds, and finally reporting. ? The importance of good governance and accountability as a pre-requisite for building good and long-term donor relationships including through compliance with donor requirements. The principles of financial and narrative reporting. ? Introduction to community-based fundraising including an overview of potential sources (e.g. individuals, companies, institutions) and methods (e.g. events, collections and proposals). ? Home exercise for each project partner to write a proposal to which the consultant will comment. 3.5 *Period for assignment* End of July and August 2010 3.6 *Location for training*: Da Nang *4 **Suggested methodology* Participatory methods should be applied during the training e.g. questions and answers, group discussions, role plays, and brain storming. *5 **Deliverables and due dates* All new or significantly modified concepts, materials and documents will be the property of NAV. Documents are to be produced in Vietnamese and as requested in English. They must be submitted both in electronic (using Microsoft Office software) and hard copies. *Task* Due date a. Work with the Capacity Building Officer of NAV for orientations on the program and target group 25th July b. Develop draft for training content and methodologies 5th August c. Develop training material 12th August d. Deliver training course in Da Nang 16th August e. Finalize the training material 21st August f. Produce a final report on activity with recommendations for future trainings. 25th August g. Submit all documents, databases, revised training material and other material to the Capacity Building Officer of NAV in hardcopy and electronically. 28th August h. Maintain regular contact with the Capacity Building Officer and FBO Program Coordinator through e-mail and/or telephone. * * * * *6 **Technical direction * The tasks will be carried out under the direction of NAV?s Capacity Building Officer. The final version of the training material and the training report will be reviewed and approved by NAV?s National Coordinator for the HIV and AIDS program. *7 **Qualifications and experiences* ? Extensive experience with proposal writing and fundraising ? At least 3 years? working experience in training on topics related to proposal writing ? At least 3 years? working experience with using participatory methodologies in training ? University degree in social sciences, business administration, education or other relevant fields ? Excellent communication skills ? Excellent writing skills in Vietnamese and preferably also in English ? Understanding/knowledge of Faith-Based Organizations is an advantage *8 **Requirements to the proposal* ? Updated CV ? Description of suggested methodology ? Main activities and timeline ? Budget (this should indicate man-days, fees and per diems including VAT, and costs related to transportation and accommodation The consultant will be paid based on days worked and actual expenditures. There will be no additional expenses paid for office space, telephone/computer usage etc. NAV will reimburse air fare, taxi and hotel fees based on agreed plans and actual vouchers. In addition, NAV will pay a per diem based on the consultant?s travel schedule. All meetings with stakeholders and arrangement of field visits and workshops will be organized by NAV. *Interested candidates are requested to send their proposal to:* Nordic Assistance to Vietnam (NAV) 76 Hai Ba Trung Hue City VIET NAM E-mail: mai at navhue.org *Questions concerning the consultancy can be directed to:* Mr. Nguyen Minh Duc, Capacity building officer E-mail: minhduc at navhue.org Cell phone: 0912 348 117 -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/3391cacc/attachment-0010.html -------------- next part -------------- A non-text attachment was scrubbed... Name: 100705 SoW advertisement proposal writing.doc Type: application/msword Size: 78848 bytes Desc: not available Url : http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/3391cacc/attachment-0010.doc From hivtwg.moderator at gmail.com Mon Jul 12 03:34:18 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:34:18 +0700 Subject: [hivaids-twg] AIDS 2010 Symposium Invite: The Continuum of Prevention and Care in Asia Pacific In-Reply-To: References: Message-ID: From: Kimberly Green Date: Sun, Jul 11, 2010 at 9:42 PM Subject: [health-vn] AIDS 2010 Symposium Invite: The Continuum of Prevention and Care in Asia Pacific To: vern weitzel , "[health-vn discussion group]" < health-vn at anu.edu.au> THE CONTINUUM OF PREVENTION AND CARE (CoPC) IN ASIA PACIFIC: Successes, challenges and contributions to health systems strengthening AIDS 2010 Vienna Satellite Symposium *********************************** DATE/TIME: SUNDAY, 18 JULY; 15:45-17:45 VENUE: Reed Messe Wien Conference Center; Session Room 4 JOIN US for an exciting session on the development of the Continuum of Prevention and Care model of HIV service delivery in Asia and the Pacific. Following an initial emergency phase for rapid scale-up of HIV services, a number of countries in the Asia-Pacific established HIV continuum of prevention and care systems to maximize the effectiveness and sustainability of HIV services. This satellite session will feature the CoPC experiences of Cambodia, Nepal, Papua New Guinea and Viet Nam. The discussion will focus on the approaches these countries used to: develop a coordinated system of HIV services, involve people living with HIV, and establish comprehensive care sites. Presentations will highlight key successes and outcomes, challenges and the contribution of the CoPC experience to health systems strengthening. Tools and guidance to support step-by-step implementation of CoPC systems will be made available during the session. CO-CHAIRS: Massimo Ghidinelli, WHO WPRO and Kimberly Green, FHI 1) The Asia-Pacific continuum of prevention and care: Highlights from a country review Speakers * Masami Fujita, WHO Viet Nam and Kimberly Green, FHI 2) Contribution of the CoPC on Cambodia?s health care system Speaker * Mean Chhi Vun, National Centre for HIV/AIDS, Dermatology and STDs 3) From the ground-up: How the CoPC has transformed HIV service delivery and contributions to palliative care and home-based care for people with chronic diseases in Papua New Guinea Speaker * Esorom Daoni, HIV/AIDS/STI, National Department of Health 4) CoPC in a fragile state: How Nepal has extended comprehensive services to most at risk populations and people living with HIV Speaker * K Rai, National Centre of AIDS and STD Control 5) CoPC in an IDU driven epidemic: The experience of Viet Nam Speaker * Do Thi Nhan, Viet Nam Authority of HIV/AIDS Control Panel respondents - Greg Grey, World AIDS Campaign - Joseph Perriens, WHO Discussion Facilitator: Iyanthi Abeyewickreme, WHO SEARO _______________________________________________ health-vn Health in Viet Nam and the Region Post message to list: health-vn at anu.edu.au List information page: http://mailman.anu.edu.au/mailman/listinfo/health-vn health-vn List from the Australia Vietnam Science-Technology Link contact: Vern Weitzel vern at coombs.anu.edu.au The accuracy of information from media articles posted on this list cannot be guaranteed and should be verified before use. -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/c40f4ca8/attachment-0010.html From hivtwg.moderator at gmail.com Mon Jul 12 03:37:03 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:37:03 +0700 Subject: [hivaids-twg] Occurrence, risk factors, diagnosis and treatment of syphilis in the prospective observational Swiss HIV Cohort Study. In-Reply-To: References: Message-ID: From: Paul Causey Date: Sun, Jul 11, 2010 at 12:17 PM Subject: [msm-asia] Occurrence, risk factors, diagnosis and treatment of syphilis in the prospective observational Swiss HIV Cohort Study. To: MSM-Asia Newgroup Occurrence, risk factors, diagnosis and treatment of syphilis in the prospective observational Swiss HIV Cohort Study. AIDS. 2010 Jul 7; Authors: Thurnheer MC, Weber R, Toutous-Trellu L, Cavassini M, Elzi L, Schmid P, Bernasconi E, Christen AB, Zwahlen M, Furrer H, BACKGROUND:: Annual syphilis testing was reintroduced in the Swiss HIV Cohort Study (SHCS) in 2004. We prospectively studied occurrence, risk factors, clinical manifestations, diagnostic approaches and treatment of syphilis. METHODS:: Over a period of 33 months, participants with positive test results for Treponema pallidum hemagglutination assay were studied using the SHCS database and an additional structured case report form. RESULTS:: Of 7244 cohort participants, 909 (12.5%) had positive syphilis serology. Among these, 633 had previously been treated and had no current signs or symptoms of syphilis at time of testing. Of 218 patients with newly detected untreated syphilis, 20% reported genitooral contacts as only risk behavior and 60% were asymptomatic. Newly detected syphilis was more frequent among men who have sex with men (MSM) [adjusted odds ratio (OR) 2.8, P < 0.001], in persons reporting casual sexual partners (adjusted OR 2.8, P < 0.001) and in MSM of younger age (P = 0.05). Only 35% of recommended cerebrospinal fluid (CFS) examinations were performed. Neurosyphilis was diagnosed in four neurologically asymptomatic patients; all of them had a Venereal Disease Research Laboratory (VDRL) titer of 1:>/=32. Ninety-one percent of the patients responded to treatment with at least a four-fold decline in VDRL titer. CONCLUSION:: Syphilis remains an important coinfection in the SHCS justifying reintroduction of routine screening. Genitooral contact is a significant way of transmission and young MSM are at high risk for syphilis. Current guidelines to rule out neurosyphilis by CSF analysis are inconsistently followed in clinical practice. Serologic treatment response is above 90% in the era of combination antiretroviral therapy. PMID: 20616699 [PubMed - as supplied by publisher] Paul Causey +66-81-984-6515 (GMT+7) Bangkok, Thailand -- You received this message because you are subscribed to the Google Groups "MSM Sexual Health - Asia" group. To post to this group, send email to msm-asia at googlegroups.com To unsubscribe from this group, send email to msm-asia+unsubscribe at googlegroups.com For more options, visit this group at http://groups.google.com/group/msm-asia?hl=en?hl=en -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/84ed5368/attachment-0010.html From hivtwg.moderator at gmail.com Mon Jul 12 03:37:54 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:37:54 +0700 Subject: [hivaids-twg] PLoS ONE: Rates and Reasons for Early Change of First HAART in HIV-1-Infected Patients in 7 Sites throughout the Caribbean and Latin America In-Reply-To: References: Message-ID: From: vern weitzel Date: Sun, Jul 11, 2010 at 7:12 AM Subject: [health-vn] PLoS ONE: Rates and Reasons for Early Change of First HAART in HIV-1-Infected Patients in 7 Sites throughout the Caribbean and Latin America To: "[health-vn discussion group]" health-vn - Health in Viet Nam and the Region New address to post messages: health-vn at anu.edu.au New list Information Page (remember your password): http://mailman.anu.edu.au/mailman/listinfo/health-vn Maximum message size: 2.5 mb. - - Clinical Trials - - PLoS Biology - PLoS Medicine - PLoS Computational Biology - PLoS Genetics - PLoS Pathogens - PLoS ONE - PLoS Neglected Tropical Diseases - *Download:* PDF| Citation| XML - *Print article* - EzReprintNew & improved! Metrics info *Total Article Views: 361 * Average Rating (0 User Ratings) 1. - Currently 0/5 Stars. See all categories 1. Insight - Currently 0/5 Stars. 2. Reliability - Currently 0/5 Stars. 3. Style - Currently 0/5 Stars. Rate This Article More Related Content Related Subject Categories Public Health and Epidemiology, Infectious Diseases Related Articles on the Web Google Scholar PubMed More Share this Article info - [image: StumbleUpon] [image: Facebook] [image: Connotea] [image: CiteULike] [image: Bibliography] [image: Twitter icon] 0diggsdigg - Email this article Public Library of Science http://www.plosone.org/article/info:doi/10.1371/journal.pone.0010490OpenAccess Research Article http://www.plosone.org/article/info:doi/10.1371/journal.pone.0010490Rates and Reasons for Early Change of First HAART in HIV-1-Infected Patients in 7 Sites throughout the Caribbean and Latin America HAART rollout in Latin America and the Caribbean has increased from approximately 210,000 in 2003 to 390,000 patients in 2007, covering 62% (51%?70%) of eligible patients, with considerable variation among countries. No multi-cohort study has examined rates of and reasons for change of initial HAART in this region. Antiretroviral-na?ve patients >?=?18 years who started HAART between 1996 and 2007 and had at least one follow-up visit from sites in Argentina, Brazil, Chile, Haiti, Honduras, Mexico and Peru were included. Time from HAART initiation to change (stopping or switching any antiretrovirals) was estimated using Kaplan-Meier techniques. Cox proportional hazards modeled the associations between change and demographics, initial regimen, baseline CD4 count, and clinical stage. Of 5026 HIV-infected patients, 35% were female, median age at HAART initiation was 37 years (interquartile range [IQR], 31?44), and median CD4 count was 105 cells/uL (IQR, 38?200). Estimated probabilities of changing within 3 months and one year of HAART initiation were 16% (95% confidence interval (CI) 15?17%) and 28% (95% CI 27?29%), respectively. Efavirenz-based regimens and no clinical AIDS at HAART initiation were associated with lower risk of change (hazard ratio (HR)?=?1.7 (95% CI 1.1?2.6) and 2.1 (95% CI 1.7?2.5) comparing neverapine-based regimens and other regimens to efavirenz, respectively; HR?=?1.3 (95% CI 1.1?1.5) for clinical AIDS at HAART initiation). The primary reason for change among HAART initiators were adverse events (14%), death (5.7%) and failure (1.3%) with specific toxicities varying among sites. After change, most patients remained in first line regimens. Adverse events were the leading cause for changing initial HAART. Predictors for change due to any reason were AIDS at baseline and the use of a non-efavirenz containing regimen. Differences between participant sites were observed and require further investigation. - Article - Metrics - Related Content - Comments: 0 - To *add a note*, highlight some text. Hide notes - Make a general comment *Jump to* - Abstract - Introduction - Methods - Results - Discussion - Supporting Information - Acknowledgments - Author Contributions - References Carina Cesar1 *, Bryan E. Shepherd2, Alejandro J. Krolewiecki1, Valeria I. Fink1, Mauro Schechter3, Suely H. Tuboi3, Marcelo Wolff4, Jean W. Pape5, Paul Leger5, Denis Padgett6, Juan Sierra Madero7, Eduardo Gotuzzo8, Omar Sued1, Catherine C. McGowan2, Daniel R. Masys2, Pedro E. Cahn1, for The Caribbean, Central and South America Network for HIV Research (CCASAnet) Collaboration, of the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Program *1* Fundaci?n Hu?sped, Buenos Aires, Argentina, *2* Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America, *3*Projeto Pra?a Onze, Hospital Universit?rio Clementino Fraga Filho and Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil, *4*Fundaci?n Arriar?n and Facultad de Medicina, Universidad de Chile, Santiago, Chile, *5* Le Groupe Ha?tien d'Etude du Sarcome de Kaposi et des Infections Opportunistes in Port-au-Prince (GHESKIO), Port-au-Prince, Haiti, *6*Instituto Hondure?o de Seguridad Social and Universidad Aut?noma de Honduras, Tegucigalpa, Honduras, *7* Instituto Nacional de Ciencias M?dicas y Nutrici?n Salvador Zubir?n, M?xico City, M?xico, *8* Universidad Peruana Cayetano Heredia Facultad de Medicina and Instituto de Medicina Tropical Alexander von Humboldt, Lima, Per? Abstract Top Background HAART rollout in Latin America and the Caribbean has increased from approximately 210,000 in 2003 to 390,000 patients in 2007, covering 62% (51%?70%) of eligible patients, with considerable variation among countries. No multi-cohort study has examined rates of and reasons for change of initial HAART in this region. Methodology Antiretroviral-na?ve patients > = 18 years who started HAART between 1996 and 2007 and had at least one follow-up visit from sites in Argentina, Brazil, Chile, Haiti, Honduras, Mexico and Peru were included. Time from HAART initiation to change (stopping or switching any antiretrovirals) was estimated using Kaplan-Meier techniques. Cox proportional hazards modeled the associations between change and demographics, initial regimen, baseline CD4 count, and clinical stage. Principal Findings Of 5026 HIV-infected patients, 35% were female, median age at HAART initiation was 37 years (interquartile range [IQR], 31?44), and median CD4 count was 105 cells/uL (IQR, 38?200). Estimated probabilities of changing within 3 months and one year of HAART initiation were 16% (95% confidence interval (CI) 15?17%) and 28% (95% CI 27?29%), respectively. Efavirenz-based regimens and no clinical AIDS at HAART initiation were associated with lower risk of change (hazard ratio (HR) = 1.7 (95% CI 1.1?2.6) and 2.1 (95% CI 1.7?2.5) comparing neverapine-based regimens and other regimens to efavirenz, respectively; HR = 1.3 (95% CI 1.1?1.5) for clinical AIDS at HAART initiation). The primary reason for change among HAART initiators were adverse events (14%), death (5.7%) and failure (1.3%) with specific toxicities varying among sites. After change, most patients remained in first line regimens. Conclusions Adverse events were the leading cause for changing initial HAART. Predictors for change due to any reason were AIDS at baseline and the use of a non-efavirenz containing regimen. Differences between participant sites were observed and require further investigation. *Citation: *Cesar C, Shepherd BE, Krolewiecki AJ, Fink VI, Schechter M, et al. (2010) Rates and Reasons for Early Change of First HAART in HIV-1-Infected Patients in 7 Sites throughout the Caribbean and Latin America. PLoS ONE 5(6): e10490. doi:10.1371/journal.pone.0010490 *Editor: *Landon Myer, University of Cape Town, South Africa *Received:* October 15, 2009; *Accepted:* April 2, 2010; *Published:* June 1, 2010 *Copyright:* ? 2010 Cesar et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. *Funding:* Funding for this work was provided in part by US NIAID (NIH 1 U01 AI069923). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. *Competing interests:* The authors have declared that no competing interests exist. * E-mail: carina.cesar at huesped.org.ar Introduction Top An estimated 1.93 million people live with HIV in Latin America and the Caribbean, comprising 5.7% of all infected persons worldwide; the adult prevalence in this region is 0.5%[1]. Access to antiretroviral (ARV) therapy has improved and at the end of 2007 approximately 390,000 patients in this region were receiving antiretroviral therapy with an overall coverage of 62% (51%?70%), although considerable variation exists between countries[2], [3]. Unfortunately, 75% of patients still initiate treatment at advanced stages of disease[4] ?[8] . Treatment toxicities and adherence problems may lead to suboptimal therapy, discontinuation, and treatment failure. Early modification of initial highly active antiretroviral therapy (HAART) has been associated with poor clinical outcomes[9]. Therefore, knowing why patients modify therapy could improve our understanding of successful HAART, guide decisions regarding initiation and management of HAART in specific patient populations, and inform interventions to reduce HAART discontinuation. The frequency and reasons for HAART change have been assessed by cohort studies from resource-rich and -limited settings, but Latin America and the Caribbean have been largely underrepresented in these studies[10] ?[16]. Observational studies from sites in Argentina, Brazil, Haiti and Peru have described the occurrence of adverse events and durability of first regimen [17] ?[23]. However, no multisite study has addressed frequency and reasons for change in this region. The Caribbean, Central and South America Network for HIV Research (CCASAnet) collaboration includes sites from seven nations: Argentina, Brazil, Chile, Haiti, Honduras, Mexico, and Peru. In an earlier study of antiretroviral-na?ve subjects starting HAART, mortality rates in the CCASAnet cohort were similar to those reported for resource-limited settings with a 1-year probability of death for the combined cohort of 8.3%, although this varied considerably across sites[8]. The purpose of the current study is to explore the frequency of, risk factors for, and reasons for changing/discontinuing HAART during the first year after initiation in the CCASAnet region. Methods Top Ethics Statement This study was conducted according to the principles expressed in the Declaration of Helsinki. Institutional Review Board approval was obtained locally for each participating site and the coordinating centre: Comit? de Bio?tica de Fundaci?n Hu?sped; Comit? de ?tica em Pesquisa-Universidade Federal Do R?o De Janeiro; Comit? ?tico-Cient?fico del Servicio de Salud Metropolitano Central, Ministerio de Salud, Gobierno de Chile; Human Research Protections Programs, Division of Research Integrity, Weill Cornell Medical College; Comit? de ?tica en Investigaci?n Biom?dica de la Unidad de Investigaci?n Cient?fica, Facultad de Ciencias M?dicas, Universidad Nacional Aut?noma de Honduras; Comit? Institucional de Investigaci?n Biom?dica en Humanos, Instituto Nacional de Ciencias M?dicas y Nutrici?n Salvador Zubir?n; Vicerrectorado de Investigaci?n, Direcci?n Universitaria de Investigaci?n, Ciencia y Tecnolog?a-DUICT, Universidad Peruana Cayetano Heredia; Institutional Review Board, Vanderbilt University. All data were de-identified prior to being transmitted to the Vanderbilt Data Coordinating Centre. In each of the countries contributing data to this study, ethical regulations and policies permit retrospective analysis of de-identified clinical data without informed consent when the research is approved by an appropriately constituted ethics committee or Institutional Review Board. These approvals were obtained in all cases and the need to obtain informed consent was waived by all of the ethics committees of the participating sites. Participants and Settings The CCASAnet cohort (www.ccasanet.vanderbilt.edu) has been described elsewhere[24]. Briefly, the collaboration was established in 2006 as Region 2 of the International Epidemiologic Databases to Evaluate AIDS (IeDEA; www.iedea-hiv.org). The cohort includes 7 sites: Fundaci?n Hu?sped in Buenos Aires, Argentina (FH-Argentina); Hospital Universit?rio Clementino Fraga Filho in Rio de Janeiro, Brazil (HUCFF-Brazil); Fundaci?n Arriar?n in Santiago, Chile (FA-Chile); Le Groupe Ha?tien d'Etude du Sarcome de Kaposi et des Infections Opportunistes in Port-au-Prince, Haiti (GHESKIO-Haiti); Instituto Hondure?o de Seguridad Social Hospital de Especialidades and Hospital Escuela in Tegucigalpa, Honduras (IHSS/HE-Honduras); Instituto Nacional de Ciencias M?dicas y Nutrici?n Salvador Zubir?n in Mexico City, Mexico (INNSZ-M?xico); and Instituto de Medicina Tropical Alexander Von Humboldt in Lima, Peru (IMTAvH-Peru). Each cohort was established at a different time between 1996 and 2002 not necessarily reflecting the availability of HAART in each country. Data audits were performed at each site by a team from the VDCC. The present analysis used data for the first year of follow-up after starting HAART collected through June 2008. Included were antiretroviral-na?ve HIV-infected patients prescribed HAART at age 18 years or older with at least one follow-up visit. Initiation of HAART at each site followed either national or World Health Organization guidelines[25] ?[30]. Guidelines from Argentina, Brazil, Chile, Honduras and Mexico recommend drug substitutions after toxicity and switching regimens after virologic failure [25], [27] ?[29]. In contrast, in Haiti and Peru failure was defined according to WHO clinical and immunologic criteria[30]. Table 1lists site-specific practices related to initiation criteria, laboratory monitoring, and regimen availability. [image: thumbnail] *Table 1. Treatment Program Characteristics across Sites.* doi:10.1371/journal.pone.0010490.t001 Outcomes The primary outcome was first change of regimen during the first year of HAART. Regimen change was defined as any alteration?switch or discontinuation?of ?1 antiretroviral. Discontinuation was defined as simultaneous stopping of all antiretrovirals without initiation of a subsequent regimen for more than 30 days. Dosage adjustments and interruptions of therapy shorter than 30 days were ignored because of inconsistent recording of short interruptions across sites. Reasons for change were collected by each site and classified at the coordinating centre. Specific definitions of reasons for regimen change, including definition of treatment failure, were not standardized across sites and only included if they prompted a regimen change. Secondary analyses classified patients who died or were lost to follow-up (LTFU) while on their first HAART as having discontinued treatment. Patients without a visit for 6 months were classified as LTFU. The 6-month interval was chosen to include the longest interval between regular visits in participant sites, although most sites scheduled visits every 3 months. Data Sources and Measurements Baseline CD4 count was defined as the measurement closest to HAART initiation but not more than 6 months prior to, or 7 days after, the date of HAART start. Baseline HIV-1 plasma viral load (PVL) was defined as the pre-HAART measurement closest to, but not more than 6 months prior to, HAART initiation. Baseline weight and hemoglobin were defined as the measurements closest to HAART initiation within +/? 30 days. HAART was defined as protease inhibitor (PI)-based (1 ritonavir-boosted or unboosted PI plus ?2 nucleoside reverse-transcriptase inhibitors [NRTI]), non-nucleoside reverse transcriptase (NNRTI)-based (1 NNRTI plus ?2 NRTIs), or other combinations (including triple NRTI regimens and any other regimen containing a minimum of three drugs). Clinical stage of disease was defined as AIDS (WHO stage 4, CDC stage C, or 1986 CDC stage 4), non-AIDS, or unknown. Statistical Analysis Kaplan-Meier estimates computed probabilities of change per site. Time was measured from the start of HAART and ended at the earliest of regimen change, discontinuation, death, last visit before LTFU, last visit before the database closing, or 365 days. The closing date was defined separately for each site as the date of the most recent visit recorded in the database, and ranged from March 2007 to June 2008. The relationship between time to change and baseline variables was assessed using Cox proportional hazards models applied separately for each site. The primary multivariable analyses only included baseline predictors whose hazard ratio could be computed for all sites. Secondary, site-specific multivariable analyses included other routinely collected predictors with >50% non-missing data. In multivariable analyses, missing values of baseline predictors were accounted for using multiple imputation techniques applied separately within each site[31]. CD4 count and date of HAART initiation were included in models as continuous variables and expanded using restricted cubic splines to avoid linearity assumptions[32]. The combined hazard ratios and 95% confidence intervals (CI) were computed based on the results of site-specific hazard ratios using the meta-analysis approach of DerSimonian and Laird [33], a random effects method which makes no assumption regarding proportional hazards across sites[34]. All analyses were performed using R statistical software, version 2.8.1 ( http://www.r-project.org). Analysis scripts are available at http://ccasanet.vanderbilt.edu/files/pub?lic/switch.nw Results Top A total of 5026 na?ve patients starting HAART with at least one follow-up visit were included. Patient characteristics at HAART initiation are summarized by site in Table 2. Across all sites, 35% were female, median age was 37 years, median CD4 count was 105 cells/?L (interquartile range [IQR]: 38, 200), 47% of subjects had clinical AIDS, and 78% of subjects had either CD4<200 cells/?L or clinical AIDS. [image: thumbnail] *Table 2. Summary of Patient Characteristics, Calendar Year, and Regimens at HAART Initiation. * doi:10.1371/journal.pone.0010490.t002 Table 2also describes initial HAART regimen per site. The majority started HAART between 2002?2005 although 26% of patients from HUCFF-Brazil initiated prior to 2000. Across sites, NNRTI-based initial regimens were most common (84%) with efavirenz (EFV) the most frequently used (58.5%) except in IMTAvH-Peru. Eight percent of initial regimens were ritonavir-boosted PI-based: saquinavir (34%), lopinavir (31%) and indinavir (26%). Unboosted PI-based regimens accounted for 5% of initial regimens in the combined cohort; but were commonly used before 2000 in HUCFF-Brazil. Other regimens were mainly triple NRTIs (89%). Among nucleosides, lamivudine (3TC) was included in nearly all initial regimens (97%). Zidovudine (ZDV) was included in nearly 80% of all initial regimens; 84% and 81% of patients on EFV- and NVP-based regimens, respectively, were on ZDV, compared to 70% of patients who were not started on NNRTI-based regimens. Seventy percent of regimens which did not contain ZDV contained d4T. Didanosine and abacavir were used in only 4.3% and 4.6% of overall regimens, respectively, and tenofovir was used rarely (1.7%). The most common initial regimens were 3TC, ZDV, EFV (41.2%); 3TC, ZDV, NVP (28.1%); 3TC, d4T, NVP (5.3%); and 3TC, d4T, EFV (4.7%). Figure 1shows Kaplan-Meier estimates of the probability of changing/discontinuing regimens during the first year by site. The estimated 3-month and 1-year probabilities of change (95% CI) for the combined cohort were 16% (15?17%) and 28% (27?29%) respectively (Table 3). Regimen change during the first year was lowest at IHSS/HE-Honduras and highest at IMTAvH-Peru. Two -hundred eighty-six patients (5.7%) died during the first year prior to changing regimens and 149 patients (3.0%) were LTFU. When these patients were analyzed as having discontinued regimens, then the estimated 3-month and 1-year probabilities of change/discontinuation were 21% (95% CI 20?22%) and 36% (95% CI 34?37%), respectively. [image: thumbnail] *Figure 1. Probability of regimen change by site.* doi:10.1371/journal.pone.0010490.g001 [image: thumbnail] *Table 3. Number of Events and Estimated Rates of Changing Regimens (95% Confidence Intervals).* doi:10.1371/journal.pone.0010490.t003 Most regimen changes were simple drug substitutions followed by other regimen changes and discontinuations. Of 1288 living patients whose initial HAART was changed, 1147 (89%) switched to a different regimen, 104 (8%) did not start a second regimen during the observed follow-up, and 37 (3%) re-started their initial regimen after an interruption ?30 days. For those patients who re-started the same regimen during the first year, the median time of interruption was 78 days. For those who switched to a different regimen, the vast majority (83%) started within a week of initial HAART discontinuation and 90% within a month. Among those who started a second regimen while in follow-up, 74% were NNRTI-based and 5% were first line PI-based. Of 1013 living patients who stopped their initial ZDV-containing regimen, 487 had a second regimen containing ZDV, 452 had a second regimen not containing ZDV, and 74 did not start a second regimen. Table 4details second regimens started within 30 days of changing initial regimen. [image: thumbnail] *Table 4. Second Regimens started within 30 days of stopping Initial Regimen.* doi:10.1371/journal.pone.0010490.t004 Clinical AIDS at HAART initiation and non-efavirenz based regimens were associated with a higher hazard of change in unadjusted analyses for most sites and in the combined cohort (data not shown). Multivariable analyses for each site and pooled across sites are given in Table 5. After adjusting for sex, age, baseline CD4 count, year of HAART initiation, and type of regimen, the hazard of change was 1.3 times higher for a person with clinical AIDS prior to HAART initiation than a person without (95% CI: 1.1 to 1.5) (Table 3). Using EFV-based regimens as the reference category, the hazard ratios for change for NVP-based regimens and non-NNRTI-based regimens were 1.7 (95% CI: 1.1 to 2.6) and 2.1 (95% CI: 1.7 to 2.5) respectively. The increased hazard for change for NVP was not observed in FA-Chile and GHESKIO-Haiti whereas it was especially pronounced in IMTAvH-Peru. Except at GHESKIO-Haiti, patients who started 3TC,ZDV,EFV generally had lower rates of change than those starting other regimens (Table S1, online supplemental material). Overall and by site there were no consistent associations between gender, age, CD4, year of HAART initiation, or ZDV-containing regimens and change. Results were similar when those who died and those who died or were lost to follow-up were assumed to have discontinued regimens (Tables S2 -S3, online supplemental material). [image: thumbnail] *Table 5. Adjusted Hazard Ratios (95% Confidence Intervals) for Regimen Change/Discontinuation in First Year.* doi:10.1371/journal.pone.0010490.t005 Multivariable analyses including HIV-1 RNA, hemoglobin, weight, and more refined regimen categories were performed for sites with sufficient data and are shown in Table S4in the online supplemental material. Higher baseline weight was associated with a lower risk of changing regimens at IMTAvH-Peru. Higher baseline hemoglobin was predictive of a decreased risk of changing regimens at GHESKIO-Haiti. Patients treated with d4T had lower hemoglobin at baseline (medians of 9.7 vs. 11.0 mg/dl, p<0.0001). Higher baseline HIV-1 RNA was predictive of changing regimens at FA-Chile, but was not an independent predictor at FH-Argentina, INNSZ-Mexico, or IMTAvH-Peru. The reported reasons for change during the first year are given in Table 6. Adverse events (AE) prompted change in 14.4% of HAART initiators, and were the most common reason for six of the seven sites. Other reasons for change were failure (1.3%), the availability of a better regimen or simplification (1.5%), drug supply problems (1.8%), and abandonment/adherence failures (1.1%). Of the patients who initiated HAART, 2.9% changed regimens for an undocumented reason. [image: thumbnail] *Table 6. Reported reasons for changing initial HAART regimen in First Year.* doi:10.1371/journal.pone.0010490.t006 The most common AE were hematological toxicity (6.7%), skin rash (3%) and gastrointestinal intolerance (1.9%), with substantial heterogeneity between sites. Of HAART initiators in IHSS/HE-Honduras, 3.7% changed regimens during the first year due to hematological adverse events, compared to 15.8% in IMTAvH-Peru. Among those with hematological adverse events, 73% were anemia, 4%. The distribution of HAART initiators changing due to skin rash also varied with FH-Argentina, FA-Chile and IMTAvH-Peru reporting 4.0%, 7.3%, and 5.5%, respectively, and other sites reporting <2%. Within the first 3 months, AE were also the most common reported reason for changing regimens. Ten percent of patients changed regimens due to adverse events: 4.7% due to hematological toxicity and 2.8% due to skin rash. Forty-two patients from GHESKIO-Haiti who were on 3TC,ABC,ZDV switched to 3TC,ZDV,EFV in April/May of 2003 because this regimen became available and was deemed superior; each of these 42 patients had been on their initial regimen for less than 3 months. For all NNRTI, boosted PI, and unboosted-PI-based regimens, AE were the main reason for change, although type of AE varied according to class. The most common AE for efavirenz-based regimens were hematological (5.7%), central nervous system (2.2%), and skin (1.6%); for nevirapine-based regimens: hematological (9.7%), skin (5.8%), liver (0.7%), and gastrointestinal intolerance (0.7%); for boosted PI-based regimens: gastrointestinal intolerance (8.3%), hematological (2.6%), and kidney (1.8%); and for unboosted PI- based regimens: gastrointestinal intolerance (7%), hematological (4.8%), and skin (1.1%). Thirty patients died within 30 days of changing their initial HAART regimen. Adverse events were the reported reasons for change for 21 of these 30 patients. Most of these deaths were HIV-related or unspecified (tuberculosis 4, Kaposi's Sarcoma 2, wasting syndrome 2, Mycobacterium avium complex 1, Cryptococcosis 1, non-Hodgkin lymphoma 1, multiple opportunistic infections 1, AIDS-related but unspecified 1,); other causes included anemia 2, unspecified pulmonary infection 2, chronic renal failure 1, unspecified cancer 1, pancytopenia 1, and missing cause of death 10 Discussion Top This is the first multi-cohort study in Latin America and the Caribbean to describe rates of and reasons for changing initial HAART regimen. We found high rates of change early after treatment initiation with substantial variation across sites, ranging from 8?28% in the first 3 months and 18?41% in the first year. These rates are similar to those reported in other cohorts[10], [12] ?[15], [35] . Also in agreement with other studies[10] ?[14], [35], [36], adverse events were the main reason for change early after HAART initiation, with significant heterogeneity in the distribution of adverse events across sites. Hematological adverse events, >70% of which were anemia, were most common. This was most frequent in IMTAvH-Peru at 67%. Previous studies from Peru also reported anemia as a main reason for discontinuation (68%), and associated this finding with the use of standard 600 mg ZDV in low weight patients[21]. ZDV use was associated with an increase risk of discontinuation in the first 120 days of therapy and this early toxicity was associated with low baseline body weight. The high rates of HAART change due to anemia in IMTAvH-Peru may also be a reflection of baseline anemia and the fact that this site closely monitors anemia and changes HAART soon after its occurrence. The distribution of change in regimen due to skin rash also varied, with high rates in FH-Argentina, FA-Chile and IMTAvH-Peru and low rates elsewhere. This could be in part related to ethnicity, although this remains controversial[37] ?[39] . GHESKIO-Haiti, with more advanced disease at baseline, had unexpectedly lower rates of change/discontinuation due to adverse events than other sites. However, the rates were similar when deaths were included as discontinuations. The availability of alternative drugs more than the occurrence of adverse events may explain this low rate. As expected and previously reported[10], [12], patients were more likely to change therapy shortly after HAART initiation because of adverse events rather than treatment failure. Failure was given as the reason for change in 5% of changes, corresponding to 1.3% of HAART initiators. This low rate primarily may be explained by the short duration of follow-up. Interruption in drug supply prompted changes in 2% of HAART initiators per site: its importance cannot be minimized since interruptions <30 days were ignored. Continuous provision of therapy is a key component of any successful HIV program, as treatment interruptions affect program effectiveness[5], [21] . Consistent with previous studies, individuals who died while on their first regimen were censored at the time of death in our primary analyses [10], [13], [14]. This analysis implicitly assumes that the frequency with which these individuals would have changed regimens had they continued to live is similar to the frequency of changing for those patients who remained in care. To examine the sensitivity of results to this assumption we performed additional analyses which categorized individuals who died while on their first regimen as having discontinued regimens. We also performed analyses, assuming those lost to follow-up stopped therapy. This latter assumption seems reasonable in sites where there were few other options for HIV care, but less reasonable for sites located in areas with several other points of care. Characteristics at HAART initiation of those subsequently lost to follow-up for the CCASAnet cohort have been described elsewhere[8]. Risk factors for changing/discontinuing first regimen were similar regardless of how those who died or were lost were classified For the combined cohort, clinical AIDS prior to HAART initiation was identified as an independent predictor for treatment change. For FH-Argentina, in contrast to other sites, there was an increased risk of change at higher CD4 counts. A previous report suggested that patients with higher CD4 counts were at higher risk of GI intolerance whereas misclassification of gastrointestinal intolerance can occur in patients with low CD4 and associated opportunistic diseases[40]. Comorbidities in patients with advanced disease and concurrent treatments for opportunistic diseases may affect antiretroviral tolerance and thereby increase risk of toxicities. Late HAART initiation was associated with higher rates of treatment change. Approximately 50% of the patients in the combined cohort started therapy at less than 100 CD4/mL, highlighting the urgent need for timely diagnosis and treatment of HIV-positive patients. Efavirenz-based regimens had the lowest hazard for change. The increased hazard for change of NVP-based regimens was especially pronounced in IMTAvH-Peru. This may be explained by the use of fixed dose combinations containing ZDV and anemia frequency. In spite of the high proportions of hematological toxicity, the hazards of change for ZDV- and non-ZDV-containing regimens were similar. We believe that since patients with anemia at baseline were typically assigned to non-ZDV containing regimens (primarily d4T), ZDV-treated patients were ?protected? from subsequent change due to anemia. However, baseline anemia status was not consistently collected for all sites. We failed to identify consistent associations between gender or age and risk of antiretroviral change, although other studies have found that younger age and female gender predict change[13] . After the first change, most patients remained on regimens within the same class. The outcome of second regimens was not assessed as it was beyond the scope of this study. Our study had several limitations. Adverse events or regimen failures were computed only if they prompted regimen change. Therefore, their frequency cannot be used to estimate their occurrence, but rather the frequency of events deemed significant enough to prompt a regimen change. Strategies for changing regimens varied throughout the region and have evolved over time. Therefore, differences between sites regarding rates of toxicities, for example, may reflect site differences in guidelines for changing regimens or availability of alternative regimens. In addition, these data were collected retrospectively, and differences between sites in reasons for change and adverse events may reflect varying levels of data capture. Results of pooled analyses should be treated with caution given the heterogeneity seen in our cohort We did not consider treatment modifications or interruptions shorter than 30 days because registration of such events varied across sites and shorter discontinuations were less likely to have been recorded. We recognize the potential impact of minor interruptions on treatment outcomes, particularly using NNRTI-based regimens; such interruptions occur frequently in real life but generally have not been considered in other cohort studies[14], [41] . Although we controlled for key variables such as CD4 count and clinical stage, patients were not randomly assigned to their initial regimens, so rates of change may be higher for certain regimens due to baseline characteristics rather than the regimen itself. However, most of the associations observed in this study are similar to those reported elsewhere [10], [12] ?[16], [35], [39] . In conclusion, the high rate of change due to adverse events is consistent with studies from other cohorts. Heterogeneity between sites may be explained by differences in baseline characteristics at HAART initiation, programmatic differences, demographics and population genetics. Unfortunately, with only 7-sites, we are unable to perform analyses to investigate the impact of site-specific factors on regimen change. Efavirenz-based regimens were widely used and showed a lower rate of discontinuation compared to nevirapine or PI-based treatments. Supporting Information Top *Table S1. * Adjusted Hazard Ratios (95% Confidence Intervals) for Regimen Change in First Year by most Common Regimens. (0.04 MB DOC) *Table S2. * Adjusted Hazard Ratios (95% Confidence Intervals) for Regimen Change/Discontinuation in First Year counting Death as a Discontinuation. (0.06 MB DOC) *Table S3. * Adjusted Hazard Ratios (95% Confidence Intervals) for Regimen Change/Discontinuation in First Year, counting Death and Loss to Follow-up as Discontinuations. (0.06 MB DOC) *Table S4. * Adjusted Hazard Ratios (95% Confidence Intervals) for Regimen Change/Discontinuation in the First Year including available Predictors for each Site. 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Study Group. Italian Cohort of Antiretroviral-Naive Patients. Aids 14: 499?507. Find this article online 11. Dorrucci M, Pezzotti P, Grisorio B, Minardi C, Muro MS, et al. (2001) Time to discontinuation of the first highly active antiretroviral therapy regimen: a comparison between protease inhibitor- and non-nucleoside reverse transcriptase inhibitor-containing regimens. Aids 15: 1733?1736. Find this article online 12. Kumarasamy N, Vallabhaneni S, Cecelia AJ, Yepthomi T, Balakrishnan P, et al. (2006) Reasons for modification of generic highly active antiretroviral therapeutic regimens among patients in southern India. J Acquir Immune Defic Syndr 41: 53?58. Find this article online 13. Mocroft A, Youle M, Moore A, Sabin CA, Madge S, et al. (2001) Reasons for modification and discontinuation of antiretrovirals: results from a single treatment centre. Aids 15: 185?194. Find this article online 14. O'Brien ME, Clark RA, Besch CL, Myers L, Kissinger P (2003) Patterns and correlates of discontinuation of the initial HAART regimen in an urban outpatient cohort. J Acquir Immune Defic Syndr 34: 407?414. Find this article online 15. Elzi L, Marzolini C, Furrer H, Ledergerber B, Cavassini M, et al. (2010) Treatment modification in human immunodeficiency virus-infected individuals starting combination antiretroviral therapy between 2005 and 2008. Arch Intern Med 170: 57?65. Find this article online 16. Boulle A, Orrel C, Kaplan R, Van Cutsem G, McNally M, et al. (2007) Substitutions due to antiretroviral toxicity or contraindication in the first 3 years of antiretroviral therapy in a large South African cohort. Antivir Ther 12: 753?760. Find this article online 17. Medeiros R, Diaz RS, Filho AC (2002) Estimating the length of the first antiretroviral therapy regiment durability in Sao Paulo, Brazil. Braz J Infect Dis 6: 298?304. Find this article online 18. Padua CA, Cesar CC, Bonolo PF, Acurcio FA, Guimaraes MD (2006) High incidence of adverse reactions to initial antiretroviral therapy in Brazil. Braz J Med Biol Res 39: 495?505. Find this article online 19. Padua CA, Cesar CC, Bonolo PF, Acurcio FA, Guimaraes MD (2007) Self-reported adverse reactions among patients initiating antiretroviral therapy in Brazil. Braz J Infect Dis 11: 20?26. Find this article online 20. Severe P, Leger P, Charles M, Noel F, Bonhomme G, et al. (2005) Antiretroviral therapy in a thousand patients with AIDS in Haiti. N Engl J Med 353: 2325?2334. Find this article online 21. Echevarria Zarate J, Lopez de Castilla Koster D, Iglesias Quilca D, Seas Ramos C, Gonz?lez Lagos E, et al. (2007) Efecto de la terapia antiretroviral de gran actividad (TARGA) en pacientes enrolados en un Hospital P?blico en Lima-Per?. Rev Med Hered [online] 18: 184?191. Find this article online 22. Astuvilca J, Arce-Villavicencio Y, Sotelo R, Quispe J, Guillen R, et al. (2007) Incidencia y factores asociados con las reacciones adversas del tratamiento antirretroviral inicial en pacientes con VIH. Rev per? med exp salud publica [online] 24: 218?224. Find this article online 23. Soria EA, Cadile II, Allende LR, Kremer LE (2008) Pharmacoepidemiological approach to the predisposing factors for highly active antiretroviral therapy failure in an HIV-positive cohort from Cordoba City (Argentina) 1995?2005. Int J STD AIDS 19: 335?338. Find this article online 24. McGowan CC, Cahn P, Gotuzzo E, Padgett D, Pape JW, et al. (2007) Cohort Profile: Caribbean, Central and South America Network for HIV research (CCASAnet) collaboration within the International Epidemiologic Databases to Evaluate AIDS (IeDEA) programme. Int J Epidemiol 36: 969?976. Find this article online 25. Comit? T?cnico Asesor de la Direcci?n de Sida y ETS del Ministerio de Salud de la Naci?n Argentina (2007) Recomendaciones para el tratamiento antirretroviral. Available: http://www.msal.gov.ar/sida/pdf/recomend aciones-tratamiento-antirretroviral.pdf . Accessed 2009, Sep 18. 26. Sociedad Argentina de Infectologia (2007) Recomendaciones para el seguimiento y tratamiento de la infeccion por HIV. Available: http://www.sadi.org.ar/files/HIV2007.pdf. Accessed 2009, Sep 18. 27. Minist?rio da Sa?deSecretaria de Vigil?ncia em Sa?dePrograma Nacional de DST e AIDS. (2008) Recomenda??es para Terapia Anti?retroviral em Adultos Infectados pelo HIV 2008. Available: http://www.aids.gov.br/data/documents/st oredDocuments/%7BB8EF5DAF-23AE-4891-AD36 -1903553A3174%7D/%7B762E0EBF-A859-4779-8 A92-704EB1F3B290%7D/consensoAdulto005c_2?008montado.pdf . Accessed 2009, Sep 18. 28. Ministerio de SaludSantiago: Minsal. Available: http://www.redsalud.gov.cl/archivos/guia?sges/vihsidaR_Mayo10.pdf . Accessed 2009, Sep 18. 29. Gu?a de manejo antirretroviral de las personas con VIH Cuarta Edicion. M?xico 2008. Available: http://www.censida.salud.gob.mx/interior?/atencion.html . Accessed 2009, Sep 18. 30. WHO (2006) Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach. ? 2006 rev. Available: http://www.who.int/entity/hiv/pub/guidel ines/artadultguidelines.pdf . Accessed 2009, Sep 18. 31. Shafer JL (1997) Analysis of Incomplete Multivariate Data. London: Chapman & Hall. 32. Harrell FEJ (2001) Regression Modeling Strategies With Applications to Linear Models, Logistic Regression, and Survival Analysis. New York: Springer. 33. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7: 177?188. Find this article online 34. Smith-Warner SA, Spiegelman D, Ritz J, Albanes D, Beeson WL, Bernstein L, et al. (2006) Methods for pooling results of epidemiologic studies: the Pooling Project of Prospective Studies of Diet and Cancer. Am J Epidemiol 163: 1053?1064. Find this article online 35. Hart E, Curtis H, Wilkins E, Johnson M (2007) National review of first treatment change after starting highly active antiretroviral therapy in antiretroviral-naive patients. HIV Med 8: 186?191. Find this article online 36. Park-Wyllie LY, Scalera A, Tseng A, Rourke S (2002) High rate of discontinuations of highly active antiretroviral therapy as a result of antiretroviral intolerance in clinical practice: missed opportunities for adherence support? Aids 16: 1084?1086. Find this article online 37. Mazhude C, Jones S, Murad S, Taylor C, Easterbrook P (2002) Female sex but not ethnicity is a strong predictor of non-nucleoside reverse transcriptase inhibitor-induced rash. Aids 16: 1566?1568. Find this article online 38. Tedaldi EM, Absalon J, Thomas AJ, Shlay JC, van den Berg-Wolf M(2008) Ethnicity, race, and gender. Differences in serious adverse events among participants in an antiretroviral initiation trial: results of CPCRA 058 (FIRST Study). J Acquir Immune Defic Syndr 47: 441?448. Find this article online 39. Subbaraman R, Chaguturu SK, Mayer KH, Flanigan TP, Kumarasamy N(2007) Adverse effects of highly active antiretroviral therapy in developing countries. Clin Infect Dis 45(8): 1093?101. Find this article online 40. Vo TT, Ledergerber B, Keiser O, Hirschel B, Furrer H, et al. (2007) Durability and outcome of initial antiretroviral treatments received during 2000?2005 by patients in the Swiss HIV Cohort Study. J Infect Dis 2008 197: 1685?1694. Find this article online 41. Kiguba R, Byakika-Tusiime J, Karamagi C, Ssali F, Mugyenyi P, et al. (2007) Discontinuation and modification of highly active antiretroviral therapy in HIV-infected Ugandans: prevalence and associated factors. J Acquir Immune Defic Syndr 45: 218?223. Find this article online Add a note to this text. Please follow our guidelines for notes and commentsand review our competing interests policy. Comments that do not conform to our guidelines will be promptly removed and the user accoun _______________________________________________ health-vn Health in Viet Nam and the Region Post message to list: health-vn at anu.edu.au List information page: http://mailman.anu.edu.au/mailman/listinfo/health-vn health-vn List from the Australia Vietnam Science-Technology Link contact: Vern Weitzel vern at coombs.anu.edu.au The accuracy of information from media articles posted on this list cannot be guaranteed and should be verified before use. -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/1c8dcbc9/attachment-0010.html From hivtwg.moderator at gmail.com Mon Jul 12 03:38:38 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:38:38 +0700 Subject: [hivaids-twg] CALL FOR ABSTRACTS: ALCOHOL AND HIV CONFERENCE, 2010, NEW DELHI In-Reply-To: References: Message-ID: From: vern weitzel Date: Sun, Jul 11, 2010 at 4:33 AM Subject: [health-vn] Fwd: CALL FOR ABSTRACTS: ALCOHOL AND HIV CONFERENCE, 2010, NEW DELHI To: "[health-vn discussion group]" *From: *"Conference Organizers" *Date: *18 June 2010 4:42:40 AM PDT *To: * *Subject: **CALL FOR ABSTRACTS: ALCOHOL AND HIV CONFERENCE, 2010, NEW DELHI* *Call for Abstract Submissions **For The Second International Conference On Alcohol And HIV:* *Insights from Intervention ?* *Deadline **30th June 2010.* The International Center for Research on Women, Institute for Community Research, Public Health Foundation of India and National Institute on Alcohol Abuse and Alcoholism are pleased to announce *T**he* *Second International Conference on Alcohol and HIV:* *Insights from Interventions* *When:*September 28 ? 30, 2010 *Where:* New Delhi, India *Abstract submission is now open and can be completed online.* The conference will highlight evaluated prevention programs, intervention research and national policies that address the links between alcohol and HIV, and that are focused on risk reduction. A special emphasis of this year?s conference is the role of gender norms that can elevate HIV-related risks for both women and men especially in the presence of alcohol Abstract submission must be completed online at http://www.alcoholhivconference2010.org/. For any further questions regarding the conference or submission please email conferenceorganizers at icrw.org or call ICRW at 91 11 4664 3333 -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/d774acae/attachment-0010.html From hivtwg.moderator at gmail.com Mon Jul 12 03:39:18 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:39:18 +0700 Subject: [hivaids-twg] 25th IUSTI European Conference on STD, HIV/AIDS 23-25 September 2010 Tbilisi, Georgia In-Reply-To: <533ECDFA-9CE0-479E-A55E-44B57A9AF920@gmail.com> References: <533ECDFA-9CE0-479E-A55E-44B57A9AF920@gmail.com> Message-ID: From: vern weitzel Date: Sun, Jul 11, 2010 at 4:12 AM Subject: [health-vn] Fwd: 25th IUSTI European Conference on STD, HIV/AIDS 23-25 September 2010 Tbilisi, Georgia To: "[health-vn discussion group]" *From: *tmsstd at anet.net.th *Date: *18 June 2010 10:56:18 PM PDT *To: *undisclosed-recipients:; *Subject: **25th IUSTI European Conference on STD, HIV/AIDS 23-25 September 2010 Tbilisi, Georgia* Dear Colleague, On behalf of Executive Committee of IUSTI (International Union Against Sexually Transmitted Infection) I am very please to invite you to join the 25th IUSTI Europe Conference on STIs & HIV/AIDS which will be held on September 23-25, 2010 in Tbilisi, Georgia The main scientific programme topics are: - STI public health interventions of the 21st Century - Biological driver of HIV - New diagnostics and rapid tests - Sexual health associate such as sexuality education, sexually risk Behavior, sexual health need for minority populations, condom promotion - Vaccines for HPV and HIV - Challenges to effective syndromic management - Selected STI updates - Male circumcision - Prevention of mother-child HIV transmission - ARV treatment and monitoring - Microbicides - Sexual health and infections - Sex worker and trafficking - Basic Science - Epidemiology of STI - STI Prevention Policy - STI in gynecology and urology In this Congress you will gain more update knowledge and share your experiences with a lot of scientists who have come to join. For more information please visit our website www.iusti2010-tbilisi.ge Or through Email secretariat at iusti2010-tbilisi.ge I am looking forward to see you at the conference. Yours sincerely, Chavalit Mangkalaviraj M.D.,M.P.H. IUSTI Executive Committee Senior Consultant in Preventive Medicine Bangrak Hospital Department of Disease Prevention and Control Ministry of Public Health 9 (formerly 189) Sathorn Road Sathorn District Bangkok 10120 Thailand -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/830f9724/attachment-0010.html From hivtwg.moderator at gmail.com Mon Jul 12 03:42:23 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:42:23 +0700 Subject: [hivaids-twg] Social Determinants of Health: Prevention-control: HIV/AIDS, Viral Hepatitis, Sexually Transmitted Infections, Tuberculosis In-Reply-To: <0A0D6D5A-F077-404F-8691-1CD387858D77@gmail.com> References: <28939CE16D9179459E89EF2C4E8E405015D131@hq-exch-is05.wdc.paho.org> <0A0D6D5A-F077-404F-8691-1CD387858D77@gmail.com> Message-ID: *From: *"Ruggiero, Mrs. Ana Lucia (WDC)" *Date: *17 June 2010 3:37:37 PM PDT *To: *EQUIDAD at LISTSERV.PAHO.ORG *Subject: **[EQ] Social Determinants of Health: Prevention-control: HIV/AIDS, Viral Hepatitis, Sexually Transmitted Infections, Tuberculosis* *Reply-To: *"Equity, Health & Human Development" *Addressing Social Determinants of Health in the Prevention and Control of HIV/AIDS, Viral Hepatitis, Sexually Transmitted Infections, and Tuberculosis * *Public Health Reports / 2010 Supplement 4 / Volume 125* Public Health Reports (PHR) is the official journal of the U.S. Public Health Service. Published by the Association of Schools of Public Health (ASPH). Available online at: http://bit.ly/clFnzM ????..A special supplement focusing on the *Social Determinants of Health*in the on-going battle to prevent and control HIV/AIDS, Viral Hepatitis, sexually transmitted infections, and Tuberculosis. This supplement covers the constant barriers society faces when fighting and attempting to rectify diseases that have plagued our society for centuries. >From economic to cultural to racial obstacles, Public Health Reports examines the ?*cause and effect*? relationships that continue to be the main hindrance to decreasing the spread of these diseases. This special supplement of Public Health Reports presents innovations, advances, and insights regarding the role of social determinants in the spread of HIV, viral hepatitis, sexually transmitted infections and tuberculosis. Research and commentary are presented on community and societal characteristics, such as the effects of incarceration and the differences in HIV transmission among foreign-born and native-born people; income and/or social status, including registered and non-registered female sex workers; stigma; and education; among other areas. The supplement includes an editorial by guest editors, Drs. Hazel Dean and Kevin Fenton of the US Centers for Disease Control and Prevention (CDC) and also includes commentary and a viewpoint penned by former CDC Directors and WHO Commission on Social Determinants of Health members Drs. David Satcher and William Foege???..? . *Content:* * Article Title * *G**uest Editorial: * *A**ddressing social determinants of health in the prevention and control of hiv/aids, viral hepatitis, sexually transmitted infections, and tuberculosis * *Kevin A. Fenton* / *Hazel D. Dean, ScD* / Hazel D. Dean, Deputy Director and Kevin A. Fenton, Director, of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention (CDC), in Atlanta, Georgia ???.This special issue of Public Health Reports (PHR) focuses on innovations and advances in incorporating a socialdeterminants- of-health (SDH) framework for addressing the interrelated epidemics of human immunodeficiency virus (HIV), viral hepatitis, sexually transmitted infections (STIs), and tuberculosis (TB) in the United States and globally. This focus is particularly timely given the evidence of increasing burden and worsening health disparities for these conditions, the evolution in our understanding of the social and structural influences on disease epidemiology, and the far-reaching implications of the global economic downturn. The global trends and adverse health impact of HIV, viral hepatitis, STIs, and TB remain among the major and urgent public health challenges of our time.1 These conditions account for substantial morbidity and mortality, with devastating fiscal and emotional costs to individuals, families, and societies. Despite decades of investment and support, the U.S. still experiences a disproportionate burden of these conditions compared with other Western industrialized nations, with substantial health disparities being observed across population subgroups and geographic regions.2 The reasons for these inequities are multifaceted and complex. It is true that individual-level determinants, including high-risk behaviors such as unsafe sexual and drug-injecting practices, are major drivers of disease transmission and acquisition risk. However, it is also clear that the patterns and distribution of these infectious diseases in the population are further influenced by a dynamic interplay among the prevalence of the infectious agent, the effectiveness of preventive and control interventions, and a range of social and structural environmental factors.3,4 Many of these conditions arise because of the circumstances in which people grow, live, work, socialize, and form relationships, and because of the systems put in place to deal with illness, all of which are, in turn, shaped by political, social, and economic forces??..? *Include a Social Determinants of Health Approach to Reduce Health Inequities* *David S. Satcher, MD, PhD* *Social Determinants of Health and Health-Care Solutions*[Feature Article] *William H. Foege, MD* *Summary of CDC Consultation to Address Social Determinants of Health for Prevention of Disparities in HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis* *Tanya Sharpe, PhD* / *Kathleen McDavid, PhD, MPH* / *Hazel D. Dean, ScD* *The Social Determinants of HIV Serostatus in Sub-Saharan Africa: An Inverse Relationship Between Poverty and HIV?* *Ashley Fox, PhD* *Prisons as Social Determinants of Hepatitis C Virus and Tuberculosis Infections* *Niyi Awofeso, MBChB* *Tuberculosis and Stigmatization: Pathways and Interventions* *Andrew Courtwright, MD* / *Abigail N. Turner, PhD* *Risk Factors for HIV Disease Progression in a Rural Southwest American Indian Population* *Jonathan Iralu, MD* / *Bonnie Duran, DrPH* / *Cynthia Pearson, PhD* / *Yizhou Jiang**, MS* / *Kevin Foley, PhD* / *Melvin Harrison, BA* / *Sexually Transmitted Diseases Among American Indians in Arizona: An Important Public Health Disparity* *Michelle Winscott, MD* *Epidemiologic Differences Between Native-Born and Foreign-Born Black People Diagnosed with HIV Infection in 33 U.S. States, 2001?2007* *Anna Satcher Johnson, MPH* / *Xiaohong Hu* / *Hazel D. Dean, ScD* *Associations of Sex Ratios and Male Incarceration Rates with Multiple Opposite-Sex Partners: Potential Social Determinants of HIV/STI Transmission * *Enrique R. Pouget, Phd* / *Trace S. Kershaw, PhD* / *Jeannette R. Ickovics, PhD* / *Kim M. Blankenship, PhD* *The Context of Economic Insecurity and Its Relation to Violence and Risk Factors for HIV Among Female Sex Workers in Andhra Pradesh, India* *Elizabeth Reed, MPH* / *Jhumka Gupta* / *Monica Biradavolu, PhD* / *Kim M. Blankenship, PhD* / *Vasavi Devireddy, BS* *Economically Motivated Relationships and Transactional Sex Among Unmarried African American and White Women: Results from a U.S. National Telephone Survey* *Kristin L. Dunkle, PhD* / *Gina M. Wingood, ScD* / *Christina Camp, PhD* / *Ralph DiClemente* *A Comparison of Registered and Unregistered Female Sex Workers in Tijuana, Mexico* *Nicole Sirotin, MD* / *Steffanie A. Strathdee, PhD* / *Remedios Lozada, MD*/ *Lucie Nguyen, MS* / *Manuel Gallardo, MD* / *Alicia Vera, MPH* / *Thomas L. Patterson, PhD* *Does Education Matter? Examining Racial Differences in the Association Between Education and STI Diagnosis Among Black and White Young Adult Females in the U.S.* *Lucy Annang, PhD* / *Katrina M. Walsemann, PhD* / *Debeshi Maitra, MHA* / *Jelani C. Kerr, PhD* * * * This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics; Information Technology - Virtual libraries; Research & Science issues. [DD/ KMC Area] ?Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings and interpretations included in the Materials are those of the authors and not necessarily of The Pan American Health Organization PAHO/WHO or its country members?. ------------------------------------------------------------------------------------ PAHO/WHO Website *Equity List - Archives - Join/remove*: http://listserv.paho.org/Archives/equidad.html *Twitter http://twitter.com/eqpaho * IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please dispose of and delete this transmission. Thank you. -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/a9c79151/attachment-0010.html From hivtwg.moderator at gmail.com Mon Jul 12 03:44:16 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:44:16 +0700 Subject: [hivaids-twg] Comment period ends soon for input on draft Business Case! In-Reply-To: <01b401cb2133$4c2912c0$e47b3840$@org> References: <01b401cb2133$4c2912c0$e47b3840$@org> Message-ID: From: Jack Beck Date: Mon, Jul 12, 2010 at 2:57 AM Subject: [msm-asia] Comment period ends soon for input on draft Business Case! To: Jack Beck *Comment period ends soon for input on draft Business Case!* 11 July 2010 Dear all, Thank you so much for your comments so far on the draft Business Case we blasted last week! If you have not yet commented, please do so now! This is an important opportunity to have your voice heard and ideas known. For more background on the Business Case (including links to the English, French and Spanish versions), read below! Thank you very much! The MSMGF *** The UNAIDS outcome framework 2009-2011 declares that one of UNAIDS? top priorities is the health and rights of men who have sex with men (MSM), sex workers, and transgender people, stating that people in these key populations can and should be empowered to protect themselves from HIV infection, achieve full health, and realise their human rights. To advance UNAIDS strategic thinking and implementation of this priority, an inter-agency ?Priority Area Working Group?, involving the UNAIDS Secretariat, UNDP, UNESCO, UNFPA, and WHO, has drafted a Business Case which articulates a proposed goal and three intended bold results for UNAIDS. The intention of this Business Case is to represent the agreed priority goal, bold results, and intended actions of all ten UNAIDS Cosponsors. Along with the UNAIDS Outcome Framework and the UNAIDS 2011-2015 strategic plan, this UNAIDS Business Case is being developed to: ? inform UNAIDS? programmatic objectives, ? guide future UNAIDS investments and action, ? identify country-level and population-level indicators to which the UNAIDS Secretariat and the Cosponsors should be accountable, and ? affirm the ways in which the UNAIDS Secretariat and ten Cosponsors leverage their respective organizational mandates and resources to work collectively to deliver results. You can find the draft Business Case below: - In English, here: http://www.msmgf.org/documents/OPP_INT_bizcaseEN.pdf - En fran?ais, ici: http://www.msmgf.org/documents/OPP_INT_bizcaseFR.pdf - En espa?ol, aqu?: http://www.msmgf.org/documents/OPP_INT_bizcaseES.pdf Please take a few minutes to provide comments and feedback on this new draft Business Case. Any input you have should be sent in an email to input at msmgf.org by 31 July 2010. Please circulate this call among your contacts and networks! *Jack Beck *|* *Communications Associate *The Global Forum on MSM & HIV (MSMGF) *436 14th Street, Suite 1500 Oakland, CA 94612 P: 510.271.1956 E: jbeck at msmgf.org www.msmgf.org -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/6870cb08/attachment-0010.html From hivtwg.moderator at gmail.com Mon Jul 12 03:45:41 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:45:41 +0700 Subject: [hivaids-twg] Skills-Building Announcement: E-Health and Social Media for Clinical HIV Management In-Reply-To: <659420.51516.qm@web37302.mail.mud.yahoo.com> References: <659420.51516.qm@web37302.mail.mud.yahoo.com> Message-ID: From: Ishdeep Kohli Date: Thu, Jul 8, 2010 at 11:55 PM Subject: [AIDS ASIA] Skills-Building Announcement: E-Health and Social Media for Clinical HIV Management To: AIDS_ASIA Announcement: Professional Development Workshop - Distance Based Learning Technologies E-Health and Social Media for Clinical HIV Management Swasthya India, Jodhpur School of Public Health, HIV Atlas and I-TECH India, announce the Professional Development Workshop, ?Distance Based Learning Technologies E-Health and Social Media for Clinical HIV Management? at the XVIII International AIDS Conference, to be held in Vienna, Austria, 18-23 July 2010. Session date: July 19, 2010 Session time: 14:30-18:00 The advent of Information and Communication Technology is seen as a vital factor in enhancing development and healthcare efforts. Countries with high incidence of HIV are benefiting from the Internet, E-Networking and Social Media to improve the efficiency of information exchange. Addressing need for cutting-edge information about HIV/AIDS in resource-limited settings the HIV/AIDS Clinical Seminar Series presentation will increase knowledge and skills of health care workers related to care, treatment, diagnosis, and comprehensive management of HIV/AIDS patients. Effective clinical training is often limited by the non-availability of appropriate cases and the challenges associated with bed side case discussions. OI videos will assist clinicians in correctly diagnosing opportunistic infections associated with HIV and build capacity of health care workers. E-Health challenges and opportunities for HIV Physicians will be presented and how Social Media can be harnessed effectively by HIV physicians. Participants will understand to utilize web-based Voice-over-Internet-Protocol (VoIP) technology to provide interactive, case-based instructional sessions on the clinical management of HIV/AIDS. The Adobe CPL platform will be explained that allows participants to see a PowerPoint presentation and hear the lecture in real time and demonstrations provide on how global HIV/AIDS experts present a variety of topics like advanced care, comprehensive management, and treatment via synchronous live sessions. An understanding of online communities and their impact on HIV clinical management and Social Media as a tool for HIV physicians will be provided. Adaptation of ICT in HIV patient care has been relatively slow and many physicians are not ready to use this opportunity. E-health provides opportunities and challenges. This session will present a detailed analysis of both. Target Audience: Physicians, Nurses, Community Health Workers, Pharmacists, Psychologists, Counselors, Social workers, Traditional or Complementary Therapy Practitioners, Lab Technicians, Trainers, Clinical Mentors, Academicians and others working in Clinical Science, Prevention Science, Epidemiology. Participants wishing to attend can confirm their participation to Ishdeep Kohli at ishdeepkohli at hotmail.com Ishdeep Kohli Director Programs and Partnerships Swasthya India Mumbai , India e-mail:> __._,_.___ -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/f91a2d4a/attachment-0010.html From hivtwg.moderator at gmail.com Mon Jul 12 03:46:31 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:46:31 +0700 Subject: [hivaids-twg] Fwd: Today's News (2010.07.09ex)-HCM City receives US$6.8 mln foreign aid Message-ID: From: Diaz, Clara Date: Fri, Jul 9, 2010 at 6:07 PM Subject: Today's News (2010.07.09ex) To: Please find attached the following AIDS-related articles compiled by UNAIDS *UNAIDS* 1. Voice of America News - *Namibia** Lifts HIV Travel Ban* 2. Botswana Gazette - *Prof Tlou appointed UNAIDS Regional Support Team Director* 3. UN News Service -* **UN lauds Namibia?s lifting of travel ban for people living with HIV/AIDS* 4. Eurasia Review - *AIDS On The Rise In Middle East, North Africa* 5. New Kerala, India - *Namibia** lifts travel ban for HIV/AIDS people * *AFRICA** AND MIDDLE EAST* 1. New Vision, Uganda - *HIV Bill should accomodate all voices * 2. The Citizen, Tanzania - *Why blame a certain gender for a disease * 3. Cameroon Tribune - *VIH - Renforcer la protection pour les enfants * 4. Le Matin, Morocco - *Le Maroc engag? ? renforcer son action * *ASIA** AND PACIFIC* 1. The Hindu, India - *Powerful HIV antibodies found for vaccine * 2. VOV News, Viet Nam - *HCM** City** receives US$6.8 mln foreign aid * *EUROPE*** 1. International Herald Tribune - *Where is the H.I.V. vaccine? (Op-Ed) * 2. Reuters - *Antibody finding could lead to AIDS vaccine* 3. Reuters - *World Bank names Zimbabwean to head AIDS program* 4. The Lancet, UK - *Innovation and education improve health in Rio's favelas* *LATIN AMERICA AND CARIBBEAN* 1. La Naci?n, Argentina - *Nuevo avance en la vacuna contra el sida * 2. Ag?ncia de Not?cias da Aids, Brazil - *Governo distribui novo medicamento contra a aids para crian?as * *NORTH AMERICA* 1. New York Times - *U.S.** to Provide $25 Million to Help Buy AIDS Drugs* 2. IPS Terra Viva - *Making 2010 a Turning Point for Women's Health * 3. TMCNet - *Major Technology Providers to Sponsor 2010 mHealth Summit Conference* 4. IPS Terra Viva - *HIV Vaccine Advances Made Ahead of Global Conference * 5. UN Dispatch - *An Argument Against the Obama Global Health Initiative * 6. Wall Street Journal - *Advance in Quest for HIV Vaccine * *UNAIDS WEB.SITE* 1. UNAIDS - UNICEF and partners help make the World Cup a win for children =========================== *UNAIDS* =========================== *Namibia Lifts HIV Travel Ban** **Voice of America News* 08/07/2010 Joe DeCapua Namibia has lifted its long-standing travel ban for people living with HIV. Namibian officials say even though there?s no record of enforcement of the ban, it did not reflect Namibia?s commitment to democracy and human rights. UNAIDS praises the decision, saying the country is now in line with international public health standards. ?The fact that visitors coming to Namibia have to fill in a visa form where they are asked whether they suffer from a contagious disease, including HIV and AIDS, which is legally done as a basis to refuse them entry into the country, is a difficult issue to face,? says Henk Van Renterghem, UNAIDS country coordinator for Namibia. What?s more, he adds, ?It?s discrimination against people suffering from a disease.? The right thing to do Van Renterghem says besides being ?the right thing to do? in bolstering human rights, lifting the ban supports the country?s public health policy. ?There is no evidence whatsoever that limiting mobility or travel of people living with HIV has any effect on the epidemic. And in this sense, people who live with the disease?get the wrong impression they should be somehow contained in their mobility and in their rights to move around freely,? he says. The United States and China recently lifted their long-standing HIV travel restrictions. But UNAIDS reports there are ?51 countries, territories and areas that continue to impose some form of restriction on the entry, stay and residence of people living with HIV based on their HIV status.? It goes on to say that five countries deny visas for even short-term stays, while 22 countries ?deport individuals once their HIV status is discovered.? Relic of the past? ?Most of these regulations and laws were put in place in the early days of the epidemic,? says Van Renterghem. ?It gives a very wrong impression of how we treat people living with HIV. We know that stigma and discrimination against people living with HIV?reduce to a large extent?the capacity to access services.? He says lifting such bans sends a message to HIV-positive people that ?we care about you. You?re equal to all other citizens and we everything to put in place a framework that allows us to provide the best possible services.? UNAIDS Executive Director Michel Sidibe has designated 2010 the year of lifting of HIV travel restrictions. ?That?s why it?s important that countries (such) as the U.S., China and Namibia actually effectively lift these regulations,? Van Renterghem says. Rights here, right now The 18th International AIDS Conference, AIDS 2010, will be held in Vienna from July 18th through the 23rd. The theme of the conference is Rights Here, Right Now. Van Renterghem says a number of news conferences and sessions are planned on the travel ban issue. UNAIDS says, ?There is no evidence that such restrictions prevent HIV transmission or protect public health. Furthermore, HIV-related travel restrictions have no economic justification, as people living with HIV can lead long and productive working lives.? *2** * *Prof Tlou appointed UNAIDS Regional Support Team Director** **Botswana Gazette*** 08/07/2010 The Joint UN Programme on HIV/AIDS (UNAIDS) has announced the appointment of Professor Dinotshe Shiela Tlou as the new Regional Support Team Director for East and Southern Africa. She will take over the role from the Acting Director, Dr. Mbulawa Mugabe, in September 2010. Shiela Tlou, a Botswana National, is currently a Professor of Nursing at the University of Botswana.Prior to that she was the Minister of Health for the Government of Botswana from 2004 to 2009, where she spearheaded the countries highly effective AIDS programme.She was a Professor of Nursing at the University of Botswana from 1999 to 2004. Sheila has held the positions of Director, WHO Collaborating Centers and Professor with the University of Botswana, Gaborone, Botswana, from 1994 to 1999. Prof. Tlou has a Doctorate of Nursing Science, majoring in Public Health Nursing and Research. She has a Master of Education, majoring in Curriculum and Instruction in the Health Sciences, from Columbia University as well as a Master of Science, majoring in Public Health Nursing and Psychology, from The Catholic University of America, Washington D.C. Sheila is a strong and committed advocate for an effective AIDS response and has demonstrated superb leadership throughout the region over many years. Upon accepting the offer of appointment, Professor Tlou noted, ?I am delighted and honored to accept the role of UNAIDS Regional Director for Eastern and Southern Africa, an organization that leads global advocacy on HIV and AIDS. I look forward to bringing my combined background of research, teaching, policy and management to the School, and to working with staff to improve HIV and AIDS responses in the region." The UNAIDS Executive Director, Mr. Michel Sidibe, comments that he is confident that she will provide excellent leadership within UNAIDS team and within the region as we continue to build and strengthen the AIDS response with countries. *4* *UN lauds Namibia?s lifting of travel ban for people living with HIV/AIDS** **UN News Service* 08/07/2010 8 July 2010 ? The Joint United Nations Programme on HIV/AIDS (UNAIDS) today welcomed Namibia?s decision to remove travel restrictions for people living with the virus, a move that aligns the country?s laws with international public health standards. The new legislation lifting restrictions for people living with HIV/AIDS and other contagious diseases took effect in Namibia on 1 July. Restrictions that limit movement based on HIV-positive status only are discriminatory and violate human rights, according to UNAIDS. There is no evidence that such restrictions prevent HIV transmission or protect public health, the agency said, adding that HIV-related travel restrictions have no economic justification, as people living with HIV can lead long and productive working lives. ?I am heartened by this announcement in Namibia,? said Michel Sidib?, UNAIDS Executive Director. ?HIV-related travel restrictions serve no purpose and hamper the global AIDS response,? he added. UNAIDS advocates for an individual?s right to freedom of movement, regardless of HIV status. There are now 51 countries, territories, and areas that continue to impose some form of restriction on the entry, stay and residence of people living with HIV based on their HIV status. Five countries deny visas even for short-term stays, while 22 countries deport individuals once their HIV-positive status is discovered. The United States and China removed long-standing HIV-related travel restrictions earlier this year. Several other countries, including Ukraine, have pledged to take steps to remove such restrictions. *5* *AIDS On The Rise In Middle East, North Africa** **Eurasia Review* 09/07/2010 By Cecily Hilleary For years, the lack of reliable data on HIV/AIDS in the Middle East and North Africa led regional governments to believe they had somehow managed to escape the epidemic. But a new United Nations report shows that numbers are on the rise: more than 400,000 people are currently living with HIV across the Middle East and North Africa region, or MENA. Of those, 68,000 need anti-retroviral treatment, but only 14 percent are actually getting it. The rest may not even know they are infected. Hind Khatib is a regional director of the U.N. Joint Programme on HIV/AIDS or UNAIDS. She has just returned from a two-day conference in Dubai, where regional leaders gathered to discuss the issue. Khatib:It's still low prevalence, but you know we've just put out the synthesis report, which was an epidemiological study of HIV and its evolution in the region, and the report says that probably, at least for the near future, we'll never have an epidemic of HIV in the region. But still, there is evidence that HIV is growing among key populations. The key populations as defined by the study are the people who are mainly drug injectors, men who have sex with men, and sex workers. So we thought that it's timely, especially that this year, there was a great effort by UNAIDS invested in the region to ensure that all the countries will actually report and live up to their commitments made to the 2001 Declaration in the U.N. General Assembly Special Session on HIV. The national reports clearly, from 20 countries out of the 21 countries in the region, Iraq was the only country that could not report, for understandable reasons - all 20 countries have shown that they have weak programs, weak surveillance, and that the coverage is very, very poor. So yes, while we have national AIDS programs, while countries are attempting to draw up their national strategies, coverage, in terms of treatment, voluntary counseling and testing and even prevention, is very, very poor. So we thought this was the time to actually convene policy makers together with civil society with small communities of people living with HIV, to get together under one roof and start talking [about] what's next. Hilleary:What's the biggest obstacle to people getting tested and treated for HIV/AIDS in the MENA region? Khatib:It's stigma. Stigma and discrimination. People are afraid. I mean, I think that knowing how HIV basically gets transmitted is something that people are afraid, that people know that they have had extra-marital sex-the whole concept of men who have sex with other men--it's a big taboo, and the region does not want to admit that we have these groups. They don't want to admit to a lot of extra-marital activities. So I think it's very much cultural and related also to religion and Islam, and people, you know, like to believe that we don't have such conducts here. But I think slowly, slowly, people here are that HIV is very much home-grown. Up until now, it has been the perception, 'Oh, we got it from outside.' I think that with a lot of advocacy and, as you know now there is a good amount of popular faces, popular stars that also engage in HIV, whether it's through UNICEF, and recently UNAIDS has appointed its first regional Goodwill Ambassador [Egyptian actor Amr Waked was recently named the first UNAIDS Goodwill Ambassador for the Middle East and North Africa region by the Joint United Nations Program on HIV/AIDS], and we are very happy that he's coming out loud, speaking about stigma and discrimination, speaking about the rights of our key populations, speaking about the time to act, speaking about the right policies, targeted action. But I think there is a lot the region still needs to do to reduce fear. Hilleary:What does the U.N. plan to do with the data it has gathered now? Khatib:First, I think we are working with countries on improving the national strategies. So it's much more targeted and it doesn't address HIV as if it's a generalized epidemic. What's next is actually to have concerted efforts to bring up awareness, because if you don't bring awareness to all different targeted groups, including the health workers. Even if you do confidential testing, you will need the people who run those services to bring awareness and educate people. It's just educating. *6* *Namibia lifts travel ban for HIV/AIDS people ** **New Kerala, India* 08/07/2010 New York, Jul 8 : The Joint United Nations Programme on HIV/AIDS (UNAIDS) on Thursday welcomed Namibia's decision to remove travel restrictions for people living with the virus, a move that aligns the country's laws with international public health standards. The new legislation lifting restrictions for people living with HIV/AIDS and other contagious diseases took effect in Namibia on 1 July. Restrictions that limit movement based on HIV-positive status only are discriminatory and violate human rights, according to UNAIDS. There is no evidence that such restrictions prevent HIV transmission or protect public health, the agency said, adding that HIV-related travel restrictions have no economic justification, as people living with HIV can lead long and productive working lives. "I am heartened by this announcement in Namibia," said Michel Sidibe, UNAIDS Executive Director. "HIV-related travel restrictions serve no purpose and hamper the global AIDS response," he added. UNAIDS advocates for an individual's right to freedom of movement, regardless of HIV status. There are now 51 countries, territories, and areas that continue to impose some form of restriction on the entry, stay and residence of people living with HIV based on their HIV status. Five countries deny visas even for short-term stays, while 22 countries deport individuals once their HIV-positive status is discovered. The United States and China removed long-standing HIV-related travel restrictions earlier this year. Several other countries, including Ukraine, have pledged to take steps to remove such restrictions. =========================== *AFRICA** AND MIDDLE EAST* =========================== *HIV Bill should accomodate all voices ** **New Vision, Uganda* 08/07/2010 On Tuesday, May 18, the HIV Prevention and Control Bill was tabled in Parliament for the first reading. This is a milestone in Uganda?s efforts to manage the HIV epidemic as it portrays the Government?s commitment in the fight against HIV/AIDS. However, in its current form, the Bill undermines the public health of Ugandans as it does not depict a comprehensive approach towards the HIV problem. The Bill promotes mandatory disclosure of the HIV status, it promotes mandatory testing for HIV and it criminalises intentional transmission of HIV/AIDS. If the Bill is to achieve a holistic response to HIV/AIDS in Uganda, its intentions would not only be limited to preventing and controlling the spread of the epidemic, but also to promote and protect the rights of people living with HIV (PHAs). The Government is obliged to respect, promote and protect the rights of all its citizens without discrimination, but the Bill does not address this. This undermines the HIV/AIDS prevention efforts. People will choose not to know their HIV status, as they will feel legally safer not to test. Otherwise, they would be proved guilty hence ?ignorance of the status becomes a defence?. An appropriate intervention would be looking at reducing barriers to voluntary testing and increasing the use of the service. The Bill also makes a woman more vulnerable to abuse yet they are already marginalised. Mothers will choose not to access antenatal services and for those who will be conditioned to test, they will keep silent about their HIV-positive status, and not access mother-to-child preventive services. In the end, they will infect their newly born babies because if they dare to disclose their HIV status, they will be hacked. Consequently, it is like shooting ourselves in the foot because we will witness an increase in the number of people living with HIV/AIDS, child and maternal mortality and morbidity. Parliament should, therefore, function objectively, not on emotions and listen to other voices, especially the civil society. This group has expressed their views about the Bill in its current form. Mandatory testing, involuntary disclosure and criminalisation ought to be removed from the HIV Bill if we have to observe public health. *The writer is a Makerere University School of Public Health-CDC HIV/AIDS fellow* *2* *Why blame a certain gender for a disease ** **The Citizen, Tanzania* 09/07/2010 By Fatima Hussenali Just over a week ago, I boarded a taxi to town, the driver happened to be a young man in his twenties. Although I listen to similar conversations often this one left me spellbound, I learnt a few things which just confirmed how ignorant our people are, regarding HIV/ Aids. The young man was telling one of the passengers in the car how difficult it is to find a 'decent' young woman these days. Being a young woman myself, I felt offended but decided not to say anything just to allow the conversation reach its logical conclusion. The 'dude' preached on how in the 'good old days', women took pride in who they were and how one would not find decent women in bars or nightclubs. "Were there shanty bars in the good old days," I asked myself or at least that's what my grandmother told me. But I continued to listen to the young man rant as he spoke of how he would not want to get involved with just any woman these days especially the ones who hang out at clubs. According to him, clubs are places where women go to hunt for men who will meet their needs even if the relationship is guaranteed to last only 24 hours or less and as a result HIV is most likely to be transmitted. "Even the innocent girls we grew up with cannot be trusted," the taxi driver rumbled on. Reacting the negative words he spoke about women and how they encourage the spread of HIV, I concluded that the brother had no respect for women. But what can I say. Everyone is entitled to their opinion. I wasn't brave enough to share my opinion with the taxi driver that day even when I felt I was clearly offended by such ill informed idle talk. Regarding by this brothers conversation a bar or a club is an evil place which makes me think that even men should not hang out there. This is not meant to attack anyone but just to point out some of the misleading issues. Often times we find men (even married ones) promising the moon and the stars to young girls, who in many cases are school dropouts in clubs and other places, while their children and wives do not even have anything to eat at home. And then you find the same men who are just never satisfied with one partner, apparently diversity is good... and the cases are endless. The issue at hand is, an epidemic such as HIV cannot be blamed on an individual or a particular gender. Time should rather be spent looking for solutions that will help everybody, for example, what can be done about young women spending their times at nightclubs with sugar daddies. How best can the HIVmessages be transmitted? Is the current education/information regarding HIV really efficient and transmitted in the right channels? Can we successfully fight the HIV pandemic? I'd say yes we can but only if each individual takes their position in this fight. And as the saying goes, It begins with you, and therefore, let?s be the change we want to see. People have to be willing to change and they have to realise that HIV/Aids is real and most of all people will have to let go of the stigma that is often caused by ignorance. People have to love themselves and their fellow humans enough not to engage in reckless behaviour. It is certain that if you are not infected with HIV you are affected. *You can reach the writer of this article on: husenalif at gmail.com * *3* *VIH - Renforcer la protection pour les enfants** **Cameroon Tribune* 07/07/2010 Eric Elouga Un atelier organis? depuis lundi par le Circb pour am?liorer la pr?vention et la recherche m?dicale Le probl?me de la mortalit? m?re-enfant en Afrique ?tait il y a quelques semaines encore, sur la table du G8 qui a tir? la sonnette d'alarme, devant le constat de pi?tinement enregistr? dans la r?alisation de cet objectif du Mill?naire pour le D?veloppement. Il n'en fallait pas plus pour que le Centre international de r?f?rence Chantal Biya pour la recherche, mette un accent particulier sur les questions de transmission ? l'enfant, dans son programme de pr?vention et de lutte contre le Vih sida. Depuis hier ? Yaound? se tient, en effet, un atelier international sur le th?me de la recherche clinique sur les enfants infect?s par le vih. Objectif de ces travaux, faire le point sur la situation g?n?rale du continent en mati?re de prise en charge clinique des patients infect?s, avec un focus particulier sur les cas des enfants. C'est ainsi qu'autour de la table, les ?minents scientifiques et chercheurs associ?s au Circb vont ainsi plancher jusqu'? demain, sur les strat?gies de pr?vention et traitement des infections de la m?re ? l'enfant De mani?re sp?cifique, l'atelier de Yaound? s'articule autour de six modules. L'importance du choix des th?rapies ? adopter face aux r?sistances du virus ? certains anti-r?troviraux, les moyens de pr?vention et de traitement des transmissions de la m?re ? l'enfant, la question des effets collat?raux des anti-r?troviraux sur les jeunes patients, le r?le de la recherche m?dicale, les applications g?n?tiques dans cette recherche et le point sur les avanc?es en mati?re de traitements et de vaccin, sont ainsi les principaux axes autour desquels tourneront les expos?s et les d?bats. De mani?re plus globale, il sera surtout question, nous a laiss? entendre un intervenant, de mettre en rapport les progr?s faits en rapport avec cette probl?matique de la recherche sur les enfants infect?s au niveau international, avec le contexte plus sp?cifique de l'Afrique. *5* *Le Maroc engag? ? renforcer son action** **Le Matin, Morocco* 08/07/2010 Le Maroc est engag? ? renforcer son action dans le cadre du plan strat?gique national de lutte contre le sida 2007-2011 pour atteindre les objectifs mondiaux, ? savoir z?ro nouveaux cas d'infection et une prise en charge totale des personnes atteintes, a assur? jeudi la ministre de la Sant?, Yasmina Baddou. Intervenant ? l'ouverture de ?l'atelier de revue ? mi-parcours du plan strat?gique national de lutte contre le Sida?, la ministre a indiqu? que ce plan vise ? assurer un acc?s global ? la pr?vention et aux soins, saluant ? cet ?gard l'implication de l'ensemble des partenaires pour la r?alisation des objectifs fix?s pour 2011. Ces objectifs, a-t-elle expliqu?, consistent ? couvrir un million de personnes appartenant aux populations cl?s les plus expos?es aux risques d'infection, accroitre et diversifier les opportunit?s de conseil et de d?pistage du Vih, assurer des soins de qualit? et une prise en charge psychosociale incluant l'acc?s aux antir?troviraux ? 4.500 personnes atteintes outre le renforcement du leadership pour une gestion et une coordination efficaces de la r?ponse multisectorielle au Vih/Sida. Mme Baddou a ?galement fait remarquer que le nombre de personnes test?es a connu ?un essor important?, ajoutant que les centres de conseil et test Vih sont pass?s de 24 en 2006 ? plus de 60 cette ann?e. A son tour, le nombre des personnes diagnostiqu?es cette ann?e s'est ?lev? ? 90.000 contre un peu plus de 57.000 en 2006, a-t-elle poursuivi, pr?cisant que parmi les personnes test?es, une proportion importante appartient aux cat?gories ? risque. De m?me, a poursuivi la ministre, le nombre des personnes sous traitement antir?troviraux a doubl? entre 2006 et 2009, passant actuellement ? pr?s de 3.000 cas. Evoquant la strat?gie de r?duction des risques chez les usagers de drogues injectables, Mme Baddou a indiqu? que celle-ci s'articule autour de quatre principaux axes: la r?duction de la demande, la r?duction des risques li?s ? ces drogues, le traitement et la prise en charge des usagers de drogues et le suivi et l'?valuation. Dans ce cadre elle a rappel? que le traitement de substitution ? la m?thadone avait ?t? lanc? en juin dernier ? titre pilote dans trois sites, faisant ainsi du Maroc le 2e pays ? introduire la m?thadone dans la r?gion d'Afrique du Nord et du Moyen-Orient (Mena). De son c?t?, le repr?sentant de l'OMS au Maroc, Said Salah Youssef, a indiqu? qu'? la faveur de son engagement politique et du Plan strat?gique de lutte contre le sida, le Maroc a enregistr? un progr?s consid?rable en la mati?re, ce qui en fait l'un des pays pionniers dans la r?gion Mena. Il a, ?galement, salu? les efforts consentis par le minist?re de la Sant?, les organisations non gouvernementales et les secteurs concern?s en vue de mettre en application le Plan strat?gique national 2007-2011, se f?licitant de la dynamique de la soci?t? civile marocaine et de la parfaire coordination des diff?rents partenaires avec les agences des Nations unies. Au programme de cet atelier, qui s'?tale sur deux jours, figurent trois axes principaux : la situation ?pid?miologique au Maroc, les obstacles et les opportunit?s, et l'analyse des plans nationaux de lutte contre le sida. *=======================* * * *ASIA** AND PACIFIC* * * *=======================*** *Powerful HIV antibodies found for vaccine** **The Hindu, India* 09/07/2010 DPA - U.S. scientists have discovered the most effective HIV antibodies to date, which could be used to find a vaccine for the virus, according to a study published in Science Thursday. A team of researchers coordinated by the National Institutes of Health (NIH) found the two proteins that can neutralize more than 90 per cent of known global strains of HIV. The VRC01 and VRC02 antibodies neutralize more strains with greater strength than any other previously known antibody, the study said. After finding out how the antibodies work and where they attach to the virus, the scientists have started developing a potential vaccine. They also said that their work could be used in HIV treatment. ?In addition, the technique the teams used to find the new antibodies represents a novel strategy that could be applied to vaccine design for many other infectious diseases,? said Anthony Fauci, director of the NIH?s National Institute of Allergy and Infectious Diseases. An AIDS vaccine, which will prevent HIV infection as effectively as vaccines prevent polio and other viral infections, is still several years away. Vaccine development is expensive and daunting because HIV is like a moving target, mutating readily. Finding individual antibodies that can neutralize HIV strains is difficult because the virus is constantly changing its surface proteins to evade recognition by the immune system - resulting in a very large number of HIV variants worldwide. But the newly found antibodies ?attach to a virtually unchanging part of the virus, and this explains why they can neutralize such an extraordinary range of HIV strains,? said John Mascola, who led one of the study teams. The findings were published shortly before a large international AIDS conference that brings together scientists, international bodies and non-governmental advocates in Vienna from July 18. *2* *HCM City receives US$6.8 mln foreign aid** **VOV News, Viet Nam* 09/07/2010 Ho Chi Minh City received a total of US$6.8 million in grants from foreign non-governmental organisations, companies and individuals in the first half of the year. Of the funding, 75 percent went to the city?s Health Department and HIV/AIDS prevention committee. The city?s achievements in social welfare, education, health, poverty reduction and job generation has encouraged the contributions of NGOs and international organizations, said Nguyen Thi My Tien, General Secretary of the Ho Chi Minh City Union of Friendship Organisations at a gathering on July 8. During the meeting with representatives of NGOs operating in the city, Tien promised that the union will work with relevant agencies to streamline the current procedures concerning NGOs? operations. The city is calling for US$713,000 aid for more than 20 projects, including legal advice and consultancy for people living with HIV and affected by HIV/AIDS; scholarships, teaching tools and equipment for poor students, students who are hearing-impaired or mentally retarded; protection and support for migrant children, street children and ethnic minority children. VOVNews/VNA *========================* *EUROPE*** *========================* *Where is the H.I.V. vaccine?(Op-Ed)** **The International Herald Tribune* 08/07/2010 Seth Berkley and Alan Bernstein On the eve of the XVIII International AIDS Conference in Vienna, it is time to face some difficult realities about the global response to H.I.V. and AIDS. More than 2.7 million people worldwide are newly infected with H.I.V. every year. Current H.I.V. drugs are not cures. Every person infected with H.I.V. will require expensive and often complex antiretroviral treatment for life. The U.S. government, the Clinton Foundation, the Global Fund to Fight H.I.V., Tuberculosis and Malaria and others are leading efforts to provide treatment to the ever-increasing millions of people in need. These efforts save lives and strengthen developing-world health systems, and they deserve strong and continued support. The 5 million people now receiving H.I.V. drugs in developing countries, however, are still just one-third of the number in need. For each person who receives treatment, 2.5 more are infected. Simply put, we cannot treat ourselves out of this pandemic. This pandemic needs a vaccine. Multiple approaches to stopping H.I.V., including condoms, circumcision and widespread promotion of monogamy and safer sex, along with new approaches in development, are all important to slowing this epidemic. Historically, however, vaccines are the best tool to limit or stop the spread of a virus. Smallpox and polio are examples of global killers that have been completely or nearly eliminated with a vaccine. So why don't we have an H.I.V. vaccine yet, and what can we do to get one? The development of an H.I.V. vaccine is slowed by the complexity of the challenge - H.I.V. is the most elusive virus ever targeted for a vaccine - but also by inadequate support for research. Consider that the global economic impact of AIDS is estimated between $20 and $50 billion every year. The cost of providing treatment to even the one-third of people who need it today is more than $10 billion per year. But the amount spent on the entire global effort to develop and test H.I.V. vaccines was only about $800 million last year - 10 percent less than 2007 funding. That's not enough to get the job done. Only four major trials of H.I.V. vaccine candidates have been conducted in 27 years of research - not nearly enough to gather critical scientific information. We are poised to take major steps forward in H.I.V. vaccine research if the effort receives the support it needs. Recently, a vaccine trial in Thailand reduced H.I.V. infection risk by 31 percent - a major advance and the first demonstration that a vaccine can prevent H.I.V. infection. While 31 percent protection is too low for a useable vaccine, it shows that a vaccine is possible. In other advances, scientists have discovered a number of antibodies that neutralize different variations of H.I.V. found around the world. Combining two or more of these antibodies in the laboratory provides protection against most strains of H.I.V. Other innovative vaccine strategies aimed at controlling H.I.V. infection have tested well in animals. Work to translate these discoveries into vaccine candidates needs support. Stepping up the H.I.V. vaccine research effort requires more funding. It may sound unrealistic to advocate for more spending on AIDS vaccines in the midst of a global economic crisis - but insufficiently funding this effort makes no sense from either a humanitarian or economic standpoint. The amounts needed to support a new era in AIDS vaccine research are small when compared to the enormous potential benefit - real and lasting control of this global epidemic. One way to increase support is to make the search for an H.I.V. vaccine a truly global effort. Today, a handful of funders led by the U.S. government pay for the bulk of global H.I.V. vaccine research. But H.I.V./AIDS is a global problem, and it demands a global solution. Current funders must continue their strong support, but other countries must also come to the table. This will help encourage the private sector - whose expertise and resources are needed to make an H.I.V. vaccine a reality, but which now plays only a minor role in H.I.V. vaccine research - to recommit itself to this essential global health goal. It's time to focus again on what seemed so clear at the beginning of this pandemic - ending H.I.V./AIDS urgently requires a vaccine. The evidence that a safe and effective H.I.V. vaccine can be developed is stronger than ever. Without a truly global effort to act on that promise, however, we may find ourselves asking the same question after 25 more years of this pandemic: Where is the H.I.V. vaccine? *2* *Antibody finding could lead to AIDS vaccine** **Reuters* 08/07/2010 *Story carried by Globe and Mail (Canada)* Maggie Fox Washington - Researchers have discovered antibodies that can protect against a wide range of AIDS viruses and said they may be able to use them to design a vaccine against the fatal and incurable virus. The bodies of some people make these immune system proteins after they are infected with the AIDS virus, when it is too late for them to do much good. But a properly designed vaccine might help the body make them much sooner, the researchers reported in Friday?s issue of the journal Science. ?I am more optimistic about an AIDS vaccine at this point in time than I have been probably in the last 10 years,? Gary Nabel of the National Institute of Allergy and Infectious Diseases, who led the study, said in a telephone interview. Two of the antibodies can attach to and neutralize 90 percent of the various mutations of the human immunodeficiency virus that causes AIDS, Dr. Nabel said. ?This is an antibody that evolved after the fact. That is part of the problem we have in dealing with HIV -- once a person becomes infected, the virus always gets ahead of the immune system,? Dr. Nabel said. ?What we are trying to do with a vaccine is get ahead of the virus.? AIDS infects about 33 million people globally, according to the United Nations AIDS agency UNAIDS. It has killed 25 million people since the pandemic began in the early 1980s and there is no vaccine or cure, although drugs can help control it. The virus is difficult to fight in part because it attacks immune system cells and in part because it mutates constantly, making it a moving target for drugs or the immune system. It has been almost impossible to make a vaccine that will affect the virus. Last September, researchers reported their biggest success yet with a vaccine that appeared to slow the rate of infection by about 30 percent in Thai volunteers but the trial raised many questions. MOVING TARGETS Researchers have been looking for parts of the virus that do not mutate so they can design vaccines that will protect against these constantly changing versions. Dr. Nabel?s team found two of the antibodies in the blood of a patient infected with HIV who had not become ill despite the infection. Such people are called non-progressors and researchers study their immune systems to find out why they control the virus better than most patients. They then found the immune system cells called B-cells that made these particular antibodies, using a new molecular device that they invented. In yet another experiment, they managed to freeze one of the antibodies in the process of attaching to and neutralizing the virus, getting an atomic-level image in a process called x-ray crystallography. Being able to ?see? what the structure looks like could enable researchers to design a vaccine using a process called rational vaccine design, akin to an established technique for making drugs called rational drug design, Dr. Nabel said. It may also be possible to design gene therapy to help patients make these antibodies themselves, or use an older technique that transfuses the antibodies directly. One of the antibodies, called VRC01, partially mimics the way an immune cell called a CD4 T-cell attaches to a piece of the AIDS virus called gp120, the researchers said. ?The antibodies attach to a virtually unchanging part of the virus, and this explains why they can neutralize such an extraordinary range of HIV strains,? Dr. John Mascola, who worked on the study, said in a statement. ?The discovery of these exceptionally broadly neutralizing antibodies to HIV and the structural analysis that explains how they work are exciting advances that will accelerate our efforts to find a preventive HIV vaccine for global use,? NIAID director Dr. Anthony Fauci added in a statement. ?In addition, the technique the teams used to find the new antibodies represents a novel strategy that could be applied to vaccine design for many other infectious diseases.? *3* *World Bank names Zimbabwean to head AIDS program** **Reuters* 08/07/2010 WASHINGTON July 8 (Reuters) - The World Bank on Thursday named David Wilson, a Zimbabwean national who has written extensively about AIDS in the developing world, to head the poverty-fighting institution's global HIV/AIDS program. Wilson, who joined the Bank in 2003, has advised governments in South Africa, Nigeria, Lebanon, Vietnam, China and Papua New Guinea. Wilson said one of the Bank's key tasks was "providing countries with evidence to better understand where and how new HIV infections are occurring, and to use proven approaches to tackle these infections." "With better evidence we can make prevention services succeed and make AIDS treatment more sustainable," he said in a statement. With more HIV/AIDS funding going to organizations such as the Geneva-based Global Fund to fight AIDS, Tuberculosis and Malaria, the World Bank has slowly shifted its focus from financing HIV/AIDS projects to advising countries on how best to manage AIDS funding and improve HIV prevention programs. Wilson will lead the Bank's delegation to the International AIDS Conference in Vienna this month, the Bank said. (Writing by Lesley Wroughton; Editing by David Storey) *4* *Innovation and education improve health in Rio's favelas** **The Lancet, UK* 10/07/2010 Sharmila Devi Access to health care in Brazil's favelas is poor, but several innovative projects in Rio de Janeiro are starting to improve the situation. Sharmila Devi reports. Nanko van Buuren rushed back to the head office of the Brazilian Institute for Innovations in Social Healthcare, the non-profit group he started in 1989 that is best known by its Portuguese acronym of Ibiss. But his waiting colleagues are long-used to the erratic time-keeping of this tall Dutchman, whom the street children of Rio de Janeiro's favelas or slums call Paitrao, which combines the Portuguese words for father and boss. On this warm afternoon in mid-April, he was delayed because he had been touring some Ibiss projects with a delegation from Success for Kids, an educational charity backed by Madonna, the latest high-profile celebrity who wanted to tackle the entrenched poverty in the favelas. ?Madonna called me personally last week to talk about how they can adapt Success for Kids to our own situation?, said van Burren. ?They will have to adapt it because a lot of kids here are running around with guns because of organised crime and the drugs trade.? Ibiss has grown into one of Rio de Janeiro's best-known non-governmental organisations through its many projects aimed at helping the city's most economically and socially excluded people. Since the beginning, its model has been to go into the favelas and ask the residents themselves not just what they need, but how they would organise it. If the programme is successful, Ibiss then lobbies the government to adopt it on a wider scale. Successful initiatives include leprosy-awareness programmes, helping children to leave or to avoid the drug gangs using football and music, and training favela residents to become community health-care workers. Ibiss has grown from just van Buuren and a handful of Brazilian staff to some 600 employees, mostly locally trained Brazilians, who work on about 62 projects. Brazil will host the soccer World Cup in 2014 and the Olympic Games in 2016 and the government has promised to spend billions of dollars on infrastructure and security to ensure safety and enjoyment for the influx of international visitors. In Rio de Janeiro, a city of about 6 million people, the 1 million residents of some 1000 favelas hope they will benefit from the largesse too. Long neglected by government agencies, they have relied on their own efforts and the help of groups such as Ibiss to ensure access to basic health care and other services, such as electricity or waste collection. The death toll from gun battles in the favelas between drug gangs, security forces and unofficial police militias is huge considering there is no actual insurgency or civil war. The UN has estimated the police murder three people a day on average in Rio de Janeiro, making them responsible for one in five killings in the city. Populated mostly by economic migrants from the north-east of Brazil, and caught between the drug gangs and the police, the favelas lack systematic access to the health-care system. There are high rates of tuberculosis and maternal and child mortality. Children are particularly vulnerable to diseases that spread in unsanitary conditions. Meanwhile, many Brazilian doctors and nurses are lured by higher salaries to the private sector. Brazil accounts for about 17% of worldwide cases of leprosy, second only to India, which has about 54% of cases. The spread of leprosy is for the most part a consequence of migration to the favelas, since patients from rural areas often interrupt their 12?18 month course of treatment when they move to Rio's favelas, said Nancy Torres, an Ibiss health worker who helps to organise self-treatment groups. Ibiss also worked with the producers of a popular telenovela, or TV soap opera, to introduce a character with leprosy to help erode its social stigma. Brazil does have one of the developing world's best programmes to combat HIV/AIDS, thanks in part to legislation guaranteeing universal access to antiretroviral treatments and the government's authorisation to local companies to produce the drugs without the consent of the patent-holder. But Joseph Amon, director of health and human rights at Human Rights Watch, said issues such as the treatment of drug dependency and the deinstitutionalisation of psychiatric care are still in need of urgent reform. Brazil is one of at least 115 countries that recognises a constitutional right to health. ?We're just starting to see the start of advocacy efforts by the government, which needs to give meaning to the constitutional right to healthcare?, he said. Some favelas have achieved progress in basic sanitation, education and roads. But many others are no-go areas for outsiders, including health workers and local journalists. Heavily armed police making a raid on drug gangs are often the only visitors. Even the more developed favelas provide a stark contrast to rich areas of Rio de Janeiro, such as Ipanema and Copacabana. The wealthiest 10% in Brazil are thought to control about 50% of the country's wealth. van Buuren, a former WHO psychiatrist, first ventured into the favelas more than 20 years ago, building up trust with the heavily armed drug lords who rule by fear. ?It's now very easy for us to do our work because we are very well-known in the slums, especially by the bosses of organised crime,? he said. ?It took years of building up confidence. One of the main reasons is that I can't look at people as just criminals or murderers. I ask how are the kids and the man thinks not as a drugs boss but as the father of his children and he's proud to explain. If you are afraid when you talk to the boss, he smells that you're afraid and you're treated in that way.? van Buuren now speaks better Portuguese than English, having fallen in love with Brazil and its people. Before moving to Brazil, he developed programmes to deliver psychiatric care to the homeless, immigrants, and other hard-to-reach populations in his native Netherlands. For WHO, he helped to train health professionals to cope with disaster and conflict situations. He said Brazilians thought he was crazy when he started Ibiss, with its ethos of enlisting people in the favelas to help to formulate solutions to their problems. ?What is funny about Brazil is that people are very open. They looked at us and said you're crazy but go ahead if you want to do it?, he said. ?In Holland, they've already created so many obstacles that you can't even start to experiment.? Ibiss ran into strong opposition when it began distributing condoms, including among street children, but condom distribution is now routine in Brazil. ?The church and other groups wanted to think that children had no sexuality and I don't know how they combined that thinking with young girls getting pregnant?, he said. One of Ibiss's biggest successes is its community health-care training programme, which has since been adopted by the Brazilian Government following strong advocacy by Ibiss. There are now more than 3000 health posts all over Brazil. ?In the early 1990s, we saw how the public health system didn't enter the slums?, he said. ?So we took people, mostly women, from the slums and gave them training, one-and-a-half days a week for nine months, in the early detection of diseases, how to seek treatment and how to get a prescription.? He said the women felt greatly empowered. ?Many would ask after they had referred someone to a medical post about the final diagnosis and they would feel incredibly proud when they found out they were right in their initial diagnosis.? Brazil is also a source country for the international trafficking of people. The government is being urged, like that of South Africa before it hosted this summer's soccer World Cup, to adopt stricter measures so that offenders are brought to justice. According to the UN, over 75 000 Brazilian women are being sexually exploited in Europe. Rio de Janeiro is seen as one of the principal points of departure for these women to leave the country. Ibiss works on the streets with male and female prostitutes and transvestites and tries to map where and how people are gathered in the better-known areas of prostitution in Rio de Janeiro. Security remains of paramount concern. The Brazilian Government has now embarked on a pacification programme in which police enter and stay in a favela to enforce law and order. Seven favelas have been occupied so far and dozens more occupations are planned in the run-up to the World Cup and Olympics. Van Buuren fears the programme could become a victim of its own success, with favela residents selling their homes for a quick profit but unable to survive for long in new shantytowns further out of town. ?Pacification has to include incentives for companies to settle in these areas and create jobs or else poor people will lose out.? *========================* * * *LATIN AMERICA AND CARIBBEAN* * * *========================* *Nuevo avance en la vacuna contra el sida ** **La Naci?n, Argentina* 09/07/2010 Sebasti?n A. R?os El descubrimiento de dos anticuerpos capaces de bloquear la infecci?n por el virus del sida (VIH) ha reavivado las esperanzas de encontrar una vacuna. En los ?ltimos a?os, esta b?squeda hab?a concluido en sucesivos fracasos, con experimentos que no fueron efectivos o generaron una protecci?n m?nima. El desarrollo de un m?todo diferente para detectar anticuerpos propios del ser humano posibilit? hallar dos (el VRC01 y el VRC02) que bloquean la infecci?n del 90% de las cepas del virus del sida conocidas. Ese nuevo procedimiento, precisamente, abre un camino de investigaci?n que renueva las esperanzas de poder contar, probablemente en el mediano plazo (en no menos de 5 a 10 a?os), con una vacuna eficaz contra el VIH. "Los descubrimientos que hemos hecho podr?an superar las limitaciones que durante mucho tiempo han bloqueado el desarrollo de vacunas contra el VIH basadas en anticuerpos", declar? ayer el doctor Peter Kwong, del Centro de Investigaci?n en Vacunas, del Instituto Nacional de Alergia y Enfermedades Infecciosas de los Estados Unidos, y autor de uno de los estudios publicados en Science donde se comunicaron los descubrimientos. Lo que los investigadores liderados por Kwong y sus colegas John Mascola y Gary Nabel lograron en primer lugar fue desarrollar un nuevo m?todo de biolog?a molecular que permite aislar los anticuerpos de los que se vale el sistema inmunol?gico para combatir los agentes infecciosos o impedir que ?stos infecten las c?lulas del organismo. El nuevo m?todo se basa en una prote?na del VIH modificada que s?lo reacciona ante los anticuerpos que impiden que el virus del sida se aferre a las c?lulas humanas antes de invadirlas. Al aplicar este m?todo a muestras de sangre de un paciente infectado los investigadores dieron con los anticuerpos VCR01 y VCR02, que han demostrado tener un poder para neutralizar el virus mucho m?s grande que todos los anticuerpos conocidos contra el VIH. Pero los investigadores fueron un paso m?s all?: determinaron la estructura at?mica de uno de esos anticuerpos en el exacto momento en que se pega al VIH impidiendo la infecci?n de la c?lula humana. "Con ese conocimiento -inform? un comunicado del instituto donde se realiz? la investigaci?n- se han comenzado a dise?ar los componentes de un candidato de vacuna que podr?a ense?ar al sistema inmune humano a producir anticuerpos similares al VRC01 que podr?an prevenir la infecci?n causada por la vasta mayor?a de las cepas de VIH de todo el mundo." Aun as?, moder? el doctor Pedro Cahn, jefe de infectolog?a del hospital Fern?ndez, "si bien se trata de un estudio auspicioso y prometedor, debe quedar en claro que es una investigaci?n b?sica e inicial, que no tiene ninguna implicancia en el corto plazo". "Muchas otras veces se logr? aislar anticuerpos neutralizantes de amplio espectro, como los que han sido descubiertos ahora, pero que despu?s no lograron cumplir su funci?n cuando fueron probados en estudios cl?nicos en seres humanos", agreg? la doctora Andrea Mangone, investigadora del Conicet en el Laboratorio de Retrovirus del hospital Garrahan. Sorteando obst?culos Pero m?s all? del descubrimiento de los mencionados anticuerpos, lo m?s interesante del trabajo es la posibilidad de contar con un nuevo m?todo -cuya efectividad a?n debe ser corroborada por otros grupos de investigaci?n- para aislar anticuerpos que puedan ser empleados para el desarrollo de vacunas o de tratamientos en VIH/sida. Es m?s, agreg? Mangone, "si esta herramienta demuestra ser tan efectiva como dicen sus creadores, incluso podr?a servir para buscar anticuerpos para otras enfermedades infecciosas". Pero volviendo al terreno del VIH/sida, lo que los expertos del Centro de Investigaci?n en Vacunas parecen haber logrado es superar dos de los obst?culos que hasta ahora han impedido el desarrollo de una vacuna eficaz. Uno de ellos es la alta capacidad del virus para mutar las prote?nas de su superficie, impidiendo que sea reconocido por el sistema inmunol?gico. "Han sido identificadas unas pocas ?reas en la superficie del virus que permanecen constantes en casi todas sus variantes -se?al? el citado comunicado-. Una de ellas es el sitio de uni?n CD4. El VRC01 y el VRC02 bloquean la infecci?n al pegarse al sitio de uni?n CD4, impidiendo que el virus se aferre a las c?lulas." "Los anticuerpos se adhieren a una parte virtualmente invariable del virus, y eso explica por qu? pueden neutralizar un rango tan extraordinario de cepas de VIH", declar? el doctor Mascola. Otro de los obst?culos para el desarrollo de vacunas contra el VIH ha sido lograr que ?stas permitan la maduraci?n completa de los anticuerpos que genera la vacuna, coment? Mangano. En los estudios publicados en Science , los investigadores proponen formas de sortear ese obst?culo. El tiempo y futuras investigaciones dir?n si est?n en lo cierto. *4* *Governo distribui novo medicamento contra a aids para crian?as ** **Ag?ncia de Not?cias da Aids, Brazil* 07/07/2010 Combina??o de dois ANTIRRETROVIRAIS em um comprimido facilita a ades?o ao tratamento, afirma infectologista Marinella Della Negra Para o HIV se tornar infeccioso dentro do corpo ? essencial que as prote?nas do v?rus sejam cortadas e estruturadas corretamente. Os inibidores da protease bloqueiam o local onde o corte deve ocorrer, impedindo os novos v?rus de amadurecer e de infectar outras c?lulas. A infectologista Marinella Della Negra, do Hospital Em?lio Ribas em S?o Paulo, defende h? v?rios anos a cria??o de melhores solu??es medicamentosas para o tratamento da AIDS em crian?as. "Os ANTIRRETROVIRAIS s?o lan?ados sempre primeiro para os adultos e levam alguns anos at? serem adaptados ? forma pedi?trica. Aquelas que est?o com falha terap?utica, por exemplo, muitas vezes ficam sem op??o de tratamento", comentou. Segundo Marinella, o comprimido do Kaletra em menor tamanho se torna mais f?cil para o tratamento pedi?trico. Ela explica que a nova f?rmula do medicamento, tamb?m chamada de baby dose, ? composta por 100mg de lopinavir e 25mg de ritonavir, enquanto que a concentra??o do comprimido original, de uso adulto, ? de 200mg de lopinavir e 50mg de ritonavir. "Damos o rem?dio conforme o metro corporal do paciente. Quando usamos o medicamento de adultos para crian?as, temos que quebrar para chegar na dose certa", comenta. De 1996 a 2009, foram registrados cerca de 11 mil casos de AIDS em menores de cinco anos no Brasil, o que representa aproximadamente 2,0% do total de notifica??es da doen?a no pa?s. De acordo com o DEPARTAMENTO DE DST, AIDS e Hepatites Virais do Minist?rio da Sa?de, 90 crian?as est?o usando a vers?o do Kaletra para crian?as. Aqueles que se adaptam ? formula??o adulta desse rem?dio somam 1600. O ?rg?o informa que a tend?ncia ? mudar aos poucos o tratamento das crian?as que usam rem?dios para adultos para a baby dose. O valor pago pelo Governo brasileiro ao laborat?rio Abbott na primeira aquisi??o do Kaletra para crian?as foi de aproximadamente 66 centavos de real por cada comprimido. Kaletra e patentes Em 2005, o ex-ministro da Sa?de Humberto Costa fez um "quase-an?ncio" de licen?a compuls?ria do Kaletra para adultos. O motivo foi a recusa da Abbott em negociar a patente do medicamento. Quatro meses depois, quando Saraiva Felipe assumiu o Minist?rio, o governo federal conseguiu uma diminui??o no pre?o do medicamento, mas desagradou a vontade de muitas das organiza??es n?o governamentais que pediam a licen?a compuls?ria do rem?dio. Uma das principais cr?ticas da sociedade civil organizada foi de que o acordo fixou o pre?o do rem?dio, com redu??es graduais, por um per?odo muito longo - at? 2011 - e n?o previu a transfer?ncia de tecnologia. Os termos do acordo tamb?m foram considerados abusivos porque garantiram o monop?lio da patente do Kaletra. Desde ent?o, o Minist?rio negocia sucess?veis quedas no pre?o do medicamento. Hoje, cerca de 200 mil pessoas est?o em tratamento antirretroviral no Brasil, sendo que 52 mil fazem uso da vers?o adulta do Kaletra. Na ?ltima compra nacional desse medicamento, o governo gastou R$ 119,7 milh?es, o que representa quase 15% do total investido para a compra de ANTIRRETROVIRAIS no pa?s. Lucas Bonanno *========================* *NORTH AMERICA* *========================* *U.S. to Provide $25 Million to Help Buy AIDS Drugs** **New York Times* 08/07/2010 By ROBERT PEAR WASHINGTON ? Kathleen Sebelius, the secretary of health and human services, said Thursday that she would provide $25 million more to help states buy life-saving medications for people with H.I.V. or AIDS. Advocates for patients said the money was not nearly enough to eliminate waiting lists, which have surged to record levels as people have lost health insurance, along with their jobs, and states have cut their budgets. Ms. Sebelius said she was ?reallocating and transferring $25 million in existing resources? to provide medicines for people on waiting lists. Dr. Howard K. Koh, the assistant secretary of health and human services in charge of the program, said the action ?reflects the administration?s commitment to H.I.V. treatment and care.? In an interview, Dr. Koh repeatedly refused to say where the money had come from. Ms. Sebelius said she was confident that the $25 million would meet the existing and projected need until the end of the fiscal year on Sept. 30. As of July 1, about 2,100 people were on waiting lists for the AIDS Drug Assistance Program in 11 states: Florida, Hawaii, Idaho, Iowa, Kentucky, Louisiana, Montana, North Carolina, South Carolina, South Dakota and Utah. Other states have narrowed eligibility, limited enrollment or restricted the drugs for which they will pay. These measures affect thousands of people. Carl Schmid, deputy executive director of the AIDS Institute, an advocacy group for patients, said: ?The $25 million will help. It?s a start. But it?s definitely not enough.? Ann Lefert, a policy analyst at the National Alliance of State and Territorial AIDS Directors, said, ?We appreciate the action taken by the Obama administration, but we are not sure it will be sufficient.? Advocacy groups and state officials had urged the administration to provide $126 million in emergency assistance for the current fiscal year, on top of the $835 million that Congress had already appropriated. The administration?s action follows expressions of deep concern by members of Congress from both parties. Three Republican senators ? Richard M. Burr of North Carolina, Tom Coburn of Oklahoma and Michael B. Enzi of Wyoming ? had implored Ms. Sebelius to address what they described as a public health crisis. John Hart, a spokesman for Mr. Coburn, said, ?The secretary is taking a step in the right direction, but it?s not enough to serve the more than 2,000 patients who are on waiting lists.? Many people with H.I.V. have been able to live long lives, with the use of antiretroviral treatments. But the drugs cost an average of $12,000 a year a person, and many people cannot afford them without public assistance. ?Once patients start taking these drugs, they must continue taking them every day for the rest of their lives,? Mr. Schmid said. The AIDS Drug Assistance Program serves mainly low-income, uninsured people, many of whom are members of minority groups. More than 168,000 people received medications through the program last year. About 45 percent of them had incomes below the poverty level ($10,830 for an individual), and all but 2 percent had incomes less than four times the poverty level ($43,320). *A version of this article appeared in print on July 9, 2010, on page A15 of the New York edition.* *2* *Making 2010 a Turning Point for Women's Health** **IPS Terra Viva* 09/07/2010 Thalif Deen UNITED NATIONS, Jul 8 (IPS) - As the international community readies to commemorate World Population Day Sunday, the United Nations is reviewing the state of the world's women - and how they stack up against the risks of maternal mortality and the lack of universal access to reproductive health. U.N. Secretary-General Ban Ki-moon wants 2010 to be "a turning point for women's and children's health". Hundreds of thousands of women - 99 percent of them in the developing world - die annually as a result of pregnancy or childbirth, he said, adding, "We know how to save their lives. We can do it with quality health systems, qualified medical staff, information and tools for preventing and treating diseases such as malaria and HIV/AIDS." A U.N. report on the status of the eight Millennium Development Goals (MDGs), including drastic reductions in hunger and poverty, says there has been slow progress in expanding the use of contraceptives by women primarily for two reasons: poverty and lack of education. "The use of contraception is lowest among the poorest women, and those with no education," it says. The study points out that "the unmet need for family planning remains moderate to high in most regions, particularly sub-Saharan Africa". At least one in four women aged 15 to 49, who are married or in a relationship, have expressed the desire to use contraceptives but do not have access to them. Still, progress has been recorded by many countries on maternal mortality. "We welcome the MDG reports indication of progress, with some nations significantly reducing maternal death ratios," Thoraya Ahmed Obaid, executive director of the U.N. Population Fund (UNFPA), told IPS. However, as the report notes, the reductions fall far below the rates required to meet the MDG target of 5.5 percent annual reduction. "Therefore, to speed up progress, we must invest more in reproductive health for women and girls," said Obaid. "If every woman received reproductive health care, maternal death and disability would cease to be the devastatingly common tragedy it is today," she added. Obaid said that evidence from research and from the progress made so far prove that investing in women is not only the right thing to do, it is also smart economics. "When women are healthy and survive, they provide enormous social and economic benefits for their families, communities and nations," she added. In a report released last year, Population Action International (PAI) said the number of African women who died from pregnancy and childbirth in 2008 was much higher than the number of casualties from all the major conflicts in Africa combined. "Maternal mortality continues to be the major cause of death among women of reproductive age (15-49) in sub-Saharan Africa," it said. Most of these women die from complications that can often be effectively treated in a health system with adequate skilled personnel, and a functioning referral system that can respond to obstetric emergencies when they occur, the report pointed out. Kathy Calvin, chief executive officer of the United Nations Foundation, told IPS, "If world leaders put women and children at the top of the global agenda, we can make real progress toward meeting the Millennium Development Goals." She said hundreds of thousands of women die needlessly during pregnancy and childbirth every year. Every death is one too many. As the U.N. secretary-general has made clear in his Joint Action Plan, everyone has a role to play in ensuring the health of the world's women, she added. "Women around the world are counting on the global community to insist on universal access to family planning and to satisfy the unmet need for contraceptives," said Calvin. Obaid said UNFPA asserts the right of everyone to be counted, especially women, girls, the poor and marginalised. Population dynamics including growth rates, age structure, fertility and mortality, migration, and more influence every aspect of human, social and economic development. "With quality data we can better track and make greater progress to achieve the Millennium Development Goals, and promote and protect the dignity and human rights of all people," she said. Obaid stressed that data can reveal striking situations in countries. "Girls may be delaying marriage, an indigenous population may be drastically underserved, and higher rates of contraceptive use and skilled birth attendance may show progress towards improving maternal health," she said. The MDGs include a 50 percent reduction in poverty and hunger; universal primary education; reduction of child mortality by two-thirds; cutbacks in maternal mortality by three-quarters; promotion of gender equality; environmental sustainability; reversal of the spread of HIV/AIDS, malaria and other diseases; and a global partnership for development between the rich and the poor. *3* *Major Technology Providers to Sponsor 2010 mHealth Summit Conference** **TMCNet* 08/07/2010 By Rajani Baburajan, TMCnet Contributor The conference organizers of the 2010 mHealth Summit announced that the wireless health research and technology providers, Abbott, Microsoft Research, Pfizer, Qualcomm, Robert Wood Johnson Foundation, Skype (News - Alert) and Verizon Wireless, have joined the 2010 mHealth Summit as sponsors. The 2010 mHealth Summit is a partnership of the Foundation for the National Institutes of Health, the National Institutes of Health and the mHealth Alliance. It focuses on advancing cross-sector collaboration in the use of wireless technology to improve health outcomes. The conference, according to 2010 mHealth Summit officials, will connect the providers in health, government, the private sector, academia and not-for-profit organizations to advance discussion and decision-making related to the intersection of mobile technology, health practice and research, and policy in the United States and abroad. Approximately 2,000 attendees, including international and domestic C-level executives, medical professionals, technologists, researchers, and policy-makers, are expected to attend the event along with over 150 exhibitors. The conference will be held Nov. 8-10 at the Walter E. Washington Convention Center in Washington, D.C. A diverse group of sponsors is offering their support, from charitable organizations, to pharmaceutical and technology companies, wireless carriers and media groups to the conference, 2010 mHealth Summit officials added. Anthony Lewis, VP, open development, of Verizon (News - Alert) Wireless, says Verizon Wireless in 2010 mHealth Summit will discuss its ideas on enabling innovation in patient participation, the quality of preventative care and cost controls as well as enhancing communication among medical professions, hospitals and patients. The attendees can learn more about the role wireless will play in the future. Qualcomm (News - Alert) will host a technology pavilion on the exhibitor floor, which will consist of 40 companies covering a broad spectrum of innovative wireless health companies. The second annual mHealth Summit will feature an expanded format that include keynotes delivered by leading corporate executives, philanthropists, policy-makers and social entrepreneurs; super sessions with key stakeholders from policy, research and technology communities; concurrent sessions addressing a range of relevant topics such as the intersection of mHealth and mFinance, and opportunities for mHealth in the current policy and regulatory environments; and, networking events to drive collaboration. Research! America, Robert Wood Johnson Foundation, PEPFAR, the Rockefeller Foundation, United Nations Foundation and Vodafone (News - Alert) Foundation are some of the supporting organizations. MobiHealthNews is the premier media partner. Other media partners include Virtual Press Office and PR Newswire (News - Alert). The focus of the 2009 mHealth Summit was to develop a new roadmap related to the integration of science and wireless solutions to improve public health delivery, particularly to underserved populations, in the U.S. and around the world. Rajani Baburajan is a contributing editor for TMCnet. To read more of Rajani's articles, please visit her columnist page. *4* *HIV Vaccine Advances Made Ahead of Global Conference ** **IPS Terra Viva* 09/07/2010 Matthew O. Berger WASHINGTON, Jul 8 (IPS) - In 1984, then-U.S. Secretary of Health and Human Services Margaret Heckler famously declared, "We hope to have such a vaccine ready for testing in approximately two years." The vaccine in question would prevent AIDS and the goal Heckler set has been missed by over 26 years. During that time, around 25 million people have died from the disease and the search for a vaccine continues. But two studies released Thursday in the journal Science give some hope to those that have worked so long on this cause. In them, researchers disclose the discovery of two antibodies - which identify and fight off viruses in the blood stream - that can stop 90 percent of known HIV strains from infecting human cells in the laboratory. While it may be years before the necessary human trials can be performed, this discovery is expected to accelerate ongoing efforts to find a HIV vaccine. It also picks up on what has become a fruitful vein for those researching in this field. One of the primary difficulties with developing a vaccine for HIV - and the primary obstacle overlooked by Heckler and many other scientists in the mid-1980s - is that HIV is a diverse and ever-changing virus. The virus continually changes the proteins that coat its surface, such that it can continually evade detection by antibodies and meaning a huge number of HIV strains currently exist in the world. To be able to design a vaccine that can keep up with the continuous transformation of the virus and be globally effective, then, is much more than a two-year process. But in recent years, scientists have found several antibodies that seem to have an effect on at least a majority of HIV strains. The Science study identifies two such antibodies. First, the scientists, led by a team from the National Institute of Allergy and Infectious Diseases (NIAID), identified areas on the surface of HIV that remain the same across all strains. One of areas, called the CD4 binding site, helps the HIV attach to and infect the human immune system. But they found that two antibodies, VRC01 and VRC02, can block infection by attaching to that binding site and blocking the HIV from attaching to immune system cells. "The antibodies attach to a virtually unchanging part of the virus, and this explains why they can neutralise such an extraordinary range of HIV strains," said John Mascola, a co-author of one of the studies and the deputy director of the NIAID's Vaccine Research Center. They also have determined how the latter antibody works and where precisely it attaches to the virus, thus enabling them to begin to lay the groundwork for a vaccine that might aid the immune system in making antibodies to prevent infection by 90 percent of HIV strains. "The discoveries we have made may overcome the limitations that have long stymied antibody-based HIV vaccine design," says Peter Kwong, a researcher at NIAID and a co-author of one of the Science studies. Other researchers have taken a different route than building antibodies. A study released in the journal Nature Biotechnology on Friday disclosed how researchers at the University of Southern California engineered human stem cells so that the gene that allows HIV to enter the cells was disabled, as it is in a small percentage of people. Mice in which these engineered human cells were multiplied and which were then infected with HIV were protected from the virus. This gene therapy solution, like the antibody-based vaccine, is still a long way from being successfully used in people, but researchers hope the progress that is being made means their work will continue to be funded, even in a tough economic climate. That gap between scientists and the governments that fund HIV/AIDS research will be a central issue addressed by the International AIDS Conference, which begins July 18 in Vienna. Looking ahead to this conference, Science contains a special section with additional studies on the prevalence and impact of HIV/AIDS. One article says that fewer than one in eight of those currently living with HIV have access to antiretroviral therapy and that many lack access to preventive measures. In another report, researchers and several NGO representatives point out that U.N. members agreed in 2006 to make comprehensive programs for HIV prevention, treatment and care universally available by the year 2010. While "this commitment has inspired national and international responses to achieve impressive results", they write, the goal of universal access has not been met. "If governments globally don't do more in terms of the quality and quantity of care for people with HIV, this will result in dire human and economic costs in the short and long term," said co-author Julio Montaner, director of the British Columbia Centre for Excellence in HIV/AIDS, president of the International AIDS Society. While continued work on vaccines and preventions may bode well for the effort to end the HIV pandemic, then, there are still many opportunities to do more. In the meantime, another 2.7 million people will continue contract the disease each year. The organisers of the Vienna conference, which is expected to bring together 20,000 HIV/AIDS researchers, hope the gathering will help keep the spotlight on the importance of continued investment in HIV prevention, treatment, care and support, even in the face of the global economic crisis. *5* *An Argument Against the Obama Global Health Initiative ** **UN Dispatch* 08/07/2010 Alanna Shaikh A new article in the journal AIDS argues against the Obama Global Health Initiative. The authors make the argument that the AIDS epidemic has a substantial impact on health systems, and that PEPFAR and support for HIV/AIDS care supports the health sector in general. They point out that ?In Southern Africa, where HIV prevalence is the highest worldwide, HIV-related diseases monopolize more than half of all hospital beds. Cutting support for AIDS, they argue damages health systems. Health funding should not pit one health issue against another. And HIV is huge factor in general health, ?In the five countries with the highest adult HIV prevalence worldwide, HIV is the single leading cause of underfive mortality and responsible for 41?56% of deaths.? They also discuss the impact of HIV on health sector workers. 40% of midwives in Zambia, for example, are HIV positive. So is 16% of South Africa?s healthcare workforce. Therefore, they posit, ?that HIV/AIDS Global Health Initiatives (GHIs) such as PEPFAR can advance and synergistically reinforce MCH and the overall healthcare infrastructure of the recipient country? Funding from PEPFAR has revitalized health facilities, increased the availability of qualified healthcare personnel, and enabled the expansion of ancillary support services such as pharmacies and diagnostic laboratories.? I remain unconvinced. It?s a powerful article and it makes some good points. And I certainly agree that integrated health system support is the best way forward on global health. I still don?t believe, though, that PEPFAR is the best way to provide that support. Their final conclusion, though, is one that I can totally get behind. They make a ?more pie? argument: we need more funding for global health, so we can stop pitting one health condition against another *Aids Online full-article: http://journals.lww.com/aidsonline/Documents/Leeper%20and%20Reddi%20PAP.pdf* *6* *Advance in Quest for HIV Vaccine ** **Wall Street Journal* 09/07/2010 By MARK SCHOOFS HIV research is undergoing a renaissance that could lead to new ways to develop vaccines against the AIDS virus and other viral diseases. In the latest development, U.S. government scientists say they have discovered three powerful antibodies, the strongest of which neutralizes 91% of HIV strains, more than any AIDS antibody yet discovered. They are now deploying the technique used to find those antibodies to identify antibodies to influenza viruses. The HIV antibodies were discovered in the cells of a 60-year-old African-American gay man, known in the scientific literature as Donor 45, whose body made the antibodies naturally. The trick for scientists now is to develop a vaccine or other methods to make anyone's body produce them as well. That effort "will require work," said Gary Nabel, director of the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases, who was a leader of the research. "We're going to be at this for a while" before any benefit is seen in the clinic, he said. The research was published Thursday in two papers in the online edition of the journal Science, 10 days before the opening of a large International AIDS Conference in Vienna, where prevention science is expected to take center stage. More than 33 million people were living with HIV at the end of 2008, and about 2.7 million contracted the virus that year, according to United Nations estimates. Vaccines, which are believed to work by activating the body's ability to produce antibodies, eliminated or curtailed smallpox, polio and other feared viral diseases, so they have been the holy grail of AIDS research. Last year, following a trial in Thailand, results of the first HIV vaccine to show any efficacy were announced. But that vaccine reduced the chances of infection only by about 30%, and controversy erupted because in one common analysis the results weren't statistically significant. That vaccine wasn't designed to elicit the new antibodies. The new discovery is part of what Wayne Koff, head of research and development at the nonprofit International AIDS Vaccine Initiative, calls a "renaissance" in HIV vaccine research. Antibodies that are utterly ineffective, or that disable just one or two HIV strains, are common. Until last year, only a handful of "broadly neutralizing antibodies," those that efficiently disable a large swath of HIV strains, had been discovered. And none of them neutralized more than about 40% of known HIV variants. But in the past year, thanks to efficient new detection methods, at least a half dozen broadly neutralizing antibodies, including the three latest ones, have been identified in peer-reviewed journals. Dennis Burton of the Scripps Institute in La Jolla, Calif., led a team that discovered two broadly neutralizing antibodies last year; he says his team has identified additional, unpublished ones. Most of the new antibodies are more potent, able to knock out HIV at far lower concentrations than their previously known counterparts. HIV is a highly mutable virus, but one place where the virus doesn't mutate much is where it attaches to a particular molecule on the surface of cells it infects. Building on previous research, researchers created a probe, shaped exactly like that critical site, and used it to attract only those antibodies that efficiently attack it. That is how they fished out of Donor 45 the special antibodies: They screened 25 million of his cells to find 12 that produced the antibodies. Donor 45's antibodies didn't protect him from contracting HIV. That is likely because the virus had already taken hold before his body produced the antibodies. He is still alive, and when his blood was drawn, he had been living with HIV for 20 years. While he has produced the most powerful HIV antibody yet discovered, researchers say they don't know of anything special about his genes that would make him unique. They expect that most people would be capable of producing the antibodies, if scientists could find the right way to stimulate their production. Dr. Nabel said his team is applying the new technique to the influenza virus. Like HIV, influenza is a highly mutable virus?the reason a new vaccine is required every year. "We want to go after a universal vaccine" by using the new technique to find antibodies to a "component of the influenza virus that doesn't change," said NIAID director Anthony Fauci. In principle, Dr. Fauci said, the technique could be used for any viral disease and possibly even for cancer vaccines. Some of the new HIV antibodies discovered over the past year attack different points on the virus, raising hopes that they could work synergistically. In unpublished research, John Mascola, deputy director of the Vaccine Research Center, has shown that one of Dr. Burton's antibodies neutralizes virtually all the strains that are resistant to the antibody from Donor 45. He also found the reverse: The antibody from Donor 45 disables HIV strains resistant to one of Dr. Burton's best antibodies. Only one strain out of 95 tested was resistant to both antibodies, he said. Dr. Mascola is one of the authors of Thursday's papers. Researchers say they plan to test the new antibodies, likely blended together in a potent cocktail, in three broad ways. First, the antibodies could be given to people in their raw form, somewhat like a drug, to prevent transmission of the virus. But they would likely be expensive and last in the body for a limited time, perhaps weeks, making that method impractical for all but specialized cases, such as to prevent mother-to-child transmission in childbirth. The antibodies could also be tested in a "microbicide," a gel that women or gay men could apply before sex to prevent infection. The antibodies might even be tried as a treatment for people already infected. While the antibodies are unlikely to completely suppress HIV on their own, say scientists, they might boost the efficacy of current antiretroviral drugs. Dr. Nabel said that the Vaccine Research Center has contracted with a company to produce an antibody suitable for use in humans so that testing in people could begin. A second way to use the new research is to stimulate the immune system to produce the antibodies. Jonas Salk injected people with a whole killed polio virus, and virtually everyone's immune system easily made antibodies that disabled the polio virus. But for HIV, the vast majority of antibodies are ineffective. Now, scientists know the exact antibodies that must be made?those found in Donor 45 and in Dr. Burton's lab, for example. So researchers need "a reverse engineering technology" to find a way to get everyone to produce them, said Greg Poland, director of vaccine research at Mayo Clinic in Rochester, Minn. That's what scientists at Merck & Co. have done. In a study published this year in the Proceedings of the National Academy of Sciences, the Merck Scientists knew that an old antibody, weaker than the newly discovered ones, attaches to a particularly vulnerable part of HIV. They created a replica of that piece of the virus to train the immune system to produce antibodies aimed at that exact spot. It was a painstaking process, requiring researchers to add chemical bonds to stabilize the replica so that it wouldn't collapse and lose its shape. Eventually, Merck was able to make experimental vaccine candidates capable of spurring guinea pigs and rabbits to produce antibodies that home in on the target site and neutralize HIV. Those vaccines weren't nearly powerful enough, but, said Dr. Koff, Merck's research provides a "proof of principle" that reverse engineering can work for the much stronger new antibodies. There are other potential pitfalls. There is evidence that Donor 45's cells took months or possibly even years to create the powerful antibodies. That means scientists might have to give repeated booster shots or devise other ways to speed up this process. Finally, there are experimental methods that employ tactics such as gene therapy. Nobel laureate David Baltimore is working on one such approach. His team at the California Institute of Technology in Pasadena, Calif., has stitched genes that code for antibodies into a harmless virus, which they then inject into mice. The virus infects mouse cells, turning them into factories that produce the antibodies. Write to Mark Schoofs at mark.schoofs at wsj.com *========================* *UNAIDS WEB.SITE* *========================* UNICEF and partners help make the World Cup a win for children *UNICEF* 09/07/2010 *A version of this story was first published at unicef.org* UNICEF has been using the 2010 FIFA World Cup to help harness the power of sport to promote children?s rights. A series of partnerships and programmes around the global football championship are providing children with the opportunity to learn about their world and be better protected. A special partnership between UNICEF and the South African government addresses potential problems that may arise due to the increased presence of people. In a country where an estimated 12 million children live in poverty, special attention is being given to unaccompanied minors, some of whom may be induced to travel to the cities where games are played in search of employment opportunities and adventure. A massive communication campaign was launched that sends out a message that child abuse and exploitation have no place in South Africa. Targeted at children, parents and tourists, the campaign uses digital, print and electronic outreach to warn about child abuse, exploitation, child sex tourism and trafficking. Partners, including hotels, car rental companies and tour operators are also disseminating messages about child rights and safety throughout their networks. Child-friendly spaces, supported by UNICEF and partners, have been open at four of the major FIFA Fan Fests in Soweto, Sandton, Nelspruit and Port Elizabeth. The sites have played to host to 15,000 to 45,000 fans as well as social workers, child and youth care workers and trained volunteers charged with identifying children who are in need of protection and emergency care. TV screens showed matches in the spaces and age-appropriate activities were offered as well. UNICEF also harnessed the influence of international stars visiting the country for the tournament, such as UNICEF Goodwill Ambassador Angelique Kidjo, to highlight the immense needs of South African children made vulnerable by poverty and HIV. Outside South Africa, a pilot programme called ?World Cup in my village? has given young people in three locations in Rwanda and Zambia the opportunity to view matches on large open-air screens and projectors. In addition to the football, the screens are broadcasting important information about children?s health and their rights. According to Anthony Lake, UNICEF Executive Director from New York: ?The World Cup gives us a chance to focus positive public attention on the special risks children face in countries like South Africa and around the world and the special efforts we can take to protect them from those threats.? -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/953bf0ac/attachment-0020.html From hivtwg.moderator at gmail.com Mon Jul 12 03:46:31 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:46:31 +0700 Subject: [hivaids-twg] Fwd: Today's News (2010.07.09ex)-HCM City receives US$6.8 mln foreign aid Message-ID: From: Diaz, Clara Date: Fri, Jul 9, 2010 at 6:07 PM Subject: Today's News (2010.07.09ex) To: Please find attached the following AIDS-related articles compiled by UNAIDS *UNAIDS* 1. Voice of America News - *Namibia** Lifts HIV Travel Ban* 2. Botswana Gazette - *Prof Tlou appointed UNAIDS Regional Support Team Director* 3. UN News Service -* **UN lauds Namibia?s lifting of travel ban for people living with HIV/AIDS* 4. Eurasia Review - *AIDS On The Rise In Middle East, North Africa* 5. New Kerala, India - *Namibia** lifts travel ban for HIV/AIDS people * *AFRICA** AND MIDDLE EAST* 1. New Vision, Uganda - *HIV Bill should accomodate all voices * 2. The Citizen, Tanzania - *Why blame a certain gender for a disease * 3. Cameroon Tribune - *VIH - Renforcer la protection pour les enfants * 4. Le Matin, Morocco - *Le Maroc engag? ? renforcer son action * *ASIA** AND PACIFIC* 1. The Hindu, India - *Powerful HIV antibodies found for vaccine * 2. VOV News, Viet Nam - *HCM** City** receives US$6.8 mln foreign aid * *EUROPE*** 1. International Herald Tribune - *Where is the H.I.V. vaccine? (Op-Ed) * 2. Reuters - *Antibody finding could lead to AIDS vaccine* 3. Reuters - *World Bank names Zimbabwean to head AIDS program* 4. The Lancet, UK - *Innovation and education improve health in Rio's favelas* *LATIN AMERICA AND CARIBBEAN* 1. La Naci?n, Argentina - *Nuevo avance en la vacuna contra el sida * 2. Ag?ncia de Not?cias da Aids, Brazil - *Governo distribui novo medicamento contra a aids para crian?as * *NORTH AMERICA* 1. New York Times - *U.S.** to Provide $25 Million to Help Buy AIDS Drugs* 2. IPS Terra Viva - *Making 2010 a Turning Point for Women's Health * 3. TMCNet - *Major Technology Providers to Sponsor 2010 mHealth Summit Conference* 4. IPS Terra Viva - *HIV Vaccine Advances Made Ahead of Global Conference * 5. UN Dispatch - *An Argument Against the Obama Global Health Initiative * 6. Wall Street Journal - *Advance in Quest for HIV Vaccine * *UNAIDS WEB.SITE* 1. UNAIDS - UNICEF and partners help make the World Cup a win for children =========================== *UNAIDS* =========================== *Namibia Lifts HIV Travel Ban** **Voice of America News* 08/07/2010 Joe DeCapua Namibia has lifted its long-standing travel ban for people living with HIV. Namibian officials say even though there?s no record of enforcement of the ban, it did not reflect Namibia?s commitment to democracy and human rights. UNAIDS praises the decision, saying the country is now in line with international public health standards. ?The fact that visitors coming to Namibia have to fill in a visa form where they are asked whether they suffer from a contagious disease, including HIV and AIDS, which is legally done as a basis to refuse them entry into the country, is a difficult issue to face,? says Henk Van Renterghem, UNAIDS country coordinator for Namibia. What?s more, he adds, ?It?s discrimination against people suffering from a disease.? The right thing to do Van Renterghem says besides being ?the right thing to do? in bolstering human rights, lifting the ban supports the country?s public health policy. ?There is no evidence whatsoever that limiting mobility or travel of people living with HIV has any effect on the epidemic. And in this sense, people who live with the disease?get the wrong impression they should be somehow contained in their mobility and in their rights to move around freely,? he says. The United States and China recently lifted their long-standing HIV travel restrictions. But UNAIDS reports there are ?51 countries, territories and areas that continue to impose some form of restriction on the entry, stay and residence of people living with HIV based on their HIV status.? It goes on to say that five countries deny visas for even short-term stays, while 22 countries ?deport individuals once their HIV status is discovered.? Relic of the past? ?Most of these regulations and laws were put in place in the early days of the epidemic,? says Van Renterghem. ?It gives a very wrong impression of how we treat people living with HIV. We know that stigma and discrimination against people living with HIV?reduce to a large extent?the capacity to access services.? He says lifting such bans sends a message to HIV-positive people that ?we care about you. You?re equal to all other citizens and we everything to put in place a framework that allows us to provide the best possible services.? UNAIDS Executive Director Michel Sidibe has designated 2010 the year of lifting of HIV travel restrictions. ?That?s why it?s important that countries (such) as the U.S., China and Namibia actually effectively lift these regulations,? Van Renterghem says. Rights here, right now The 18th International AIDS Conference, AIDS 2010, will be held in Vienna from July 18th through the 23rd. The theme of the conference is Rights Here, Right Now. Van Renterghem says a number of news conferences and sessions are planned on the travel ban issue. UNAIDS says, ?There is no evidence that such restrictions prevent HIV transmission or protect public health. Furthermore, HIV-related travel restrictions have no economic justification, as people living with HIV can lead long and productive working lives.? *2** * *Prof Tlou appointed UNAIDS Regional Support Team Director** **Botswana Gazette*** 08/07/2010 The Joint UN Programme on HIV/AIDS (UNAIDS) has announced the appointment of Professor Dinotshe Shiela Tlou as the new Regional Support Team Director for East and Southern Africa. She will take over the role from the Acting Director, Dr. Mbulawa Mugabe, in September 2010. Shiela Tlou, a Botswana National, is currently a Professor of Nursing at the University of Botswana.Prior to that she was the Minister of Health for the Government of Botswana from 2004 to 2009, where she spearheaded the countries highly effective AIDS programme.She was a Professor of Nursing at the University of Botswana from 1999 to 2004. Sheila has held the positions of Director, WHO Collaborating Centers and Professor with the University of Botswana, Gaborone, Botswana, from 1994 to 1999. Prof. Tlou has a Doctorate of Nursing Science, majoring in Public Health Nursing and Research. She has a Master of Education, majoring in Curriculum and Instruction in the Health Sciences, from Columbia University as well as a Master of Science, majoring in Public Health Nursing and Psychology, from The Catholic University of America, Washington D.C. Sheila is a strong and committed advocate for an effective AIDS response and has demonstrated superb leadership throughout the region over many years. Upon accepting the offer of appointment, Professor Tlou noted, ?I am delighted and honored to accept the role of UNAIDS Regional Director for Eastern and Southern Africa, an organization that leads global advocacy on HIV and AIDS. I look forward to bringing my combined background of research, teaching, policy and management to the School, and to working with staff to improve HIV and AIDS responses in the region." The UNAIDS Executive Director, Mr. Michel Sidibe, comments that he is confident that she will provide excellent leadership within UNAIDS team and within the region as we continue to build and strengthen the AIDS response with countries. *4* *UN lauds Namibia?s lifting of travel ban for people living with HIV/AIDS** **UN News Service* 08/07/2010 8 July 2010 ? The Joint United Nations Programme on HIV/AIDS (UNAIDS) today welcomed Namibia?s decision to remove travel restrictions for people living with the virus, a move that aligns the country?s laws with international public health standards. The new legislation lifting restrictions for people living with HIV/AIDS and other contagious diseases took effect in Namibia on 1 July. Restrictions that limit movement based on HIV-positive status only are discriminatory and violate human rights, according to UNAIDS. There is no evidence that such restrictions prevent HIV transmission or protect public health, the agency said, adding that HIV-related travel restrictions have no economic justification, as people living with HIV can lead long and productive working lives. ?I am heartened by this announcement in Namibia,? said Michel Sidib?, UNAIDS Executive Director. ?HIV-related travel restrictions serve no purpose and hamper the global AIDS response,? he added. UNAIDS advocates for an individual?s right to freedom of movement, regardless of HIV status. There are now 51 countries, territories, and areas that continue to impose some form of restriction on the entry, stay and residence of people living with HIV based on their HIV status. Five countries deny visas even for short-term stays, while 22 countries deport individuals once their HIV-positive status is discovered. The United States and China removed long-standing HIV-related travel restrictions earlier this year. Several other countries, including Ukraine, have pledged to take steps to remove such restrictions. *5* *AIDS On The Rise In Middle East, North Africa** **Eurasia Review* 09/07/2010 By Cecily Hilleary For years, the lack of reliable data on HIV/AIDS in the Middle East and North Africa led regional governments to believe they had somehow managed to escape the epidemic. But a new United Nations report shows that numbers are on the rise: more than 400,000 people are currently living with HIV across the Middle East and North Africa region, or MENA. Of those, 68,000 need anti-retroviral treatment, but only 14 percent are actually getting it. The rest may not even know they are infected. Hind Khatib is a regional director of the U.N. Joint Programme on HIV/AIDS or UNAIDS. She has just returned from a two-day conference in Dubai, where regional leaders gathered to discuss the issue. Khatib:It's still low prevalence, but you know we've just put out the synthesis report, which was an epidemiological study of HIV and its evolution in the region, and the report says that probably, at least for the near future, we'll never have an epidemic of HIV in the region. But still, there is evidence that HIV is growing among key populations. The key populations as defined by the study are the people who are mainly drug injectors, men who have sex with men, and sex workers. So we thought that it's timely, especially that this year, there was a great effort by UNAIDS invested in the region to ensure that all the countries will actually report and live up to their commitments made to the 2001 Declaration in the U.N. General Assembly Special Session on HIV. The national reports clearly, from 20 countries out of the 21 countries in the region, Iraq was the only country that could not report, for understandable reasons - all 20 countries have shown that they have weak programs, weak surveillance, and that the coverage is very, very poor. So yes, while we have national AIDS programs, while countries are attempting to draw up their national strategies, coverage, in terms of treatment, voluntary counseling and testing and even prevention, is very, very poor. So we thought this was the time to actually convene policy makers together with civil society with small communities of people living with HIV, to get together under one roof and start talking [about] what's next. Hilleary:What's the biggest obstacle to people getting tested and treated for HIV/AIDS in the MENA region? Khatib:It's stigma. Stigma and discrimination. People are afraid. I mean, I think that knowing how HIV basically gets transmitted is something that people are afraid, that people know that they have had extra-marital sex-the whole concept of men who have sex with other men--it's a big taboo, and the region does not want to admit that we have these groups. They don't want to admit to a lot of extra-marital activities. So I think it's very much cultural and related also to religion and Islam, and people, you know, like to believe that we don't have such conducts here. But I think slowly, slowly, people here are that HIV is very much home-grown. Up until now, it has been the perception, 'Oh, we got it from outside.' I think that with a lot of advocacy and, as you know now there is a good amount of popular faces, popular stars that also engage in HIV, whether it's through UNICEF, and recently UNAIDS has appointed its first regional Goodwill Ambassador [Egyptian actor Amr Waked was recently named the first UNAIDS Goodwill Ambassador for the Middle East and North Africa region by the Joint United Nations Program on HIV/AIDS], and we are very happy that he's coming out loud, speaking about stigma and discrimination, speaking about the rights of our key populations, speaking about the time to act, speaking about the right policies, targeted action. But I think there is a lot the region still needs to do to reduce fear. Hilleary:What does the U.N. plan to do with the data it has gathered now? Khatib:First, I think we are working with countries on improving the national strategies. So it's much more targeted and it doesn't address HIV as if it's a generalized epidemic. What's next is actually to have concerted efforts to bring up awareness, because if you don't bring awareness to all different targeted groups, including the health workers. Even if you do confidential testing, you will need the people who run those services to bring awareness and educate people. It's just educating. *6* *Namibia lifts travel ban for HIV/AIDS people ** **New Kerala, India* 08/07/2010 New York, Jul 8 : The Joint United Nations Programme on HIV/AIDS (UNAIDS) on Thursday welcomed Namibia's decision to remove travel restrictions for people living with the virus, a move that aligns the country's laws with international public health standards. The new legislation lifting restrictions for people living with HIV/AIDS and other contagious diseases took effect in Namibia on 1 July. Restrictions that limit movement based on HIV-positive status only are discriminatory and violate human rights, according to UNAIDS. There is no evidence that such restrictions prevent HIV transmission or protect public health, the agency said, adding that HIV-related travel restrictions have no economic justification, as people living with HIV can lead long and productive working lives. "I am heartened by this announcement in Namibia," said Michel Sidibe, UNAIDS Executive Director. "HIV-related travel restrictions serve no purpose and hamper the global AIDS response," he added. UNAIDS advocates for an individual's right to freedom of movement, regardless of HIV status. There are now 51 countries, territories, and areas that continue to impose some form of restriction on the entry, stay and residence of people living with HIV based on their HIV status. Five countries deny visas even for short-term stays, while 22 countries deport individuals once their HIV-positive status is discovered. The United States and China removed long-standing HIV-related travel restrictions earlier this year. Several other countries, including Ukraine, have pledged to take steps to remove such restrictions. =========================== *AFRICA** AND MIDDLE EAST* =========================== *HIV Bill should accomodate all voices ** **New Vision, Uganda* 08/07/2010 On Tuesday, May 18, the HIV Prevention and Control Bill was tabled in Parliament for the first reading. This is a milestone in Uganda?s efforts to manage the HIV epidemic as it portrays the Government?s commitment in the fight against HIV/AIDS. However, in its current form, the Bill undermines the public health of Ugandans as it does not depict a comprehensive approach towards the HIV problem. The Bill promotes mandatory disclosure of the HIV status, it promotes mandatory testing for HIV and it criminalises intentional transmission of HIV/AIDS. If the Bill is to achieve a holistic response to HIV/AIDS in Uganda, its intentions would not only be limited to preventing and controlling the spread of the epidemic, but also to promote and protect the rights of people living with HIV (PHAs). The Government is obliged to respect, promote and protect the rights of all its citizens without discrimination, but the Bill does not address this. This undermines the HIV/AIDS prevention efforts. People will choose not to know their HIV status, as they will feel legally safer not to test. Otherwise, they would be proved guilty hence ?ignorance of the status becomes a defence?. An appropriate intervention would be looking at reducing barriers to voluntary testing and increasing the use of the service. The Bill also makes a woman more vulnerable to abuse yet they are already marginalised. Mothers will choose not to access antenatal services and for those who will be conditioned to test, they will keep silent about their HIV-positive status, and not access mother-to-child preventive services. In the end, they will infect their newly born babies because if they dare to disclose their HIV status, they will be hacked. Consequently, it is like shooting ourselves in the foot because we will witness an increase in the number of people living with HIV/AIDS, child and maternal mortality and morbidity. Parliament should, therefore, function objectively, not on emotions and listen to other voices, especially the civil society. This group has expressed their views about the Bill in its current form. Mandatory testing, involuntary disclosure and criminalisation ought to be removed from the HIV Bill if we have to observe public health. *The writer is a Makerere University School of Public Health-CDC HIV/AIDS fellow* *2* *Why blame a certain gender for a disease ** **The Citizen, Tanzania* 09/07/2010 By Fatima Hussenali Just over a week ago, I boarded a taxi to town, the driver happened to be a young man in his twenties. Although I listen to similar conversations often this one left me spellbound, I learnt a few things which just confirmed how ignorant our people are, regarding HIV/ Aids. The young man was telling one of the passengers in the car how difficult it is to find a 'decent' young woman these days. Being a young woman myself, I felt offended but decided not to say anything just to allow the conversation reach its logical conclusion. The 'dude' preached on how in the 'good old days', women took pride in who they were and how one would not find decent women in bars or nightclubs. "Were there shanty bars in the good old days," I asked myself or at least that's what my grandmother told me. But I continued to listen to the young man rant as he spoke of how he would not want to get involved with just any woman these days especially the ones who hang out at clubs. According to him, clubs are places where women go to hunt for men who will meet their needs even if the relationship is guaranteed to last only 24 hours or less and as a result HIV is most likely to be transmitted. "Even the innocent girls we grew up with cannot be trusted," the taxi driver rumbled on. Reacting the negative words he spoke about women and how they encourage the spread of HIV, I concluded that the brother had no respect for women. But what can I say. Everyone is entitled to their opinion. I wasn't brave enough to share my opinion with the taxi driver that day even when I felt I was clearly offended by such ill informed idle talk. Regarding by this brothers conversation a bar or a club is an evil place which makes me think that even men should not hang out there. This is not meant to attack anyone but just to point out some of the misleading issues. Often times we find men (even married ones) promising the moon and the stars to young girls, who in many cases are school dropouts in clubs and other places, while their children and wives do not even have anything to eat at home. And then you find the same men who are just never satisfied with one partner, apparently diversity is good... and the cases are endless. The issue at hand is, an epidemic such as HIV cannot be blamed on an individual or a particular gender. Time should rather be spent looking for solutions that will help everybody, for example, what can be done about young women spending their times at nightclubs with sugar daddies. How best can the HIVmessages be transmitted? Is the current education/information regarding HIV really efficient and transmitted in the right channels? Can we successfully fight the HIV pandemic? I'd say yes we can but only if each individual takes their position in this fight. And as the saying goes, It begins with you, and therefore, let?s be the change we want to see. People have to be willing to change and they have to realise that HIV/Aids is real and most of all people will have to let go of the stigma that is often caused by ignorance. People have to love themselves and their fellow humans enough not to engage in reckless behaviour. It is certain that if you are not infected with HIV you are affected. *You can reach the writer of this article on: husenalif at gmail.com * *3* *VIH - Renforcer la protection pour les enfants** **Cameroon Tribune* 07/07/2010 Eric Elouga Un atelier organis? depuis lundi par le Circb pour am?liorer la pr?vention et la recherche m?dicale Le probl?me de la mortalit? m?re-enfant en Afrique ?tait il y a quelques semaines encore, sur la table du G8 qui a tir? la sonnette d'alarme, devant le constat de pi?tinement enregistr? dans la r?alisation de cet objectif du Mill?naire pour le D?veloppement. Il n'en fallait pas plus pour que le Centre international de r?f?rence Chantal Biya pour la recherche, mette un accent particulier sur les questions de transmission ? l'enfant, dans son programme de pr?vention et de lutte contre le Vih sida. Depuis hier ? Yaound? se tient, en effet, un atelier international sur le th?me de la recherche clinique sur les enfants infect?s par le vih. Objectif de ces travaux, faire le point sur la situation g?n?rale du continent en mati?re de prise en charge clinique des patients infect?s, avec un focus particulier sur les cas des enfants. C'est ainsi qu'autour de la table, les ?minents scientifiques et chercheurs associ?s au Circb vont ainsi plancher jusqu'? demain, sur les strat?gies de pr?vention et traitement des infections de la m?re ? l'enfant De mani?re sp?cifique, l'atelier de Yaound? s'articule autour de six modules. L'importance du choix des th?rapies ? adopter face aux r?sistances du virus ? certains anti-r?troviraux, les moyens de pr?vention et de traitement des transmissions de la m?re ? l'enfant, la question des effets collat?raux des anti-r?troviraux sur les jeunes patients, le r?le de la recherche m?dicale, les applications g?n?tiques dans cette recherche et le point sur les avanc?es en mati?re de traitements et de vaccin, sont ainsi les principaux axes autour desquels tourneront les expos?s et les d?bats. De mani?re plus globale, il sera surtout question, nous a laiss? entendre un intervenant, de mettre en rapport les progr?s faits en rapport avec cette probl?matique de la recherche sur les enfants infect?s au niveau international, avec le contexte plus sp?cifique de l'Afrique. *5* *Le Maroc engag? ? renforcer son action** **Le Matin, Morocco* 08/07/2010 Le Maroc est engag? ? renforcer son action dans le cadre du plan strat?gique national de lutte contre le sida 2007-2011 pour atteindre les objectifs mondiaux, ? savoir z?ro nouveaux cas d'infection et une prise en charge totale des personnes atteintes, a assur? jeudi la ministre de la Sant?, Yasmina Baddou. Intervenant ? l'ouverture de ?l'atelier de revue ? mi-parcours du plan strat?gique national de lutte contre le Sida?, la ministre a indiqu? que ce plan vise ? assurer un acc?s global ? la pr?vention et aux soins, saluant ? cet ?gard l'implication de l'ensemble des partenaires pour la r?alisation des objectifs fix?s pour 2011. Ces objectifs, a-t-elle expliqu?, consistent ? couvrir un million de personnes appartenant aux populations cl?s les plus expos?es aux risques d'infection, accroitre et diversifier les opportunit?s de conseil et de d?pistage du Vih, assurer des soins de qualit? et une prise en charge psychosociale incluant l'acc?s aux antir?troviraux ? 4.500 personnes atteintes outre le renforcement du leadership pour une gestion et une coordination efficaces de la r?ponse multisectorielle au Vih/Sida. Mme Baddou a ?galement fait remarquer que le nombre de personnes test?es a connu ?un essor important?, ajoutant que les centres de conseil et test Vih sont pass?s de 24 en 2006 ? plus de 60 cette ann?e. A son tour, le nombre des personnes diagnostiqu?es cette ann?e s'est ?lev? ? 90.000 contre un peu plus de 57.000 en 2006, a-t-elle poursuivi, pr?cisant que parmi les personnes test?es, une proportion importante appartient aux cat?gories ? risque. De m?me, a poursuivi la ministre, le nombre des personnes sous traitement antir?troviraux a doubl? entre 2006 et 2009, passant actuellement ? pr?s de 3.000 cas. Evoquant la strat?gie de r?duction des risques chez les usagers de drogues injectables, Mme Baddou a indiqu? que celle-ci s'articule autour de quatre principaux axes: la r?duction de la demande, la r?duction des risques li?s ? ces drogues, le traitement et la prise en charge des usagers de drogues et le suivi et l'?valuation. Dans ce cadre elle a rappel? que le traitement de substitution ? la m?thadone avait ?t? lanc? en juin dernier ? titre pilote dans trois sites, faisant ainsi du Maroc le 2e pays ? introduire la m?thadone dans la r?gion d'Afrique du Nord et du Moyen-Orient (Mena). De son c?t?, le repr?sentant de l'OMS au Maroc, Said Salah Youssef, a indiqu? qu'? la faveur de son engagement politique et du Plan strat?gique de lutte contre le sida, le Maroc a enregistr? un progr?s consid?rable en la mati?re, ce qui en fait l'un des pays pionniers dans la r?gion Mena. Il a, ?galement, salu? les efforts consentis par le minist?re de la Sant?, les organisations non gouvernementales et les secteurs concern?s en vue de mettre en application le Plan strat?gique national 2007-2011, se f?licitant de la dynamique de la soci?t? civile marocaine et de la parfaire coordination des diff?rents partenaires avec les agences des Nations unies. Au programme de cet atelier, qui s'?tale sur deux jours, figurent trois axes principaux : la situation ?pid?miologique au Maroc, les obstacles et les opportunit?s, et l'analyse des plans nationaux de lutte contre le sida. *=======================* * * *ASIA** AND PACIFIC* * * *=======================*** *Powerful HIV antibodies found for vaccine** **The Hindu, India* 09/07/2010 DPA - U.S. scientists have discovered the most effective HIV antibodies to date, which could be used to find a vaccine for the virus, according to a study published in Science Thursday. A team of researchers coordinated by the National Institutes of Health (NIH) found the two proteins that can neutralize more than 90 per cent of known global strains of HIV. The VRC01 and VRC02 antibodies neutralize more strains with greater strength than any other previously known antibody, the study said. After finding out how the antibodies work and where they attach to the virus, the scientists have started developing a potential vaccine. They also said that their work could be used in HIV treatment. ?In addition, the technique the teams used to find the new antibodies represents a novel strategy that could be applied to vaccine design for many other infectious diseases,? said Anthony Fauci, director of the NIH?s National Institute of Allergy and Infectious Diseases. An AIDS vaccine, which will prevent HIV infection as effectively as vaccines prevent polio and other viral infections, is still several years away. Vaccine development is expensive and daunting because HIV is like a moving target, mutating readily. Finding individual antibodies that can neutralize HIV strains is difficult because the virus is constantly changing its surface proteins to evade recognition by the immune system - resulting in a very large number of HIV variants worldwide. But the newly found antibodies ?attach to a virtually unchanging part of the virus, and this explains why they can neutralize such an extraordinary range of HIV strains,? said John Mascola, who led one of the study teams. The findings were published shortly before a large international AIDS conference that brings together scientists, international bodies and non-governmental advocates in Vienna from July 18. *2* *HCM City receives US$6.8 mln foreign aid** **VOV News, Viet Nam* 09/07/2010 Ho Chi Minh City received a total of US$6.8 million in grants from foreign non-governmental organisations, companies and individuals in the first half of the year. Of the funding, 75 percent went to the city?s Health Department and HIV/AIDS prevention committee. The city?s achievements in social welfare, education, health, poverty reduction and job generation has encouraged the contributions of NGOs and international organizations, said Nguyen Thi My Tien, General Secretary of the Ho Chi Minh City Union of Friendship Organisations at a gathering on July 8. During the meeting with representatives of NGOs operating in the city, Tien promised that the union will work with relevant agencies to streamline the current procedures concerning NGOs? operations. The city is calling for US$713,000 aid for more than 20 projects, including legal advice and consultancy for people living with HIV and affected by HIV/AIDS; scholarships, teaching tools and equipment for poor students, students who are hearing-impaired or mentally retarded; protection and support for migrant children, street children and ethnic minority children. VOVNews/VNA *========================* *EUROPE*** *========================* *Where is the H.I.V. vaccine?(Op-Ed)** **The International Herald Tribune* 08/07/2010 Seth Berkley and Alan Bernstein On the eve of the XVIII International AIDS Conference in Vienna, it is time to face some difficult realities about the global response to H.I.V. and AIDS. More than 2.7 million people worldwide are newly infected with H.I.V. every year. Current H.I.V. drugs are not cures. Every person infected with H.I.V. will require expensive and often complex antiretroviral treatment for life. The U.S. government, the Clinton Foundation, the Global Fund to Fight H.I.V., Tuberculosis and Malaria and others are leading efforts to provide treatment to the ever-increasing millions of people in need. These efforts save lives and strengthen developing-world health systems, and they deserve strong and continued support. The 5 million people now receiving H.I.V. drugs in developing countries, however, are still just one-third of the number in need. For each person who receives treatment, 2.5 more are infected. Simply put, we cannot treat ourselves out of this pandemic. This pandemic needs a vaccine. Multiple approaches to stopping H.I.V., including condoms, circumcision and widespread promotion of monogamy and safer sex, along with new approaches in development, are all important to slowing this epidemic. Historically, however, vaccines are the best tool to limit or stop the spread of a virus. Smallpox and polio are examples of global killers that have been completely or nearly eliminated with a vaccine. So why don't we have an H.I.V. vaccine yet, and what can we do to get one? The development of an H.I.V. vaccine is slowed by the complexity of the challenge - H.I.V. is the most elusive virus ever targeted for a vaccine - but also by inadequate support for research. Consider that the global economic impact of AIDS is estimated between $20 and $50 billion every year. The cost of providing treatment to even the one-third of people who need it today is more than $10 billion per year. But the amount spent on the entire global effort to develop and test H.I.V. vaccines was only about $800 million last year - 10 percent less than 2007 funding. That's not enough to get the job done. Only four major trials of H.I.V. vaccine candidates have been conducted in 27 years of research - not nearly enough to gather critical scientific information. We are poised to take major steps forward in H.I.V. vaccine research if the effort receives the support it needs. Recently, a vaccine trial in Thailand reduced H.I.V. infection risk by 31 percent - a major advance and the first demonstration that a vaccine can prevent H.I.V. infection. While 31 percent protection is too low for a useable vaccine, it shows that a vaccine is possible. In other advances, scientists have discovered a number of antibodies that neutralize different variations of H.I.V. found around the world. Combining two or more of these antibodies in the laboratory provides protection against most strains of H.I.V. Other innovative vaccine strategies aimed at controlling H.I.V. infection have tested well in animals. Work to translate these discoveries into vaccine candidates needs support. Stepping up the H.I.V. vaccine research effort requires more funding. It may sound unrealistic to advocate for more spending on AIDS vaccines in the midst of a global economic crisis - but insufficiently funding this effort makes no sense from either a humanitarian or economic standpoint. The amounts needed to support a new era in AIDS vaccine research are small when compared to the enormous potential benefit - real and lasting control of this global epidemic. One way to increase support is to make the search for an H.I.V. vaccine a truly global effort. Today, a handful of funders led by the U.S. government pay for the bulk of global H.I.V. vaccine research. But H.I.V./AIDS is a global problem, and it demands a global solution. Current funders must continue their strong support, but other countries must also come to the table. This will help encourage the private sector - whose expertise and resources are needed to make an H.I.V. vaccine a reality, but which now plays only a minor role in H.I.V. vaccine research - to recommit itself to this essential global health goal. It's time to focus again on what seemed so clear at the beginning of this pandemic - ending H.I.V./AIDS urgently requires a vaccine. The evidence that a safe and effective H.I.V. vaccine can be developed is stronger than ever. Without a truly global effort to act on that promise, however, we may find ourselves asking the same question after 25 more years of this pandemic: Where is the H.I.V. vaccine? *2* *Antibody finding could lead to AIDS vaccine** **Reuters* 08/07/2010 *Story carried by Globe and Mail (Canada)* Maggie Fox Washington - Researchers have discovered antibodies that can protect against a wide range of AIDS viruses and said they may be able to use them to design a vaccine against the fatal and incurable virus. The bodies of some people make these immune system proteins after they are infected with the AIDS virus, when it is too late for them to do much good. But a properly designed vaccine might help the body make them much sooner, the researchers reported in Friday?s issue of the journal Science. ?I am more optimistic about an AIDS vaccine at this point in time than I have been probably in the last 10 years,? Gary Nabel of the National Institute of Allergy and Infectious Diseases, who led the study, said in a telephone interview. Two of the antibodies can attach to and neutralize 90 percent of the various mutations of the human immunodeficiency virus that causes AIDS, Dr. Nabel said. ?This is an antibody that evolved after the fact. That is part of the problem we have in dealing with HIV -- once a person becomes infected, the virus always gets ahead of the immune system,? Dr. Nabel said. ?What we are trying to do with a vaccine is get ahead of the virus.? AIDS infects about 33 million people globally, according to the United Nations AIDS agency UNAIDS. It has killed 25 million people since the pandemic began in the early 1980s and there is no vaccine or cure, although drugs can help control it. The virus is difficult to fight in part because it attacks immune system cells and in part because it mutates constantly, making it a moving target for drugs or the immune system. It has been almost impossible to make a vaccine that will affect the virus. Last September, researchers reported their biggest success yet with a vaccine that appeared to slow the rate of infection by about 30 percent in Thai volunteers but the trial raised many questions. MOVING TARGETS Researchers have been looking for parts of the virus that do not mutate so they can design vaccines that will protect against these constantly changing versions. Dr. Nabel?s team found two of the antibodies in the blood of a patient infected with HIV who had not become ill despite the infection. Such people are called non-progressors and researchers study their immune systems to find out why they control the virus better than most patients. They then found the immune system cells called B-cells that made these particular antibodies, using a new molecular device that they invented. In yet another experiment, they managed to freeze one of the antibodies in the process of attaching to and neutralizing the virus, getting an atomic-level image in a process called x-ray crystallography. Being able to ?see? what the structure looks like could enable researchers to design a vaccine using a process called rational vaccine design, akin to an established technique for making drugs called rational drug design, Dr. Nabel said. It may also be possible to design gene therapy to help patients make these antibodies themselves, or use an older technique that transfuses the antibodies directly. One of the antibodies, called VRC01, partially mimics the way an immune cell called a CD4 T-cell attaches to a piece of the AIDS virus called gp120, the researchers said. ?The antibodies attach to a virtually unchanging part of the virus, and this explains why they can neutralize such an extraordinary range of HIV strains,? Dr. John Mascola, who worked on the study, said in a statement. ?The discovery of these exceptionally broadly neutralizing antibodies to HIV and the structural analysis that explains how they work are exciting advances that will accelerate our efforts to find a preventive HIV vaccine for global use,? NIAID director Dr. Anthony Fauci added in a statement. ?In addition, the technique the teams used to find the new antibodies represents a novel strategy that could be applied to vaccine design for many other infectious diseases.? *3* *World Bank names Zimbabwean to head AIDS program** **Reuters* 08/07/2010 WASHINGTON July 8 (Reuters) - The World Bank on Thursday named David Wilson, a Zimbabwean national who has written extensively about AIDS in the developing world, to head the poverty-fighting institution's global HIV/AIDS program. Wilson, who joined the Bank in 2003, has advised governments in South Africa, Nigeria, Lebanon, Vietnam, China and Papua New Guinea. Wilson said one of the Bank's key tasks was "providing countries with evidence to better understand where and how new HIV infections are occurring, and to use proven approaches to tackle these infections." "With better evidence we can make prevention services succeed and make AIDS treatment more sustainable," he said in a statement. With more HIV/AIDS funding going to organizations such as the Geneva-based Global Fund to fight AIDS, Tuberculosis and Malaria, the World Bank has slowly shifted its focus from financing HIV/AIDS projects to advising countries on how best to manage AIDS funding and improve HIV prevention programs. Wilson will lead the Bank's delegation to the International AIDS Conference in Vienna this month, the Bank said. (Writing by Lesley Wroughton; Editing by David Storey) *4* *Innovation and education improve health in Rio's favelas** **The Lancet, UK* 10/07/2010 Sharmila Devi Access to health care in Brazil's favelas is poor, but several innovative projects in Rio de Janeiro are starting to improve the situation. Sharmila Devi reports. Nanko van Buuren rushed back to the head office of the Brazilian Institute for Innovations in Social Healthcare, the non-profit group he started in 1989 that is best known by its Portuguese acronym of Ibiss. But his waiting colleagues are long-used to the erratic time-keeping of this tall Dutchman, whom the street children of Rio de Janeiro's favelas or slums call Paitrao, which combines the Portuguese words for father and boss. On this warm afternoon in mid-April, he was delayed because he had been touring some Ibiss projects with a delegation from Success for Kids, an educational charity backed by Madonna, the latest high-profile celebrity who wanted to tackle the entrenched poverty in the favelas. ?Madonna called me personally last week to talk about how they can adapt Success for Kids to our own situation?, said van Burren. ?They will have to adapt it because a lot of kids here are running around with guns because of organised crime and the drugs trade.? Ibiss has grown into one of Rio de Janeiro's best-known non-governmental organisations through its many projects aimed at helping the city's most economically and socially excluded people. Since the beginning, its model has been to go into the favelas and ask the residents themselves not just what they need, but how they would organise it. If the programme is successful, Ibiss then lobbies the government to adopt it on a wider scale. Successful initiatives include leprosy-awareness programmes, helping children to leave or to avoid the drug gangs using football and music, and training favela residents to become community health-care workers. Ibiss has grown from just van Buuren and a handful of Brazilian staff to some 600 employees, mostly locally trained Brazilians, who work on about 62 projects. Brazil will host the soccer World Cup in 2014 and the Olympic Games in 2016 and the government has promised to spend billions of dollars on infrastructure and security to ensure safety and enjoyment for the influx of international visitors. In Rio de Janeiro, a city of about 6 million people, the 1 million residents of some 1000 favelas hope they will benefit from the largesse too. Long neglected by government agencies, they have relied on their own efforts and the help of groups such as Ibiss to ensure access to basic health care and other services, such as electricity or waste collection. The death toll from gun battles in the favelas between drug gangs, security forces and unofficial police militias is huge considering there is no actual insurgency or civil war. The UN has estimated the police murder three people a day on average in Rio de Janeiro, making them responsible for one in five killings in the city. Populated mostly by economic migrants from the north-east of Brazil, and caught between the drug gangs and the police, the favelas lack systematic access to the health-care system. There are high rates of tuberculosis and maternal and child mortality. Children are particularly vulnerable to diseases that spread in unsanitary conditions. Meanwhile, many Brazilian doctors and nurses are lured by higher salaries to the private sector. Brazil accounts for about 17% of worldwide cases of leprosy, second only to India, which has about 54% of cases. The spread of leprosy is for the most part a consequence of migration to the favelas, since patients from rural areas often interrupt their 12?18 month course of treatment when they move to Rio's favelas, said Nancy Torres, an Ibiss health worker who helps to organise self-treatment groups. Ibiss also worked with the producers of a popular telenovela, or TV soap opera, to introduce a character with leprosy to help erode its social stigma. Brazil does have one of the developing world's best programmes to combat HIV/AIDS, thanks in part to legislation guaranteeing universal access to antiretroviral treatments and the government's authorisation to local companies to produce the drugs without the consent of the patent-holder. But Joseph Amon, director of health and human rights at Human Rights Watch, said issues such as the treatment of drug dependency and the deinstitutionalisation of psychiatric care are still in need of urgent reform. Brazil is one of at least 115 countries that recognises a constitutional right to health. ?We're just starting to see the start of advocacy efforts by the government, which needs to give meaning to the constitutional right to healthcare?, he said. Some favelas have achieved progress in basic sanitation, education and roads. But many others are no-go areas for outsiders, including health workers and local journalists. Heavily armed police making a raid on drug gangs are often the only visitors. Even the more developed favelas provide a stark contrast to rich areas of Rio de Janeiro, such as Ipanema and Copacabana. The wealthiest 10% in Brazil are thought to control about 50% of the country's wealth. van Buuren, a former WHO psychiatrist, first ventured into the favelas more than 20 years ago, building up trust with the heavily armed drug lords who rule by fear. ?It's now very easy for us to do our work because we are very well-known in the slums, especially by the bosses of organised crime,? he said. ?It took years of building up confidence. One of the main reasons is that I can't look at people as just criminals or murderers. I ask how are the kids and the man thinks not as a drugs boss but as the father of his children and he's proud to explain. If you are afraid when you talk to the boss, he smells that you're afraid and you're treated in that way.? van Buuren now speaks better Portuguese than English, having fallen in love with Brazil and its people. Before moving to Brazil, he developed programmes to deliver psychiatric care to the homeless, immigrants, and other hard-to-reach populations in his native Netherlands. For WHO, he helped to train health professionals to cope with disaster and conflict situations. He said Brazilians thought he was crazy when he started Ibiss, with its ethos of enlisting people in the favelas to help to formulate solutions to their problems. ?What is funny about Brazil is that people are very open. They looked at us and said you're crazy but go ahead if you want to do it?, he said. ?In Holland, they've already created so many obstacles that you can't even start to experiment.? Ibiss ran into strong opposition when it began distributing condoms, including among street children, but condom distribution is now routine in Brazil. ?The church and other groups wanted to think that children had no sexuality and I don't know how they combined that thinking with young girls getting pregnant?, he said. One of Ibiss's biggest successes is its community health-care training programme, which has since been adopted by the Brazilian Government following strong advocacy by Ibiss. There are now more than 3000 health posts all over Brazil. ?In the early 1990s, we saw how the public health system didn't enter the slums?, he said. ?So we took people, mostly women, from the slums and gave them training, one-and-a-half days a week for nine months, in the early detection of diseases, how to seek treatment and how to get a prescription.? He said the women felt greatly empowered. ?Many would ask after they had referred someone to a medical post about the final diagnosis and they would feel incredibly proud when they found out they were right in their initial diagnosis.? Brazil is also a source country for the international trafficking of people. The government is being urged, like that of South Africa before it hosted this summer's soccer World Cup, to adopt stricter measures so that offenders are brought to justice. According to the UN, over 75 000 Brazilian women are being sexually exploited in Europe. Rio de Janeiro is seen as one of the principal points of departure for these women to leave the country. Ibiss works on the streets with male and female prostitutes and transvestites and tries to map where and how people are gathered in the better-known areas of prostitution in Rio de Janeiro. Security remains of paramount concern. The Brazilian Government has now embarked on a pacification programme in which police enter and stay in a favela to enforce law and order. Seven favelas have been occupied so far and dozens more occupations are planned in the run-up to the World Cup and Olympics. Van Buuren fears the programme could become a victim of its own success, with favela residents selling their homes for a quick profit but unable to survive for long in new shantytowns further out of town. ?Pacification has to include incentives for companies to settle in these areas and create jobs or else poor people will lose out.? *========================* * * *LATIN AMERICA AND CARIBBEAN* * * *========================* *Nuevo avance en la vacuna contra el sida ** **La Naci?n, Argentina* 09/07/2010 Sebasti?n A. R?os El descubrimiento de dos anticuerpos capaces de bloquear la infecci?n por el virus del sida (VIH) ha reavivado las esperanzas de encontrar una vacuna. En los ?ltimos a?os, esta b?squeda hab?a concluido en sucesivos fracasos, con experimentos que no fueron efectivos o generaron una protecci?n m?nima. El desarrollo de un m?todo diferente para detectar anticuerpos propios del ser humano posibilit? hallar dos (el VRC01 y el VRC02) que bloquean la infecci?n del 90% de las cepas del virus del sida conocidas. Ese nuevo procedimiento, precisamente, abre un camino de investigaci?n que renueva las esperanzas de poder contar, probablemente en el mediano plazo (en no menos de 5 a 10 a?os), con una vacuna eficaz contra el VIH. "Los descubrimientos que hemos hecho podr?an superar las limitaciones que durante mucho tiempo han bloqueado el desarrollo de vacunas contra el VIH basadas en anticuerpos", declar? ayer el doctor Peter Kwong, del Centro de Investigaci?n en Vacunas, del Instituto Nacional de Alergia y Enfermedades Infecciosas de los Estados Unidos, y autor de uno de los estudios publicados en Science donde se comunicaron los descubrimientos. Lo que los investigadores liderados por Kwong y sus colegas John Mascola y Gary Nabel lograron en primer lugar fue desarrollar un nuevo m?todo de biolog?a molecular que permite aislar los anticuerpos de los que se vale el sistema inmunol?gico para combatir los agentes infecciosos o impedir que ?stos infecten las c?lulas del organismo. El nuevo m?todo se basa en una prote?na del VIH modificada que s?lo reacciona ante los anticuerpos que impiden que el virus del sida se aferre a las c?lulas humanas antes de invadirlas. Al aplicar este m?todo a muestras de sangre de un paciente infectado los investigadores dieron con los anticuerpos VCR01 y VCR02, que han demostrado tener un poder para neutralizar el virus mucho m?s grande que todos los anticuerpos conocidos contra el VIH. Pero los investigadores fueron un paso m?s all?: determinaron la estructura at?mica de uno de esos anticuerpos en el exacto momento en que se pega al VIH impidiendo la infecci?n de la c?lula humana. "Con ese conocimiento -inform? un comunicado del instituto donde se realiz? la investigaci?n- se han comenzado a dise?ar los componentes de un candidato de vacuna que podr?a ense?ar al sistema inmune humano a producir anticuerpos similares al VRC01 que podr?an prevenir la infecci?n causada por la vasta mayor?a de las cepas de VIH de todo el mundo." Aun as?, moder? el doctor Pedro Cahn, jefe de infectolog?a del hospital Fern?ndez, "si bien se trata de un estudio auspicioso y prometedor, debe quedar en claro que es una investigaci?n b?sica e inicial, que no tiene ninguna implicancia en el corto plazo". "Muchas otras veces se logr? aislar anticuerpos neutralizantes de amplio espectro, como los que han sido descubiertos ahora, pero que despu?s no lograron cumplir su funci?n cuando fueron probados en estudios cl?nicos en seres humanos", agreg? la doctora Andrea Mangone, investigadora del Conicet en el Laboratorio de Retrovirus del hospital Garrahan. Sorteando obst?culos Pero m?s all? del descubrimiento de los mencionados anticuerpos, lo m?s interesante del trabajo es la posibilidad de contar con un nuevo m?todo -cuya efectividad a?n debe ser corroborada por otros grupos de investigaci?n- para aislar anticuerpos que puedan ser empleados para el desarrollo de vacunas o de tratamientos en VIH/sida. Es m?s, agreg? Mangone, "si esta herramienta demuestra ser tan efectiva como dicen sus creadores, incluso podr?a servir para buscar anticuerpos para otras enfermedades infecciosas". Pero volviendo al terreno del VIH/sida, lo que los expertos del Centro de Investigaci?n en Vacunas parecen haber logrado es superar dos de los obst?culos que hasta ahora han impedido el desarrollo de una vacuna eficaz. Uno de ellos es la alta capacidad del virus para mutar las prote?nas de su superficie, impidiendo que sea reconocido por el sistema inmunol?gico. "Han sido identificadas unas pocas ?reas en la superficie del virus que permanecen constantes en casi todas sus variantes -se?al? el citado comunicado-. Una de ellas es el sitio de uni?n CD4. El VRC01 y el VRC02 bloquean la infecci?n al pegarse al sitio de uni?n CD4, impidiendo que el virus se aferre a las c?lulas." "Los anticuerpos se adhieren a una parte virtualmente invariable del virus, y eso explica por qu? pueden neutralizar un rango tan extraordinario de cepas de VIH", declar? el doctor Mascola. Otro de los obst?culos para el desarrollo de vacunas contra el VIH ha sido lograr que ?stas permitan la maduraci?n completa de los anticuerpos que genera la vacuna, coment? Mangano. En los estudios publicados en Science , los investigadores proponen formas de sortear ese obst?culo. El tiempo y futuras investigaciones dir?n si est?n en lo cierto. *4* *Governo distribui novo medicamento contra a aids para crian?as ** **Ag?ncia de Not?cias da Aids, Brazil* 07/07/2010 Combina??o de dois ANTIRRETROVIRAIS em um comprimido facilita a ades?o ao tratamento, afirma infectologista Marinella Della Negra Para o HIV se tornar infeccioso dentro do corpo ? essencial que as prote?nas do v?rus sejam cortadas e estruturadas corretamente. Os inibidores da protease bloqueiam o local onde o corte deve ocorrer, impedindo os novos v?rus de amadurecer e de infectar outras c?lulas. A infectologista Marinella Della Negra, do Hospital Em?lio Ribas em S?o Paulo, defende h? v?rios anos a cria??o de melhores solu??es medicamentosas para o tratamento da AIDS em crian?as. "Os ANTIRRETROVIRAIS s?o lan?ados sempre primeiro para os adultos e levam alguns anos at? serem adaptados ? forma pedi?trica. Aquelas que est?o com falha terap?utica, por exemplo, muitas vezes ficam sem op??o de tratamento", comentou. Segundo Marinella, o comprimido do Kaletra em menor tamanho se torna mais f?cil para o tratamento pedi?trico. Ela explica que a nova f?rmula do medicamento, tamb?m chamada de baby dose, ? composta por 100mg de lopinavir e 25mg de ritonavir, enquanto que a concentra??o do comprimido original, de uso adulto, ? de 200mg de lopinavir e 50mg de ritonavir. "Damos o rem?dio conforme o metro corporal do paciente. Quando usamos o medicamento de adultos para crian?as, temos que quebrar para chegar na dose certa", comenta. De 1996 a 2009, foram registrados cerca de 11 mil casos de AIDS em menores de cinco anos no Brasil, o que representa aproximadamente 2,0% do total de notifica??es da doen?a no pa?s. De acordo com o DEPARTAMENTO DE DST, AIDS e Hepatites Virais do Minist?rio da Sa?de, 90 crian?as est?o usando a vers?o do Kaletra para crian?as. Aqueles que se adaptam ? formula??o adulta desse rem?dio somam 1600. O ?rg?o informa que a tend?ncia ? mudar aos poucos o tratamento das crian?as que usam rem?dios para adultos para a baby dose. O valor pago pelo Governo brasileiro ao laborat?rio Abbott na primeira aquisi??o do Kaletra para crian?as foi de aproximadamente 66 centavos de real por cada comprimido. Kaletra e patentes Em 2005, o ex-ministro da Sa?de Humberto Costa fez um "quase-an?ncio" de licen?a compuls?ria do Kaletra para adultos. O motivo foi a recusa da Abbott em negociar a patente do medicamento. Quatro meses depois, quando Saraiva Felipe assumiu o Minist?rio, o governo federal conseguiu uma diminui??o no pre?o do medicamento, mas desagradou a vontade de muitas das organiza??es n?o governamentais que pediam a licen?a compuls?ria do rem?dio. Uma das principais cr?ticas da sociedade civil organizada foi de que o acordo fixou o pre?o do rem?dio, com redu??es graduais, por um per?odo muito longo - at? 2011 - e n?o previu a transfer?ncia de tecnologia. Os termos do acordo tamb?m foram considerados abusivos porque garantiram o monop?lio da patente do Kaletra. Desde ent?o, o Minist?rio negocia sucess?veis quedas no pre?o do medicamento. Hoje, cerca de 200 mil pessoas est?o em tratamento antirretroviral no Brasil, sendo que 52 mil fazem uso da vers?o adulta do Kaletra. Na ?ltima compra nacional desse medicamento, o governo gastou R$ 119,7 milh?es, o que representa quase 15% do total investido para a compra de ANTIRRETROVIRAIS no pa?s. Lucas Bonanno *========================* *NORTH AMERICA* *========================* *U.S. to Provide $25 Million to Help Buy AIDS Drugs** **New York Times* 08/07/2010 By ROBERT PEAR WASHINGTON ? Kathleen Sebelius, the secretary of health and human services, said Thursday that she would provide $25 million more to help states buy life-saving medications for people with H.I.V. or AIDS. Advocates for patients said the money was not nearly enough to eliminate waiting lists, which have surged to record levels as people have lost health insurance, along with their jobs, and states have cut their budgets. Ms. Sebelius said she was ?reallocating and transferring $25 million in existing resources? to provide medicines for people on waiting lists. Dr. Howard K. Koh, the assistant secretary of health and human services in charge of the program, said the action ?reflects the administration?s commitment to H.I.V. treatment and care.? In an interview, Dr. Koh repeatedly refused to say where the money had come from. Ms. Sebelius said she was confident that the $25 million would meet the existing and projected need until the end of the fiscal year on Sept. 30. As of July 1, about 2,100 people were on waiting lists for the AIDS Drug Assistance Program in 11 states: Florida, Hawaii, Idaho, Iowa, Kentucky, Louisiana, Montana, North Carolina, South Carolina, South Dakota and Utah. Other states have narrowed eligibility, limited enrollment or restricted the drugs for which they will pay. These measures affect thousands of people. Carl Schmid, deputy executive director of the AIDS Institute, an advocacy group for patients, said: ?The $25 million will help. It?s a start. But it?s definitely not enough.? Ann Lefert, a policy analyst at the National Alliance of State and Territorial AIDS Directors, said, ?We appreciate the action taken by the Obama administration, but we are not sure it will be sufficient.? Advocacy groups and state officials had urged the administration to provide $126 million in emergency assistance for the current fiscal year, on top of the $835 million that Congress had already appropriated. The administration?s action follows expressions of deep concern by members of Congress from both parties. Three Republican senators ? Richard M. Burr of North Carolina, Tom Coburn of Oklahoma and Michael B. Enzi of Wyoming ? had implored Ms. Sebelius to address what they described as a public health crisis. John Hart, a spokesman for Mr. Coburn, said, ?The secretary is taking a step in the right direction, but it?s not enough to serve the more than 2,000 patients who are on waiting lists.? Many people with H.I.V. have been able to live long lives, with the use of antiretroviral treatments. But the drugs cost an average of $12,000 a year a person, and many people cannot afford them without public assistance. ?Once patients start taking these drugs, they must continue taking them every day for the rest of their lives,? Mr. Schmid said. The AIDS Drug Assistance Program serves mainly low-income, uninsured people, many of whom are members of minority groups. More than 168,000 people received medications through the program last year. About 45 percent of them had incomes below the poverty level ($10,830 for an individual), and all but 2 percent had incomes less than four times the poverty level ($43,320). *A version of this article appeared in print on July 9, 2010, on page A15 of the New York edition.* *2* *Making 2010 a Turning Point for Women's Health** **IPS Terra Viva* 09/07/2010 Thalif Deen UNITED NATIONS, Jul 8 (IPS) - As the international community readies to commemorate World Population Day Sunday, the United Nations is reviewing the state of the world's women - and how they stack up against the risks of maternal mortality and the lack of universal access to reproductive health. U.N. Secretary-General Ban Ki-moon wants 2010 to be "a turning point for women's and children's health". Hundreds of thousands of women - 99 percent of them in the developing world - die annually as a result of pregnancy or childbirth, he said, adding, "We know how to save their lives. We can do it with quality health systems, qualified medical staff, information and tools for preventing and treating diseases such as malaria and HIV/AIDS." A U.N. report on the status of the eight Millennium Development Goals (MDGs), including drastic reductions in hunger and poverty, says there has been slow progress in expanding the use of contraceptives by women primarily for two reasons: poverty and lack of education. "The use of contraception is lowest among the poorest women, and those with no education," it says. The study points out that "the unmet need for family planning remains moderate to high in most regions, particularly sub-Saharan Africa". At least one in four women aged 15 to 49, who are married or in a relationship, have expressed the desire to use contraceptives but do not have access to them. Still, progress has been recorded by many countries on maternal mortality. "We welcome the MDG reports indication of progress, with some nations significantly reducing maternal death ratios," Thoraya Ahmed Obaid, executive director of the U.N. Population Fund (UNFPA), told IPS. However, as the report notes, the reductions fall far below the rates required to meet the MDG target of 5.5 percent annual reduction. "Therefore, to speed up progress, we must invest more in reproductive health for women and girls," said Obaid. "If every woman received reproductive health care, maternal death and disability would cease to be the devastatingly common tragedy it is today," she added. Obaid said that evidence from research and from the progress made so far prove that investing in women is not only the right thing to do, it is also smart economics. "When women are healthy and survive, they provide enormous social and economic benefits for their families, communities and nations," she added. In a report released last year, Population Action International (PAI) said the number of African women who died from pregnancy and childbirth in 2008 was much higher than the number of casualties from all the major conflicts in Africa combined. "Maternal mortality continues to be the major cause of death among women of reproductive age (15-49) in sub-Saharan Africa," it said. Most of these women die from complications that can often be effectively treated in a health system with adequate skilled personnel, and a functioning referral system that can respond to obstetric emergencies when they occur, the report pointed out. Kathy Calvin, chief executive officer of the United Nations Foundation, told IPS, "If world leaders put women and children at the top of the global agenda, we can make real progress toward meeting the Millennium Development Goals." She said hundreds of thousands of women die needlessly during pregnancy and childbirth every year. Every death is one too many. As the U.N. secretary-general has made clear in his Joint Action Plan, everyone has a role to play in ensuring the health of the world's women, she added. "Women around the world are counting on the global community to insist on universal access to family planning and to satisfy the unmet need for contraceptives," said Calvin. Obaid said UNFPA asserts the right of everyone to be counted, especially women, girls, the poor and marginalised. Population dynamics including growth rates, age structure, fertility and mortality, migration, and more influence every aspect of human, social and economic development. "With quality data we can better track and make greater progress to achieve the Millennium Development Goals, and promote and protect the dignity and human rights of all people," she said. Obaid stressed that data can reveal striking situations in countries. "Girls may be delaying marriage, an indigenous population may be drastically underserved, and higher rates of contraceptive use and skilled birth attendance may show progress towards improving maternal health," she said. The MDGs include a 50 percent reduction in poverty and hunger; universal primary education; reduction of child mortality by two-thirds; cutbacks in maternal mortality by three-quarters; promotion of gender equality; environmental sustainability; reversal of the spread of HIV/AIDS, malaria and other diseases; and a global partnership for development between the rich and the poor. *3* *Major Technology Providers to Sponsor 2010 mHealth Summit Conference** **TMCNet* 08/07/2010 By Rajani Baburajan, TMCnet Contributor The conference organizers of the 2010 mHealth Summit announced that the wireless health research and technology providers, Abbott, Microsoft Research, Pfizer, Qualcomm, Robert Wood Johnson Foundation, Skype (News - Alert) and Verizon Wireless, have joined the 2010 mHealth Summit as sponsors. The 2010 mHealth Summit is a partnership of the Foundation for the National Institutes of Health, the National Institutes of Health and the mHealth Alliance. It focuses on advancing cross-sector collaboration in the use of wireless technology to improve health outcomes. The conference, according to 2010 mHealth Summit officials, will connect the providers in health, government, the private sector, academia and not-for-profit organizations to advance discussion and decision-making related to the intersection of mobile technology, health practice and research, and policy in the United States and abroad. Approximately 2,000 attendees, including international and domestic C-level executives, medical professionals, technologists, researchers, and policy-makers, are expected to attend the event along with over 150 exhibitors. The conference will be held Nov. 8-10 at the Walter E. Washington Convention Center in Washington, D.C. A diverse group of sponsors is offering their support, from charitable organizations, to pharmaceutical and technology companies, wireless carriers and media groups to the conference, 2010 mHealth Summit officials added. Anthony Lewis, VP, open development, of Verizon (News - Alert) Wireless, says Verizon Wireless in 2010 mHealth Summit will discuss its ideas on enabling innovation in patient participation, the quality of preventative care and cost controls as well as enhancing communication among medical professions, hospitals and patients. The attendees can learn more about the role wireless will play in the future. Qualcomm (News - Alert) will host a technology pavilion on the exhibitor floor, which will consist of 40 companies covering a broad spectrum of innovative wireless health companies. The second annual mHealth Summit will feature an expanded format that include keynotes delivered by leading corporate executives, philanthropists, policy-makers and social entrepreneurs; super sessions with key stakeholders from policy, research and technology communities; concurrent sessions addressing a range of relevant topics such as the intersection of mHealth and mFinance, and opportunities for mHealth in the current policy and regulatory environments; and, networking events to drive collaboration. Research! America, Robert Wood Johnson Foundation, PEPFAR, the Rockefeller Foundation, United Nations Foundation and Vodafone (News - Alert) Foundation are some of the supporting organizations. MobiHealthNews is the premier media partner. Other media partners include Virtual Press Office and PR Newswire (News - Alert). The focus of the 2009 mHealth Summit was to develop a new roadmap related to the integration of science and wireless solutions to improve public health delivery, particularly to underserved populations, in the U.S. and around the world. Rajani Baburajan is a contributing editor for TMCnet. To read more of Rajani's articles, please visit her columnist page. *4* *HIV Vaccine Advances Made Ahead of Global Conference ** **IPS Terra Viva* 09/07/2010 Matthew O. Berger WASHINGTON, Jul 8 (IPS) - In 1984, then-U.S. Secretary of Health and Human Services Margaret Heckler famously declared, "We hope to have such a vaccine ready for testing in approximately two years." The vaccine in question would prevent AIDS and the goal Heckler set has been missed by over 26 years. During that time, around 25 million people have died from the disease and the search for a vaccine continues. But two studies released Thursday in the journal Science give some hope to those that have worked so long on this cause. In them, researchers disclose the discovery of two antibodies - which identify and fight off viruses in the blood stream - that can stop 90 percent of known HIV strains from infecting human cells in the laboratory. While it may be years before the necessary human trials can be performed, this discovery is expected to accelerate ongoing efforts to find a HIV vaccine. It also picks up on what has become a fruitful vein for those researching in this field. One of the primary difficulties with developing a vaccine for HIV - and the primary obstacle overlooked by Heckler and many other scientists in the mid-1980s - is that HIV is a diverse and ever-changing virus. The virus continually changes the proteins that coat its surface, such that it can continually evade detection by antibodies and meaning a huge number of HIV strains currently exist in the world. To be able to design a vaccine that can keep up with the continuous transformation of the virus and be globally effective, then, is much more than a two-year process. But in recent years, scientists have found several antibodies that seem to have an effect on at least a majority of HIV strains. The Science study identifies two such antibodies. First, the scientists, led by a team from the National Institute of Allergy and Infectious Diseases (NIAID), identified areas on the surface of HIV that remain the same across all strains. One of areas, called the CD4 binding site, helps the HIV attach to and infect the human immune system. But they found that two antibodies, VRC01 and VRC02, can block infection by attaching to that binding site and blocking the HIV from attaching to immune system cells. "The antibodies attach to a virtually unchanging part of the virus, and this explains why they can neutralise such an extraordinary range of HIV strains," said John Mascola, a co-author of one of the studies and the deputy director of the NIAID's Vaccine Research Center. They also have determined how the latter antibody works and where precisely it attaches to the virus, thus enabling them to begin to lay the groundwork for a vaccine that might aid the immune system in making antibodies to prevent infection by 90 percent of HIV strains. "The discoveries we have made may overcome the limitations that have long stymied antibody-based HIV vaccine design," says Peter Kwong, a researcher at NIAID and a co-author of one of the Science studies. Other researchers have taken a different route than building antibodies. A study released in the journal Nature Biotechnology on Friday disclosed how researchers at the University of Southern California engineered human stem cells so that the gene that allows HIV to enter the cells was disabled, as it is in a small percentage of people. Mice in which these engineered human cells were multiplied and which were then infected with HIV were protected from the virus. This gene therapy solution, like the antibody-based vaccine, is still a long way from being successfully used in people, but researchers hope the progress that is being made means their work will continue to be funded, even in a tough economic climate. That gap between scientists and the governments that fund HIV/AIDS research will be a central issue addressed by the International AIDS Conference, which begins July 18 in Vienna. Looking ahead to this conference, Science contains a special section with additional studies on the prevalence and impact of HIV/AIDS. One article says that fewer than one in eight of those currently living with HIV have access to antiretroviral therapy and that many lack access to preventive measures. In another report, researchers and several NGO representatives point out that U.N. members agreed in 2006 to make comprehensive programs for HIV prevention, treatment and care universally available by the year 2010. While "this commitment has inspired national and international responses to achieve impressive results", they write, the goal of universal access has not been met. "If governments globally don't do more in terms of the quality and quantity of care for people with HIV, this will result in dire human and economic costs in the short and long term," said co-author Julio Montaner, director of the British Columbia Centre for Excellence in HIV/AIDS, president of the International AIDS Society. While continued work on vaccines and preventions may bode well for the effort to end the HIV pandemic, then, there are still many opportunities to do more. In the meantime, another 2.7 million people will continue contract the disease each year. The organisers of the Vienna conference, which is expected to bring together 20,000 HIV/AIDS researchers, hope the gathering will help keep the spotlight on the importance of continued investment in HIV prevention, treatment, care and support, even in the face of the global economic crisis. *5* *An Argument Against the Obama Global Health Initiative ** **UN Dispatch* 08/07/2010 Alanna Shaikh A new article in the journal AIDS argues against the Obama Global Health Initiative. The authors make the argument that the AIDS epidemic has a substantial impact on health systems, and that PEPFAR and support for HIV/AIDS care supports the health sector in general. They point out that ?In Southern Africa, where HIV prevalence is the highest worldwide, HIV-related diseases monopolize more than half of all hospital beds. Cutting support for AIDS, they argue damages health systems. Health funding should not pit one health issue against another. And HIV is huge factor in general health, ?In the five countries with the highest adult HIV prevalence worldwide, HIV is the single leading cause of underfive mortality and responsible for 41?56% of deaths.? They also discuss the impact of HIV on health sector workers. 40% of midwives in Zambia, for example, are HIV positive. So is 16% of South Africa?s healthcare workforce. Therefore, they posit, ?that HIV/AIDS Global Health Initiatives (GHIs) such as PEPFAR can advance and synergistically reinforce MCH and the overall healthcare infrastructure of the recipient country? Funding from PEPFAR has revitalized health facilities, increased the availability of qualified healthcare personnel, and enabled the expansion of ancillary support services such as pharmacies and diagnostic laboratories.? I remain unconvinced. It?s a powerful article and it makes some good points. And I certainly agree that integrated health system support is the best way forward on global health. I still don?t believe, though, that PEPFAR is the best way to provide that support. Their final conclusion, though, is one that I can totally get behind. They make a ?more pie? argument: we need more funding for global health, so we can stop pitting one health condition against another *Aids Online full-article: http://journals.lww.com/aidsonline/Documents/Leeper%20and%20Reddi%20PAP.pdf* *6* *Advance in Quest for HIV Vaccine ** **Wall Street Journal* 09/07/2010 By MARK SCHOOFS HIV research is undergoing a renaissance that could lead to new ways to develop vaccines against the AIDS virus and other viral diseases. In the latest development, U.S. government scientists say they have discovered three powerful antibodies, the strongest of which neutralizes 91% of HIV strains, more than any AIDS antibody yet discovered. They are now deploying the technique used to find those antibodies to identify antibodies to influenza viruses. The HIV antibodies were discovered in the cells of a 60-year-old African-American gay man, known in the scientific literature as Donor 45, whose body made the antibodies naturally. The trick for scientists now is to develop a vaccine or other methods to make anyone's body produce them as well. That effort "will require work," said Gary Nabel, director of the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases, who was a leader of the research. "We're going to be at this for a while" before any benefit is seen in the clinic, he said. The research was published Thursday in two papers in the online edition of the journal Science, 10 days before the opening of a large International AIDS Conference in Vienna, where prevention science is expected to take center stage. More than 33 million people were living with HIV at the end of 2008, and about 2.7 million contracted the virus that year, according to United Nations estimates. Vaccines, which are believed to work by activating the body's ability to produce antibodies, eliminated or curtailed smallpox, polio and other feared viral diseases, so they have been the holy grail of AIDS research. Last year, following a trial in Thailand, results of the first HIV vaccine to show any efficacy were announced. But that vaccine reduced the chances of infection only by about 30%, and controversy erupted because in one common analysis the results weren't statistically significant. That vaccine wasn't designed to elicit the new antibodies. The new discovery is part of what Wayne Koff, head of research and development at the nonprofit International AIDS Vaccine Initiative, calls a "renaissance" in HIV vaccine research. Antibodies that are utterly ineffective, or that disable just one or two HIV strains, are common. Until last year, only a handful of "broadly neutralizing antibodies," those that efficiently disable a large swath of HIV strains, had been discovered. And none of them neutralized more than about 40% of known HIV variants. But in the past year, thanks to efficient new detection methods, at least a half dozen broadly neutralizing antibodies, including the three latest ones, have been identified in peer-reviewed journals. Dennis Burton of the Scripps Institute in La Jolla, Calif., led a team that discovered two broadly neutralizing antibodies last year; he says his team has identified additional, unpublished ones. Most of the new antibodies are more potent, able to knock out HIV at far lower concentrations than their previously known counterparts. HIV is a highly mutable virus, but one place where the virus doesn't mutate much is where it attaches to a particular molecule on the surface of cells it infects. Building on previous research, researchers created a probe, shaped exactly like that critical site, and used it to attract only those antibodies that efficiently attack it. That is how they fished out of Donor 45 the special antibodies: They screened 25 million of his cells to find 12 that produced the antibodies. Donor 45's antibodies didn't protect him from contracting HIV. That is likely because the virus had already taken hold before his body produced the antibodies. He is still alive, and when his blood was drawn, he had been living with HIV for 20 years. While he has produced the most powerful HIV antibody yet discovered, researchers say they don't know of anything special about his genes that would make him unique. They expect that most people would be capable of producing the antibodies, if scientists could find the right way to stimulate their production. Dr. Nabel said his team is applying the new technique to the influenza virus. Like HIV, influenza is a highly mutable virus?the reason a new vaccine is required every year. "We want to go after a universal vaccine" by using the new technique to find antibodies to a "component of the influenza virus that doesn't change," said NIAID director Anthony Fauci. In principle, Dr. Fauci said, the technique could be used for any viral disease and possibly even for cancer vaccines. Some of the new HIV antibodies discovered over the past year attack different points on the virus, raising hopes that they could work synergistically. In unpublished research, John Mascola, deputy director of the Vaccine Research Center, has shown that one of Dr. Burton's antibodies neutralizes virtually all the strains that are resistant to the antibody from Donor 45. He also found the reverse: The antibody from Donor 45 disables HIV strains resistant to one of Dr. Burton's best antibodies. Only one strain out of 95 tested was resistant to both antibodies, he said. Dr. Mascola is one of the authors of Thursday's papers. Researchers say they plan to test the new antibodies, likely blended together in a potent cocktail, in three broad ways. First, the antibodies could be given to people in their raw form, somewhat like a drug, to prevent transmission of the virus. But they would likely be expensive and last in the body for a limited time, perhaps weeks, making that method impractical for all but specialized cases, such as to prevent mother-to-child transmission in childbirth. The antibodies could also be tested in a "microbicide," a gel that women or gay men could apply before sex to prevent infection. The antibodies might even be tried as a treatment for people already infected. While the antibodies are unlikely to completely suppress HIV on their own, say scientists, they might boost the efficacy of current antiretroviral drugs. Dr. Nabel said that the Vaccine Research Center has contracted with a company to produce an antibody suitable for use in humans so that testing in people could begin. A second way to use the new research is to stimulate the immune system to produce the antibodies. Jonas Salk injected people with a whole killed polio virus, and virtually everyone's immune system easily made antibodies that disabled the polio virus. But for HIV, the vast majority of antibodies are ineffective. Now, scientists know the exact antibodies that must be made?those found in Donor 45 and in Dr. Burton's lab, for example. So researchers need "a reverse engineering technology" to find a way to get everyone to produce them, said Greg Poland, director of vaccine research at Mayo Clinic in Rochester, Minn. That's what scientists at Merck & Co. have done. In a study published this year in the Proceedings of the National Academy of Sciences, the Merck Scientists knew that an old antibody, weaker than the newly discovered ones, attaches to a particularly vulnerable part of HIV. They created a replica of that piece of the virus to train the immune system to produce antibodies aimed at that exact spot. It was a painstaking process, requiring researchers to add chemical bonds to stabilize the replica so that it wouldn't collapse and lose its shape. Eventually, Merck was able to make experimental vaccine candidates capable of spurring guinea pigs and rabbits to produce antibodies that home in on the target site and neutralize HIV. Those vaccines weren't nearly powerful enough, but, said Dr. Koff, Merck's research provides a "proof of principle" that reverse engineering can work for the much stronger new antibodies. There are other potential pitfalls. There is evidence that Donor 45's cells took months or possibly even years to create the powerful antibodies. That means scientists might have to give repeated booster shots or devise other ways to speed up this process. Finally, there are experimental methods that employ tactics such as gene therapy. Nobel laureate David Baltimore is working on one such approach. His team at the California Institute of Technology in Pasadena, Calif., has stitched genes that code for antibodies into a harmless virus, which they then inject into mice. The virus infects mouse cells, turning them into factories that produce the antibodies. Write to Mark Schoofs at mark.schoofs at wsj.com *========================* *UNAIDS WEB.SITE* *========================* UNICEF and partners help make the World Cup a win for children *UNICEF* 09/07/2010 *A version of this story was first published at unicef.org* UNICEF has been using the 2010 FIFA World Cup to help harness the power of sport to promote children?s rights. A series of partnerships and programmes around the global football championship are providing children with the opportunity to learn about their world and be better protected. A special partnership between UNICEF and the South African government addresses potential problems that may arise due to the increased presence of people. In a country where an estimated 12 million children live in poverty, special attention is being given to unaccompanied minors, some of whom may be induced to travel to the cities where games are played in search of employment opportunities and adventure. A massive communication campaign was launched that sends out a message that child abuse and exploitation have no place in South Africa. Targeted at children, parents and tourists, the campaign uses digital, print and electronic outreach to warn about child abuse, exploitation, child sex tourism and trafficking. Partners, including hotels, car rental companies and tour operators are also disseminating messages about child rights and safety throughout their networks. Child-friendly spaces, supported by UNICEF and partners, have been open at four of the major FIFA Fan Fests in Soweto, Sandton, Nelspruit and Port Elizabeth. The sites have played to host to 15,000 to 45,000 fans as well as social workers, child and youth care workers and trained volunteers charged with identifying children who are in need of protection and emergency care. TV screens showed matches in the spaces and age-appropriate activities were offered as well. UNICEF also harnessed the influence of international stars visiting the country for the tournament, such as UNICEF Goodwill Ambassador Angelique Kidjo, to highlight the immense needs of South African children made vulnerable by poverty and HIV. Outside South Africa, a pilot programme called ?World Cup in my village? has given young people in three locations in Rwanda and Zambia the opportunity to view matches on large open-air screens and projectors. In addition to the football, the screens are broadcasting important information about children?s health and their rights. According to Anthony Lake, UNICEF Executive Director from New York: ?The World Cup gives us a chance to focus positive public attention on the special risks children face in countries like South Africa and around the world and the special efforts we can take to protect them from those threats.? -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/953bf0ac/attachment-0021.html From hivtwg.moderator at gmail.com Mon Jul 12 06:32:29 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 12:32:29 +0700 Subject: [hivaids-twg] An HIV epidemic is ready to emerge in the Philippines In-Reply-To: <265B3372-94AF-4742-A1F4-E12933E27754@revisionasia.com> References: <265B3372-94AF-4742-A1F4-E12933E27754@revisionasia.com> Message-ID: From: Paul Causey Date: Mon, Jul 12, 2010 at 10:59 AM Subject: [msm-asia] An HIV epidemic is ready to emerge in the Philippines To: MSM-Asia Newgroup An HIV epidemic is ready to emerge in the Philippines >From Journal of the International AIDS Society Abstract Background: The state of the HIV epidemic in the Philippines has been described as "low and slow", which is in stark contrast to many other countries in the region. A review of the conditions for HIV spread in the Philippines is necessary. Methods: We evaluated the current epidemiology, trends in behaviour and public health response in the Philippines to identify factors that could account for the current HIV epidemic, as well as to review conditions that may be of concern for facilitating an emerging epidemic. Results: The past control of HIV in the Philippines cannot be attributed to any single factor, nor is it necessarily a result of the actions of the Filipino government or other stakeholders. Likely reasons for the epidemic's slow development include: the country's geography is complicated; injecting drug use is relatively uncommon; a culture of sexual conservatism exists; sex workers tend to have few clients; anal sex is relatively uncommon; and circumcision rates are relatively high. In contrast, there are numerous factors suggesting that HIV is increasing and ready to emerge at high rates, including: the lowest documented rates of condom use in Asia; increasing casual sexual activity; returning overseas Filipino workers from high-prevalence settings; widespread misconceptions about HIV/AIDS; and high needle-sharing rates among injecting drug users. There was a three-fold increase in the rate of HIV diagnoses in the Philippines between 2003 and 2008, and this has continued over the past year. HIV diagnoses rates have noticeably increased among men, particularly among bisexual and homosexual men (114% and 214% respective increases over 2003-2008). The average age of diagnosis has also significantly decreased, from approximately 36 to 29 years. Conclusions: Young adults, men who have sex with men, commercial sex workers, injecting drug users, overseas Filipino workers, and the sexual partners of people in these groups are particularly vulnerable to HIV infection. There is no guarantee that a large HIV epidemic will be avoided in the near future. Indeed, an expanding HIV epidemic is likely to be only a matter of time as the components for such an epidemic are already present in the Philippines. # # # See the full article in the APOCM Resource Library at http://msmasia.org/tl_files/2010%20resources/10-7_resources/HIV_epidemic_ready_to_emerge_Philippines.pdf Or the original posting on j1as.org at http://www.jiasociety.org/content/13/1/16. -- You received this message because you are subscribed to the Google Groups "MSM Sexual Health - Asia" group. To post to this group, send email to msm-asia at googlegroups.com To unsubscribe from this group, send email to msm-asia+unsubscribe at googlegroups.com For more options, visit this group at http://groups.google.com/group/msm-asia?hl=en?hl=en -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/e2c920bb/attachment-0010.html From ThanhHuong at fhi.org.vn Mon Jul 12 07:47:17 2010 From: ThanhHuong at fhi.org.vn (Huong, Pham Thi Thanh) Date: Mon, 12 Jul 2010 13:47:17 +0700 Subject: [hivaids-twg] Coordinator, Drug Use Interventions at FHI/ Vietnam Message-ID: <98DC86CEF032774F8F4FDE97CDC08CFA01021F1B@fhi-server1.fhi.org.vn> Kindly please help to circulate the attached job announcement. Thank you very much. Pham Thanh Huong | Human Resource Officer, FHI Vietnam 7th Floor, Hanoi Tourist Building, 18 Ly Thuong Kiet, Hanoi, Vietnam Office: +84-4-3934-8560 | Fax:+84-4-3934-8650 Mobile: +84 (0) 903254878 -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/47e7ee67/attachment-0010.html -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 1550 bytes Desc: image001.jpg Url : http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/47e7ee67/attachment-0010.jpe -------------- next part -------------- A non-text attachment was scrubbed... Name: JOB Ad- Coordinator, Drug Use Intervention.pdf Type: application/octet-stream Size: 69318 bytes Desc: JOB Ad- Coordinator, Drug Use Intervention.pdf Url : http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/47e7ee67/attachment-0010.obj From hivtwg.moderator at gmail.com Tue Jul 13 03:37:58 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Tue, 13 Jul 2010 09:37:58 +0700 Subject: [hivaids-twg] HIV in China: Understanding the Social Aspects of the Pandemic In-Reply-To: References: Message-ID: From: Date: Tue, Jul 13, 2010 at 7:04 AM Subject: [AIDS ASIA] HIV in China: Understanding the Social Aspects of the Pandemic To: AIDS_ASIA at yahoogroups.com HIV in China: Understanding the Social Aspects of the Pandemic Jing Jun, Heather Worth (eds) UNSW Press, August 2010, 240pp, PB , 234x153mm After China's first HIV-positive patient was reported in 1985, among those initially infected were peasants who had sold their plasma to international companies. Then it became clear that sex workers and injecting drug users were also becoming infected, and later, transient populations, ethnic groups and the poor. The realisation that HIV was a profoundly social issue had begun to dawn. It was becoming clear that epidemic was being propelled by three main economic drivers: the blood trade, the drug trade, and the sex trade. In this unique book young Chinese scholars map some of the most important social, political and cultural characteristics of the HIV epidemic in that country. The result of a collaboration between the University of New South Wales and Tsinghua University in Beijing, HIV in China uncovers some hidden truths about the spread of the disease and its social impacts. Contents Introduction Building Capacities of Social Research in HIV Jing Jun & Heather Worth 1 An Overview of China's HIV Epidemic Jing Jun & Heather Worth 2 Occupational Concerns among Female Sex Workers in China Huang Yingying 3 Drugs, HIV, and Chinese Youth Jing Jun 4 The Role of a Machine in the HIV Outbreak in Central China Su Chunyan 5 Fears of Identity Exposure among Gay Men Living with HIV Zhang Yuping 6 HIV Disclosure and Condom Use after Seropositive Diagnosis Sun Yongli 7 The Central Place of the Chinese Family in HIV Narratives He Mingjie 8 Stigma and HIV Discourse in China Zhang Youchun 9 Ethnicity and Gender in Social Research on HIV in China Huan Jianli About the Editors Professor Jing Jun is a Sociology Department professor and Director of the Social Policy Research Centre at Tsinghua University in Beijing. He is a policy advisor for China's National Center for HIV/AIDS Prevention and Control and the China-UK HIV/AIDS Prevention and Care Project. Associate Professor Heather Worth heads the International HIV Research Group in the School of Public Health and Community Medicine at UNSW. http://www.unswpress.com.au/isbn/9781742231693.htm __._,_.___ Reply to sender| Reply to group| Reply via web post| Start a New Topic Messages in this topic( 1) Recent Activity: Visit Your Group __ -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100713/2dcba364/attachment-0010.html From hivtwg.moderator at gmail.com Tue Jul 13 03:39:20 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Tue, 13 Jul 2010 09:39:20 +0700 Subject: [hivaids-twg] UN HONOURS 25 GROUPS FOR OUTSTANDING COMMUNITY-BASED RESPONSE TO HIV/AIDS In-Reply-To: <201007121605.o6CG51L6008521@mx7.un.org> References: <201007121605.o6CG51L6008521@mx7.un.org> Message-ID: From: UNNews Date: Mon, Jul 12, 2010 at 11:05 PM Subject: UN HONOURS 25 GROUPS FOR OUTSTANDING COMMUNITY-BASED RESPONSE TO HIV/AIDS To: news9 at secint00.un.org UN HONOURS 25 GROUPS FOR OUTSTANDING COMMUNITY-BASED RESPONSE TO HIV/AIDS New York, Jul 12 2010 12:05PM Community-based groups working for prisoners? rights in Burkina Faso and treatment services for drug users in Nepal are among the 25 winners announced by the United Nations today for the 2010 Red Ribbon Award for outstanding local leadership and action in responding to AIDS. ?Grassroots and community-based organizations are at the heart of the global response to AIDS,? said Jan Beagle, who serves as Deputy Executive Director for Management and External Relations at the Joint UN Programme on HIV/AIDS (<" http://www.unaids.org/en/KnowledgeCentre/Resources/PressCentre/PressReleases/2010/20100712_PR_RedRibbonAward.asp ">UNAIDS). ?UNAIDS is proud to celebrate and honour these groups who have mobilized themselves to meet the needs of the most vulnerable in their communities with energy, passion, and compassion. The red ribbon award winners give a resounding voice to the voiceless.? There were 720 nominations from over 100 countries for the <" http://www.redribbonaward.org/index.php">Red Ribbon Award, which is named after the global symbol in the movement to address AIDS and is given by the UNAIDS family every two years. The 25 winners, representing 17 countries, were selected by a group of civil society experts in the community response to HIV for having demonstrated the most remarkable efforts in terms of innovation, impact, sustainability, strategic partnerships, gender sensitivity and social inclusion. ?Communities really hold the key to finding solutions to their own problems," said Dr. Helene Gayle, President and Chief Executive Officer of the non-governmental organization CARE, and a member of this year?s selection committee. ?So while those of us with a lot of outside expertise may know the theories, community organizations are best suited to reach those most in need when it comes to applying them.? The winners, each of whom will receive a cash award and international recognition for their efforts, are invited to participate in the XVIII International AIDS Conference to be held in Vienna from 18 to 23 July. They will be guests of honour at a formal awards ceremony there and will host a forum for dialogue and exchange between policy makers and community representatives. Jeffrey O?Malley, Director of the HIV/AIDS Practice at the UN Development Programme (<" http://content.undp.org/go/newsroom/2010/july/undp-announces-2010-red-ribbon-award-winners-.en">UNDP), noted that these organizations clearly demonstrate that effective responses to the epidemic require the full participation of front-line, community-based groups. ?Community groups recognize that AIDS is one of many issues that are tied together,? he said. ?They understand that AIDS requires an exceptional response but they also understand that you need to link AIDS to broader issues of health, development and justice to be effective.? ________________ For more details go to UN News Centre at http://www.un.org/news To change your profile or unsubscribe go to: http://www.un.org/apps/news/email/ -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100713/ebefffaa/attachment-0010.html From hivtwg.moderator at gmail.com Tue Jul 13 03:40:36 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Tue, 13 Jul 2010 09:40:36 +0700 Subject: [hivaids-twg] Today's News (2010.07.12ex) In-Reply-To: <5C59F89A4AB30C4FB23C2A916FA702E2017CC384@GE-MAILHQ-01.global.unaids.org> References: <5C59F89A4AB30C4FB23C2A916FA702E2017CC384@GE-MAILHQ-01.global.unaids.org> Message-ID: From: Diaz, Clara Date: Mon, Jul 12, 2010 at 7:03 PM Subject: Today's News (2010.07.12ex) To: Please find attached the following AIDS-related articles compiled by UNAIDS *UNAIDS* 1. Southern Africa Times - *Namibia** lifts HIV travel restriction * *AFRICA** AND MIDDLE EAST* 1. Cameroon Tribune - *Public-Private Partnership To Fight HIV* 2. UN IRIN - *EAST AFRICA**: Community HIV drug distribution improves adherence * 3. IPS-Africa - *Concerns over Cost of New HIV/AIDS Treatment Regime * 4. The Namibian - *Government Scraps Aids Clause From Visa Forms * 5. The Citizen, Tanzania - *Polygamy ups HIV infection risk in Kenya * *ASIA** AND PACIFIC* 1. New Kerala, India - *Fear of AIDS during CWG, NGO calls for health cards to sex workers * 2. Jakarta Post - *Bali** loses influential HIV/AIDS activist * 3. Medical News Net, Australia - *Science special section examines HIV/AIDS in Russia, Ukraine * *EUROPE*** 1. The Guardian, UK - *Better housing will improve health in Haiti * 2. AFP - *Sex now chief cause of Ukraine's AIDS epidemic * 3. AFP - *Zimbabwe** lacks AIDS drugs to expand treatment: official * *LATIN AMERICA AND CARIBBEAN* 1. Jamaica Gleaner - *For everyone to count, they must be counted * 2. La Prensa, Honduras - *El 70% de casos de sida afecta a parejas j?venes * 3. La Ag?ncia de Not?cias da Aids, Brazil - *Projeto que possibilita soropositivos aposentados por invalidez a prestarem assessoria intelectual remunerada deve ser votado na pr?xima quarta-feira pelo Senado * *NORTH AMERICA* 1. New York Times - *Obama to Outline Plan to Cut H.I.V. Infections* 2. Los Angeles Times - *The truth of China's response to HIV/AIDS * 3. New York Times -* **Waiting Lists for the AIDS Drug Assistance Program (Letter) * 4. TIME Magazine - *AIDS Vaccine: The Promise of HIV Antibodies * 5. PR Newswire - *Online Coverage of XVIII International Aids Conference to Include Daily Webcasts, Live Coverage, Podcasts and News Recaps* 6. Associated Press - *S. Africa** holds education summit before WCup final* *UNAIDS WEB.SITE* 1. UNAIDS - Research project during the World Cup gathers data on sex workers and HIV 2. UNAIDS - *AIDSspace @ Vienna 2010 * =========================== *UNAIDS* =========================== *Namibia lifts HIV travel restriction ** **Southern Africa Times* 12/07/2010 By Charles Tjatindi Windhoek - Namibia has lifted travel restrictions on people living with HIV/AIDS, warranting entry, stay and residence in the country. The reforms, which took effect on 1 July 2010 - also remove entry restrictions against people living with other contagious diseases. Namibia's Minister of Home Affairs, Rosalia Nghidinwa in a statement delivered in parliament on Wednesday said the restriction was lifted in the interest of the country's national HIV and Aids response efforts. The minister admitted that it was an 'oversight' that the regulation was placed on visa application forms, which meant that people who were HIV positive would be turned down when applying for a visa to enter Namibia. She said although there is no known case of enforcement of the regulation prior to its lifting, its existence created a wrong impression of Namibia as a democracy and its national and international commitments to a human rights-based approach to responding to fostered stigma and discrimination towards people living with HIV and Aids. 'The National HIV/AIDS Policy and frameworks clearly state the need for greater efforts to ensure that people living with HIV have full access to rights and services, and continue to participate actively in Namibian society,' said Nghidinwa The regulation, before being amended, considered a wide range of 'infectious diseases as grounds for restriction by the ministry of home affairs and immigration such as tuberculosis, trachoma, syphilis, leprosy and Human Acquired Immune Deficiency Syndrome Virus (HIV). The amended regulation now only places emphasis on 'contagious diseases'. It now reads 'Any contagious infection or virus or disease (air borne or transmitted through casual contact) that exists or may develop from time to time that is declared a Public Health Emergency of International Concern..' The amendment, according to Nghidinwa, will be communicated to all of the country's immigration offices, points of entries, border posts, airports and Namibian missions abroad to educate and inform prospective visitors to Namibia on the changes made with regard to the visa application conditions. UNAIDS, the joint United Nations Programme on HIV/Aids welcomed the lifting of the regulations, noting that restrictions that limit movement based on HIV-positive status are discriminatory and violate human rights. 'There is no evidence that such restrictions prevent HIV transmission or protect public health. Furthermore, HIV-related travel restrictions have no economic justification, as people living with HIV can lead long and productive working lives', the UNAIDS said in a statement. =========================== *AFRICA** AND MIDDLE EAST* =========================== *Public-Private Partnership To Fight HIV** **Cameroon Tribune* 09/07/2010 Effa Tambenkongho The Treatment Access Watch presented their observation in the field from various HIV treatment centres and in turn launched the association. Treatment Access Watch, TAW is an independent observatory group of individuals who carried out a study or an observatory in the various HIV treatment centres around the country to find out all aspects involved with HIV in the treatment centres. The findings, the government intends to use to ameliorate the sector of HIV treatment, the Delegate of Health, Andr? Bite Fouda said during the launching of TAW at Maison du Combattant, Bonanjo, Douala. The Delegate said they need a public/private partnership in the fight against HIV because the Government cannot do all alone. He said government is ready to work with TAW in The field. According to the findings of TAW as explained by Marie Therese Mengueme, there is a problem of people refusing to take their medication and putting in place the medication and treatment. Some patients complained of waiting for long at the UPEC pharmacy, and purchaise of their medication the payment of consultation fee just to buy their medication. There were complaints of The nurses on seat who are often slow especially when they are many. Dr Gerald Sume, Regional Coordinator in Charge of Vaccination, said the observation of TAW was done in about some 27 HIV treatment centres and the discrepancies found would be used by the government to ameliorate the sector. He added that the government cannot do everything alone. TAW also used the opportunity to officially launch its activities presented by Forgui Forgui To and Guy Bertrand Tengp?. It was said to be an initiative of two bodies, Positive Generation and synergy of Human and Social Science, 3SH, all in the promotion of human rights and treatment of patients. The main activity of this independent observatory group is to listen to the points of view of the users of health services and to put in place a free Anti retroviral distribution procedure in the Centre and Littoral Regions. *2* *EAST AFRICA: Community HIV drug distribution improves adherence** **UN IRIN* 07/07/2010 NAIROBI, 7 July 2010 (PlusNews) - Local East African programmes are discovering the benefits of bringing HIV services closer to rural communities, with mobile drug distribution improving HIV-positive patients' adherence to antiretroviral treatment (ART). "While there might be health facilities in rural areas, they are normally far flung; by using mobile care and treatment centres, it is easy to reach populations, many of whom are normally too poor to have transport to the established health centres," Waziri Rashid Njau from the Support for International Change (SIC), a local HIV-focused NGO in Tanzania, told IRIN/PlusNews. "We have used this in northern Tanzania and we have seen reduced cases of loss [of contact with patients] to follow up; local health facilities record higher cases of drop-out amongst patients than we do," he added. Patients must visit a hospital for their initial diagnosis and ART prescription, and are required to visit the health centre periodically, but in between visits, SIC uses community-based volunteers and trained medical workers to drive around villages refilling prescriptions as well as providing education on condom use and the prevention of opportunistic infections. SIC in Tanzania reaches nearly 2,500 people with mobile ART clinics and has so far trained around 200 health workers in Babati District in northern Tanzania. Bridging health system gaps Tanzania suffers from a critical shortage of medical personnel, so the mobile drug distribution is performing a much-needed function. The Ministry of Health reported in 2007 that the country had 1,339 doctors; many regions have a doctor-to-patient ratio as low as 0.1 to 10,000. Community drug distribution has also been successful in neighbouring Uganda, where a 2008 study carried out in the eastern district of Tororo by local NGO The AIDS Support Organization (TASO) found that out of 2,115 active clients enrolled for antiretroviral therapy at the community drug distribution points, only 22 - about one percent - were lost to follow up. In comparison, a 2009 Ugandan study found that about a quarter of HIV-positive patients in clinical settings dropped out of programmes during the clinical assessment stage, even before they were put on ART. One of the main reasons given for not returning to health centres was the high cost of transport. "Our experience is that it is a lot easier to deal with large numbers of antiretroviral clients with this model? Space at health centres is limited, and it is easy to visit them where they are," said Emmanuel Patta, a field officer with TASO. TASO has 77 community drug distribution points in Tororo, each catering for an average of 30 antiretroviral therapy clients. Involving HIV-positive people "Because follow-up is normally done by people living with HIV themselves, this provides an avenue to use them as a resource in the fight against HIV/AIDS," SIC?s Njau noted. "You get to create awareness among community members and not only those who are infected, but even those who are not infected or might not know their status," he added. "Through these models, you get an opportunity that is community-owned to reach out to them and create awareness." At the community drug distribution points, clients have the opportunity to share experiences and support each other on issues related to side effects, adherence, community awareness and stigma, and this also provides an opportunity for optimal use of limited resources. Challenges Njau noted that despite efforts to involve people living with HIV in the programme, and to teach their communities to accept them, stigma remained a concern. "Stigma might make these clients not want to go where people will know them ... [They] would rather go far away [for treatment]," he said. And in many areas poor nutrition remains a challenge to the adherence of clients of community-based drug distribution. "Poverty inhibits good nutrition among many ART clients, which can at times hinder the effectiveness of treatment programmes," Njau said. Despite the problems, TASO?s Patta said community drug distribution had for the most part worked extremely well and could "work effectively in places that experience shortages of staff and health facilities". *3* *Concerns over Cost of New HIV/AIDS Treatment Regime** **IPS-Africa* 10/07/2010 Claire Ngozo LILIONGWE, Jul 10 (IPS) - As government implements a new HIV/AIDS treatment regimen according to latest world standards, a major grouping of non-governmental organisations are concerned that the high cost of the new medication will mean government will no longer be able provide free treatment to as many people as before. The Malawi Network of People Living with HIV/AIDS (MANET+) advocacy officer George Kampango told IPS that the new drugs, which cost three times as much as the current regime used, will be too expensive for government to manage providing free treatment to the poor and children. MANET+ is worried that not everyone who needs the antiretroviral therapy (ART) will have access. "At the moment, not all people who require treatment are getting it. Government is failing to provide free treatment for many poor people and children including orphans who need it most," said Kampango. Out of Malawi?s 13.1 million total population, 65 percent lives below the poverty line of less than one dollar per day, according to the United Nations. The country is also home to about 560,000 AIDS orphans, most of whom are also HIV-positive, according to 2007 government statistics. "The new drugs are even much more expenive and we fear that government will struggle even more to make them available even to those people who are already accessing treatment free of charge. Poor children are likely to be penalised from accessing the drugs because they are not usually a priority for treatment," Kampango said. Currently the Malawi government provides free anti-retroviral drugs to about 250,000 people. There are up to one million people living with HIV and the HIV prevalence rate is at 12 percent, according to the Ministry of Health. The country has been procuring the first line of the HIV course of therapy comprising of Stavudine, Lamivudine and Nevirapine at about 33 dollars but the new drugs will cost the government 100 dollars per month for every person, according to Principal Secretary for HIV and AIDS in the office of the president and cabinet, Dr. Mary Shawa. "Malawi is changing the treatment in line with World Health Organisation (WHO) guidelines which are urging countries to phase-out the current first line of treatment which is blamed for increased side-effects," Shawa said. WHO introduced new guidelines for the treatment of HIV and prevention of mother-to-child transmission (PMTCT) on Nov. 30, 2009. The U.N. indicates in the revised guidelines that countries also need to start providing treatment much earlier when the measure of immune system strength, the CD4 count, is at 350 cells per cubic millilitre or less and not at the current 200. The new recommendation also guides countries to provide the therapy of either Zidovudine or Tenofovir even if the patient has not started displaying AIDS symptoms. But MANET+ is arguing that there are still many people in the country who, at the moment, cannot access free HIV treatment because of lack of resources within government coffers and that adopting the new regimen will make the situation worse. "It will be more challenging for government now to provide drugs to people infected with HIV because starting treatment earlier will translate into people being on the drugs for more years than before. This would mean much higher costs for the antiretroviral (ARV) drugs," worried Kampango. Malita Luka, 35, from Nsalu in Lilongwe told IPS that the news that government is adopting a more expensive therapy is worrisome. She and her nine-year-old child have been waiting in vain to go on the ART provided free of charge by government, after they were diagnosed HIV-positive a year ago. "My child and I are always falling sick and I think we should be put on therapy but the medical people say that we are not sick enough yet to access treatment," said Luka. She said her cousin, a cross-border trader who makes good money and is also HIV-positive, has managed to go on the treatment through private practitioners after she failed to access it free of charge. "I can?t afford to do the same and I now fear that it will be even more difficult for my child and I to access the free drugs now that they will be more expensive even for government," worried Luka. The Malawi National AIDS Commission (NAC), a public trust which coordinates national response to HIV and AIDS, has been complaining about lack of finances for the programme. NAC acting executive director, Bridget Chibwana, was quoted earlier this year in the local media that lack of funds is a major obstacle in adopting the new AIDS treatment. Other challenges include lack of enough infrastructure and shortages of health workers. Malawi continues to seek more funding for HIV interventions from the Global Fund and other donors, according to NAC. Meanwhile, there might be hope for people like Luka, the Malawi government has added more resources to HIV interventions in the 2010/2011 national budget. The country?s finance minister Ken Kandodo said in his 2010 budget statement that in this financial year the health sector has been allocated a total of 300 million dollars. Of this, 75 million dollars has been allocated to the NAC "to combat HIV/AIDS pandemic". Still MANET+ is planning on advocating for more resources and government commitment towards the fight against HIV/AIDS. "We are planning on an advocacy programme so that the new treatment guidelines should be well thought through before being implemented," said Kampango. *5* *Government Scraps Aids Clause From Visa Forms** **The Namibian* 09/07/2010 The Ministry of Home Affairs has removed a controversial requirement on entry visa application forms to declare one's HIV-AIDS status and other infectious diseases like tuberculosis. "Even though there is no example of the enforcement of this regulation in Namibia, its existence created the wrong impression of Namibia as a democracy and its national and international commitments to a human rights-based approach to responding to HIV-AIDS and fostered stigma and discrimination towards people living with it," Home Affairs Minister Rosalia Nghidinwa told Parliament on Wednesday. "It was an oversight that the regulation was placed on the visa application forms," she added. The Immigration Control Regulation promulgated in terms of the Immigration Control Act in Government Notice No 134 of 1994, listed several diseases in terms of the visa application forms including tuberculosis or any other lung disease; trachoma or any other contagious eye diseases; framboesia, yaws, scabies or any other contagious bacterial or other skin disease; syphilis or any other venereal disease, leprosy and HIV-AIDS. The wording in the regulation on the visa application forms has now been changed to "contagious infection or viruses or diseases, any contagious infection or virus or disease (airborne or transmitted through casual contact) that exist or may develop from time to time that is declared a Public Health Emergency of International Concern (PHEIC) and which warrants restriction of international travel and mobility as per the International Health Regulation adopted by the Fifty-Eight World Health Assembly (2005)." Namibia is party to the WHO. The Ministry of Home Affairs will delete the old text from the Namibia visa application form on its website and will communicate the scrapped list of diseases to all its immigration offices, points of entry, border posts, airports and Namibian diplomatic missions. *6* *Polygamy ups HIV infection risk in Kenya** **The Citizen, Tanzania* 12/07/2010 By Samuel Siringi, Citizen Correspondent, Nairobi Thirteen of every 100 married Kenyan women have co-wives. This means they are married to men who have at least one or more other wives, according to the latest official statistics on population trends. Although the figure represents a drop from the 16 of every 100 married women who had co-wives in 2003, the Kenya Demographic and Health Survey (KDHS), 2008/2009 says Kenyan men should restrain themselves from taking more than one wife. Polygamy means multiple spouses; polygyny means multiple wives; and polyandry means multiple husbands. Experts believe that in Kenya polygyny is one of the social practices fuelling the spread of HIV/Aids. It also perpetuates large families, frustrating campaigns to control population growth estimated at 2.3 per cent per year. Results of last year?s national population census ? now scheduled to be released next month? are expected to show that Kenya has a population of 40 million people, a number so high that it will dominate today?s World Population Day official celebrations being held in Mombasa. ?We get worried by polygamous marriages because they increase the likelihood that co-wives will compete among themselves at having more children and end up contributing to the average number of births per women,? said Samuel Ogola, a programme officer at the National Coordinating Agency for Population and Development. The situation, he said, was worse among less educated women, an observation confirmed in the KDHS report. It shows that educated women were less likely to practice polygamy, a practice that was common in past centuries when having more women and children was considered to be a status symbol and a source of pride for men. Having more daughters in the past was seen as a source of wealth from the dowry paid to their families when they were married. Libyan leader Muammar Gaddafi is expected to lead a large delegation to the 13th African Union Summit of Heads of State in Kampala later this month. *=======================* * * *ASIA** AND PACIFIC* * * *=======================*** *Fear of AIDS during CWG, NGO calls for health cards to sex workers** **New Kerala, India* 12/07/2010 New Delhi, Jul 12 : There is a grave fear of HIV/AIDS virus attacking more people in the national capital with the ensuing Commonwealth Games, an NGO has claimed. ''It is presumed that during the upcoming Games in Delhi, more sex workers will visit the city from various places inside and outside the country. These workers might carry the HIV/AIDS virus with them,'' Khairati Lal Bhola, chief of Bharatiya Patita Uddhar Sabha, said. However, if health cards are issued to them before the mega event so as to ensure their regular medical check-ups, the affect can be mitigated, he added. ''Such cards were given to the sex workers after the 1982 Asian Games when the first HIV positive case was detected in the country and they were valid from 1988 to 1992. Thereafter, the scheme was scrapped and the health cards were not renewed,'' Mr Bhola said. He informed UNI that the organisation has written letters to Union Health Minister Ghulam Nabi Azad and Delhi Health Minister Kiran Walia to take immediate action on the above proposal. --UNI *2* *Bali loses influential HIV/AIDS activist ** **Jakarta Post* 12/07/2010 Ni Komang Erviani, Contributor, Buleleng An activist who devoted his life to eradicating the discrimination faced by people living with HIV/AIDS has passed away. Made Suparja died Wednesday at the age of 60, in his house in Goris hamlet, Pejarakan village in Gerokgak, Buleleng. Suparja was known for his fight to establish a support group for people living with AIDS in Buleleng regency, and for his tireless campaigning to end discrimination against people with the disease. "I was about to take my husband to the hospital *on Wednesday morning*, but before we could reach the ambulance, he suddenly stopped responding. I thought he was sleeping," Suparja's wife, Made Siti, told The Jakarta Post on Thursday during her husband's cremation ceremony in Banyuatis cemetery in Buleleng. Suparja allegedly succumbed to complications relating to liver problems and diabetes. "We really lost Pak Suparja, who contributed to the abolition of stigma and discrimination surrounding AIDS sufferers. He changed people's views toward HIV/AIDS," said Riko Wibawa, activist from Citra Usadha Indonesia, a foundation focusing on prevention and rehabilitation of HIV/AIDS. Suparja has spent his life struggling to end the stigma. He started his fight in Goris, his home hamlet. With support from the foundation, he relentlessly campaigned to the people in his village about the nature of HIV/AIDS and its means of transmission. Suparja found out in 2000 that he had contracted HIV, which was attributed to unprotected sex with multiple partners during his youth. Suparja was devastated to learn he had been infected with HIV, but even more so when finding his wife has also contracted the infection. In desperation, the couple considered suicide. Suparja managed to escape from his depression thanks to assistance from the foundation's activists. As he reestablished his life, he faced discrimination from his surrounding community. He was not even allowed to use glass when he bought a drink in the village's food stall. Annoyed by the discrimination, he started his fight to spread understanding that the infection didn't spread via social contact, and could only be transmitted through sexual activities and blood contact. "Pak Suparja really helped us to give correct the society's understanding of HIV transmission. Now, there is no discrimination against people suffering HIV/AIDS in the village," said Siti Mariani, a foundation activist. Suparja also carried out similar campaign in Buleleng by establishing support group Tali Kasih for HIV/AIDS patients in the regency. There are currently 15 HIV/AIDS patients taking part in the program. "We hope to end discrimination against *HIV/AIDS* patients," Suparja said in a 10-minute video footage recorded by the Bali branch of the AIDS commission. "Pak Suparja's passing will not hold waver our commitment to eradicate discrimination against the patients. Suparja wouldn't want us to stop fighting. We will continue his fight for the sake of the patients," Siti Mariani said. *4* *Science special section examines HIV/AIDS in Russia, Ukraine** **Medical News Net, Australia* 12/07/2010 In a special section in advance of the International AIDS Conference, Science examines the "state of the HIV/AIDS epidemic in Russia and Ukraine, which account for more than 90% of HIV infections in Eastern Europe." "With a travel grant from the Open Society Institute's Public Health Program, correspondent Jon Cohen and photographer Malcolm Linton visited researchers, clinicians, advocates, and affected communities in both countries," according to the introduction. "The central dilemma is that HIV in the region has been mainly transmitted by injecting drug users [IDUs] sharing needles, and the 'harm reduction' strategies successfully used in Western Europe and elsewhere, such as needle exchange or opiate-substitution treatment, have not taken root in the more conservative climate of the East. ... Building a strong response to HIV/AIDS takes several years in almost every country. But Russia, Ukraine, and their neighbors have an advantage: They can learn from the many other countries that began confronting the virus more than a decade before it hit Eastern Europe" (Jasny et. al., 7/9). One article looks at the spread of HIV/AIDS in Eastern Europe and Central Asia and countries' responses to the epidemic. "In all of the regions of the world, it was possible with awareness and prevention to stop the growth, and yet the epidemic is still growing here," according to Dennis Broun, the UNAIDS regional director based in Moscow. "Many on the frontlines of combating the epidemic in both countries stress that great strides have been made in preventing mother-to-child transmission and providing anti-HIV drugs for treatment. But they have become deeply frustrated by many other aspects of the response to their epidemics?particularly the limited help available for IDUs, who often are reviled," the publication writes *========================* *EUROPE*** *========================* *Better housing will improve health in Haiti** **The Guardian, UK* 12/07/2010 Peter Williams Haiti, with its population of 9.5 million ? the size of the UK's five largest cities ? has for much of the last century remained one of the poorest countries in the world. Prior to the 12 January earthquake, the average life expectancy was 43 years, in stark comparison with the UK's 79 years. Major barriers to social development have been cross cutting ? not least a legacy of bad governance and the unequal distribution of resources. The country simply lacked the necessary investment in infrastructure which so many of its neighbours (excluding Cuba) prioritised in the 1980s and 90s ? chief among these were civil, health and ICT investments. Natural disasters have certainly compounded the challenge ? in 2008, hurricanes left 1 million homeless and brought an increase of widespread infectious diseases. In the wake of the 12 January earthquake, all of these challenges and more came to a head. The earthquake left 1.5 million homeless, almost 0.5 million injured and tens of thousands in need of psychosocial support. The large number of internally displaced people has dramatically increased the risk of communicable disease transmission. It therefore comes as little surprise that the country faces the two-fold challenge of improving both the health and housing of millions: challenges which are interdependent. Let's explore the facts. When a lack of access to suitable water, sanitation and housing is compounded by overcrowding, conditions are ripe for health risks such as diarrhoea and respiratory-related illnesses. A more latent danger (not because it's any less of a threat, but because it is harder to detect) is the increased susceptibility to socio-medical challenges such as HIV/Aids ? for which high-risk behaviours correlate to poor socio-economic status such as bad living conditions. Let us not forget that at the time of the earthquake, there were approximately 120,000 people living with HIV in Haiti. For the latter, research shows sub-standard housing increases the risk of opportunistic illnesses among people living with HIV/Aids. Poor heating and ventilation causes mould, fungus and bacteria which compromise the respiratory system. Yet there is a solution: bring in improved ventilation and reduce indoor humidity and you significantly reduce the risk of the HIV-positive individual contracting tuberculosis (TB). These are simple solutions, but still one-third of people living with HIV/Aids are co-infected with TB. In fact, without proper treatment, 90% of people with HIV/Aids die within months of contracting TB. Following the Asian tsunami, the publication Lessons Learned from Aceh (published by Arup/DEC) provides guidance for the future actions of the international community. One of the key lessons learned from the "build back better" model was that a multi-sector approach to reconstruction is not only necessary but central to delivering a lasting improvement to people's lives. In Indonesia, this meant an improvement to livelihoods through training projects which were integrated with rebuilding. In Haiti, I would advocate the same but expand this to include a shifting of the paradigm to look at civil infrastructure and health as two interconnected areas of development. Architecture for Health in Vulnerable Environments is committed to this approach, firmly believing in a new landscape where locals ? civil society, public and private sectors ? can champion the use and reuse of housing as a key strategy for improving health. This can be through the support of innovative ideas which prioritise the built environment in combating disease as well as investing in models of decentralised healthcare. A reprioritised model towards community home-based care systems fits well with the socio-cultural landscape of Haiti, where social and informal networks have a history of being alive and strong and where, sadly, hospitals and health clinics are now damaged or under resourced. We've heard time and again that earthquakes don't kill people ? buildings do. But I would add that buildings can also dramatically improve people's lives, reduce the risk of poor health and increase the chances of an already ailing individual leading a longer and healthier life. Yes, of course it is essential to bring emergency shelter and medications for those most urgently in need, but let us also seize the opportunity to start something new. As we rebuild in Haiti, let's keep this vision at the forefront of the agenda: health and housing as co-dependent instruments of development. *2* *Sex now chief cause of Ukraine's AIDS epidemic** **AFP* 11/07/2010 By Anya Tsukanova KIEV ? "I am not a drug addict!" insisted Andri, 32, staring desperately at the walls of a clinic for people with HIV in Kiev. The young father contracted HIV through a casual sexual relationship, like alarming numbers of others in a country where heterosexual transmission has overtaken drug abuse as the main cause of AIDS. The trend has alarmed researchers, showing that the HIV epidemic in Ukraine has now moved out of the niche of intravenous drug users and into the heterosexual mainstream. With an HIV prevalence rate of 1.11 percent among Ukraine's adult population as of 2009, the former Soviet republic is one of the states in Europe worst hit by the epidemic. For years, the virus has been spread mainly in Ukraine by intravenous drug users but the trend has changed with startling speed. Since 2008, more Ukrainians have been contracting HIV through heterosexual sex than through drug abuse. In 2009, 43 percent of Ukrainians infected with HIV caught the virus through heterosexual sex and 35 percent by drug injection. Experts have warned that this means the epidemic risks no longer affecting mainly high-risk groups like drug users, prostitutes and homosexuals but the general population as a whole. "There are already signs of a generalisation" with the HIV infection rate of pregnant women now standing at more than one percent in some regions, said Svitlana Antonyak, an official from the national HIV clinic. "Two thirds of cases of sexual transmission are linked to intravenous drug use," said Tetyana Deshko of the Ukrainian branch of the NGO International HIV/AIDS alliance. She described the typical path of transmission in today's Ukraine: "A drug user who probably does not know he is HIV positive has a relationship with a woman who probably does not know that her partner is a drug user." Andri was infected with HIV during an adulterous relationship with a former lover who he suspects now is a drug addict. "I saw the traces of injections on her arms but she said it was because she had just been to hospital," said Andri, who learned of his diagnosis at the start of the year. He insists that he used a condom, but it broke. "I put another one on, and thought that it would do. It was stupid. Stupid!" Almost half of Ukrainians between 25-49 who say they had more than one sexual partner in a year do not use condoms, said a national report compiled by the Ukrainian ministry of health for UNAIDS. "A condom is often seen (in Ukraine) as a sign of not trusting your partner," said Tetyana Deshko. Moreover many in Ukraine still see AIDS as a problem affecting only disadvantaged groups." "There's lack of information campaigns of good quality, capable of changing young people's behaviour," Antonyak said. "My 20-year old son told me he always uses a condom because he was here, at the hospital, helped me and saw people suffering here. Probably that's what we need to do", she added. Alarmingly "only one HIV victim in four" in Ukraine is actually aware that they have been infected, said the national report. As of January, 101,000 Ukrainians were infected with HIV according to official figures but the real number is estimated at 360,000. The number of deaths from AIDS was 19,000 between 1987 and April. However in a ray of hope, the use of antiretroviral therapy resulted in the first cut in the mortality rate from AIDS, of 2.6 percent, last year. Antiretrovirals were introduced to Ukraine only six years ago. But funds are limited and at least 7,500 patients who need the drugs are not receiving them. "We really need help from donors," said Svitlana Cherenko, head of the state committee for the fight against AIDS. Ukraine already received 230 million dollars from the Global Fund to Fight AIDS, Tuberculosis and Malaria for the years 2004-2012 and will this month put in a new request with the organisation for estimated 300 million dollars for 2012-2017. Copyright ? 2010 AFP. All rights reserved *3* *Zimbabwe lacks AIDS drugs to expand treatment: official ** **AFP* 11/07/2010 HARARE ? Zimbabwe may not have enough anti-AIDS drugs to comply with World Health Organisation recommendations on providing treatment to people with HIV, a top health official said Sunday. Zimbabwe is currently treating about 200,000 people whose immune systems have been severely weakened by the disease, but the WHO recommends that treatment should start earlier. "The number of people in need of treatment will double if we follow the World Health Organisation plan," Tsitsi Mutasa Apollo, co-ordinator of HIV treatment in the health ministry, said in the state-run Sunday Mail. "We are likely to experience more drug shortages," said Apollo. The new guidelines would mean about 500,000 people need treatment, the paper said. Zimbabwe's prevention and treatment campaign relies on donor funding, after a near decade of economic crisis also which crippled health services. The country imposes an AIDS levy on workers to fund drug procurement for over 1.6 million people living with the virus. Last year HIV infected 13.7 percent of adults, down from a high of 33 percent in 1999. The decline has been attributed to donor-backed prevention campaigns which promotes safe sex and discourages multiple sexual partners. Copyright ? 2010 AFP. All rights reserved *========================* * * *LATIN AMERICA AND CARIBBEAN* * * *========================* *For everyone to count, they must be counted** **Jamaica Gleaner* 12/07/2010 Thoraya Ahmed Obaid, Contributor Every country counts its people. The numbers tell decision-makers about current and future needs. "Everyone counts" is the theme for this year's World Population Day. If people and their characteristics are not counted, governments cannot plan. If identification is not granted, it is impossible to track progress over a lifetime. If a birth certificate indicates a need for schooling, that informs the education system. If death records specify, to the extent possible, cause of death, health systems can be oriented to meet actual needs. If death records specify causes related to HIV/AIDS and other infectious diseases, pregnancy and childbirth, specific health services can be prioritized. Government planning depends on local and regional information that is supplemented by interviews with the groups most concerned. Such data makes it possible to meet real needs. Good data is critical for evidence-based policies and programmes for improving people's lives. Yet, while timely and reliable data is routine in richer countries, many resource-constrained developing countries struggle to conduct the censuses and surveys that they need for effective planning. Population and housing censuses For the past 30 years, the United Nations Population Fund (UNFPA) has played a lead operational role in helping to build countries' capacities for data collection and analysis. A current focus of UNFPA support is successful implementation of the 2010 round of population and housing censuses (2005-2014). In 2009, UNFPA supported 77 governments' national population and housing censuses and paved the way for other censuses in 2010. This work is often complex, as in Iraq, the occupied Palestinian territories and Sudan. In Eastern Europe and Central Asia, UNFPA is promoting new data-collection technologies and assisting Bosnia and Herzegovina to conduct a census. In Africa, UNFPA is helping to analyse data collected by recent censuses in Chad, Liberia and Nigeria. All these countries could not complete their censuses in 2000, and Liberia's successful census ended a period of more than 30 years in which no statistical work could be done. In Asia and the Pacific, the enumerations are successfully concluded in Bhutan, Democratic People's Republic of Korea and Vietnam; and censuses are being prepared for East Timor and Mongolia. In Latin America and the Caribbean, national statistical institutes are participating in training to enhance skills for data collection and analysis. Census data reveals compelling characteristics about employment, education and health services in countries. It provides information about population growth, the movements of people, age structures, poverty levels, urbanisation and the spatial distribution of a country's population. Countries can use that information to plan investments, save lives and improve opportunities for present and future generations. With world attention focused on achieving the Millennium Development Goals by 2015, and the upcoming MDG10 Summit at the United Nations in September, the availability of consistent and comparable statistical information has become even more crucial. Data for development plays a prominent role in monitoring progress, assessing and realigning plans and strategies, and conducting effective advocacy. Data, and public access to it, contributes to transparency and accountability. UNFPA, the United Nations Population Fund, is an international development agency that promotes the right of every woman, man and child to enjoy a life of health and equal opportunity. UNFPA supports countries in using population data for policies and programmes to reduce poverty and to ensure that every pregnancy is wanted, every birth is safe, every young person is free of HIV/AIDS, and every girl and woman is treated with dignity and respect. UNFPA - because everyone counts. *Thoraya Ahmed Obaid, is UNFPA executive director. Feedback may be sent to columns at gleanerjm.com* *2* *El 70% de casos de sida afecta a parejas j?venes ** **La Prensa, Honduras* 11/07/2010 Tegucigalpa. , Honduras - Los j?venes siguen siendo blanco f?cil del sida. Un informe del Programa del Sida de las Naciones Unidas, indica que el 70% de los casos en el pa?s se da en parejas j?venes y se estima que al a?o se registran m?s de 1,300 personas infectadas. El asesor en la materia de las Naciones Unidas, Kenneth Rodr?guez, inform? que fuentes ?oficiales reportan aproximadamente 28,600 personas infectadas con el VIH hasta diciembre de 2009?. Pese a estar en julio, no hay nuevas cifras recientes, dijo. El experto se?al? que la epidemia tiene sus particularidades y una de ellas es que tiene que ver con el comportamiento humano y sexual. Precis? que en ?Honduras aproximadamente siete mil personas reciben tratamiento; pero hay una brecha, es decir, todav?a tenemos una deuda porque en este momento diez mil personas necesitan tratamiento. Entonces podr?a ser una brecha important?sima que todav?a est? por cubrirse?. *3* *Projeto que possibilita soropositivos aposentados por invalidez a prestarem assessoria intelectual remunerada deve ser votado na pr?xima quarta-feira pelo Senado** **Ag?ncia de Not?cias da Aids, Brazil* 10/07/2010 A PLS 273/08 ? do senador Romeu Tuma (PTB-SP) e deve ser votada nesta quarta-feira, 14 de julho, pela Comiss?o de Constitui??o, Justi?a e Cidadania (CCJ), informa a Ag?ncia Senado.. O relator, senador Neuto de Conto (PMDB-SC) apresentou voto favor?vel. Na justifica??o, Tuma enumera doen?as que inviabilizam a energia f?sica do trabalhador, mas que podem n?o comprometer o trabalho intelectual da pessoa, como seria o caso da AIDS. Nessas situa??es, explica ele, ainda que o servidor queira continuar na ativa, se a junta m?dica assim decidir, a pessoa pode ser obrigada a se aposentar. Tamb?m por esse motivo, alega o autor, consider?vel n?mero de servidores acaba se aposentando com "proventos irris?rios" e valores que n?o alcan?am sequer a metade da remunera??o que recebiam na ativa. Tal situa??o, avalia Tuma, pode comprometer a qualidade de vida da pessoa e de sua fam?lia. Apesar de n?o haver nenhuma proibi??o expressa na legisla??o, os aposentados n?o podem exercer qualquer atividade remunerada, nem mesmo como bolsistas em trabalhos acad?micos, como palestras ou pesquisas. E quem n?o segue essa proibi??o, acrescenta o senador, corre o risco de sofrer uma a??o de improbidade administrativa por quebra do princ?pio da moralidade que rege a administra??o p?blica. "O preconceito ao servidor p?blico aposentado por invalidez torna-se mais n?tido e evidente quando se compara com o servidor aposentado por qualquer outro motivo", considera Tuma. Se aprovada pelo Senado, a proposta de lei vai ? san??o do Presidente da Rep?blica, promulga??o e entra em vig?ncia. Reda??o da Ag?ncia de Not?cias da AIDS, com informa??es da Ag?ncia Senado *========================* *NORTH AMERICA* *========================* *Obama to Outline Plan to Cut H.I.V. Infections** **New York Times* 11/07/2010 By ROBERT PEAR WASHINGTON ? President Obama will unveil a new national strategy this week to curb the AIDS epidemic by slashing the number of new infections and increasing the number of people who get care and treatment. ?Annual AIDS deaths have declined, but the number of new infections has been static and the number of people living with H.I.V. is growing,? says a final draft of the report, obtained by The New York Times. In the report, the administration calls for steps to reduce the annual number of new H.I.V. infections by 25 percent within five years. ?Approximately 56,000 people become infected each year, and more than 1.1 million Americans are living with H.I.V.,? the report says. Mr. Obama plans to announce the strategy, distilled from 15 months of work and discussions with thousands of people around the country, at the White House on Tuesday. While acknowledging that ?increased investments in certain key areas are warranted,? the report does not propose a major increase in federal spending. It says the administration will redirect money to areas with the greatest need and population groups at greatest risk, including gay and bisexual men and African-Americans. The federal government now spends more than $19 billion a year on domestic AIDS programs. On average, the report says, one person is newly infected with H.I.V. every nine and a half minutes, but tens of thousands of people with the virus are not receiving any care. If they got care, the report says, they could prolong their own lives and reduce the spread of the virus to others. By 2015 the report says, the United States should ?increase the proportion of newly diagnosed patients linked to clinical care within three months of their H.I.V. diagnosis to 85 percent,? from the current 65 percent. The first-ever national AIDS strategy has been in the works since the start of the administration. It comes in the context of growing frustrations expressed by some gay rights groups. They say that more money is urgently needed for the AIDS Drug Assistance Program, and they assert that the White House has not done enough to secure repeal of the law banning military service by people who are openly gay or bisexual. The report tries to revive the sense of urgency that gripped the nation in the first years after discovery of the virus that causes AIDS. ?Public attention to the H.I.V. epidemic has waned,? the report says. ?Because H.I.V. is treatable, many people now think that it is no longer a public health emergency.? The report calls for ?a more coordinated national response to the H.I.V. epidemic? and lays out specific steps to be taken by various federal agencies. Mr. Obama offers a compliment to President George W. Bush, who made progress against AIDS in Africa by setting clear goals and holding people accountable. The program begun by Mr. Bush, the President?s Emergency Plan for AIDS Relief, ?has taught us valuable lessons about fighting H.I.V. and scaling up efforts around the world that can be applied to the domestic epidemic,? the report says. Mr. Obama?s strategy is generally consistent with policies recommended by public health specialists and advocates for people with H.I.V. But some experts had called for higher goals, more aggressive timetables and more spending on prevention and treatment. The report makes these points: ?Far too many people infected with H.I.V. are unaware of their status and may unknowingly transmit the virus to their partners. By 2015, the proportion of people with H.I.V. who know of their condition should be increased to 90 percent, from 79 percent today. ?The new health care law will significantly expand access to care for people with H.I.V., but federal efforts like the Ryan White program will still be needed to fill gaps in services. ?Federal spending on H.I.V. testing and prevention does not match the need. States with the lowest numbers of H.I.V./AIDS cases often receive the most money per case. The federal government should allocate more of the money to states with the highest ?burden of disease.? ?Health officials must devote ?more attention and resources? to gay and bisexual men, who account for slightly more than half of new infections each year, and African-Americans, who account for 46 percent of people living with H.I.V. ?The H.I.V. transmission rate, which indicates how fast the epidemic is spreading, should be reduced by 30 percent in five years. At the current rate, about 5 of every 100 people with H.I.V. transmit the virus to someone in a given year. If the transmission rate is unchanged, the report says, ?within a decade, the number of new infections would increase to more than 75,000 per year and the number of people living with H.I.V. would grow to more than 1.5 million.? The report finds that persistent discrimination against people with H.I.V. is a major barrier to progress in fighting the disease. ?The stigma associated with H.I.V. remains extremely high,? it says. ?People living with H.I.V. may still face discrimination in many areas of life, including employment, housing, provision of health care services and access to public accommodations.? The administration promises to ?strengthen enforcement of civil rights laws? protecting people with H.I.V. One political challenge for the administration is to win broad public support for a campaign that will focus more narrowly on specific groups and communities at high risk for H.I.V. infection. ?Just as we mobilize the country to support cancer research whether or not we believe that we are at high risk of cancer and we support public education whether or not we have children,? the report says, ?fighting H.I.V. requires widespread public support to sustain a long-term effort.? *A version of this article appeared in print on July 12, 2010, on page A10 of the New York edition * *2* *The truth of China's response to HIV/AIDS** **Los Angeles Times* 11/07/2010 By Joe Amon The man who may be China's most prominent defender of the rights of people living with HIV, Wan Yanhai, took refuge in the United States in April, after months of harassment by Chinese authorities. His organization, Aizhixing, has been repeatedly audited by government officials and is in imminent danger of being shut down. Other nongovernmental AIDS organizations have been similarly threatened, and people infected with HIV or at risk of infection in China continue to face discrimination and abuse. So why then, in late June, did the chief of the Global Fund to Fight AIDS, Tuberculosis and Malaria ? a $20-billion public/private fund that operates in 144 countries ? thank the Chinese government for its efforts on AIDS prevention, treatment and care, and say nothing publicly about the rights of HIV-infected people? The praise from Michel Kazatchkine, executive director of the Global Fund, was directed at the Chinese vice premier, Li Keqiang ? the same person who, as governor of Henan province from 1998 to 2003, oversaw an intense government cover-up of an HIV epidemic, victimizing both patients and their advocates. Kazatchkine is not the only international figure to uncritically praise the Chinese response to AIDS. In 2005, Jim Yong Kim, then director of the World Health Organization's HIV Department, visited China and declared: "After it was discovered that people in China got infected via blood transmission in hospitals and through intravenous drug use, the government went to extraordinary lengths to stop transmission." His statement rewrites history. The "extraordinary lengths" China pursued included harassing and putting under house arrest Dr. Gao Yaojie, the doctor who exposed the problem. Gao, 83, fled China in 2009. She has said since that she is afraid to return. Another well-known AIDS activist, Hu Jia, is serving a 3 1/2-year sentence for "inciting subversion of state authority," an offense used to punish those who criticize the government or the Communist Party of China. His arrest was part of a wider crackdown on Chinese citizens before the 2008 Beijing Olympic Games. The comments of Kazatchkine and the plight of Wan, Gao and Hu are emblematic of the HIV/AIDS response in China: On paper, the Chinese government has laws and policies that are protective of the rights of an estimated 700,000 people living with HIV in the country. In practice, these policies are frequently undermined by the actions of police and public security forces, who round up "undesirables" such as sex workers and drug users and intimidate and censor civil society organizations working to expand HIV outreach. This tension was highlighted in report released by UNAIDS last year that found that two-thirds of HIV-infected people in China have not sought treatment because of fear, ignorance and discrimination. UNAIDS' director, Michel Sidibe, said then that China needed to "break the conspiracy of silence" surrounding HIV/AIDS. But clearly, it is not just the Chinese government that needs to break the conspiracy of silence; it is also the international donor community. It would be wise to listen to what inmates at any of the approximately 700 compulsory drug detention centers in China have to say. Human Rights Watch's research has found that the roughly 500,000 people at these centers are routinely beaten, forced to work for up to 18 hours a day without pay, have no access to drug dependency treatment and are denied even basic medical care. Under China's 2008 anti-drug law, drug users, even first-time users, are locked up for three to six years, without trial, in "treatment" centers that have a relapse rate of as high as 90%. Our research found that some detention center guards provided drugs to "patients"; and one guard admitted using the mandatory HIV test results to determine which female drug users to have sex with. The Global Fund, as part of its more than $1 billion in HIV funding to the Chinese government, supports a variety of programs in these centers, including "provider-initiated" HIV testing and training of detention center staff members. The United States supports similar programs in China and Vietnam, without any, as one senior U.S. official admitted, "rules of engagement." United Nations agencies, such as UNICEF and UNODC, have also funded programs in detention centers in the region. To his credit, Kazatchkine has acknowledged that torture occurs in these centers and has called for them to be closed. He has not, however, announced an end to the funding of programs in the centers, clinging to the false promise of the "ethical" delivery of services to detained drug users, something that may be a comfort to those in Geneva but in effect subsidizes and potentially legitimizes what are clearly unlawful centers. For $1 billion, the Global Fund should be able to buy at least a small amount of accountability in addition to providing uncritical praise. They should use this month's International AIDS Conference in Vienna, which has a human rights theme, to speak out publicly about the harassment of Chinese AIDS activists and work with other donors to announce an end of funding for detention center programs. Funding efforts to keep people from being locked up, by expanding community-based drug dependency treatment, legal services and outreach to drug users ? not typically understood as "health" interventions ? would save more lives. China has made some strides in the fight against AIDS. But the government should be held to account for stifling the work and voices of Chinese AIDS activists and nongovernmental organizations. The International AIDS Conference focuses this year on human rights because abuses fuel the HIV epidemic. Governments and donors must dedicate themselves to ensuring that support for human rights is central to their response to AIDS. *Joe Amon is director of health and human rights at Human Rights Watch. * Copyright ? 2010, The Los Angeles Times *3* *Waiting Lists for the AIDS Drug Assistance Program (Letter)** **New York Times* 09/07/2010 To the Editor: Your report about growing waiting lists for the federal AIDS Drug Assistance Program (?Slump Cripples Aid for Drugs to Treat H.I.V.,? front page, July 1) is deeply troubling to me. As a member of the Florida Senate, I know that legislators from both parties worked diligently during our state?s legislative session this spring to ensure that we adequately financed our share of the AIDS Drug Assistance Program. Nearly 18,000 Floridians rely on this program for lifesaving antiretroviral drugs, which can cost thousands of dollars a month. Thanks to increased availability of these drugs through the program, we have seen a significant decrease in AIDS-related illness and death in our state. Unfortunately, the economic downturn has forced more people to turn to government for help with their H.I.V. medication. As a result, we now have close to 400 Floridians on the waiting list for the program, and other states are likewise seeing more applications for AIDS drug assistance. I will continue to work with Gov. Charlie Crist and my colleagues in the Florida Legislature to ensure that we provide our state share of financing for the program. I likewise call on the Obama administration and Congress to make sure that sufficient federal money is available, so that all patients on waiting lists receive H.I.V. medications. In the richest country on the planet, where these lifesaving drugs are readily available, this is nothing short of a moral imperative. *Nan Rich, Sunrise, Fla., July 1, 2010 * *The writer is vice chairwoman of the Health and Human Services Appropriations Committee in the Florida Senate. * *4* *AIDS Vaccine: The Promise of HIV Antibodies** **TIME Magazine* 10/07/2010 By Alice Park In the continuing search for the Achilles heel of HIV, researchers may finally be enjoying some success. This week, government researchers at the Vaccine Research Center of the National Institute of Allergy and Infectious Diseases (NIAID) reported the discovery of two naturally occurring antibodies that may block HIV. Describing their work in two separate papers in the journal Science, AIDS experts said that in lab experiments, the antibodies had successfully prevented more than 90% of circulating HIV strains from infecting human cells. This is not the first discovery of so-called broadly neutralizing antibodies. Last September, scientists at Scripps Research Institute and the International AIDS Vaccine Initiative (IAVI) identified two other antibodies that prevent against infection from 80% of existing HIV strains ? the most potent known antibodies at the time. The findings were also published in Science. The two sets of antibodies target different regions of the virus-cell interface ? together they could help scientists develop a formidable vaccine against AIDS, says Dr. Anthony Fauci, director of NIAID. "The strategy is going to be to put the best antibodies together, and you are going to have a whopper against HIV," he says. Antibodies are the first-line soldiers of the immune system. Produced by specialized cells in the body that recognize incoming viruses and bacteria, antibodies act as molecular barricades, latching onto and blocking pathogens from infecting healthy cells. This antibody response is the core of all vaccine-based disease prevention. But HIV is notoriously changeable. The virus continuously alters the makeup of the proteins on its surface, eluding attack from antibodies created by the immune system and from the relatively weak vaccines that have been developed against the virus so far. The two new antibodies described in the current Science paper work by blocking a protein on the surface of HIV that the virus normally uses like a key to access healthy cells. This key, which tends to remain constant across most strains of the virus, binds to an entry point on a healthy cell surface, called the CD4 receptor site. When antibodies attach to this region of HIV, it cannot interact with CD4 or get inside a host cell. Because this particular site on HIV is so crucial and rarely mutates, the virus keeps it jealously hidden under convoluted folds of its protein coat, which makes most antibodies designed to latch onto it ineffective. Certain individuals, however, generate antibodies that recognize and bind to the site more easily, so when they are infected with HIV, they are able to fight off infection. NIAID scientists identified the new antibodies by screening the blood of one HIV-infected African American patient who produced them naturally. By lifting the obstructive protein covering that HIV uses to guard its CD4-binding site, and isolating only those antibodies that were tailor-made to attach to this gate, scientists zeroed in on just two antibodies that were able to neutralize an unprecedented 90% of circulating HIV strains. Previous experiments on CD4 have identified other naturally occurring antibodies. But these were effective against only 40% to 50% of HIV strains in tests in the lab because they were less precisely targeted, acting on a combination of the actual binding site and the virus's surrounding protein coat. In the 2009 study led by Dennis Burton of Scripps Research Institute, scientists focused on a different type of antibody involved in the actual process of viral entry. In order to infect a cell once HIV finds an entry point, the virus changes shape, folding itself into a form that allows it to slip inside the healthy cell. Burton's antibodies interrupt that action, blocking about 80% of circulating HIV strains from taking the shape necessary for infection. However, Burton says he and his team are still figuring out exactly how the process works. Taken together, the recent discoveries boost the prospect of using broadly neutralizing antibodies as the backbone of an HIV vaccine, experts say. In Burton's study, the antibodies were isolated from a blood sample from Africa; in the current study, the antibodies cam from an African American man. In each case, the patients were infected with a different strain of HIV. That's important, Burton says, because it confirms that effective antibodies can be produced by people on different continents carrying different strains of the virus. "The more you see different people making antibodies, the more relaxed you become that different people can do it, and therefore given the right vaccine, that more people can make antibodies against HIV," he says. So far, the newly discovered antibodies have been tested only in a lab dish. But Burton says he is a few months from beginning animal studies to determine whether his antibodies can prevent HIV infection in a living system as well they do in the lab. Experts remain hopeful that this line of work will someday lead to the development of an AIDS vaccine than can be tested in humans. "I can guarantee that you're not going to get a vaccine unless you get good antibodies," says Fauci. *5* *Online Coverage of XVIII International Aids Conference to Include Daily Webcasts, Live Coverage, Podcasts and News Recaps** **PR Newswire* 09/07/2010 MENLO PARK, Calif., and GENEVA, July 9 /PRNewswire-USNewswire/ -- The International AIDS Society (IAS) and the Kaiser Family Foundation will provide worldwide online access to the XVIII International AIDS Conference (AIDS 2010) taking place in Vienna, Austria, July 18-23, 2010. Kaiser -- an independent operating foundation and non-partisan source of facts, information, and analysis, based in Menlo Park, Calif., USA -- is the official webcaster for AIDS 2010, providing daily coverage of conference developments on its website, http://www.kff.org/aids2010. In addition to more than 50 online webcasts of conference sessions, podcasts will be available for downloading in both English and Russian. Some sessions, including the Opening and Closing Sessions, will be presented via live webcast, while other coverage will be tape-delayed by a few hours and available on-demand. The webcasts will include sessions featuring former U.S. President Bill Clinton, South African Deputy President Kgalema Motlanthe, South African Health Minister Aaron Motsoaledi, philanthropist Bill Gates and Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases at the U.S. National Institutes of Health. A daily video recap of conference developments with Science magazine's Jon Cohen will also be available. An outline of scheduled coverage is available at http://www.kff.org/aids2010. Kaiser's Daily Global Health Policy Report, a free, daily news summary service will be enhanced during the week of the conference to include summaries of what the global media are reporting from the conference and original recaps of information that may not be covered elsewhere. Kaiser is also providing session coverage for the official and independent conference hubs, which will feature a viewing of select sessions followed by discussions and workshops on how the sessions' content can be applied locally. The three official conference hubs will be held in Moscow, Russia, Kiev, Ukraine, and Almaty, Kazakhstan, while more than 30 independent hubs in over 20 countries are already planned. A widget for sharing Kaiser's content is available for organizations and individuals who want to further spread the information by carrying the coverage on their own websites, blogs or social networking pages. "The partnership with Kaiser Family Foundation is central to our ability to extend the reach of the International AIDS Conference well beyond the conference venue and dates," said IAS Acting Executive Director, Mats Ahnlund. "In conjunction with our other online resources, the webcasts ensure that those unable to attend the conference have access to its key resources, while providing a lasting record of conference proceedings. Kaiser's substantive and technical expertise, along with their well-earned reputation for high-quality coverage, makes them the ideal webcasting partner." "This eight-year running partnership allows us to play a vital role in ensuring people around the world can learn about the important developments in HIV/AIDS that come out of this conference," said Drew Altman, Ph.D., Kaiser President and CEO. "By providing free, online access, we are helping to connect the information and advances generated at the conference to communities in the developed and developing world, ultimately raising awareness of the HIV/AIDS epidemic and the efforts to address it." AIDS 2010 will provide presentations of important new scientific research and opportunities for dialogue on the major challenges facing the global response to AIDS. The 2010 conference theme, Rights Here, Right Now, emphasizes human rights as a prerequisite to a successful response to HIV, including equal access to health care and life-saving prevention and treatment programs. There are more than 33 million people living with HIV worldwide. More information about the XVIII International AIDS Conference, including the latest program details, is available at http://www.aids2010.org. Kaiser's AIDS 2010 conference coverage will be available through the Foundation's Global Health Gateway, http://globalhealth.kff.org , which also features original policy analysis and polling on the U.S. role in global health; country-specific data through the Global Health Facts database; regularly updated resources tracking major policy and budget developments; news summaries from the Kaiser Daily Global Health Policy Report; and a reporter's guide to covering global health. *6* *S. Africa holds education summit before WCup final** **Associated Press* 11/07/2010 *Story carried by Washington Post* By DONNA BRYSON PRETORIA, South Africa -- South Africa's president read fellow leaders a lesson before heading out with them to Sunday's World Cup final. Just hours before the Dutch-Spanish final, President Jacob Zuma convened leaders from Burkina Faso, Kenya, Togo, Mozambique, the Netherlands and neighboring Zimbabwe at an education summit in the capital. At the meeting, he urged African leaders to ensure parents don't have to pay school fees or buy uniforms, costs that can keep children out of school. He also called on leaders from developed countries to honor pledges to support education in poor countries. "We convened this summit because of our strongly held view that the first soccer World Cup tournament on African soil should have a lasting legacy," Zuma said at the meeting, which was also attended by U.N. and international sporting officials. "The most important investment in the future of any nation is in education," Zuma said. "No legacy could be higher than that." The summit is the culmination of 1GOAL, a campaign supported by football's governing body FIFA to use the attention the World Cup commands to publicize the need to get more children into school. An estimated 72 million children aren't in school and millions more do not have access to quality education, according to 1GOAL. 1GOAL has brought in luminaries from sports, entertainment and politics to push the campaign - Portuguese superstar Cristiano Ronaldo, Colombian pop star Shakira, Hillary Clinton and others. Zimbabwe's President Robert Mugabe was among those at the summit. Post-independence Zimbabwe's education was once widely praised, preparing graduates for high-level jobs across southern Africa and in the West. But with the nation's economic collapse blamed on Mugabe's policies and its international isolation because of his poor human rights records, young Zimbabweans are dropping out of school and leaving the country to work or beg. Zuma's administration had been criticized for inviting Mugabe for the World Cup final and summit. Last week, Ayanda Ntsaluba, a top foreign ministry official, told reporters asking Mugabe was "a normal invitation extended to a ... sitting president of a neighboring country." While Mugabe did not address the summit, Nthabiseng Tshabalala, a 12-year-old in her blue-and-white Soweto school uniform, did. "I wish all children could go to school like I do," she said. Dutch Prime Minister Jan Peter Balkenende said the international financial crisis could not be an excuse. "Destroying education and health systems by cutting budgets is not the way to achieve sound economic recovery," he said. Ensuring all the world's children have a chance to finish at least primary school is one of eight goals set at a U.N. conference in 2000. The Millennium Development Goals, which include halving poverty and halting the spread of AIDS as well as the education target, were to be met by 2015. With five years to go, the struggle to meet the deadline will the subject of a U.N. conference in September in New York. UNESCO, the U.N. cultural and educational and cultural organization, is urging donors to step up aid for education in Africa. It says aid for basic education in sub-Saharan Africa has dropped from $1.72 billion in 2007 to $1.65 billion in 2008, even as more children enroll in schools. "Education is Africa's most powerful antidote to poverty," UNESCO Director-General Irina Bokova said in a statement last week lauding Zuma for holding Sunday's summit. "Leaders must seize this occasion to put their full support behind providing Africa's children with a quality education." *========================* *UNAIDS WEB.SITE* *========================* Research project during the World Cup gathers data on sex workers and HIV *UNAIDS* 12/07/2010 As part of the UN South Africa Programme of Support to the FIFA 2010 World Cup, UNFPA and SWEAT (Sex Worker Education & Advocacy Taskforce) partnered with South African researchers to investigate key dimensions of HIV and sex work during the tournament. This rigorous research was supported by a telephone helpline service to respond to health and human rights concerns of sex workers during the World Cup. According to Mr. Eric Harper, Executive Director of SWEAT: ?These projects give weight to the rights watch dimension for most-at-risk-populations that is so vital when the largest sporting event in the world occurs.? Sex work in South Africa became one of the most talked about issues in preparation for the tournament. Newspapers warned of an influx of sex workers to the country to exploit the lucrative potential of the arrival of thousands of soccer fans. As the programme?s lead researcher, Marlise Richter, maintained: ?Public health and human rights responses to international sporting events should be based on rigorous, systematic research - not on fear-mongering and sensationalism.? This referred to media reports that over-estimated the number of foreign sex workers headed to the country and the result of confusing issues of trafficking and sex work. The research also addresses the significant data shortages related to sex work and HIV in South Africa in the longer term. The research assessed sex worker fears, expectations and experiences of the World Cup, gathered information on sex worker mobility, frequency of health care visits and interaction with police. It also tracked the number of clients and potential changes in sex work activity during the World Cup. The tournament presented a strategic opportunity for South Africa to respond to the challenges that the sex industry poses in a rights-based way and provided the momentum for these issues to be taken further in the future. At the same time, conducting research that tracked the changes in the sex work sector during a big, international sporting event is vital to inform future policy and planning for similar events across the world. Following a right-to-health approach, and in accordance with the UNAIDS Guidance Note on HIV and Sex Work , UNFPA supported SWEAT to provide sexual and reproductive health services, including HIV prevention, to sex workers during the tournament and beyond. Sex workers? ability to look after their health, more especially their sexual and reproductive health, is inextricably linked to their ability to access human rights in general. Commenting on the initiative, Dianne Massawe, Project Officer for SWEAT said: ?This partnersunhip affords us the opportunity to respond specifically to the sexual and reproductive health aspect through increased outreach and distribution of safer sex tools and information to sex workers. In addition, the telephone helpline provide[d] valuable assistance to sex workers around the human rights abuses they face.? South Africa is often referred to as the epicentre of the AIDS epidemic, home to the world?s largest number of people living with HIV. Within this epicentre, populations most at risk of HIV infection must be prioritised in prevention strategies. UNFPA supports SWEAT in research that will generate further evidence on the need for comprehensive programmes that promote a human rights-based approach to universal access to HIV prevention, treatment, care and support in the context of adult sex work. The completed research report is expected by September 2010. *2* *AIDSspace @ Vienna 2010** **UNAIDS* 12/07/2010 Ahead of the XVIII International AIDS Conference in Vienna, AIDSspace.org has created a group to provide a forum for AIDSspace members to share information and updates on events during the six day conference. Members can start discussions as well as send a promotional e-postcard to spread the word. Members who join the group are provided with a specially-designed AIDSspace badge to show support for the conference. In addition to forums, the group page provides links to key conference resources, such as the official conference programme, webcasting, and the daily bulletin. An interactive calendar offers an overview of the key sessions, satellites and other events happening throughout the week. During the conference, the group will be updated daily with news from Vienna. AIDSspace.org was launched in November 2009 as an online network for the 33.4 million people living with HIV and the millions engaged in the AIDS response. -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100713/7ed006f8/attachment-0010.html From ongdong at live.com Tue Jul 13 08:21:58 2010 From: ongdong at live.com (THANH DONG) Date: Tue, 13 Jul 2010 14:21:58 +0700 Subject: [hivaids-twg] Thong bao hop GIPA thang 7 (Announce GIPA subgroup in July) In-Reply-To: <98DC86CEF032774F8F4FDE97CDC08CFAFD26CB@fhi-server1.fhi.org.vn> References: <98DC86CEF032774F8F4FDE97CDC08CFAFD2477@fhi-server1.fhi.org.vn>, <98DC86CEF032774F8F4FDE97CDC08CFAFD26CB@fhi-server1.fhi.org.vn> Message-ID: Xin chao cac anh, chi; Nhu da hua trong buoi hop GIPA toi se gui toi cac anh/ chi thong bao keu goi nop de xuat cho du an Doi thoai va mau de xuat cua CARE. Chuc cac anh, chi thanh cong Thanh Xin chao cac anh/ chi; Thay mat nhom chu tao dien dan GIPA nhom nho, chung toi xin thong bao buoi hop GIPA lan nay se tien hanh luc Thoi gian: Luc 14h 00 ngay 12 thang 7 nam 2010 (Thu hai); Dia diem: Phong hop so 101, tang 1, Tai Trung uong Hoi lien hiep phu nu so 39, Hang Chuoi , Ha Noi; Neu anh chi co bat cu cau hoi nao lien quan den buoi hop xin vui long lien he voi Dong Duc Thanh Chu toa nhom GIPA. So dien thoai: 0165. 8338. 023 Rat vui duoc don tiep anh/ chi tai buoi hop Dong Duc Thanh Dear all; On behalf of GIPA subgroup's chairmans, We would like to announce will be conducted at 14 h.00 on July 12, 2010 (Monday) in meeting room 101 first floor At Woman central union at numbers 39, Hang Chuoi str, Hanoi. If you have any question related to this meeting call to Dong Duc Thanh is chairman please. My cell phone numbers: 0165. 8338. 023 Warm welcome to all of you in meeting Best regards Thanh Hotmail: Trusted email with Microsoft?s powerful SPAM protection. Sign up now. Hotmail: Powerful Free email with security by Microsoft. Get it now. Hotmail: Powerful Free email with security by Microsoft. Get it now. _________________________________________________________________ Hotmail: Trusted email with powerful SPAM protection. https://signup.live.com/signup.aspx?id=60969 -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100713/2c74ff10/attachment-0010.html -------------- next part -------------- A non-text attachment was scrubbed... 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Name: Doi Thoai_Proposal Form_2010_Vn.doc Type: application/msword Size: 112640 bytes Desc: not available Url : http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100713/2c74ff10/attachment-0021.doc From ongdong at live.com Tue Jul 13 08:23:04 2010 From: ongdong at live.com (THANH DONG) Date: Tue, 13 Jul 2010 14:23:04 +0700 Subject: [hivaids-twg] To chuc CARE CARE keu goi nop de xuat In-Reply-To: <98DC86CEF032774F8F4FDE97CDC08CFAFD26CB@fhi-server1.fhi.org.vn> References: <98DC86CEF032774F8F4FDE97CDC08CFAFD2477@fhi-server1.fhi.org.vn>, <98DC86CEF032774F8F4FDE97CDC08CFAFD26CB@fhi-server1.fhi.org.vn> Message-ID: Xin chao cac anh, chi; Nhu da hua trong buoi hop GIPA toi se gui toi cac anh/ chi thong bao keu goi nop de xuat cho du an Doi thoai va mau de xuat cua CARE. Chuc cac anh, chi thanh cong Thanh Xin chao cac anh/ chi; Thay mat nhom chu tao dien dan GIPA nhom nho, chung toi xin thong bao buoi hop GIPA lan nay se tien hanh luc Thoi gian: Luc 14h 00 ngay 12 thang 7 nam 2010 (Thu hai); Dia diem: Phong hop so 101, tang 1, Tai Trung uong Hoi lien hiep phu nu so 39, Hang Chuoi , Ha Noi; Neu anh chi co bat cu cau hoi nao lien quan den buoi hop xin vui long lien he voi Dong Duc Thanh Chu toa nhom GIPA. So dien thoai: 0165. 8338. 023 Rat vui duoc don tiep anh/ chi tai buoi hop Dong Duc Thanh Dear all; On behalf of GIPA subgroup's chairmans, We would like to announce will be conducted at 14 h.00 on July 12, 2010 (Monday) in meeting room 101 first floor At Woman central union at numbers 39, Hang Chuoi str, Hanoi. If you have any question related to this meeting call to Dong Duc Thanh is chairman please. My cell phone numbers: 0165. 8338. 023 Warm welcome to all of you in meeting Best regards Thanh Hotmail: Trusted email with Microsoft?s powerful SPAM protection. Sign up now. Hotmail: Powerful Free email with security by Microsoft. Get it now. Hotmail: Powerful Free email with security by Microsoft. Get it now. Hotmail: Trusted email with powerful SPAM protection. Sign up now. _________________________________________________________________ Hotmail: Trusted email with Microsoft?s powerful SPAM protection. https://signup.live.com/signup.aspx?id=60969 -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100713/c7929c19/attachment-0010.html -------------- next part -------------- A non-text attachment was scrubbed... Name: Doi Thoai_Call for Proposals_2010_Vn.doc Type: application/msword Size: 159232 bytes Desc: not available Url : http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100713/c7929c19/attachment-0020.doc -------------- next part -------------- A non-text attachment was scrubbed... Name: Doi Thoai_Proposal Form_2010_Vn.doc Type: application/msword Size: 112640 bytes Desc: not available Url : http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100713/c7929c19/attachment-0021.doc From DIEPNGUYEN at iom.int Tue Jul 13 09:49:04 2010 From: DIEPNGUYEN at iom.int (NGUYEN Hoang Diep) Date: Tue, 13 Jul 2010 15:49:04 +0700 Subject: [hivaids-twg] Invitation to IOM Satellite at Vienna Message-ID: <197FD5F9B6D189428FACC7069059249F047F87F4@SGNEX01.as.iom.net> Dear Mod, Please help to circulate this email. Thank you, Diep ________________________________ From: BORLAND Rosilyne Sent: Monday, July 12, 2010 4:13 PM To: BORLAND Rosilyne Subject: invitation to IOM Satellite at Vienna The IOM invites you to start your morning right at the upcoming Vienna AIDS Conference. Join us for a discussion of the latest research and responses on HIV and mobile populations. Featured speakers include Mr. Stephen Sianga, Director, Directorate of Social & Human Development and Special Programmes, Southern African Development Community Please share this notice widely ----------------------------------------- ================= The information contained in this electronic message and any attachments are intended for specific individuals or entities, and may be confidential, proprietary or privileged. If you are not the intended recipient, please notify the sender immediately, delete this message and do not disclose, distribute or copy it to any third party or otherwise use this message. The content of this message does not necessarily reflect the official position of the International Organization for Migration (IOM) unless specifically stated. Electronic messages are not secure or error free and may contain viruses or may be delayed, and the sender is not liable for any of these occurrences. -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100713/7b94cba5/attachment-0010.html -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/gif Size: 140277 bytes Desc: image001.gif Url : http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100713/7b94cba5/attachment-0010.gif -------------- next part -------------- A non-text attachment was scrubbed... Name: IOM Activites at AIDS 2010.pdf Type: application/octet-stream Size: 52839 bytes Desc: IOM Activites at AIDS 2010.pdf Url : http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100713/7b94cba5/attachment-0010.obj From hivtwg.moderator at gmail.com Wed Jul 14 03:06:48 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Wed, 14 Jul 2010 09:06:48 +0700 Subject: [hivaids-twg] New approach to HIV treatment could save 10 million lives, says UN report In-Reply-To: <05F5D8D0-2A9C-4B76-AC89-1127EC1B75EB@gmail.com> References: <05F5D8D0-2A9C-4B76-AC89-1127EC1B75EB@gmail.com> Message-ID: New approach to HIV treatment could save 10 million lives, says UN report Michel Sidib?, UNAIDS Executive Director, with the *Outlook* report 13 July 2010 ? A new United Nations report says that a radically simplified approach to ensuring access to HIV treatment for everyone who needs it could prevent 10 million deaths by 2025 and 1 million new infections annually. The so-called Treatment 2.0, says the Joint UN Programme on HIV/AIDS (UNAIDS), could lower the cost of treatment, simplify treatment regimens, ease the burden on health systems, and improve the quality of life for people living with HIV and their families. Document available at: http://data.unaids.org/pub/Outlook/2010/20100713_outlook_treatment2_0_en.pdf ?We can bring down costs so investments can reach more people,? Michel Sidib?, UNAIDS Executive Director, said at the report?s launch in Geneva today. ?This means doing things better ? knowing what to do, channelling resources in the right direction and not wasting them, bringing down prices and containing costs. We must do more with less.? The agency estimates that there were 33.4 million people living with HIV worldwide at the end of 2008, as well as nearly 2.7 million new infections and 2 million AIDS-related deaths. It adds that only one third of the world?s 15 million people in need of HIV treatment are accessing life-saving medicines. For the new plan to succeed, the agency?s *Outlook * report calls for action to be taken across five key areas. Firstly, it calls for the creation of a better pill that is less toxic and for a simple diagnostic tool to monitor treatment. Secondly, evidence suggests that people living with HIV who have reduced the level of virus in their bodies, through antiretroviral therapy, are less likely to transmit it. As a result, UNAIDS says that if everyone in need has access to treatment, this could reduce the number of new HIV infections by one third annually. The report also urges slashing the cost of antiretroviral treatment, especially for hospitalization and monitoring treatment, which can cost twice as much as drugs. Fourth, UNAIDS stresses the need to improve voluntary HIV testing and counselling, since starting treatment at the right time, optimally when their CD4 count ? a measure of immune system strength ? is around 350, boosts the efficacy of treatment and increases life expectancy. Lastly, Treatment 2.0 will be fully successful if communities are mobilized and involved in managing treatment programmes and access. ?Not only could Treatment 2.0 save lives, it has the potential to give us a significant prevention dividend,? said Mr. Sidib?. The report also shows that young people are leading the prevention revolution, with 15 of the most severely affected countries reporting a 25 per cent drop in HIV prevalence among this key population. In eight countries ? C?te d?Ivoire, Ethiopia, Kenya, Malawi, Namibia, Tanzania, Zambia and Zimbabwe ? significant HIV prevalence declines have been accompanied by positive changes in sexual behaviour among young people. Mr. Sidib? cautioned that flatlining or reductions in investments in HIV will only hurt the AIDS response, with nearly $27 billion required this year to meet country-set targets for universal access to HIV prevention, treatment, care and support. ?The AIDS response needs a stimulus package now,? the official underlined. ?Donors must not turn back on investments at a time when the AIDS response is showing results.? His agency recommends that nations invest between 0.5 and 3 per cent of government revenue into their AIDS response programmes, but warned that for the majority of countries severely affected by the epidemic, national investments, even at optimal levels, are insufficient. Also included in the report released today are the results of a public opinion poll that shows that nearly three decades into the epidemic, countries continue to rank AIDS high on the list of the most important challenges the world faces. Overall in the survey, AIDS is perceived to be the top healthcare issue in the world, followed by safe drinking water. The publication wraps up with a ?Last Word? from UNAIDS Goodwill Ambassador Annie Lennox, who said that ?as a woman and mother, I feel compelled to speak out, and try to raise awareness in the best way I can, to try to use my platform to do so.? -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100714/9c01da70/attachment-0010.html -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 8657 bytes Desc: not available Url : http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100714/9c01da70/attachment-0010.jpe -------------- next part -------------- A non-text attachment was scrubbed... Name: 13-07-2010aids.jpg Type: image/jpeg Size: 8657 bytes Desc: not available Url : http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100714/9c01da70/attachment-0010.jpg From hivtwg.moderator at gmail.com Wed Jul 14 03:08:08 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Wed, 14 Jul 2010 09:08:08 +0700 Subject: [hivaids-twg] Today's News (2010.07.13ex) Jakarta Post - Women with AIDS are mostly housewives Message-ID: From: Diaz, Clara Date: Tue, Jul 13, 2010 at 6:21 PM Subject: Today's News (2010.07.13ex) To: Please find attached the following AIDS-related articles compiled by UNAIDS *UNAIDS* 1. Reuters - *Safer sex by young in Africa drives HIV rates down * 2. AFP - *Sida: l'?pid?mie recule fortement chez les jeunes de 15 ? 24 ans* 3. El Mundo, Spain - *El sue?o de una pastilla al d?a contra el sida* 4. ORF, Austria - *Aids: Zweite Epidemiewelle in Europa * 5. The Guardian, UK - *HIV rates fall among young people in worst-affected countries, figures show* 6. La Jornada, Mexico - *Premia ONU a organismo mexicano por su lucha contra el VIH-Sida * 7. UN News Service - *UN honours 25 groups for outstanding community-based response to AIDS* 8. Le Nouvelliste, Haiti - *Avec la propagation de la fi?vre du football, stoppons la propagation du VIH* *AFRICA** AND MIDDLE EAST* 1. The Citizen, Tanzania - *Heed Call on ARVs (Editorial)* 2. The Herald, Zimbabwe - *HIV, Aids - the Elderly's Role Neglected (Op-Ed) * *ASIA** AND PACIFIC* 1. Jakarta Post - *Women with AIDS are mostly housewives* 2. Times of India - *56 kids get HIV, hepatitis after blood transfusion* *EUROPE*** 1. Reuters - *White House AIDS strategy to focus on prevention* 2. Reuters - *AIDS Journal Op Ed: "PEPFAR and Maternal and Child Health Initiatives Must Not Compete" * 3. L?Hebdo.ch - *Sida: le choix d'une r?v?lation* *LATIN AMERICA AND CARIBBEAN* 1. Cr?nica de Hoy, Mexico - *?Fracas? la guerra contra las drogas?: Cardoso, Zedillo y Gaviria* 2. ORM, Brazil - *Crian?as com HIV ter?o novo medicamento * *NORTH AMERICA* 1. New York Times - *Desperate Addicts Inject Others? Blood* 2. Voicwe of America News - *World AIDS Conference to Focus on HIV/AIDS, Tuberculosis * 3. Boston Globe - *Clear way for easier AIDS tests, despite objections by activists (Editorial)* 4. Voice of America News - *Asia** Faces Tough Fight in Keeping HIV Infection Rate Low* 5. Washington Post - *Administration's new HIV/AIDS policy focuses on lowering infection rate * *UNAIDS WEB.SITE* 1. UNAIDS - UNDP Announces 2010 Red Ribbon Award Winners 2. UNAIDS - *Ten million deaths and 1 million new HIV infections could be averted if countries meet HIV treatment targets * 3. UNAIDS - *New UNAIDS OUTLOOK report 2010 launched * =========================== *UNAIDS* =========================== *Safer sex by young in Africa drives HIV rates down** **Reuters* 13/07/2010 By Kate Kelland LONDON (Reuters) - Young people in Africa are leading a "revolution" in HIV prevention and driving down rates of the disease by having safer sex and fewer sexual partners, the United Nations AIDS programme said on Tuesday. The prevalence of the human immunodeficiency virus (HIV) that causes AIDS is falling among young people in 16 of the 25 countries most affected by the disease, a study by UNAIDS found, with many of them on track to hit a 25 percent reduction target in HIV/AIDS rates in 15- to 24-year-olds by the end of the year. "Young people have shown that they can be agents of change in the prevention revolution," the report said. It called on governments worldwide to learn from this progress and provide comprehensive programmes for sexual health education, access to HIV testing and wide availability of prevention methods such as condoms. An estimated 5 million young people around the world aged between 15 and 24 are living with HIV, the often fatal and incurable virus that causes AIDS. Nearly 80 percent of those people live in sub-Saharan Africa. HIV is spread during sex, in blood and breast milk, and by contaminated needles. According to UNAIDS, an estimated 900,000 new infections occurred among young people in 2008 and the vast majority of those cases were in young women in Africa. In a study published ahead a global AIDS conference due to be held in Vienna next week, UNAIDS found that in 16 of the 25 worst affected countries, rates of HIV had been falling among young people, with some of the most dramatic declines seen in Kenya, where there was a 60 percent change between 2000 and 2005. Botswana, Ivory Coast, Ethiopia, Kenya, Malawi, Namibia and Zimbabwe have all achieved a goal set agreed in 2001 to reduce HIV prevalence in 15 to 24-year-olds by 25 percent by 2010, it said. Burundi, Lesotho, Rwanda, Swaziland, the Bahamas and Haiti were all "likely to achieve" it The study found the main drivers of the reductions were changes in sexual behaviour. Young people in 13 of the 25 countries were waiting longer before they become sexually active. In more than half of the 25 countries, young people were choosing to have fewer sexual partners. Condom use was also on the increase, the study found, with 10 countries reporting more use of condoms among women and 13 reporting increased condom use among men. Cameroon, Tanzania and Uganda reported increases in condom use by both sexes. UNAIDS said in November that an estimated 33.4 million people worldwide were currently infected with the AIDS virus. *2** * *Sida: l'?pid?mie recule fortement chez les jeunes de 15 ? 24 ans** **AFP*** 13/07/2010 GEN?VE ? L'?pid?mie de sida a nettement recul? chez les jeunes de 15 ? 24 ans dans pr?s de la moiti? des 25 pays les plus s?rieusement touch?s au monde, particuli?rement en Afrique subsaharienne, gr?ce notamment ? une "utilisation accrue" du pr?servatif, a annonc? mardi l'Onusida. "La pr?valence du VIH parmi les jeunes est en baisse dans de nombreux pays cl?s", avance le rapport annuel du Programme commun des Nations Unies sur le VIH/sida, qui rappelle que 80% des jeunes contamin?s -- soit 4 millions de personnes -- vivent dans la r?gion de l'Afrique subsaharienne. Ces pays "ont atteint ou sont en passe d'atteindre l'objectif international de r?duction de 25% de la pr?valence du VIH parmi les jeunes, convenu ? la Conf?rence internationale (des Nations unies) sur la population et le d?veloppement en 1994", poursuit le rapport. Les pays qui ont atteint l'objectif sont le Botswana, la C?te d'Ivoire, l'Ethyopie, le Kenya, le Malawi, la Namibie et le Zimbabwe. Et parmi les pays qui devraient atteindre cet objectif d'ici fin 2010 figurent le Burundi, le Lesotho, le Rwanda, le Swaziland, les Bahamas et Ha?ti. Il s'agit d'une "perc?e essentielle pour briser la trajectoire de l'?pid?mie de sida", observe le rapport. Le rapport montre que pour la premi?re fois la r?duction de la pr?valence du VIH co?ncide avec un changement de comportement sexuel. Les experts soulignent qu'un "changement se produit chez les jeunes ? travers le monde, en particulier dans certaines parties de l'Afrique subsaharienne". Ils expliquent ce recul par une entr?e plus tardive dans la vie sexuelle, par une r?duction du nombre des partenaires sexuels et par une "utilisation accrue" du pr?servatif chez les 15-24 ans ayant des partenaires multiples. Environ 5 millions de jeunes ?g?s de 15 ? 24 ans vivent avec le sida, selon Onusida. Au total, quelque 900.000 jeunes ont ?t? contamin?s en 2008, 66% d'entre eux ?tant des femmes, selon le rapport. Copyright ? 2010 AFP. Tous droits r?serv?s. *4* *El sue?o de una pastilla al d?a contra el sida** **El Mundo, Spain* 13/07/2010 ?NGEL D?AZ MADRID.- Una optimizaci?n del actual tratamiento para el sida, tanto a nivel farmac?utico como econ?mico y social, podr?a reducir en un tercio el n?mero de contagios y evitar 10 millones de muertes de aqu? a 2025, seg?n un informe de ONUSIDA, el programa conjunto de Naciones Unidas contra esta enfermedad. El n?cleo de esta predicci?n, que es en realidad un llamamiento a la industria farmac?utica y la comunidad pol?tica internacional, se asentar?a en la posibilidad de reunir todo el tratamiento en una sola p?ldora diaria. De este modo, no s?lo se reducir?an los gastos en medicaci?n, sino tambi?n las inversiones necesarias para hacerla llegar al paciente y realizar un seguimiento terap?utico del mismo, las cuales ascienden a un 80% del coste total del tratamiento. Las terapias antirretrovirales se han simplificado y perfeccionado enormemente desde su aparici?n, en 1985. Pero subsisten importantes problemas asociados a ellos: si aparecen resistencias, hay que cambiar a un tratamiento de los llamados de segunda o tercera l?nea, que son mucho m?s costosos e inaccesibles en muchos lugares. Adem?s, algunos efectos secundarios requieren de una atenci?n m?dica muy cercana. En los pa?ses en desarrollo, donde el acceso a terapias ya es limitado, estas complicaciones pueden suponer una barrera insalvable. Por ello, el organismo de la ONU demanda m?s avances: "Una s?la y mejorada pastilla con toxicidad reducida y a prueba de resistencias tendr?a menos necesidades de monitorizaci?n del tratamiento", lo que permitir?a que pudieran seguirlo m?s personas a un menor coste. A falta de unos d?as para la Conferencia Internacional del Sida en Viena (Austria), ONUSIDA ha emitido un informe especial en el que recoge todas las posibles mejoras para lograr que los antirretrovirales lleguen con garant?as a todos los rincones del planeta. En la actualidad, s?lo un tercio de los infectados por el VIH recibe tratamiento m?dico, mientras que la mayor?a (60%) no es consciente de haber contraido la infecci?n hasta que desarrolla los s?ntomas del sida. Para mejorar esta situacion, el organismo pide que los pa?ses cumplan sus compromisos y aumenten sus inversiones contra la epidemia. Un aspecto esencial, precisamente en los pa?ses donde m?s afecta la enfermedad, ser?a la movilizaci?n de las comunidades locales y el respeto a los derechos humanos. "Los pobres del mundo rural, hombres que mantienen sexo con hombres, usuarios de drogas, trabajadores del sexo; estos grupos tienen muy buenas razones para no confiar en los servicios p?blicos de salud que dirigen sus gobiernos", sostiene el informe. Menos contagios El perfeccionamiento de las terapias antirretrovirales no s?lo provocar?a que ?stas llegaran a m?s pacientes, sino que reducir?a el n?mero de contagios. El riesgo de transmisi?n del virus, tanto de madres a hijos como por v?a sexual o sangu?nea, es significaticamente menor cuando el portador del VIH est? recibiendo un tratamiento adecuado, por lo que la extensi?n del uso de antirretrovirales es tambi?n una pol?tica de prevenci?n necesaria. El informe de la ONU destaca, en cualquier caso, que ya se han producido importantes avances en este terreno en los ?ltimos a?os. En pa?ses de renta media o baja, hab?a un total de 400.000 pacientes en tratamiento en el a?o 2003. En cinco a?os, la cifra se ha multiplicado por 12, hasta alcanzar los cinco millones, de acuerdo a los datos m?s recientes disponibles. Sin embargo, cuando se miran las cifras globales, a?n son mayor?a los que no reciben medicaci?n o ni siquiera saben que portan el virus. De hecho, se estima que por cada dos personas nuevas que acceden al tratamiento, cinco son contagiadas. Otra de las mejoras necesarias para alcanzar los objetivos de ONUSIDA, que se engloban en lo que el organismo ha denominado 'Tratamiento 2.0', ser?a el desarrollo de herramientas de diagn?stico m?s accesibles, que permitieran al paciente examinar por s? mismo si ha sido v?ctima de un contagio o evaluar los niveles de sus virus o defensas, al igual que ya existen test de embarazo dom?sticos o los diab?ticos pueden medir f?cilmente sus niveles de az?car. *5* *Aids: Zweite Epidemiewelle in Europa ** **ORF, Austria* 13/07/2010 In manchen Staaten Europas gibt es nach Angaben der Vereinten Nationen eine zweite Aids-Epidemiewelle. Kritisch ist die Situation in Osteuropa, in vielen Weltregionen d?rfte die H?ufigkeit von HIV/Aids aber ein Plateau erreicht haben.. Positiv ist, so der stellvertretende Generaldirektor des Aids-Programms der Vereinten Nationen (UNAIDS), Paul De Lay: "Wir sehen in 15 Staaten der Erde mit einem hohen Anteil an HIV-Infizierten, dass man vor allem bei j?ngeren Menschen eine ?nderung von Risikoverhalten bewirken kann." De Lay sprach mit der APA anl?sslich des heute, Dienstag, in Genf von UNAIDS vorgestellten "Outlook Report 2010": "Die Analyse der weltweiten Aids/HIV-Daten wird bis Oktober dauern. Wir k?nnen aber anl?sslich der Internationalen Aids Konferenz in Wien Trends vorstellen." In Summe ergibt sich f?r De Lay ein gemischtes Bild: "Weltweit sehen wir, dass die Zahl der Infizierten ein Plateau erreicht hat. Aber in Staaten wie Russland, Ukraine, Wei?russland oder Georgien erh?ht sich die Zahl der Neuinfektionen." "Neue Generation mit Risikoverhalten" De Lay: "Auch in L?ndern wie Deutschland und Gro?britannien steigt die Zahl der Neuinfektionen. Hier haben wir es mit einer zweiten Welle der Epidemie zu tun. Zehn Jahre oder mehr nach der ersten Welle haben wir eine neue Generation von Jugendlichen, die Risikoverhalten aufweisen, Drogen injizieren, keine Kondome verwenden. Das hei?t einfach, dass wir Heranwachsende st?ndig neu aufkl?ren und informieren m?ssen." W?hrend in Westeuropa diese zweite Welle langsamer ablaufe, sei die Situation in Osteuropa kritisch. De Lay: "Wir sehen dort eine beunruhigende Zunahme der HIV-Infektionen - vor allem wegen intraven?sen Drogenkonsums. Innerhalb eines Jahres kann in bestimmten Bev?lkerungsgruppen die H?ufigkeit von HIV-Infektionen von ein bis zwei Prozent auf 30 Prozent zunehmen. Eine Welle mit heterosexueller ?bertragung l?uft hingegen viel langsamer ab." *HIV rates fall among young people in worst-affected countries, figures show * *The Guardian, UK* 13/07/2010 Sarah Boseley, Health Editor The United Nations hailed a breakthrough in the fight against Aids today with the release of figures showing that the prevalence of HIV has dropped among young people in 15 of the worst-affected countries in the world. The news was even better in 12 of the countries, where HIV levels have fallen by 25% among people aged 15-24, in response, UNAIDS believes, to dogged prevention campaigns, warning of the dangers of HIV/Aids and the need for people to change their sexual behaviour. Michel Sidib?, head of UNAIDS which released the report before the International Aids conference in Vienna next week, said that young people were leading a badly needed prevention revolution, adding that authorities needed to change tack in the battle against HIV/Aids. "I think for me what is very important is to say to the world that we are at the defining moment now, where we need to re-shape completely the Aids response," he said. This redefinition must take place, he said, because of rising treatment costs for HIV and the global economic crisis. "The world is demanding change. We cannot continue with the same response. It is not sustainable. It is very clear from public opinion region by region that Aids continues to be a top priority, but they are calling for a paradigm shift." The costs of antiretroviral drugs for the millions who need them was going through the roof, he said. Even countries such as Brazil, which successfully made cheap Aids drugs available to all, were now hitting financial problems because the first-line drugs were no longer effective enough ? HIV becomes resistant over time. Third-line drugs in Brazil now cost $19,000 (?12,600) per person per year. But drugs alone, even if they were affordable, would not be enough. "While we were trying to push the treatment, we were seeing that new infections were growing and growing and we were not convinced we were making progress with young people," said Sidib?. So the report that UNAIDS is now releasing offers rare hope for a new strategy which must have prevention at its heart, even while efforts to make simpler, cheaper treatment available continue. "Young people are taking the lead, which is progress," said Sidib?. "For the first time there is a correlation between that (declining prevalence) and behaviour, which for me is very important news in terms of dealing with the epidemic." The biggest drop was in Kenya, where HIV in 15-24-year-olds was down by 60% between 2000 and 2005. In urban areas it went down from 14.2% to 5.4%, while in rural areas it dropped from 9.2% to 3.6%. In Ethiopia, the report shows a 47% change among young pregnant women in urban areas and 29% in rural areas. In Malawi and C?te d'Ivoire, prevalence among young, pregnant, urban women fell by 56% and in Burundi and Haiti it dropped by nearly half. Reductions of more than a third took place in Namibia, Zimbabwe, Botswana, Rwanda and Lesotho. Most of the figures come from antenatal clinics, where pregnant young women are tested. Mathematical modelling shows that they are a good indicator of trends across the whole age group. Population surveys are better, however, and were available in seven countries. In six of those countries, a drop in prevalence was seen among young women ? but in only four out of the seven was there a drop in prevalence among young men. UNAIDS believes the progress is down to the success of efforts to persuade young people to change their sexual behaviour. In 13 countries where research was carried out, young people were reported to be waiting longer before they first have sex. Usually this was young women rather than young men, but in Cameroon, Ethiopia, Malawi and Zambia, both young men and women were waiting longer. The study also found that both young men and women were having fewer sexual partners and that condom use has increased among young women as well as among young men. *8* *Premia ONU a organismo mexicano por su lucha contra el VIH-Sida * *La Jornada, Mexico** **12*/07/2010 Nueva York. El Programa de Naciones Unidas para el Desarrollo anunci? este lunes que el mexicano Colectivo SerGay fue distinguido entre otros 25 grupos civiles con el premio Mo?o Rojo por su labor a favor de minor?as sexuales y combatir el contagio del VIH-Sida. El organismo mexicano fue distinguido por ?exponer injusticias y documentar violaciones a los derechos humanos de minor?as sexuales y grupos marginales en el central estado mexicano de Aguascalientes. Adem?s, por su trabajo para ofrecer a las minor?as sexuales un centro de apoyo comunitario que brinda asistencia m?dica, terap?utica y psicol?gica. El premio Mo?o Rojo ?nombrado en honor al s?mbolo mundial de la campa?a contra el contagio de VIH-Sida? fue creado para reconocer a organizaciones comunitarias que realicen un trabajo sobresaliente para reducir el contagio y el impacto de este flagelo en sus comunidades. Cada una de las entidades premiadas recibir? un premio en efectivo y ser? invitada a participar en la XVIII Conferencia Internacional sobre el VIH-Sida, a celebrarse la pr?xima semana en Viena, Austria, inform? la ONU. Los 25 ganadores de este a?o fueron seleccionados de entre organismos de m?s de 100 pa?ses por sus esfuerzos en t?rminos de ?innovaci?n, impacto, sostenibilidad, alianzas estrat?gicas, sensibilidad de g?nero e inclusi?n social?. En Am?rica Latina y El Caribe, la ONU tambi?n reconoci? a la Asociaci?n Comit? Contra El Sida Caba?as, en El Salvador, a la Asociaci?n de Mujeres Meretrices de Argentina y a la Organizaci?n Productiva de Mujeres en Acci?n (POWA, por sus siglas en ingl?s), de Belice. El Mo?o Rojo fue entregado tambi?n a 10 organismos civiles en Africa, dos ubicados en pa?ses ?rabes, tres localizados en la zona Asia-Pac?fico y seis en Europa del Este y Asia central. ?ONUSIDA se enorgullece de celebrar y honrar a estos grupos que se han movilizado para satisfacer las necesidades de los m?s vulnerables en nuestras comunidades, con energ?a, pasi?n y compasi?n?, dijo Jan Beagle, directora alterna de ONUSIDA, el ?rgano de Naciones Unidas contra el contagio del VIH-Sida. *9* *UN honours 25 groups for outstanding community-based response to AIDS** **UN News Service* 12/07/2010 12 July 2010 ? Community-based groups working for prisoners? rights in Burkina Faso and treatment services for drug users in Nepal are among the 25 winners announced by the United Nations today for the 2010 Red Ribbon Award for outstanding local leadership and action in responding to AIDS. ?Grassroots and community-based organizations are at the heart of the global response to AIDS,? said Jan Beagle, who serves as Deputy Executive Director for Management and External Relations at the Joint UN Programme on HIV/AIDS (UNAIDS). ?UNAIDS is proud to celebrate and honour these groups who have mobilized themselves to meet the needs of the most vulnerable in their communities with energy, passion, and compassion. The red ribbon award winners give a resounding voice to the voiceless.? There were 720 nominations from over 100 countries for the Red Ribbon Award, which is named after the global symbol in the movement to address AIDS and is given by the UNAIDS family every two years. The 25 winners, representing 17 countries, were selected by a group of civil society experts in the community response to HIV for having demonstrated the most remarkable efforts in terms of innovation, impact, sustainability, strategic partnerships, gender sensitivity and social inclusion. ?Communities really hold the key to finding solutions to their own problems," said Dr. Helene Gayle, President and Chief Executive Officer of the non-governmental organization CARE, and a member of this year?s selection committee. ?So while those of us with a lot of outside expertise may know the theories, community organizations are best suited to reach those most in need when it comes to applying them.? The winners, each of whom will receive a cash award and international recognition for their efforts, are invited to participate in the XVIII International AIDS Conference to be held in Vienna from 18 to 23 July. They will be guests of honour at a formal awards ceremony there and will host a forum for dialogue and exchange between policy makers and community representatives. Jeffrey O?Malley, Director of the HIV/AIDS Practice at the UN Development Programme (UNDP), noted that these organizations clearly demonstrate that effective responses to the epidemic require the full participation of front-line, community-based groups. ?Community groups recognize that AIDS is one of many issues that are tied together,? he said. ?They understand that AIDS requires an exceptional response but they also understand that you need to link AIDS to broader issues of health, development and justice to be effective.? *10* *Avec la propagation de la fi?vre du football, stoppons la propagation du VIH** **Le Nouvelliste, Haiti* 06/07/2010 Ha?ti: Avec l'arriv?e des supporters de football du monde entier pour soutenir leurs ?quipes favorites pendant la Coupe du monde de la FIFA 2010, nous ne devons pas perdre de vue un visiteur ind?sirable - le VIH. Pourquoi devrions-nous parler du VIH pendant la Coupe du monde ? Pour deux raisons. D'abord, un ?v?nement sportif aussi important que la Coupe du monde peut faciliter la propagation du VIH par la combinaison de l'excitation, de l'alcool et de rapports sexuels non prot?g?s. Ensuite, pendant les 90 minutes que dure un match de football, pr?s de 80 b?b?s na?tront avec le VIH. Ceci se traduit par 430 000 b?b?s infect?s chaque ann?e. Nous avons les moyens de stopper cette trag?die, nous devons agir - aujourd'hui m?me. Les stars du football et Ambassadeurs de bonne volont? de l'ONUSIDA Emmanuel Adebayor du Togo et Michael Ballack d'Allemagne se sont joints ? l'ONUSIDA pour lancer une campagne mondiale pour pr?venir l'infection des b?b?s par le VIH. La campagne vise ? mobiliser la communaut? du football pour l'amener ? ? donner un carton rouge au SIDA ? et ? ?liminer la transmission du VIH de la m?re ? l'enfant d'ici ? 2014, au moment de la prochaine Coupe du monde au Br?sil. A ce jour, les capitaines de football de nombreux pays - Australie, Cameroun, C?te d'Ivoire, France, Ghana, Gr?ce, Nigeria, Paraguay, Serbie, Afrique du Sud et Uruguay - ont sign? un Appel qui les engage ? utiliser le pouvoir et l'influence du football pour cr?er une g?n?ration sans VIH. Il est possible d'?liminer presque totalement la transmission du VIH de la m?re ? l'enfant. Dans les pays ? revenu ?lev?, la transmission du VIH de la m?re ? l'enfant a chut? de 25% jusqu'? 1% ? 5% ces derni?res ann?es avec la disponibilit? croissante du d?pistage du VIH chez les femmes enceintes et l'utilisation accrue des m?dicaments antir?troviraux pendant et apr?s l'accouchement. L'on retrouve ces succ?s maintenant dans des pays comme le Botswana, la Namibie et le Swaziland. Mais l'on doit faire plus. Dans la plupart des pays africains, 45% seulement des femmes enceintes s?ropositives ont acc?s aux m?dicaments antir?troviraux pour la pr?vention de la transmission du VIH aux nouveau-n?s, et 28% seulement des femmes enceintes font le test du VIH. Dans de nombreux pays africains, le SIDA est devenu la premi?re cause de d?c?s chez les nourrissons et les jeunes enfants. En Haiti 730 b?b?s naissent avec le VIH chaque ann?e, et 57% des femmes enceintes s?ropositives ont acc?s aux m?dicaments antir?troviraux. D'apr?s le MSPP, il y a plus de111 centres de sante a travers Haiti, ou les femmes enceintes VIH (+) peuvent aller pour suivre un traitement profilactique pour proteger le bebe, afin qu'il naisse sans le VIH. Des progr?s ont ?t? constat?s en Afrique du Sud, pays h?te de la Coupe du monde. Le gouvernement sud-africain a fait montre d'un leadership hardi sur le SIDA ces derniers mois avec le lancement d'une campagne nationale de d?pistage et de traitement du VIH qui exhorte les Sud-Africains ? faire le test du VIH. La campagne vise ? fournir, d'ici 2011, un conseil et d?pistage gratuits et syst?matiques ? 15 millions de personnes, contre 2,5 millions en 2009 - soit six fois plus en deux ans seulement. Et quelque 1,5 million de personnes recevront une th?rapie antir?trovirale d'ici ? juin 2011, contre 1 million en 2009. A mesure que s'accro?t le nombre de m?res qui connaissent leur statut s?rologique et ont un acc?s accru ? la th?rapie antir?trovirale, l'on s'attend ? voir baisser consid?rablement la transmission du VIH. Avec des combinaisons plus efficaces de m?dicaments antir?troviraux, l'Afrique du Sud pourrait aller vers l'?limination quasi-totale de la transmission de la m?re ? l'enfant. Si l'Afrique du Sud, pays qui compte le plus de personnes vivant avec le VIH, peut briser la trajectoire de l'?pid?mie du SIDA, l'on peut esp?rer que d'autres pays en fassent autant. Avec la fi?vre du football qui se propage au monde entier, faisons tout ce qui est en notre pouvoir pour stopper la propagation du VIH. Nous le pouvons! Michel Sidib?, Directeur ex?cutif de l'ONUSIDA =========================== *AFRICA AND MIDDLE EAST* =========================== *Heed Call on ARVs (Editorial)** **The Citizen, Tanzania* 12/07/2010 Tanzania, according to Unaids data, has an estimated 1.4 million people living with HIV/Aids. The disease's prevalence rate among adults, relative to 2007 figures, is 6.2 per cent. Although the government has committed to ensuring universal access to anti-retroviral (ARV) drugs by 2010, this year, only an estimated 250,000 people have access to ARVs. Close to 200,000 people who need the drugs are unable to access them. Besides the costs associated with treatment of the disease, including the need to buy supplementary food, ill-treatment at hospitals and general stigma are major barriers affecting access to treatment. A few days ago, there were reports that medical practitioners at an Arusha hospital allegedly prescribed HIV/Aids patients expired ARVs, with an assurance that there would be no problems if the drugs were taken within 6 months after the expiry date. This report is shocking, to say the least. It is no secret that a compromise in the manner in which ARV's are supposed to be handled can severely affect the health of the user. Following the doctors' instructions is therefore key to success in fighting the HIV/Aids pandemic. The obvious downside to ARV use is that missing out on drugs or going against medical instructions on dosage can cause considerable health damage. It is therefore very unfortunate that certain medical practitioners would want to jeopardize the lives of their patients by misadvising them on drug use. We would like to appeal to members of the general public to realize that people living with HIV/Aids are normal human beings that deserve respect like any other Tanzanians. It is very wrong therefore to treat them otherwise. Besides, it is a national duty for all of us to help the government fight the spread of HIV/Aids. *5* *HIV, Aids - the Elderly's Role Neglected (op-Ed)** **The Herald, Zimbabwe* 13/07/2010 Conrad Gweru Harare ? The devastating effects of HIV and Aids have been felt in the old aged population, mainly because the active population is being wiped out leaving old parents and children to look after each other. The change in the demographic composition of the Zimbabwean population owing to Aids is such that older persons and children are left behind without any means of livelihood. This means older people have become primary care givers of the sick and orphans but they have no clear means of looking after themselves. They are not adequately recognised in current country policy and interventions on HIV/Aids. The impact of HIV and Aids on older people is under-reported in terms of them looking after orphans as well as their infection rates. Focus here is on the challenges faced by the aging generation and possible policy interventions as well as possible interventions by the donor community. The effects of HIV and Aids on all sections of the community are immense. A lot has been discussed on the effects of the pandemic at various fora to some length, but only inasfar as the virus affects the younger generation or the so-called sexually active age groups. Yet this dreaded condition has come to affect all social groupings. Unfortunately very little attention has been directed at exploring the effects of the pandemic on our aging population. In order for universal access to treatment, care and support to be truly achieved, there is need to channel resources towards the aged as they are making immense contribution in today's society although with limited resources. A number of older persons who look after orphans and the sick do not benefit directly from programmes meant to combat HIV and Aids. They are currently marginally involved in the design, delivery and monitoring of the programmes. Policies either deliberately or by default exclude older persons from active contribution to the programmes. Elderly people bear the brunt of taking care of terminally ill and orphaned grandchildren, yet with reduced access to sustaining adequate incomes. HIV is intricately bound to the challenges of poverty and impacts older persons in one or more of the following ways. As the infected through sexual activity and when providing care to adults infected with the virus and secondly through caring for grandchildren orphaned and made vulnerable by HIV and Aids, although with very limited resources and or knowledge to do so. UNAids, which leads the global response to the pandemic, currently uses 25 core indicators to monitor progress in tackling HIV and Aids, yet none of these monitors the impact on or prevalence among the over 50 years. This exclusion is leading to a critical lack of awareness of the effects on older people, and their neglect in national and international responses. As a result, many are unable to access vital information, treatment and support. None of the 25 core indicators address who is providing care to people living or affected by HIV and Aids, nor measure the support these care givers receive. Without this information, appropriate assistance to people and those under their care cannot be delivered. As an example indicators used to measure number of sexual partners and condom use focus solely on the 15-49 age groups, perpetuating the false assumption that people over 50 no longer have sexual relations, of which this is simply not the case. Until all age groups are included in the global response, the international goal of universal access to prevention, treatment, and care by 2010 will not be achieved. Traditionally older persons are a group of people who should be looked after by their families but in this era they are now exposed to the "mammoth" task of caring for family members living with HIV and Aids as well as orphans. This caring role strains older people who are already struggling to make ends meet. Some of the children under the care of older persons are living positively and one cannot dispute that without adequate knowledge of the virus, palliative care for these children can be strenuous in terms of accessing resources as well as general health of these children. They lack regular income support, they struggle to ensure that their grandchildren receive education, they are not receiving adequate information to access their rights and entitlements and to protect themselves in their critical care giving role and they are challenged to maintain their health and that of those under their care. The increase in home based care and orphan care due to Aids places an enormous burden on the elderly, especially women. In developing countries like Zimbabwe, where the welfare system has limited resources and is under extreme conditions of poverty, stigma, lack of support and abuse resulting from witchcraft accusations and other challenges faced in old age. In its State of the world report in 2007, Unicef acknowledged for the first time the roles of older persons who care for children orphaned by Aids. In Zimbabwe 60-61 percent of orphans are under the care of older persons. *Conrad Gweru is an advocacy officer at HelpAge Zimbabwe* *=======================* * * *ASIA** AND PACIFIC* * * *=======================*** *Women with AIDS are mostly housewives** **Jakarta Post* 13/07/2010 JAKARTA: According to the National Commission for AIDS (Komnas-AIDS), "good" housewives make up 59.9 percent of women living with HIV in Indonesia. Commission secretary Nafsiah Mboi said here Monday that, according to official data, women account for 25 percent of the 3,525 people living with HIV nationwide. "They are monogamous, faithful wives and not drug users who use syringes. They most probably contracted the disease from their husbands who have used syringes or practiced unsafe sex," Nafsiah said as quoted by kompas.com. She also lamented the lack of awareness among men about the use of condoms, saying that it was important for men who have more than one sexual partner men to use condoms, even when having sex with their wives. - JP *4* *56 kids get HIV, hepatitis after blood transfusion** **Times of India* 13/07/2010 JODHPUR: At least 56 children suffering from thalassaemia tested positive for HIV, hepatitis B and hepatitis C after receiving blood transfusion at government-run Umaid hospital in Jodhpur. They are among the 130 thalassaemic children registered with Jodhpur?s Marwar Thalassaemic Society, said a source. Terming it as a case of negligence, Union health minister Ghulam Nabi Azad said that the state government was responsible in the case. ?It is a case of negligence. It is the responsibility of the state government to take proper precautions,? Azad said in Srinagar. In the last one-and-a-half years, at least eight thalassaemic children in the city were found to be HIV positive while 46 others were infected by hepatitis B virus prompting a probe by the state government. In December 2008, five children tested positive for HIV and 29 for hepatitis C virus. In May 2010, three more children were found HIV positive and 17 suffered from hepatitis C. According to the Thalassaemic Society, if all the children who received blood transfusion are tested, the numbers may go up. Recently, members met the principal of S N Medical College and the divisional commissioner and demanded nucleic acid test at Umaid Hospital blood bank to prevent infection during transfusion. Medical college principal R K Aseri said a proposal for nucleic acid test ? which is a more advanced blood test ? has been sent to Rajasthan government which is now studying the expenses involved. The college has also formed a three-member committee to probe if there are any flaws in the blood bank's testing methods. The Society also demanded special consideration for families below poverty line and adequate staff and resources at Umaid Hospital's thalassaemia ward.Society secretary Vipin Gupta said, ?We want the blood banks to have better technology.'' Currently, ELISA test has a longer window period, disabling it to detect any antibody at early stage in the donated blood. Window period is the time taken for seroconversion ater exposure to the HIV virus. tnn & agencies *========================* *EUROPE*** *========================* *White House AIDS strategy to focus on prevention** **Reuters* 13/07/2010 By Maggie Fox, Health and Science Editor WASHINGTON (Reuters) - President Barack Obama released a domestic AIDS strategy on Monday that aims to cut the infection rate by 25 percent, test 90 percent of those infected and get 85 percent of patients treated right away. The new plan, to be formally released on Tuesday, also has modest aims to get 20 percent more of the most at-risk groups such as gay and bisexual men and blacks treated with drugs to control their infections. "Unless we take bold actions, we face a new era of rising infections, greater challenges in serving people living with HIV, and higher health care costs," the report reads. The United States should be able to lower the annual number of new infections by 25 percent from 56,300 to 42,225 a year by 2015, the plan said. It also proposes to cut the HIV transmission rate by 30 percent. Currently, 5 percent of HIV patients infect someone else and the plan aims to lower this to 3.5 percent. The U.S. Centers for Disease Control and Prevention says 79 percent of people infected with the human immunodeficiency virus that causes AIDS know they have it. The plan aims to increase this to 90 percent. To this end, the plan calls for the U.S. Food and Drug Administration to make a top priority the review of new HIV diagnostic tests. It also promises to get 85 percent of newly diagnosed patients into a doctor's office or clinic within three months. Currently, 65 percent get treated that quickly. The plan also targets behavior. "Congress and State legislatures should consider the implementation of laws that promote public health practice and underscore the existing best evidence in HIV prevention for sexual minorities," it reads. More than 1.1 million people in the United States are infected with the human immunodeficiency virus that causes AIDS, according to the Centers for Disease Control and Prevention. While only about 5 percent of patients infect someone else, this is enough to keep levels of the virus stable in the United States, the CDC says. The fatal and incurable virus is spread during sex, in blood and breast milk and by contaminated needles. The U.S. government has a program to fight AIDS globally -- PEPFAR, or President's Emergency Plan for AIDS Relief -- but there has not been a similar coherent domestic strategy. While the administration of former President George W. Bush was praised for coming up with PEPFAR, it was widely criticized for promoting abstinence-only education in place of more comprehensive programs stressing condom use. The new Obama plan includes abstinence but also stresses other approaches. "We must also move away from thinking that one approach to HIV prevention will work, whether it is condoms, pills, or information," the plan reads. "Instead, we need to develop, evaluate, and implement effective prevention strategies and combinations of approaches including efforts such as expanded HIV testing (since people who know their status are less likely to transmit HIV), education and support to encourage people to reduce risky behaviors (and) the strategic use of medications and biomedical interventions," it adds. Some AIDS activist groups began criticizing the policy even before it was released, saying it did not come close to doing what they had hoped. The AIDS virus infects 33 million people globally and has killed 25 million since the pandemic began in the 1980s. In Africa, most new AIDS patients are women infected by men during sex. In the United States HIV disproportionately affects men who have sex with men, blacks and Hispanics. (Editing by Eric Beech) *6* *AIDS Journal Op Ed: "PEPFAR and Maternal and Child Health Initiatives Must Not Compete"** **Reuters* 12/07/2010 Just Days Ahead of the XVIII Int`l AIDS Conference Set to Convene in Vienna, Austria on July 18th, Opinion Piece Argues Against US Retreat on Global AIDS Funding Co-Authored by AIDS Healthcare Foundation Board Member, Anand Reddi, Article Questions Ethical Legitimacy and Scientific Merit of Obama Administration`s Plan to Fund `Mother and Child Campaign` at Expense of Full Funding for AIDS Program Article Available Online at www.AIDSonline.com LOS ANGELES--(Business Wire)-- Just days ahead of the XVIII International AIDS Conference July 18-23 in Vienna, Austria, the journal AIDS-the official journal of the International AIDS Society-published an opinion piece by Sarah C. Leeper and Anand Reddi which argues against the Obama administration`s current take on global health which, the authors believe, frame HIV/AIDS and maternal and child health initiatives as competing funding priorities-to the detriment of both. The article refers to the Obama administration`s new, 6-year, $63 billion Global Health Initiative which includes the reauthorization of the President`s Emergency Plan for AIDS Relief (PEPFAR)-the successful US global AIDS program-as well as support for maternal and child health (MCH) initiatives rooted in a proposal published in the Journal of the American Medical Association by Colleen Denny and Ezekiel Emmanuel (a healthcare advisor to President Obama) known as the Mother and Child Campaign. The authors state: "The architects of the Obama administration`s Global Health Initiative recommend funding the Mother and Child Campaign at the expense of future funding increases for PEPFAR. The idea that differing global health initiatives must compete with each other lacks not only ethical legitimacy but also scientific merit. We believe that MCH need not be framed in opposition to PEPFAR. Confronting illness in isolation - whether by funding PEPFAR at the expense of programs that target MCH or vice versa - cannot be our way forward. Given the intimate connection between HIV/AIDS and MCH, we affirm supporting PEPFAR and MCH programs together. We argue that policies that de-emphasize PEPFAR threaten to undermine, rather than support, MCH in countries with high HIV/AIDS prevalence." Mr. Reddi is a member of the Board of Directors of AIDS Healthcare Foundation (AHF), the largest global AIDS organization, which earlier this month led a delegation of five AIDS treatment clients and medical care providers from Uganda to lobby in Washington, DC, asking members of Congress to honor the US` landmark commitment to PEPFAR. The group, all of whom were treatment clients or medical health care providers, lobbied members to increase PEPFAR funding to come closer to the full $48 billion authorized by Congress in 2008; to urge legislators to demand accountability so that PEPFAR countries operate their AIDS treatment programs in the most cost effective ways by reducing the amount permitted to be spent on overhead and bureaucracy; and to immediately eliminate caps on the number of people allowed in PEPFAR-funded treatment programs in hard-hit countries like Uganda and elsewhere. The opinion piece is particularly timely as it is expected that a major topic of the upcoming Vienna conference-the largest gathering of global HIV/AIDS stakeholders-will be concerns regarding a diminishing commitment to global HIV/AIDS funding. "Despite the strides PEPFAR has made, the fight against AIDS is in retreat," said Michael Weinstein, President of AIDS Healthcare Foundation. "PEPFAR is not fully funded, and the administration has disregarded laws that would ensure that programs are cost effective and treat the most people possible. Inefficient and wasteful practices continue, denying care to millions. Competing global health priorities must not get in the way of honoring the promise made by the US when the landmark global AIDS program was introduced. Unfortunately, the catastrophic impact of this retreat is under way. Treatment programs in Uganda, Mozambique, Botswana and Nigeria have instituted caps on treatment slots and are turning people away or experiencing drug shortages." Added Weinstein: "All of the progress and momentum that we have made is at risk. The conference in Vienna must focus on sending a clear message that punishing the success we have already achieved by pulling back support will have catastrophic consequences." The paper "United States global health policy: HIV/AIDS, maternal and child health, and the President`s Emergency Plan for AIDS Relief (PEPFAR)" can be read in its entirety here. About Anand Reddi Anand Reddi is a second year medical student at the University of Colorado, School of Medicine. Prior to medical school, Anand was a Fulbright Scholar to South Africa. In South Africa, Anand assisted McCord Hospital`s Sinikithemba HIV/AIDS Clinic. His Fulbright research with Sarah Leeper demonstrated that pediatric highly active antiretroviral therapy (HAART) is effective despite the challenges of a resource-limited setting. Reddi and Leeper have also written extensively on the benefits of a family-centered antiretroviral treatment model (Reddi and Leeper publications). About Sarah Leeper Sarah Leeper is a third year medical student at Brown University. Prior to medical school she worked with the Children Right's Center (CRC) in South Africato develop the Living Positively Handbook, which teaches HIV-positive children about their illness in an honest and age-appropriate way. AIDS Healthcare Foundation (AHF) is the largest global AIDS organization. AHF currently provides medical care and/or services to more than 139,000 individuals in 23 countries worldwide in the US, Africa, Latin America/Caribbean, the Asia Pacific Region and Eastern Europe. www.aidshealth.org *9* *Sida: le choix d'une r?v?lation** **L^Hebdo.ch* 07/07/2010 Par Tasha Rumley SANT?. D?voiler que le VIH coule dans ses veines est un pas que peu de s?ropositifs franchissent. Rencontre avec une famille genevoise et un politicien fran?ais qui se sont lanc?s. Certains laissent ?chapper une larme de fiert? au premier jour d??cole de leur enfant. Pancho ne se l?est pas permis, bien qu?envahi d?une tension visc?rale. Ce jour-l?, il l?che une bombe aux parents de Th?nex (GE): ?Ma fille est s?ropositive et elle ira en classe avec vos enfants.? Aux yeux ?bahis succ?dent des mots de sollicitude. Pancho a su faire passer cette v?rit? d?conseill?e aux s?ropositifs. C??tait en 1996. Elodie avait 4 ans. Sa m?re, elle ne l?avait presque pas connue: le sida l?avait fauch?e, ? 26 printemps. Pancho ?levait sa fillette seul, rong? d?inqui?tude pour sa sant? et la vie sociale qui attend un enfant du sida. Mais plut?t que de subir leur condition, Pancho l?a domestiqu?e. D?une part, il s?est mis ? t?moigner pour le ?Projet ?cole?, qui sensibilise les ?l?ves romands. D?autre part, il a ?lev? sa fille sans tabous, dans une totale transparence, malgr? les inqui?tudes de la p?diatre. Apr?s l?annonce collective ? l??cole de Th?nex, il a renouvel? l?op?ration pour chaque nouveau camarade d?Elodie. ?Lorsqu?on arrivait ? un go?ter d?anniversaire, je demandais aux parents de leur parler en t?te-?-t?te. Et l?, mes larmes remontaient toutes seules. Je craignais qu?on nous jette dehors.? Mais jamais, la porte ne leur a ?t? claqu?e. De la bouche des enfants sont bien sorties quelques perfidies. ?Ton sida, il pue!? a essuy? l??coli?re, au m?me titre que le petit myope est trait? de crapaud ? lunettes. Mais l??pisode qui a ?branl? sa scolarit? n?est pas venu de son ?cole. Lorsque la classe pr?pare un ?change dans la commune de Graveson (France), Elodie est interdite de s?jour par l??cole d?accueil. Apr?s les vocif?rations de Pancho, la directrice l?accepte, ? condition qu?elle loge chez le m?decin plut?t qu?en famille. Le p?re l?envoie valser et embarque sa fille pour une vir?e ? deux, compresse sur cette premi?re blessure. N?e s?ropositive. ?On m?a souvent dit que je lui faisais du tort en r?v?lant notre s?ropositivit??, souffle Pancho. Pourtant, l?homme s?emplit de fiert? lorsqu?il voit son adolescente avaler sa trith?rapie en public et r?pondre laconiquement ?contre le sida? aux regards interrogateurs. Car pour la jeune fille de maintenant 17 ans, le VIH est aussi ordinaire que les globules rouges dans son sang. Le virus est un h?ritage de ses parents, ex-toxicomanes qui esp?raient ne pas le lui transmettre. ?Il y avait une chance sur cinq pour qu?Elodie soit s?ropositive, se rappelle Pancho. On ne pouvait m?me pas le d?terminer ? la naissance, il fallait attendre des mois.? Les m?decins ont sans doute voulu ?pargner l?homme qui voyait mourir sa compagne et ne lui ont annonc? la s?ropositivit? du b?b? qu?apr?s le d?c?s. Elodie avait 2 ans. Petit copain. Les m?dicaments, les visites chez le m?decin, la fatigue chronique ont sculpt? la vie de l?enfant. Devenue grande, elle a pris en main la r?v?lation de sa maladie, qu?elle livre de mani?re s?lective. Avec les copines, aucun probl?me. Plus d?licat dans ses recherches d?apprentissage, o? la v?rit? lui garantirait une discrimination ? l?embauche. Mais face ? l?amour n? ce printemps avec un copain de classe, son secret a fil? tout droit jusqu?? ses l?vres. ?Je le lui ai dit apr?s quatre jours! s?exclame-t-elle. Je me sentais trop mal.? Exemplaire, le gar?on dig?re l?annonce et parvient ? rassurer ses propres parents. Aujourd?hui, il passe la nuit chez Elodie et vice-versa. Bien que le VIH soit ind?tectable dans son sang ? elle n?est donc pas contagieuse ? Elodie reste soucieuse. ?J?ai peur de le contaminer?, souffle-t-elle. Mais Pancho la rassure, ravi de voir ses premi?res exp?riences se d?rouler paisiblement. L?homme ?cul? par la vie se r?concilie avec elle par sa fille. ?Gr?ce au traitement, le jour o? Elodie aura un enfant, il sera s?ron?gatif?, sourit-il, r?veur ? l?id?e de cette douce revanche sur le destin. Le sida en politique. Elodie pourra vivre heureuse et avoir beaucoup d?enfants. Cependant son histoire berce comme un conte. Ce lent apprivoisement de la maladie et des r?actions qu?elle peut d?clencher reste le privil?ge des anonymes. Sur la sc?ne publique, la r?v?lation d?clenche les foudres. En 2002, Jean-Luc Romero, conseiller r?gional d?Ilede-France (socialiste, ex-UMP), a ?t? le premier politicien ? r?v?ler sa s?ropositivit?. ?C??tait un secret lourd qui m??puisait, alors que je voulais mettre mes forces dans la lutte contre la maladie?, se rappelle-t-il. Ses proches et son m?decin lui pr?disaient la mort sociale, mais il a pass? outre, d?autant plus que ce choix ?tait partiellement contraint: le journal gay T?tu avait fait son coming out de l?homosexualit? sans le consulter. ?Je craignais qu?il arrive la m?me chose avec ma s?ropositivit?. Je savais que ce serait une catastrophe.? Jean-Luc Romero publie alors un livre, Virus de vie. Apr?s l?avoir pr?sent? en public, il verse les larmes de quinze ann?es de sida cach?. ?Cela m?a lib?r?, lav?.? Les ?lecteurs ne partagent pas ce soulagement. F?ru du net ? il ach?te l?iPad le jour de sa sortie aux USA mais ?crit ? la plume ? bec ? Jean-Luc Romero voit s??lever une cybercampagne. Sur son blog, les injures homophobes et s?rophobes se m?lent dans une haine brutale. En lui, les conservateurs rigoristes trouvent un bouc ?missaire, qu?ils accusent d??tre m?me responsable de la mort de jeunes sid?ens, pour son mauvais exemple. Parmi ses pairs ?galement, le malaise est patent. ?Les hommes politiques ne parlent jamais de la maladie ou de la mort, observe-t-il. C?est vu comme un aveu de faiblesse. Beaucoup ont consid?r? que j?avais ?t? impudique.? Il n?y a gu?re que face aux s?ropositifs que le jeune quinquag?naire a ?t? rass?r?n?. En tant que fondateur de l?association Elus locaux contre le sida, Jean-Luc Romero visite officiellement des s?ropositifs depuis 1995. ?A l??poque, ils me remerciaient mais disaient que je ne comprendrais jamais ce que c??tait de vivre avec le VIH...? Maintenant d?voil?, il re?oit un message par semaine sur Facebook de jeunes s?ropositifs en mal de rep?res. Discriminations au travail. La v?rit? n?a pas pris la forme d?un tremplin pour sa carri?re politique. Au contraire, elle s?est fig?e depuis. Quant ? cr?er des vocations, l??chec est total: aucun personnage public ne s?est depuis risqu? au coming out du sida, ? l?exception de l?actrice Charlotte Valandrey, aux r?les ?pisodiques. Vide social, obstacles et discrimination professionnels, la r?v?lation du sida se paie cash. A l?Aide suisse contre le sida, le constat est alarmant: 40% des demandes de conseil juridique concernent les probl?mes au travail, comme le mobbing ou le licenciement abusif, justifi? par un pr?texte alibi. Une enqu?te de 2003 du Fonds national suisse a r?v?l? que trois quarts des personnes dont le sida avait ?t? connu de l?employeur ont subi des cons?quences n?gatives et 28% ont perdu leur travail. ?La confidentialit? est donc le premier souci de ceux qui nous contactent, explique Deborah Glejser, porte-parole du Groupe sida Gen?ve. Ils craignent la rumeur et veulent garder la ma?trise sur la r?v?lation.? L?association se passe donc d?en-t?te sur ses enveloppes et voile son num?ro de t?l?phone. Chacun ? leur ?chelle, Pancho, Elodie et Jean-Luc Romero sont des pionniers. Apr?s avoir essuy? les pl?tres, ils esp?rent voir leurs semblables se jeter ? l?eau, seul moyen pour d?dramatiser l?annonce. En revanche, toute question inquisitrice de l?employeur reste ill?gale.? LE SIDA EN SUISSE 25 000 personnes vivent avec le VIH en Suisse. Chaque ann?e, environ 600 ? 700 nouveaux cas sont d?clar?s. 70% des s?ropositifs travaillent. Parmi eux, 70% le font ? plein temps. Ce sont les trith?rapies qui leur ont permis d?avoir une activit? professionnelle normale et les employeurs ont l?interdiction l?gale de se renseigner sur leur possible s?ropositivit?. 28% des s?ropositifs ont perdu leur emploi (licenciement ou d?mission forc?e) suite ? une r?v?lation. *========================* * * *LATIN AMERICA AND CARIBBEAN* * * *========================* *?Fracas? la guerra contra las drogas?: Cardoso, Zedillo y Gaviria** **Cr?nica de Hoy, Mexico* 13/07/2010 Los ex presidentes de Brasil, Fernando Henrique Cardoso; Colombia, C?sar Gaviria; y M?xico, Ernesto Zedillo, firmaron ayer la ?Declaraci?n de Viena? de la Conferencia Internacional SIDA 2010, que pide alternativas a la ?guerra contra las drogas? por considerar que ?ha fracasado? ?La guerra contra las drogas ha fracasado?, asegur? Cardoso en un comunicado conjunto, en el que respalda la declaraci?n de la conferencia internacional sobre el sida, que se celebrar? en Viena del 18 al 23 de julio. ?En Am?rica Latina el ?nico resultado de la prohibici?n ha sido el cambio de las ?reas de cultivo y carteles de un pa?s al otro, sin reducir la violencia ni la corrupci?n que genera el narcotr?fico?, agreg?. La declaraci?n solicita que las decisiones en materia de estupefacientes se tomen sobre la base de evidencias cient?ficas, y sostiene que ?la penalizaci?n de los consumidores de drogas il?citas est? fomentando la epidemia de VIH con consecuencias sociales y de salud tremendamente negativas?. ?Las pol?ticas represivas est?n firmemente basadas en prejuicios, miedos y en posturas ideol?gicas. La manera de salvaguardar los derechos humanos, la seguridad y la salud est? relacionada con estrategias de paz y no de guerra?, concluye Cardoso. ?Que tomen nota actuales gobernantes?. Por su parte, Julio Montaner, presidente de la Conferencia SIDA 2010, agreg? que ?la guerra contra las drogas ha tenido un impacto incre?blemente negativo en Am?rica Latina y el hecho de que la Declaraci?n de Viena est? recibiendo este gran aval de ex jefes de Estado, deber?a servir como ejemplo a aquellos que se encuentran en el poder en la actualidad?. Fuera de ?frica subsahariana, el uso de drogas inyectables es la causa de uno de cada tres nuevos casos de infecciones de Virus de Inmunodeficiencia Humana (VIH), causante del sida, mientras que en algunas zonas de Europa del Este y Asia Central es la principal causa de contagio, seg?n los organizadores de la conferencia. Por ello, la Declaraci?n de Viena solicita que medidas con efectos positivos contrastados sean aplicadas y se eliminen las restricciones legales en algunos pa?ses. Esta declaraci?n, que ha sido elaborada por un comit? de expertos entre los que se encuentra la Nobel de Medicina Fran?oise Barr?-Sinoussi, ha sido tambi?n respaldada por destacados intelectuales como el peruano Mario Vargas Llosa, el brasile?o Paulo Coelho y el nicarag?ense Sergio Ram?rez. La Declaraci?n de Viena puede consultarse en internet en ladeclaraciondeviena.com. *4* *Crian?as com HIV ter?o novo medicamento** **ORM, Brazil* 11/07/2010 Atualmente, estima-se que 2,1 milh?es de crian?as entre seis meses e 15 anos vivem com HIV/AIDS em todo o mundo, segundo o Programa Conjunto das Na??es Unidas sobre HIV/AIDS (Unaids). A maior taxa de infec??o pelo v?rus ? encontrada na ?frica. L? est?o 90% dos casos registrados. No Brasil, aproximadamente 10 mil crian?as e adolescentes t?m a doen?a. A incid?ncia da AIDS no mundo ? sempre uma batalha para especialistas. Quando se trata de crian?as, ent?o, as dificuldades s?o ainda maiores, j? que a luta para minimizar os riscos de contamina??o continua sendo a principal meta das autoridades. Todo esse desafio agora conta com uma nova arma: o Kaletra, um comprimido de baixa concentra??o, que tem a a??o inibidora de enzimas para o tratamendo da doen?a. A chegada do novo medicamento, que combina dois componentes em um ?nico rem?dio, foi recebida com expectativa por m?dicos brasileiros, que antes utilizavam no tratamento de crian?as e adolescentes uma outra droga. O rem?dio, por?m, era uma adapta??o de outros medicamentos, sendo que em solu??o oral, que, al?m de sabor desagrad?vel, necessita de refrigera??o, o que, para os m?dicos, prejudica o tratamento, j? que dificulta a ades?o dos pequenos pacientes. A infectologista Marinella Della Negra, que integra a equipe do Hospital Emilio Ribas, de S?o Paulo, ? uma das especialistas pioneiras no tratamento de AIDS infantil no Brasil. H? 30 anos trabalhando com esse p?blico, a m?dica explica que o Brasil ? considerado um exemplo no enfrentamento da doen?a. "O Brasil ? apontado como refer?ncia na luta contra a epidemia de HIV/AIDS no mundo, pois tem uma pol?tica p?blica exemplar para combate e tratamento desta infec??o", observa. *========================* *NORTH AMERICA* *========================* *Desperate Addicts Inject Others? Blood** **New York Times* 12/07/2010 By DONALD G. McNEIL Jr. Desperate heroin users in a few African cities have begun engaging in a practice that is so dangerous it is almost unthinkable: they deliberately inject themselves with another addict?s blood, researchers say, in an effort to share the high or stave off the pangs of withdrawal. The practice, called flashblood or sometimes flushblood, is not common, but has been reported in Dar es Salaam, Tanzania, on the island of Zanzibar and in Mombasa, Kenya. It puts users at the highest possible risk of contracting AIDS and hepatitis. While most AIDS transmission in Africa is by heterosexual sex, the use of heroin is growing in some cities, and experts are warning that flashblood ? along with syringe-sharing and other dangerous habits ? could fuel a new wave of AIDS infections. ?Injecting yourself with fresh blood is a crazy practice ? it?s the most effective way of infecting yourself with H.I.V.,? said Dr. Nora D. Volkow, director of the National Institute on Drug Abuse, which supports the researchers who discovered the practice. ?Even though the number who do it is a relatively small group, they are vectors for H.I.V. because they support themselves by sex work.? Sheryl A. McCurdy, a professor of public health at the University of Texas in Houston, first described the practice five years ago in a brief letter to The British Medical Journal and recently published a study of it in the journal Addiction. ?I don?t really know how widespread it is,? said Dr. McCurdy who is contacting other researchers working with addicts to get them to survey their subjects about it. ?There?s pretty circular movement in East Africa, so I wouldn?t be surprised if it?s in other cities.? Increasing use of heroin in parts of Africa has the potential to magnify the AIDS epidemic. In most East African countries like Tanzania and Kenya, only 3 to 8 percent of adults are infected with the AIDS virus, far fewer than in southern Africa, where the rates reach 15 to 25 percent. But among those who inject heroin, the rates are far higher. In Tanzania, about 42 percent of addicts are infected. The rate is even higher ? 64 percent ? among female addicts, Dr. McCurdy said, and since most support themselves through prostitution, they are in two high-risk groups, and their customers are at risk of catching the disease. Most of the addicts she has interviewed who practice flashblood, Dr. McCurdy said, are women. For them, sharing blood is more of an act of kindness than an attempt to get high: a woman who has made enough money to buy a sachet of heroin will share blood to help a friend avoid withdrawal. The friend is often a fellow sex worker who has become too old or sick to find customers. By contrast, on Zanzibar, it is mostly among men, according to a 2006 study in The African Journal of Drug and Alcohol Studies, which found that about 9 percent of the 200 drug-injectors interviewed practiced it. There have also been reports in East African newspapers of addicts selling their blood, but those have not been confirmed by medical researchers. And, there have been scattered reports of flashblood-type practices in other countries with large numbers of heroin addicts, including Pakistan, but they also have not been confirmed by researchers. Whether or not someone can actually a get drug rush from such a relatively tiny amount of blood has never been tested, Dr. McCurdy said. Humans have about five quarts of blood and the flashblood-user injects less than a teaspoon. ?They say they do,? she said. ?They pass out as if they just got a high. But I?ve talked to doctors who say that could be entirely the placebo effect.? One possibility, she said, is that traces of the drug are still in the syringe. After piercing a vein, an addict will typically draw some blood into the syringe, push it back out and repeat that three or four times to make sure all the heroin has been flushed into their blood. Those offering flashblood will usually hand over the syringe after only one in-out cycle. The heroin sold in East Africa, she added, is often quite strong because it has come from relatively pure shipments on their way to Europe from Afghanistan or Asia. Until recently, heroin use was uncommon on the continent because most Africans are too poor for traffickers to bother with. But in the last decade, smugglers have begun using port cities like Dar es Salaam and Mombasa and airport cities like Nairobi and Johannesburg as way stations on their routes: law-enforcement officials can often be bribed, and couriers from countries with no history of drug smuggling may escape searches by European border officers. The couriers may be paid in drugs, which they resell. With more local users, more heroin is being sold in Africa. In the last decade, law-enforcement and drug treatment agencies said, heroin use has increased, especially in Kenya and Tanzania, South Africa and Nigeria. Brown heroin that must be heated and inhaled ? ?chasing the dragon? ? has given way to water-soluble white heroin that can be injected. Prices have fallen by as much as 90 percent. While a teaspoon of blood is more than enough to transfer diseases like AIDS, said Dr. James AuBuchon, president-elect of the American Association of Blood Banks, it would not be enough to cause a life-threatening immune reaction, as can ensue when a patient gets a transfusion from someone of the wrong blood type. Instead, ?you?d likely get only brief symptoms,? he said. Dr. AuBuchon, who practices in Seattle, said he had never heard of flashblood, but added that he was horrified by the idea. ?What,? he asked, ?are they thinking?? *A version of this article appeared in print on July 13, 2010, on page D1 of the New York edition* *5* *World AIDS Conference to Focus on HIV/AIDS, Tuberculosis ** **Voice of America News* 12/07/2010 Debra Daugherty | Kayelitsha, South Africa Twenty-five thousand people are expected to gather in Vienna July 18 to 23 for the World AIDS Conference. Global health experts will focus on a lethal line-up - HIV/AIDs and tuberculosis. TB is a leading cause of HIV-related deaths worldwide. The World Health Organization says 40 percent of people with TB in South Africa also have HIV. The co-infection rate is highest in the township of Kayelitsha. And, there is a growing threat from multi-drug resistant TB, an aggressive strain that is much more difficult to treat. Caregiver Mercy Nongongo runs a small soup kitchen from a tiny shack. She buys the ingredients with her own money and makes sure that TB patients have something to eat before taking their medicine. "They know that the work I'm doing is going to help them," said Mercy Nongongo. "They believe in me." TB has a firm grip on the township of Khayelitsha on the outskirts of Cape Town. Patientsat the community clinic say despite being sick, they are hopeful. The clinic has seen an increase in the number of people with multi-drug-resistant tuberculosis or MDR TB. It's a virulent strain that occurs when a person with TB fails to complete the six to nine-month course of medication or catches TB from another person who is ill with a drug resistant-strain. The problem? It often takes more than two months to diagnose MDR-TB. Dr. Sweetness Siwendu treats TB patients at Site C Clinic: "It would be really great if we could have a vaccine - and if not, then at least be able to diagnose TB as soon as possible - preferably within the same day," said Dr. Siwendu. On the other side of town, scientists are working on a genetic test they hope will cut the time it takes to diagnose MDR-TB from 70 days to two days. Their work dovetails with research at the South African Tuberculosis Vaccine Initiative where Dr. Sizulu Moyo and other researchers are trying to develop vaccines to prevent TB. "I think the prospects are good," said Dr. Moyo. "There are a lot of players that have come in - and there's a lot of support from organizations such as the WHO? I think that creates a good environment where people can work and make progress in getting together a new vaccine." While researchers continue to work on vaccines, the key is to raise awareness around treating TB. The World Health Organization aims to reduce by half the number of people who die from tuberculosis by the year 2015. Communities like Kayelitsha are key. Here, care at home and in a clinic helps people follow through on their treatment. "No one today need die of TB," said Dr. Marcos Espinal. "No child should see the life of a mother or father destroyed by a disease that is completely curable. We need to challenge governments, decision-makers and community leaders to stand together to fight TB and eventually wipe out this devastating disease." And it's people like Gladys Jaxa, says Dr. Marcos Espinal of the Stop TB Partnership, who would benefit. She has MDR-TB and now is dependent on Mercy Nongongo for medicine. It's vital that she completes the course of up to two years of pills and injections. If she lapses, she could infect 10 to 15 people a year, one or two of whom may develop full blown TB or MDR-TB. But while the medication can be unpleasant, Jaxa is already noticing the difference it makes. "Before the treatment, I couldn't even walk?.I was hopeless," said Gladys Jaxa. "Now after treatment, I can even go to the toilet, I can go to the shop, I can do little things." It's the little things that Mercy Nongono and her helpers do best for their patients. But those little things make a big difference *6* *Clear way for easier AIDS tests, despite objections by activists (Editorial)** **Boston Globe* 13/07/2010 SCREENING FOR HIV ought to be a routine part of medical care. Each year, about 600 Massachusetts residents become infected with the virus. Unless they are tested, many will be unaware of their condition, spreading the disease to others and missing out on treatment for themselves. Existing state law puts up a speed bump, by demanding a special written consent form before doctors can check for the AIDS virus. A bill before the state Senate would bring the rules for HIV screening closer to those for other routine tests. The change is warranted, yet some AIDS activists are opposing it in overheated terms. The current law made sense in the early years of the epidemic, when there was no successful treatment for it and medical confidentiality practices were weak. But much has changed, and the US Centers for Disease Control and Prevention has recommended since 2006 that the HIV test become more standard, more like screens for blood sugar or cholesterol. In that spirit, the new legislation would require only verbal consent for HIV testing. Doctors would still be required to tell patients of their right to opt out. And the bill recognizes that stigma still exists, and forbids disclosure of test results to anyone except the patient without the patient?s written approval. While the bill has the support of the heads of many clinics and community health centers serving populations at high risk of HIV infection, including the Fenway Health Center in Boston, some AIDS activists oppose it ? most notably the AIDS Action Committee. The group raises the specter that, if the bill passes, patients could be tested without their knowledge. This is false, as is the group?s assertion that the bill ?would eliminate any need to get your consent for HIV testing.?? Because a company that makes anti-HIV drugs is lobbying for the bill, AIDS Action further depicts the measure as an effort by an ?out-of-state pharmaceutical giant?? to ?gut critical legal protections for people being tested for HIV.?? Actually, there?s nothing sinister about this bill. And there?s ample evidence that the current setup ? which signals that people should hesitate to be tested ? keeps some people from finding out their status. A key indicator of the need for more testing in Massachusetts is that about one-third of those testing positive for HIV become sick with full-blown AIDS within two months. Such a quick descent means that they have already been infected for years, likely transmitting the infection and not benefiting from any treatment themselves. This is unconscionable. More routine testing will save lives. ? Copyright 2010 Globe Newspaper Company. *7* *Asia Faces Tough Fight in Keeping HIV Infection Rate Low** **Voice of America News* 12/07/2010 Brian Padden | Jakarta At the coming AIDS conference in Vienna, experts will examine the state of the global fight against HIV. The United Nations says most Asian countries have an AIDS infection rate of less than one percent. But because of the large populations, that translates to almost five-million people living with HIV. Health experts say the key to preventing a widespread epidemic in Asia is to reach out to people engaging in high-risk behaviors. Rasta, like many first-time patients at an AIDS clinic in Jakarta, is apprehensive. She says she is afraid of what she might find out from the HIV test. The clinic is one of the more than 700 facilities working to stem the rising HIV infection rate in Indonesia. Here, like in many parts of Asia, AIDS is concentrated within groups that participate in high-risk behaviors, such as sex workers, homosexual men and injecting drug users. The U.S. Agency for International Development's HIV/AIDS advisor here, Lisa Baldwin, says while Indonesia has only a 0.1 percent HIV infection rate nationally, the rate for injecting drug users in Jakarta is 56 percent. For sex workers it is 16 percent. Baldwin says working with these high-risk groups now could prevent a wider epidemic in Indonesia and many other parts of Asia. "They are a population that could really be a bridging population to the more general community," said Baldwin. "So I think there is opportunity to really clamp down and keep this more contained but there are also opportunities for this to spill out." In addition to taking blood samples and testing for HIV, the staff at the clinic also counsel clients to use condoms during sex and use sterile needles to prevent infection. Some in the Islamic religious community object to these programs, which they say condone immoral behavior. But Nafsia Mboi, the secretary-general of the Indonesian National AIDS Prevention Commission, says its role is not to judge the patient but to treat and prevent the disease. "While those that think this is a disease of sinners, I usually say, well they are still Indonesian, sinners or not sinners," Mboi said. "They are still Indonesian and they have the right to life and the right to health, the right to education and so that is our responsibility." In China, the United Nations says 700,000 people live with HIV or AIDS. Chinese health officials say in the past, misinformation about how the disease spreads, discrimination and a lack of treatment made people reluctant to seek help. But they say today education efforts like this public service announcement featuring basketball player Yao Ming have helped increase understanding. And with support from international organizations like the Global Fund, antiretroviral drugs to treat AIDS are increasingly available in China and elsewhere in Asia. These developments have encouraged more people in China to get tested. But Jiang, who is living with AIDS in Beijing and does not want his full name known, says the stigma of AIDS remains. He says he has only told other patients and nurses about his condition because the pressure in society is too much. Thailand is one of the few countries in Asia that has significantly reduced the spread of HIV and AIDS. The World Health Organization says between 1989 and 1994 the number of new sexually transmitted disease cases among men treated at government clinics, plummeted by more than 90 percent. Former Cabinet minister Mechai Viravaidya led the condom use promotion. His efforts include opening a restaurant called Cabbages and Condoms that gives diners condoms. But the AIDS activist says the Thai government's commitment was key to containing the disease. "Firstly, there was political commitment and financial commitment," said Mechai. "All the money spent on HIV prevention or treatment in Thailand, 90 percent came from the government or from within the country. Only 10 percent from the outside. So many countries do not have the political or the financial commitment and expect the rest of the world to save you." And with much of the region doing well economically, USAID's Baldwin says donors are expecting more Asian countries to take over funding AIDS programs soon. "So you know, I think the donors are all prioritizing and one of the factors that is always considered is how much money is there within the local economy to be, should there be to contribute," Baldwin said. In some countries, such as Indonesia, international donors provide 80 percent or more of the AIDS funding. Baldwin says that can not continue indefinitely. *8* *Administration's new HIV/AIDS policy focuses on lowering infection rate** **Washington Post* 13/07/2010 By Anne E. Kornblut The White House will unveil the first formal national HIV/AIDS strategy on Tuesday, a plan that aims to reduce the number of new cases by 25 percent in the next five years, officials said. Noting that the number of new infections in the United States has been static -- and that the number of people living with HIV is growing -- the new policy would direct more resources toward African Americans and gay and bisexual men. Latinos and substance abusers should also be a priority, the report says, stating, "We must reorient our efforts by giving much more attention and resources" to those four groups, who are the "populations at highest risk." The announcement comes as President Obama faces pressure from gay rights advocates to do more for their community, including hastening the repeal of the ban on homosexuals serving openly in the military. The new HIV/AIDS policy has been summarized in a 60-page report that credits the Bush administration for its efforts to address the disease but also laments the country's general lack of concern. "The public's sense of urgency associated with combating the epidemic appears to be declining" since the days when infections first emerged, the report says. In addition to slashing the infection rate, the strategy calls for increasing patients' access to care so that 85 percent of those infected will receive care within three months of being diagnosed, compared with 65 percent who do so now. It says that 90 percent of all people who have HIV or AIDS should know they are infected, up from the current 79 percent. A further goal should be to reduce the HIV transmission rate by 30 percent. The report says the twin aims of cutting new infections and increasing the number of patients who receive care will advance Obama's goal of making the United States "a place where new HIV infections are rare and when they do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, gender identity or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination." The strategy does not call for a massive spending increase. Obama and his aides devoted considerable time to developing the new policy, including holding 14 community discussions and nearly a dozen White House meetings, officials said. The president will speak publicly about the strategy Tuesday afternoon, at a reception for people who work on HIV/AIDS. Earlier in the day, Health and Human Services Secretary Kathleen Sibelius will hold an event to discuss the policy. She will be joined by White House Domestic Policy Council director Melody Barnes, White House Director of the Office of National HIV/AIDS policy Jeffrey Crowley and Assistant Secretary of Health and Human Services Howard Koh. *========================* *UNAIDS WEB.SITE* *========================* UNDP Announces 2010 Red Ribbon Award Winners *UNAIDS* 12/07/2010 *Biennial global award celebrates outstanding community leadership and action on AIDS * New York, July 12. Twenty-five community-based organisations representing 17 countries across the globe have won the 2010 Red Ribbon Award. The Red Ribbon Award, named after the global symbol in the movement to address AIDS, is a joint effort of the UNAIDS family. The award recognizes outstanding community organisations for their work in reducing the spread and impact of AIDS. ?Grassroots and community based organizations are at the heart of the global response to AIDS,? said UNAIDS Deputy Executive Director, Management & External Relations Jan Beagle, ?UNAIDS is proud to celebrate and honor these groups who have mobilized themselves to meet the needs of the most vulnerable in their communities with energy, passion, and compassion. The red ribbon award winners give a resounding voice to the voiceless.? Each of the winning organizations receives a cash award and international recognition for their innovation and leadership in responding to the AIDS epidemic. The organizations are invited to participate in the XVIII International AIDS Conference held in Vienna next week where they will be guests of honour at a formal Award Ceremony and will host a forum for dialogue and exchange between policy makers and community representatives. ?Communities really hold the key to finding solutions to their own problems," said Dr. Helene Gayle, President and CEO of CARE, and a member of this year's jury panel. "So while those of us with a lot of outside expertise may know the theories, community organizations are best suited to reach those most in need when it comes to applying them.? Out of 720 nominations from over 100 countries, the 25 winners were judged to have demonstrated the most remarkable efforts in terms of innovation, impact, sustainability, strategic partnerships, gender sensitivity and social inclusion. The winners were selected by a Technical Review Committee of civil society representatives who are experts in the community response to HIV. ?These organizations clearly demonstrate that effective responses to the epidemic require the full participation of front-line, community-based groups. Community groups recognize that AIDS is one of many issues that are tied together. They understand that AIDS requires an exceptional response but they also understand that you need to link AIDS to broader issues of health, development and justice to be effective,? said Jeffrey O?Malley, Director of the HIV/AIDS Practice at UNDP. UNDP is honoured to announce the 2010 Red Ribbon Award Winners: AFRICA Association P?nitentiaire Africaine is an organization in Burkina Faso that has served as a model for raising awareness of prisoners' human rights, specifically the right to health, which includes HIV prevention, treatment, care and support. Center for Domestic Violence Prevention works at the civil society and government levels in Uganda to build an environment that is supportive of women?s rights to safety and equality, underlying issues behind women?s vulnerability to HIV in that nation. Chrysalide operates a centre of support for women with HIV, drug users, sex workers and ex-prisoners, and has through HIV prevention and sensitization programmes reduced stigma and discrimination experienced by people living with HIV in communities throughout Mauritius. Elan d?Amour has played a catalytic role in improving access to HIV treatment and care by modelling how to integrate community organizations into the health care system of Cote d?Ivoire. Nikat Women?s Association is the first community-based association in Addis Ababa, Ethiopia that is devoted to improving the living conditions of low-income women and commercial sex workers, thereby fighting poverty and protecting the right to health. Physicians for Social Justice has trained family caregivers and volunteers in Nigeria to conduct home visits to support people living with HIV, and in particular women, thereby challenging existing gender and cultural stereotypes. Positive Women?s Network has been at the forefront of the HIV response in South Africa by creating a safe space for women with HIV, comprehensively addressing their needs and forming a powerful group that educates the wider community about HIV. Pride Community Health Organization Zambia operates a safe haven in Zambia for people living with HIV, particularly orphans, vulnerable children, youth, women and people with disabilities, providing them with HIV and tuberculosis care, and support through home-based care services. The Initiative for Equal Rights was established in response to human rights violations against sexual minorities and focuses on the health needs of men who have sex with men, slowly breaking the silence around issues of sexual minorities in Nigeria. Uganda Young Positive has mobilized over 20,000 young people across Uganda to conduct advocacy activities and become a point of convergence for all other youth organisations that advocate for greater support for people living with HIV. ARAB STATES Substance Abuse Research Center ? SARC-AMAN is the first organisation in Gaza, the Palestinian territories to tackle issues of drug use and HIV, including stigma and misconceptions associated with these issues, in student and refugee populations. Widows, Orphans and People Living with HIV/AIDS is a community organisation of people living with HIV in Southern Sudan and works to increase access to anti-retroviral treatment by forming partnerships with hospitals, facilitating referrals for treatment, and developing a home-based care system. ASIA AND THE PACIFIC Novices Aids Intervention and Rehabilitation Network is an organisation of novice Buddhist monks who have been trained as HIV peer-educators, breaking the stigma associated with HIV and becoming a model for other novice monks and monastic schools in Thailand. Positive Voice is an organisation of drug users and former drug users in Nepal, successfully lobbying for access to harm reduction services and anti-retroviral treatment for people who use drugs. The Youth Volunteer Group is the first community-based organisation working across four regions of Thailand to respond to the needs of children and young people living with or affected by HIV. EASTERN EUROPE AND CENTRAL ASIA Albanian Association of PLWHA (AAP) reaches out and provides support to key populations at higher risk in Albania such as women in prison and children living with or affected by HIV. In addition AAP also targets health-care and education-system staff to advocate for targeted services. International Treatment Preparedness Coalition in Eastern Europe and Central Asia (ITPCru) mobilises and trains people living with HIV in Russia to advocate for their inclusion in local, regional and international decision-making mechanisms, and facilitates information exchange, distributing crucial information through its innovative web and media campaigns. Penitentiary Initiative has developed an effective model of integrated services for inmates living with HIV in six under-resourced prisons of Ukraine. SPIN Plus is a pioneer and leader in community-based organising throughout Tajikstan, providing innovative and peer-based services in to drug users and people living with HIV. Svitanok Club is the first organisation in the Donetsk, Ukraine region that is created and managed by people living with HIV and drug users, becoming a catalyst in the creation of other organisations serving this population. Timur Islamov Charitable Foundation has built a strong relationship with local authorities and public health centres in Russia, facilitating its provision of services such as HIV testing, referrals, and support programmes for drug users. LATIN AMERICA AND THE CARIBBEAN Asociaci?n Comit? Contra El Sida Caba?as ? CoCoSI has improved awareness of HIV prevention, stigma and discrimination in El Salvador by providing education on reproductive health rights, HIV and STIs, gender, sexuality, domestic violence, and gender-based violence. Asociaci?n de Mujeres Meretrices de la Argentina ? AMMAR is a network of 15,000 sex workers that has successfully advocated for the adoption of municipal codes and ordinances in Argentina that protect and promote the rights of sex workers. Colectivo SerGay de Aguascalientes, A.C. works to expose injustice and document human rights violations towards sexual minorities and marginalized groups in Aguascalientes, Mexico, and provides those populations with a community centre that is a safe space for medical, therapeutic and psychological support. Productive Organisation for Women in Action ? POWA uses a mobile information booth, featuring live music and dancing, to attract a wide range of community members in Belize and educate them about HIV, gender-based violence, condom use, and HIV testing and referral services. For more information about the Red Ribbon Award, go to www.redribbonaward.org *2* *Ten million deaths and 1 million new HIV infections could be averted if countries meet HIV treatment targets** **UNAIDS* 13/07/2010 *New UNAIDS report shows that young people are leading the prevention revolution, with 15 of the most severely affected countries reporting a 25% drop in HIV prevalence among this key population. New global opinion poll shows that AIDS continues to be of major importance for the public around the world. * GENEVA, 13 July 2010 ? The new UNAIDS Outlook report outlines a radically simplified HIV treatment platform called Treatment 2.0 that could decrease the number of AIDS-related deaths drastically and could also greatly reduce the number of new HIV infections. Evidence shows that new HIV infections among young people, in the 15 countries most affected by HIV, are dropping significantly as young people embrace safer sexual behaviours. Also in the report, a sweeping new UNAIDS and Zogby International public opinion poll shows that nearly 30 years into the AIDS epidemic, region by region, countries continue to rank AIDS high on the list of the most important issues facing the world. And an economic analysis makes the case for making health a necessity, not a luxury, outlining the critical need for donor countries to sustain AIDS investments and calling on richer developing countries to invest more in HIV and health. The report was launched in Geneva ahead of the XVIII International AIDS Conference in Vienna. The UNAIDS Executive Director, Mr Michel Sidib?, stressed that innovation in the AIDS response can save more lives. ?For countries to reach their universal access targets and commitments, we must reshape the AIDS response. Through innovation we can bring down costs so investments can reach more people.? According to UNAIDS? estimates there were 33.4 million people living with HIV worldwide at the end of 2008. In the same year there were nearly 2.7 million new HIV infections and 2 million AIDS-related deaths. Treatment 2.0 saves lives Treatment 2.0 is a new approach to simplify the way HIV treatment is currently provided and to scale up access to life saving medicines. Using a combination of efforts it could bring down treatment costs, make treatment regimens simpler and smarter, reduce the burden on health systems and improve the quality of life for people living with HIV and their families. Modelling suggests that compared with current treatment approaches, Treatment 2.0 could avert an additional 10 million deaths by 2025. In addition, the new approach could also reduce new HIV infections by up to 1 million annually if countries provide antiretroviral therapy to all people in need, following revised WHO treatment guidelines. Today, 5 million of the 15 million people in need are accessing these life-saving medicines. To achieve the full benefits of Treatment 2.0 progress has to be made across five areas: 1.Create a better pill and diagnostics: UNAIDS calls for the innovation of a smarter, better pill that is less toxic and for diagnostics that are easier to use. Monitoring treatment requires complex equipment and specialized laboratory technicians. A simple diagnostic tool could help to reduce the burden on health systems. Such a simplified treatment platform could defray costs and increase people?s access to treatment. 2.Treatment as prevention: antiretroviral therapy reduces the level of the virus in the body. Evidence shows that when people living with HIV have lowered their viral load they are less likely to transmit HIV. It is estimated that ensuring everyone in need has access to treatment, according to the current treatment guidelines, could result in up to a one third reduction in new HIV infections annually. Optimizing HIV treatment coverage will also result in other health prevention benefits, including much lower rates of tuberculosis and malaria among people living with HIV. 3.Stop cost being an obstacle: despite drastic reductions in drug pricing over the past ten years, the costs of antiretroviral therapy programmes continue to rise. Drugs can be even more affordable?however, potential gains are highest in the area of reducing the non-drug-related costs of providing treatment, such as hospitalization, monitoring treatment, and out-of-pocket expenses. Currently these costs are twice the cost of the drugs themselves. Treatment 2.0 is expected to reduce the cost per AIDS-related death averted by half. 4.Improve uptake of voluntary HIV testing and counselling and linkages to care: when people know their HIV status they can start treatment when their CD4 count is around 350, rather than waiting until they are feeling sick. Starting treatment at the right time increases the efficacy of current treatment regimens and increases life expectancy. 5.Strengthen community mobilization: by involving the community in managing treatment programmes, treatment access and adherence can be improved. Demand creation will also help bring down costs for extensive outreach and help reduce the burden on health care systems. ?Not only could Treatment 2.0 save lives, it has the potential to give us a significant prevention dividend,? said Mr Sidib?, speaking at the launch of the report. Young people leading the prevention revolution A new UNAIDS study shows that young people are leading the HIV prevention revolution. HIV prevalence among young people has declined by more than 25% in 15 of the 25 countries most affected by AIDS. These declines are largely due to falling new HIV infections among young people. In eight countries?C?te d?Ivoire, Ethiopia, Kenya, Malawi, Namibia, the United Republic of Tanzania, Zambia and Zimbabwe?significant HIV prevalence declines have been accompanied by positive changes in sexual behaviour among young people. For example, in Kenya there was a 60% decline in HIV prevalence between 2000 and 2005. HIV prevalence dropped from 14.2% to 5.4% in urban areas and from 9.2% to 3.6% in rural areas in the same period. Similarly in Ethiopia there was a 47% reduction in HIV prevalence among pregnant young women in urban areas and a 29% change in rural areas. Young people in 13 countries, including Cameroon, Ethiopia, and Malawi, are waiting longer before they become sexually active. Young people were also having fewer multiple partners in 13 countries. And condom use by young people during last sex act increased in 13 countries. There are 5 million young people living with HIV worldwide, making up about 40% of new infections. The Benchmark survey An international public poll on HIV commissioned for the first time by UNAIDS shows that nearly 30 years into the AIDS epidemic, region by region, countries continue to rank AIDS high on the list of the most important issues facing world. For example, in India about two thirds report that the AIDS epidemic is more important than other issues the world is currently facing. Overall, respondents put AIDS as the top health-care issue in the world. Furthermore, about half of the respondents are optimistic that the spread of HIV can be stopped by 2015. There is recognition of efforts to raise public awareness about HIV over the course of the AIDS response, with one in three respondents considering it the greatest achievement of the response so far. This was followed by implementation of HIV prevention programmes and the development of new antiretroviral drugs. When asked about how their country was doing against the epidemic, about 41% of respondents said that their country was dealing effectively with the problem. Only one in three people believe the world is responding effectively to AIDS. For 62% of people surveyed in Sweden, the availability of funding/resources or the availability of affordable health care is keeping the world from effectively responding to HIV. Some 60% of people in the United Kingdom also felt that the lack of funding was the main obstacle. Other challenges cited by the people surveyed mirror on the ground experience, with more than half of respondents saying the availability of prevention services was the most important obstacle?stigma and discrimination were cited as another barrier. When it came to HIV treatment, nearly six in ten believe it is the duty of the state to provide for free or subsidized treatment for people living with HIV. The poll surveyed adults in 25 countries representing all regions with nearly 12,000 respondents. Investments in HIV must be sustained, efficient and predictable Investment in HIV is smart and proven. At this turning point, flat-lining or reductions in investments will hurt the AIDS response. In 2010 an estimated US$ 26.8 billion is required to meet country-set targets for universal access to HIV prevention, treatment, care and support. ?The AIDS response needs a stimulus package now. Donors must not turn back on investments at a time when the AIDS response is showing results,? said Mr Sidib?. ?The 0.7% target on international aid and the Abuja target of 15% for health cannot be buried.? UNAIDS recommends that national HIV programmes invest between 0.5% and 3% of government revenue in the AIDS response. In recent years many countries have increased their domestic investments in the AIDS response. For example, the South African Government increased its budget for AIDS by 30% to US$ 1 billion in 2010. However, for the majority of the countries severely affected by AIDS, domestic investments alone, even when raised to optimal levels, will not suffice to meet all their resource needs. UNAIDS calls on richer developing countries to meet a substantial proportion of their resource needs from domestic sources. Currently, 50% of the global resources requirement for low- and middle-income countries is in 68 countries where the national need is less than 0.5% of their gross national income. These countries have 26% of the people living with HIV and receive 17% of international assistance for AIDS. According to the report, current investments in HIV can become more efficient, effective and predictable. ?We can bring down costs so investments can reach more people,? said Mr Sidib?. ?This means doing things better?knowing what to do, channelling resources in the right direction and not wasting them, bringing down prices and containing costs. We must do more with less.? *3* *New UNAIDS OUTLOOK report 2010 launched ** **UNAIDS* 13/07/2010 Ahead of the XVIII International AIDS Conference to be held in Vienna from 18 ? 23 July, UNAIDS has launched its OUTLOOK Report 2010 in Geneva. Key findings: The new UNAIDS Outlook report outlines a radically simplified HIV treatment platform called Treatment 2.0 that could decrease the number of AIDS-related deaths drastically and could also greatly reduce the number of new HIV infections. Evidence shows that new HIV infections among young people, in the 15 countries most affected by HIV, are dropping significantly as young people embrace safer sexual behaviours. Also in the report, a sweeping new UNAIDS and Zogby International public opinion poll shows that nearly 30 years into the AIDS epidemic, region by region, countries continue to rank AIDS high on the list of the most important issues facing the world. And an economic analysis makes the case for making health a necessity, not a luxury, outlining the critical need for donor countries to sustain AIDS investments and calling on richer developing countries to invest more in HIV and health. *Read press release* *Download full report* *(pdf, 6MB)* *Visit the OUTLOOK micro site* -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100714/d2067de0/attachment-0010.html From ThanhHuong at fhi.org.vn Wed Jul 14 04:08:36 2010 From: ThanhHuong at fhi.org.vn (Huong, Pham Thi Thanh) Date: Wed, 14 Jul 2010 10:08:36 +0700 Subject: [hivaids-twg] Program Officer, Care and Treatment at FHI/Vietnam Message-ID: <98DC86CEF032774F8F4FDE97CDC08CFA01022263@fhi-server1.fhi.org.vn> Please help to circulate the attached job announcement. Thank you very much. Pham Thanh Huong | Human Resource Officer, FHI Vietnam 7th Floor, Hanoi Tourist Building, 18 Ly Thuong Kiet, Hanoi, Vietnam Office: +84-4-3934-8560 | Fax:+84-4-3934-8650 Mobile: +84 (0) 903254878 -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100714/9076e81c/attachment-0010.html -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/jpeg Size: 1550 bytes Desc: image001.jpg Url : http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100714/9076e81c/attachment-0010.jpe -------------- next part -------------- A non-text attachment was scrubbed... Name: Job Ad- C&T PO.doc Type: application/msword Size: 370688 bytes Desc: Job Ad- C&T PO.doc Url : http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100714/9076e81c/attachment-0010.doc From ChhetriP at unaids.org Wed Jul 14 05:56:55 2010 From: ChhetriP at unaids.org (Chhetri, Prashikha) Date: Wed, 14 Jul 2010 06:56:55 +0200 Subject: [hivaids-twg] =?utf-8?q?Announcement/Th=C3=B4ng_b=C3=A1o_TWG_Lunc?= =?utf-8?q?htime_Seminar_Tuesday_20_July?= Message-ID: Th?a c?c b?n ??ng nghi?p, T?i r?t h?n h?nh ???c th?ng b?o bu?i h?i th?o chuy?n ?? t?i ??y v? ch? ?? ?Tri?n khai c?c h?at ??ng t?an di?n t? gi?m h?i v? ph?t hi?n cho t?i ch?m s?c v? ?i?u tr? t?i H? N?i, Vi?t Nam?, s? ???c t? ch?c: Th?i gian: 12h00 ? 13h30 Ng?y: th? Ba ng?y 20/07/2010 ??a ?i?m: Tr??ng ??i h?c Y t? C?ng c?ng H? N?i, 138 Gi?ng V? B?c s? Vincent Guerard, Nghi?n c?u sinh ti?n s? c?a T? ch?c Medicins du Monde s? tr?nh b?y v? Ph?n t?ch Hi?u qu? Chi ph? c?a Trung t?m D? ph?ng v? ?i?u tr? HIV, Qu?n T?y H? v? t?p trung th?o lu?n: ? ?o l??ng hi?u su?t v? hi?u qu? chi ph? c?a m? h?nh ?ang th?c hi?n ? T?m hi?u m?t s? t?c ??ng t??ng h? gi?a c?c ho?t ??ng d? ph?ng v? c?c h?at ??ng ch?m s?c v? ?i?u tr? ? Th?o lu?n v? kh? n?ng ?p d?ng c?a m? h?nh v?o c?c ?i?u ki?n t??ng t? Xin vui l?ng g?i ??ng k? tham d? v? n?u r? y?u c?u v? ch? ?? ?n ki?ng b?ng email cho ch? ??ng Th? Y?n (dthy at hsph.edu.vn) mu?n nh?t v?o 12.00 tr?a, th? Hai, ng?y 19 th?ng 07 n?m 2010 _____________________________________________________ Dear colleagues, The next HIV Technical Working Group Lunchtime Seminar, "Implementing comprehensive activities from harm reduction and detection to care and treatment, in the context of Ha Noi, Viet Nam" will be held: Time: 12 - 13.30 Date: Tuesday, 20 July 2010 Place: Hanoi School of Public Health, 138 Giang Vo Vincent Guerard, MD, MSC, PhD of Medicins du Monde will present a cost effectiveness analysis of their HIV prevention and treatment centre in Tay Ho and discuss: * The efficacy and cost effectiveness of the model * Possible synergies between prevention activities and care and treatment activtiies * Replicability of the model Please RSVP to Ms. Dang Thi Yen (dthy at hsph.edu.vn) by 12pm, Monday 19 July to reserve your space and a light lunch. Prashikha Chhetri Assistant Planning and Management Officer UNAIDS Viet Nam No. 24 Lane 11 Trinh Hoai Duc Street, Ha Noi Viet Nam PH: +84 (4) 37342824 Mob: +84 (0) 1213010192 Email: chhetrip at unaids.org Web: www.unaids.org P Please don't print this e-mail unless you really need to. Thank you. ________________________________ -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100714/df26215b/attachment-0010.html From hivtwg.moderator at gmail.com Wed Jul 14 08:46:23 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Wed, 14 Jul 2010 14:46:23 +0700 Subject: [hivaids-twg] =?utf-8?q?REPORT_Launching=3A_=E2=80=9CLegal_enviro?= =?utf-8?q?nments=2C_human_rights_and_HIV_responses_among_MSM_and_t?= =?utf-8?q?ransgender_people_in_Asia?= In-Reply-To: References: Message-ID: From: Edmund Settle Date: Wed, Jul 14, 2010 at 12:23 PM Subject: [msm-asia] REPORT Launching: ?Legal environments, human rights and HIV responses among MSM and transgender people in Asia To: SEA-AIDS , msm-asia at googlegroups.com, apcom-gb at googlegroups.com *Legal environments, human rights and HIV responses among MSM and transgender people in Asia and the Pacific: An agenda for action* UNDP APCOM The report ?Legal environments, human rights and HIV responses among MSM and transgender people in Asia and the Pacific: An agenda for action? will be released at the XVIII International AIDS Conference, Vienna, at the session on Criminalizing Homosexual Behaviour: Human Rights Violation and Obstacles to Effective HIV/AIDS Prevention, 20 July 2010. For more information on this session please visit: http://www.aids2010-abstracts.org/planner/sp.php?go=pp&sessID=1759 yours, Edmund -- -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100714/aca2c652/attachment-0010.html From hivtwg.moderator at gmail.com Wed Jul 14 08:47:06 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Wed, 14 Jul 2010 14:47:06 +0700 Subject: [hivaids-twg] Live broadcast CDC - Strategies to Improve Child Survival 9 am -EDT. Thursday 15 July In-Reply-To: <952639.73656.qm@web37306.mail.mud.yahoo.com> References: <952639.73656.qm@web37306.mail.mud.yahoo.com> Message-ID: From: AIDS ASIA Date: Tue, Jul 13, 2010 at 7:28 AM Subject: [AIDS ASIA] Live broadcast CDC - Strategies to Improve Child Survival 9 am -EDT. Thursday 15 July To: AIDS_ASIA CDC?s Public Health Grand Rounds, entitled ?Strategies to Improve Child Survival Globally to be held on Thursday, July 15, at 9 a.m. (EDT). With millions of preventable deaths of children under 5 years of age each year, the challenges are rooted in economic, cultural, and geographic barriers ? half of all child deaths occur in Africa and 42% in Asia. Child mortality is not only a key indicator of a nation?s health, but is also a broad reflection of a nation?s development. This fact was a driving force in the creation of the UN?s Millennium Development Goals, which identified child mortality, and its closely related goals of maternal health and infectious diseases, as three of the eight top priorities for the world. In response to this global health burden, efforts are underway to increase access to vaccines, clean water, better nutrition, and other resources that will ultimately benefit the health of children around the globe. This session of Public Health Grand Rounds will review progress in recent decades, assess our continued challenges, and discuss new and important strategies aimed at increasing child survival throughout the world. Watch the live broadcast at: www.cdc.gov/about/grand-rounds (video archive to be posted 48 hours after the presentation). For questions or comments, please email grandrounds at cdc.gov. Thomas R. Frieden, M.D., M.P.H. Director, CDC, and Administrator, ATSDR Strategies to Improve Child Survival Globally Kevin DeCock, MD, F.R.C.P. Director, Center for Global Health (CDC) Cynthia Whitney MD, MPH Acting Chief of the Respiratory Diseases Branch, National Center for Immunization and Respiratory Diseases (CDC) Robert Quick, MD, MPH Medical Epidemiologist, Division of Foodborne, Waterborne, and Environmental Diseases National Center for Emerging and Zoonotic Infectious Diseases (CDC) Brent Burkholder, MD, MA Director, Global Immunization Division National Center for Immunization and Respiratory Diseases (CDC) Discussant: Nancy Binkin, MD, MPH Chief, Policy and Evidence Unit UNICEF __._,_.___ -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100714/f94df78f/attachment-0010.html From hivtwg.moderator at gmail.com Wed Jul 14 08:47:41 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Wed, 14 Jul 2010 14:47:41 +0700 Subject: [hivaids-twg] UPDATE: Media Advisory, Vienna IAC, Addressing Legal Environments Blocking Effective HIV Responses In-Reply-To: References: Message-ID: From: Edmund Settle Date: Tue, Jul 13, 2010 at 10:11 AM Subject: [msm-asia] UPDATE: Media Advisory, Vienna IAC, Addressing Legal Environments Blocking Effective HIV Responses To: msm-asia at googlegroups.com, SEA-AIDS , apcom-gb at googlegroups.com *Media Advisory* Rights Here, Rights Now: *Addressing Legal Environments Blocking Effective HIV Responses* *New York, 12 July 2010* ? Legal environments play an important role in HIV responses. As noted in the Vienna Declaration, laws and practices that punish those living with or most vulnerable to HIV have a damaging effect on the epidemic and response. Whether in the context of same-sex sexual relations, drug use, HIV transmission, anti-discrimination, or sex work, supportive legal environments can be powerful tools for countries struggling to control their epidemics. In line with the much welcome human rights focus of AIDS 2010, UNDP will host two press conferences to showcase new initiatives on addressing the role which laws, law enforcement and access to justice play in facilitating effective HIV responses. *Press Conference #1 * *Title: Global Commission on HIV and the Law* The Commission will develop evidence-informed recommendations for national legal environments that promote effective HIV responses. Representatives from the Commission, together with representatives from UNDP, UNAIDS and civil society will engage in dialogue with the media to highlight the key legal and human rights issues which are ?game-changers? for the HIV response. Venue: Press Conference Room 3 (Media Centre) Date: 7/19/2010 Time: 11:00 AM - 12:00 PM Participants: H.E. Festus Mogae, Former President of Botswana and Commissioner, Global Commission on HIV and the Law Shereen El Feki, Commissioner, Global Commission on HIV and the Law; Mr Prasada Rao, Member Secretary, Global Commission on HIV and the Law; Jeffrey O?Malley, Director, UNDP HIV/AIDS Practice; Paul De Lay, Deputy Executive Director, Programmes, UNAIDS; (moderated by Murray Proctor, Australia?s AIDS Ambassador) *Press Conference #2* *Title: Legal environments, human rights and HIV responses among men who have sex with men and transgender people in Asia and the Pacific: An agenda for action* Despite recent successes, current legal environments often fail to adequately protect the rights of men who have sex with men and transgender people. Male-to-male sex is criminalized in 19 out of 48 countries in the Asia Pacific region, leading in many cases to vigilantism and abuse by local authorities. The study?s author, together with representatives from UNDP and civil society will discuss the key findings. Venue: Press Conference Room 3 (Media Centre) Date: 7/21/2010 Time: 10:00 AM - 11:00 PM Participants: Jeffrey O?Malley, Director, UNDP HIV/AIDS Practice; John Godwin, lead author; Shivananda Khan OBE, Chair of APCOM; (moderated by Dr Mandeep Dhaliwal, UNDP Cluster Leader: Human Rights, Gender and Sexual Diversity) *For more information contact:* Zoran Stevanovic | Bratislava | Regional Communications Advisor UNDP, Europe and the CIS | tel. +421 2 59337 428, mob. +421 908 729 846 | zoran.stevanovic at undp.org Mandeep Dhaliwal | New York | Cluster Leader: Human Rights, Gender and Sexual Diversities Cluster, UNDP | tel. +1 646 642 4612 | mandeep.dhaliwal at undp.org UNDP is the UN?s global development network, an organization advocating for change and connecting countries to knowledge, experience and resources to help people build a better life. We are on the ground in 166 countries, working with them on their own solutions to global and national development challenges. As they develop local capacity, they draw on the people of UNDP and our wide range of partners. www.undp.org -- -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100714/6ed8f0af/attachment-0010.html From hivtwg.moderator at gmail.com Wed Jul 14 08:48:19 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Wed, 14 Jul 2010 14:48:19 +0700 Subject: [hivaids-twg] Hong Kong HIV/AIDS situation in first quarter of 2010 In-Reply-To: References: Message-ID: From: Date: Mon, Jul 12, 2010 at 9:35 AM Subject: [AIDS ASIA] Hong Kong HIV/AIDS situation in first quarter of 2010 To: AIDS_ASIA at yahoogroups.com HIV/AIDS situation in first quarter of 2010 A total of 101 cases of Human Immunodeficiency Virus (HIV) infections were reported in the first quarter of 2010 to the Centre for Health Protection (CHP) of the Department of Health (DH), bringing the cumulative total of reported HIV infections to 4,544 since 1984. Reviewing the AIDS situation in Hong Kong at a press conference today (June 1), Consultant (Special Preventive Programme) of CHP, Dr Wong Ka-hing said that sexual transmission continued to be the major mode of HIV transmission in Hong Kong. Dr Wong stressed the importance of the proper use of condoms in reducing the risk of HIV infection. "HIV is the cause of AIDS and, without treatment, half of the HIV-infected people will progress to AIDS within 10 years. "People who had a history of unprotected sex should call the DH's AIDS Hotline on 2780 2211 2780 2211 for a free, anonymous and confidential HIV test." Dr Wong said. Of the 101 HIV cases reported in the first quarter of this year, 20 acquired the infection via heterosexual contact, 41 via homosexual or bisexual contact, four through drug injection, and one through mother-to-child transmission. The routes of transmission of the remaining 35 cases were yet undetermined due to inadequate information. The 101 cases comprised 75 males and 26 females. The newly diagnosed cases of this quarter were mainly reported by three major sources: public hospitals and clinics (33 cases), private hospitals and clinics (25 cases) and the AIDS Unit of DH (20 cases). Nineteen new cases of AIDS (Acquired Immune Deficiency Syndrome) were reported in the first quarter of 2010, bringing to 1,125 the total number of confirmed AIDS cases reported since 1985. Forty-two per cent of the new AIDS cases were related to heterosexual contact and 42 per cent to homosexual or bisexual contact. In this quarter, the most common AIDS-defining illness was Pneumocystis Pneumonia (PCP), a kind of chest infection. http://www.info.gov.hk/aids/english/press/2010/100601.htm __._,_.___ -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100714/b4bf030c/attachment-0010.html From hivtwg.moderator at gmail.com Thu Jul 15 02:54:21 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Thu, 15 Jul 2010 08:54:21 +0700 Subject: [hivaids-twg] IAS Satellite session - Are we winning against HIV in Asia? In-Reply-To: References: Message-ID: From: Date: Thu, Jul 15, 2010 at 1:32 AM Subject: [AIDS ASIA] IAS Satellite session - Are we winning against HIV in Asia? To: AIDS_ASIA at yahoogroups.com 18th IAS Conference on AIDS Vienna, Austria, 18-23 July 2010 Satellite session - Are we winning against HIV in Asia? (Jointly hosted by UNAIDS/TGF) Venue Mini Room 2 Date Sunday, 18 July 2010 Time 15h45 to 17h45 Co Chair(s) Murray Proctor (AIDS Ambassador) /Tim Martineau (UNAIDS) Speakers Swarup Sarkar (TGF) Zunyou Wu (CDC China) Ryuichi Komatsu (TGF) Anand Grover (UN Special Rapporteur on the Right to Health) Panellist for moderated question and answer: Dr Nafsiah Mboi (NAC, Indonesia) Andrew Hunter (Seven Sisters, Asia) Ashok Alexander (Bill and Melinda Gates Foundation, India) Steve Kraus (UNAIDS, Moderator) Issues: 1. Can Asia meet Universal access targets? 2. What are the impediments to achieve UA? 3. What different stakeholders need to do differently to make UA a reality? Contact: Pradeep Kakkattil kakkattilp at unaids.org ; mobile +41 79 445 1500 Swarup Sarkar swarup.sarkar at theglobalfund.org; mobile +41 79 793 1043 Paul Yan paul.yan at theglobalfund.org ; mobile: + 41 79 747 6595 __._,_.___ Reply to sender| Reply to group| Reply via web post| Start a New Topic Messages in this topic( 1) Re HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100715/b77b545f/attachment-0010.html From nguyen.yen at healthright.org Wed Jul 14 11:04:47 2010 From: nguyen.yen at healthright.org (Nguyen Yen) Date: Wed, 14 Jul 2010 06:04:47 -0400 Subject: [hivaids-twg] Job announcement - Foster Care Officer - HealthRight International Message-ID: <82B448C6F5D66A4EA47681A30D3EB21A09DF2D22F4@nycmail> Dear all, We are looking for a Foster Care Officer for HealthRight International. You are kindly requested to forward the attachment to any one, who are interested in this position. Dear chi Ngan Ha, Please help me to post this announcement on Job opportunities topic on NGO website Thank you and best regards, Nguyen Thi Yen Administrative Assistant HEALTHRIGHT INTERNATIONAL formerly Doctors of the World-USA 25 Bui Thi Xuan Street, Hanoi, Vietnam Tel: (844)39447761 Fax: (844)39447763 Email: nguyen.yen at healthright.org www.healthright.org> Celebrating 20 YEARS Building lasting access to health for excluded communities -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100714/67a6d5b5/attachment-0010.html -------------- next part -------------- A non-text attachment was scrubbed... Name: Foster_Care_Officer_HealthRight International.doc Type: application/msword Size: 56832 bytes Desc: Foster_Care_Officer_HealthRight International.doc Url : http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100714/67a6d5b5/attachment-0010.doc From hivtwg.moderator at gmail.com Thu Jul 15 02:57:33 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Thu, 15 Jul 2010 08:57:33 +0700 Subject: [hivaids-twg] Today's News (2010.07.14ex)- China - Battling AIDS and discrimination Message-ID: From: Diaz, Clara Date: Wed, Jul 14, 2010 at 7:53 PM Subject: Today's News (2010.07.14ex) To: Please find attached the following AIDS-related articles compiled by UNAIDS *AFRICA** AND MIDDLE EAST* 1. Mail & Guardian, SA - *HIV rates fall in worst-affected countries * 2. Dailyl Nation, Kenya - *Safer sex drives HIV rates down * 3. Daily Mail, Ghana - *Africa**'s Young 'Change Sex Habits And Lower HIV Rates' * 4. Mail & Guardian, SA - *HIV vaccine the only real answer * 5. UN IRIN - *Poll ranks AIDS as top health issue * 6. PressAfrik - *Afrique : recul du sida chez les 15-24 ans, gr?ce au pr?servatif * 7. El Moujahid, Algeria - *L'?pid?mie du sida en net recul chez les cat?gories jeunes * *ASIA** AND PACIFIC* 1. Bernama, Malaysia - *New Approach To HIV Treatment Could Save 10 Million Lives By 2025 * 2. The Star, Malaysia - *UN sets out AIDS treatment plan to save 10 million * 3. Manorama Online, Malaysia - *Time for efficiency in fighting AIDS, Gates says* 4. Global Times, China - *Battling AIDS and discrimination * 5. DNA, India - *India**'s patent regime hurting across Asia-Pacific* *EUROPE*** 1. Reuters - *UN sets out AIDS treatment plan to save 10 million* 2. BBC News - *Africa**'s young 'change sex habits and lower HIV rates' * 3. The Independent, UK -* **HIV hopes queried over cases in young Africans * 4. The Guardian, UK - *Row over Obama's Aids strategy * 5. AidsMap News, UK - *UNAIDS calls for radical simplification of treatment to support HIV prevention* 6. Le Monde - *L'Onusida lance une nouvelle strat?gie m?dicale contre la pand?mie * 7. AFP - *HIV prevalence falling among youths: UNAIDS* 8. AFP - *Sida: l'?pid?mie recule fortement chez les jeunes de 15 ? 24 ans (Onusida) * 9. Reuters - *HIV/AIDS numbers from around the world* 10. EFE, Spain - *Diez millones de muertes podr?an evitarse con nuevo tratamiento contra VIH * *LATIN AMERICA AND CARIBBEAN* 1. Hoy Digital, DR - *Nueva esperanza para afectados de VIH* 2. La Jornada, Mexico -* **Reporta Onusida baja en la transmisi?n del VIH entre j?venes de 16 de los 25 pa?ses m?s afectados * 3. El Universal, Venezuela - *ONU propone evitar un mill?n de nuevas infecciones de sida al a?o * 4. La Naci?n, Argentina - *Cada vez m?s mujeres contraen el virus del sida * 5. El Nacional, Venezuela - *ONU informa que disminuye la incidencia de VIH entre los j?venes en ?frica * 6. La Gaceta, Argentina - *La ONU propone un nuevo enfoque para reducir los contagios y las muertes por VIH * 7. GacetaWeb, Brazil - *Brasil deve investir mais na preven??o da Aids, diz ONU * *NORTH AMERICA* 1. Los Angeles Times - *U.N. moves toward quicker AIDS treatment in developing countries* 2. CNN - *Report: Youth leading Africa's war on AIDS * 3. Voice of America News - *AIDS Top List of Global Health Concerns* 4. WebMD - *Youth Put a Dent in AIDS Epidemic* 5. Voice of America News - *In South Asia, Efforts to Halt Spread of HIV Make Headway * 6. Globe and Mail, Canada - *10 million HIV-AIDS deaths preventable by 2025, UN says * 7. Associated Press - *Obama promises commitment to combating HIV/AIDS * 8. Bloomberg Business Week - *Young People Delay Sex, Help Stem New HIV Infections* 9. Associated Press - *UN: HIV among young people going down in Africa* 10. Philadelphia Inquirer - *Obama details national HIV plan * *UNAIDS WEB.SITE* 1. UNAIDS - European Parliament votes for rights-based AIDS response =========================== *AFRICA** AND MIDDLE EAST* =========================== *HIV rates fall in worst-affected countries** **Mail & Guardian, SA* 14/07/2010 The United Nations hailed a breakthrough in the fight against Aids on Tuesday with the release of figures showing that the prevalence of HIV has dropped among young people in 15 of the worst-affected counties in the world. The news was even better in 12 of the countries, where HIV levels have fallen by 25% among people aged 15-24, in response, UNAids believes, to dogged prevention campaigns, warning of the dangers of HIV/Aids and the need for people to change their sexual behaviour. Michel Sidib?, head of UNAids which released the report before the International Aids conference in Vienna next week, said that young people were leading a badly needed prevention revolution, adding that authorities needed to change tack in the battle against HIV/Aids. "I think for me what is very important is to say to the world that we are at the defining moment now, where we need to re-shape completely the Aids response," he said. This redefinition must take place, he said, because of rising treatment costs for HIV and the global economic crisis. "The world is demanding change. We cannot continue with the same response. It is not sustainable. It is very clear from public opinion region by region that Aids continues to be a top priority, but they are calling for a paradigm shift." The costs of antiretroviral drugs for the millions who need them was going through the roof, he said. Even countries such as Brazil, which successfully made cheap Aids drugs available to all, were now hitting financial problems because the first-line drugs were no longer effective enough -- HIV becomes resistant over time. Third-line drugs in Brazil now cost $19 per person per year. But drugs alone, even if they were affordable, would not be enough. "While we were trying to push the treatment, we were seeing that new infections were growing and growing and we were not convinced we were making progress with young people," said Sidib?. So the report that UNAids is now releasing offers rare hope for a new strategy which must have prevention at its heart, even while efforts to make simpler, cheaper treatment available continue. "Young people are taking the lead, which is progress," said Sidib?. "For the first time there is a correlation between that [declining prevalenc] and behaviour, which for me is very important news in terms of dealing with the epidemic." The biggest drop was in Kenya, where HIV in 15-24-year-olds was down by 60% between 2000 and 2005. In urban areas it went down from 14,2% to 5,4%, while in rural areas it dropped from 9,2% to 3,6%. In Ethiopia, the report shows a 47% change among young pregnant women in urban areas and 29% in rural areas. In Malawi and C?te d'Ivoire, prevalence among young, pregnant, urban women fell by 56% and in Burundi and Haiti it dropped by nearly half. Reductions of more than a third took place in Namibia, Zimbabwe, Botswana, Rwanda and Lesotho. Most of the figures come from antenatal clinics, where pregnant young women are tested. Mathematical modelling shows that they are a good indicator of trends across the whole age group. Population surveys are better, however, and were available in seven countries. In six of those countries, a drop in prevalence was seen among young women -- but in only four out of the seven was there a drop in prevalence among young men. UNAids believes the progress is down to the success of efforts to persuade young people to change their sexual behaviour. In 13 countries where research was carried out, young people were reported to be waiting longer before they first have sex. Usually this was young women rather than young men, but in Cameroon, Ethiopia, Malawi and Zambia, both young men and women were waiting longer. The study also found that both young men and women were having fewer sexual partners and that condom use has increased among young women as well as among young men. - guardian.co.uk ? Guardian News and Media 2010 *2* *Safer sex drives HIV rates down ** **Daily Nation, Kenya* 13/07/2010 LONDON - Young people in Africa are leading a ?revolution? in HIV prevention and driving down rates of the disease by having safer sex and fewer sexual partners, the United Nations Aids programme said today. The prevalence of the human immunodeficiency virus (HIV) that causes AIDS is falling among young people in 16 of the 25 countries most affected by the disease, a study by UNAids found, with many of them on track to hit a 25 percent reduction target in HIV/Aids rates in 15- to 24-year-olds by the end of the year. ?Young people have shown that they can be agents of change in the prevention revolution,? the report said. It called on governments worldwide to learn from this progress and provide comprehensive programmes for sexual health education, access to HIV testing and wide availability of prevention methods such as condoms. An estimated 5 million young people around the world aged between 15 and 24 are living with HIV, the often fatal and incurable virus that causes Aids. Nearly 80 per cent of those people live in sub-Saharan Africa. HIV is spread during sex, in blood and breast milk, and by contaminated needles. According to UNAids, an estimated 900,000 new infections occurred among young people in 2008 and the vast majority of those cases were in young women in Africa. In a study published ahead a global Aids conference due to be held in Vienna next week, UNAids found that in 16 of the 25 worst affected countries, rates of HIV had been falling among young people, with some of the most dramatic declines seen in Kenya, where there was a 60 percent change between 2000 and 2005. Botswana, Cote d?Ivoire, Ethiopia, Kenya, Malawi, Namibia and Zimbabwe have all achieved a goal set agreed in 2001 to reduce HIV prevalence in 15 to 24-year-olds by 25 percent by 2010, it said. Burundi, Lesotho, Rwanda, Swaziland, the Bahamas and Haiti were all ?likely to achieve? it. The study found the main drivers of the reductions were changes in sexual behaviour. Young people in 13 of the 25 countries were waiting longer before they become sexually active. In more than half of the 25 countries, young people were choosing to have fewer sexual partners. Condom use was also on the increase, the study found, with 10 countries reporting more use of condoms among women and 13 reporting increased condom use among men. Cameroon, Tanzania and Uganda reported increases in condom use by both sexes. UNAids said in November that an estimated 33.4 million people worldwide were currently infected with the Aids virus. (Reuters) * * *3* *Africa's Young 'Change Sex Habits And Lower HIV Rates'** **Daily Mail, Ghana* 14/07/2010 The prevalence of HIV among young people in countries worst-affected by Aids, mainly in Africa, has fallen, new figures from the UN show. In a report, UNAids says the incidence of HIV has decreased by up to 25% as young people between the ages of 15 and 24 change their sexual behaviour. The report says it is in response to Aids prevention campaigns. But the UN says it is on the rise in Uganda, which had been praised for its HIV fight, because of "complacency". According to the UN, five million young people live with HIV worldwide, making up 40% of new infections. 'Warning' Uganda's vigorous campaign against HIV/Aids had helped to reduce the prevalence of the virus - which reached 30% in the 1990s - to single-digit figures. "After the reduction and introduction of treatment, most of the people were not feeling anymore of the same pressure for prevention programmes," Michel Sidibe, the executive director of UNAids, told the BBC. "So what we are experiencing today in Uganda is what we need to be scared about it - it's progress, and not sustaining [those] results due to probably a complacency." However, the other data was a positive sign of change as young people in Africa were taking responsibility for their own health and well-being, he said. "Young people are not just perceiving themselves anymore as a passive beneficiaries of programmes, but they are making themselves actors of change," he said. "For me, that is a major, major shift in our prevention programmes." Treatment problems The BBC's Imogen Foulkes in Geneva says the UN is releasing the figures ahead of this year's international conference on Aids, which begins in Vienna on Sunday. The Outlook report says young people in 16 of the world's 25 worst-affected countries with HIV are becoming sexually active later and having fewer sexual partners. In countries such as Botswana, Ethiopia, Kenya, Malawi and Zimbabwe the reduction in new HIV infections, measured among young pregnant women presenting for antenatal check-ups, indicates that these nations will achieve UN targets for reducing HIV rates among the young this year. While the UN believes significant progress is being made, on treatment the picture is somewhat different, our reporter says. Aids treatment remains complicated and expensive, and, worldwide, only a third of those who need anti-retrovirals are actually receiving them. The UN says more resources are needed to develop simpler and cheaper Aids medicines, and to streamline diagnosis and treatment. *5* *HIV vaccine the only real answer ** **Mail & Guardian, SA* 12/07/2010 ELIZABETH MATAKA: ANALYSIS It is 2010. This should ring a bell -- or, perhaps sounds an alarm ?if not in the back of all minds, at least in those attending the annual conference of the International Aids Society being held this week in Vienna. This is the year when "universal access" to HIV prevention and treatment was to have become a reality. By now everyone ought to have the tools and know-how needed to prevent HIV. And anyone in need of antiretroviral therapy (ART) should find it a clinic visit away. Needless to say, we aren't there yet, as the 7 400 new HIV infections daily attests. And at last count just four million of the estimated 9.5-million people in low and middle-income countries who needed HIV drugs were getting them, according to UNAids. That fraction, though far short of the declared target, actually represents a noteworthy accomplishment: it equates to a tenfold expansion of access to ART in just five years -- a feat that would ordinarily invite applause. Unfortunately, little about HIV or the pandemic it has spawned lies in the realm of the ordinary. Underlying the 5.5-million soul shortfall is the grim fact that for every two people who are put on ART today, an additional five are newly infected by HIV. This is a particularly serious problem in sub-Saharan Africa, where the majority of new infections occur. It's time for us to become a little more realistic about this global crisis. Access to treatment is vital, not only because it is a humanitarian imperative but also because it may well have the potential to lower rates of HIV transmission significantly. Those on treatment have less HIV circulating in their systems and are less likely to pass it on. At the same time, it is clear that if we truly seek to approach universal levels of access to treatment, we must find ways to reduce the number of people who need it in the first place. Any other course is simply unsustainable. Thus, we must renew efforts aimed at HIV prevention. Discussions around universal access have tended to focus almost exclusively on ART and care for the HIV-positive. Yet "universal access" is promised for HIV prevention as well. Had the Aids community kept this balance more in mind, we might be closer than we are now to meeting the established goals for combating Aids. Dr David Kihumuro Apuuli, director general of the Uganda Aids Commission, has said that the recent bump in new HIV infections in his country, after years of decline and stabilisation, may in part be attributed to the disproportionate stress that has been placed on treatment. Sadly, current HIV-prevention efforts are inadequate. This is partly because condoms, needle-exchange programmes and accurate information about HIV prevention are not universally available. But it is also because current modes of prevention have inherent limitations, depending as they do on people changing their behaviour (a tall order) and doing so consistently (even taller). What's more, women, who are more biologically vulnerable than men to HIV infection, have no means of prevention that they can use without a partner's consent and often lack control over their sexual activity. At any rate, according to the Aids2031 project, even if all existing HIV-prevention and treatment programmes were expanded to their full scale, they would, over the next few decades, cut new HIV infections only by half. And getting there would cost $35 billion annually -- about three times as much as is currently invested in such efforts. It appears that neither treatment alone nor an exclusive reliance on existing prevention approaches is likely to offer a sustainable response to the crisis. So what can be done to deal the pandemic a death blow? The only real hope we have is to develop and deploy better prevention strategies, such as pre-exposure prophylaxis, microbicides and preventive HIV vaccines. These would not replace existing prevention strategies but, if used in combination with them, could greatly cut into the incidence of new HIV infections. Preventive tools that can be initiated and controlled by vulnerable populations would be particularly helpful. They would do much, for example, to empower women, who have a disproportionately high risk of contracting HIV in the very places that have been hit hardest by the pandemic. In 2008 roughly 47% of infected adults the world over were women, according to UNAids; but in sub-Saharan Africa women represented 60% of all new infections. Vaccines, in particular, would empower women and other vulnerable groups to protect themselves from HIV, because immunisation does not necessarily depend on the cooperation of sexual partners. But that is not the only reason an HIV vaccine would be of particular practical value to the people of Africa. To be adopted, new medical tools must be both cost-effective and easily incorporated into existing health systems. Vaccines fit the bill. No one would suggest that an effective Aids vaccine is around the corner. Its development will take years and is sure to be dogged by with failure. We will have to temper our anticipation with patience. But one thing we can say for sure is that an effective preventive vaccine offers the best hope we have of ever putting an end to this pandemic. Let?s keep that idea front and centre as we debate where to steer the "universal access" movement in the years that lie ahead. *Elizabeth Mataka is the United Nations special envoy for HIV/Aids in Africa * *6* *Poll ranks AIDS as top health issue ** **UN IRIN* 14/07/2010 JOHANNESBURG, 14 July 2010 (PlusNews) - AIDS is the world?s most important health-care issue according to people all over the world who were polled for their perceptions of the AIDS epidemic in a new survey commissioned by UNAIDS. Optimism about the state of the global AIDS epidemic and progress in responding to it varied widely, often along geographical lines. In sub-Saharan Africa, where most HIV infections occur, 31 percent of respondents chose the term "getting worse" to describe the issue, while another 30 percent chose "tragic". In South and Southeast Asia participants were more likely to see the situation as "hopeful" or "manageable". Nearly half of all respondents were optimistic that the spread of HIV could be stopped by 2015 with the proper use of resources, although pessimism reigned in some countries, including Japan, the United Kingdom and Ukraine. While 44 percent of all respondents said the world was not responding effectively to AIDS, those in Eastern Europe, the USA and sub-Saharan Africa were most likely to express this view, yet 75 percent of respondents in the Caribbean, and 53 percent in South and Southeast Asia, believed the opposite was true. Perceptions of country and community responses were also divided, with Senegal giving their country the highest approval rating, closely followed by Uganda and Jamaica. Less than one percent of Ukrainian respondents believed their country was responding effectively to AIDS; Russia and Latvia fared slightly better, and just 16 percent of South Africans were convinced that their country's response was effective. Respondents were more likely to agree that AIDS was a problem in their country than in their community. In the USA, for example, about 70 percent thought it was a problem for the country but only a third felt it was a problem in their community. One in three people considered public awareness about AIDS as the greatest achievement of responses to the epidemic, but more than half the respondents also viewed a lack of awareness as the greatest obstacle to HIV responses. A lack of funding and resources were also seen as major obstacles, but nearly six in 10 felt governments had a role to play in providing treatment for their HIV-positive citizens. The perception that people living with HIV should receive subsidized treatment was strongest in the Caribbean and Asia, but less than half the participants in the USA agreed. Almost half the respondents felt stigma and discrimination towards people living with HIV were significant obstacles to HIV responses, but 20 percent said they would not work with an HIV-positive person. Acceptance of people living with HIV was highest in sub-Saharan Africa and the Caribbean. Most people did not feel they were personally at risk of acquiring HIV, regardless of where they lived. Only 25 percent of people in sub-Saharan Africa felt they were at risk, while people in Australia and the USA were least worried about contracting HIV. Nearly 12,000 adults in 25 countries responded to the online survey, which was conducted between March and May 2010. *8* *Afrique : recul du sida chez les 15-24 ans, gr?ce au pr?servatif ** **PressAfrik* 14/07/2010 Le nouveau rapport de l?ONUSIDA vient d??tre pr?sent? ce mardi avant la 18e conf?rence internationale sur le sida qui se d?roulera du 18 au 23 juillet 2010 ? Vienne en Autriche. L??pid?mie de sida continue de reculer et il semble cette ann?e que ce soit la tranche des 15-24 ans qui ait b?n?fici? de cette baisse dans de nombreux pays notamment gr?ce ? une ? utilisation accrue ? du pr?servatif. Les r?sultats montrent que la pr?valence du VIH a baiss? d?un quart, parmi les jeunes et cela a ?t? constat? parmi les quinze pays les plus durement touch?s par ce fl?au. Un chiffre important quand on sait que 8 jeunes contamin?s sur 10, soit 4 millions d?individus vivent en Afrique subsaharienne. Un changement de comportement qui semble s?amorcer dans certains pays de ce continent. Utilisation du pr?servatif de mani?re ? plus accrue ? selon les termes du rapport, pour des jeunes qui ont des partenaires multiples mais aussi qui ont d?marr? leur vie sexuelle plus tardivement, observent les experts. Le Botswana, la C?te d?Ivoire, l?Ethiopie, le Kenya, le Malawi, la Namibie et le Zimbabwe ont d?j? atteint l?objectif international de r?duction de la pr?valence ? 25%. Quant au Burundi, au Lesotho, au Rwanda, au Swaziland, aux Bahamas et Ha?ti, ils sont en passe de l?atteindre d?ici la fin de l?ann?e. ? Ainsi, tous les acteurs de cette lutte doivent se r?organiser pour innover en mati?re de riposte et inciter tous les pays ? p?renniser leurs engagements et notamment les pays en d?veloppement qui peuvent le faire ? s?investir dans la prise en charge du VIH et dans la sant? ? pr?cise le directeur de l?ONUSIDA. Dix millions de d?c?s suppl?mentaires d?ici 2025 et un million, soit un tiers des nouvelles infections ? VIH, pourraient ?tre ?vit?s. Des objectifs envisageables pour l?organisation des Nations unies qui insiste sur une nouvelle approche : ? en faire plus avec moins d?argent ?.. (Rfi) *9* *L'?pid?mie du sida en net recul chez les cat?goriesjeunes ** **El Moujahid, Algeria* 13/07/2010 Le programme commun des Nations unies sur le sida (Onusida) a indiqu? mardi que l'?pid?mie du sida a nettement recul? chez les cat?gories jeunes dans pr?s de la moiti? des 25 pays les plus s?rieusement touch?s au monde, dont ceux de l'Afrique subsaharienne. Selon le rapport annuel de l'Onusida, "la pr?valence du VIH parmi les jeunes (15 ? 24) est en baisse dans de nombreux pays cl?s", en particulier dans la r?gion de l'Afrique subsaharienne. L'objectif international de r?duction de 25% de la pr?valence du VIH parmi les jeunes, convenu ? la Conf?rence internationale des Nations unies sur la population et le d?veloppement en 1994, est atteint ou en passe d'?tre atteint dans ces pays, se f?licite le rapport. Parmi les pays qui ont atteint cet objectif, figurent le Botswana, la C?te d'Ivoire, l'Ethiopie, le Kenya, le Malawi, la Namibie et le Zimbabwe. Et ceux qui devraient l'atteindre d'ici fin 2010 sont notamment le Burundi, le Lesotho, le Rwanda, le Swaziland, les Bahamas et Ha?ti. D'apr?s le document, il s'agit d'une "perc?e essentielle pour briser la trajectoire de l'?pid?mie de sida", une maladie qui a touch? environ 5 millions de jeunes ?g?s de 15 ? 24 ans vivant dans ces r?gions. *=======================* * * *ASIA** AND PACIFIC* * * *=======================*** *New Approach To HIV Treatment Could Save 10 Million Lives By 2025** **Bernama, Malaysia* 14/07/2010 NEW YORK, July 14 (Bernama) -- A new United Nations (UN) report says that a radically simplified approach in HIV treatment, could prevent 10 million deaths by 2025, and one million infections annually, according to Emirates news agency (WAM) on Tuesday. The so-called 'Treament 2.0', says the Joint UN Programme of HIV/AIDS (UNAIDS) could lower the cost of treatment, simplify treatment regimens, ease the burden on health systems, as well as improve the quality of life for people living with HIV and their families. The agency estimates that there were 33.4 million people living with HIV worldwide at the end of 2008, as well as nearly 2.7 million new infections and 2 million AIDS-related deaths. It adds that only one third of the world's 15 million people in need of HIV treatment are accessing life-saving medicines. "By bringing down costs, so that investments and treatment can reach more people. In other words, we know what we are doing, channelling resources in the right direction," Michel Sidib, UNAIDS Executive Director said at the report's launch in Geneva on Tuesday. To make the new plan to succeed, the agency's Outlook report calls for action to be taken across five key areas. Firstly, it calls for the creation of a better pill that is less toxic and for a simple diagnostic tool to monitor treatment. Secondly, evidence suggests that people living with HIV who have reduced the level of virus in their bodies, through antiretroviral therapy, are less likely to transmit it. As a result, UNAIDS says that if everyone in need has access to treatment, this could reduce the number of new HIV infections by one third annually. The report also urges slashing the cost of antiretroviral treatment, especially for hospitalization and monitoring treatment, which can cost twice as much as drugs. Fourth, UNAIDS stresses the need to improve voluntary HIV testing and counselling since starting treatment at the right time, optimally when their CD4 count - a measure of immune system strength - is around 350, boosts the efficacy of treatment and increases life expectancy. Lastly, Treatment 2.0 will be fully successful if communities are mobilized and involved in managing treatment programmes and access. "Not only could Treatment 2.0 save lives, it has the potential to give us a significant prevention dividend," said Sidib. The report also shows that young people are leading the prevention revolution, with 15 of the most severely affected countries reporting a 25 per cent drop in HIV prevalence among this key population. In eight countries - C te d'Ivoire, Ethiopia, Kenya, Malawi, Namibia, Tanzania, Zambia and Zimbabwe - significant HIV prevalence declines have been accompanied by positive changes in sexual behaviour among young people. Nearly US$27 billion is required this year to meet country-set targets for universal access to HIV prevention, treatment, care and support. The agency recommends that nations invest between 0.5 and 3 per cent of government revenue into their AIDS response programmes, but warned that for the majority of countries severely affected by the epidemic, national investments, even at optimal levels, are insufficent. The report also included the results of a public opinion poll that shows that nearly three decades into the epidemic, countries continue to rank AIDS high on the list of the most important challenges the world faces. Overall in the survey, AIDS is perceived to be the top healthcare issue in the world, followed by safe drinking water *2* *UN sets out AIDS treatment plan to save 10 million** **The Star, Malaysia* 14/07/2010 By Kate Kelland, Reuters LONDON (Reuters) - Ten million AIDS deaths could be averted by 2025 and a million new HIV infections a year prevented if countries took a fresh look at how to meet targets on treating the disease, the United Nations AIDS programme said on Tuesday. The UNAIDS Outlook report called for a simpler approach to tackling the human immunodeficiency virus (HIV) that causes AIDS, one it said could drastically cut the number of AIDS-related deaths and help to stop HIV from spreading. World leaders set this year as a deadline for universal access to treatment for all HIV/AIDS patients who need it. Most campaigners say this target will be missed but global health organisations are using it as a focus for new ideas on fighting the epidemic while funding is squeezed due to budget cuts. "With a rising treatment bill, countries in economic crisis and increasing preventions needs, the world is demanding change in the AIDS response," Paul de Lay, a UNAIDS deputy director, told reporters on a telephone briefing. He said UNAIDS was determined that through innovation, the costs of AIDS care could be reduced and AIDS drugs could reach more people who need them. UNAIDS described its vision for "Treatment 2.0" as a new approach aimed at simplifying the way HIV treatment is provided and improving access to life-saving medicines. It calls for a combination of efforts on drug development and pricing, using treatment to increase prevention, improving healthcare delivery and testing, and involving more community workers in treating AIDS patients to reduce the need for highly qualified doctors and expensive laboratories. The World Health Organisation's HIV/AIDS director told Reuters last week he too wants more efficiency and innovation in AIDS care to make better use of scarce funds. According to UNAIDS estimates 33.4 million people were living with HIV worldwide at the end of 2008. In the same year there were nearly 2.7 million new HIV infections and 2 million AIDS deaths. The heaviest burden is in sub-Saharan Africa, which accounted for 71 percent of new HIV infections in 2008 The UNAIDS report was published before an AIDS conference starts in Vienna on July 18 when 25,000 scientists, health workers, activists and government officials will discuss the latest advances against the disease. The global economic crisis is hitting AIDS funding levels -- a factor campaigners say is already putting lives at risk. But UNAIDS said its ideas could bring down costs, make treatment simpler and better, cut the burden on health systems and improve quality of life for people with HIV. De Lay also said more focused targeting of resources now would pay off in the years ahead, possibly leading to a decline in funding needs in around 10 years' time. "Scaling up treatment will have a significant prevention dividend and we hope if that is done right, that the costs will remain the same and then ultimately go down," he said. A mathematical modelling study conducted by UNAIDS suggested that compared with current treatment approaches, the Treatment 2.0 plan could avert an extra 10 million deaths by 2025 and reduce new HIV infections by up to 1 million every year if countries provided AIDS drugs to all those who need them. *3* *Time for efficiency in fighting AIDS, Gates says** **Manorama Online, Malaysia* 14/07/2010 By Maggie Fox, Health and Science Editor WASHINGTON (Reuters) - No big influxes of new money are coming to fight the AIDS pandemic, but some smarter targeting and using approaches that have been shown to work can still save lives, Microsoft founder and philanthropist Bill Gates said on Tuesday. Focusing more treatment on women in Africa, drug users in places where needles drive the epidemic and on gay and bisexual men where that is appropriate can go a long way to fighting the virus, Gates told reporters. "We can focus our prevention efforts. We can look at where there is the most impact," Gates said. Gates, whose Bill& Melinda Gates Foundation spends a large chunk of its $34 billion endowment on fighting AIDS, is influential in directing other spending as well. He has pushed governments, non-profit groups and other philanthropies to join efforts he supports. One big goal is to extend treatment to more people. An estimated 33.4 million people worldwide are infected with the human immunodeficiency virus that causes AIDS. Only about five million people get drugs that can keep patients healthy and reduce the risk they will infect someone else. "With treatment, the challenge is the financing," Gates told reporters in a preview of a keynote speech next Tuesday at the International AIDS Society conference in Vienna. The conference is a gathering of AIDS researchers, activists, patients and advocates held every two years. "We want to broaden treatment. The only way to do that is efficiency," Gates said, noting that no one has the money to treat everyone who needs it. "Clearly we are facing a major challenge in terms of funding because the global economic downturn has a lot of governments looking hard at their budgets," he said. He noted that intense pressure had persuaded drug makers such as GlaxoSmithKline to provide inexpensive drugs to poor countries and to allow generic pharmaceutical companies to make cheap copies in countries such as India. "Now we need to look at delivery costs, personnel costs and administration costs," Gates said. "It is clear from some countries where treatment costs are quite low that if we take best practices and spread those around, we can really do a lot better there." While treatment saves lives and prevents new infections, it is not the only way to prevent the spread of the disease, Gates said. "Other prevention efforts continue to be very important, like male circumcision, like pushing for behavior change, including condom use." Gates has also pressed for development of a microbicide -- a gel, cream or device that women, and perhaps men, can insert to protect themselves from sexual transmission of the virus. *4* *Battling AIDS and discrimination** **Global Times, China* 14/07/2010 By Wu Ningning In China, a country whose last decade has been defined by making bold strides in response to HIV/AIDS, discrimination against HIV/AIDS sufferers is still rife. People with, or suspected of having HIV, may be turned away from hospitals or schools, denied housing or employment and shunned by friends or co-workers. However, most people with HIV choose silence as their defense against discrimi-nation. Therefore, the seminar entitled "Anti Aids Discrimination and Stigma" jointly held by UNAIDS (United Nations Program on HIV/AIDS) and MSIC (Marie Stopes International China) on July 8 focused on looking at strategies to strip away discrimination and stigma. The China Stigma Index Report, a report based on a survey of the experience of more than 2,000 respondents living with HIV in China, was released at the seminar, mapping out the harsh realities HIV carriers face. "The report is the first of its kind in China and among the first in the world," explained Xue Cheng, program assistant of UNAIDS. The report revealed one third of all respondents said their status has been revealed to others without their permission. More than 40 percent reported have faced HIV-related discrimination. More than 12 percent had been refused medical care at least once since they tested positive. "So much work remains to be done in particu-lar in addressing stigma and discrimination," added Xue Cheng. The China Stigma Index Report pictures generally how stigma and discrimination fuel the spread of AIDS in China, a detailed study conducted by Xia Donghua, Project Manager of MSIC, analyzes the severity of the issue in terms of laws and legislations. According to Xia, even though new legislation that outlaws discrimination against people with HIV/AIDS has been in place since 2004, HIV carriers or AIDS patients are rarely protected because of poor policy enforcement and the vague definition of discrimination in law. Many patients know they could bring action against those who violate their rights, but the success rate in doing so is actually very low. Xia suggested the government should pay more attention to the efficiency of the law and policy implementation. Promoting and protecting women with HIV patients' human rights and enhancing their awareness of their rights with regard to discrimination and stigma were also on the agenda of the seminar. Female patients often suffer doubly, not only from the disease, but also from abuse by their spouses and isolation from their families, said Tiantian, a woman with HIV, who set up Dandelion, an on-line female anti-discrimination organization, to help women strengthen their ability to protect themselves from HIV/AIDS and the attendant stigma. "The recent creation of similar organizations enhances the impression that women patients will no longer suffer discrimination just because of their gender," added Tiantian. According to the newly released numbers, it is estimated that up to the end of 2009 out of the 748,000 adults in China living with HIV and AIDS, 30.6 percent are women. wuningning at globaltimes.com.cn *6* *India's patent regime hurting across Asia-Pacific** **DNA, India* 13/07/2010 Priyanka Golikeri / DNA Mumbai: Sitting in a first-floor room of a nondescript school building off Thakurdwar Road at Charni Road in south Mumbai, Eldred Tellis is a picture of frustration and agony As the founder director of Sankalp Rehabilitation Trust, which works with HIV/AIDS patients, Tellis is confronted with the challenge of providing affordable treatment for patients of hepatitis C, a liver disease that affects almost 95% of users of injectable drug. Unless hepatitis C is treated, no effort to save AIDS patients would suffice. ?Hepatitis C medicines are incredibly expensive. We just can?t treat patients,? says Tellis. Two key hepatitis C medicines?pegylated interferon alpha 2a and pegylated interferon alpha 2b ? both patented in India, cost between $16,000 and $18,000 (Rs 7.5-8.4 lakh) for a 48-week course of treatment. Same is the case with patented HIV/AIDS medicines like raltegravir, which costs Euro 2000 (Rs 1.2 lakh) per year in India, and etravirine priced internationally (no separate pricing for developing countries) at about $8000 (Rs 3.7 lakh) per year. Other than the patent-holders, no other company can manufacture the medicines till the patents expire. ?The older medicines for HIV/AIDS are given by the government, but the newer ones, which are patented, are just unaffordable. With competition, prices come down. But that?s not possible in case of patented drugs. Hence, patients are left to God?s mercy,? says Loon Gangte, president of Delhi Network of Positive People, which works with HIV/AIDS patients. The sentiments of Gangte and Tellis are reflected across Asia Pacific, in countries that depend on India for supply of low-cost off-patent (generic) medicines. Estimates suggest that 200 million people around the world are infected with hepatitis C, while a report by the World Health Organisation (WHO), Unicef and UNAIDS, shows that at the end of 2008, about 5 million HIV/AIDS patients were not having access to treatment. ?We are seeing several deaths due to hepatitis C across Asia-Pacific, although no specific numbers are available. India is the pharmacy of the world. Patients look forward to cheap medicines from India, but as key HIV/AIDS and hepatitis C medicines hold patents in India, its a huge setback for patients in our region,? says Giten Khwairakpam, programme coordinator, Coalition of Asia Pacific Regional Network on HIV/AIDS, which works in Vietnam, Malaysia, Papua New Guinea, East Timor, Myanmar, etc. Abdullah Denovan from Indonesia, who is the national coordinator of Indonesian Network of HIV Infected Persons, also echoes Khwairakpam?s views. ?In 2009, there were over 15,000 hepatitis C cases in Indonesia. Estimates show that, from the 1980s to September 2009, Indonesia had about 18,442 HIV/AIDS sufferers. There may be many more unreported cases. There are no generics from India due to the patents.? Manipur-based Deepak Leimapokpam, a user of injectable drugs who is afflicted by both HIV and hepatitis C is one of the very few who has managed to source funds from friends and relations abroad. ?99% of hepatitis C patients across India, specially in states like Manipur, Mizoram, Nagaland, are bereft of treatment. Of the more than 300 people with Hepatitis C whom I know, just two- three are on treatment,? says Leimapokpam, who is with the Manipur Network for Positive People in Imphal. Leimapokpam says he spends about Rs 14,000-15,000 for a vial of the medicine per week. ?Patients with both hepatitis C and HIV need to take the hepatitis C treatment for a year, and Rs 14,000 per week is just unimaginable.? Five years after India adopted the product patent and 20-year patent regime, in accordance with the trade related aspects of intellectual property rights agreement (Trips) of the World Trade Organisation (WTO), the adverse effects of the regime are rubbing salt into the wounds of patients across countries. ?Local manufacturing in developing countries is not developed. Hence we have to depend on India,? says Kannikar Kijtiwatchakul, coordinator, health consumer protection programme, Chulalongkom University in Thailand. Apart from Thailand, Indonesia, less developed countries like Lesotho, buy nearly 95% of all anti-retrovirals from India. Moreover, international humanitarian aid organisation Medecins Sans Frontieres, which provides treatment to 140,000 HIV/AIDS patients in 30 countries, buys more than 80% of its HIV/AIDS drugs from India. Also, about half the essential medicines that Unicef distributes and 75% medicines distributed by the International Dispensary Association in developing countries come from India. Industry estimates suggest, that by 2015, when the Indian pharmaceutical market would be worth $20 billion, about 15% of total drugs would be patented molecules. Anuradha Salhotra, managing partner at intellectual property law firm Lall, Lahiri & Salhotra, says the minute Trips came into effect, patent filings rose and will continue going up. ?That is frightening for all patients dependent on India. If key medicines are patented, it would allow patent holders to charge whatever they want and would push millions below poverty line,? says Khwairakpam. *========================* *EUROPE*** *========================* *UN sets out AIDS treatment plan to save 10 million** **Reuters* 13/07/2010 By Kate Kelland LONDON (Reuters) - Ten million AIDS deaths could be averted by 2025 and a million new HIV infections prevented every year if countries took a fresh look at how to meet targets for treating the disease, the United Nations AIDS programme said on Tuesday. The UNAIDS Outlook report called for a simpler approach to tackling the human immunodeficiency virus (HIV) that causes AIDS, one it said could drastically cut the number of AIDS-related deaths and help to stop HIV from spreading. World leaders set this year as a deadline for universal access to treatment for all HIV/AIDS patients who need it. Most campaigners say this target will be missed but global health organisations are using it as a focus for new ideas on fighting the epidemic while funding is squeezed due to budget cuts. "For countries to reach their universal access targets and commitments, we must reshape the AIDS response," UNAIDS director Michel Sidibe told reporters. "Through innovation we can bring down costs so investments can reach more people." UNAIDS described its vision for "Treatment 2.0" as a new approach aimed at simplifying the way HIV treatment is provided and improving access to life-saving medicines. It calls for a combination of efforts on drug development and pricing, using treatment to increase prevention, improving healthcare delivery and testing, and involving more community workers in treating AIDS patients to reduce the need for highly qualified doctors and expensive laboratories. The World Health Organisation's HIV/AIDS director told Reuters last week he too wants more efficiency and innovation in AIDS care to make better use of scarce funds. According to UNAIDS estimates 33.4 million people were living with HIV worldwide at the end of 2008. In the same year there were nearly 2.7 million new HIV infections and 2 million AIDS deaths. The heaviest burden is in sub-Saharan Africa, which accounted for 71 percent of new HIV infections in 2008 The study was published before an AIDS conference starts in Vienna on July 18 when 25,000 scientists, health workers, activists and government officials will discuss the latest advances against the disease. The global economic crisis is hitting AIDS funding levels -- a factor campaigners say is already putting lives at risk. But UNAIDS said its ideas could bring down costs, make treatment simpler and better, cut the burden on health systems and improve quality of life for people with HIV. A mathematical modelling study conducted by UNAIDS suggested that compared with current treatment approaches, the Treatment 2.0 plan could avert an extra 10 million deaths by 2025 and reduce new HIV infections by up to 1 million every year if countries provided AIDS drugs to all those who need them. "Not only could Treatment 2.0 save lives, it has the potential to give us a significant prevention dividend," Sidibe said. *2* *Africa's young 'change sex habits and lower HIV rates'** **BBC News* 14/07/2010 The prevalence of HIV among young people in countries worst-affected by Aids, mainly in Africa, has fallen, new figures from the UN show. In a report, UNAids says the incidence of HIV has decreased by up to 25% as young people between the ages of 15 and 24 change their sexual behaviour. The report says it is in response to Aids prevention campaigns. But the UN says it is on the rise in Uganda, which had been praised for its HIV fight, because of "complacency". According to the UN, five million young people live with HIV worldwide, making up 40% of new infections. 'Warning' Uganda's vigorous campaign against HIV/Aids had helped to reduce the prevalence of the virus - which reached 30% in the 1990s - to single-digit figures. "After the reduction and introduction of treatment, most of the people were not feeling anymore of the same pressure for prevention programmes," Michel Sidibe, the executive director of UNAids, told the BBC. "So what we are experiencing today in Uganda is what we need to be scared about it - it's progress, and not sustaining [those] results due to probably a complacency." However, the other data was a positive sign of change as young people in Africa were taking responsibility for their own health and well-being, he said. "Young people are not just perceiving themselves anymore as a passive beneficiaries of programmes, but they are making themselves actors of change," he said. "For me, that is a major, major shift in our prevention programmes." Treatment problems The BBC's Imogen Foulkes in Geneva says the UN is releasing the figures ahead of this year's international conference on Aids, which begins in Vienna on Sunday. The Outlook report says young people in 16 of the world's 25 worst-affected countries with HIV are becoming sexually active later and having fewer sexual partners. In countries such as Botswana, Ethiopia, Kenya, Malawi and Zimbabwe the reduction in new HIV infections, measured among young pregnant women presenting for antenatal check-ups, indicates that these nations will achieve UN targets for reducing HIV rates among the young this year. While the UN believes significant progress is being made, on treatment the picture is somewhat different, our reporter says. Aids treatment remains complicated and expensive, and, worldwide, only a third of those who need anti-retrovirals are actually receiving them. The UN says more resources are needed to develop simpler and cheaper Aids medicines, and to streamline diagnosis and treatment *3* *HIV hopes queried over cases in young Africans** **The Independent, UK* 13/07/2010 By Jeremy Laurance, Health Editor Almost 25 years after the message on safe sex as a defence against Aids was conceived there are signs that it is getting through to the youth of Africa. The number of young people infected with HIV has fallen by a quarter in 12 of the 25 worst-affected countries in the world, and is on a downward trend in four others, the joint United Nations programme on Aids reported today. It is 15-24 year olds who are leading the ?prevention revolution?, it says, by waiting longer to become sexually active, having fewer multiple partners and increasingly using condoms. However, doubt was cast on the upbeat message by researchers yesterday. In South Africa, a 60 per cent reduction in HIV infections among women aged 15-24 between 2002-5 and 2005-8, reported in the journal Public Library of Science (PLoS) last month, has been criticised for its poor methodology, untested assumptions and for producing misleading results. UNAIDs says in its latest ?Outlook? report that there were 33.4 million people living with HIV worldwide in 2008, of whom 2.7 million became infected that year and 2 million died. Despite the investment of billions of dollars over the last decade only five million of the 15 million people who need anti-retroviral treatment are currently receiving it. Further gains against the pandemic could be made by simplifying treatment. UNAIDS calls for the development of a ?smarter, better pill? that is less toxic and requires less monitoring which could save costs - currently twice as much as the pills themselves - and lead to expanded coverage. Trreatment with anti-retroviral drugs can cut transmission of the disease by more than 90 per cent. UNAIDS says treating everyone with the drugs they need could cut new HIV infections by a third, as well as reducing the incidence of tuberculosis and malaria among those carrying HIV. Offering treatment encourages people to come forward for testing, reducing the risk to others. Michel Sidibe, UNAIDS executive director, said: ?For countries to reach their universal access targets and commitments [on anti-retroviral drugs] we must reshape the Aids response. Through innovation we can bring down costs so investments can reach more people.? The report says HIV prevalence declined by 60 per cent in Kenya between 2000 and 2005. In Ethiopia it fell by 47 per cent in urban areas, based on testing pregnant women, and by 29 per cent in rural areas. Malawi, Namibia, Tanzania, Zambia, Zimbabwe and Cote d?Ivoire saw similar falls. In South Africa, which has the highest number of HIV infected people, there is dispute over whether the disease is in retreat. The household survey by Thomas Rehle of the Human Sciences Research Council in Capetown, South Africa, showing a 60 per cent fall in infections in young women published in PLoS last month received wide publicity and was hailed as showing the country was on course to hit its ambitious target of halving HIV infections overall by 2012. Till B?rnighausen, epidemiologist at the Africa Centre for Health and Population Studies, University of KwaZulu-Natal, said the findings were based on assumptions about the population, death rates from Aids and effects of treatment, which, if altered, could invalidate the results. Reported condom use had increased but other measures of sexual behaviour such as age of first sex and multiple partners had not. "There is little evidence from other sources that HIV incidence is coming down [in South Africa]. The 60 per cent claim would be a huge success - we would like to see more evidence to give it plausibility. What could have triggered such a reduction after so long with no change? It is dangerous to make such a strong claim because it could lead to a switch of focus from prevention to treatment or a decision not to increase funding for HIV for a group that still needs a lot of focus. Women report an increase in condom use but it could be women reporting that, not using them. Other measures of behaviour have not changed such as age of sexual debut and the number of women having more than one sexual partner. There is one outstanding report of increased condom use but not much evidence that other sexual risk taking has changed." Referring to the PloS study, he added: ?My strong feeling is that with some changed assumptions, the significance and size of the finding would have disappeared. Many senior colleagues here feel we should write a letter [to the journal] outlining our scientific criticisms vigorously.? *4* *Row over Obama's Aids strategy** **The Guardian, UK* 13/07/2010 Sarah Boseley?s GlobalHealthBlog Posted by Sarah Boseley As UNAIDS calls for a re-shaping of the campaign against HIV/Aids in the developing world, President Obama is under attack for under-funding the effort both in poor countries and at home Michel Sidibe, head of UNAIDS, said we are at "a defining moment" in the response to HIV/Aids in an interview with me this morning. He was talking about the need to re-shape the campaign, as he put it, in the face of rising numbers of people getting infected and economic recession. It has to be about prevention - and UNAIDS has released some very hopeful data on HIV prevalence falling among young people as they adopt safer sexual practices - although we also need a cheaper, simplified treatment regime. Putting people on treatment, of course, also has a preventive effect, by making them less infectious. But all the problems of HIV in the developing world are mirrored in the richest nation on the planet. Simmering discontent over President Obama's decision to flat-line Aids funding for poor countries may be turning into something more explosive. Today, the administration is unveiling its strategy against Aids in the USA. The document was leaked to the New York Times, which published a story yesterday. There will be no more money - instead what there is will be redirected to the most at-risk groups. Aids campaigners in the US say it is far from good enough. Shockingly, there are people with HIV who are waiting for treatment in the US, just as there are in the developing world. This is from a statement by the Aids Healthcare Foundation: As of July 9th, there were 2,291 people on waiting lists in 12 states including 605 in Florida?which has the third highest incidence of AIDS in the nation?and which only started its wait list June 1st. Regarding the 2,200 Americans on waiting lists to receive lifesaving HIV/AIDS medications through the nation's AIDS Drug Assistance Program (ADAP): In an effort to address the crisis, Senators Burr, Coburn and Enzi introduced S. 3401, the ACCESS ADAP Act, a bill which provides $126 million in unobligated stimulus funds to eliminate waiting lists through Fiscal Year 2010. The bill failed to gain the support of the Administration or Congress. The $126 million was a number provided by state AIDS directors as the amount of additional federal funding required to meet current program needs given the number of people on waiting lists, expected number of new patients and budget cuts per state. The AHF, the largest global Aids organisation, has Obama in its sights over his Aids policy at home and abroad. George Bush, it is beginning to be muttered, did better. Here is an advert the AHF is going to be putting out, comparing the two. No guesses for who is likely to come off worse. The International Aids conference begins in Vienna on Sunday. There is much to talk about. I think there's every chance it will be heated. *5* *UNAIDS calls for radical simplification of treatment to support HIV prevention** **AidsMap News, UK* 13/07/2010 Keith Alcorn UNAIDS today called for a radically simplified approach to antiretroviral therapy in order to maximise the prevention benefits of HIV treatment, labelling the approach `Treatment 2.0`. In a report issued ahead of the Eighteenth International AIDS Conference in Vienna, which takes place between July 18th and 23rd, UNAIDS says that a successful transition to a `Treatment 2.0` mode of managing HIV disease could avert 10 million AIDS deaths by 2025 and one million new infections each year. Treatment 2.0 will require progress in five areas, said Michel Sidib?, executive director of UNAIDS: A once-daily fixed dose combination that is less toxic, less vulnerable to resistance if treatment is missed, and which could be managed without laboratory monitoring, together with simple point-of-care diagnostics that would allow HIV treatment to be monitored at any health facility. Maximising access to treatment for everyone in current medical need, in the expectation that as in recent cohort studies in Africa, treatment will greatly reduce the number of new infections. Reduce the cost of treatment, especially the non-drug-associated costs like monitoring, staffing and hospitalisation of people who start treatment very late. (Up to 80% of the cost of treatment may be non-drug-associated, UNAIDS claims, although recent studies have found wide variations according to the country examined). Maximise the uptake of HIV testing so that people can be diagnosed earlier and start treatment earlier. This will have an impact on both deaths and new infections, and increase life expectancy. Strengthen community mobilisation: by involving the community in managing treatment programmes, treatment access and adherence can be improved. Demand creation will also help bring down costs for extensive outreach and help reduce the burden on health care systems. New data supporting some of these approaches will be presented at next week?s International AIDS Conference, but the chief question about the long-term impact of this approach remains how many infections will be prevented by antiretroviral treatment. UNAIDS estimates that new HIV infections could be reduced by one-third worldwide, but there is disagreement among epidemiological modellers regarding the impact of wider treatment according to current guidelines, with one group suggesting that in some circumstances, wider treatment according to current guidelines might have little net benefit in cost-effectiveness terms, because the reduction in infections would be insufficient to offset the additional costs of treatment. HIV prevalence declining among young people in worst-hit countries UNAIDS also released new information on HIV prevalence trends among young people in countries with a high burden of HIV infection, showing that HIV prevalence among young people has declined by more than 25% in 15 of the 25 countries most affected by AIDS. These declines are largely due to falling new HIV infections among young people. In eight countries?C?te d?Ivoire, Ethiopia, Kenya, Malawi, Namibia, the United Republic of Tanzania, Zambia and Zimbabwe?significant HIV prevalence declines have been accompanied by positive changes in sexual behaviour among young people. For example, in Kenya there was a 60% decline in HIV prevalence between 2000 and 2005. HIV prevalence dropped from 14.2% to 5.4% in urban areas and from 9.2% to 3.6% in rural areas in the same period. Similarly in Ethiopia there was a 47% reduction in HIV prevalence among pregnant young women in urban areas and a 29% change in rural areas. Young people in 13 countries, including Cameroon, Ethiopia, and Malawi, are waiting longer before they become sexually active. Young people were also having fewer multiple partners in 13 countries. And condom use by young people during last sex act increased in 13 countries. There are 5 million young people living with HIV worldwide, making up about 40% of new infections. Investments need to be sustained but money must be better spent, says UNAIDS ?The AIDS response needs a stimulus package now. Donors must not turn back on investments at a time when the AIDS response is showing results,? said Mr Sidib?. ?The 0.7% target on international aid and the Abuja target of 15% for health cannot be buried.? UNAIDS recommends that national HIV programmes invest between 0.5% and 3% of government revenue in the AIDS response. In recent years many countries have increased their domestic investments in the AIDS response. For example, the South African Government increased its budget for AIDS by 30% to US$ 1 billion in 2010. However, for the majority of the countries severely affected by AIDS, domestic investments alone, even when raised to optimal levels, will not suffice to meet all their resource needs. UNAIDS called on richer developing countries to meet a substantial proportion of their resource needs from domestic sources. Currently, 50% of the global resources requirement for low- and middle-income countries is in 68 countries where the national need is less than 0.5% of their gross national income. These countries have 26% of the people living with HIV and receive 17% of international assistance for AIDS. According to the report, current investments in HIV can become more efficient, effective and predictable. ?We can bring down costs so investments can reach more people,? said Mr Sidib?. ?This means doing things better?knowing what to do, channelling resources in the right direction and not wasting them, bringing down prices and containing costs. We must do more with less.? *Adapted from UNAIDS press release* *6* *L'Onusida lance une nouvelle strat?gie m?dicale contre la pand?mie** **Le Monde* 13/07/2010 L'Onusida, qui coordonne l'action des diff?rentes agences des Nations unies dans la lutte contre la pand?mie, a rendu publiques, mardi 13 juillet, ? Gen?ve, les grandes lignes de ce qui est d?sormais consid?r? comme le traitement d'avenir contre la maladie. Une strat?gie m?dicale de deuxi?me g?n?ration, baptis?e "Traitement 2.0", dont la force majeure r?side dans sa double fonction : parade th?rapeutique contre les effets pathologiques du virus VIH d'une part, arme pr?ventive contre sa transmission d'autre part. Alors que le virus continue de progresser (7 400 nouvelles infections par jour dans le monde), les ?tudes se sont multipli?es, ces derni?res ann?es, qui d?montrent la capacit? des traitements antir?troviraux ? r?duire le risque de transmission du VIH. Au plan th?orique, rien que de tr?s logique : un traitement bien conduit rend la charge virale ind?tectable dans le sang, r?duisant presque ? z?ro le risque de transmission. Selon les mod?les math?matiques de l'Organisation mondiale de la sant? (OMS), le d?pistage volontaire universel du VIH, une fois par an, chez l'ensemble des adultes, suivi aussit?t d'un traitement antir?troviral en cas d'infection, permettrait ainsi, en dix ans, de r?duire de 95 % l'incidence annuelle de l'infection par le VIH. Dans la pratique, cet acc?s universel au traitement est loin d'?tre acquis. Certes, dans les pays ? revenu faible ou moyen, environ 5 millions de personnes re?oivent actuellement une th?rapie contre le sida - ce qui constitue d?j? un progr?s consid?rable. "Nouvelle strat?gie" "Il y dix ans, il n'y avait quasiment pas de traitements disponibles pour ces pays", rappelle Michel Sidib?, directeur ex?cutif de l'Onusida. "En six ans, nous avons multipli? par douze le nombre de personnes qui en b?n?ficient. Mais sur les 15 millions d'individus ayant besoin d'un traitement, pr?s de 10 millions n'en re?oivent toujours pas." La maladie court donc plus vite que les soins : quand deux personnes commencent un traitement contre le VIH, cinq, dans le m?me temps, sont nouvellement infect?es. Si l'on veut parvenir ? utiliser les m?dicaments ? des fins pr?ventives, il faut imp?rativement passer ? la vitesse sup?rieure. En investissement financier comme en efficacit? sur le terrain. Tel est l'objet du Traitement 2.0, dont les grands axes viennent d'?tre pr?cis?s. "Il s'agit de proposer un traitement simplifi? et beaucoup moins cher, avec une administration et des infrastructures sanitaires moins lourdes qu'actuellement", r?sume Michel Sidib?. Simplifier le traitement ? Par exemple gr?ce ? la promotion de trith?rapies g?n?riques combin?es et ? dose fixe. Dans les pays en d?veloppement, la solution "une pilule par jour", qui associe trois m?dicaments dans un m?me comprim?, augmenterait consid?rablement le respect de leur prescription par les patients, tout en am?liorant leur qualit? de vie. "Certains de ces traitements sont d?j? disponibles, mais il faut d?velopper des g?n?riques ayant moins d'effets secondaires et moins de toxicit? ? long terme", soulignent les experts d'Onusida. "Les ?tudes dont nous disposons attestent que cette approche globale produirait des dividendes : la mise en oeuvre du "Traitement 2.0" permettrait d'?viter un million de nouvelles infections d'ici ? 2015, soit une r?duction de 30 %, et d'?viter 10 millions de d?c?s d'ici ? 2025", calcule Michel Sidib?. Techniquement, affirme-t-il, l'objectif peut ?tre atteint sans grande contrainte. "La question qui se pose est avant tout politique : sommes-nous pr?ts ? aller vers cette nouvelle strat?gie ?" *Paul Benkimoun et Catherine Vincent* *7* *HIV prevalence falling among youths: UNAIDS** **AFP* 13/07/2010 GENEVA ? Prevalence of HIV among young people is falling in some of the worst-hit countries around the world amid a change in their sexual behaviour patterns, UNAIDS said Tuesday. "For the first time... reductions in HIV prevalence among young people have coincided with a change in sexual behaviour patterns among people," said the Joint UN Programme on HIV/AIDS in a report. "A change is happening among young people across the world, especially in parts of sub-Saharan Africa" where about 80 percent of infected youths -- four million -- live," said UNAIDS. "Waiting longer to become sexually active, young people have fewer multiple partners and there?s an increased use of condoms among those with multiple partners," it noted. Botswana, Ivory Coast, Ethiopia, Kenya, Malawi, Namibia and Zimbabwe have managed to cut their prevalence rates among youths by a quarter. Burundi, Lesotho, Rwanda, Swaziland, the Bahamas, Haiti, South Africa, Tanzania and Zambia count among countries which are on track to meeting the same target by the end of 2010, said UNAIDS. This is a "breakthrough essential for breaking the trajectory of the AIDS epidemic," said the agency. However, UNAIDS director of monitoring and evaluation Paul De Lay said that while the epidemic is showing a declining trend in sub-Saharan Africa, it is gaining ground among the young in eastern European countries such as Russia, Ukraine, Georgia and Belarus. About five million youths aged 15 to 24 worldwide live with HIV/AIDS. Some 900,000 youths were infected in 2008, 66 percent of them women, said UNAIDS. Copyright ? 2010 AFP. All rights reserved *8* *Sida: l'?pid?mie recule fortement chez les jeunes de 15 ? 24 ans (Onusida)* * **AFP* 13/07/2010 *Story carried by Tribune de Gen?ve, TV5, TSR.ch, 24Heures.ch, Romandie News (CH), Atlasvista (Morocco), LeMatin.ch, Europe1, France24, Les ?chos, RTL Info.Le Figaro, Ouest France,* GENEVE, 13 JUIL 2010 | L'?pid?mie de sida a nettement recul? chez les jeunes de 15 ? 24 ans dans pr?s de la moiti? des 25 pays les plus s?rieusement touch?s au monde, particuli?rement en Afrique subsaharienne, gr?ce notamment ? une "utilisation accrue" du pr?servatif, a annonc? mardi l'Onusida L'?pid?mie de sida a nettement recul? chez les jeunes de 15 ? 24 ans dans pr?s de la moiti? des 25 pays les plus s?rieusement touch?s au monde, particuli?rement en Afrique subsaharienne, gr?ce notamment ? une "utilisation accrue" du pr?servatif, a annonc? mardi l'Onusida. "La pr?valence du VIH parmi les jeunes est en baisse dans de nombreux pays cl?s", avance le rapport annuel du Programme commun des Nations Unies sur le VIH/sida, qui rappelle que 80% des jeunes contamin?s -- soit 4 millions de personnes -- vivent dans la r?gion de l'Afrique subsaharienne. Cette question sera au coeur des d?bats de la 18e conf?rence internationale sur le sida qui se tiendra la semaine prochaine ? Vienne, en pr?sence notamment de l'ancien pr?sident am?ricain Bill Clinton, a indiqu? aux journalistes le directeur ex?cutif d'Onusida, Michel Sidib?, lors de la pr?sentation du rapport. Les donn?es compl?tes sur l'?volution de l'?pid?mie chez les jeunes dans les pays d'Afrique subsaharienne seront pr?sent?es ? Vienne, a pr?cis? M. Sidib?. Ces pays "ont atteint ou sont en passe d'atteindre l'objectif international de r?duction de 25% de la pr?valence du VIH parmi les jeunes, convenu ? la Conf?rence internationale (des Nations unies) sur la population et le d?veloppement en 1994", explique le rapport. Les pays qui ont atteint l'objectif sont le Botswana, la C?te d'Ivoire, l'Ethyopie, le Kenya, le Malawi, la Namibie et le Zimbabwe. Et parmi les pays qui devraient atteindre cet objectif d'ici fin 2010 figurent le Burundi, le Lesotho, le Rwanda, le Swaziland, les Bahamas, Ha?ti, l'Afrique du Sud, la Tanzanie et la Zambie. Il s'agit d'une "perc?e essentielle pour briser la trajectoire de l'?pid?mie de sida", observe le rapport. "Le rapport montre que pour la premi?re fois la r?duction de la pr?valence du VIH co?ncide avec un changement de comportement sexuel. Les experts soulignent qu'un "changement se produit chez les jeunes ? travers le monde, en particulier dans certaines parties de l'Afrique subsaharienne". Ils expliquent ce recul par une entr?e plus tardive dans la vie sexuelle, par une r?duction du nombre des partenaires sexuels et par une "utilisation accrue" du pr?servatif chez les 15-24 ans ayant des partenaires multiples. Mais si l'?pid?mie a recul? en Afrique subsaharienne, elle est en revanche en hausse chez les jeunes d'Europe de l'Est, a relev? le directeur ex?cutif adjoint d'Onusida, Paul De Lay, citant la Russie, l'Ukraine, la G?orgie et la Bi?lorussie. Environ 5 millions de jeunes ?g?s de 15 ? 24 ans vivent dans le monde avec le sida, selon Onusida. Au total, quelque 900.000 jeunes ont ?t? contamin?s en 2008, 66% d'entre eux ?tant des femmes, selon le rapport. L'organisme onusien, qui d?nombre 33,4 millions de personnes tous ?ges confondus vivant avec le VIH ? travers le monde fin 2008, a ?galement publi? pour la premi?re fois un sondage international sur le sida. Selon l'enqu?te, la moiti? des interrog?s sont optimistes quant ? la possibilit? de stopper la propagation du sida d'ici ? 2015. *9* *HIV/AIDS numbers from around the world** **Reuters* 13/07/2010 A major international conference on AIDS starts in Vienna on July 18, when thousands of scientists, health workers, activists, and government officials will gather to discuss the latest advances against the disease An estimated 33.4 million people worldwide are infected with the human immunodeficiency virus (HIV) that causes AIDS, according to figures issued by the Joint UN Programme on HIV/AIDS (UNAIDS). Here are some AIDS figures from around the world: THE GLOBAL PICTURE: * Global deaths from AIDS reached an estimated 2 million in 2008, the same number as in 2007. Since the AIDS pandemic started in the early 1980s, almost 60 million people have been infected with the virus and 25 million have died of HIV-related causes. * In 2008, around 430,000 children were born with HIV, bringing to 2.1 million the total number of children under 15 living with HIV. Young people account for around 40 percent of all new adult (those aged 15 and over) HIV infections worldwide. * The annual number of new HIV infections remained the same in 2008 as for 2007 at 2.7 million. This is down from 3.0 million in 2001. * Although 33.4 million people had the human immunodeficiency virus (HIV) in 2008, more of them are living with HIV than ever before, at least in part due to the beneficial effects of AIDS drugs known as antiretroviral therapy. There are currently 26.3 million adults over 25 living with HIV. AFRICA & ASIA: * Sub-Saharan Africa remains the region most heavily affected by HIV, accounting for 67 percent of all people living with the virus worldwide, 71 percent of AIDS-related deaths and 91 percent of all new infections among children. * An estimated 1.9 million people were newly infected with HIV in sub-Saharan Africa in 2008, bringing to 22.4 million the number of Africans living with HIV. * The nine countries in southern Africa continue to bear a disproportionate share of the global AIDS burden. Each of them has an adult HIV rate of more than 10 percent. * With an adult HIV prevalence of 26 percent in 2007, Swaziland has the most severe level of infection in the world. Lesotho's epidemic seems to have stabilised, with an adult HIV rate of 23.2 percent in 2008. * South Africa continues to be home to the world's largest population of people living with HIV -- 5.7 million in 2007. More than 250,000 South Africans died of AIDS-related diseases in 2008 and almost 2 million children there have lost one or both parents to the epidemic. * Asia, home to 60 percent of the world's population, is second only to sub-Saharan Africa in terms of people living with HIV. An estimated 4.7 million people were living with HIV in Asia in 2008. * India accounts for roughly half of Asia's HIV cases. With the exception of Thailand, where HIV affects 1.4 percent of adults, every country in Asia has an adult HIV infection rate of less than 1 percent. OTHER REGIONS: * Rates of HIV in eastern Europe and Central Asia are on the rise, with severe and growing epidemics in the Ukraine and Russia. With an adult HIV prevalence of 1.6 percent in 2007, Ukraine has the highest prevalence in all of Europe. In eastern Europe 1.5 million people were living with HIV. * In Latin America, new HIV infections totalled an estimated 170,000 in 2008 bringing to 2 million the number of people living with HIV there. An estimated 77,000 people died of AIDS-related illnesses there last year. * There were 2.3 million people living with HIV in 2008 in North America and western and central Europe. Sources: Reuters/UNAIDS (Writing by David Cutler, London Editorial Reference Unit; editing by Kate Kelland and Jon Loades-Carter) *10* *Diez millones de muertes podr?an evitarse con nuevo tratamiento contra VIH* * **EFE, Spain* 13/07/2010 *Story carried by ABC (Spain), El Tiempo (Colombia), El Confidencial (Spain), Paraguay.com, Semana (Colombia), Hoy Digital (Spain)* Ginebra, 13 jul (EFE).- Al menos diez millones de muertes a causa del VIH y un mill?n de nuevos contagios podr?an evitarse en 2025 si se aplicase un nuevo tratamiento antirretroviral llamado 2.0, propuesto por ONUSIDA, la agencia de Naciones Unidas para la lucha contra el sida. "Se trata de simplificar la manera en la que actualmente se suministran los tratamientos contra el VIH y aumentar el acceso a estas medicinas", dijo Michel Sidib?, director ejecutivo de ONUSIDA, durante la presentaci?n en Ginebra del informe 2010, pre?mbulo de la Conferencia de Viena sobre Sida de la pr?xima semana. El 2.0 es un tratamiento multidisciplinar que engloba iniciativas para la prevenci?n del VIH, nuevas pr?cticas para su detecci?n e innovadoras f?rmulas para crear f?rmacos m?s inocuos. Sidib? explic? que el 2.0, "reducir?a los costes de los tratamientos y el nivel t?xico de los antirretrovirales", combinaci?n que "facilitar?a el acceso a las medicinas dr?sticamente", con un pron?stico de reducci?n de diez millones de muertes y un mill?n de infecciones en el 2025. Hoy, s?lo cinco millones de los m?s de quince afectados por el Virus de Inmunodeficiencia Humana (VIH) -causante del sida- en el mundo tienen acceso a tratamientos, por lo que ONUSIDA propone a los pa?ses donantes aunar esfuerzos para implementar el 2.0, y producir "p?ldoras m?s sencillas y menos t?xicas". "Considerar el tratamiento como una prevenci?n" y aumentar el n?mero de test de detecci?n gratuitos son otros dos puntos de la propuesta de la agencia de la ONU. El estudio de ONUSIDA tambi?n contempla que los j?venes est?n liderando el actual proceso de lucha contra el sida, ya que la prevalencia de VIH entre este sector de la poblaci?n ha disminuido m?s de un 25 por ciento en 15 de los 25 pa?ses m?s afectados por la pandemia. En ocho pa?ses, Costa de Marfil, Etiop?a, Kenia, Malawi, Namibia, Tanzania, Zambia y Zimbabue, los ?ndices han disminuido y tambi?n se han detectado cambios positivos en el comportamiento sexual de los j?venes, detalla del informe. EFE *========================* * * *LATIN AMERICA AND CARIBBEAN* * * *========================* *Nueva esperanza para afectados de VIH** **Hoy Digital, DR* 13/07/2010 Paloma Almoguera, Ginebra, (EFE).- Diez millones de muertes a causa del VIHy un mill?n de nuevas infecciones podr?an evitarse en el 2025 si seaplicase un nuevo tratamiento, llamado 2.0, propuesto por ONUSIDA,la agencia de Naciones Unidas en la lucha contra el Sida. "Se trata de simplificar la manera en la que actualmente sesuministran los tratamientos contra el VIH y aumentar el acceso aestas medicinas", dijo Michel Sidib?, director ejecutivo de ONUSIDA,durante la presentaci?n en Ginebra del informe 2010, pre?mbulo de laConferencia de Viena sobre Sida de la pr?xima semana. El 2.0 es un tratamiento que engloba iniciativas para laprevenci?n del VIH, nuevas pr?cticas para su detecci?n e innovadorasf?rmulas para crear f?rmacos m?s inocuos, aunque a?n no hay ningunaque se haya aplicado. Sidib? explic? que el 2.0 "reducir?a los costes de lostratamientos y el nivel t?xico de los antirretrovirales",combinaci?n, dijo, que "facilitar?a el acceso a las medicinasdr?sticamente", con un pron?stico de reducci?n de diez millones demuertes y un mill?n de infecciones en el 2025. Hoy, s?lo cinco millones de los m?s de quince afectados por VIHen el mundo tienen acceso a tratamientos, por lo que ONUSIDA proponea los pa?ses donantes aunar esfuerzos para poner en marcha el 2.0 ycrear "p?ldoras m?s sencillas y menos t?xicas", "mejorar laprevenci?n" y aumentar "el n?mero de test de detecci?n gratuitos". El estudio de ONUSIDA tambi?n contempla que los j?venes -entre 14y 25 a?os- est?n liderando el actual proceso de lucha contra elSida, ya que la prevalencia de VIH entre este sector de la poblaci?nha disminuido m?s de un 25 por ciento en 15 de los 25 pa?ses m?safectados por la pandemia. En Costa de Marfil, Etiop?a, Kenia, Malawi, Namibia, Tanzania,Zambia y Zimbabue los ?ndices han disminuido y tambi?n se handetectado cambios positivos en el comportamiento sexual de losj?venes, detalla del informe. Tambi?n en Burundi, Lesotho, Ruanda, Swazilandia, Bahamas y Hait?los j?venes empiezan a tomar m?s precauciones para frenar el n?merode contagios y esperan m?s tiempo hasta ser sexualmente activos. A pesar de estos cambios positivos, a?n hay al menos cincomillones de j?venes en el mundo con VIH. El informe apunta que treinta a?os despu?s del descubrimiento dela epidemia al menos 60 millones de personas han sido infectadas y25 millones han muerto debido a las llamadas enfermedadesoportunistas que emergen tras el contagio. Adem?s, de las 33,4 millones de personas que viven en laactualidad con VIH, la mitad son mujeres. Entre los datos favorables, el informe de ONUSIDA relata que lapandemia se ha estabilizado en la mayor parte de las regiones,aunque sus ?ndices siguen aumentando en el este de Europa y en elcentro de Asia debido a los elevados porcentajes de nuevasinfecciones. ?frica subsahariana contin?a siendo la regi?n m?s afectada delplaneta, ya que, en el a?o 2008, registr? un 71 por ciento de lasnuevas infecciones mundiales. Asimismo, el acceso de las mujeres a los preservativos femeninosaument? de forma inaudita, con un n?mero r?cord de 50 millones en2009. Una encuesta llevada a cabo por ONUSIDA para la elaboraci?n delinforme expuso que hoy en d?a el VIH sigue siendo uno de losprincipales problemas que enfrenta la sociedad. "Estamos en un momento crucial para poder crear un nuevo enfoquede lucha contra el Sida", apunt? Sidib?. La propuesta de ONUSIDA es que los pa?ses apuesten fuerte por unnuevo modelo de lucha, como puede ser el tratamiento 2.0 que laorganizaci?n promueve: "una nueva respuesta para frenar lapandemia", concluy? Sidib?. *3* *Reporta Onusida baja en la transmisi?n del VIH entre j?venes de 16 de los 25 pa?ses m?s afectados * *La Jornada, Mexico* 14/07/2010 Londres, 13 de julio. Los j?venes africanos est?n encabezando una ?revoluci?n? en la prevenci?n del sida y ayudando a reducir los ?ndices de transmisi?n debido a que tienen pr?cticas sexuales m?s seguras y menor n?mero de parejas, dijo el martes el programa de Naciones Unidas para la enfermedad. La incidencia del virus de inmunodeficiencia humana (VIH), que causa el sida, est? cayendo entre los j?venes en 16 de los 25 pa?ses m?s afectados por la enfermedad, seg?n un estudio de Onusida. Muchos de ellos van en camino de alcanzar el objetivo de reducci?n de 25 por ciento en los ?ndices de VIH/sida en las personas de entre 15 y 24 a?os para finales de a?o. ?Los j?venes han mostrado que pueden ser agentes de cambio en la revoluci?n de la prevenci?n?, se?ala el informe. El documento pide a los gobiernos de todo el mundo que aprendan de sus avances y proporcionen programas globales sobre educaci?n en salud sexual, acceso a las pruebas del VIH y disponibilidad generalizada a los m?todos de prevenci?n como condones. En todo el mundo, aproximadamente 5 millones de j?venes de entre 15 y 24 a?os viven con VIH, el virus a menudo mortal e incurable que causa el sida. Casi 80 por ciento de ellos viven en ?frica subsahariana. El VIH se contagia a trav?s de las relaciones sexuales, la sangre, la leche materna y las agujas contaminadas. Seg?n Onusida, en 2008 se produjeron aproximadamente 900 mil infecciones nuevas entre los j?venes, la gran mayor?a africanos. En un estudio publicado antes de la conferencia mundial sobre el sida, que se celebrar? la semana pr?xima en Viena, la agencia hall? que en 16 de los 25 pa?ses m?s afectados los ?ndices de VIH hab?an descendido entre los j?venes. Uno de los declives m?s significativos se registr? en Kenia, donde hubo un cambio de 60 por ciento entre 2000 y 2005. Botsuana, Costa de Marfil, Etiop?a, Kenia, Malaui, Namibia y Zimbabue alcanzaron el objetivo acordado en 2001 para reducir la prevalencia entre las edades de 15 y 24 a?os en 25 por ciento para 2010, dijo. En Burundi, Lesotho, Ruanda, Suazilandia, Bahamas y Hait?, la meta es ?probablemente lograble?. El estudio hall? que los principales motores de las reducciones son los cambios en el comportamiento sexual. Los j?venes en 13 de los 25 pa?ses est?n esperando m?s tiempo antes de iniciar su vida sexual. En m?s de la mitad de los pa?ses tambi?n optan por tener menos parejas sexuales. El uso de condones tambi?n est? en alza, seg?n el estudio. Diez pa?ses informan de mayor uso de condones entre las mujeres y 13 de mayor empleo entre los hombres. Camer?n, Tanzania y Uganda reportaron aumentos en ambos sexos. Onusida dijo en noviembre que alrededor de 33.4 millones de personas est?n infectadas con el virus del sida en todo el mundo. (Reuters) *4* *ONU propone evitar un mill?n de nuevas infecciones de sida al a?o** **El Universal, Venezuela* 14/07/2010 Londres.- El programa de Naciones Unidas para el Sida, Onusida, dijo el martes que se podr?an evitar diez millones de muertes hasta 2025 y un mill?n de nuevas infecciones por a?o si los pa?ses adoptan un nuevo enfoque para cumplir con los objetivos para tratar la enfermedad, rese?? Reuters. El reporte de Onusida propuso un abordaje m?s simple para lidiar con el virus de inmunodeficiencia humana (VIH) que causa el sida, que asegur? podr?a reducir dr?sticamente el n?mero de muertes relacionadas con la infecci?n y ayudar a detener la transmisi?n. "Se trata de simplificar la manera como actualmente se suministran los tratamientos contra el VIH y aumentar el acceso a estas medicinas", dijo Michel Sidib?, director ejecutivo de Onusida, seg?n cita Efe. El 2.0 es un tratamiento que engloba iniciativas para la prevenci?n del VIH, nuevas pr?cticas para su detecci?n e innovadoras f?rmulas para crear f?rmacos m?s inocuos. Sidib? explic? que el 2.0 "reducir?a los costes de los tratamientos y el nivel t?xico de los antirretrovirales", combinaci?n, dijo, que "facilitar?a el acceso a las medicinas dr?sticamente". *5* *Cada vez m?s mujeres contraen el virus del sida** **La Naci?n, Argentina* 14/07/2010 Actualmente, ser mujer se convirti? en un factor de riesgo para contraer el virus de la inmunodeficiencia humana (VIH). Es que la tendencia de la epidemia en el mundo revela una "feminizaci?n" en los ?ltimos a?os. "Las mujeres somos m?s vulnerables", sostuvo ayer ante periodistas la doctora Mabel Bianco, presidenta de la Fundaci?n para el Estudio y la Investigaci?n de la Mujer (FEIM). Se refer?a, entre otros factores, a las diferencias anat?micas con los hombres. "El principal fluido despu?s de la sangre en cantidad de virus es el semen y las mujeres tenemos un continente mayor susceptible de contraer el virus en las relaciones sexuales, como es la vagina y la boca. En cambio, en las relaciones por v?a anal [el riesgo] es el mismo para las relaciones entre personas de distinto y el mismo sexo", explic?. Y las relaciones sexuales sin protecci?n son la causa del 87% de las infecciones femeninas, seg?n FEIM, que coordina la iniciativa internacional Women... Arise! (Mujeres... ?Arriba!). Esta red internacional de 35 ONG participar? la semana pr?xima de la XVIII Conferencia Internacional del Sida, en Viena. A trav?s de distintas acciones, tratar? de dar visibilidad a la inequidad de g?nero en la transmisi?n del VIH. "Est? alimentando la epidemia en el mundo", apunt? Bianco. Adem?s, reclamar? "que los gobiernos cumplan con sus compromisos" y que elaboren "programas de prevenci?n para mujeres y ni?as". En el pa?s, seg?n FEIM, las nuevas infecciones entre los 15 y 24 a?os son 1,2 veces m?s frecuentes en las mujeres que en los hombres, mientras que tambi?n est?n creciendo las infecciones en las mayores de 50 a?os. Fabiola Czubaj *6* *ONU informa que disminuye la incidencia de VIH entre los j?venes en ?frica* * **El Nacional, Venezuela* 13/07/2010 El n?mero de j?venes infectados con el VIH en Africa est? bajando en 16 de los 25 pa?ses m?s afectados por el virus, seg?n un nuevo informe de la agencia del sida de las Naciones Unidas. La cifra baj? por lo menos en un 25% en una docena de naciones, dijo el informe. En Kenia, la tasa de infecci?n entre personas de 15 a 24 a?os se redujo de un 14% en el 2000 al 5,4% en las ?reas rurales. La reducci?n en las tasas de VIH coincidi? con un cambio en el comportamiento sexual, como el de tener menos parejas sexuales o el aumento del uso del cond?n, dijo la agencia UNAIDS. Pero no pudo aclarar si el cambio se debi? a recientes pol?ticas de la ONU, que se han centrado mayormente en comprar remedios para el sida en vez de prevenir infecciones. Algunos expertos dijeron que el nuevo enfoque sobre la prevenci?n llegaba demasiado tarde. "Gracias a la falla estrat?gica de la ONU, muchas m?s personas est?n ahora infectadas que lo que habr?an estado si se hubiesen enfocado mucho antes en la prevenci?n", afirm? Philip Stevens, experto en pol?tica de salud en la International Policy Network. Los datos de UNAIDS se basaron en encuestas de poblaci?n y tienen un significativo margen de error. "Los j?venes han demostrado que pueden ser agentes de cambio en la revoluci?n para la prevenci?n (del sida)", dice la agencia en su informe. La investigaci?n confirma que el brote de sida lleg? a su m?xima incidencia hace m?s de una d?cada y que la enfermedad est? declinando. En un informe el a?o pasado, la agencia dijo que el n?mero de personas infectadas con el VIH no vari?, aproximadamente 33 millones, en los dos ?ltimos a?os. UNAIDS tambi?n pidi? m?s fondos para combatir la epidemia. En el 2008, el mundo gast? m?s de 15.000 millones de d?lares en la lucha contra el sida, aproximadamente la mitad de cuya cifra provino de Estados Unidos *7* *La ONU propone un nuevo enfoque para reducir los contagios y las muertes por VIH** **La Gaceta, Argentina* 14/07/2010 LONDRES.- El programa de Naciones Unidas para el sida dijo que se podr?an evitar 10 millones de muertes hasta 2025 y un mill?n de nuevas infecciones por a?o si los pa?ses adoptaran un nuevo enfoque para cumplir con los objetivos del tratamiento contra el mal. Onusida propuso un abordaje m?s simple para lidiar con el VIH que causa el sida, y asegur? que podr?a reducir dr?sticamente el n?mero de muertes relacionadas con la infecci?n y ayudar a detener la transmisi?n. El director ejecutivo de Onusida, Michel Sidib?, dijo en Ginebra al lanzar el informe 2010 que para que los pa?ses alcancen sus objetivos y compromisos de acceso universal, se debe remodelar la respuesta al Sida. "Mediante la innovaci?n podemos reducir costos; as? las inversiones podr?n llegar a m?s personas", agreg?. La innovaci?n a la que hizo referencia Sidib? es el Tratamiento 2.0, que implica un nuevo enfoque de la enfermedad y simplifica la forma en que se est? suministrando el tratamiento del VIH. Adem?s, ampl?a el acceso a medicamentos que pueden salvar vidas. Seg?n Onusida, mediante la combinaci?n de esfuerzos se podr?an reducir los costos del tratamiento, hacer que los reg?menes de este sean m?s simples e inteligentes, disminuir la carga de los sistemas sanitarios y mejorar la calidad de vida de los que viven con VIH y de sus familias. Los estudios de modelos sugieren que, en comparaci?n con los enfoques actuales, el Tratamiento 2.0 podr?a evitar unas 10 millones de muertes para 2025. Adem?s, el nuevo enfoque ser?a capaz de disminuir las infecciones por el VIH en m?s de un mill?n cada a?o. Para eso, los pa?ses deben suministrar terapias antirretrov?ricas a aquellos que las necesitan, en consonancia con las directrices de tratamiento revisadas de la OMS. En la actualidad, de los 15 millones de personas que los necesitan, s?lo cinco millones tienen acceso a medicamentos. Para obtener todos los beneficios del Tratamiento 2.0, Sidib? estima que es necesario crear mejores f?rmacos con poca toxicidad y formas de diagn?stico m?s f?ciles de utilizar, lo que reducir?a la carga de los sistemas sanitarios. Otro punto importante es usar el tratamiento como prevenci?n, ya que la terapia antirretroviral reduce el nivel del virus en el organismo. (Reuter-Especial) *8* *Brasil deve investir mais na preven??o da Aids, diz ONU ** **GazetaWeb, Brazil* 13/07/2010 Um relat?rio divulgado nesta ter?a-feira pela Unaids (Programa das Na??es Unidas para HIV/Aids) elogia a forma como o Brasil lida com a Aids, mas tamb?m sugere que o pa?s amplie seus investimentos na preven??o da doen?a. "O Brasil deveria aumentar os esfor?os para atingir o objetivo de acesso universal ? preven??o do HIV, considerando que menos de 7% do total de gastos com a Aids s?o destinados ? preven??o", diz o relat?rio Panorama Unaids 2010, publicado anualmente. O documento, que cita dados referentes ao ano de 2008, informa que o Brasil gastou, naquele ano, US$ 623 milh?es (cerca de R$ 1,1 bilh?o) com seu programa de Aids. O relat?rio afirma que, entre 2003 e 2008, um ter?o dos novos casos de Aids no Brasil foram diagnosticados nos ?ltimos est?gios da doen?a. "Ampliar os testes de Aids e os servi?os de acompanhamento para prevenir diagn?sticos tardios deve ser uma prioridade", diz o documento. "Com sua reputa??o em rela??o ao tratamento e sua abordagem em termos de direitos humanos, o Brasil continua estendendo sua lideran?a ao redor do mundo", afirma a Unaids, ressaltando, no entanto, que apenas 50% das mulheres gr?vidas soropositivas no Brasil t?m acessos a servi?os para prevenir a transmiss?o do HIV ao feto. "O n?mero de maternidades que efetivamente realizam esses servi?os de preven??o da transmiss?o da doen?a para a crian?a deveria aumentar, sobretudo em ?reas remotas, como a regi?o da Amaz?nia, no norte e no nordeste do pa?s." Soropositivos A ?ndia, que assumiu o compromisso de ampliar os esfor?os de preven??o, diz a Unaids, aloca 67% do or?amento de seu programa nacional de Aids para campanhas preventivas. Em quatro Estados indianos fortemente afetados pela doen?a, 80% dos profissionais do sexo j? se beneficiam de programas de preven??o. "Maiores esfor?os precisam ser feitos agora em rela??o aos usu?rios de drogas, homessexuais masculinos e transg?neros", diz o documento em rela??o ? ?ndia, que possui 2,4 milh?es de soropositivos. No Brasil, existem 630 mil pessoas contaminadas pela Aids. Os dados da ONU mostram que 33,4 milh?es de pessoas viviam com o v?rus HIV no mundo at? o final de 2008. No mesmo ano, foram registrados 2,7 milh?es de novos casos de infec??o e 2 milh?es de mortes causadas pela Aids. China e ?frica O Panorama Unaids 2010 analisa como as grandes economias emergentes, sobretudo os pa?ses do grupo BRIC (Brasil, R?ssia, ?ndia e China) podem atuar para interromper o aumento do n?mero de casos. O relat?rio tamb?m focaliza uma aten??o especial em rela??o ? ?frica do Sul. A China possui 740 mil soropositivos, segundo dados de 2009. O desafio no pa?s, diz a ONU, ? reverter a expans?o da doen?a, concentrada principalmente em cinco prov?ncias, que representam 53% do total de casos. "Os testes de HIV s?o poucos. A cobertura do tratamento antiretroviral e os servi?os de preven??o da transmiss?o da doen?a da m?e para o filho permanecem insuficientes" na China, afirma o relat?rio. O estudo tamb?m revela que a epidemia de Aids entre os jovens de 15 a 24 anos foi reduzida de maneira significativa em v?rios dos 25 pa?ses mais atingidos pela doen?a, situados na ?frica. Botswana, Costa do Marfim, Eti?pia, Qu?nia, Malaui, Nam?bia e Zimb?bue conseguiram atingir o objetivo de redu??o de 25% de incid?ncia do HIV entre os jovens, fixado pela ONU, diz o relat?rio *========================* *NORTH AMERICA* *========================* *U.N. moves toward quicker AIDS treatment in developing countries** **Los Angeles Times* 14/07/2010 Thomas H. Maugh II, Los Angeles Times The United Nations' agency in charge of AIDS policy is lowering the threshold for treating HIV-positive individuals in developing countries in the hope that earlier treatment will prevent hospitalizations and reduce related medical care costs, the organization said Tuesday. The announcement is part of a new report issued in advance of next week's international AIDS conference in Vienna, the biennial meeting at which researchers present the most recent AIDS research and policy decisions The agency currently requires that a patient's CD4 level, a measure of the severity of infection, fall below 200 cells per cubic millimeter before treatment is begun, but at that level patients often already have some AIDS symptoms. The agency will now allow treatment to begin once the level has fallen to 350, at which point the patient is still relatively healthy. Normal levels are 500 or higher. The agency is also developing a new therapeutic regimen, called Treatment 2.0, that will rely more heavily on combinations of drugs, rather than single drugs, as first-line therapy to block the progression of infections. It also will incorporate new, less expensive diagnostic tests to monitor infection levels and the progress of therapy. "We expect there might be a relatively minor increase in the need for additional funding ? but the resource needs for treatment will be lower over the next decade," Dr. Bernhard Schwartlander, UNAIDS' director for evidence strategy and results, said at a news conference. "Today, the majority of patients come to clinics when they are very, very sick. It's much, much cheaper and simpler to treat them before they get sick." The new treatment regimen is also expected to reduce new infections because patients with their infections under control by medication are much less likely to transmit the virus to sexual partners. The agency estimates that implementation of the program could prevent 10 million deaths and avert 1 million new infections by 2025. The rationale for the new approach is that the secondary costs of HIV treatment, including hospitalizations, monitoring and out-of-pocket expenses, are now twice as high as the cost of the drugs themselves. But implementing the approach will take time. Many existing drugs could be used in the program, Schwartlander said, but they would need to be combined into a single pill. That will require additional clinical trials and assessments of dose optimization, which could take the rest of the year, at least. New, simpler tests for monitoring HIV levels and overall health in patients are also becoming available, and UNAIDS is working with manufacturers to hasten their arrival, he said. "We expect to have the first products on the market for monitoring CD4 levels by the end of the year and for viral load testing by next year," he said. An estimated 33 million people worldwide are living with HIV infections. About 2.7 million people are newly infected each year and an estimated 2 million die from AIDS and its complications. About 5 million people in developing countries are receiving HIV medications, "a twelvefold increase in the past six years and up from almost nothing in 2002," Schwartlander said. But an additional 10 million are in need of therapy. To reach them in the immediate future will require boosting funding by about $10 billion from the current level of about $16 billion per year. UNAIDS is urging individual countries in Africa and elsewhere to contribute 0.5% to 3% of their government revenue to national HIV programs, Dr. Paul De Lay, deputy executive director of the UNAIDS program branch, said at the news conference. Even so, he added, "the majority of the most affected countries will continue to rely primarily on international assistance." One piece of good news in the report is that the infection rate among young people in the most severely affected countries is falling. Among 15 of those countries, the prevalence of HIV among young people ? the target group for most prevention campaigns ? has fallen 25%. "Young people are adopting safer sexual behaviors, including delaying their sexual debut, having fewer partners and using more condoms," De Lay said. thomas.maugh at latimes.com Copyright ? 2010, The Los Angeles Times *2* *Report: Youth leading Africa's war on AIDS** **CNN* 13/07/2010 AIDS is losing its stranglehold on a key demographic in Africa, according to a U.N. report released Tuesday, and it appears the driving force behind the trend is common sense. People between the ages of 15 and 24 are among the hardest-hit by sexually transmitted infections, and 80 percent (4 million) of young HIV patients live in sub-Saharan Africa, UNAIDS reports. Polls show that AIDS is among the foremost concerns of citizens living in many African countries, and if the U.N. data are accurate, teens and young adults in these countries have decided to reverse the trend. ?Young people are leading the prevention revolution by taking definitive action to protect themselves,? the report states. ?The impact: HIV prevalence among young people is falling in 16 of the 25 countries most affected by AIDS.? Read the report (PDF) Among the nations leading the way ? and raising hopes that they can slash their countries' 1994 AIDS rates among young people ? are Botswana, Ivory Coast, Ethiopia, Kenya, Malawi, Namibia and Zimbabwe. Kenya, according to the data, had one of the most significant decreases with rates in urban areas dropping from 14.2 percent in 2000 to 5.4 percent in 2005. Several behaviors are cited as the reason for the drop. In 13 countries, young people are waiting longer to have sex. Another 13 countries reported that young folks had fewer sexual partners in the last year. And while condom use by one gender or the other is up in several countries, Cameroon, Tanzania and Uganda reported increased condom use among men and women. ?For the first time, the report shows that reductions in HIV prevalence among young people have coincided with a change in sexual behaviors patterns among people,? according to the report, which calls declining HIV infections among young people ?a breakthrough essential for breaking the trajectory of the AIDS epidemic.? Read the report (PDF) Of the 25 countries that comprise the bulk, or 85 percent, of the world?s AIDS sufferers, 13 are located in Africa, according to another report by UNAIDS. It says young women ? who are twice as likely to contract HIV than young men ? are particularly vulnerable in sub-Saharan African. While China, India, South Africa and Nigeria require the most resources to fight AIDS, the two African nations face the greatest domestic shortfalls in what they can devote to the battle. The UNAIDS report, which coincides with the Obama administration?s unveiling of its domestic AIDS strategy, calls for empowering young people to continue the fight against AIDS. It also calls for rights-based health education and increased testing and prevention efforts. ?Young people have shown that they can be change agents in the prevention revolution,? the report concludes. *3* *AIDS Top List of Global Health Concerns** **Voice of America News* 13/07/2010 Lisa Schlein | Geneva A new international opinion poll shows AIDS tops the list of health concerns among people in countries in all regions of the world. The poll was conducted by UNAIDS and Zogby International before a major AIDS conference next week in Vienna. Nearly 30 years into the AIDS epidemic, the first of its kind poll on HIV finds people everywhere rank AIDS high on the list of the most important issues facing the world. UNAIDS Executive Director Michel Sidibe said about half the 12,000 poll respondents are optimistic that the spread of HIV can be stopped by 2015. "However, half of all the people surveyed say a lack of funding is an obstacle," said Sidibe. "And, more than 70 percent say resources should go to HIV-prevention. This highlights the importance of stopping new infections." The AIDS pandemic appears to have stabilized in most regions, although Eastern Europe and central Asia continue to have high rates of new HIV infections. UNAIDS officials say 57 percent of new infections in these regions are occurring among people injecting drugs. Sub-Saharan Africa remains the most heavily affected region, accounting for 71 percent of all new HIV infections. Sidibe said the worldwide response to AIDS is showing results, but the epidemic remains a serious problem. "We estimated that in 2008, there were 33.4 million people living with HIV around the world ... and two-million people died of AIDS-related illnesses," said Sidibe. The UNAIDS/ZOGBY opinion poll shows one in three people consider public awareness about AIDS to be the greatest achievement of the international efforts. This is followed by implementation of HIV prevention programs and the development of new anti-retroviral drugs. More than half of those surveyed consider the availability of prevention services to be the most important obstacle. Stigma and discrimination are cited as other barriers. In another significant finding, a new UNAIDS report shows HIV prevalence among young people is dropping in many key countries around the world, especially in parts of sub-Saharan Africa. Sidibe says the report shows there has been a 25-percent reduction of HIV infections in young people in 15 of the most affected countries. They include Botswana, Ethiopia, Kenya, Malawi, Namibia, Tanzania, Zambia and Zimbabwe. "These excellent results in this report have happened because young people are adopting safer behaviors, young people are choosing to have sex later, to have fewer partners and they are using condoms," said Sidibe. Five-million people living with HIV are receiving life-saving anti-retroviral treatment, but an additional 10 million are in need of treatment. UNAIDS says a better, cheaper, easier to use pill could save their lives and prevent one-million new HIV infections. *4* *Youth Put a Dent in AIDS Epidemic** **WebMD* 13/07/2010 By Denise Mann, WebMD Health News Reviewed by Laura J. Martin, MD July 13, 2010 -- Younger people across the globe, including those who live in Africa and other areas hard hit by AIDS, may be helping to ease the epidemic, a new study shows. There was a 25% reduction in HIV prevalence among 15 of the 25 countries most affected by AIDS, and this is largely due to behavior changes among younger people. Specifically, there have been declines in HIV prevalence among youths in the Ivory Coast, Ethiopia, Kenya, Malawi, Namibia, Tanzania, Zambia, and Zimbabwe. The data were reported during a UNAIDS-sponsored telebriefing that serves as a kickoff for the XVIII International Aids Conference in Vienna. UNAIDS is a joint United Nations program aimed at improving access to HIV prevention, treatment, care, and support. "There is a glimmer of hope that in countries where HIV/AIDS prevalence is high, young people are taking things in their own hands and watching out for themselves," says Mahesh Mahalingam, a spokesman for UNAIDS. "Young people are changing their behavior by having sex later, using condoms if they have more than one partner, or having fewer partners." For example, young people in 13 countries including Cameroon and Malawai are waiting longer to have sex for the first time, and younger people are having fewer sexual partners and are more likely to use condoms in 13 countries, the study showed. "We have come a long way, but there is still so much more to go," he tells WebMD. Today, more than 5 million people are on treatment, which is 12 times more than there was six years, but the goal is to get 15 million people treated to avert 10 million deaths by 2025, he says. A new survey also released by UNAIDS shows that individuals do think this is possible. More than 90% of people feel that AIDS is still one of the most important public health issues facing the world, and the majority believe that the epidemic can be pushed back by 2015. The new survey included information from 12,000 adults in 25 countries. "Our main achievement is awareness of HIV, but the flip side is that just one in three people believe that the world is responding effectively to AIDS," Mahalinghan says. About 41% of countries said they thought their country was dealing effectively with HIV/AIDS, the new survey showed. "HIV is still an epidemic to watch out for, and we must continue to invest," he says Future AIDS Treatment Part of the plan involves the creation of a "dream" pill, explains for evidence strategy and results in the UNAIDS Program Branch, in a conference call. A combination pill would simplify the current treatment regimen, improving access to care, he says. "We already do have drugs that, if used in different combinations, could get us closer to an ideal pill that is resistance proof, and highly efficient, but further clinical studies are needed and will take another year or two," he says. "It will not be available tomorrow even though individual substances may be here," he explains. HIV drug resistance occurs when the virus changes so that a drug is no longer effective against HIV. "A fixed-dose combination pill may be more expensive, but prices will go down because you will not need hospital stays, so the initial treatment will be cheaper and scaling up treatment will have a significant prevention dividend," adds Paul DeLay, the deputy executive director of UNAIDS. The group also called for more funding. In 2010, $26.8 billion will be required to make all of this happen. *5* *In South Asia, Efforts to Halt Spread of HIV Make Headway** **Voice of America News* 13/07/2010 Anjana Pasricha | New Delhi A quarter century after the first HIV cases were detected in India, efforts to halt the spread of the virus are making headway in South Asia. But ignorance and stigma surrounding the disease still remain major stumbling blocks in a region where poverty and illiteracy are widespread. Outreach program brings about awareness Thousands of people from villages and towns in Assam, turned up to see what the seven-coach 'Red Ribbon Express' train had to offer, as it chugged across the remote north eastern state earlier this month. The train, which has counseling and medical services, and a troupe of artists on board, is traveling across India to sensitize people about HIV. Rakhi Chakraborty is assistant director of the Assam AIDS Control Society. She says exhibits on the train, street plays and other programs demonstrate how the virus is contracted and transmitted, as well as what treatments are available. "So many people visited and those people, they really took interest. They have seen the whole train. They asked so many questions. There were so many people who came for counseling voluntarily. They came for testing also," Chakraborty said. Targeted population For a quarter century after the first HIV cases were diagnosed in India, populous cities such as Delhi, Mumbai and Chennai were the epicenter of the battle against AIDS. Here, prevention programs targeted the most vulnerable groups such as sex workers, truckers and migrant labor. But, as the virus spreads through the heart of the country, initiatives such as the 'Red Ribbon Express' are trying to end ignorance or overcome stigma attached to AIDS in remote areas and villages. South Asia has an estimated three million people living with the AIDS virus. A majority of them are in the region's most populous country, India, which has the third largest number of people living with HIV in the world, after South Africa and Nigeria. After a slow start in tackling HIV, India began making serious efforts to confront the problem in recent years. These efforts have yielded dividends, especially in southern states where prevalence was the highest. Program Coordinator Asa Andersson, at UNAIDS in New Delhi, says there is a "decreasing trend" in the prevalence of AIDS. "We can say that the epidemic is stabilizing and in certain parts also decreasing. So you see a declining rate of HIV prevalence in the country, so in that sense I think it is positive," he said. Positive strides apparent, but warning against complacency However, health workers warn against complacency. They say that, although fears that HIV would spiral out of control have ebbed, serious challenges remain. Suniti Solomon, has been on the frontlines of the fight against AIDS since 1986, when she helped detect India's first HIV cases in the southern state, Tamil Nadu. Solomon says the profile of the patients at the center she runs for HIV patients in Chennai has changed. Earlier, a majority of her patients were truckers and sex workers. Now they are injecting drug users and men having sex with men. India recently scrapped a law outlawing homosexuality. But even now, Solomon says many men prefer not to talk about their sexual preferences. "In India they won't come and tell you they are gay," Solomon said. "Gay people are getting married and they lead a bisexual life. So to get a history out of them is very difficult, but we try our best. Unfortunately they also transmit the virus to their partners, that is their wives and, then, on to their children." Extending prevention program to include more groups Asa Andersson at UNAIDS says India needs to target more prevention and treatment programs at groups where the incidence of HIV is still a big concern, such as injecting drug users, young female sex workers and homosexuals. "Where they need to focus more is of course to increase the coverage among these groups," Andersson says. "I think the crucial heart to reach among the population, among this group, need further attention." For many volunteers involved in the fight against AIDS, the most important concern has not changed since the first HIV case came to light -- the need to cajole more people to determine if they carry the AIDS virus. Suniti Solomon says about half the people living with HIV are not even aware of it. "Most important, I think they should focus on voluntary counseling, testing. Though India has about 4,000 voluntary counseling, testing centers all over the country, very few really come up, because of stigma again to have a test done," Solomon said. "So I think it should be a community mobilization to help people to come up for testing." That is exactly what the 'Red Ribbon Express' hopes to do, as it winds its way through the country for the rest of the year. *6* *10 million HIV-AIDS deaths preventable by 2025, UN says** **Globe and Mail, Canada* 13/07/2010 Andr? Picard Public Health Reporter At least 10 million HIV-AIDS deaths could be averted by 2025, but doing so requires a dramatic expansion and simplification of treatment, the man leading the international fight against the epidemic says. ?We must reshape the AIDS response,? said Michel Sidib?, executive director of UNAIDS, the United Nations Program on HIV-AIDS. That new approach, dubbed Treatment 2.0, calls for 15 million people worldwide to be treated with antiretroviral drugs that can slow the progression of HIV-AIDS symptoms ? up from the five million currently undergoing treatment. Mr. Sidib? said that ramping up treatment efforts requires several innovations, including; ? A better pill: Current treatments can be quite toxic and patients develop resistance. UNAIDS hopes to develop a ?resistance-proof? medication, ideally a one-pill-a-day format; ? Better diagnostics: More than two-thirds of current treatment costs go to testing and monitoring of patients; cheaper, easy-to-use tests for viral load and CD4 count are being developed; ? Viewing treatment as a key prevention tool: Patients being treated with antiretrovirals are far less likely to transmit the virus; UNAIDS estimates that one million new infections a year would be averted if everyone was treated early. UNAIDS officials conceded that implementing Treatment 2.0 would not be cheap: Treating 15 million people worldwide would cost an estimated $26-billion each year, even if the costs of testing are reduced. Currently, about $16-billion is being spent on HIV-AIDS drug programs. ?We?re $10-billion short a year,? said Paul De Lay, deputy executive director of UNAIDS. He said getting those additional funds will not be easy in tough economic times but insisted that it is a good investment because the number of HIV-AIDS cases will fall and treatment costs will be reduced sharply. ?Investments in prevention pay results,? Mr. De Lay said. Bill Gates, co-chairman of the Bill & Melinda Gates Foundation, said he endorsed the thrust of the new approach but it would take time to implement. ?Realistically, for the next few years, funding will not be going up and that?s a real constraint,? he said in a teleconference. ?We?re not going to be able to treat everyone with HIV.? Mr. Gates said the financial pressures make innovation and efficiency all the more important in the field of HIV-AIDS. ?There is a real opportunity to drive efficiency and better spending on the prevention side,? he said. For example, Mr. Gates said the best bang-for-the-buck can come from promoting circumcision in sub-Saharan Africa, the epicenter of the pandemic. He said prevention programs should also be more targeted at high-risk groups in specific countries, such as commercial sex workers in India and intravenous drug users in China. There were an estimated 33.4 million people in the world living with HIV-AIDS at the end of 2008. In the same year, there were an estimated 2.7 million new infections and two million AIDS-related deaths, according to UNAIDS. Bernard Schwartlander, chief epidemiologist at UNAIDS, said that while much work remains to be done, it is important to recognize how much progress has been made in recent years. For example, five million people are now taking antiretrovirals in the developing world, up from ?almost nothing? in 2002. In 15 of 25 of the hardest-hit countries, the prevalence of HIV-AIDS has fallen by 25 per cent or more in the past decade, Dr. Schwartlander noted. UNAIDS recommends that countries spend between 0.5 per cent and 3 per cent of their government revenues on their response to HIV-AIDS, but few countries meet that target. *7* *Obama promises commitment to combating HIV/AIDS** **Associated Press* 13/07/2010 *Story carried by Washington Post* By JULIE PACE WASHINGTON -- President Barack Obama said Tuesday a new strategy for combating HIV and AIDS fulfills America's obligation to stopping the spread of the virus and rooting out the inequities and attitudes on which it thrives. The strategy sets a goal of reducing new infections by 25 percent over the next five years; getting treatment for 85 percent of patients within three months of their diagnosis; and increasing education about the virus, even in communities with low rates of infection. "Fighting HIV/AIDS in America and around the world will require more than just fighting the virus," Obama said at a White House reception honoring the work of those in the HIV and AIDS community. "It will require a broader effort to make life more just and equitable." While medical breakthroughs have greatly improved quality of life for the 1.1 million Americans living with HIV, the U.S. has struggled to lower the rate of new infections. The new strategy sets a goal of reducing new infections by 25 percent over the next five years. About 56,000 people in the U.S. become infected each year, a rate that has held steady for about a decade. "We've been keeping pace when we should be gaining ground," said Health and Human Services Secretary Kathleen Sebelius at a separate event unveiling the strategy earlier in the day. Part of the strategy for lowering new infections relies on targeting HIV prevention efforts at the highest-risk populations, which include gay and bisexual men as well as black Americans, far more than is done today. That means finding creative ways to spread successful local programs that help HIV-negative people stay that way, as well as providing education and treatment for people who are living with HIV to reduce their chances of spreading the virus, said Chris Collins of the Foundation for AIDS Research, one of the many groups who advised administration officials during the months-long process of devising the strategy. The administration is allocating $30 million from the massive health care overhaul Congress passed earlier this year toward implementation of the new plan. Some AIDS activists criticized the plan for not setting more ambitious goals and for not funding the benchmarks it lays out. "The president's plan is so flawed that it might actually represent a step backwards in combating HIV and AIDS in the United States," said Charles King, president of Housing Works, a community-based AIDS organization. The strategy aims to copy some of the steps credited with spurring the success of a Bush administration policy to fight AIDS in hard-hit developing countries. That includes setting specific targets and mandating coordination among different government agencies to guard against missteps and wasted, duplicated efforts. "We've never had that kind of coordinated, accountable effort to address AIDS in America, and that's what we need," Collins said. There is a new HIV infection every 9 1/2 minutes in the U.S. But about one of every five people living with HIV doesn't know it. Access to care plays a role in prevention, too, because the more virus in someone's bloodstream, the easier it is for that person to spread infection through such things as unprotected sex. In one step toward reducing disparities in access to care, the Obama administration on Friday reallocated $25 million to states that have waiting lists for their AIDS Drug Assistance Programs, which provide treatment help for the uninsured and underinsured. The National Alliance of State & Territorial AIDS Directors reported that more than 2,200 people in 12 states were on waiting lists for ADAP help as of last week. --- AP Medical Writer Lauran Neergaard contributed to this report. *8* *Young People Delay Sex, Help Stem New HIV Infections** **Bloomberg Business Week* 13/07/2010 July 13 (Bloomberg) -- Young people in the countries most ravaged by AIDS are opting to delay sexual activity and have fewer partners, helping stem the rate of new HIV infections, a report shows. Infections among young people have fallen by more than 25 percent in 15 of the 25 countries most affected by the AIDS- causing virus, according to the report published by United Nations today. ?Young people are adopting safer behaviors,? Michel Sidibe, executive director of the UNAIDS program, said in a telephone interview today. ?Young people are choosing, for example, to have sex later and to have fewer partners.? The prevalence of HIV among pregnant women aged 15 to 24 fell 60 percent in Kenya between 2000 and 2005, UNAIDS said in the report. Prevalence declined 56 percent in urban areas of Malawi and Ivory Coast, and by half in Burundi and Haiti. Young pregnant women are considered an indicator of the trend among young people generally, UNAIDS said. About 5 million people between the ages of 15 and 24 are living with HIV, of which 80 percent live in sub-Saharan Africa, according to the report. AIDS kills about 2 million people each year, making it the most deadly infectious disease. Providing treatment to all people who need it would help avoid 10 million AIDS-related deaths by 2025, and prevent 1 million new infections a year, according to the report. --Editors: Kristen Hallam, Marthe Fourcade To contact the reporter on this story: Simeon Bennett in Singapore at sbennett9 at bloomberg.net To contact the editor responsible for this story: Jason Gale at j.gale at bloomberg.net. *9* *UN: HIV among young people going down in Africa** **Associated Press* 13/07/2010 *Story carried by Washington Post* By MARIA CHENG LONDON ? The number of young people infected with HIV in Africa is falling in 16 of the 25 countries hardest hit by the virus, according to a new report by a U.N. agency. The number of young people infected with HIV dropped by at least 25 percent in a dozen countries, the U.N. AIDS report said. In Kenya, the infection rate among people aged 15 to 24 fell from about 14 percent in 2000 to 5.4 percent in urban areas. The drop in HIV rates coincided with a change in sexual behavior, like having fewer sexual partners or increased condom used, UNAIDS said. But the agency could not say the drop was because of recent U.N. policies, which have mainly focused on buying AIDS drugs rather than preventing infections. Some experts said new focus on prevention was too little, too late. "Thanks to the U.N.'s strategic blunder, many more people are now infected than would have otherwise been the case had they focused on prevention much earlier," said Philip Stevens, a health policy expert at International Policy Network. The UNAIDS data were based on population surveys and mathematical modeling, and come with a significant margin of error. "Young people have shown that they can be change agents in the (AIDS) prevention revolution," UNAIDS wrote in its report. The research provides further evidence the AIDS outbreak peaked more than a decade ago and that the disease is on the decline. In a report last year, the agency said the number of people infected with HIV had remained unchanged ? at about 33 million ? for the last two years. UNAIDS also called for more money to combat the epidemic. In 2008, the world spent more than $15 billion on AIDS, with about half of that coming from the United States. In its report, UNAIDS said that "what's been good for the AIDS response has been good for global health in general." But a study published last month found there was little correlation between U.S. money spent on AIDS and improvements in other health areas across Africa. UNAIDS called for countries to invest more in their own HIV programs. It noted South Africa and Nigeria, two of Africa's wealthiest countries, receive the most money from international donors. Stevens said that while some recent AIDS investments ? like putting more people on drugs ? have clearly saved lives, it has also distorted health spending. Despite only causing 4 percent of deaths, AIDS gets about 20 cents of every public health dollar. "The same amount of money that we spend on AIDS could save many, many more lives more cheaply by vaccinating children or distributing cheap treatments for diarrhea," he said. "Aid agencies have a responsibility to ensure they save the most lives possible with the amount of money they have available," he said. "Spending the lion's share on HIV clearly does not do that." AP Medical Writer Marilynn Marchione contributed from Milwaukee. Online: http://www.unaids.org Copyright ? 2010 The Associated Press. All rights reserved. *10* *Obama details national HIV plan** **Philadelphia Inquirer* 14/07/2010 By Noam N. Levey, Chicago Tribune WASHINGTON - President Obama acknowledged an uncomfortable reality as he announced the nation's first comprehensive national HIV/AIDS strategy at a White House ceremony Tuesday: While the United States has made tremendous gains treating people infected with the virus, efforts to prevent the spread of the disease have continued to lag. Even as the federal government spent tens of billions of dollars to develop and administer new drugs for HIV patients, the number of new people infected every year has remained virtually unchanged for a decade. An estimated 1.1 million Americans are living with HIV, the virus that causes AIDS, with 56,000 new infections annually. "We are keeping pace when we should be gaining ground," Secretary of Health and Human Services Kathleen Sebelius said Tuesday at the White House. The strategy sets a goal of reducing new infections by 25 percent over the next five years; getting treatment for 85 percent of patients within three months of their diagnosis; and increasing education about the virus, even in communities with low rates of infection. "Fighting HIV/AIDS in America and around the world will require more than just fighting the virus," Obama said at a White House reception honoring the work of those in the HIV and AIDS community. "It will require a broader effort to make life more just and equitable." The plan includes more than 100 specific directives to federal agencies to develop standards for assessing prevention programs, build new education campaigns for ethnic communities, step up screening of federal prisoners, and take scores of other steps over the next year and a half to meet the new goals. Georges C. Benjamin, executive director of the American Public Health Association, called the new national strategy "a lifesaving public-health intervention," echoing widespread praise for the new strategy. For many who have been laboring to control HIV/AIDS, the specific steps are particularly welcome after years of disappointing progress. "It outlines these really important points in curbing this epidemic," said Nurit Shein, executive director of the Mazzoni Center, a treatment organization in Philadelphia: "reducing rates of infection, [increasing] access to care, minimizing the stigma, and tailoring prevention" to high-risk groups. American public-health efforts in the 1980s and early '90s helped dramatically cut new infections by more than half. But there are now slightly more new infections a year than there were in the early '90s, when they bottomed out at about 49,000 a year, the Centers for Disease Control and Prevention estimates. And an estimated one person in five infected with HIV today does not know it - a rate the new strategy aims to cut in half by 2015. Particularly disturbing to many activists has been the persistently high infection rates among gay and bisexual men, who account for more than half of all new infections, and among African Americans. Black men and women account for 46 percent of people living with HIV, though they represent just 13 percent of the population, according to the CDC. Infection rates for black men are particularly high in Philadelphia, where heterosexual black women also are infected at higher rates than nationally. "I am ecstatic that our nation finally has a real comprehensive HIV strategy," said Gary J. Bell, executive director of Bebashi, an AIDS services organization in the city's African American community. "Unfortunately at times the issue of HIV has been hijacked by special interests who thought it was a gay disease, to those who thought abstinence was the only strategy, to those who thought that money shouldn't be going toward the issue at all." The strategy aims to copy some of the steps credited with spurring the success of a Bush administration policy to fight AIDS in hard-hit developing countries. That includes setting specific targets and mandating coordination among different government agencies to guard against missteps and wasted, duplicated efforts. "We've never had that kind of coordinated, accountable effort to address AIDS in America, and that's what we need," said Chris Collins of the Foundation for AIDS Research, one of the many groups who advised administration officials during the months-long process of devising the strategy. But many experts say the prevention efforts have not kept pace with the development of powerful new drugs that allow many people with HIV to live relatively normal lives. Part of the challenge, they said, is the very success produced by medical breakthroughs, which has led to less vigilance about, for example, avoiding unprotected sex. Many also feel that prevention is underfunded. An estimated 4 percent of the federal government's $19 billion domestic HIV/AIDS budget goes to prevention. And while the administration is allocating $30 million from the massive health-care overhaul Congress passed earlier this year toward implementation of the new plan, cities and states around the country have been cutting prevention funding in attempts to balance their budgets. While most AIDS advocates applauded Obama's new plan, they were also realistic. "I think it's a beginning. I don't think it's enough, but I think it is setting us in the right direction to curb this epidemic," said Shein of the Mazzoni Center, which provides health services to Philadelphia's gay, lesbian, bisexual, and transgender community. -------------------------------------------------------------------------------- Staff writer Brooke Minters contributed to this article, which also contains material from the Associated Press. *========================* *UNAIDS WEB.SITE* *========================* European Parliament votes for rights-based AIDS response *UNAIDS* 14/07/2010 In the lead up to the 2010 International AIDS Conference in Vienna, the European Parliament has voted on a Motion for a Resolution on a rights-based approach to the EU's response to HIV. Referring to the UNAIDS Outcome Framework 2009-2011, the Resolution strongly supports the Joint Programme's position on human rights issues such as decriminalization of sexual transmission, injecting drug users and on men who have sex with men. Passed by an overwhelming majority of members on 8 July 2010, the Resolution also asks EU member states to meet their commitments as well as to step up efforts in addressing HIV as a global public health priority with human rights as central to its prevention, treatment, care and support, including in EU development cooperation. The XVIII International AIDS Conference which starts in Vienna on 18 July 2010 will run under the theme of human rights: ?Rights Here, Right Now.? Vice-President and High Representative of the European Union, Ms Catherine Ashton, made a strong statement to the Members of the Parliament in support of the Resolution: ?I am confident that the Vienna Conference will help us to move forward in enforcing the rights of people to be protected against avoidable HIV infections and in gaining access to the evidence-based prevention and highly efficient treatment that so many honourable Members have referred to this evening.? She also gave a personal commitment to ensure its effective implementation by the European Commission, saying, ?I want to assure you as well that we will maintain and increase our dedication to defending these rights inside Europe, but also as part of our relations with third countries whether they are close to our borders or on other continents. The Resolution calls on the European Commission and the Council to promote efforts to decriminalise HIV transmission and exposure and to support harm reduction programmes for prisoners and injecting drug users. Recognizing that addressing women?s needs was an essential measure for curbing the epidemic, the Resolution also calls for expanding access to sexual and reproductive health care programmes. It also called for member states to promote best policies and practices in the political dialogue at global and country-level regarding rights-based responses to HIV and calls on the Commission and the Council to work with UNAIDS and other partners to improve indicators for measuring progress at global, national and at programmatic level to reduce HIV-related stigma and discrimination, including indicators specific to key populations. UNAIDS urges the removal of all punitive laws, policies, practices, stigma and discrimination that block effective responses to AIDS including in the areas of sex work, travel restrictions, homophobia and criminalization of HIV transmission. With an estimated 33.4 million people living with HIV globally and 2.7 million newly infected in 2008, countries continue to rank AIDS high on the list of the most important issues facing the world -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100715/07d3d86d/attachment-0010.html From hivtwg.moderator at gmail.com Thu Jul 15 03:06:26 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Thu, 15 Jul 2010 09:06:26 +0700 Subject: [hivaids-twg] Intervene now to slow nascent AIDS epidemic [about Middle East and Northern Africa - MENA] In-Reply-To: <7E74E816-BBDC-481E-8DEE-3399CC4E86FE@revisionasia.com> References: <7E74E816-BBDC-481E-8DEE-3399CC4E86FE@revisionasia.com> Message-ID: From: Paul Causey Date: Wed, Jul 14, 2010 at 3:53 PM Subject: [msm-asia] Intervene now to slow nascent AIDS epidemic [about Middle East and Northern Africa - MENA] To: MSM-Asia Newgroup [Not dissimilar from parts of Asia Pacific?] Intervene now to slow nascent AIDS epidemic Increased testing, counseling, and treatment services are immediately needed for those most at risk of contracting HIV/AIDS in the Middle East and North Africa. While the prevalence of HIV/AIDS is low in the region's general population, the fraction of people who have the disease but have not yet been diagnosed is high. CORNELL (US)?With the exceptions of Djibouti, Somalia and Southern Sudan, HIV transmission in the Middle East and North Africa (MENA) is among the lowest worldwide. But pockets of higher transmission exist in specific populations, including networks and contacts of injecting drug users, men who have sex with men, and female sex workers and their clients, according to the region?s first large-scale study on HIV and AIDS. ?We are no longer in the dark in terms of HIV spread in MENA,? says Laith Abu-Raddad, assistant professor of public health at Cornell University and co-author of a new study, presented recently at a policy dialogue in Dubai, United Arab Emirates.. ?After nearly seven years of research, we have at last a comprehensive view of the status of the epidemic in this region and of the populations and countries most affected by this disease. ?The road map for what needs to be addressed in relation to HIV in MENA is now clear.? The study calls for increased testing, counseling, and treatment services for the most at-risk populations. Since the epidemic among these groups is still in its infant stage, there is a window of opportunity to address it before it grows potentially steeply in some of the most at-risk populations. While the prevalence of HIV/AIDS is low in the region?s general population, Abu-Raddad says, the fraction of people who have the disease but have not yet been diagnosed is high. ?Stigma associated with HIV/AIDS is a barrier to HIV testing in this region, but this is only one of the barriers,? he explains. ?The fundamental barriers remain the limited HIV response at the country level and the lack of cohesion of HIV efforts at the country and regional levels.? Other key findings of the report include: * While overall there is no considerable HIV transmission in the general population of MENA, substantial epidemics have emerged in the last decade among networks and contacts of injecting drug users, men who have sex with men, and female sex workers and their clients. Men practice most of the high-risk behaviors, and the majority of women acquire their infection from their infected spouses. * HIV prevalence among injecting drug users range between 0 and 38 percent, reaching higher rates among certain select injecting populations. Levels of sharing of non-sterile injecting equipment are high among injecting drug users, increasing the risk of HIV transmission. * While HIV prevalence among men who have sex with men in the region still remains lower than in other regions (between 0 and 28 percent), several countries are experiencing rising epidemics among this group. By 2008, sexual transmission between men accounted for an increasing number of the total HIV infections in several countries. Men who have sex with men in the region appear to engage in high levels of risk behavior such as multiple sexual partnerships, high levels of male sex work and low rates of consistent condom use. * Female sex work in MENA is lower than in other regions, and HIV prevalence among female sex workers and their clients is still at relatively low levels in most MENA countries (though at levels much higher than in the general population). * Large epidemics among female sex workers are found mainly in Djibouti, Somalia and Southern Sudan. The report was produced by the World Bank, the World Health Organization, and the Joint United Nations Programme on HIV/AIDS. -- -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100715/8264a753/attachment-0010.html From hivtwg.moderator at gmail.com Thu Jul 15 03:07:53 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Thu, 15 Jul 2010 09:07:53 +0700 Subject: [hivaids-twg] Pukaar is now available online In-Reply-To: <901592.52292.qm@web8805.mail.in.yahoo.com> References: <901592.52292.qm@web8805.mail.in.yahoo.com> Message-ID: From: javed abbas Date: Wed, Jul 14, 2010 at 2:20 PM Subject: [msm-asia] Pukaar is now available online To: msm asia Dear all, The latest edition of Pukaar (July 2010, Issue No 70) the NFI?s quarterly journal focusing on Asian male sexualities and wellbeing is now available on our website, *Contents include: * - APCOM governing board meeting - Launch of the Global Commission on HIV and the Law - Homophobia in Indonesia on the rise - Hostility flies in the face of true Koranic teaching - International Day Against Homophobia and Transphobia - Punitive and discriminatory laws - Bihar's shotgun weddings - MSM and mental health - MSM and transgenders right to health - Homophobia in the age of AIDS - The case of the third gender - ESCAP regional call for action to achieve Universal Access - India's gays happy to remain in the closet - Sexuality, citizenship and sexual rights - Part One Please go to http://www.nfi.net/Jul10Pukaar.pdf to get the online version. Thanks With Regards, Javed abbas Knowledge and Resource Centre NFI South Asia Programme Office Email: javed at nfi.net Website: www.nfi.net -- -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100715/66e02af1/attachment-0010.html From hivtwg.moderator at gmail.com Fri Jul 16 03:03:16 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Fri, 16 Jul 2010 09:03:16 +0700 Subject: [hivaids-twg] Today's News (2010.07.15ex)-China - University students to take AIDS test Message-ID: From: Diaz, Clara Date: Thu, Jul 15, 2010 at 7:41 PM Subject: Today's News (2010.07.15ex) To: Please find attached the following AIDS-related articles compiled by UNAIDS *UNAIDS* 1. AFP - *China**'s AIDS activists face uphill struggle* 2. Le Figaro - *Sida: les derniers chiffres (Onusida) * 3. Afrique en ligne - *Sant?: La port?e d'un nouveau traitement du VIH-SIDA * 4. Siglo XXI, Guatemala - *Urgen fortalecer vigilancia del sida * *AFRICA** AND MIDDLE EAST* 1. BuaNews, SA - *Motlanthe to Attend Intl Aids Conference * 2. Somaliland Press - *Djibouti**: Aids fight targets Ethiopian truckers along the borders * 3. Arab News - *Dr. Sana to head HIV/AIDS program * *ASIA** AND PACIFIC* 1. Xinhua News, China - *University students to take AIDS test * 2. Xinhua News, China - *HIV, AIDS, TB pose threat to tribals in heartland India * 3. Post-Courier, PNG - *Bank South Pacific embraces fight against HIV/AIDS in PNG* *EUROPE*** 1. AFP - *'Significant advances' made towards AIDS vaccine * 2. AFP - *New phase in global AIDS battle* 3. AFP - *HIV: Top medical journal blasts Russia over drug users * 4. AFP - *Traitements contre le sida: les pays riches rappel?s ? leurs engagements * 5. Financial Times, UK - *Aids prognosis uncertain in New Delhi* *LATIN AMERICA AND CARIBBEAN* 1. Milenio, Mexico - *Buscar?n dar confidencialidad a pruebas de Sida en Tamaulipas * 2. El Colombiano - *Altas cifras de Sida en el pa?s * *NORTH AMERICA* 1. Newsweek - *Obama?s New Effort to Curb the Spread of HIV/AIDS * 2. Washington Post - *Death Rate From HIV Falls 75% With Early Treatment, Study Finds* 3. Washington Post - *A national battle plan against HIV/AIDS* 4. New York Times - *AIDS Agency Gets a New Home, and a Founder?s Ire* 5. New York Times - *Revolution? Da. Sexual? Nyet.* 6. Huffington Post - *Our Baffling New National AIDS Plan * 7. Boston Globe - *State proposal is not the answer * =========================== *UNAIDS* =========================== *China's AIDS activists face uphill struggle** **AFP* 14/07/2010 By Marianne Barriaux BEIJING ? Wan Yanhai, China's top AIDS activist, said he suffered years of harassment from authorities which eventually came to a head earlier this year when he fled to the United States with his family. He is just one of the nation's AIDS campaigners who face ongoing pressure -- a situation that is hampering China's efforts to improve HIV prevention and control, activists and experts say. "The situation for AIDS activists is really not hopeful," said Lan Yujiao, one of the staff members of Wan's organisation Aizhixing who remains in Beijing to continue his work. "And I don't think this situation will change any time soon," she told AFP. China says that at least 740,000 people are living with HIV, but campaigners say the actual figure could be far higher. The head of UNAIDS, Michel Sidibe, warned last year that 50 million people in the country were at risk of contracting the AIDS virus, mainly through unprotected sex or the sharing of needles. Faced with this problem, the government has started talking more openly about HIV prevention and control in China, where people with AIDS still encounter huge discrimination in employment, education and healthcare. In 2007, China allowed the first TV ad campaign promoting the use of condoms and last year, the health ministry and the United Nations launched an ad against HIV discrimination featuring basketball star Yao Ming. This April, China announced it had lifted a longstanding ban on HIV-positive foreigners entering the country, in a move applauded by UN Secretary General Ban Ki-moon and the World Health Organisation. But the hassling of some independent campaigners and organisations -- a theme likely to be discussed at the six-day International AIDS conference opening in Vienna on Sunday -- has nevertheless continued. Like Wan, high-profile AIDS activist Gao Yaojie left China for the United States last year due to ongoing pressure. AIDS campaigner Hu Jia was sentenced to more than three years in prison in 2008 on subversion charges. Wan told AFP in May that he fled China because he feared for his safety. He said he had been under constant pressure from police, tax authorities and other government departments until his departure. In the past, he had been detained several times or placed under police surveillance for his activities. "Look at Mrs Gao and Mr Wan... who threw themselves into AIDS prevention work very early on. They faced huge pressure -- they were monitored, harassed, and they had no alternative but to leave China," said Lan. Following Wan's departure, Aizhixing continues to face obstacles. According to its website, police threatened the group's temporary leader in June and told him he could be arrested at any moment if he continued his involvement in the organisation. Last week, Aizhixing was due to screen a documentary on a student living with HIV but the show was postponed after police interviewed staff, citing a need to "maintain stability" as a reason for the questioning, Lan said. Joe Amon, head of the health and human rights division of Human Rights Watch, says civil society groups are crucial for HIV prevention work among high-risk people such as drug users or sex workers who distrust the government. "By preventing NGOs and activists from having a voice, the government is essentially cutting off those most at risk from information and services critical to both prevention and treatment," he said. Experts say part of the problem lies in Beijing's distrust of independent organisations -- an issue the health ministry and civil society representatives tried to address this month by pledging to work together on AIDS. "The challenge you have in China is that whilst the Ministry of Health is inching towards engagement with civil society, that's not necessarily true of the government as a whole," said Mark Heywood, an adviser to UNAIDS. "One arm of government in the health department doesn't seem to be working with another arm of government in public security, so there's a pattern of harassment with NGOs like Aizhixing and that's not good." Heywood added that the government was uncomfortable with the advocacy role of some non-governmental organisations and activists who drew attention to issues such as corruption and drug shortages. Aizhixing's Lan agreed, saying: "I think that we maintain an attitude of independent criticism, and they don't want to see that." And according to Heywood, prominent groups such as Aizhixing are not alone. "Many of the organisations that I've worked with tell similar tales... being informed that they can't hold a meeting or being approached by the police to explain particular activities," he said. Still, Corinna-Barbara Francis, a London-based China researcher for Amnesty International, said that an increasing number of these grassroots groups were being allowed to operate in China. "To the extent that they don't take on a high profile... they tend to be left to operate. But they have very few resources and if they try to push the boundaries, then they get into trouble," she said. Copyright ? 2010 AFP. All rights reserved *5* *Sida: les derniers chiffres (Onusida) ** **Le Figaro* 15/07/2010 AFP - Voici les chiffres sur l'?pid?mie de sida dans le monde fournis par l'Onusida dans son dernier rapport annuel, publi? en 2009 et portant sur l'ann?e 2008. L'organisme onusien y a ajout? des donn?es concernant les jeunes ? la veille de la 18?me Conf?rence internationale sur le sida (18-23 juillet ? Vienne). - PERSONNES INFECTEEES PAR LE VIRUS : Le virus a infect? 2,7 millions de personnes en 2008, soit une baisse de 17% depuis 2001. Environ 33,4 millions de personnes, dont pr?s de la moiti? de femmes, vivaient en 2008 avec le virus, dont 2,1 millions d'enfants ?g?s de moins de 15 ans. Un chiffre en progression constante, du fait des effets positifs du traitement antir?troviral. Au total, depuis le d?but de la maladie, 60 millions de personnes ont ?t? infect?es. - DECES : Environ 2 millions de personnes sont mortes en 2008 de causes li?es au sida, un chiffre inchang? par rapport ? 2007. Au total 25 millions de personnes sont mortes du sida depuis le d?but de la maladie. - AFRIQUE : L'Afrique subsaharienne est la r?gion la plus durement touch?e avec 67% de l'ensemble des personnes vivant avec le VIH dans le monde (5% en moyenne de la population africaine), et pr?s des trois quarts des d?c?s. 71% des nouvelles infections sont intervenues en Afrique. 14 millions d'enfants y sont orphelins ? cause de la maladie. 60% des personnes y vivant avec le VIH sont des femmes. - EUROPE ORIENTALE ET ASIE CENTRALE : C'est la seule r?gion du monde o? la pr?valence de l'?pid?mie continue de monter. De 2001 ? 2008, elle a augment? de 66% (de 900.000 ? 1,5 million). Les nouvelles infections se d?clarent au premier chef parmi les consommateurs de drogues injectables (38,5 ? 50% sont infect?s en Ukraine, 37% en Russie). - TRAITEMENT: Plus de 4 millions de personnes dans les pays en voie de d?veloppement avaient acc?s ? un traitement ? la fin de l'ann?e 2008, contre 3 millions un an auparavant. Dans le monde, au moins 4,7 millions de personnes recevaient un traitement, soit 42% des personnes qui en auraient besoin (le traitement est donn? ? partir d'un certain niveau d'infection). - INFECTION MERE/ENFANT : 45% des femmes enceintes s?ropositives ont re?u en 2008 un traitement pour pr?venir la transmission du virus ? leurs enfants, contre 33% en 2007. - JEUNES : Environ 5 millions de jeunes ?g?s de 15 ? 24 ans vivent dans le monde avec le sida. L'?pid?mie a nettement recul? chez les jeunes de 15 ? 24 ans dans pr?s de la moiti? des 25 pays les plus s?rieusement touch?s au monde, essentiellement en Afrique subsaharienne. Mais elle est en hausse chez les jeunes d'Europe de l'Est. *6* *Sant?: La port?e d'un nouveau traitement du VIH-SIDA ** **Afrique en ligne* 15/07/2010 Sant? Traitement du VIH/SIDA - Un nouveau rapport des Nations unies indique qu'une approche radicalement simplifi?e pour assurer l'acc?s de tous au traitement du VIH pourrait emp?cher 10 millions de d?c?s d'ici 2025 et un million de nouvelles infections par an. Le Programme commun des Nations unies sur le VIH/SIDA (ONUSIDA) a indiqu?, dans un communiqu? mardi, que la proc?dure connue sous l'appellation 'Traitement 2.0' pourrait faire baisser le co?t du traitement, simplifier le mode d'administration du traitement, r?duire le fardeau sur les syst?mes de sant? et am?liorer la qualit? de vie des personnes vivant avec le VIH et de leurs familles. 'Nous pouvons abaisser les co?ts, afin que les investissements puissent b?n?ficier ? davantage de personnes', a d?clar? Michel Sidib?, le directeur ex?cutif de l'ONUSIDA, lors du lancement du rapport ? Gen?ve. L'ONUSIDA a estim? qu'il y avait 33,4 millions de personnes vivant avec le VIH ? travers le monde ? la fin de l'ann?e 2008, ainsi que pr?s de 2,7 millions de nouvelles infections et 2 millions de d?c?s li?s au Sida. Elle a ?galement r?v?l? que seulement un tiers des 15 millions de personnes dans le monde ayant besoin d'un traitement du VIH ont acc?s ? ces m?dicaments vitaux. Pour la r?ussite du nouveau plan, le rapport a pr?conis? des mesures dans cinq domaines cl?s. Premi?rement, il a pr?conis? la mise au point d'une mol?cule moins toxique et d'un outil de diagnostic simple pour surveiller le traitement. Deuxi?mement, l'exp?rience a montr? que les personnes vivant avec le VIH dont la charge virale a ?t? r?duite gr?ce ? une th?rapie antir?troviral, sont moins susceptibles de transmettre le virus. En cons?quence, l'ONUSIDA estime que si chacun avait acc?s au traitement, cela pourrait r?duire d'un tiers le nombre de nouvelles infections au VIH par an. Troisi?mement, le rapport a recommand? la r?duction du co?t du traitement antir?troviral, en particulier pour l'hospitalisation et le suivi du traitement qui, selon lui, co?te deux fois plus que les m?dicaments. Quatri?mement, l'ONUSIDA a insist? sur la n?cessit? de renforcer le d?pistage volontaire et l'accompagnement psychologique, puisque commencer le traitement au bon moment stimule l'efficacit? du traitement et augmente l'esp?rance de vie. Finalement, le 'Traitement 2.0' sera tout ? fait couronn? de succ?s si les communaut?s sont mobilis?es et impliqu?es dans la gestion des programmes et de l'acc?s au traitement. 'Le Traitement 2.0 peut non seulement sauver des vies, mais il pourrait nous permettre de toucher les dividendes substantiels de la pr?vention', a d?clar? M. Sidib?. Le rapport a ?galement montr? que les jeunes m?nent la r?volution de la pr?vention, avec 15 des pays les plus s?v?rement touch?s qui affichent une baisse de 25 pour cent de la pr?valence du VIH parmi cette frange de la population. Il a cit? huit pays - la C?te d'Ivoire, l'Ethiopie, le Kenya, le Malawi, le Namibie, la Tanzanie, la Zambie et le Zimbabwe - o? une baisse importante de la pr?valence du VIH a ?t? not?e ainsi que des changements positifs du comportement sexuel des jeunes. M. Sidib? a cependant averti que 'r?duire les investissements dans la lutte contre le VIH serait pr?judiciable au contr?le du Sida, avec pr?s de 27 milliards de dollars am?ricains requis cette ann?e pour atteindre les objectifs fix?s par pays pour l'acc?s de tous ? la pr?vention, au traitement et ? la prise en charge du VIH'. 'La lutte contre le Sida a besoin d'une s?rie de mesure de soutien maintenant et les bailleurs ne doivent pas tourner le dos aux investissements ? un moment o? les actions donnent des r?sultats', a-t-il affirm?. L'ONUSIDA a ?galement recommand? que les nations investissent entre 0,5 et 3 pour cent des recettes gouvernementales dans leurs programmes de lutte contre le Sida, tout en avertissant que pour la majorit? des pays s?v?rement touch?s par l'?pid?mie, les investissements nationaux, m?me ? un niveau optimal, ?taient insuffisants. Sont ?galement inclus dans le rapport les r?sultats d'un sondage d'opinion qui montrent que pr?s de trois d?cennies apr?s la d?couverte de l'?pid?mie, les pays continuent ? consid?rer le Sida comme un des plus importants d?fis ? relever par la communaut? internationale. Dans l'ensemble, dans l'?tude, le Sida est per?u comme la principale pr?occupation en mati?re de sant?, suivi de l'acc?s ? une eau potable. Le rapport se termine sur un dernier mot de l'ambassadrice de bonne volont? de l'ONUSIDA, Annie Lennox, qui a d?clar?: 'En tant que femme et m?re, je me sens oblig?e d'en parler et de tenter de sensibiliser de la meilleure mani?re en utilisant ma plateforme pour le faire'. *7* *Urgen fortalecer vigilancia del sida ** **Siglo XXI, Guatemala* 15/07/2010 Bogot?. En Latinoam?rica, donde se mantiene el drama de los afectados por VIH/Sida con cifras no exactas por la cantidad de personas desconocedoras de su condici?n de portadoras del virus causante de la enfermedad, la prevenci?n es una urgencia. En la antesala de la Conferencia Mundial del Sida que se celebrar? en Viena (del 18 al 23 pr?ximos), los datos latinoamericanos demuestran que la epidemia, presente desde hace tres d?cadas, subsiste pese a los esfuerzos p?blicos y privados. El ?ltimo informe de 2008 del Programa Conjunto de las Naciones Unidas contra el Sida (Onusida) destaca a pa?ses como Brasil y M?xico por su liderazgo en el campo de la prevenci?n, pero urge a ?fortalecer los sistemas de vigilancia en Latinoam?rica? y a tener ?evidencias m?s s?lidas para la planificaci?n nacional en la prevenci?n del VIH?. Recientemente el director de Onusida, Michel Sidib?, habl? de la urgencia general de ?una revoluci?n en la prevenci?n?, especialmente en segmentos demogr?ficos vulnerables. ?El hecho de que por cada 2 personas a las que ponemos en tratamiento otras 5 se contagian? evidencia, a su juicio, ?que tenemos que movilizarnos con fuerza para impulsar la prevenci?n?. Radiograf?a regional El informe de la ONU, cuyas cifras difieren de las presentadas por los gobiernos de Latinoam?rica y el Caribe, destaca a esta regi?n como hogar de la epidemia de ?bajo nivel? y ?concentrada?. Seg?n los datos generales del documento, en la regi?n hay unos 2 millones de personas que viven con el virus, de los que casi 170 mil son nuevos infectados, y hasta 2008 se han contabilizado 77 mil muertes por la infecci?n. En Centroam?rica, las cifras de enfermos var?an entre los 28 mil en Honduras, los 24,756 de El Salvador, o los 20,488 de Guatemala, donde el Centro Nacional de Epidemiolog?a reporta que se contabilizan unos 6,500 nuevos casos de contagiados por el virus cada a?o. En Panam?, desde 1984 hasta diciembre de 2009, se han registrado 10,381 casos, y los fallecidos a causa de la epidemia son 7,005, mientras que en Nicaragua el n?mero de portadores es de 4,784. =========================== *AFRICA** AND MIDDLE EAST* =========================== *Motlanthe to Attend Intl Aids Conference * *BuaNews, SA* 15/07/2010 Pretoria ? Deputy President Kgalema Motlanthe will on Friday lead a high level government delegation to the International AIDS conference in Vienna, Austria. Convened under the theme: "Rights here, Right Now", the six-day conference which kicks off on Sunday, will provide South Africa with a platform to demonstrate the importance of sustained investments in HIV in achieving broader national and international health and development goals. South Africa's participation at this year's conference comes amid an unprecedented massive HIV Counseling and Testing (HCT) campaign launched by President Jacob Zuma in April this year. This campaign seeks to test about 15 million people for HIV by June next year while also promoting positive sex behavior. On World AIDS Day in December last year, President Zuma announced far-reaching policy interventions around treatment; initiating patients on ARVs far sooner than was the case before, amongst others. Motlanthe will be supported at the conference by Health Minister, Dr. Aaron Motsoaledi and Public Works Deputy Minister, Henrietta Bogopane-Zulu. Motsoaledi will deliver an address during the plenary session of day three of the conference focusing on the theme of Universal Access and Treatment Scale-up. South Africa's delegation at the conference will also provide a progress report against the indicators identified in the Declaration of Commitment signed by the UN General Assembly Special Session on HIV and AIDS (UNGASS) in June 2001. Key among these commitments was the realization of Universal Access to HIV prevention and Treatment interventions by 2010 *2* *Djibouti: Aids fight targets Ethiopian truckers along the borders** **Somaliland Press* 15/07/2010 Djibouti (Somalilandpress) ? An official agreement of cooperation was signed yesterday between the Republic of Djibouti, the U.S. Agency for International Development (USAID), the terminal operator World (DP World), based in Dubai, and Family Health International (FHI). According to a statement issued after the signing ceremony by the Djibouti Ministry of Foreign Affairs and International Cooperation, ? It is the first public private partnership funded by the United States to Djibouti? in order to generate better access to health care along the Djibouti-Ethiopia corridor. This development will provide much needed health services and development project along increasingly busy shipping routs between Djibouti and Ethiopia. The document signing ceremony of Memorandum of Understanding, which was held yesterday in the building of the Ministry of Foreign Affairs, was attended by Minister of International Cooperation, Mr. Ahmed Ali Silay, Minister of Health, Mr. Abdallah Abdillahi Miguil, the U.S. ambassador to Djibouti, Mr. James C. Swan, the representative of USAID in Djibouti, Stephanie Funk and Project Director FHI, Dorothy Muroki. Also present at this occasion, the president of the Ports Authority and the Djibouti Free Zone, Doualeh Mr. Aden, the executive director of the Port of Djibouti and the Container Terminal Doraleh, Johannes (Hans) de Jong and the Coordinator of Social Responsibilities of International Company DP World, Mr. Ethan Chorin. The alliance between DP World, U.S. and Djibouti governments will benefit thousands of people along a busy road that connect Djibouti and Ethiopia. The project is part of International initiative to prevent spread of AIDS and other epidemics along major transportation areas. The programs aims to increase awareness and adoption of healthy behaviors to the risk of transmission of HIV/AIDS, also increase awareness of other health problems along major transportation corridors in nine countries in East Africa, Central and Southern Africa, including Djibouti. More than 800 trucks a day pass along the road connecting neighboring Djibouti to Ethiopia. The initiative is designed to established 38 awareness posts or ?Safe Stops? along the high-risk areas along transportation routes in the cities of Central and East Africa where truckers, port workers and members of the community can access basic medical care, health education and a safe place to rest. Under the terms of the MOU, the DP World will supervise and finance the construction of a new community center ?Safe Stop,? a 1,600 square feet facility near the container terminal DP World in Doraleh, on the outskirts of the capital of Djibouti. The truckers, port workers and members of surrounding communities will benefit from the services of a clinic. The facility will include exam rooms, a private recreation center and Internet access. *6* *Dr. Sana to head HIV/AIDS program ** **Arab News* 14/07/2010 By SULTAN AL-TAMIMI | ARAB NEWS JEDDAH: The Ministry of Health appointed on Tuesday Dr. Sana Flimban as general manager of the ministry?s HIV/AIDS program. Flimban has previously held several posts within the ministry and has worked on several HIV/AIDS awareness campaigns. A graduate in medicine and surgery from King Abdulaziz University, Flimban has attended a training program on internal medicine in Scotland. She was also part of an international training program against HIV/AIDS held in the US. *=======================* * * *ASIA** AND PACIFIC* * * *=======================*** *University students to take AIDS test** **Xinhua News, China* 15/07/2010 by Yang Yijun BEIJING, July 15 (Xinhaunet) -- University students in East China's Zhejiang province are to undergo physical examinations in an effort to get an accurate picture of the HIV/AIDS infection rate among the student population. The results will help related departments work out detailed and effective measures to control and prevent the disease from spreading further, according to Zhejiang Provincial Center for Disease Control and Prevention (CDC), which is running the program. The move comes after the Hangzhou branch of the CDC found eight HIV carriers during a spot check of 2,000 university students at three universities, a case rate of 0.4 percent. According to research conducted by the CDC, there are an increasing number of university students aged 19 to 23 who are HIV carriers or AIDS patients, Xinhua News Agency quoted a Zhejiang CDC official as having said. Sexual contact is the major route of transmission for the virus and gay men are at higher risk of contracting the disease, the official said. Zhejiang CDC has yet to disclose when the examinations will begin and how many students will be involved in the program. At the end of May, there were more than 100 new HIV carriers and AIDS patients in Hangzhou, a 7.28 percent increase compared to the same period last year, according to statistics from the Hangzhou CDC. About 3.7 percent of the city's new carriers are students, the majority of which contracted the disease via sexual contact. Among them, 48.3 percent are gay. The use of condoms is the most effective means of protection against the virus, said an official of Shanghai CDC, who added that multiple sexual partners posed a high risk of infection. Universities in China are stepping up their efforts to educate students about sexual health and how to prevent the spread of HIV/AIDS. "We have a lecture on AIDS prevention for all freshmen at our university, because we have noticed that university students are more and more sexually open," said Xu Liyun, a tutor at Shanghai International Studies University. "Some students may feel embarrassed at the lecture, but we insist on their attending in order to protect them from getting hurt due to a lack of knowledge," she explained. The Red Cross also periodically joins forces with campus doctors to educate students on how to protect themselves from contracting the virus, Xu added. (Source: China Daily) *2* *HIV, AIDS, TB pose threat to tribals in heartland India ** **Xinhua News, China* 15/07/2010 BASTAR, India, July 15 (Xinhua) -- In the mountains of Abujmarh, in the districts of Narainpur, Bijapur and Dantewara live the Maria tribals of Bastar origin. This 3,900-square-kilometer tract of closed region shelters about 6,000 people in some 190 villages. However, the tribal-dominated region is at risk of AIDS prevalence due to poor awareness and backwardness. It may further snowball into tuberculosis-HIV co-infection. No surprise, TB still causes most deaths in Chhattisgarh. It is more so because Chhattisgarh shares its geographical borders with Maharashtra, Andhra Pradesh, West Bengal and Orrisa, which are high AIDS prevalence states. The jungle here is rich in medicinal plants and herbs, but the medicines made from these never reach the inhabitants of the jungle -- the tribals. The inhabitants of the jungle is not part of the market because they have no money. If the ailing people do not have money, their only cure is death. "The local administration is not concerned with human life; it is there to sell contracts -- contracts for exploiting jungles, for mining, building roads and hospitals," said S.K. Sagar, a teacher in a nearby village. State Tuberculosis Officer Dr. D.S. Sonwani says that essential efforts should be enforced for prevention of TB and AIDS in the region. "Tuberculosis and HIV may result into a deadly co-epidemic. The HIV and AIDS are the greatest risk factor for the development of active TB and fuels a resurgence of the TB epidemic in areas of high HIV prevalence," Sonwani adds. "Besides coordination of TB and HIV resources, there is a need to strengthen prevention and care networks to sustain TB-HIV services, particularly to improve access to early treatment and care for the HIV-infected," said Dr. Mahindra Pal, formerly associated with AIDS Society. The state health department is likely to enter into understanding with the National AIDS Control Organization (NACO) soon for the third phase of implementation of AIDS control programs. The department believes that control efforts over the linkage between TB and HIV and AIDS would then be also seen at the operational levels. "As of now the fact remains that the state of Chhattisgarh is yet to initiate its serious preparation to meet the frightening challenge of HIV syndrome and its association with TB in Chhattisgarh, particularly the tribal areas," said Pal. *4* *Bank South Pacific embraces fight against HIV/AIDS in PNG** **Post-Courier, PNG* 15/07/2010 PORT MORESBY (POST COURIER) ---- The HIV/AIDS epidemic is increasing at all sectors of life despite many efforts made to reduce the trend. The Bank South Pacific (BSP) among other corporate bodies has embraced the fight to safeguard the workforce and human resources in Papua New Guinea (PNG). The bank on Monday presented a cheque for K50,000 to the Business Coalition Against HIV/AIDS (BAHA) to join forces against the current trend of the epidemic. The BSP is a gold sponsor of BAHA this year and this sponsorship is part of its commitment to the work of BAHA in the response to HIV/AIDS in the private sector in the country. The bank has a HIV/AIDS workplace policy with BAHA to safeguard its employees in terms of ongoing awareness and training in the workplace. In turn, BAHA makes sure that one or two staff members from BSP branches nationwide are given priority to attend training when BAHA?s training team visits their provinces to conduct HIV workplace training. The BAHA is a non-profit organisation (NGO) responding to HIV/AIDS on behalf of the private sector in PNG. Its co-function is to make sure companies develop HIV workplace policies and assist them in the implementation of the work at their respective workplaces. The BAHA thanked BSP for the sponsorship and encouraged all other companies operating in PNG to contact BAHA to help develop their HIV workplace policies. ..PNS *========================* *EUROPE*** *========================* *'Significant advances' made towards AIDS vaccine** **AFP* 15/07/2010 JEAN-LOUIS SANTINI After decades of trying to develop a vaccine against AIDS, global health authorities are finally beginning to make "significant advances" towards their goal, Anthony Fauci, head of the US institute of infectious diseases, told AFP. "Up to a few years ago, even though we have been trying for a couple of decades to develop a vaccine, unsuccessfully, we have not even had a small clue that we were going in the right direction," Fauci told AFP. But two key events that have taken place in the past few years have changed that and led to "significant advances in the development of a vaccine," said Fauci, who is head of the National Institute for Allergy and Infectious Disease (NIAID). The first of those key turning-point events was a clinical trial of an HIV/AIDS vaccine which was conducted last year in Thailand on 16,000 people. "The results showed a small to modest positive effect on the acquisition of HIV -- not good enough to be able to distribute a vaccine but good enough to tell us that it was a conceptual advance that at least makes us feel now that a vaccine is possible," Fauci said. Then, last week, scientists at NIAID published a paper in the journal Science about research that had helped them to identify two antibodies in an HIV-positive individual, which, when put together "block 90 percent" of HIV strains, Fauci said. "What that is telling us is that you can identify the portion of the virus that you would like to use as a vaccine, because we know that when the antibodies bind to that portion, it knock down the virus," he said. The next step will be to try to inject that part of the virus into an individual to produce a protective response against HIV infection, said Fauci in an interview with AFP days before the 18th international conference on AIDS, to be held in Vienna, Austria. The Thai study and the report in Science have left scientists feeling "much more confident that ultimately we will have a vaccine" against HIV/AIDS, although it was still impossible to say exactly when that would be, said Fauci. An AIDS vaccine was probably several years away, which means that in the meantime, the fight against HIV/AIDS must continue to focus on prevention by using tried and true tactics such as condom distribution, male circumcision, blocking mother-to-baby transmission and offering syringe exchange programs, he said. Ways have to be found, too, to improve access to these preventive measures, especially in developing countries where only 20 percent of "populations who would benefit" actually have access to them, he added. Along with improving access to the preventive methods, Fauci urged global health authorities and governments to continue to work to develop other forms of prevention, such as microbicides. And he recommended "treating as many people as we possibly can because we know that when you treat more people, you lessen the probability that they would infect other people. "You could almost have what we call treatment as a form of prevention," until a vaccine is finally developed, said Fauci. ? 2010 AFP *3* *New phase in global AIDS battle** **AFP* 16/07/2010 By Richard Ingham PARIS ? AIDS experts gather in Vienna on Sunday for a six-day rally on the new options emerging in a war which after nearly three turbulent decades is entering a stable, promising phase. Expected to draw more than 20,000 researchers, policymakers and grassroots workers, the International AIDS Conference is the 18th since acquired immune deficiency syndrome came to light in 1981. For almost all this time, the conferences have been the theatre for frustration and sometimes anger. Doctors would reel off the latest setbacks in the quest to treat and prevent the AIDS virus, while activists pounded the drum for money and action by Big Pharma. Today, though, the mood is brighter than ever. Indeed, many AIDS warriors are talking cautiously of a foe that is on the way to being contained and one day will be rolled back. "One day, we will have to turn our minds on how to wipe out the virus," Jean-Francois Delfraissy, director of France's National Agency for AIDS Research (ANRS), said in an interview. The optimism comes from the success of antiretroviral drugs, the "cocktail" of drugs that, like a boot pressed firmly on the throat of a killer, keeps HIV suppressed. For millions, this medication has transformed the human immunodeficiency virus (HIV) from a death sentence to a chronic but manageable disease. Even better, antiretrovirals are also emerging as a policy tool for prevention. Lowering viral levels to below perceptible levels massively reduces the risk of handing on the pathogen between sex partners or from a pregnant mother to her child. There is also hugely encouraging news about male circumcision for preventing the spread of HIV to men, and even a few glimmers of hope from the lab, where scientists are toiling for a vaccine and virus-thwarting microbicide gel. "We really are at an important crossroads," Gottfried Hirnschall, new director of HIV/AIDS at the UN's World Health Organisation (WHO), said in an interview. "It's all coming together. We no longer have this treatment-versus-prevention conversation. The question now is about making the best of the resources we have, and in the most intelligent way." Many terrible problems remain, Hirnschall cautioned. More than 33 million people live with the virus and each year 2.7 million more cases of HIV occur. Stigma, ignorance and discrimination, in many places, are entrenched. Millions of poor, needy people have yet to clutch the drug lifeline. To help them, a key question in Vienna is how to finetune the use of antiretrovirals and mesh them with low-cost medical support, using nurses or medical orderlies as substitutes for doctors. Doctors may be advised to start prescribing anti-HIV drugs at an earlier stage of infection, a tactic that would save more lives and, say some, be a cost-saver too, as healthy people are more productive for longer. Yet does the world have the will, at a time of belt-tightening, to foot the bill for treating people sooner? This year, 25 billion dollars has to be mustered for fighting AIDS in poorer countries, according to a UNAIDS estimate. So far, there is a funding shortfall of 11.3 billion, according to an analysis published last week in the US journal Science. That means a 2006 vow by UN members to provide "universal access" to HIV drugs, prevention, treatment and care by the end of 2010 is set to become one more headline-making political promise that fell flat. "The success of ARVs (antiretrovirals) made it so people think HIV is no longer there," said Julio Montaner, director of the BC Centre for Excellence in HIV/AIDS in Vancouver, Canada, and president of the International AIDS Society, which is organising the conference. "Politicians basically react on a short-term agenda. Since HIV treatment became effective, people are not under the same pressure that they used to be." The Vienna conference will also turn the spotlight on Eastern Europe, where the epidemic is being driven especially by intravenous drug users. Russia and Ukraine, the two hotspots of infection, are under pressure to scrap policies that criminalise drug users and to encourage needle-exchange programmes and help to wean addicts off heroin by using methadone, a safer substitute for opiates. VIPs attending include former US president Bill Clinton, Microsoft tycoon and philanthropist Bill Gates, rock star Annie Lennox and Hollywood actress Whoopi Goldberg. Copyright ? 2010 AFP. All rights reserved *4* *HIV: Top medical journal blasts Russia over drug users** **AFP* 14/07/2010 PARIS ? Russia could more than halve its rates of new HIV infections by ending criminalisation of intravenous drug users, experts said in the British Medical Journal (BMJ) on Wednesday. In an analysis published ahead of the International AIDS Conference, the experts said Russia's strict laws on drug use had helped fan its HIV/AIDS epidemic. Research shows that the risk of HIV infection can be slashed by substituting heroin and other illegal opiates with a safer, legal drug and encouraging addicts to swap dirty needles for sterile ones, they said. Twenty-two pilot programmes supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria have prevented 37,000 HIV infections, they reported. In Russia's case, the country could cut its HIV rates by up to 55 percent if it implemented these policies, according to a mathematical model presented in the article. At present, Russia prohibits opioid substitution and has only 75 needle-exchange programmes for an estimated two million injecting drug users, around a third of whom are thought to have the human immunodeficiency virus (HIV). "Our projections suggest that Russia could substantially reduce the incidence of HIV infection if it permitted the use of opioid substitution treatment," says the analysis headed by Tim Rhodes, a professor of public health sociology at the London School of Hygiene and Tropical Medicine. "The benefits could be even greater than we estimate, as the model does not include changes in offending, or in antiretroviral HIV treatment." The six-day 18th International AIDS Conference opens in Vienna on Sunday, with the spotlight placed on the HIV epidemic unfurling in Eastern Europe and the former Soviet states. Intravenous drug use is a well-known accelerator of HIV, through sharing syringes contaminated with the virus and through prostitution, as infected addicts turn to sex work to get money for their habit. According to a 2008 study in The Lancet, 16 million people around the world inject drugs, three million of whom live in Eastern Europe. After Russia, Ukraine has the highest number of drug injectors in the region, a tally estimated at 290,000, the BMJ said. Supporters of so-called harm reduction programmes say that drug users have a better chance of weaning themselves off this high-risk behaviour if they are given support and not forced into a life of illegality. The World Health Organisation (WHO) classifies opiate substitutes as an "essential medicine." Two substitutes, methadone and buprenorphine, are prescribed to more than 650,000 in Europe. Copyright ? 2010 AFP. All rights reserved *5* *Traitements contre le sida: les pays riches rappel?s ? leurs engagements** **AFP* 14/07/2010 VIENNE - Julio Montaner, co-pr?sident de la 18e conf?rence internationale sur le sida qui s'ouvre dimanche ? Vienne, a rappel? mercredi aux pays riches leur engagement ? financer l'acc?s universel aux traitements contre le sida, pris par le G8 en 2005, avant la crise financi?re. Selon le dernier rapport du programme des Nations Unies sur le sida, un tiers seulement des besoins sont couverts, avec 5 millions de personnes concern?es et 10 millions en attente. L'engagement en faveur d'un acc?s universel aux traitements pris en 2005 "?tait clair. La crise financi?re est devenue l'excuse parfaite pour changer d'objectifs et parler d'autres choses", a regrett? M. Montaner, pr?sident de la soci?t? internationale sur le sida (IAS) qui organise la conf?rence internationale, dans un entretien avec l'AFP. L'accent mis sur la sant? maternelle lors du dernier G8 fin juin, avec le d?blocage de 7,3 milliards de dollars, est "noble, mais ne doit pas se faire au d?pens de l'acc?s universel au traitement contre le sida", a insist? M. Montaner. Le professeur de m?decine en poste ? l'Universit? de Colombie-Britannique (Canada) rel?ve que les Etats ont su trouver les milliards n?cessaires pour sauver le syst?me financier. "Le taux de mise sous traitement est inf?rieur ? la propagation de la maladie. Si nous n'augmentons pas de mani?re significative le nombre de personnes sous traitement, nous serons bient?t dans une situation intenable", a pr?venu le scientifique, rappelant que les trith?rapies pr?viennent de nouvelles infections. Il a temp?r? les espoirs de l'?laboration rapide d'un vaccin apr?s les travaux publi?s par des chercheurs am?ricains il y a quelques jours. "Cela ne conduira ? aucune avanc?e majeure dans le futur imm?diat. Nous devons agir maintenant avec les instruments dont nous disposons" sous peine de laisser exploser le ph?nom?ne. M?me si des maladies telles que la malaria sont plus meurtri?res, le sida reste "sp?cial" en raison des atteintes aux droits de l'Homme subies par les malades. "Vous n'?tes pas discrimin?s si vous avez un cancer de la prostate", a soulign? M. Montaner. Quelque 25.000 participants sont attendus ? Vienne entre le 18 et le 23 juillet pour cette conf?rence, le plus grand ?v?nement mondial sur le sujet. ?AFP *6* *Aids prognosis uncertain in New Delhi** **Financial Times, UK* 14/07/2010 By Amy Kazmin In 2006 Prashant Buradkar was bankrupt and close to death. The driver from the small Indian industrial town of Chandrapur had spent the previous two years selling his few assets to pay medical bills to fight HIV. ?I was not even in a position to eat or drink,? he recalls. ?I was feeling like I was not going to survive.? Lying emaciated on a cot one day, he read startling news: a clinic at a nearby paper mill would be offering free HIV/Aids treatment. Today Mr Buradkar?s weight is back up and he drives a school bus. He is one of about 290,000 Indians receiving free antiretroviral drugs from a programme funded by the Global Fund to Fight Aids, Tuberculosis and Malaria. India, which is monitoring 883,000 HIV-positive cases, expects about 600,000 to receive treatment over the next few years. Despite this improved access to life-saving drugs, there is disquiet among Aids activists and health professionals about what lies ahead. The Geneva-based Global Fund will support India?s treatment programme until 2016, but beyond that lies uncertainty as donors enter an era of austerity and New Delhi has shown little willingness to fill the void. India?s situation is far from unique. The challenge of how to replace existing donor programmes is of such global concern it is one of the main agenda items at the international Aids conference in Vienna that begins this weekend. An estimated 2.3m of India?s 1.2bn people are infected with HIV, a prevalence rate of only 0.2 per cent but Asia?s largest infected population and the world?s third largest, after South Africa and Nigeria. The ramp-up in treatment since 2004, after sustained international pressure and an inflow of foreign financing, has marked a sharp turn for a government that long resisted pleas to provide free drugs to Aids patients even while Cipla, Ranbaxy and other Indian pharmaceutical companies emerged as leading producers of low-cost generic Aids medicines for other developing countries. ?This is one of the good examples of moral pressure really working,? says Siddharth Dube, an HIV/Aids expert with the New York-based World Policy Institute. ?India started treatment access really late. There were these issues of blame, like ?the people who get HIV are people who have done something to contract it?. So why should they get medicine for free, when people with other diseases weren?t getting any?? But Mr Dube fears that, once international funding for Aids treatment ends, the government will back away from its commitment. ?I don?t think the government is in principle at all committed to providing free, or almost free, medicine to people suffering from a chronic, potentially fatal disease.? While companies are rushing to build swish private hospitals for India?s increasingly affluent middle-classes, the government spends just 0.9 per cent of gross domestic product on public health, among the lowest ratios in the world. This low priority is reflected in the dilapidated, poorly equipped public hospitals where most Indians seek treatment. ?The Aids treatment centres have been the best functioning parts of most hospitals,? says Mr Dube. Despite the poor state of its underfunded public health infrastructure, Damodar Bachani, deputy director-general of India?s National Aids Control Organisation, insists the government will not abandon those living with Aids. ?The government of India made a commitment when they stated that any person with HIV who requires treatment, according to the guidelines, will be given free drugs, regardless of ability to pay,? he says. ?It?s the finance ministry?s problem to identify the resources for this, whether domestic or foreign.? Aids patients say New Delhi?s ambivalence is reflected in its hesitancy to provide second-line treatment for patients resistant to frontline Aids drugs. To get second-line drugs, patients must be screened by officials to determine whether they are below the poverty line, a criterion with much room for interpretation. ?If you have a fridge or a ceiling fan, they may say you are not below the poverty line,? says Loon Gangte, an activist with the Delhi Network of Positive People. Activists say second-line treatment, which costs about Rs10,000 ($215, ?170, ?140) a month, is even beyond the means of many lower middle-class families. Sundar Sundaram, an Aids expert in Chennai, says: ?Anyone who goes on second-line treatment without enough money will become impoverished anyway.? Copyright The Financial Times Limited 2010. *========================* * * *LATIN AMERICA AND CARIBBEAN* * * *========================* *Buscar?n dar confidencialidad a pruebas de Sida en Tamaulipas ** **Milenio, Mexico* 15/07/2010 Inform? Alejandro Cort?s Calder?n, coordinador estatal del programa VIH/Sida. Ciudad Victoria.- ?La mayor?a de los centros de salud rurales est?n compuestos por un consultorio y sala de espera, no hay mucho espacio y hay mucha gente, pero se est?n buscando las estrategias y darle importancia a la confidencialidad?, dijo Alejandro Cort?s Calder?n, coordinador estatal del programa VIH/Sida. Subray? que se tiene gente muy capacitada en todos los centros de salud tanto en zonas urbanas como rurales, pero lo que hace falta son espacios para garantizar esa confidencialidad a la paciente. Explic? que esta fue una de las razones por las que el Congreso local no pudo darle total car?cter obligatorio a la prueba, por la falta de condiciones totales de confidencialidad. Dijo que estas objeciones expuestas por principios de derechos humanos no han incidido para frenar el programa, ya que 99 por ciento de las mujeres gestantes a las que se oferta la prueba, la aceptan sin problemas. *3* *Altas cifras de Sida en el pa?s ** **El Colombiano* 15/07/2010 Colprensa Bogot? Seg?n cifras del Alto Comisionado de las Naciones Unidas para los Refugiados, Acnur, desde 1983 hasta 2009 hay un acumulado de 24 mil muertes de personas afectadas por el virus del VIH sida, sin embargo, esta cifra podr?a ser mayor. Diana Pe?arete, consultora de Acnur para el VIH sida, asegur? que en Colombia hay un registro de 26 mil afectados por el virus, "las proyecciones que tenemos y que tiene Onusida, es que podr?a haber entre 170 mil y 220 mil casos". Seg?n Acnur, la poblaci?n desplazada es una de las m?s vulnerables en el pa?s, lo que no quiere decir que sea la m?s infectada. "Nosotros en Colombia tenemos una epidemia mucho m?s concentrada. Esto significa que hay poblaciones m?s vulnerables que otras, por ciertos factores como el hecho de no tener acceso al sistema de salud y no poder prevenir y evitar infectarse del VIH. Por eso el enfoque de promoci?n y prevenci?n debe estar dirigido a estos grupos vulnerables y es ah? donde nosotros vemos que hay una brecha porque no vemos acciones focalizadas hacia grupos vulnerables en el pa?s", manifest? Pe?arete. Con mucha frecuencia esta poblaci?n se ha quejado, en las diferentes regionales de la Defensor?a, del rechazo, la discriminaci?n y el maltrato por parte de las entidades que tienen la obligaci?n de garantizar el servicio de salud" dijo el defensor del Pueblo, Volmar P?rez. *========================* *NORTH AMERICA* *========================* *Obama?s New Effort to Curb the Spread of HIV/AIDS ** **Newsweek* 14/07/2010 Preventing people from contracting HIV, one of the biggest obstacles in the fight against AIDS in America, is getting renewed attention from the Obama administration. On the same day that Bill Gates called for more funding and stronger leadership to combat HIV/AIDS, President Obama, in a move activists dubbed ?significant,? outlined a national strategy that?s meant to be more comprehensive than previous measures and announced the allocation of $30 million to drive the effort. This is not the first time this administration has tackled HIV/AIDS. Last year the government budgeted $45 million over five years to highlight the alarming rate of infection in the U.S. and to refocus attention on the issue. But that plan, called Act Against AIDS, didn?t address prevention, which activists regard as essential in any anti-AIDS campaign. ?We?ve had a broken model that doesn?t fund prevention, but treatment alone,? says Nancy Mahon, executive director of the MAC AIDS Fund and among those involved in discussions leading up to formulation of the new policy, which was announced by Obama on Tuesday in the East Room of the White House and spelled out in a presidential memorandum. The policy builds on previous efforts by making a stronger attempt to tie together many levels of state, federal, and private cooperation. It will focus specifically on gay and bisexual men, black men and women, male and female Hispanics, and substance abusers. It aims, by 2015, to reduce the number of infections by 25 percent, decrease the number of people living with HIV by 30 percent, and increase the number of people aware of their positive status from 79 percent to 90 percent. ?Reducing new HIV infections; improving care for people living with HIV/AIDS; narrowing health disparities?these are the central goals of our national strategy,? Obama said. How those goals will be accomplished is not yet clear: Obama tasked all agencies involved?the departments of Health and Human Services, Justice, Labor, Housing and Urban Development, and Veterans Affairs, along with and the Social Security Administration?to submit a report to the Office of National AIDS Policy and the Office of Management and Budget within 150 days of the presidential memo, detailing their plans for implementing the strategy. Obama also called for more private-public partnerships like the one between Washington, D.C., and the MAC AIDS fund to distribute free female condoms around the city. He did not elaborate on how such partnerships should be achieved, but Mahon says she?s buoyed by the announcement, particularly because of the emphasis on prevention and the tangible targets and goals set by the president, which she said represents significant progress. ?Could they have given $60 million instead of $30 million? Sure,? she says. But overall, Obama ?has shown more leadership than all presidents combined on the domestic front? in combating HIV/AIDS, she adds. The president?s announcement followed a speech by Gates, whose Bill and Melinda Gates Foundation helps raise and invest billions of dollars every year to fight HIV/AIDS, which called for greater funding and better prevention strategies. Speaking to an audience via teleconference, Gates said the global recession should not be allowed to hinder practices that have worked, noting that HIV-infection rates have declined 17 percent since 2001. ?There are countries that despite the economic challenges they face are being quite generous both on a relative and absolute basis and substantially the biggest funder is the U.S. with the PEPFAR program,? Gates said, referring to America?s international HIV/AIDS strategy. ?We should highlight the cases where governments are doing the right things and hopefully draw others in to do the same.? Gates?s remarks were a preview of the keynote address he will deliver at the International AIDS Conference, which kicks off Sunday in Vienna *2* *Death Rate From HIV Falls 75% With Early Treatment, Study Finds** **Washington Post* 14/07/2010 By Kristine Aquino (c) 2010 Bloomberg News Researchers tested two groups of 408 adults with HIV, the AIDS-causing virus. Among patients given antiviral drugs after their infection-fighting cells fell below a certain level, 23 people died, exceeding the 6 deaths in the group whose participants were provided earlier treatment, the study showed. The results support findings in a previous study of medical records published last year. The latest trial also shows early antiretroviral treatment reduces the likelihood of tuberculosis, a leading cause of death among HIV patients, by 50 percent. "Access to antiretroviral therapy should be expanded," researchers including Daniel W. Fitzgerald at Weill Cornell Medical College in New York wrote in the study. In the latest trial, conducted in Haiti from 2005 to 2008, patients were given drugs based on their level of a white blood cell type known as CD4+. All participants had a CD4+ count of more than 200 and less than 350 per cubic millimeter of blood. The World Health Organization recommends patients start antiretroviral therapy when their CD4+ count drops to 350. A higher CD4+ count means greater infection-fighting ability because the immune system hasn't yet been depressed by the virus. The early-treatment group began taking a combination of zidovudine, lamivudine and efavirenz within two weeks after enrollment, the researchers said. Patients in the standard- treatment group were given the therapy when their CD4+ count fell to 200 or when AIDS developed. The antiretroviral drugs cost about $200 per person annually, according to the study. Zidovudine and lamivudine are sold as Combivir by a subsidiary of GlaxoSmithKline Plc, while Bristol-Myers Squibb Co. sells efavirenz as Sustiva. Truvada and Atripla, respectively a two- and three-drug combination, are the world's biggest-selling AIDS medicines and are made by Foster City, California-based Gilead Sciences Inc. A previous study, published in the same journal in April 2009, reviewed 17,000 HIV patient records and found that people who received treatment at earlier stages of infection reduced the risk of early death by as much as 94 percent. Tuberculosis is the leading infectious killer of HIV patients and accounts for about 13 percent of AIDS deaths globally, the United Nations AIDS agency said on its website. *3* *A national battle plan against HIV/AIDS** **Washington Post* 14/07/2010 Familiar. That?s what strikes me about the National HIV/AIDS Strategy for the United States released yesterday. This is not a criticism. The 60-page document is neither unimaginative nor reinventing the wheel. It rightly brings the federal government in line with the clear-eyed, innovative actions being taken across the country to stem the epidemic. What gives this approach authority is that it is backed by the power of the presidency. I?ve written a lot about the HIV/AIDS epidemic here in Washington, where at least 3 percent of the city?s population is living with the disease. That?s a wide swath of heartache across every socio-economic strata. But we know that African Americans and men who have sex with men are bearing the brunt of the epidemic -- in the District and across the country. The District now makes HIV testing a part of routine care. And it is pushing to get people into treatment sooner than they currently are. That the city has those devastating statistics and a plan to (try to) slow the spread of the epidemic is a testament to Shannon Hader, the outgoing HIV/AIDS chief, and the man who appointed her, Mayor Adrian Fenty. I see that same commitment and focus in the new federal plan. It?s the same commitment and focus that has made the President?s Emergency Plan for AIDS Relief (PEPFAR) a global success -- and now those lessons are being brought to bear at home. Obama has ordered six federal agencies to submit a report on how they will implement the national strategy within 150 days. The domestic goals are reasonably ambitious, meaning they stand a chance of being met. The number of new infections should be reduced by 25 percent by 2015. By that same year, there should be a 20 percent increase (to 85 percent) in the proportion of patients linked to care within three months of their diagnosis. And within that same five-year period, the proportion of gay and bisexual men and African Americans, respectively, with undetectable viral loads should be increased by 20 percent. Obama has ordered the Office of National AIDS Policy to report to him every year on its progress in meeting these goals. Another reason they stand a chance of being met is because the administration will focus its prevention efforts in the communities where HIV has hunkered down. Not every person or group has an equal chance of becoming infected with HIV. Yet, for many years, too much of our Nation?s response has been conducted as though everyone is equally at risk for HIV infection. Stopping HIV transmission requires that we focus more intently on the groups and communities where the most cases of new infections are occurring. This is bound to be a controversial statement. It could reinforce the mistaken impression that HIV/AIDS impacts ?other people.? But this gets to the heart of why the HIV/AIDS epidemic has been so difficult to fight -- a lack of honest discussion, which feeds the stigma that chokes off the discussion before one can be had. We also must be honest that even if we?re not among those most at-risk, we have a responsibility to protect ourselves and others. Every nine and a half minutes, an American becomes HIV-positive. Put more starkly, five people became infected during the 48-minute announcement ceremony at the White House yesterday. Every year, more than 56,000 Americans become HIV-positive. While this rate of infection has been rather steady over the last decade, the number of people living with HIV/AIDS -- now at 1.1 million -- continues to grow. Knowing one's HIV status is key to fighting the epidemic. Knowledge is power -- power to get into treatment if infected, power to protect yourself if you?re not. With one in five people living with HIV unaware of their status, knowledge can save your life. By Jonathan Capehart (blog) *4* *AIDS Agency Gets a New Home, and a Founder?s Ire** **New York Times* 14/07/2010 By FRED A. BERNSTEIN Gay Men?s Health Crisis, an organization that emerged in the early days of the AIDS epidemic, now serves 15,000 clients from its space at 119 West 24th Street in Manhattan. So when its landlord, F. M. Ring Associates, decided to raise the organization?s rent ? to more than $8 million a year from $6 million ? it faced a crisis of its own. While finding space in Manhattan is not easy for anyone, organizations that provide social services on-site may encounter particular difficulties. ?There?s always an issue, when you?re going into a commercial or residential building, of whether the social service organization is going to blend in well,? said Suzanne Sunshine, whose S. Sunshine & Associates provides real estate services to nonprofits. ?There may be stereotyping? of the organization?s clients by potential landlords, she said. Landlords will not refuse to rent to social service organizations, she said, ?but you know, from the responses you get, whether they want you in their building.? For Gay Men?s Health Crisis, known as G.M.H.C., there were signs of resistance from building owners, said the group?s chief executive, Marjorie Hill. Dr. Hill said that more than two years ago, after the organization learned of the impending rent increase, it engaged Cushman & Wakefield as its broker. It eventually considered more than 40 sites around Manhattan. One landlord, she said, told her he didn?t want a soup kitchen in his building. ?We don?t have a soup kitchen,? she said, explaining that the organization does serve meals to clients. ?When a law firm has clients come in for 8 a.m. meetings, they typically service breakfast and no one says, ?My God, it?s a soup kitchen.? ? She said that, in talking with potential landlords, she encountered ?a lot of misinformation about H.I.V. and AIDS.? She was surprised, she said, ?that sometimes we had to teach H.I.V. 101.? Dr. Hill said that Gay Men?s Health Crisis entered into negotiations with six landlords before deciding to rent two floors of 450 West 33rd Street. The bunkerlike building houses, among other tenants, The Associated Press, The Daily News of New York and the public broadcaster WNET. The broadcaster (which is consolidating its Manhattan operations) agreed to sublet 165,000 square feet on the building?s sixth and seventh floors to Gay Men?s Health Crisis for about as much as the organization had been paying on West 24th Street. The deal with WNET required the approval of the building?s owner, Broadway Partners, a private real estate investment firm. In order to get that approval, the organization agreed to a number of restrictions, some of which have aroused the ire of AIDS activists, including Larry Kramer, a co-founder of Gay Men?s Health Crisis. In a series of e-mail messages and meetings, Mr. Kramer went so far as to call on Dr. Hill to resign for, in his view, putting the interests of the landlord ahead of those of the organization?s clients. Among Mr. Kramer?s objections is that the lease does not allow medical services to be performed on-site. Kathleen Robinson, director of media relations for the NewYork-Presbyterian Hospital/Weill Cornell Medical Center, said that about 650 G.M.H.C. patients use its clinic on West 24th Street. Dr. Hill said that the clinic will not be able to move to the West 33rd Street location, which she said "is regrettable but not fatal" to her organization?s mission. Another concern is the absence of a full kitchen at the 33rd Street site. Marcelo Maia, a G.M.H.C. client and volunteer, said clients tended to organize their visits around the hot meal program. ?You might come for lunch, and stay to see a housing counselor, or a lawyer,? Mr. Maia said. But Dr. Hill said that despite a change in kitchen equipment the group would still be able to provide hot meals. Also controversial is a plan to have clients and staff enter not through the building?s main lobby, but through a separate, storefront entrance. Mr. Kramer has decried that as a kind of Jim Crow approach that stigmatizes H.I.V.-positive people. Dr. Hill sees the private entrance as providing clients with easy access to the building. In fact, she says, there are great advantages to the new location, where most of the organization will be on a single floor. Gay Men?s Health Crisis?s current vertical arrangement makes the organization feel more fractured than it actually is, Dr. Hill said. In addition, she said, the group will be inheriting about $4 million in improvements from WNET. ?It?s an upgrade for all of G.M.H.C., including the executive office,? she said. An eight-year lease was signed on June 24. One thing Dr. Hill and her critics agree on is that the new building may be difficult for some clients to reach, given its location, closer to the Hudson River than to subways. Mr. Maia said he kept thinking about the worst possible situations, including people having to walk there in the winter, with the wind in their face. ?We?re not talking about healthy people,? he said. ?We?re talking about people with compromised immune systems.? Mr. Kramer also said that the amount of construction planned near the West 33rd Street site ? including the Hudson Yards development and the extension of the No. 7 subway line ? would expose immunocompromised people to ?a public health hazard every day.? But Dr. Hill rejected Mr. Kramer?s suggestion that G.M.H.C. remain in its current space until it found a better deal, saying she would not spend money on fees for overstaying a lease that could be spent on H.I.V. testing and other client services. ?We will be in our new space on Jan. 1,? she said. Ms. Sunshine said that social service organizations looking for space in residential and commercial buildings could face challenges fitting in. One of her clients is Year Up NYC, which provides job training to young adults. She said she was able to place Year Up in an office building in the Financial District because the organization made its students follow rules of workplace decorum. ?They can?t chew gum. They have to be on time,? she said, ?If they?re not, they?re out of the program.? As for Gay Men?s Health Crisis, Dr. Hill said, ?We did make some adjustments in order to secure what is a very good deal, and I have no regrets.? But by leaving a leafy residential neighborhood for an industrial section of the Far West Side, the organization may be changing more than its address. Mr. Maia said, ?If clients find another place that?s more convenient, or if other community service organizations see this vacuum open in the middle of Chelsea, and choose to fill it,? people might not bother coming to West 33rd Street. ?I?m not only concerned about clients,? he said, ?but about the future of G.M.H.C. itself.? *5* *Revolution? Da. Sexual? Nyet.** **New York Times* 14/07/2010 By MICHAEL SCHWIRTZ MOSCOW - PAST the topless woman dancing in a cage and the towering transvestite perched on three-inch heels, Ksenia Borisova was trying to grab the attention of passers-by. Her wares were housed in immaculate displays, complete with colorful instruction manuals, but after five years in business she was still having difficulty generating much interest. As always, sex toys are a tough sell in Russia. ?We have to try to enlighten the customers,? said Ms. Borisova, an owner of Erotic Fantasy, a supplier of German-made intimate equipment in Russia. ?No one knows what, why and how: what lubricant is, why a dildo is needed, how to use vaginal balls.? Other vendors at a recent convention for sex shop owners in Moscow were similarly vexed. Two decades after government-imposed prudishness ended with the Soviet collapse, Russians still shy away from embracing European-style sexual mores. Despite a burst of licentiousness in the early 1990s, when pornography and prostitution surged through the country, the sexual revolution has never really taken hold here. Sure, sexual innuendo is commonplace: on television and in glossy magazines and in the provocative attire of women on the streets. Advertisements with busty models have long replaced posters of square-jawed women scything wheat. But, when it comes to the bedroom, Ms. Borisova and others said, tastes here tend toward vanilla. ?There is just no sexual culture, none,? said Nadezhda Dovgal, one of the organizers of the sex shop convention, called the X?Show. ?People are still ashamed.? This is partly the legacy of the Soviet era, she said. The Soviet government tried to drive all talk of sex under the covers, leaving public life effectively neutered. A lack of private space, especially in the communal apartments of major cities, limited access to sexual encounters even more. ?There is no sex in the U.S.S.R.? was a satirical slogan of the perestroika era. ?We have always had sex, but information on this topic was practically nonexistent,? said Yelena Khanga, who hosted Russia?s first talk show about sex in the 1990s, coyly named ?About That.? In general,? she said, ?it was not acceptable to speak about sex.? She said that when she started her show, which for the first time openly confronted topics like H.I.V./AIDS, homosexuality and workplace sexual harassment, ?it was like a bomb went off.? Though such topics are less provocative these days, the annual X-Show, which is in its ninth year, might still be a bit edgy, even if largely subdued by the standards of such events in the West. Beyond the caged strippers ? and the coterie of men drooling over them ? were models decked out in the latest latex fashions demonstrating proper whipping techniques. Ms. Dovgal, the X?Show organizer, framed the convention as a social welfare project for a country where sex education is practically nonexistent. ?We know that we are needed to help people preserve their families,? she said. ?It is not important for us whether your partner is a man or a woman,? she said. ?What is important is that there is harmony in the relationship.? While Ms. Dovgal?s recipe for marital bliss might not be for everyone, it is clear that Russian families are in crisis. There were three divorces for every five marriages in 2008, according to the Russian statistics agency. Russia is also suffering from a demographic crisis. The population declined by 6.6 million people between 1993 and 2008, according to a 2008 United Nations report. Emigration and a high mortality rate among middle-aged men are part of the cause. But so is a low birthrate. To get couples copulating, some Russian officials have come up with several ideas that Ms. Dovgal and her sex shop colleagues would certainly endorse. For several years the government of the Ulyanovsk region has set aside a special birthing day, when couples are given a day off to help reverse the population decline. Prizes are given to mothers whose children are born on June 12, Russia?s national day. Yet, for all Ms. Dovgal?s concern for families (?Unfortunately, we are not allowed to admit people younger than 18 years old,? she said), demographics did not seem to be the main concern for many visitors at the X?Show. ?I?m into fetish mostly ? pretty clothes, corsets, leggings, collars, whips, things like that,? said Olga Podolskaya, 41, a psychologist. Though the exhibition lacked the extravagance of similar events she had attended in Berlin, she said things were improving. Earlier, she said ?the products in sex shop were limited to plastic penises. ?Now, along with an increase in selection, there are ? how do I put it ? various extra services: seminars, photo sessions, there are stories and various books.? Indeed, the outlook for Russia?s sex toy industry does not necessarily appear to be as grim as some vendors described. In the last 10 years the number of sex shops in Moscow has grown from around 5 to over 150, Ms. Dovgal said, and there are many more Internet-based companies. Sergei Agarkov, a prominent Russian sexologist, framed the change as sexual evolution rather than revolution. He said he believed that Russians were slowly growing more comfortable with sex as a new post-Soviet generation has come of age. ?These are the carriers of a new culture,? Mr. Agarkov said. ?They are completely different people. They are relatively free. They do not have the prejudices that their parents had. And together with them, attitudes towards sex are changing.? That seemed to be the attitude of Dmitri Karablin, a 20-year-old student, who along with his girlfriend was perusing the kiosks at the X?Show in search of vibrators and a sexy maid outfit. ?People are less ashamed,? he said. ?I have a young mother and can talk to her about these things. She even once recommended a store that I should go to.? *A version of this article appeared in print on July 15, 2010, on page E1 of the New York edition.** * *6* *Our Baffling New National AIDS Plan** **Huffington Post* 14/07/2010 Chris Norwood Founder Health People, 1,000 Women for the Nobel Peace Prize Nominee The Obama Administration's process for developing a National AIDS Plan was so inclusive and interesting -- with its 14 community forums around the nation plus various meetings with the most affected groups -- that one began to actually expect a National AIDS Plan that was inclusive and interesting. The 60-page document the Administration released yesterday can be succinctly described as disappointing. More sadly, it is simply baffling. Despite all the community meetings, there is no vision of how to go back and rebuild the crucial community involvement in fighting AIDS which was purposefully destroyed by federal and local governments in the past five years. There is no compelling vision of the future -- for example, how we are going to integrate our now more than one million citizens with HIV/AIDS back into real lives, with employment and an existence beyond social services. Are we just going to go on this way, depressing year after year, with those with the education and background to return to a productive and satisfying "real life" being able to do so with the advantage of better treatment while the majority -- no matter how well or badly they are doing physically -- are left to live out the rest of their lives in a bizarre nether world of "medical case management" and "social services?" Equally, there is no vision for drastically reforming drug and treatment development. Right now, the "academic centers", meaning major research hospitals, which receive millions from the National Institutes of Health to undertake patient trials of promising treatments are allowed to go on and on year after year, receiving their millions without enrolling enough people with HIV/AIDS in trials to actually finish testing various new drugs. This stark enrollment failure also reflects the contempt for community now so evident throughout our whole AIDS effort. Most elite research centers simply will not make real contacts or partnerships with community organizations in the low-income neighborhoods where most people with HIV/AIDS now reside, thereby eliminating even the possibility that most of the current population with HIV/AIDS will even learn about promising treatments, much less enroll in a trial. Our new plan also makes no mention of American AIDS orphans and children living precariously in families where the parent---usually a single mother---has AIDS. The United States has the most AIDS orphans in the Western world; we don't know how many because, to this day, no one, whether the Centers for Disease Control, or local health departments, bothers to count them. Yes, the nation that gives the most help to AIDS orphans elsewhere---which certainly is admirable---has not one national program or funding stream to provide help and attention to its own AIDS orphans! A plan which mentions them not at all obviously will not change that. It is not that the National AIDS Plan is wrong in what it does say. It is all for "intensifying HIV prevention efforts in communities where HIV is most concentrated," "increasing access to care and improving health outcomes for people living with HIV," and "a more coordinated national response to the HIV epidemic." Who could disagree? But the important issues left out -- almost bizarrely unmentioned -- are what make this plan so incomprehensible. For example, the term "peer educator" is not used once in the entire 60 pages. Peer educators, for those not familiar with them, are local people, representative of the populations they are educating -- in this instance, people with HIV/AIDS who have been intensively trained to be prevention educators and to teach good self-care to others. For most of the American epidemic, they formed an extraordinary public health army across the United States, the frontlines that enabled us to get AIDS under some control even though it was widespread by the time real attention was paid. But, in 2007, the federal government decided that "professionals" should take over virtually all AIDS-associated jobs, and it substantially destroyed funding for peer educators, particularly those doing the outreach that got HIV-positive people into treatment and who provided the local support groups and education that helped them understand and stick to their treatment. The results were disastrous -- and lethal -- as we see only too well in New York City. Under the Bloomberg Administration, New York actually started defunding and destroying its own community-based AIDS care and support service programs, with their concentration of peer educators, in 2005, two years before changes in federal funding largely destroyed them across the country. Immediately on losing these very localized services---which were switched to large medical centers and social service agencies mainly in Manhattan--- the Bronx and Brooklyn, the city's two poorest boroughs, which had reached a point many would have said was not possible (they were doing equally well as Manhattan in bringing down deaths) -- fell behind again. Every year since, fewer blacks and women received AIDS care and support services and every year the portion of women in New York City HIV/AIDS deaths has increased. The community forums were impressive. Yet, almost nothing these AIDS-stricken communities had to say about the critical importance of being helped and funded to fight AIDS, themselves, became part of this document. *7* *State proposal is not the answer** **Boston Globe* 15/07/2010 RE ?CLEAR way for easier AIDS tests, despite objections by activists?? (Editorial, July 13): The Globe?s endorsement of state legislation that replaces written consent for HIV testing with a provision that patients simply be notified of HIV testing misses the central point of the debate: We all want to expand HIV testing to ensure that people who are unaware of their positive status receive medical care, but this proposed change in the law will not achieve that result. There is nothing in the proposed legislation that requires, or even encourages, doctors to offer HIV testing. Passage of this bill will not result in the Globe?s call for more routine HIV testing. One of the biggest barriers to expanded testing is that too many primary care physicians who are not HIV specialists are uncomfortable talking to their patients about HIV and do not view the public health imperative to find undiagnosed cases as their job. We need to change physician culture and devote more resources to HIV testing rather than eliminate written consent, which is the strongest way to ensure that people are not tested for HIV without their knowledge. The ?notice and opt-out?? proposal in this legislation is particularly vulnerable to abuse and lack of clarity. While the Globe dismisses the importance of Gilead Sciences Inc.?s involvement with this legislation, people have a right to know that the money and lobbying power behind efforts to eliminate legal protections for HIV testing have come from an out-of-state pharmaceutical company and not the HIV or LGBT communities here. Bennett H. Klein, Senior attorney AIDS Law Project director Gay & Lesbian Advocates & Defenders, Boston ? Copyright 2010 Globe Newspaper Company. -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100716/fe39c402/attachment-0010.html From hivtwg.moderator at gmail.com Fri Jul 16 03:05:17 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Fri, 16 Jul 2010 09:05:17 +0700 Subject: [hivaids-twg] Call for Papers for Special Themed Issue/... MSM and TG communities deploying digital technologies In-Reply-To: References: Message-ID: From: Paul Causey Date: Thu, Jul 15, 2010 at 10:37 AM Subject: [msm-asia] Call for Papers for Special Themed Issue/... MSM and TG communities deploying digital technologies To: MSM-Asia Newgroup , APTransNet < APTransNet at googlegroups.com> Call for Papers for Special Themed Issue July 15, 2010 Building the HIVe: Increasing social and political science representation in the HIV field by MSM and TG communities deploying digital technologies http://www.digitalcultureandeducation.com/uncategorized/building-the-hive/ This special themed issue of Digital Culture & Education (DCE) will showcase the diverse ways that men who have sex with men (MSM) and transgender (TG) communities deploy networked and mobile technologies to intervene in HIV public health and education practices in ways to confront stigma, realise health, sexual and human rights, and improve HIV/AIDS prevention, treatment, care and support. This call for papers targets participants from the Global Forum on MSM and HIV?s (MSMGF) pre-conference entitled, ?Be Heard? and the XVIII International AIDS Conference in Vienna, but also invites contributions from activists, artists, researchers, and service-providers not attending. The ambition is to share and learn from effective practices in using digital technologies to scale up Universal Access to HIV-related prevention, care, treatment, and support for sexual minority communities worldwide. Editors: Gurmit Singh, University of Leeds; Christopher S. Walsh, The Open University; George Ayala, The Global Forum on MSM and HIV Despite the change in behaviours and sexual practices due to networked and mobile technologies, there remains a lack of willingness to rethink current paradigms for HIV interventions aimed at changing individual behaviours. Effective prevention programmes must now respond to digitally-based and -driven sexual-social behaviours in a global network society geared towards maximising sexual pleasure. The ubiquity of networked, mobile technologies, and the proliferation of social networking tools, combined with the realisation that HIV is a profoundly social disease, challenges current disciplinary biomedical approaches to HIV. Yet, there is a lack of necessary investment in social and political science research on the public health added value of deploying the Internet and mobile technologies by MSM and TG communities for HIV/AIDS prevention, treatment, care and support. This special themed issue presents dynamic interventions that draw on the capabilities of networked and mobile technologies, to build the ?HIVe.? The HIVe is an open, non-hierarchical, fluid ecology of HIV activists, practitioners, researchers, and scholars, that actively advocate, disseminate, and promote localised and successful intervention-based practices and challenges. The HIVe exploits the Internet and mobile technologies to advance the impact of the social and political sciences for Universal Access in MSM and TG communities. This special themed issue of Digital Culture & Education (DCE) begins a journey to build the HIVe by developing, exploring, and substantiating the creative and effective merging of HIV and ?e? around sexual-social practices and networks, which can shape and influence the future of interdisciplinary and interconnected public health, human rights and education programmes and policies. Submissions from gay, lesbian, bisexual and transgender community-based organizations that deploy networked and/or mobile technologies in their programmes and interventions are particularly relevant. These manuscripts could be case studies, impact evaluations, or community-based applied research narratives, that illuminate potential openings for advocacy and for policy change in approaches to community-based HIV interventions. Submissions can include ?traditional? print texts on empirical research, as well as non-traditional approaches and formats (e.g. descriptions of artefacts, digital storytelling, audio-visual art, etc.). Potential research and practice questions are: * What are the characteristics of community-driven social and political science approaches in concentrated epidemics that add value to the effectiveness of public health interventions using networked and mobile technologies for HIV prevention, treatment, care and support? * What strategic and theoretical insights from these emerging community-based social and political science approaches can be woven together to conceptualize and build the HIVe ? a systems-based model for HIV prevention, treatment, care and support, that draws together community development, public health, digital culture and education, and technology? DCE is committed to building research literacy in social and political science approaches and encourages submissions from developing country authors, from non-scientific and non-native English speaking backgrounds. The journal will offer targeted online mentoring to authors who submit papers of high potential for consideration. Interested authors should send their manuscripts to the editor of Digital Culture & Education at editor at digitalcultureandeducation.com by October 1, 2010. Building the HIVe: Increasing social and political science representation in the HIV field by MSM and TG communities deploying digital technologies will be published in January 2011. PDF version http://www.digitalcultureandeducation.com/cms/wp-content/uploads/2010/07/DCE_call_for_papers_the_HIVe.pdf -- -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100716/e2d6ef75/attachment-0010.html From hivtwg.moderator at gmail.com Fri Jul 16 07:01:05 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Fri, 16 Jul 2010 13:01:05 +0700 Subject: [hivaids-twg] More Study Urged on Risks, Benefits of Earlier HIV Therapy In-Reply-To: <6A350107-0C30-441E-8D23-38C4DFF7602A@revisionasia.com> References: <6A350107-0C30-441E-8D23-38C4DFF7602A@revisionasia.com> Message-ID: From: Paul Causey Date: Fri, Jul 16, 2010 at 11:05 AM Subject: [msm-asia] More Study Urged on Risks, Benefits of Earlier HIV Therapy To: MSM-Asia Newgroup More Study Urged on Risks, Benefits of Earlier HIV Therapy Increased death risk noted in patients currently not recommended to start antiretrovirals: study http://www.businessweek.com/lifestyle/content/healthday/641158.html THURSDAY, July 15 (HealthDay News) -- Among HIV patients with a high level of CD4 immune cells, those who aren't taking antiretroviral therapy have a moderately increased risk of death, a new study has found. The researchers said their findings point to the need for continuing studies to examine the risks and benefits of starting antiretroviral therapy, or ART, for patients with high CD4 cell counts. As HIV infection progresses, CD4 cell levels decrease. Currently, treatment with ART is recommended when a patient's CD4 count drops below 350 cells per microliter. For this study, researchers examined data from 40,830 HIV patients, aged 20 to 59, in Europe and North America, who had at least one CD4 count greater than 350 cells per microliter while not taking ART. The patients were divided into four risk groups: men who have sex with men, heterosexuals, injection drug users, and those with other or unknown risk factors. An analysis of 401 of 419 deaths revealed that the risk of death compared to the general population was 30 percent higher for men who have sex with men, 2.94 times higher for heterosexuals, 9.37 times higher for injection drug users, and 4.57 times higher for those with other or unknown risk factors. Compared to patients with CD4 counts of 350-499 cells per microliter, the death rate was 23 percent lower in patients with counts of 500-699 cells per microliter, and 34 percent lower for those with counts of 700 cells or more per microliter, according to the study findings, which were published online July 15 in The Lancet. "The increase in risk was substantial in injecting drug users and the heterosexual group but was small in men who have sex with men [MSM]. This finding suggests that much of the raised risk in the former two risk groups probably results from confounding by socioeconomic and lifestyle factors rather than being an effect of HIV infection itself," Rebecca Lodwick of the HIV Epidemiology and Biostatistics Group at University College London Medical School, and colleagues wrote in their report. "The magnitude of the raised risk in the MSM group is more likely to reflect the effect of HIV itself," they noted in a news release from the journal's publisher. "These data suggest that HIV may increase the risk of death in people who have not taken ART and have CD4 count greater than 350 cells per microliter, but any such increase appears relatively modest. Because ART might reduce the risk of death in such patients, these findings support the need for continuing studies of the risks and benefits of starting ART at CD4 counts greater than 350 cells per microliter," they concluded. -- -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100716/1ee21a40/attachment-0010.html From hivtwg.moderator at gmail.com Fri Jul 16 14:24:14 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Fri, 16 Jul 2010 20:24:14 +0700 Subject: [hivaids-twg] =?utf-8?q?=E2=80=98HIV/AIDS_and_Rehabilitation_Cent?= =?utf-8?b?ZXJzIGluIFZpZXRuYW3igJku?= Message-ID: *Please find below the link to the suite of Reports to support Phase I of a research project on ?HIV/AIDS and Rehabilitation Centers in Vietnam?. The research served to explore the sexual and reproductive health, care, needs and choices of current and former detainees and their sexual partners. These reports are available in English and Vietnamese and are composed of:* * 1. **Introductory Report* *2. **Section 1 ? Literature Review* *3. **Section 2 ? Situational Needs Assessment and Analysis* *4. **Section 3 ? Consultative Workshop Report* *5. **Section 4 ? Health Resource Materials* http://www.ngocentre.org.vn/content/reports-support-phase-i-research-project-hivaids-and-rehabilitation-centres-vietnam -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100716/6fa57390/attachment-0010.html From hivtwg.moderator at gmail.com Fri Jul 16 14:25:40 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Fri, 16 Jul 2010 20:25:40 +0700 Subject: [hivaids-twg] Today's News (2010.07.16ex) Viet Nam - HIV/AIDS epidemic changes in gender, age group Message-ID: From: Diaz, Clara Date: Fri, Jul 16, 2010 at 7:31 PM Subject: Today's News (2010.07.16ex) To: Please find attached the following AIDS-related articles compiled by UNAIDS *UNAIDS* 1. Financial Times, UK - *Gates calls for better use of HIV funds * 2. The National, UAE - *Middle East HIV/Aids policies under scrutiny * 3. Walf Fajdri, Senegal - *Absence de financement de la lutte contre le Vih : Les malades du sida en sursis * *AFRICA** AND MIDDLE EAST* 1. Mmegi, Botswana - *Mogae attends global AIDs meeting * 2. Addis Fortune - *Firm Signs 25 Million Br HIV Equipment Support Deal * *ASIA** AND PACIFIC* 1. Global Times, China - *Hospital refuses to treat migrant worker with HIV * 2. Nh?n D?n, Viet Nam - *HIV/AIDS epidemic changes in gender, age group * 3. Jakarta Post - *RI gets debt relief to aid TB plan * *EUROPE*** 1. IRIN Plus News - *GLOBAL: The big five at AIDS 2010 * 2. The Lancet, UK -* **ART in low-resource settings: how to do more with less * 3. Reuters - *Budget choices on AIDS funds threaten lives ?report* 4. AFP - *AIDS funding cuts a death sentence for millions, MSF warns* 5. AFP - *Norway**'s princess in Vienna for AIDS conference* 6. L?Express - *Sida: les pays riches doivent tenir leurs promesses de dons * 7. El Peri?dico, Spain - *La cuesti?n no es sida o no sida* *LATIN AMERICA AND CARIBBEAN* 1. Jamaica Observer - *The link between HIV and gender violence * 2. El Tiempo, Colombia - *Conferencia internacional sobre el Sida abordar? propuestas prometedoras en Viena, Austria * 3. Cimac Not?cias, Mexico - *Situaci?n de la pandemia por VIH/Sida en el mundo * *NORTH AMERICA* 1. Washington Post - *Obama's HIV/AIDS strategy: sound, but not sufficient* 2. IPS Terra Viva - *Former Presidents Denounce Drug War Ahead of AIDS Meet * 3. Boston Globe - *Study rethinks AIDS prevalence among Haitians * 4. Wall Street Journal - *Bill Gates Talks AIDS Vaccine Potential, Research Funding* *UNAIDS WEB.SITE* 1. UNAIDS - Joint statement of UN agencies on criminal charges brought against HIV activists and health and social workers in eastern Europe and central Asia 2. UNAIDS - *18th International AIDS Conference to open in Vienna * 3. UNAIDS - *Join UNAIDS and IAS at host Town Hall on reshaping the future of AIDS * 4. UNAIDS - *Eastern European countries show increasing new HIV infections while some harm reduction programmes are decreasing * =========================== *UNAIDS* =========================== *Gates calls for better use of HIV funds** **Financial Times, UK* 15/07/2010 By Andrew Jack in Vienna Billions of dollars could be saved in the fight to tackle HIV in the developing world through better management, which could keep hundreds of thousands more people alive, Bill Gates has warned. Mr Gates, the co-founder of Microsoft who runs and funds the world?s largest philanthropic organisation, told the Financial Times that there was considerable scope to save money on treatment, staffing, testing, administration and fees paid to consultants in rich countries. He argued for more efficient channelling of prevention efforts to approaches such as male circumcision, and pledged more financial support to test and disseminate more such approaches. His comments, ahead of a keynote speech at an international Aids conference in Vienna next week, reflect growing calls among organisations involved in HIV to boost efficiency as donor governments threaten funding cuts. The calls come as criticism rises over waste in HIV programmes and after a decade during which annual spending on the disease has risen to $16bn, with demands this year alone for $27bn to sharply boost prevention and treat millions more people who are infected but who are currently without access to drugs. ?Clearly we?re facing a major challenge in terms of funding because of the global economic downturn,? said Mr Gates. ?Realistically, for the next several years, the funding will not be going up.? UNAids, the United Nations? Aids body, also issued a report this week, calling for a new approach it dubbed ?Treatment 2.0? to save costs through policies including greater use of local people to provide medical support and public health advice. Michel Sidib?, its director, told the FT that the cost of antiretroviral drugs produced locally in countries such as South Africa were bought preferentially by the government, even though they were more than 50 per cent more expensive than the average of the same drugs produced by a range of manufacturers across the developing world. But his organisation?s report stressed that drugs represented only a third of total treatment costs, and more should be done to cut the price of laboratory work and the delivery of services. Mr Gates veered away from criticising the activities of international funders and those providing treatment to date as high cost, stressing that they had been motivated by the need to tackle the epidemic as quickly as possible. But he pledged in future to fund efforts to ?maximise the impact? of efforts to tackle HIV, marking a modest shift towards greater emphasis on improving management after years during which his foundation has instead focused on funding new tools such as vaccines and microbicide gels to tackle infection. He admitted that much funding of prevention had not been adequately targeted on varied groups in different countries, such as injecting drug users and gay men in eastern Europe, and heterosexual couples with multiple sexual partners in parts of Africa. Copyright The Financial Times Limited 2010 *5* *Middle East HIV/Aids policies under scrutiny** **The National, UAE* 15/07/2010 James Reinl, United Nations Correspondent NEW YORK // Ill-treatment and discrimination against Aids victims in the Middle East is coming under the spotlight again, with the UN investigating ?punitive laws and human rights violations? against sufferers. Last month?s UN conference in Dubai found many countries in the Middle East and North Africa fall ?well short? of providing universal treatment, with sufferers often subject to ill-treatment, social stigma and discrimination. The world body has now launched a ?Global Commission on HIV and the Law? to assess whether legal structures criminalise certain types of high-risk behaviour and drive the disease underground. Dr Mandeep Dhaliwal, an Aids expert for the UN Development Programme (UNDP), said it is ?terribly important? to investigate punitive laws in the Middle East and said commissioners will meet in the region to study its legal architecture. Michel Sidib?, the head of UNAIDS, is expected to preside over the high-level probe next year, which will involve health chiefs, justice ministers and other government officials from across the Middle East. Women are more vulnerable to HIV when laws fail to protect them from rape, both inside and outside marriage, experts warn. Forcibly testing migrants and then deporting those found to be infected can also be counterproductive. Laws against homosexuality, drug use and prostitution drive high-risk behaviour underground and make those involved less likely to get tested for HIV, the UN says. While not necessarily advocating for legalising prostitution and narcotics, commissioners will evaluate whether other policy tactics ? such as allowing so-called ?shooting galleries? or testing clinics for sex workers ? can help prevent the disease from spreading. ?Some 106 countries still report having laws and policies that present significant obstacles to effective HIV responses,? said Helen Clark, head of UNDP. ?We need environments which protect and promote the human rights of those who are most vulnerable to HIV.? Over the next 18 months, the commission will evaluate which legal frameworks are most effective at tackling the spread of Aids, and pinpoint those that violate human rights. Findings from its report, due at the end of next year, will not be legally binding but are expected to be built into a UN General Assembly resolution. ?We must stand shoulder to shoulder with people who are living with HIV and who are most at risk,? said Mr Sidib?. ?By transforming negative legal environments, we can help tomorrow?s leaders achieve an Aids-free generation.? The latest UN figures count 33.4 million people around the world living with HIV, with only 310,000 across the Middle East and North Africa. Some 2.7 million people become infected and a further 2 million die from the disease each year. jreinl at thenational.ae *6* *Absence de financement de la lutte contre le Vih : Les malades du sida en sursis** **Walf Fadjri, Senegal* 15/07/2010 Sur les 20 milliards ? r?colter ainsi que s?y ?taient engag?s en 2005 les pays industrialis?s, seuls 100 millions de dollars sont disponibles au Fonds mondial de lutte contre le sida, la tuberculose et le paludisme. Ce qui met en sursis les malades du sida, ainsi que le souligne le co-pr?sident de la conf?rence internationale sur le sida qui s?ouvre dimanche ? Vienne. Les personnes vivant avec le virus du Sida sont-elles en sursis ? C?est la question que l?on est tent? de se poser si on consid?re que sur les 20 milliards ? r?colter pour les trois prochaines ann?es, le Fonds mondial de lutte contre le sida, la tuberculose et le paludisme n?a r?uni que 100 millions de dollars. Ce qui laisse supposer que les dons des pays industrialis?s dans le cadre de la lutte contre le sida ont ?t? gel?s depuis l?av?nement de la crise financi?re internationale. Face ? cette situation, les pays riches doivent tenir leurs promesses, a demand? Julio Montaner, co-pr?sident de la 18e conf?rence internationale sur le sida qui s'ouvre dimanche ? Vienne. En pr?vision de cette conf?rence, ce dernier a tenu ? rappeler les gouvernements des pays industrialis?s ? leur devoir. En effet, l'engagement de financer l'acc?s universel aux traitements contre le sida, a ?t? pris par le G8 en 2005, avant la crise ?conomique. ?La crise financi?re est devenue l'excuse parfaite pour changer d'objectifs et parler d'autres choses?, regrette Julio Montaner. L'accent mis sur la sant? maternelle lors du dernier G8 fin juin, avec le d?blocage de 7,3 milliards de dollars, est ?noble, mais ne doit pas se faire aux d?pens de l'acc?s universel au traitement contre le sida?, a-t-il insist?, relevant que les Etats ont su trouver les milliards n?cessaires pour sauver le syst?me financier de la crise. ?Le taux de mise sous traitement est inf?rieur ? la propagation de la maladie. Si nous n'augmentons pas de mani?re significative le nombre de personnes sous traitement, nous serons bient?t dans une situation intenable?, a pr?venu le scientifique, rappelant que les trith?rapies pr?viennent de nouvelles infections. Derni?rement ? Dakar, le Directeur de Gip Ensemble pour une solidarit? th?rapeutique hospitali?re en r?seau (Esther) France, le Professeur Gilles Brucker, avait exprim? ses craintes quant aux financements sur le Vih/Sida. C?est ainsi qu?il avait plaid? pour que les moyens soient au rendez-vous dans le cadre de la lutte contre la pand?mie. ?L?argent est le nerf de la guerre. Nous sommes confront?s ? un probl?me de ressources financi?res dans le cadre de la prise en charge du Vih/Sida pour ?tre plus efficace. Avec la crise ?conomique mondiale, europ?enne et internationale, il faut continuer ce plaidoyer pour que les moyens soient au rendez-vous?, a-t-il dit. Et d?ajouter : ?Beaucoup reste ? faire pour ?largir cette action de traitement universel, assurer la d?centralisation des soins, permettre aux malades d?acc?der aux traitements de seconde et m?me de troisi?me ligne?. Le Pr Brucker s?exprimait lors de la cinqui?me r?union du Comit? de liaison Esther/S?n?gal. Le Directeur de Esther France a exprim? la n?cessit? pour la communaut? internationale de mobiliser les financements n?cessaires pour prendre en charge la question du Sida, notamment dans les pays du Sud o? la pand?mie constitue un v?ritable fl?au. De son avis, au-del? des enjeux m?dicaux, cet investissement doit ?tre fait pour des raisons morales, humaines et ?conomiques. VIH/ SIDA : Recul de l??pid?mie chez les jeunes Africains Selon le dernier Rapport de l'Onusida, en 2008, pr?s de 2,7 millions de nouvelles infections ont ?t? enregistr?es dans le monde. Dans le m?me temps, l'Agence onusienne a relev? 2 millions de d?c?s. Mais bonne nouvelle, la pr?valence du Vih parmi les jeunes de 15 ? 24 ans a nettement recul? dans 15 des 25 pays les plus affect?s qui ?ont atteint ou sont en passe d'atteindre l'objectif de r?duction de 25 % de la pr?valence du Vih parmi les jeunes?, pr?cisent les auteurs du rapport. Cette diminution est particuli?rement marqu?e en Afrique subsaharienne, gr?ce notamment ? une ?utilisation accrue? du pr?servatif. Les auteurs expliquent aussi ce recul par une entr?e plus tardive dans la vie sexuelle et une r?duction du nombre des partenaires sexuels. R?unis derni?rement ? Dakar, les personnes vivant avec le virus du Sida de certains pays de la sous-r?gion ont interpell? l?Oms et l?Onusida. L?acc?s au traitement est un casse-t?te pour les personnes vivant avec le virus. Ces derni?res sont souvent confront?es ? des difficult?s dans la prise en charge avec des ruptures de stock sur les antir?troviraux et l?absence de m?decin sp?cialiste. Issa NIANG =========================== *AFRICA** AND MIDDLE EAST* =========================== *Mogae attends global AIDs meeting ** **Mmegi, Botswana* 15/07/2010 STAFF WRITER Former president, Festus Mogae will travel to Vienna, Austria this Saturday to attend the XVIII International AIDS Conference (AIDS 2010) at the invitation of Roche, a pharmaceutical company, which has a presence in southern Africa. According to Mogae's private secretary, Bapasi Mphusu, the International AIDS Conference is the largest global meeting on HIV, where every two years 25,000 participants representing all stakeholders in the world's response to HIV meet to assess progress and identify future priorities. AIDS 2010, the 18th in this series of international AIDS conferences, is organised by the International AIDS Society (IAS) in partnership with government, scientific and civil society partners in Austria and international partners from civil society and the United Nations. IAS, which is based in Geneva, Switzerland, is the world's leading independent association of HIV professionals.Mphusu revealed that the former president will participate at a Roche Satellite symposium on 'Scaling Up Access for Treatment and Monitoring: What will it take to Deliver?' on Tuesday where he will speak on 'The Challenges, Successes and Failures of the Botswana HIV Epidemic Response'. The following day, the former president is expected to attend and make informal remarks at the launching of the Global Commission on HIV Prevention while on Thursday he will participate at a session titled 'Leaders against Criminalisation of Sex Work, Sodomy, Use and Possession of Drugs and HIV Transmission'. Mphusu said Mogae will make a statement on the reasons why criminalisation of HIV transmission is bad public policy, and how countries can be persuaded to limit the use of criminal law to address cases of intentional transmission of HIV and instead focus on effective public health and human rights strategies. "While in Vienna, Mogae will chair a meeting of the Champions for an HIV-Free Generation and collaborating partners such as the World Bank, Bill and Melinda Gate Foundation, UNICEF, UNAIDS, SADC, WHO and PEPFAR," he said. Mogae is expected to return on July 25, 2010. *2* *Firm Signs 25 Million Br HIV Equipment Support Deal** **Addis Fortune* 12/07/2010 Eden Sahle The Ethiopian Health and Nutrition Research Institution (EHNRI) signed a five-year medical equipment maintenance agreement worth 25 million Br with Becton Dickinson International on Wednesday, July 7, 2010. For the next five years Becton Dickinson will provide maintenance services for the 150 FACS Count and 15 FACS Caliburs laboratory devices it sold in Ethiopia, which are used to test the CD4 count in HIV-positive blood, free of charge, according to the agreement. The company will also provide training for local technicians on how to maintain and fix the equipment. "The training and maintenance will be conducted by seven engineers from Kenya," Nick Bright, regional director of Becton Dickinson International East Africa, told Fortune. Although Becton Dickinson has been providing maintenance for equipment and training of local technicians for the past three year, this is the first time it signed an agreement with the EHNRI to continue to do so for a fixed period of time. Ethiopia is the first East African country to receive this kind of support from Becton Dickinson, Bright said. This laboratory equipment is used to test the CD4 count of HIV-positive people to determine whether they should start taking antiretroviral medication as well as to determine their progress. "The maintenance of this equipment will ensure that patients get uninterrupted laboratory service," Tsehaynesh Mesele (MD), director of the EHNRI, said. The maintenance support will go to all public hospitals that have the equipment, both at the regional and federal levels. The five-year support agreement will also reduce the cost of spare parts, according to the medical director. *=======================* * * *ASIA** AND PACIFIC* * * *=======================*** *Hospital refuses to treat migrant worker with HIV ** **Global Times, China* 16/07/2010 By Zou Le A female migrant worker who was seriously injured in a wage dispute is accusing a county hospital in North China's Inner Mongolia Autonomous Region of refusing to treat her wounds after the medical staff discovered she was HIV positive. Li Na joined 10 of her co-workers from a construction project Monday to demand unpaid wages from the contractor. The confrontation led to a violent brawl in which Li was beaten into a coma and later sent to the People's Hospital of Dalate Qi, according to Zuo Xiaojun, an eyewitness. After waking up from the coma, Li said she was spitting blood and felt severe pain in her head and body. The doctors took some X-rays and gave her a blood test, which came back positive for HIV. At that point, Li said, "They told me that my condition was fine and refused to conduct fur-ther examinations. They asked me to leave the hospital immediately." Li felt that her condition was serious enough to require further examinations, but the doc-tors refused and she finally left the hospital Wednesday night. "I felt really hopeless and wondered if it was because of my HIV status," Li said. The Global Times' repeated calls to both the hospital and the local health bureau went unanswered Thursday. Li told the Global Times that she contracted the HIV virus about 10 years ago after she sold her blood to an illegal blood center in Henan Province. Li alleges that the hospital disclosed her HIV test results to other people. Li Xiong, a co-worker who went to visit her in the hospital, said he was "horrified" when the doctors told people in the room that Li has AIDS. Despite a nationwide education campaign on HIV/AIDS awareness, the stigma of the incurable disease and discrimination against AIDS sufferers is prevalent among many people. "Most doctors do not have the most fundamental knowledge of HIV/AIDS beyond their own medical field," said Pan Suiming, director of the Institute for Research on Sexuality and Gender of Renmin University of China. Pan, who published a report based on interviews with people living with HIV/AIDS in 21 provinces last year, said "the most discrimination this group feels is from medical workers." Pan said the rules stipulate that doctors cannot refuse to treat patients who are HIV positive, but that there are no penalties for violators. According to a 2009 report by several organizations, including UNAIDS, one fourth of all medical workers in China hold discriminatory views against people with HIV/AIDS, and 12 percent of the patients say they have been refused medical treatment at least once. *2* *HIV/AIDS epidemic changes in gender, age group** **Nh?n D?n, Viet Nam* 16/07/2010 The HIV/AIDS epidemic has changed significantly regarding gender and age groups, deputy head of Vietnam Administration of HIV/AIDS Control, Chu Quoc An, said on July 15 at an online meeting to review the fight against the disease in the first six months of this year. As of June 30, the country had 176,436 people with HIV/AIDS. Ho Chi Minh City recorded the highest number of patients in the nation with 25.9% of HIV-infected people, he said. According to the statistics, there was a major change in the gender ratio among the infected with 70% men and 30% women in 2010. In 2009, the rate was 82% and 18%, respectively. The 20-29 age group makes up 39% of those infected in 2010, against 52% in 2009 while the 30-39 age group accounts for 42.6% in 2010, against 31% last year. An affirmed that HIV/AIDS prevention work has achieved positive results in the first six months of the year, covering 494 districts in 61 cities and provinces. It drew 4,600 collaborators, established 315 points for anti-retroviral (ARV) treated and treating over 42,000 AIDS patients. However, the work still faces problems, including the overload of patients at ARV treatment facilities, especially in Ho Chi Minh City, the shortage of qualified staff and difficulties for high-risk groups in accessing HIV preventative services. At the online event, representatives from 18 provinces put forward proposals such as promoting training for HIV/AIDS field staff and providing equipment and human resources for HIV prevention centres in the provinces.(VNA) *3* *RI gets debt relief to aid TB plan** **Jakarta Post* 16/07/2010 Indonesia is set to invest an additional AUS$37.5 million (US$33.1 million) to supplement its health budget in the flight against tuberculosis (TB), malaria and HIV/AIDS. The investment is part of a joint program between Indonesia and Australia. The governments agreed to forgive an AUS$75-million debt owed by Indonesian to Australia as part of the Debt2Health program, a Finance Ministry official said Thursday. Australia will write off half of its debt if Indonesia channels the remaining half to the Debt2Health program. The Debt2Health program was expected to reduce the country?s foreign debt and to enhance public health programs to combat HIV/AIDS, TB, and malaria ? the latter two of which were entirely preventable and curable, said Rahmat Waluyanto, the Finance Ministry?s debt management director general. ?Indonesia has the third highest rate of tuberculosis in the world and more than 90,000 people die from the disease every year,? he said. TB is one of the biggest killers in Indonesia, with 300 deaths from the disease each day, according to reports. Dr. Chalik Masulili of the Global Fund ? an international financing institution in charge of disbursement ? said the Debt2Health funds would be distributed to finance the procurement of expensive TB, malaria and anti-retroviral drugs. Unsubsidized anti-TB drugscan cost as much as Rp 520,000 (US$57.70) for a five-day supply. Treatment, which lasts from six to 12 months, will be available for free at government-run public health centers, he said. ?The investment will also be geared toward the improvement of directly observed, short-term treatment, known as DOTS, to tackle TB,? he said. The Debt2Health initiative would help the Health Ministry and non-governmental organizations to develop health-related projects to work together more effectively to fight the diseases, Chalik added. Robert Fillip, chairman of the Innovative Financing Global Fund, said an independent body consisting of members of the government, academia and the private sector would be in charge of monitoring disbursement. Debt2Health?s initiative would ensure TB patients receive continuous and monitored treatment. Patients in developing countries sometimes stop taking the medication when they feel free of symptoms, leading the contagion to multiply, develop drug resistance or eventually cause deaths, Fillip added. Rizal Affandi, Deputy for the Economic Cooperation and International Financing at the Economics Coordinating Ministry, said Debt2Health was agreed upon by the Indonesian government with creditor countries under the Paris Club grouping. The Indonesian government, he said, had implemented projects under a debt swap mechanism with four countries: Germany, United States, Italy, and Australia. Germany previously supported the Debt2Health program by repurposing a 50-million euro debt held by Indonesia. Earlier this month, the government targeted reducing cases of TB by 50 percent, from 443 out of 100,000 citizens in 1990, to 222 by 2015. The Ministry of Health recorded 1.1 million cases of malaria in 2009, while the AIDS Control Commission said there had been more than 20,500 AIDS cases since Jan. 1987, and 4,000 had died from it. (tsy/ebf) *========================* *EUROPE*** *========================* *GLOBAL: The big five at AIDS 2010** **IRIN PlusNews* 15/07/2010 VIENNA, 15 July 2010 (PlusNews) - "Rights Here, Right Now" is the theme of the 18th International AIDS Conference, also known as "AIDS 2010", opening on 18 July in Vienna, Austria. Around 25,000 policy-makers, programme implementers, scientists, community workers, activists and people living with HIV will gather to discuss the latest developments in the field of HIV/AIDS. IRIN/PlusNews has listed some of the issues likely to top the list during the five-day event. Universal Access ? Under different circumstances, the champagne would be on ice as the December 2010 deadline for universal access to HIV prevention, treatment and care approaches; instead, the HIV/AIDS fraternity at AIDS 2010 will be going back to the drawing board, as pitifully few countries have achieved the universal access targets set by the United Nations General Assembly Special Session on HIV/AIDS in 2005. Participants will look for lessons to be learned. Prevention, in particular, remains a huge challenge: for every two people put on antiretroviral (ARV) treatment there are five new infections. Discussions on new strategies are likely to focus on HIV prevention in high-risk groups like sex workers and mobile populations. New Science ? Researchers will use AIDS 2010 to unveil progress in new prevention technologies. A positive result from CAPRISA 004, a large South African trial of a microbicide gel containing the ARV drug, tenofovir, would give a welcome boost to a field that has promised much but produced few positive results. Cost-saving in HIV programming ? As international donor support for HIV shrinks, policy-makers and implementers are keen to find cheaper and more efficient ways to run HIV treatment programmes. Possible solutions include task-shifting ? using less qualified personnel to carry out some functions usually performed by doctors and nurses ? and simplified HIV treatment programmes. Pressure is also mounting on national governments, particularly in developing countries, to increase their budgets for HIV. The cost-effectiveness of new treatment guidelines by the World Health Organization, which recommend putting people on ARVs at a CD4 count (a measure of immune strength) of 350, up from a previous recommendation of 200, will be examined. Treatment as prevention - Evidence is mounting that ARV treatment greatly lowers the likelihood of transmitting HIV, as well as mortality from tuberculosis and other opportunistic infections. Mathematical modelling studies show that implementing voluntary universal testing programmes, and immediately starting ARV treatment for people who test positive, could eventually eliminate HIV all together. Activists will use the possibility of an end to the AIDS epidemic to encourage tired donor nations to increase rather than cut their financial support by emphasising that more people on ARVs will mean fewer new infections and, in the long term, a need for less funding. The difficulties and possibilities of treatment as prevention, using ARVs to prevent HIV in high-risk groups (pre-exposure prophylaxis), and the short-term use of ARVs to reduce the chance of HIV infection after potential exposure (post-exposure prophylaxis), will all be dissected. HIV and injection drug use ? One of the main modes of transmission in Asia, Eastern Europe and Latin America will be discussed in presentations on preventing high-risk behaviour among injecting drug users (IDUs), their human rights, and their inclusion in HIV prevention and treatment programmes. On 13 July, former presidents Fernando Henrique Cardoso of Brazil, Ernesto Zedillo of M?xico and C?sar Gaviria of Colombia - countries with major drug-trafficking problems - formally endorsed the Vienna Declaration. The declaration includes a call to forgo the "drug war" in favour of policies based on scientific evidence of the benefits of needle and syringe programmes and drug substitution therapy. *2* *ART in low-resource settings: how to do more with less** **The Lancet, UK* 16/07/2010 Comment Olivier Koole a, Robert Colebunders a b In The Lancet today, Margaret May and colleagues1 report prognostic models for patients starting antiretroviral therapy in sub-Saharan Africa. The group analysed data from four large scale-up cohorts in the Southern and West African regions that participate in the International epidemiologic Databases to Evaluate AIDS (IeDEA). On the basis of identified risk factors for death, May and colleagues constructed two prognostic models: one with CD4 cell count, clinical stage, bodyweight, age, and sex; and one that replaced CD4 cell count with total lymphocyte count and haemoglobin concentration in the blood. The group concluded that both models provide similarly strong discrimination for prediction of early mortality in patients starting antiretrovirals in sub-Saharan Africa. May and colleagues reported that, during the first year after starting antiretrovirals, 912 (8%) of 11 153 patients died. Mortality would have been higher than that reported if complete follow-up data were available,2 or if centres that provided antiretroviral therapy with less external support than those participating in the IeDEA network were included. The main reason for this high mortality was late presentation of patients to initial care and late start of treatment. However, even after adjustment for CD4 cell count, death rates in patients on antiretrovirals are much higher in sub-Saharan Africa than they are in industrialised countries.3 The scarcity of diagnostic facilities and treatment options for opportunistic infections are the major contributing factors to this high mortality. Conversely, the roles of immune reconstitution inflammatory syndrome and toxic effects of antiretroviral therapy remain to be established.4 Unfortunately, since the introduction of antiretroviral therapy in sub-Saharan Africa, no well-designed post-mortem investigation has been done to guide us about predominant causes of death. May and colleagues reported biological variables as prognostic indicators; although in sub-Saharan Africa socioeconomic factors are important determinants of survival,5 such as the ability to pay for food, drugs, investigations, transport, and support of a family member during their time in hospital. May and colleagues1 mainly discuss mortality while patients are taking antiretrovirals, but an unacceptably high pretreatment mortality in sub-Saharan Africa remains. In countries such as the Democratic Republic of the Congo, most antiretroviral programmes have stopped enrolling new patients,6 and new slots for treatment only become available when a patient dies or is transferred out. Waiting lists for starting antiretrovirals have been reintroduced, leading to increased pretreatment mortality.7 There is a widening gap between what WHO recommends for treatment of patients with HIV infections in low-income countries8 and what is available and feasible. WHO recommends that antiretrovirals should be started for patients with a CD4 cell count of 350 cells per ?L or fewer, and advises against the use of stavudine.8 Many treatment centres in sub-Saharan Africa are decreasing their threshold for starting antiretroviral therapy to fewer than 200 CD4 cells per ?L because of insufficient access to drugs,9 and stavudine is still widely used because other drugs are too expensive. The challenges to treat all patients with HIV infection are enormous. While disease burden is increasing, funds remain the same or are decreasing. Not only do we have to treat more patients, treat them earlier, and provide better drugs, but also we have to treat increasing numbers of patients with resistant viruses10 (not only because of poor adherence but also because of depleted stocks of antiretrovirals). There is a growing pessimism among donors about how to deal with the difficulty of HIV treatment in resource-poor settings. There is a move towards control of other diseases with less expensive therapies that are time-restricted and strengthening of health systems instead of provision of antiretrovirals. Funding for HIV treatment should again be put on the international agenda otherwise the efforts of the past will have been in vain.11 At the same time, we should improve programme efficiency. The Development of Anti-Retroviral Therapy in Africa (DART) study12 showed that a greater public health effect would be gained from widening of access to antiretrovirals than by provision of routine laboratory monitoring for patients who are already receiving treatment. Certainly, more research is needed about the role of different laboratory examinations in the scale-up of antiretroviral therapy in resource-limited settings. Testing of targeted viral load13 instead of CD4 cell count might be the way forward before doctors consider switching patients to more expensive second-line regimens. We need further research on the integration of antiretroviral services into routine care and we need to expand pre-service HIV education and training instead of the more costly post-service training.14 As long-term funding for HIV is running flat and access to antiretrovirals is still a huge challenge, HIV research aimed at how to do more with less should be a top priority research issue for the coming years. RC has consulted for and received honoraria from GlaxoSmithKline, and travel expenses from Merck Sharp & Dohme and Bristol-Myers Squibb. RC's institute has received grant support from Tibotec, Gilead, and Pfizer. References 1 May M, Boulle A, Phiri S, et alfor IeDEA Southern Africa and West Africa. Prognosis of patients with HIV-1 infection starting antiretroviral therapy in sub-Saharan Africa: a collaborative analysis of scale-up programmes. Lancet 201010.1016/S0140-6736(10)60666-6. published online July 16. PubMed 2 Yu JK, Chen SC, Wang KY, et al. True outcomes for patients on antiretroviral therapy who are ?lost to follow-up? in Malawi. Bull World Health Organ 2007; 85: 550-554. CrossRef | PubMed 3 The Antiretroviral Therapy in Lower Income Countries (ART-LINC) Collaboration and ART Cohort Collaboration (ART-CC) groups. Mortality of HIV-1-infected patients in the first year of antiretroviral therapy: comparison between low-income and high-income countries. Lancet 2006; 367: 817-824. Summary | Full Text | PDF(122KB) | CrossRef | PubMed 4 Muller M, Wandel S, Colebunders R, Attia S, Furrer H, Egger Mfor IeDEA Southern and Central Africa. Immune reconstitution inflammatory syndrome in patients starting antiretroviral therapy for HIV infection: a systematic review and meta-analysis. Lancet Infect Dis 2010; 10: 251-261. Summary | Full Text | PDF(284KB) | CrossRef | PubMed 5 Commission on Social Determinants of Health, WHO. Closing the gap in a generation. Health equity through action on the social determinants of health. http://www.who.int/social_determinants/thecommission/finalreport/en/index.html. (accessed June 20, 2010). 6 Campaign for Access to Essential Medicines, M?decins Sans Fronti?res. Punishing success? Early signs of a retreat from commitment to HIV/AIDS care and treatment. http://www.msf.org.uk/UploadedFiles/AidsReport_200911051940.pdf. (accessed June 20, 2010). 7 Lawn SD, Myer L, Orrell C, Bekker LG, Wood R. Early mortality among adults accessing a community-based antiretroviral service in South Africa: implications for programme design. AIDS 2005; 19: 2141-2148. PubMed 8 WHO. Rapid advice: antiretroviral therapy for HIV infection in adults and adolescents. http://www.who.int/hiv/pub/arv/advice/en. (accessed June 20, 2010). 9 Roehr B. More people face treatment rationing as AIDS funding is cut. BMJ 2010; 340: c2284. PubMed 10 Hosseinipour MC, van Oosterhout JJ, Weigel R, et al. The public health approach to identify antiretroviral therapy failure: high-level nucleoside reverse transcriptase inhibitor resistance among Malawians failing first-line antiretroviral therapy. AIDS 2009; 23: 1127-1134. CrossRef | PubMed 11 Piot P, Kazatchkine M, Dybul M, Lob-Levyt J. AIDS: lessons learnt and myths dispelled. Lancet 2009; 374: 260-263. Full Text | PDF(120KB) | CrossRef | PubMed 12 DART Trial Team. Routine versus clinically driven laboratory monitoring of HIV antiretroviral therapy in Africa (DART): a randomised non-inferiority trial. Lancet 2010; 375: 123-131. Summary | Full Text | PDF(233KB) | CrossRef | PubMed 13 Lynen L, An S, Koole O, et al. An algorithm to optimize viral load testing in HIV-positive patients with suspected first-line antiretroviral therapy failure in Cambodia. J Acquir Immune Defic Syndr 2009; 52: 40-48. CrossRef | PubMed 14 Renggli V, De Ryck I, Jacob S, et al. HIV education for health-care professionals in high prevalence countries: time to integrate a pre-service approach into training. Lancet 2008; 372: 341-343. CrossRef | PubMed a Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium b Epidemiology and Social Medicine, University of Antwerp, B2000 Antwerp, Belgium *3* *Budget choices on AIDS funds threaten lives ?report** **Reuters* 15/07/2010 By Kate Kelland, Health and Science Correspondent LONDON, July 15 (Reuters) - Reduced funds from rich donor nations to treat HIV/AIDS in poorer nations will ultimately lead to more graves and higher care costs for people who get sick while they wait for drugs, a leading charity said on Thursday. Medecins Sans Frontieres (MSF) said political budget choices made by rich countries who are either freezing or cutting overseas aid money for HIV treatment programmes were already starting to affect AIDS patients and putting lives at risk. "Unless they are reversed, these policies and decisions will impede the progress of the fight against AIDS for the years to come," MSF's Sharonann Lynch told reporters at a briefing. The medical charity published a report ahead of a major international conference on AIDS which starts in Vienna on Sunday in which it set out "the 10 consequences of AIDS treatment delayed, deferred, or denied." The report suggested that far from cutting back on treatment projects in high-risk developing regions such as sub-Saharan Africa, donors should recognise that investing now in earlier treatment for more patients would pay off later. "In light of the financial crisis, donors may be tempted to walk away from their commitments to provide universal access to AIDS treatment," it said. "But these policies are short-sighted and fail to take into account long-term payoffs, including savings in economic terms, as well as increased quality of life and quality outcomes." MSF criticised the German government, which it said was planning to cut its donations to the Global Fund to fight AIDS to a third of previous levels, offering just 200 million euros ($256 million). It also hit out at Austria, which despite hosting the 2010 AIDS conference had always refused to pledge money to the Global Fund and was still doing so. The United States, too, was "flatlining" funding for AIDS treatment, MSF said. An estimated 33 million people around the world are infected with the human immunodeficiency virus (HIV) that causes AIDS, and more than half of the 9.5 million people who need AIDS drugs cannot get them, according to the United Nations. The Global Fund has a $20 billion funding gap that it will be seeking to close at a replenishment conference due in October. MSF said evidence showed that getting AIDS drugs to people with HIV before they get too ill meant they needed fewer expensive doctors and hospitals later on. It also helps slow the spread of the virus, which is mainly transmitted via sex, by reducing the viral load of those who are HIV positive. Its report cited data from various studies, including one from rural Thyolo, a district of Malawi, where the charity helps provide HIV services through health clinics. It said that in Thyolo district, universal access to treatment and care has been reached -- meaning at least eight out of 10 people in who need AIDS drugs get them. Because of this, a 37 percent reduction in the district's death rate was measured between 2000 and 2007 in death registers, coffin sales and church funerals. Death rates decreased over time as ART coverage increased, MSF said, and an estimated 10,156 deaths were averted in the district over an eight-year period. "We're at a fork in the road: either governments summon the political will and financial resources to treat AIDS in developing countries, or current funding for AIDS treatment stagnates," says Tido von Schoen-Angerer, an MSF campaign director. "It's a question of choice: if they don't help us treat AIDS, there will be more graves." (Editing by Myra MacDonald) *4* *AIDS funding cuts a death sentence for millions, MSF warns** **AFP* 15/07/2010 VIENNA ? Cutbacks in rich-world funding for AIDS treatment could sentence millions of sufferers to death for lack of access to anti-retroviral (ARV) drugs, Medecins Sans Frontieres warned Thursday. "Donors have started to shift their support away from HIV/AIDS, and funding is not keeping up with the need," the medical charity warned in a report ahead of a major AIDS conference in Vienna next week. "If nothing is done, most of (those infected with HIV) will die within the next few years," it said, in a study based on fieldwork in eight African countries. According to MSF, many donors have frozen their contribution to the fight against AIDS -- partly due to the financial crisis -- with the United States planning to cut its support for ARV drugs in Mozambique by 15 percent over the next four years. The Global Fund to Fight AIDS, TB and Malaria is trying to raise 20 billion dollars (15.5 billion euros) for the next three years. So far it has received just a few hundred million dollars, the author of the report, Mit Philips, told journalists. "It is a very frustrating feeling to see that in spite of the achievements that have been made... the international donors, for the moment, show less interest and less resolve to continue to support the fight against HIV/AIDS," she said. "It's as if they want to give up the fight halfway through. We want to tell them: 'you cannot turn back now on AIDS treatment, it's too important'." While some three million HIV patients now have access to anti-retroviral drugs in Africa, the continent worst affected by the virus, another six million were still without treatment, MSF warned. By reducing funding, donor countries would ensure that even fewer patients received care, or received it too late, it added in its report. Turning people away from clinics, for lack of staff or resources, would also destroy the sense of trust that took years to build with local communities and make people less willing to come forward and get tested in a region where HIV still carries a strong stigma. MSF's study showed that early and sustained treatment of HIV patients had born fruit in several regions, including Malawi's Thyolo district where the overall death rate dropped by a stunning 37 percent between 2000 and 2007, thanks to universal access to ARVs. Where patients get treatment, "there is an overall reduction of mortality in the community, there is also less tuberculosis and we start to see, where there is a high coverage of ARV, also a reduction in the number of new cases (of HIV/AIDS)," said Philips. Copyright ? 2010 AFP. All rights reserved *5* *Norway's princess in Vienna for AIDS conference** **AFP* 15/07/2010 VIENNA ? Norway's Crown Princess Mette-Marit will be in Vienna this weekend for an AIDS gala and the opening of a Youth Pavilion at the AIDS 2010 conference, organisers said Thursday. The princess will one of the guests of honour at a special gala being held in the Austrian parliament on the sidelines of the glitzy AIDS charity Life Ball this Saturday. The gala's highlight will be an auction to raise money for the TREAT Asia (Therapeutics Research, Education, and AIDS Training in Asia) project. And on Monday Mette-Marit will open the Youth Pavillion of the World AIDS conference on July 18-23. On the guest list of this year's Life Ball, an annual fashion-show-cum-party-event marking its 18th anniversary this year, are Hollywood actress Whoopi Goldberg and former US president Bill Clinton. Last year, the Life Ball raised close to 1.5 million euros (two million dollars), which are distributed each year to various projects to combat the disease and help its victims. The 18th World AIDS conference in Vienna will bring together some 25,000 experts, health professionals and policy makers to discuss progress in fighting AIDS and look at ways to provide further prevention and treatment against the HIV virus which causes it. Copyright ? 2010 AFP. All rights reserved *6* *Sida: les pays riches doivent tenir leurs promesses de dons ** **L?Express* 15/07/2010 Les pays riches doivent tenir leurs promesses. Julio Montaner, co-pr?sident de la 18?me conf?rence internationale sur le sida qui s'ouvre dimanche ? Vienne, a rappel? mercredi 14 juillet les gouvernements ? leur devoir. L'engagement de financer l'acc?s universel aux traitements contre le sida, a ?t? pris par le G8 en 2005, avant la crise ?conomique. Mais le Fond mondial de lutte contre le sida, la tuberculose et le paludisme (GFATM) n'a r?uni que 100 millions de dollards jusqu'? pr?sent sur les 20 milliards qu'il devait r?colter pour les trois prochaines ann?es. "La crise financi?re est devenue l'excuse parfaite pour changer d'objectifs et parler d'autres choses", regrette Julio Montaner. L'accent mis sur la sant? maternelle lors du dernier G8 fin juin, avec le d?blocage de 7,3 milliards de dollars, est "noble, mais ne doit pas se faire au d?pens de l'acc?s universel au traitement contre le sida", a-t-il insist?, relevant que les Etats ont su trouver les milliards n?cessaires pour sauver le syst?me financier de la crise. "Le taux de mise sous traitement est inf?rieur ? la propagation de la maladie. Si nous n'augmentons pas de mani?re significative le nombre de personnes sous traitement, nous serons bient?t dans une situation intenable", a pr?venu le scientifique, rappelant que les trith?rapies pr?viennent de nouvelles infections. *7* *La cuesti?n no es sida o no sida** **El Per?odico de Cataluyna, Spain* 16/07/2010 Jordi Casabona, Fundaci? Sida i Societat. Pese a que el sida ha desaparecido de los medios de comunicaci?n, el n?mero de nuevos infectados sigue aumentando en muchos pa?ses y en varios grupos de nuestro entorno, y con m?s o menos eco medi?tico ?seg?n la habilidad de los correspondientes gabinetes de comunicaci?n? se siguen llevando adelante iniciativas. No hace mucho, el Ministerio de Sanidad, en el marco de la presidencia europea, organiz? la Conferencia sobre Sida y Vulnerabilidad; hace dos semanas se celebr? el 13? Congreso de Seisida en Santiago de Compostela, y en Catalunya se est? celebrando el 15 aniversario de la creaci?n del centro de investigaci?n biom?dica IRSI-Caixa, un exitoso ejemplo de colaboraci?n entre el sector p?blico (Departament de Salut) y el privado (La Caixa). Pero las pocas noticias que llegan a los medios suelen estar relacionadas con los aspectos m?s biol?gicos de la epidemia, reflejando una vez m?s la enorme dificultad que existe para aumentar el rigor cient?fico y la difusi?n de la investigaci?n en prevenci?n, y utilizarla para mejorar la efectividad de las intervenciones que sabemos que contribuyen a evitar nuevos contagios. De hecho, todas las intervenciones biom?dicas tienen un componente de comportamiento y otro social a tener en cuenta. Por ejemplo, por muy eficaz que sea un f?rmaco, si el enfermo no se lo toma regularmente, no tendr? efecto; o bien, por muy barato que sea realizarse las pruebas diagn?sticas, si los afectados est?n socialmente rechazados, se tender? a no hacerlas. El diagn?stico del VIH es un ejemplo paradigm?tico de esta interacci?n, pues, por el mal pron?stico y el estigma tradicionalmente asociados al sida, su realizaci?n siempre ha estado rodeada de una importante excepcionalidad, tanto desde el punto de vista normativo como sobre c?mo y d?nde hay que hacerlo. Pero si bien la excepcionalidad ha sido necesaria, a veces ha dificultado tambi?n el acceso al propio diagn?stico. Ahora que el VIH puede considerarse una enfermedad cr?nica, es una buena oportunidad para ?sin dejar de combatir el estigma-- facilitar la normalizaci?n social de esta infecci?n y en particular de su diagn?stico. Hacerlo ayudar? a que m?s personas se hagan la prueba y a que muchos infectados lo sepan antes; y el diagn?stico precoz de la infecci?n no solo asegura un mejor pron?stico para el paciente, porque se puede empezar a tratar antes, sino que adem?s favorece que este evite la transmisi?n. En nuestro contexto se empiezan a introducir las pruebas de diagn?stico r?pido (que en 15 minutos permiten saber si una persona est? infectada y pueden ser realizadas por personal no sanitario convenientemente entrenado). Esta tecnolog?a ofrece una excelente oportunidad para debatir y consensuar algunos de estos aspectos transversales. Es preciso hacerla llegar activamente a las poblaciones m?s vulnerables a la infecci?n y con menor acceso a los servicios sanitarios. Pero siempre sin perder de vista la importancia de este acto diagn?stico, pues he visto propuestas de realizar la prueba en la calle como si se tratara de un acto festivo. Normalizaci?n s?, pero no banalizaci?n. La infecci?n por el VIH sigue siendo una enfermedad grave y, en muchos casos, mortal. Adem?s, la prueba del sida debe debatirse y ofrecer en el contexto de la salud sexual en general. El importante aumento de algunas infecciones de transmisi?n sexual (ITS) cl?sicas, como la s?filis o la clamidia, y muy especialmente el n?mero de abortos en chicas adolescentes y el de dispensaciones de la p?ldora del d?a siguiente para evitar el embarazo, nos indican que el problema no es solo el sida. Quien se expone a un embarazo no deseado se expone tambi?n a una ITS, incluyendo el sida, y viceversa. Tener el sida o no tenerlo, no es la cuesti?n. La reciente encuesta hecha por el Ministerio de Sanidad dice que el 40% de los encuestados no utiliza ning?n m?todo de anticoncepci?n en su primera relaci?n sexual, y adem?s los m?todos anticonceptivos m?s efectivos no evitan la adquisici?n de ITS; por el contrario, los m?todos de barrera, como el preservativo, que s? protegen de algunas ITS, ni se utilizan siempre ni siempre que se utilizan se hace correctamente. Estos d?as se han tomado dos medidas importantes para normalizar el VIH y la promoci?n de la salud sexual. Por un lado, en Catalunya se ha aprobado un decreto que considera el VIH una infecci?n de declaraci?n obligatoria y nominal, tal y como lo son otras infecciones como la tuberculosis, la meningitis y el sarampi?n; por otro, se aplica en el Estado la ley de salud sexual y reproductiva, que regula y garantiza el acceso a la interrupci?n voluntaria del embarazo. Pero, de nuevo, la salud sexual va mucho m?s all? de los aspectos m?dicos y, teniendo en cuenta los datos existentes y la importante sexualizaci?n experimentada por nuestra sociedad, en general, y en particular en los productos y publicidad dirigidos a los j?venes, la educaci?n sexual en la escuela y los mensajes para aumentar la edad de la primera relaci?n o disminuir el n?mero de compa?eros y compa?eras sexuales no deben considerarse moralizadores, sino unos objetivos t?cnicos m?s. Fundaci? Sida i Societat. *========================* * * *LATIN AMERICA AND CARIBBEAN* * * *========================* *The link between HIV and gender violence** **Jamaica Observer* 12/07/2010 By NADINE WILSON WITH a recent survey showing that at least 12 per cent of women between 15-49 years were the victims of forced sexual abuse at one point during their lifetime, the National Family Planning Board (NFPB) on Tuesday hosted a workshop to look at gender-based violence (GBV) and its implications for the fight against HIV/AIDS. In addition to addressing the underlying issues and disseminating current data on the prevalence of HIV/AIDS and GBV, the workshop also brought persons from the National HIV/STI programme at the Ministry of Health and the Bureau of Women's Affairs together to discuss the way forward as they tackle the 'two epidemics'. Apart from showing the incidence of forced sexual abuse among women of reproductive age, the 2008 Reproductive Health Survey also showed that at least one in three women experienced at least one type of abuse, and one in five reported having experienced physical or sexual intimate partner violence in their lifetime. During her dissemination of the survey data, executive director of the NFPB Dr Olivia McDonald described some of the findings as being "very frightening", and sought to show the direct and indirect link to HIV/AIDS and GBV. "Sexual violence poses a direct biological risk for HIV because where there is forced intercourse, there is usually some vaginal trauma or laceration, and wherever there is trauma, this will facilitate transmission of any sexually transmitted infection, including HIV," she said. She also pointed to the fact that women were unable to negotiate condom use during forced sexual intercourse, and that the fear of violence sometimes prevented women from getting tested or disclosing their status. In addition to this, the doctor also asserted that the "experience of violence may be linked to increased risk taking". "Risk-taking behaviours would include multi-partners (and) non-primary partners. These are women who may have a main partner, but they also have what the army would call a second in command," she explained. In her address to those in attendance at the workshop, Co-ordinator for HIV Treatment and Care at the Ministry of Health Dr Debbie Carrington pointed to the importance of addressing GBV, as her group forges ahead to achieve the millennium development goal "to halt and reverse the HIV epidemic by 2015". "As a country and a region, we still have a far way to go to ensure protection of our most vulnerable populations," she said. But Executive Director of the Bureau of Women's Affairs Faith Webster assured that her organisation in fulfilling its mandate, and has been undertaking a number of projects and workshops to enlighten women about their rights and to empower them. She said that her group will be "increasing efforts to eliminate violence against women", even as it remains mindful of the fact that men are also being abused and need to be helped as well. As it relates to their role in the elimination of HIV/AIDS, Director of Policy and Research at the Bureau Jennifer Williams said the organisation currently partners with the United Nations Population Fund to distribute condoms to encourage safe sex. She said they have also been trying to change the mindset of teenage boys about the treatment of women through a series of workshops that they host throughout the year. "We have been conducting public education on HIV and AIDS and we have also been conducting public education on gender-based violence," she added. But even with increasing interventions and campaigns to stem the transmission of HIV, Director of Policy Formulation, Monitoring and Evaluation at the NFPB Kevin Bell said people seemed "to hear it, but they tune out". His statement comes amidst his analysis of the 2008 survey, which showed that a significant percentage of the population still harboured myths about the disease and were not going for testing. This was primarily the case among those living in the North East region of the country. "We need to reduce the predisposing circumstances -- those circumstances that put people at risk to gender-based violence and HIV/AIDS," he said. *2* *Conferencia internacional sobre el Sida abordar? propuestas prometedoras en Viena, Austria ** **El Tiempo, Colombia* 16/07/2010 An?lisis de diagn?stico precoz para todo aquel que lo desee o tratamientos m?s sencillos y m?s r?pidos son algunas de las iniciativas. El Sida mata a unas dos millones de personas cada a?o. La Sociedad Internacional del Sida ha elegido para el evento, que se celebra del 18 al 23 de julio en Viena y que contar? con m?s de 20.000 investigadores, m?dicos y miembros de asociaciones, el tema "Derechos aqu? y ahora". La igualdad en el acceso al tratamiento y la prevenci?n es el fundamento de una respuesta adecuada a la pandemia, seg?n los organizadores. "Ser? la conferencia de los sin voz", seg?n el director ejecutivo de OnuSida, Michel Sidib?. El "aqu?" se refiere a la proximidad de Europa oriental y Asia central, ?nicas regiones en las que la epidemia avanza, especialmente entre los consumidores de drogas inyectables. Tres ex presidentes latinoamericanos e intelectuales de esa regi?n aportaron su respaldo a la "Declaraci?n de Viena" que exige una nueva pol?tica sobre las drogas para prevenir la propagaci?n del Sida. El ex mandatario brasile?o Fernando Henrique Cardoso, el mexicano Ernesto Zedillo y el colombiano C?sar Gaviria firmaron este documento redactado por expertos de renombre en ocasi?n de la 18? conferencia internacional. El escritor peruano Mario Vargas Llosa y el brasile?o Paulo Coelho tambi?n suscribieron el informe. Los expertos que impulsan la "Declaraci?n de Viena" juzgan que las pol?ticas represivas contra la droga contribuyen a la difusi?n del virus, ya que los toxic?manos tienen escaso acceso a los cuidados m?dicos. Una contaminaci?n de cada tres, fuera del Africa subsahariana, est? relacionada con una inyecci?n de droga. En Asia Central y en Europa del Este, ?nicas regiones en donde la epidemia progresa, se trata de un primer factor de contagio. "La guerra contra la droga fracas?. En Am?rica Latina el ?nico resultado de la prohibici?n es el de desplazar las zonas de cultivo y los carteles de un pa?s a otro sin reducir la violencia o la corrupci?n que genera el tr?fico", lament? Cardoso, citado en el comunicado. Los tres ex jefes de Estado dirigen la Comisi?n Latinoamericana sobre las drogas y la democracia que, seg?n su sitio Internet, trabaja en favor de pol?ticas contra la droga m?s eficaces y m?s humanas. Las nuevas pistas de lucha contra la enfermedad son numerosas. Para OnuSida, hay que facilitar el acceso al tratamiento con una pastilla "m?s inteligente, mejor y menos t?xica", y un sistema de distribuci?n m?s simple y barato. De esta manera, seg?n la agencia de Naciones Unidas, se podr?a reducir en un mill?n anual las nuevas infecciones y evitar 10 millones de muertes de aqu? a 2025. Para ir m?s lejos, se abordar? en Viena la posibilidad de un an?lisis de diagn?stico precoz (voluntario) que se ofrecer?a a todos, y de un tratamiento propuesto a todos los seropositivos, incluso si su nivel de infecci?n es muy bajo. Tambi?n se hablar? de la circuncisi?n, que protege parcialmente a los hombres, de los microbicidas, que podr?an un d?a proteger a las mujeres. En cuanto a la vacuna, nada realmente nuevo, pero la investigaci?n "contin?a de forma muy activa", seg?n el profesor Delfraissy. Seg?n un especialista estadounidense, hace mucho tiempo que la comunidad de investigadores no era "tan optimista". Los ?ltimos datos publicados parecen dar la raz?n a los m?s optimistas, con un retroceso de la enfermedad en los j?venes de entre 15 y 24 a?os en casi la mitad de los 25 pa?ses m?s afectados. La excepci?n es Europa oriental. La cuesti?n de los costes, agravada por la crisis financiera y la desgana de los donantes, tambi?n es importante. Este a?o har?an falta 25.000 millones de d?lares para luchar contra la pandemia en los pa?ses pobres, y actualmente faltan 11.300 millones, seg?n un an?lisis publicado en la revista estadounidense Science. Bill Gates y Bill Clinton formar?n parte de las personalidades presentes, junto a numerosos ministros de Sanidad. *3* *Situaci?n de la pandemia por VIH/Sida en el mundo** **Cimac Not?cias, Mexico* 15/07/2010 Por Guadalupe Cruz Jaimes M?xico DF, 15 jul 10 (CIMAC).- El pr?ximo domingo iniciar? la XVIII Conferencia Internacional sobre el Sida (AIDS 2010), en Viena, Austria, donde representantes de gobiernos de varios pa?ses, de Naciones Unidas y de organizaciones internacionales expondr?n la situaci?n de la pandemia en el mundo y los compromisos que las autoridades deben asumir para reducir la propagaci?n del virus de inmunodeficiencia humana (VIH). La Conferencia Internacional, que se llevar? a cabo del 18 al 23 de julio pr?ximo, tendr? como uno de los temas a tratar, la violencia contra las mujeres y ni?as, como un factor que detona un aumento del s?ndrome de inmunodeficiencia adquirida (Sida) en esta poblaci?n. Otros temas que abordar?n especialistas en el estudio de la pandemia, activistas en contra de la propagaci?n del VIH y representantes de distintos gobiernos del mundo, ser? la criminalizaci?n de las personas Usuarias de Drogas Inyectables (UDI), sostienen las organizaciones que suscriben la Declaraci?n, previa a la Conferencia Internacional. Ello se debe a que el encarcelamiento de las UDI en condiciones de hacinamiento, y sobrepoblaci?n deriva en una mayor propagaci?n del virus y en consecuencia significa un incremento de personas enfermas de Sida. Por lo anterior, la Declaraci?n de Viena, iniciada por la Sociedad Internacional de SIDA (IAS), el Centro Internacional de Ciencia en Pol?tica de Drogas y el Centro de la Columbia Brit?nica para la Excelencia en VIH/SIDA (BC-CFE), se?ala que se deben adoptar acciones que garanticen a las personas UDI, acceso a servicios m?dicos y el apoyo que necesiten. El respeto a los derechos humanos de las personas portadoras del VIH/Sida, ser? otro de los ejes fundamentales de la discusi?n en la AIDS 2010, donde se prev? la asistencia de 20 mil personas. La Conferencia Internacional sobre el Sida es el encuentro bienal, convocado por organizaciones como la IAS, de personas dedicadas a la investigaci?n y ejecuci?n de pol?ticas en respuesta mundial frente al VIH. De acuerdo con el programa del encuentro, que se encuentra en la p?gina www.aids2010.org, en los seis d?as de trabajo se discutir?n problem?ticas como el acceso universal al tratamiento y prevenci?n de personas portadoras del VIH/Sida, estrategias para una cura, progresos en las terapias antirretrovirales y los medicamentos para prevenir el virus. Las exposiciones estar?n a cargo de especialistas en la pandemia del VIH de distintos sectores, provenientes de Per?, Estados Unidos, Canad?, Austria, Suiza, Rusia, Ucrania, India, Zimbawe y Sud?frica. AIDS 2010 EN VIDEO-CONFERENCIA EN ESPA?OL A quienes les interese conocer la informaci?n que se discutir?n en la AIDS 2010, la Red Comunitaria sobre el VIH/sida del Estado espa?ol (Red2002) transmitir? las conferencias en tiempo real, traducidas para las personas hispanohablantes, en la p?gina web: www.red2002.org.es/hub2010. En este sitio, adem?s de poder escuchar las conferencias traducidas al espa?ol en tiempo real, tambi?n podr?n consultarse las exposiciones de d?as u horas anteriores. Asimismo, la Red2002 ofrece en su p?gina de Internet un chat de Facebook para facilitar el debate y el contacto entre las personas interesadas en el tema. La transmisi?n y el intercambio de ideas sobre el tema, mediante la conexi?n a la red, tiene por objetivo fomentar la participaci?n, el conocimiento y la discusi?n de la comunidad preocupada por hacer frente al VIH/Sida, que no pueda asistir a Viena. *========================* *NORTH AMERICA* *========================* *Obama's HIV/AIDS strategy: sound, but not sufficient** **Washington Post* 15/07/2010 PostPartisan Blog Earlier this week, President Obama announced a comprehensive national HIV/AIDS strategy. It is needed. America?s domestic AIDS problem has dropped from the headlines since the early days of fear and controversy -- both of which were calmed by a better understanding of transmission and the development effective treatments. But more than a million Americans are living with HIV/AIDS, and infection rates on their current course will increase this number over time. AIDS is on the advance in America and, as I?ve written, the demographics of the disease are changing -- becoming more prevalent among the poor, minorities and women. The administration?s strategy summarizes the best current thinking on AIDS in America. But the president?s announcement was attended with some unnecessary rhetorical fuzziness. ?Fighting HIV/AIDS in America and around the world will require more than just fighting the virus,? he said. ?It will require a broader effort to make life more just and equitable.? Hopefully, we can make some progress reducing the rate of new HIV infections before the arrival of the peaceable kingdom. Obama also gave us more of a framework than a plan. Little gets accomplished in government without the alignment of authority, resources and responsibility. The President?s Emergency Plan for AIDS Relief (PEPFAR) succeeded internationally with a simple theory: put someone in charge, give them the resources they need, and hold them personally accountable for outcomes. By this measure, the new domestic AIDS strategy raises more questions than it answers. The report comes out of the National AIDS Policy Council at the White House, which does not have direct, government-wide authority over this issue. The new resources dedicated to the effort -- $30 million -- are minimal. And if the targets in the strategy are not met, it is not clear that anyone is held directly responsible. The goals of this strategy, though, are worthy: reduce new infections by 25 percent over the next five years, increase the percentage of the infected who know their status, increase the percentage of those who get quickly from diagnosis into care. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes for Health, points to several positive elements of the new AIDS strategy (which he helped to produce), beginning with its realism about the current nature of the crisis. ?It is important to avoid stigmatizing any group,? Fauci told me, ?but we can?t act like HIV is an equal opportunity disease.? While African Americans comprise about 12 to 13 percent of the U.S. population, they account for nearly 50 percent of new HIV infections. And about half of new infections are found among men who have sex with men. The strategy, Fauci says, ?takes the sugar coating away? ? allowing public health officials to focus on the greatest needs. Fauci also welcomes the strategy?s emphasis on linking HIV testing to care. He recounts the recent case of a District man who arrived at NIH with an advanced case of AIDS. The man had been tested and diagnosed three years before, but had never received care for his condition. ?We not only need aggressive testing,? says Fauci, ?we need aggressive efforts to make sure we don?t let people fall between the cracks.? This new AIDS strategy is sound. Still, it is not a substitute for a strong, well-funded presidential initiative to combat AIDS in America -- which is the next, logical step. By Michael Gerson *3* *Former Presidents Denounce Drug War Ahead of AIDS Meet** **IPS Terra Viva* 15/07/2010 Stephen Leahy BERLIN, Jul 14 (IPS) - The failed "war on drugs" has not only badly damaged countries where it is waged, it is responsible for driving up HIV infection rates in some countries, says an official declaration endorsed Wednesday by three former Latin American presidents in advance of the XVIII International AIDS Conference that begins Jul. 18 in Vienna. In Eastern Europe and Central Asia, injecting drug use is the primary cause of new HIV infections. Outside of sub- Saharan Africa, injecting drug use accounts for approximately one in three new cases of HIV, experts will report at the week-long meeting. "The war on drugs has failed...Instead of sticking to failed policies with disastrous consequences, we must direct our efforts to the reduction of consumption and the reduction of the harm caused by drugs to people and society," said former Brazilian president Fernando Henrique Cardoso. "Repressive policies are firmly rooted in prejudices, fears and ideological visions. The way forward to safeguard human rights, security and health is a strategy of peace not war," said Cardoso. Cardoso, along with former presidents Ernesto Zedillo of M??xico and C??sar Gaviria of Colombia, have endorsed the Vienna Declaration that lists a range of harms stemming from the war on drugs, and notes that the criminalisation of people who use drugs has resulted in record high incarceration rates, placing a massive burden on taxpayers. The declaration calls on countries to undertake a transparent review of the effectiveness of current drug policies and reform those policies on the basis of science- based evidence and public health objectives. An estimated 20,000 conference participants will be in Vienna for the international AIDS Conference, and organisers are encouraging them to sign on to the declaration and join the growing call for evidence-based drug policies. Forty leading scientists and experts worked on the declaration, said Evan Wood, a researcher at Canada's British Columbia Center for Excellence in HIV/AIDS and founder of the International Centre for Science in Drug Policy, a network of scientists, academics and health practitioners. "The declaration calls for decriminalising drug users because the scientific evidence clearly shows that criminalisation pushes drug users into the margins of society with little access to HIV prevention or other public health services," Wood told IPS in an interview. Making drug users criminals is a recipe for the spread of HIV and other diseases, he said. Sharing injection equipment is three times more likely to transmit HIV than sexual intercourse. And that's why Eastern Europe and Russia and other countries have become HIV infection hotbeds. In Russia, the number of HIV-infected people increased tenfold from an estimated 100,000 to one million mainly amongst the injecting drug using population. That's largely the result of policies that reject harm reduction policies such as the use of methadone and needle exchanges. Harm reduction involves providing access to methadone, needle exchange services, and counseling - a well-proven strategy for reducing illegal drug use, crime and the associated violence and reducing HIV infection rates. Methadone is illegal in Russia, Uzbekistan and other countries. There is no government support for needle exchange programmes in Russia or more than 70 other countries. While methadone is still legal in Canada, the current Stephen Harper government is withdrawing its support from needle exchange programmes, not because they don't work but over misplaced morality or ideology, says Reed. "Canada is pulling harm reduction out of its drug strategy and pushing for a much harder line on drug users just like in the U.S." Criminalising drug users has become big business in the U.S., where more than two million people are incarcerated, many prisons are for-profit businesses, and billions of dollars are poured into the war on drugs. Governments and the general public do not understand that the war on drugs is responsible for much of the drug-related crime and violence. Illicit drug trade is all about supply and demand. High-profile arrests of major drug dealers simply leaves a supply shortage and power vacuum that directly leads to increased violence as drug gangs and dealers fight for the extraordinary profitable business, critics say. "The reality is that hard-line drug enforcement policies do far more harm than good," said Wood. A review of 20 years of scientific research last fall revealed that 82 percent of the studies found the various wars on drugs simply increase violence. Mexico is a textbook example. In 2006, it launched a massive, nationwide counter-narcotics campaign. By 2008, drug violence claimed 6,290 lives in that year alone - double the number from 2007. In first eight weeks of 2009, more than 1,000 people were killed. Since 2006, the total number killed has surpassed 17,000 people, including scores of judges, police, and journalists. By contrast, Portugal removed criminal penalties for the personal use of all drugs in 2001. HIV infection rates have fallen sharply, as has underage drug-taking. The number of people seeking drug treatment has increased but overall drug use has not increased. Drug dealing remains a crime. Meanwhile, the U.S., where the war on drugs got started in the 1970s, has the highest rates of cocaine and marijuana use in the world. "I hope that the Vienna Declaration will inspire many more political leaders to cast aside the drug war rhetoric and embrace evidence-based policies that can meaningfully improve community health and safety," said AIDS 2010 Chair Dr. Julio Montaner, president of the International AIDS Society. *4* *Study rethinks AIDS prevalence among Haitians ** **Boston Globe* 15/07/2010 Posted by Elizabeth Cooney In the early days of the AIDS epidemic, before the syndrome had a scientific name, the illness was sometimes called ?the 4H disease,? named for four groups thought to be at highest risk: homosexuals, hemophiliacs, heroin users, and Haitians. Haitians who immigrated to the United States have been stigmatized, and even blamed for bringing the virus to North America, since that time, partly based on higher estimates of infections among Haitian-born people compared to other groups. A new study led by a Haitian-American researcher challenges those rates with data showing that the prevalence of AIDS among Haitian immigrants is similar to the levels reported among African-Americans. Dr. Linda Marc of the Center for Multicultural Mental Health Research at Cambridge Health Alliance led a team that analyzed national AIDS data from 1985 through 2007. According to the US Centers for Disease Control and Prevention, Haitian-born immigrants made up 1.2 percent of AIDS cases in the country, but they accounted for only 0.18 percent of the US population. That amounts to a seven-fold over-representation of AIDS among Haitian immigrants compared to the US population as a whole. But when higher population figures from Haitian consulates in US cities were used, that over-representation of AIDS cases fell to four-fold, which is about the same level as among African-Americans. Haitian immigrants are likely to be undercounted by American census takers, Marc and her co-authors write, particularly if they are not in the country legally. Sources at Haitian consulates estimate that 1.2 million Haitian-born people live in the United States, double the US census figure. Marc?s paper, which appears in the journal AIDS, also reports that Haitian immigrants tend to be diagnosed with HIV at a later stage than other people. That means public health messages need to be targeted and tailored to this group, Marc said in an interview. ?We didn?t know that Haitians are getting in much later for their diagnoses,? she said. ?They?re not being tested for HIV as part of routine care and they don?t recognize the signs and symptoms of the illness. It has major implications for us.? *Elizabeth Cooney is a former health reporter for the Worcester Telegram & Gazette* *AIDS Journal: http://journals.lww.com/aidsonline/Abstract/publishahead/HIV_among_Haitian_born_persons_in_the_United.99485.aspx * *6* *Bill Gates Talks AIDS Vaccine Potential, Research Funding** **Wall Street Journal* 13/07/2010 By Robert A. Guth Bill Gates can leave his hat on. A major backer of the quest to beat HIV and AIDS, Gates in March 2005 said that if a vaccine for the disease was found within ten years he would ?eat my hat.? That didn?t mean that he was pessimistic that a vaccine could be found ? only realistic that the hurdles are great. Last week one of those hurdles was cleared when U.S. government scientists said they found three antibodies that work against HIV, including one that neutralizes 91% of HIV strains. The discovery is an important step towards a possible HIV vaccine and follows results of a trial last year of a vaccine that had modest results in stopping the spread of the HIV virus. In an interview Tuesday, Gates said that both developments were ?positive and exciting? but turning them into an efficacious vaccine will take more time that anyone can predict. ?I would love to eat my hat but it?s not likely,? he said. Scientists and clinicians have less than five years to prove him wrong. His philanthropy, the Bill & Melinda Gates Foundation, is financing many of them. Gates?s comments come as the global recession threatens funding of global health programs, prompting fears that progress against AIDS and other diseases could slow in coming years. The concerns are expected to permeate next week?s big AIDS conference in Vienna, where Gates will deliver a speech on how to expand AIDS prevention efforts ? such as male circumcision ? and how to make existing AIDS treatment programs more efficient. Gates said that despite the funding challenges, he remains optimistic that recent progress won?t be lost to the recession. He estimates that while overall health-related funding has leveled off, it hasn?t dropped. ?As we have scientific progress and we?re smarter about how we spend the money, we can increase the impact,? he said. Longer term, scientists hope to turn the recent developments into a vaccine. The naturally occurring antibodies announced last week were discovered in the body of a 60-year-old African-American gay man. Researchers now must devise a vaccine that can produce the antibodies in everyone. ?We?re still in the situation that even the best case is like an eight-to-ten-year time-frame,? Gates said. *========================* *UNAIDS WEB.SITE* *========================* Joint statement of UN agencies on criminal charges brought against HIV activists and health and social workers in eastern Europe and central Asia *UNAIDS* 15/07/2010 GENEVA, 15 July 2010?Five United Nations agencies?UNICEF, UNFPA, WHO, UNAIDS, and UNDP?express concern that health and social workers have suffered as a result of their professional activities in the response to HIV in several countries in eastern Europe and central Asia. Persecution, criminal investigation, arrests and sentencing of HIV activists as well as health and social workers affect not only the lives of the people involved but also discourage other activists and professionals, and deprive societies of some of the most valuable and vital resources in the response to the epidemic?people?s commitment and energy at the community level. Health, social and outreach workers are at the front line of the response to HIV, providing critical assistance to the hundreds of thousands of people who need it. They also help countries meet their goals and obligations in the HIV response, linking government efforts with the most vulnerable to HIV?young people and populations at high risk of infection. In several countries of eastern Europe and central Asia, health and social workers and volunteers have been prosecuted because of their professional activities?activities they felt compelled to carry out in order to save lives, as the epidemic does not wait for societies to adjust and re-examine principles and approaches. The activities of these practitioners have been guided by scientific evidence on how best to achieve good public health outcomes. Often challenging taboos, health and social workers inform adolescents about the behaviours that lead to HIV infection, help injecting drug users through harm reduction activities, support prevention programmes for sex workers and men who have sex with men, and work in oral substitution centres for drug users or in health facilities in conditions that are far from perfect. Eastern Europe and central Asia is the only region in the world where new HIV infections remain on the rise. The contribution of these front-line practitioners is essential in responding to the epidemic in the region. They need the support and protection of authorities, and their basic human rights must be ensured. The UN agencies urge governments to acknowledge the critical role of health and social workers in the prevention and treatment of HIV infection and to better understand the complexity of their work. We appeal to the governments of the region to bring an end to counterproductive persecution and harassment, to discontinue procedures that hamper their work and release those who have been detained. *2* *18th International AIDS Conference to open in Vienna** **UNAIDS* 16/07/2010 The XVIII International AIDS Conference (AIDS 2010) will begin in Vienna on 18 July. A pivotal year in the AIDS response, it will coincide with a major push for expanded access to HIV prevention, treatment, care and support as 2010 is the target year set by countries to achieve universal access to HIV services and comes ten years after nations committed to the historic Millennium Development Goals. With the international financial downturn and bleak global economic outlook threatening to undermine public investments, the event hopes to help keep HIV on the front burner, and is a chance to demonstrate the importance of continued HIV investments to broader health and development goals. ?Rights Here, Right Now? The overarching theme of AIDS 2010 is "Rights Here, Right Now". It highlights that the protection of human rights is a fundamental prerequisite to an effective response to HIV?whether directly involving people living with HIV or particular groups, such as women and girls, men who have sex with men, people who use drugs, sex workers or young people. AIDS 2010 will provide a multidisciplinary forum for networking and the sharing of information related to new research and evidence-based programmes and policies. It is a chance for the many stakeholders involved in HIV to take stock of where the epidemic is, evaluate recent scientific developments and lessons learnt, and collectively chart a course forward. HIV epidemics in Eastern Europe and Central Asia Taking place in Vienna, AIDS 2010 will turn attention towards the growing epidemics in Eastern Europe and Central Asia where an estimated 1.5 million people were living with HIV in 2008, a rise of 66% from 2001. HIV prevalence in the region is also on the rise, with severe and growing epidemics in the Ukraine and the Russian Federation. One of the highlights of the AIDS response in the region is the high coverage of services to prevent mother-to-child HIV transmission. In December 2008, coverage of services to prevent mother-to-child transmission exceeded 90% in Eastern Europe and Central Asia. However reaching many of people at higher risk of HIV remains a challenge. Injecting drug use is the main mode of HIV transmission in this region. An estimated 3.7 million people inject drugs, and roughly one in four are thought to be HIV-positive. Evidence suggests that injecting drug users in the region, are often the least likely to receive antiretroviral therapy. Preventing sexual transmission of HIV prevention will also be high on the conferences agenda. With increasing transmission among the sexual partners of drug users, many countries in the region are also experiencing a transition from an epidemic concentrated among injecting drug users to one that is increasingly characterized by significant sexual transmission. UNAIDS at Vienna UNAIDS will be publishing live updates from the conference. UNAIDS @ Vienna blog, on twitter and facebook. During the upcoming week interviews with activists and conference goers on their perspectives of the conference and the AIDS response will also be posted on YouTube. Vienna partners The conference takes place every two years and is the largest gathering for those who work in the AIDS response including policymakers, people living with HIV and civil society. Local and regional partners include the host the City of Vienna, the Government of Austria, Austrian AIDS Society, Aids Hilfe Wien, East Europe & Central Asia Union of PLHIV, European AIDS Clinical Society and the European Commission. International partners include UNAIDS and its Cosponsors, WHO and the United Nations Office on Drugs and Crime; the International Council of AIDS Service Organizations; the Global Network of People Living with HIV/AIDS; the International Community of Women Living with HIV/AIDS; the World Young Women?s Christian Association; and the Caribbean Vulnerable Communities Coalition. *3* *Join UNAIDS and IAS at host Town Hall on reshaping the future of AIDS** **UNAIDS* 16/07/2010 Towards a paradigm shift in HIV treatment and prevention At this defining moment?reshaping the AIDS response is a necessity. Join UNAIDS and the International AIDS Society to set the tone for the AIDS 2010 Conference: challenging and encouraging delegates to call for and join a movement to reshape the AIDS response to reach universal access to HIV prevention, treatment, care and support. Guest speakers include Kgalema Motlanthe, Deputy President of South Africa; Julio Montaner, President of the International AIDS Society, and Michel Sidib?, Executive Director of UNAIDS. Bring your ideas to this interactive Town Hall event and engage with leaders in the AIDS response. Panelists include: Rolake Odetoyinbo, Executive Director, Positive Action for Treatment Access, Mphu Ramatlapeng, Minister of Health and Social Welfare of Lesotho and Barbara Lee, US Congresswoman, 9th District of California. Annie Lennox, long-time AIDS activist and UNAIDS International Goodwill Ambassador, will lend her unique voice to setting the tone for the Conference. Hosted by James Chau, News Anchor, China Central Television; UNAIDS National Goodwill Ambassador for China. To attend and promote the event on facebook, go to: www.facebook.com/?ref=home#!/event.php?eid=110421382341713&ref=mf Note to broadcasters: The Town Hall event will be offered to broadcasters rights-free. Please contact Saya Oka, okas at unaids.org *4* *Eastern European countries show increasing new HIV infections while some harm reduction programmes are decreasing ** **UNAIDS* 16/07/2010 *UNAIDS concerned that a number of counties in this region are reporting reductions in critical investments in the AIDS response. * VIENNA, 16 July 2010 ? Eastern Europe and Central Asia is the only region where HIV incidence clearly remains on the rise. Early indications are that the number of newly diagnosed HIV cases in 2009 has increased since 2008. Russian Federation has reported an 8% increase in reported cases, Georgia a 10% increase and Belarus a 22% increase. Injecting drug use remains the primary route of transmission in the region. Use of contaminated equipment during injecting drug use was the source of 57% of newly diagnosed cases in eastern Europe in 2007. An estimated 3.7 million people in the region currently inject drugs, of which one in four are believed to be HIV positive. ?It should concern all of us that some countries are closing down HIV prevention services for injecting drug users when they should be scaling up,? said Mr Michel Sidib?, Executive Director of UNAIDS. ?Epidemics driven by injecting drug use can grow rapidly when HIV prevention services are not available.? In the latest round of country progress reports, coverage of HIV prevention programmes for injecting drug use remains low. In the Russian Federation, coverage was 23.8% in 2007, but only 13.6% in 2009 and Georgia went from 17% down to 11.4% in the same time period. As most injecting drug users are sexually active?often with non-injecting partners?the existence of a major injection-driven epidemic has also fuelled a growth in heterosexual transmission of HIV in the region. Ukraine has the highest level of reported HIV cases in the region. The number of new infections in the country has gone up from 18,963 in 2008 to 19,840 in 2009, and heterosexual transmission has eclipsed injection driven transmission. The news comes as the global AIDS community gathers in Vienna for the XVIII International AIDS conference. ?Eastern Europe can not lag behind in the prevention revolution,? added Mr Sidib?. ?Evidence shows unequivocally, harm reduction programmes save lives and are a smart investment.? -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100716/edaf2e8e/attachment-0010.html From vern.weitzel at gmail.com Fri Jul 16 19:50:41 2010 From: vern.weitzel at gmail.com (vern weitzel) Date: Fri, 16 Jul 2010 11:50:41 -0700 Subject: [hivaids-twg] HIV/AIDS: The Stories and Trends Behind the Science - Medecins Sans Frontieres (MSF) Message-ID: <8F7E0431-09C8-47F1-8152-382563AF6A4C@gmail.com> http://www.doctorswithoutborders.org/publications/article.cfm?id=4590&cat=special-report SPECIAL REPORT HIV/AIDS: The Stories and Trends Behind the Science JULY 14, 2010 SPECIAL REPORT Download Report [4.8 MB] MORE RESOURCES HIV Facts Sheet Despite the growing evidence that rapid scale up of HIV/AIDS treatment reduces unnecessary death, staves off disease, and reduces transmission of the virus, international donors are wavering and sending the message to scale back treatment plans. On July 15, Doctors Without Borders/M?decins Sans Fronti?res (MSF) will hold a media teleconference on the key issues that will be discussed at the XVIII International AIDS Conference (IAC) in Vienna, presenting some of the findings from its field projects. These include: ? How starting HIV treatment earlier has dramatically reduced mortality and boosted treatment success, clearly supporting the benefits of pursuing an aggressive international response to the AIDS pandemic ? How using medicines, which for the moment are more expensive but cause fewer side effects, would actually reduce costs in the long-run and mean an end to the second-class care that patients in the developing world currently receive ? How newer medicines can become more affordable and an explosion in drug costs can be staved off Yet as donors retreat from funding AIDS, progress threatens to be stopped dead in its tracks. MSF already sees the consequences of donors? backtracking on commitments to fund expanded HIV treatment worldwide. MSF is launching its report ?The Ten Consequences of AIDS Treatment Delayed, Deferred, or Denied? ? a guide to the devastation that can be expected if the trend continues. "We're at a fork in the road: either governments summon the political will and financial resources to treat AIDS in developing countries, or current funding for AIDS treatment stagnates, which means patients will see their treatment delayed, deferred and denied? says Dr. Tido von Schoen-Angerer, director of the MSF Campaign for Access to Essential Medicines. ?It's a question of choice: if they don't help us treat AIDS, there will be more graves." -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100716/484d1c18/attachment-0010.html -------------- next part -------------- A non-text attachment was scrubbed... Name: MSF-10-Consequences-Report.jpg Type: image/jpeg Size: 45887 bytes Desc: not available Url : http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100716/484d1c18/attachment-0010.jpg From hivtwg.moderator at gmail.com Mon Jul 12 03:28:50 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:28:50 +0700 Subject: [hivaids-twg] The financial burden of HIV care, and ART in Indonesia In-Reply-To: References: Message-ID: From: Date: Sun, Jul 11, 2010 at 10:06 AM Subject: [AIDS ASIA] The financial burden of HIV care, and ART in Indonesia To: AIDS_ASIA at yahoogroups.com Cc: sigitriyarto2002 at yahoo.com The financial burden of HIV care, including antiretroviral therapy, on patients in three sites in Indonesia Sigit Riyarto,1* Budi Hidayat,2 Benjamin Johns,3 Ari Probandari,4 Yodi Mahendradhata,1 Adi Utarini,1 Laksono Trisnantoro1 and Sabine Flessenkaemper5 1Department of Public Health, School of Medicine, University of Gajah Mada, Jogjakarta, Indonesia, 2School of Public Health, University of Indonesia, Indonesia, 3Consultant, Baltimore, MD, USA, 4Department of Public Health, Medical Faculty, University of Sebelas Maret, Surakarta, Indonesia and 5Former Medical Officer, World Health Organization, Jakarta Office, Jakarta, Indonesia *Corresponding author. Department of Public Health, Medical Faculty, University of Gajah Mada, Jl. Farmako Sekip Utara, Jogjakarta, Indonesia. Tel: ?62-274-549423. Fax: ?62-274-549423. E-mail: sigitriyarto2002 at yahoo.com Accepted 23 October 2009 This paper assesses the extent of the financial burden due to out-of-pocket payments for health care incurred by people living with HIV (PLHIV) and the effect of this burden on their financial capacity. Data were collected in a cross-sectional survey of 353 PLHIV from three cities in Indonesia (Jakarta, Jogjakarta and Merauke). Respondents in Jakarta were sampled from one hospital and one non-governmental organization working with PLHIV. In Jogjakarta and Merauke, all HIV patients on antiretroviral therapy (ART) who came to selected hospitals during the interview period were asked to participate in the survey. The survey collected data on the frequency and extent of payments for HIV-related care, with answers cross-checked against medical records. Results show that PLHIV had different burdens of payments in the different geographical areas. On average, respondents in Jogjakarta spent 68%, and PLHIV on ART in Jakarta spent 96%, of monthly expenditure for HIV related care, indicating a substantial financial burden for many ART patients. These patients depended on several sources of finance to cover the costs of their care, with donations from their immediate family being the most common method, selling assets and payments from personal income being the second most common method in Jakarta and Jogjakarta, respectively. Most PLHIV in these two areas did not have insurance. In Merauke, there were little observed out-of-pocket payments because the government covers medical costs via the local budget and health insurance for the poor. The results of this study confirm previous findings that providing subsidized ART drugs alone does not ensure financial accessibility to HIV care. Thus, the government of Indonesia at central and local levels should consider covering HIV care additional to providing antiretroviral drugs free of charge. Social health insurance should also be encouraged. Keywords ART, HIV/AIDS, financial barriers, access, Indonesia Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine Health Policy and Planning 2010;25:272?282 doi:10.1093/heapol/czq004272 __._,_.___ -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/f43bb452/attachment-0011.html From hivtwg.moderator at gmail.com Mon Jul 12 03:29:35 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:29:35 +0700 Subject: [hivaids-twg] Satellite Session Announcement:: Social Media Lab for Clinicians and HCWs in HIV/AIDS In-Reply-To: References: <659420.51516.qm@web37302.mail.mud.yahoo.com> Message-ID: From: Ishdeep Kohli Date: Sun, Jul 11, 2010 at 3:26 PM Subject: [AIDS ASIA] Satellite Session Announcement:: Social Media Lab for Clinicians and HCWs in HIV/AIDS To: AIDS_ASIA at yahoogroups.com Satellite Session Announcement: Social Media Lab for Clinicians and HCWs in HIV/AIDS Swasthya India, Jodhpur School of Public Health, HIV Atlas are pleased to announce the Consortium ?Social Media Network for HIV Response?. We are organizing the Satellite Session ?Social Media Lab for Clinicians and HCWs in HIV/AIDS?, at the XVIII International AIDS Conference, to be held in Vienna, Austria, 18-23 July 2010. The Satellite Session will take place on Sunday, 18 July, 11:15 - 13:15, in Mini Room 7 ? Kohli, Ishdeep (Facilitator), Mumbai, India ? Purohit, Anil (Chairperson), Boston, United States Information and Communication Technology is seen as a vital factor in enhancing development and healthcare efforts. Internet, E-Networking, Social Media, Mobile Phones and Telemedicine can improve the efficiency of HIV/AIDS information exchange in resource-limited settings. Clinicians will be introduced to social media tools to increase their knowledge and skills in accessing and disseminating live HIV/AIDS information through the internet, mobile devices and other interactive media. An understanding of online communities and their impact on HIV clinical management will be provided. Clinicians will be presented methods of using such social media tools to gain access to target audiences including PLWHA, their support groups, as well as monitor and gauge responses from the target audience. This workshop will help clinicians and health care workers understanding the basics of how these tools can be used to influence knowledge, attitudes, behaviors and in rapidly disseminating cutting edge research and evidence-based case management approaches. Speakers: 1. Introductory Remarks on Information and Communication Technologies JVR Prasada Rao Special Advisor to Executive Director, UNAIDS India 2. Expert Sourcing for Real-Time AIDS Management by Front-Line Health Workers Shih, Ting (Click Diagnostics) Boston, United States 3. Distance Learning and HIV Clinical Seminar Series for HIV Physicians Manoharan, Gurusamy (I-TECH) Chennai, India 4. Cloud Consulting: Using Electronic Groups for Physician Communication Colby, Donn (Harvard Medical School AIDS Initiative in Vietnam (HAIVN) Vietnam 5. NGO and IT Maximization Khorakiwala, Huzaifa (Wockhardt Foundation) Mumbai, India 6. Reaching out to Communities through Mobile Technologies for Positive Health and Livelihood Outcome: Experience from India Aggarwal, Vikas (Project Concern International/ India) New Delhi, India 7. Social Media for Response to HIV Harsh, Jagdish (HIV-ATLAS) New Delhi, India 8. Scope of Internet Mediated Social Communication in HIV Response Thomas, Joe (AIDS-India, AIDS AIDS-Asia, Jodhpur School of Public Health) Melbourne, Australia Participants wishing to attend can confirm their participation to Ishdeep Kohli at ishdeepkohli at hotmail.com Ishdeep Kohli Executive Director ? Programs and Partnerships Swasthya India Mumbai, India __._,_.___ -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/4ae6d0f4/attachment-0011.html -------------- next part -------------- A non-text attachment was scrubbed... Name: winmail.dat Type: application/ms-tnef Size: 4426 bytes Desc: not available Url : http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/4ae6d0f4/attachment-0011.bin From hivtwg.moderator at gmail.com Mon Jul 12 03:30:54 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:30:54 +0700 Subject: [hivaids-twg] NAV's job opportunity: Scaling-up the Faith-Based Response to HIV and AIDS in Vietnam In-Reply-To: References: <191F5790-640A-4A58-A8C4-27A4A3542DDB@gmail.com> Message-ID: From: vern weitzel Date: Sun, Jul 11, 2010 at 9:23 PM Subject: [opportunities] Fwd: NAV's job opportunity: Scaling-up the Faith-Based Response to HIV and AIDS in Vietnam To: "[Opportunities]" Sent from the Opportunities Mailing List. If you reply, please do not CC everyone on the list. Rather, send a separate message to the individual you are replying to. Address to post a new message: opportunities at ngocentre.org.vn Avoid sending attachments, but if you must send them keep them small - 500 kilobyte maximum for each email. Please, no housing ads - only office space suitable for an NGO. To change your subscription: http://ngocentre.org.vn/mailman/listinfo/opportunities *From: *Hoang Thanh Mai *Date: *5 July 2010 4:18:34 AM PDT *Subject: **NAV's job opportunity * Dear colleagues, Nordic Assistance to Vietnam is seeking for consultant to develop a concept and training material on proposal writing and conduct training for project implementing partners. Could you please help us to post the advertisement ( see attached file) on technical website. Thank you for your support. Best wishes, Mai ____________________ Hoang Thanh Mai Nordic Assistance to Vietnam Administrator Add: 76 Hai Ba Trung Street, Hue City, Vietnam Tel/fax: + 84-54-3822613 Mob: + 84-913449448 Email: mai at navhue.org website: www.nca.no *Scope of Work* * * Project: ?Scaling-up the Faith-Based Response to HIV and AIDS in Vietnam? Topic: Development of a concept and training material on proposal writing and conduct training for project implementing partners Period of assignment: End of July to end of August Closing date: July 18th Ref. no: CB.2010.09 * * *1 **Background* Nordic Assistance to Vietnam (NAV) was established in 1994 as a consortium of three Nordic Non-Governmental Organizations. NAV?s three main program areas are community development, gender-based violence and HIV and AIDS. For the latter NAV has implemented programs since 1996 through working with self-help groups for People Living with HIV (PLHIV) and Faith-Based Organizations (FBOs) in Thua Thien Hue and Hai Phong provinces. The program is funded through the President?s Emergency Plan for AIDS Relief (PEPFAR) under the United States Agency for International Development (USAID). Project sites include Hai Phong, Quang Ninh, Hanoi, Hue, Danang and Ho Chi Minh City. The overall goal of the program is ?to enable the faith?based community to contribute towards reducing the impact of HIV and AIDS in Vietnam?. The program of NAV has the following components: 1) Prevention (abstinence and be faithful and other behavior change), 2) Palliative and home-based care, 3) Orphans and Vulnerable Children (OVC), and 4) Other policy development and systems strengthening. The latter is comprised of institutional capacity building, and reduction of stigma & discrimination. The primary partners for the program are Buddhist and Catholic FBOs as well as the Fatherland Front. Among the Catholic partners are religious orders of sisters, churches and charity clinics under the Catholic Dioceses and among the Buddhist partners selected pagodas and universities under the Buddhist Associations. *2 **Justification* Sustainability of community-based HIV and AIDS activities is dependent upon many aspects, whereof capacity building on project management and fund raising is one important component. A first resource mobilization training was held in 2009 for the partners of the program ?Scaling-up the faith-based response to HIV and AIDS in Vietnam. In order to provide more practical skills and knowledge on the full cycle from project proposal writing to management of funds and reporting, a follow-up training will be organized for key partners in August 2010. *3. **The assignment* 3.1 *Purpose of the assignment* ? *Overall objective*: Enable FBOs through capacity building to identify donors and to write funding proposals that reflect the objectives and needs of the proposed project and the requirements of the donor. 3.2 *Target groups* ? *Primary target group: *Monks, nuns, priests, sisters and lay volunteers of Buddhist and Catholic FBOs with a leading administrative role in their organization and with good written communication skills. ? *Secondary target group:* Project and field staff who are working for NAV on the program: *?Scaling up the faith-based response to HIV/AIDS in Vietnam?*. 1.3 2.3 3.3 *Main tasks for the consultant* ? Develop a concept and model for training on proposal writing ? Develop support material and tools on proposal writing ? Conduct training on proposal writing for key project partners ? Write a report from the training, which includes recommendations for future trainings ? Adjust materials and training concept in accordance with feedback from participants.** 3.4 *Key elements to be included in the material and training* ? Introduction to fundraising (potential funding sources and channels) ? Funding from institutional donors and INGOs (who are they, what are they interested in, where and how to find funding opportunities) the full cycle of fundraising from proposal writing to management of funds, and finally reporting. ? The importance of good governance and accountability as a pre-requisite for building good and long-term donor relationships including through compliance with donor requirements. The principles of financial and narrative reporting. ? Introduction to community-based fundraising including an overview of potential sources (e.g. individuals, companies, institutions) and methods (e.g. events, collections and proposals). ? Home exercise for each project partner to write a proposal to which the consultant will comment. 3.5 *Period for assignment* End of July and August 2010 3.6 *Location for training*: Da Nang *4 **Suggested methodology* Participatory methods should be applied during the training e.g. questions and answers, group discussions, role plays, and brain storming. *5 **Deliverables and due dates* All new or significantly modified concepts, materials and documents will be the property of NAV. Documents are to be produced in Vietnamese and as requested in English. They must be submitted both in electronic (using Microsoft Office software) and hard copies. *Task* Due date a. Work with the Capacity Building Officer of NAV for orientations on the program and target group 25th July b. Develop draft for training content and methodologies 5th August c. Develop training material 12th August d. Deliver training course in Da Nang 16th August e. Finalize the training material 21st August f. Produce a final report on activity with recommendations for future trainings. 25th August g. Submit all documents, databases, revised training material and other material to the Capacity Building Officer of NAV in hardcopy and electronically. 28th August h. Maintain regular contact with the Capacity Building Officer and FBO Program Coordinator through e-mail and/or telephone. * * * * *6 **Technical direction * The tasks will be carried out under the direction of NAV?s Capacity Building Officer. The final version of the training material and the training report will be reviewed and approved by NAV?s National Coordinator for the HIV and AIDS program. *7 **Qualifications and experiences* ? Extensive experience with proposal writing and fundraising ? At least 3 years? working experience in training on topics related to proposal writing ? At least 3 years? working experience with using participatory methodologies in training ? University degree in social sciences, business administration, education or other relevant fields ? Excellent communication skills ? Excellent writing skills in Vietnamese and preferably also in English ? Understanding/knowledge of Faith-Based Organizations is an advantage *8 **Requirements to the proposal* ? Updated CV ? Description of suggested methodology ? Main activities and timeline ? Budget (this should indicate man-days, fees and per diems including VAT, and costs related to transportation and accommodation The consultant will be paid based on days worked and actual expenditures. There will be no additional expenses paid for office space, telephone/computer usage etc. NAV will reimburse air fare, taxi and hotel fees based on agreed plans and actual vouchers. In addition, NAV will pay a per diem based on the consultant?s travel schedule. All meetings with stakeholders and arrangement of field visits and workshops will be organized by NAV. *Interested candidates are requested to send their proposal to:* Nordic Assistance to Vietnam (NAV) 76 Hai Ba Trung Hue City VIET NAM E-mail: mai at navhue.org *Questions concerning the consultancy can be directed to:* Mr. Nguyen Minh Duc, Capacity building officer E-mail: minhduc at navhue.org Cell phone: 0912 348 117 -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/3391cacc/attachment-0011.html -------------- next part -------------- A non-text attachment was scrubbed... Name: 100705 SoW advertisement proposal writing.doc Type: application/msword Size: 78848 bytes Desc: not available Url : http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/3391cacc/attachment-0011.doc From hivtwg.moderator at gmail.com Mon Jul 12 03:34:18 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:34:18 +0700 Subject: [hivaids-twg] AIDS 2010 Symposium Invite: The Continuum of Prevention and Care in Asia Pacific In-Reply-To: References: Message-ID: From: Kimberly Green Date: Sun, Jul 11, 2010 at 9:42 PM Subject: [health-vn] AIDS 2010 Symposium Invite: The Continuum of Prevention and Care in Asia Pacific To: vern weitzel , "[health-vn discussion group]" < health-vn at anu.edu.au> THE CONTINUUM OF PREVENTION AND CARE (CoPC) IN ASIA PACIFIC: Successes, challenges and contributions to health systems strengthening AIDS 2010 Vienna Satellite Symposium *********************************** DATE/TIME: SUNDAY, 18 JULY; 15:45-17:45 VENUE: Reed Messe Wien Conference Center; Session Room 4 JOIN US for an exciting session on the development of the Continuum of Prevention and Care model of HIV service delivery in Asia and the Pacific. Following an initial emergency phase for rapid scale-up of HIV services, a number of countries in the Asia-Pacific established HIV continuum of prevention and care systems to maximize the effectiveness and sustainability of HIV services. This satellite session will feature the CoPC experiences of Cambodia, Nepal, Papua New Guinea and Viet Nam. The discussion will focus on the approaches these countries used to: develop a coordinated system of HIV services, involve people living with HIV, and establish comprehensive care sites. Presentations will highlight key successes and outcomes, challenges and the contribution of the CoPC experience to health systems strengthening. Tools and guidance to support step-by-step implementation of CoPC systems will be made available during the session. CO-CHAIRS: Massimo Ghidinelli, WHO WPRO and Kimberly Green, FHI 1) The Asia-Pacific continuum of prevention and care: Highlights from a country review Speakers * Masami Fujita, WHO Viet Nam and Kimberly Green, FHI 2) Contribution of the CoPC on Cambodia?s health care system Speaker * Mean Chhi Vun, National Centre for HIV/AIDS, Dermatology and STDs 3) From the ground-up: How the CoPC has transformed HIV service delivery and contributions to palliative care and home-based care for people with chronic diseases in Papua New Guinea Speaker * Esorom Daoni, HIV/AIDS/STI, National Department of Health 4) CoPC in a fragile state: How Nepal has extended comprehensive services to most at risk populations and people living with HIV Speaker * K Rai, National Centre of AIDS and STD Control 5) CoPC in an IDU driven epidemic: The experience of Viet Nam Speaker * Do Thi Nhan, Viet Nam Authority of HIV/AIDS Control Panel respondents - Greg Grey, World AIDS Campaign - Joseph Perriens, WHO Discussion Facilitator: Iyanthi Abeyewickreme, WHO SEARO _______________________________________________ health-vn Health in Viet Nam and the Region Post message to list: health-vn at anu.edu.au List information page: http://mailman.anu.edu.au/mailman/listinfo/health-vn health-vn List from the Australia Vietnam Science-Technology Link contact: Vern Weitzel vern at coombs.anu.edu.au The accuracy of information from media articles posted on this list cannot be guaranteed and should be verified before use. -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/c40f4ca8/attachment-0011.html From hivtwg.moderator at gmail.com Mon Jul 12 03:37:03 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:37:03 +0700 Subject: [hivaids-twg] Occurrence, risk factors, diagnosis and treatment of syphilis in the prospective observational Swiss HIV Cohort Study. In-Reply-To: References: Message-ID: From: Paul Causey Date: Sun, Jul 11, 2010 at 12:17 PM Subject: [msm-asia] Occurrence, risk factors, diagnosis and treatment of syphilis in the prospective observational Swiss HIV Cohort Study. To: MSM-Asia Newgroup Occurrence, risk factors, diagnosis and treatment of syphilis in the prospective observational Swiss HIV Cohort Study. AIDS. 2010 Jul 7; Authors: Thurnheer MC, Weber R, Toutous-Trellu L, Cavassini M, Elzi L, Schmid P, Bernasconi E, Christen AB, Zwahlen M, Furrer H, BACKGROUND:: Annual syphilis testing was reintroduced in the Swiss HIV Cohort Study (SHCS) in 2004. We prospectively studied occurrence, risk factors, clinical manifestations, diagnostic approaches and treatment of syphilis. METHODS:: Over a period of 33 months, participants with positive test results for Treponema pallidum hemagglutination assay were studied using the SHCS database and an additional structured case report form. RESULTS:: Of 7244 cohort participants, 909 (12.5%) had positive syphilis serology. Among these, 633 had previously been treated and had no current signs or symptoms of syphilis at time of testing. Of 218 patients with newly detected untreated syphilis, 20% reported genitooral contacts as only risk behavior and 60% were asymptomatic. Newly detected syphilis was more frequent among men who have sex with men (MSM) [adjusted odds ratio (OR) 2.8, P < 0.001], in persons reporting casual sexual partners (adjusted OR 2.8, P < 0.001) and in MSM of younger age (P = 0.05). Only 35% of recommended cerebrospinal fluid (CFS) examinations were performed. Neurosyphilis was diagnosed in four neurologically asymptomatic patients; all of them had a Venereal Disease Research Laboratory (VDRL) titer of 1:>/=32. Ninety-one percent of the patients responded to treatment with at least a four-fold decline in VDRL titer. CONCLUSION:: Syphilis remains an important coinfection in the SHCS justifying reintroduction of routine screening. Genitooral contact is a significant way of transmission and young MSM are at high risk for syphilis. Current guidelines to rule out neurosyphilis by CSF analysis are inconsistently followed in clinical practice. Serologic treatment response is above 90% in the era of combination antiretroviral therapy. PMID: 20616699 [PubMed - as supplied by publisher] Paul Causey +66-81-984-6515 (GMT+7) Bangkok, Thailand -- You received this message because you are subscribed to the Google Groups "MSM Sexual Health - Asia" group. To post to this group, send email to msm-asia at googlegroups.com To unsubscribe from this group, send email to msm-asia+unsubscribe at googlegroups.com For more options, visit this group at http://groups.google.com/group/msm-asia?hl=en?hl=en -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/84ed5368/attachment-0011.html From hivtwg.moderator at gmail.com Mon Jul 12 03:37:54 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:37:54 +0700 Subject: [hivaids-twg] PLoS ONE: Rates and Reasons for Early Change of First HAART in HIV-1-Infected Patients in 7 Sites throughout the Caribbean and Latin America In-Reply-To: References: Message-ID: From: vern weitzel Date: Sun, Jul 11, 2010 at 7:12 AM Subject: [health-vn] PLoS ONE: Rates and Reasons for Early Change of First HAART in HIV-1-Infected Patients in 7 Sites throughout the Caribbean and Latin America To: "[health-vn discussion group]" health-vn - Health in Viet Nam and the Region New address to post messages: health-vn at anu.edu.au New list Information Page (remember your password): http://mailman.anu.edu.au/mailman/listinfo/health-vn Maximum message size: 2.5 mb. - - Clinical Trials - - PLoS Biology - PLoS Medicine - PLoS Computational Biology - PLoS Genetics - PLoS Pathogens - PLoS ONE - PLoS Neglected Tropical Diseases - *Download:* PDF| Citation| XML - *Print article* - EzReprintNew & improved! 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Rate This Article More Related Content Related Subject Categories Public Health and Epidemiology, Infectious Diseases Related Articles on the Web Google Scholar PubMed More Share this Article info - [image: StumbleUpon] [image: Facebook] [image: Connotea] [image: CiteULike] [image: Bibliography] [image: Twitter icon] 0diggsdigg - Email this article Public Library of Science http://www.plosone.org/article/info:doi/10.1371/journal.pone.0010490OpenAccess Research Article http://www.plosone.org/article/info:doi/10.1371/journal.pone.0010490Rates and Reasons for Early Change of First HAART in HIV-1-Infected Patients in 7 Sites throughout the Caribbean and Latin America HAART rollout in Latin America and the Caribbean has increased from approximately 210,000 in 2003 to 390,000 patients in 2007, covering 62% (51%?70%) of eligible patients, with considerable variation among countries. No multi-cohort study has examined rates of and reasons for change of initial HAART in this region. Antiretroviral-na?ve patients >?=?18 years who started HAART between 1996 and 2007 and had at least one follow-up visit from sites in Argentina, Brazil, Chile, Haiti, Honduras, Mexico and Peru were included. Time from HAART initiation to change (stopping or switching any antiretrovirals) was estimated using Kaplan-Meier techniques. Cox proportional hazards modeled the associations between change and demographics, initial regimen, baseline CD4 count, and clinical stage. Of 5026 HIV-infected patients, 35% were female, median age at HAART initiation was 37 years (interquartile range [IQR], 31?44), and median CD4 count was 105 cells/uL (IQR, 38?200). Estimated probabilities of changing within 3 months and one year of HAART initiation were 16% (95% confidence interval (CI) 15?17%) and 28% (95% CI 27?29%), respectively. Efavirenz-based regimens and no clinical AIDS at HAART initiation were associated with lower risk of change (hazard ratio (HR)?=?1.7 (95% CI 1.1?2.6) and 2.1 (95% CI 1.7?2.5) comparing neverapine-based regimens and other regimens to efavirenz, respectively; HR?=?1.3 (95% CI 1.1?1.5) for clinical AIDS at HAART initiation). The primary reason for change among HAART initiators were adverse events (14%), death (5.7%) and failure (1.3%) with specific toxicities varying among sites. After change, most patients remained in first line regimens. Adverse events were the leading cause for changing initial HAART. Predictors for change due to any reason were AIDS at baseline and the use of a non-efavirenz containing regimen. Differences between participant sites were observed and require further investigation. - Article - Metrics - Related Content - Comments: 0 - To *add a note*, highlight some text. Hide notes - Make a general comment *Jump to* - Abstract - Introduction - Methods - Results - Discussion - Supporting Information - Acknowledgments - Author Contributions - References Carina Cesar1 *, Bryan E. Shepherd2, Alejandro J. Krolewiecki1, Valeria I. Fink1, Mauro Schechter3, Suely H. Tuboi3, Marcelo Wolff4, Jean W. Pape5, Paul Leger5, Denis Padgett6, Juan Sierra Madero7, Eduardo Gotuzzo8, Omar Sued1, Catherine C. McGowan2, Daniel R. Masys2, Pedro E. Cahn1, for The Caribbean, Central and South America Network for HIV Research (CCASAnet) Collaboration, of the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Program *1* Fundaci?n Hu?sped, Buenos Aires, Argentina, *2* Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America, *3*Projeto Pra?a Onze, Hospital Universit?rio Clementino Fraga Filho and Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil, *4*Fundaci?n Arriar?n and Facultad de Medicina, Universidad de Chile, Santiago, Chile, *5* Le Groupe Ha?tien d'Etude du Sarcome de Kaposi et des Infections Opportunistes in Port-au-Prince (GHESKIO), Port-au-Prince, Haiti, *6*Instituto Hondure?o de Seguridad Social and Universidad Aut?noma de Honduras, Tegucigalpa, Honduras, *7* Instituto Nacional de Ciencias M?dicas y Nutrici?n Salvador Zubir?n, M?xico City, M?xico, *8* Universidad Peruana Cayetano Heredia Facultad de Medicina and Instituto de Medicina Tropical Alexander von Humboldt, Lima, Per? Abstract Top Background HAART rollout in Latin America and the Caribbean has increased from approximately 210,000 in 2003 to 390,000 patients in 2007, covering 62% (51%?70%) of eligible patients, with considerable variation among countries. No multi-cohort study has examined rates of and reasons for change of initial HAART in this region. Methodology Antiretroviral-na?ve patients > = 18 years who started HAART between 1996 and 2007 and had at least one follow-up visit from sites in Argentina, Brazil, Chile, Haiti, Honduras, Mexico and Peru were included. Time from HAART initiation to change (stopping or switching any antiretrovirals) was estimated using Kaplan-Meier techniques. Cox proportional hazards modeled the associations between change and demographics, initial regimen, baseline CD4 count, and clinical stage. Principal Findings Of 5026 HIV-infected patients, 35% were female, median age at HAART initiation was 37 years (interquartile range [IQR], 31?44), and median CD4 count was 105 cells/uL (IQR, 38?200). Estimated probabilities of changing within 3 months and one year of HAART initiation were 16% (95% confidence interval (CI) 15?17%) and 28% (95% CI 27?29%), respectively. Efavirenz-based regimens and no clinical AIDS at HAART initiation were associated with lower risk of change (hazard ratio (HR) = 1.7 (95% CI 1.1?2.6) and 2.1 (95% CI 1.7?2.5) comparing neverapine-based regimens and other regimens to efavirenz, respectively; HR = 1.3 (95% CI 1.1?1.5) for clinical AIDS at HAART initiation). The primary reason for change among HAART initiators were adverse events (14%), death (5.7%) and failure (1.3%) with specific toxicities varying among sites. After change, most patients remained in first line regimens. Conclusions Adverse events were the leading cause for changing initial HAART. Predictors for change due to any reason were AIDS at baseline and the use of a non-efavirenz containing regimen. Differences between participant sites were observed and require further investigation. *Citation: *Cesar C, Shepherd BE, Krolewiecki AJ, Fink VI, Schechter M, et al. (2010) Rates and Reasons for Early Change of First HAART in HIV-1-Infected Patients in 7 Sites throughout the Caribbean and Latin America. PLoS ONE 5(6): e10490. doi:10.1371/journal.pone.0010490 *Editor: *Landon Myer, University of Cape Town, South Africa *Received:* October 15, 2009; *Accepted:* April 2, 2010; *Published:* June 1, 2010 *Copyright:* ? 2010 Cesar et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. *Funding:* Funding for this work was provided in part by US NIAID (NIH 1 U01 AI069923). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. *Competing interests:* The authors have declared that no competing interests exist. * E-mail: carina.cesar at huesped.org.ar Introduction Top An estimated 1.93 million people live with HIV in Latin America and the Caribbean, comprising 5.7% of all infected persons worldwide; the adult prevalence in this region is 0.5%[1]. Access to antiretroviral (ARV) therapy has improved and at the end of 2007 approximately 390,000 patients in this region were receiving antiretroviral therapy with an overall coverage of 62% (51%?70%), although considerable variation exists between countries[2], [3]. Unfortunately, 75% of patients still initiate treatment at advanced stages of disease[4] ?[8] . Treatment toxicities and adherence problems may lead to suboptimal therapy, discontinuation, and treatment failure. Early modification of initial highly active antiretroviral therapy (HAART) has been associated with poor clinical outcomes[9]. Therefore, knowing why patients modify therapy could improve our understanding of successful HAART, guide decisions regarding initiation and management of HAART in specific patient populations, and inform interventions to reduce HAART discontinuation. The frequency and reasons for HAART change have been assessed by cohort studies from resource-rich and -limited settings, but Latin America and the Caribbean have been largely underrepresented in these studies[10] ?[16]. Observational studies from sites in Argentina, Brazil, Haiti and Peru have described the occurrence of adverse events and durability of first regimen [17] ?[23]. However, no multisite study has addressed frequency and reasons for change in this region. The Caribbean, Central and South America Network for HIV Research (CCASAnet) collaboration includes sites from seven nations: Argentina, Brazil, Chile, Haiti, Honduras, Mexico, and Peru. In an earlier study of antiretroviral-na?ve subjects starting HAART, mortality rates in the CCASAnet cohort were similar to those reported for resource-limited settings with a 1-year probability of death for the combined cohort of 8.3%, although this varied considerably across sites[8]. The purpose of the current study is to explore the frequency of, risk factors for, and reasons for changing/discontinuing HAART during the first year after initiation in the CCASAnet region. Methods Top Ethics Statement This study was conducted according to the principles expressed in the Declaration of Helsinki. Institutional Review Board approval was obtained locally for each participating site and the coordinating centre: Comit? de Bio?tica de Fundaci?n Hu?sped; Comit? de ?tica em Pesquisa-Universidade Federal Do R?o De Janeiro; Comit? ?tico-Cient?fico del Servicio de Salud Metropolitano Central, Ministerio de Salud, Gobierno de Chile; Human Research Protections Programs, Division of Research Integrity, Weill Cornell Medical College; Comit? de ?tica en Investigaci?n Biom?dica de la Unidad de Investigaci?n Cient?fica, Facultad de Ciencias M?dicas, Universidad Nacional Aut?noma de Honduras; Comit? Institucional de Investigaci?n Biom?dica en Humanos, Instituto Nacional de Ciencias M?dicas y Nutrici?n Salvador Zubir?n; Vicerrectorado de Investigaci?n, Direcci?n Universitaria de Investigaci?n, Ciencia y Tecnolog?a-DUICT, Universidad Peruana Cayetano Heredia; Institutional Review Board, Vanderbilt University. All data were de-identified prior to being transmitted to the Vanderbilt Data Coordinating Centre. In each of the countries contributing data to this study, ethical regulations and policies permit retrospective analysis of de-identified clinical data without informed consent when the research is approved by an appropriately constituted ethics committee or Institutional Review Board. These approvals were obtained in all cases and the need to obtain informed consent was waived by all of the ethics committees of the participating sites. Participants and Settings The CCASAnet cohort (www.ccasanet.vanderbilt.edu) has been described elsewhere[24]. Briefly, the collaboration was established in 2006 as Region 2 of the International Epidemiologic Databases to Evaluate AIDS (IeDEA; www.iedea-hiv.org). The cohort includes 7 sites: Fundaci?n Hu?sped in Buenos Aires, Argentina (FH-Argentina); Hospital Universit?rio Clementino Fraga Filho in Rio de Janeiro, Brazil (HUCFF-Brazil); Fundaci?n Arriar?n in Santiago, Chile (FA-Chile); Le Groupe Ha?tien d'Etude du Sarcome de Kaposi et des Infections Opportunistes in Port-au-Prince, Haiti (GHESKIO-Haiti); Instituto Hondure?o de Seguridad Social Hospital de Especialidades and Hospital Escuela in Tegucigalpa, Honduras (IHSS/HE-Honduras); Instituto Nacional de Ciencias M?dicas y Nutrici?n Salvador Zubir?n in Mexico City, Mexico (INNSZ-M?xico); and Instituto de Medicina Tropical Alexander Von Humboldt in Lima, Peru (IMTAvH-Peru). Each cohort was established at a different time between 1996 and 2002 not necessarily reflecting the availability of HAART in each country. Data audits were performed at each site by a team from the VDCC. The present analysis used data for the first year of follow-up after starting HAART collected through June 2008. Included were antiretroviral-na?ve HIV-infected patients prescribed HAART at age 18 years or older with at least one follow-up visit. Initiation of HAART at each site followed either national or World Health Organization guidelines[25] ?[30]. Guidelines from Argentina, Brazil, Chile, Honduras and Mexico recommend drug substitutions after toxicity and switching regimens after virologic failure [25], [27] ?[29]. In contrast, in Haiti and Peru failure was defined according to WHO clinical and immunologic criteria[30]. Table 1lists site-specific practices related to initiation criteria, laboratory monitoring, and regimen availability. [image: thumbnail] *Table 1. Treatment Program Characteristics across Sites.* doi:10.1371/journal.pone.0010490.t001 Outcomes The primary outcome was first change of regimen during the first year of HAART. Regimen change was defined as any alteration?switch or discontinuation?of ?1 antiretroviral. Discontinuation was defined as simultaneous stopping of all antiretrovirals without initiation of a subsequent regimen for more than 30 days. Dosage adjustments and interruptions of therapy shorter than 30 days were ignored because of inconsistent recording of short interruptions across sites. Reasons for change were collected by each site and classified at the coordinating centre. Specific definitions of reasons for regimen change, including definition of treatment failure, were not standardized across sites and only included if they prompted a regimen change. Secondary analyses classified patients who died or were lost to follow-up (LTFU) while on their first HAART as having discontinued treatment. Patients without a visit for 6 months were classified as LTFU. The 6-month interval was chosen to include the longest interval between regular visits in participant sites, although most sites scheduled visits every 3 months. Data Sources and Measurements Baseline CD4 count was defined as the measurement closest to HAART initiation but not more than 6 months prior to, or 7 days after, the date of HAART start. Baseline HIV-1 plasma viral load (PVL) was defined as the pre-HAART measurement closest to, but not more than 6 months prior to, HAART initiation. Baseline weight and hemoglobin were defined as the measurements closest to HAART initiation within +/? 30 days. HAART was defined as protease inhibitor (PI)-based (1 ritonavir-boosted or unboosted PI plus ?2 nucleoside reverse-transcriptase inhibitors [NRTI]), non-nucleoside reverse transcriptase (NNRTI)-based (1 NNRTI plus ?2 NRTIs), or other combinations (including triple NRTI regimens and any other regimen containing a minimum of three drugs). Clinical stage of disease was defined as AIDS (WHO stage 4, CDC stage C, or 1986 CDC stage 4), non-AIDS, or unknown. Statistical Analysis Kaplan-Meier estimates computed probabilities of change per site. Time was measured from the start of HAART and ended at the earliest of regimen change, discontinuation, death, last visit before LTFU, last visit before the database closing, or 365 days. The closing date was defined separately for each site as the date of the most recent visit recorded in the database, and ranged from March 2007 to June 2008. The relationship between time to change and baseline variables was assessed using Cox proportional hazards models applied separately for each site. The primary multivariable analyses only included baseline predictors whose hazard ratio could be computed for all sites. Secondary, site-specific multivariable analyses included other routinely collected predictors with >50% non-missing data. In multivariable analyses, missing values of baseline predictors were accounted for using multiple imputation techniques applied separately within each site[31]. CD4 count and date of HAART initiation were included in models as continuous variables and expanded using restricted cubic splines to avoid linearity assumptions[32]. The combined hazard ratios and 95% confidence intervals (CI) were computed based on the results of site-specific hazard ratios using the meta-analysis approach of DerSimonian and Laird [33], a random effects method which makes no assumption regarding proportional hazards across sites[34]. All analyses were performed using R statistical software, version 2.8.1 ( http://www.r-project.org). Analysis scripts are available at http://ccasanet.vanderbilt.edu/files/pub?lic/switch.nw Results Top A total of 5026 na?ve patients starting HAART with at least one follow-up visit were included. Patient characteristics at HAART initiation are summarized by site in Table 2. Across all sites, 35% were female, median age was 37 years, median CD4 count was 105 cells/?L (interquartile range [IQR]: 38, 200), 47% of subjects had clinical AIDS, and 78% of subjects had either CD4<200 cells/?L or clinical AIDS. [image: thumbnail] *Table 2. Summary of Patient Characteristics, Calendar Year, and Regimens at HAART Initiation. * doi:10.1371/journal.pone.0010490.t002 Table 2also describes initial HAART regimen per site. The majority started HAART between 2002?2005 although 26% of patients from HUCFF-Brazil initiated prior to 2000. Across sites, NNRTI-based initial regimens were most common (84%) with efavirenz (EFV) the most frequently used (58.5%) except in IMTAvH-Peru. Eight percent of initial regimens were ritonavir-boosted PI-based: saquinavir (34%), lopinavir (31%) and indinavir (26%). Unboosted PI-based regimens accounted for 5% of initial regimens in the combined cohort; but were commonly used before 2000 in HUCFF-Brazil. Other regimens were mainly triple NRTIs (89%). Among nucleosides, lamivudine (3TC) was included in nearly all initial regimens (97%). Zidovudine (ZDV) was included in nearly 80% of all initial regimens; 84% and 81% of patients on EFV- and NVP-based regimens, respectively, were on ZDV, compared to 70% of patients who were not started on NNRTI-based regimens. Seventy percent of regimens which did not contain ZDV contained d4T. Didanosine and abacavir were used in only 4.3% and 4.6% of overall regimens, respectively, and tenofovir was used rarely (1.7%). The most common initial regimens were 3TC, ZDV, EFV (41.2%); 3TC, ZDV, NVP (28.1%); 3TC, d4T, NVP (5.3%); and 3TC, d4T, EFV (4.7%). Figure 1shows Kaplan-Meier estimates of the probability of changing/discontinuing regimens during the first year by site. The estimated 3-month and 1-year probabilities of change (95% CI) for the combined cohort were 16% (15?17%) and 28% (27?29%) respectively (Table 3). Regimen change during the first year was lowest at IHSS/HE-Honduras and highest at IMTAvH-Peru. Two -hundred eighty-six patients (5.7%) died during the first year prior to changing regimens and 149 patients (3.0%) were LTFU. When these patients were analyzed as having discontinued regimens, then the estimated 3-month and 1-year probabilities of change/discontinuation were 21% (95% CI 20?22%) and 36% (95% CI 34?37%), respectively. [image: thumbnail] *Figure 1. Probability of regimen change by site.* doi:10.1371/journal.pone.0010490.g001 [image: thumbnail] *Table 3. Number of Events and Estimated Rates of Changing Regimens (95% Confidence Intervals).* doi:10.1371/journal.pone.0010490.t003 Most regimen changes were simple drug substitutions followed by other regimen changes and discontinuations. Of 1288 living patients whose initial HAART was changed, 1147 (89%) switched to a different regimen, 104 (8%) did not start a second regimen during the observed follow-up, and 37 (3%) re-started their initial regimen after an interruption ?30 days. For those patients who re-started the same regimen during the first year, the median time of interruption was 78 days. For those who switched to a different regimen, the vast majority (83%) started within a week of initial HAART discontinuation and 90% within a month. Among those who started a second regimen while in follow-up, 74% were NNRTI-based and 5% were first line PI-based. Of 1013 living patients who stopped their initial ZDV-containing regimen, 487 had a second regimen containing ZDV, 452 had a second regimen not containing ZDV, and 74 did not start a second regimen. Table 4details second regimens started within 30 days of changing initial regimen. [image: thumbnail] *Table 4. Second Regimens started within 30 days of stopping Initial Regimen.* doi:10.1371/journal.pone.0010490.t004 Clinical AIDS at HAART initiation and non-efavirenz based regimens were associated with a higher hazard of change in unadjusted analyses for most sites and in the combined cohort (data not shown). Multivariable analyses for each site and pooled across sites are given in Table 5. After adjusting for sex, age, baseline CD4 count, year of HAART initiation, and type of regimen, the hazard of change was 1.3 times higher for a person with clinical AIDS prior to HAART initiation than a person without (95% CI: 1.1 to 1.5) (Table 3). Using EFV-based regimens as the reference category, the hazard ratios for change for NVP-based regimens and non-NNRTI-based regimens were 1.7 (95% CI: 1.1 to 2.6) and 2.1 (95% CI: 1.7 to 2.5) respectively. The increased hazard for change for NVP was not observed in FA-Chile and GHESKIO-Haiti whereas it was especially pronounced in IMTAvH-Peru. Except at GHESKIO-Haiti, patients who started 3TC,ZDV,EFV generally had lower rates of change than those starting other regimens (Table S1, online supplemental material). Overall and by site there were no consistent associations between gender, age, CD4, year of HAART initiation, or ZDV-containing regimens and change. Results were similar when those who died and those who died or were lost to follow-up were assumed to have discontinued regimens (Tables S2 -S3, online supplemental material). [image: thumbnail] *Table 5. Adjusted Hazard Ratios (95% Confidence Intervals) for Regimen Change/Discontinuation in First Year.* doi:10.1371/journal.pone.0010490.t005 Multivariable analyses including HIV-1 RNA, hemoglobin, weight, and more refined regimen categories were performed for sites with sufficient data and are shown in Table S4in the online supplemental material. Higher baseline weight was associated with a lower risk of changing regimens at IMTAvH-Peru. Higher baseline hemoglobin was predictive of a decreased risk of changing regimens at GHESKIO-Haiti. Patients treated with d4T had lower hemoglobin at baseline (medians of 9.7 vs. 11.0 mg/dl, p<0.0001). Higher baseline HIV-1 RNA was predictive of changing regimens at FA-Chile, but was not an independent predictor at FH-Argentina, INNSZ-Mexico, or IMTAvH-Peru. The reported reasons for change during the first year are given in Table 6. Adverse events (AE) prompted change in 14.4% of HAART initiators, and were the most common reason for six of the seven sites. Other reasons for change were failure (1.3%), the availability of a better regimen or simplification (1.5%), drug supply problems (1.8%), and abandonment/adherence failures (1.1%). Of the patients who initiated HAART, 2.9% changed regimens for an undocumented reason. [image: thumbnail] *Table 6. Reported reasons for changing initial HAART regimen in First Year.* doi:10.1371/journal.pone.0010490.t006 The most common AE were hematological toxicity (6.7%), skin rash (3%) and gastrointestinal intolerance (1.9%), with substantial heterogeneity between sites. Of HAART initiators in IHSS/HE-Honduras, 3.7% changed regimens during the first year due to hematological adverse events, compared to 15.8% in IMTAvH-Peru. Among those with hematological adverse events, 73% were anemia, 4%. The distribution of HAART initiators changing due to skin rash also varied with FH-Argentina, FA-Chile and IMTAvH-Peru reporting 4.0%, 7.3%, and 5.5%, respectively, and other sites reporting <2%. Within the first 3 months, AE were also the most common reported reason for changing regimens. Ten percent of patients changed regimens due to adverse events: 4.7% due to hematological toxicity and 2.8% due to skin rash. Forty-two patients from GHESKIO-Haiti who were on 3TC,ABC,ZDV switched to 3TC,ZDV,EFV in April/May of 2003 because this regimen became available and was deemed superior; each of these 42 patients had been on their initial regimen for less than 3 months. For all NNRTI, boosted PI, and unboosted-PI-based regimens, AE were the main reason for change, although type of AE varied according to class. The most common AE for efavirenz-based regimens were hematological (5.7%), central nervous system (2.2%), and skin (1.6%); for nevirapine-based regimens: hematological (9.7%), skin (5.8%), liver (0.7%), and gastrointestinal intolerance (0.7%); for boosted PI-based regimens: gastrointestinal intolerance (8.3%), hematological (2.6%), and kidney (1.8%); and for unboosted PI- based regimens: gastrointestinal intolerance (7%), hematological (4.8%), and skin (1.1%). Thirty patients died within 30 days of changing their initial HAART regimen. Adverse events were the reported reasons for change for 21 of these 30 patients. Most of these deaths were HIV-related or unspecified (tuberculosis 4, Kaposi's Sarcoma 2, wasting syndrome 2, Mycobacterium avium complex 1, Cryptococcosis 1, non-Hodgkin lymphoma 1, multiple opportunistic infections 1, AIDS-related but unspecified 1,); other causes included anemia 2, unspecified pulmonary infection 2, chronic renal failure 1, unspecified cancer 1, pancytopenia 1, and missing cause of death 10 Discussion Top This is the first multi-cohort study in Latin America and the Caribbean to describe rates of and reasons for changing initial HAART regimen. We found high rates of change early after treatment initiation with substantial variation across sites, ranging from 8?28% in the first 3 months and 18?41% in the first year. These rates are similar to those reported in other cohorts[10], [12] ?[15], [35] . Also in agreement with other studies[10] ?[14], [35], [36], adverse events were the main reason for change early after HAART initiation, with significant heterogeneity in the distribution of adverse events across sites. Hematological adverse events, >70% of which were anemia, were most common. This was most frequent in IMTAvH-Peru at 67%. Previous studies from Peru also reported anemia as a main reason for discontinuation (68%), and associated this finding with the use of standard 600 mg ZDV in low weight patients[21]. ZDV use was associated with an increase risk of discontinuation in the first 120 days of therapy and this early toxicity was associated with low baseline body weight. The high rates of HAART change due to anemia in IMTAvH-Peru may also be a reflection of baseline anemia and the fact that this site closely monitors anemia and changes HAART soon after its occurrence. The distribution of change in regimen due to skin rash also varied, with high rates in FH-Argentina, FA-Chile and IMTAvH-Peru and low rates elsewhere. This could be in part related to ethnicity, although this remains controversial[37] ?[39] . GHESKIO-Haiti, with more advanced disease at baseline, had unexpectedly lower rates of change/discontinuation due to adverse events than other sites. However, the rates were similar when deaths were included as discontinuations. The availability of alternative drugs more than the occurrence of adverse events may explain this low rate. As expected and previously reported[10], [12], patients were more likely to change therapy shortly after HAART initiation because of adverse events rather than treatment failure. Failure was given as the reason for change in 5% of changes, corresponding to 1.3% of HAART initiators. This low rate primarily may be explained by the short duration of follow-up. Interruption in drug supply prompted changes in 2% of HAART initiators per site: its importance cannot be minimized since interruptions <30 days were ignored. Continuous provision of therapy is a key component of any successful HIV program, as treatment interruptions affect program effectiveness[5], [21] . Consistent with previous studies, individuals who died while on their first regimen were censored at the time of death in our primary analyses [10], [13], [14]. This analysis implicitly assumes that the frequency with which these individuals would have changed regimens had they continued to live is similar to the frequency of changing for those patients who remained in care. To examine the sensitivity of results to this assumption we performed additional analyses which categorized individuals who died while on their first regimen as having discontinued regimens. We also performed analyses, assuming those lost to follow-up stopped therapy. This latter assumption seems reasonable in sites where there were few other options for HIV care, but less reasonable for sites located in areas with several other points of care. Characteristics at HAART initiation of those subsequently lost to follow-up for the CCASAnet cohort have been described elsewhere[8]. Risk factors for changing/discontinuing first regimen were similar regardless of how those who died or were lost were classified For the combined cohort, clinical AIDS prior to HAART initiation was identified as an independent predictor for treatment change. For FH-Argentina, in contrast to other sites, there was an increased risk of change at higher CD4 counts. A previous report suggested that patients with higher CD4 counts were at higher risk of GI intolerance whereas misclassification of gastrointestinal intolerance can occur in patients with low CD4 and associated opportunistic diseases[40]. Comorbidities in patients with advanced disease and concurrent treatments for opportunistic diseases may affect antiretroviral tolerance and thereby increase risk of toxicities. Late HAART initiation was associated with higher rates of treatment change. Approximately 50% of the patients in the combined cohort started therapy at less than 100 CD4/mL, highlighting the urgent need for timely diagnosis and treatment of HIV-positive patients. Efavirenz-based regimens had the lowest hazard for change. The increased hazard for change of NVP-based regimens was especially pronounced in IMTAvH-Peru. This may be explained by the use of fixed dose combinations containing ZDV and anemia frequency. In spite of the high proportions of hematological toxicity, the hazards of change for ZDV- and non-ZDV-containing regimens were similar. We believe that since patients with anemia at baseline were typically assigned to non-ZDV containing regimens (primarily d4T), ZDV-treated patients were ?protected? from subsequent change due to anemia. However, baseline anemia status was not consistently collected for all sites. We failed to identify consistent associations between gender or age and risk of antiretroviral change, although other studies have found that younger age and female gender predict change[13] . After the first change, most patients remained on regimens within the same class. The outcome of second regimens was not assessed as it was beyond the scope of this study. Our study had several limitations. Adverse events or regimen failures were computed only if they prompted regimen change. Therefore, their frequency cannot be used to estimate their occurrence, but rather the frequency of events deemed significant enough to prompt a regimen change. Strategies for changing regimens varied throughout the region and have evolved over time. Therefore, differences between sites regarding rates of toxicities, for example, may reflect site differences in guidelines for changing regimens or availability of alternative regimens. In addition, these data were collected retrospectively, and differences between sites in reasons for change and adverse events may reflect varying levels of data capture. Results of pooled analyses should be treated with caution given the heterogeneity seen in our cohort We did not consider treatment modifications or interruptions shorter than 30 days because registration of such events varied across sites and shorter discontinuations were less likely to have been recorded. We recognize the potential impact of minor interruptions on treatment outcomes, particularly using NNRTI-based regimens; such interruptions occur frequently in real life but generally have not been considered in other cohort studies[14], [41] . Although we controlled for key variables such as CD4 count and clinical stage, patients were not randomly assigned to their initial regimens, so rates of change may be higher for certain regimens due to baseline characteristics rather than the regimen itself. However, most of the associations observed in this study are similar to those reported elsewhere [10], [12] ?[16], [35], [39] . In conclusion, the high rate of change due to adverse events is consistent with studies from other cohorts. Heterogeneity between sites may be explained by differences in baseline characteristics at HAART initiation, programmatic differences, demographics and population genetics. Unfortunately, with only 7-sites, we are unable to perform analyses to investigate the impact of site-specific factors on regimen change. Efavirenz-based regimens were widely used and showed a lower rate of discontinuation compared to nevirapine or PI-based treatments. Supporting Information Top *Table S1. * Adjusted Hazard Ratios (95% Confidence Intervals) for Regimen Change in First Year by most Common Regimens. (0.04 MB DOC) *Table S2. * Adjusted Hazard Ratios (95% Confidence Intervals) for Regimen Change/Discontinuation in First Year counting Death as a Discontinuation. (0.06 MB DOC) *Table S3. * Adjusted Hazard Ratios (95% Confidence Intervals) for Regimen Change/Discontinuation in First Year, counting Death and Loss to Follow-up as Discontinuations. (0.06 MB DOC) *Table S4. * Adjusted Hazard Ratios (95% Confidence Intervals) for Regimen Change/Discontinuation in the First Year including available Predictors for each Site. (0.09 MB DOC) Acknowledgments Top *CCASAnet Steering Group*: Pedro Cahn (Argentina), Mauro Schechter (Brazil), Marcelo Wolff (Chile), Jean William Pape (Haiti), Denis Padgett (Honduras), Juan Sierra Madero (Mexico), Eduardo Gotuzzo (Peru), Daniel Masys (USA). Author Contributions Top Conceived and designed the experiments: CTC BES AJK VIF MS SHT MW JWP PL DP JSM EG CCM DRM PC. Performed the experiments: CTC BES PC. Analyzed the data: CTC BES AJK VIF MS SHT MW JWP PL DP JSM EG CCM DRM PC. Contributed reagents/materials/analysis tools: CTC BES PC. Wrote the paper: CTC BES AJK VIF MS SHT MW JWP PL DP JSM EG CCM DRM PC. References Top 1. UNAIDS (2007) AIDS epidemic update. Available: http://www.unaids.org/en/HIV_data/2007Ep?iUpdate/default.asp . Accessed 2009, Sep 18. 2. Chequer P, Cuchi P, Mazin R, Garcia Calleja JM (2002) Access to antiretroviral treatment in Latin American countries and the Caribbean. Aids 16: Suppl 3S50?57. Find this article online 3. WHO (2008) Towards Universal Access Progress Report. Scaling up priority HIV/AIDS interventions in the health sector. Available: http://www.who.int/hiv/pub/2008progressr?eport/en . Accessed 2009, Sep 18. 4. Louis C, Ivers LC, Smith Fawzi MC, Freedberg KA, Castro A (2007) Late presentation for HIV care in central Haiti: factors limiting access to care. AIDS Care 19: 487?491. Find this article online 5. Wolff MJ, Beltran CJ, Vasquez P, Ayala MX, Valenzuela M, et al. (2005) The Chilean AIDS cohort: a model for evaluating the impact of an expanded access program to antiretroviral therapy in a middle-income country?organization and preliminary results. J Acquir Immune Defic Syndr 40: 551?557. Find this article online 6. Souza- PR Jr, Szwarcwald CL, Castilho EA (2007) Delay in introducing antiretroviral therapy in patients infected by HIV in Brazil, 2003?2006. Clinics 62: 579?584. Find this article online 7. Keiser O, Anastos K, Schechter M, Balestre E, Myer L, et al. (2008) Antiretroviral therapy in resource-limited settings 1996 to 2006: patient characteristics, treatment regimens and monitoring in sub-Saharan Africa, Asia and Latin America. Trop Med Int Health 13: 870?879. Find this article online 8. Tuboi SH, Schechter M, McGowan CC, Cesar C, Krolewiecki A, et al. (2009) Mortality During the First Year of Potent Antiretroviral Therapy in HIV-1-Infected Patients in 7 Sites Throughout Latin America and the Caribbean. J Acquir Immune Defic Syndr 51: 615?623. Find this article online 9. Park WB, Choe PG, Kim SH, Jo JH, Bang JH, et al. (2007) Early modification of initial HAART regimen associated with poor clinical outcome in HIV patients. AIDS Res Hum Retroviruses 23: 794?800. Find this article online 10. d'Arminio Monforte A, Lepri AC, Rezza G, Pezzotti P, Antinori A, et al. (2000) Insights into the reasons for discontinuation of the first highly active antiretroviral therapy (HAART) regimen in a cohort of antiretroviral naive patients. I.CO.N.A. 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O'Brien ME, Clark RA, Besch CL, Myers L, Kissinger P (2003) Patterns and correlates of discontinuation of the initial HAART regimen in an urban outpatient cohort. J Acquir Immune Defic Syndr 34: 407?414. Find this article online 15. Elzi L, Marzolini C, Furrer H, Ledergerber B, Cavassini M, et al. (2010) Treatment modification in human immunodeficiency virus-infected individuals starting combination antiretroviral therapy between 2005 and 2008. Arch Intern Med 170: 57?65. Find this article online 16. Boulle A, Orrel C, Kaplan R, Van Cutsem G, McNally M, et al. (2007) Substitutions due to antiretroviral toxicity or contraindication in the first 3 years of antiretroviral therapy in a large South African cohort. Antivir Ther 12: 753?760. Find this article online 17. Medeiros R, Diaz RS, Filho AC (2002) Estimating the length of the first antiretroviral therapy regiment durability in Sao Paulo, Brazil. Braz J Infect Dis 6: 298?304. Find this article online 18. Padua CA, Cesar CC, Bonolo PF, Acurcio FA, Guimaraes MD (2006) High incidence of adverse reactions to initial antiretroviral therapy in Brazil. Braz J Med Biol Res 39: 495?505. Find this article online 19. Padua CA, Cesar CC, Bonolo PF, Acurcio FA, Guimaraes MD (2007) Self-reported adverse reactions among patients initiating antiretroviral therapy in Brazil. Braz J Infect Dis 11: 20?26. Find this article online 20. Severe P, Leger P, Charles M, Noel F, Bonhomme G, et al. (2005) Antiretroviral therapy in a thousand patients with AIDS in Haiti. N Engl J Med 353: 2325?2334. Find this article online 21. Echevarria Zarate J, Lopez de Castilla Koster D, Iglesias Quilca D, Seas Ramos C, Gonz?lez Lagos E, et al. (2007) Efecto de la terapia antiretroviral de gran actividad (TARGA) en pacientes enrolados en un Hospital P?blico en Lima-Per?. Rev Med Hered [online] 18: 184?191. Find this article online 22. Astuvilca J, Arce-Villavicencio Y, Sotelo R, Quispe J, Guillen R, et al. (2007) Incidencia y factores asociados con las reacciones adversas del tratamiento antirretroviral inicial en pacientes con VIH. Rev per? med exp salud publica [online] 24: 218?224. Find this article online 23. Soria EA, Cadile II, Allende LR, Kremer LE (2008) Pharmacoepidemiological approach to the predisposing factors for highly active antiretroviral therapy failure in an HIV-positive cohort from Cordoba City (Argentina) 1995?2005. Int J STD AIDS 19: 335?338. Find this article online 24. McGowan CC, Cahn P, Gotuzzo E, Padgett D, Pape JW, et al. (2007) Cohort Profile: Caribbean, Central and South America Network for HIV research (CCASAnet) collaboration within the International Epidemiologic Databases to Evaluate AIDS (IeDEA) programme. Int J Epidemiol 36: 969?976. Find this article online 25. Comit? T?cnico Asesor de la Direcci?n de Sida y ETS del Ministerio de Salud de la Naci?n Argentina (2007) Recomendaciones para el tratamiento antirretroviral. Available: http://www.msal.gov.ar/sida/pdf/recomend aciones-tratamiento-antirretroviral.pdf . Accessed 2009, Sep 18. 26. Sociedad Argentina de Infectologia (2007) Recomendaciones para el seguimiento y tratamiento de la infeccion por HIV. Available: http://www.sadi.org.ar/files/HIV2007.pdf. Accessed 2009, Sep 18. 27. Minist?rio da Sa?deSecretaria de Vigil?ncia em Sa?dePrograma Nacional de DST e AIDS. (2008) Recomenda??es para Terapia Anti?retroviral em Adultos Infectados pelo HIV 2008. Available: http://www.aids.gov.br/data/documents/st oredDocuments/%7BB8EF5DAF-23AE-4891-AD36 -1903553A3174%7D/%7B762E0EBF-A859-4779-8 A92-704EB1F3B290%7D/consensoAdulto005c_2?008montado.pdf . Accessed 2009, Sep 18. 28. Ministerio de SaludSantiago: Minsal. Available: http://www.redsalud.gov.cl/archivos/guia?sges/vihsidaR_Mayo10.pdf . Accessed 2009, Sep 18. 29. Gu?a de manejo antirretroviral de las personas con VIH Cuarta Edicion. M?xico 2008. Available: http://www.censida.salud.gob.mx/interior?/atencion.html . Accessed 2009, Sep 18. 30. WHO (2006) Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach. ? 2006 rev. Available: http://www.who.int/entity/hiv/pub/guidel ines/artadultguidelines.pdf . Accessed 2009, Sep 18. 31. Shafer JL (1997) Analysis of Incomplete Multivariate Data. London: Chapman & Hall. 32. Harrell FEJ (2001) Regression Modeling Strategies With Applications to Linear Models, Logistic Regression, and Survival Analysis. New York: Springer. 33. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7: 177?188. Find this article online 34. Smith-Warner SA, Spiegelman D, Ritz J, Albanes D, Beeson WL, Bernstein L, et al. (2006) Methods for pooling results of epidemiologic studies: the Pooling Project of Prospective Studies of Diet and Cancer. Am J Epidemiol 163: 1053?1064. Find this article online 35. Hart E, Curtis H, Wilkins E, Johnson M (2007) National review of first treatment change after starting highly active antiretroviral therapy in antiretroviral-naive patients. HIV Med 8: 186?191. Find this article online 36. Park-Wyllie LY, Scalera A, Tseng A, Rourke S (2002) High rate of discontinuations of highly active antiretroviral therapy as a result of antiretroviral intolerance in clinical practice: missed opportunities for adherence support? Aids 16: 1084?1086. Find this article online 37. Mazhude C, Jones S, Murad S, Taylor C, Easterbrook P (2002) Female sex but not ethnicity is a strong predictor of non-nucleoside reverse transcriptase inhibitor-induced rash. Aids 16: 1566?1568. Find this article online 38. Tedaldi EM, Absalon J, Thomas AJ, Shlay JC, van den Berg-Wolf M(2008) Ethnicity, race, and gender. Differences in serious adverse events among participants in an antiretroviral initiation trial: results of CPCRA 058 (FIRST Study). J Acquir Immune Defic Syndr 47: 441?448. Find this article online 39. Subbaraman R, Chaguturu SK, Mayer KH, Flanigan TP, Kumarasamy N(2007) Adverse effects of highly active antiretroviral therapy in developing countries. Clin Infect Dis 45(8): 1093?101. Find this article online 40. Vo TT, Ledergerber B, Keiser O, Hirschel B, Furrer H, et al. (2007) Durability and outcome of initial antiretroviral treatments received during 2000?2005 by patients in the Swiss HIV Cohort Study. J Infect Dis 2008 197: 1685?1694. Find this article online 41. Kiguba R, Byakika-Tusiime J, Karamagi C, Ssali F, Mugyenyi P, et al. (2007) Discontinuation and modification of highly active antiretroviral therapy in HIV-infected Ugandans: prevalence and associated factors. J Acquir Immune Defic Syndr 45: 218?223. Find this article online Add a note to this text. Please follow our guidelines for notes and commentsand review our competing interests policy. Comments that do not conform to our guidelines will be promptly removed and the user accoun _______________________________________________ health-vn Health in Viet Nam and the Region Post message to list: health-vn at anu.edu.au List information page: http://mailman.anu.edu.au/mailman/listinfo/health-vn health-vn List from the Australia Vietnam Science-Technology Link contact: Vern Weitzel vern at coombs.anu.edu.au The accuracy of information from media articles posted on this list cannot be guaranteed and should be verified before use. -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/1c8dcbc9/attachment-0011.html From hivtwg.moderator at gmail.com Mon Jul 12 03:38:38 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:38:38 +0700 Subject: [hivaids-twg] CALL FOR ABSTRACTS: ALCOHOL AND HIV CONFERENCE, 2010, NEW DELHI In-Reply-To: References: Message-ID: From: vern weitzel Date: Sun, Jul 11, 2010 at 4:33 AM Subject: [health-vn] Fwd: CALL FOR ABSTRACTS: ALCOHOL AND HIV CONFERENCE, 2010, NEW DELHI To: "[health-vn discussion group]" *From: *"Conference Organizers" *Date: *18 June 2010 4:42:40 AM PDT *To: * *Subject: **CALL FOR ABSTRACTS: ALCOHOL AND HIV CONFERENCE, 2010, NEW DELHI* *Call for Abstract Submissions **For The Second International Conference On Alcohol And HIV:* *Insights from Intervention ?* *Deadline **30th June 2010.* The International Center for Research on Women, Institute for Community Research, Public Health Foundation of India and National Institute on Alcohol Abuse and Alcoholism are pleased to announce *T**he* *Second International Conference on Alcohol and HIV:* *Insights from Interventions* *When:*September 28 ? 30, 2010 *Where:* New Delhi, India *Abstract submission is now open and can be completed online.* The conference will highlight evaluated prevention programs, intervention research and national policies that address the links between alcohol and HIV, and that are focused on risk reduction. A special emphasis of this year?s conference is the role of gender norms that can elevate HIV-related risks for both women and men especially in the presence of alcohol Abstract submission must be completed online at http://www.alcoholhivconference2010.org/. For any further questions regarding the conference or submission please email conferenceorganizers at icrw.org or call ICRW at 91 11 4664 3333 -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/d774acae/attachment-0011.html From hivtwg.moderator at gmail.com Mon Jul 12 03:39:18 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:39:18 +0700 Subject: [hivaids-twg] 25th IUSTI European Conference on STD, HIV/AIDS 23-25 September 2010 Tbilisi, Georgia In-Reply-To: <533ECDFA-9CE0-479E-A55E-44B57A9AF920@gmail.com> References: <533ECDFA-9CE0-479E-A55E-44B57A9AF920@gmail.com> Message-ID: From: vern weitzel Date: Sun, Jul 11, 2010 at 4:12 AM Subject: [health-vn] Fwd: 25th IUSTI European Conference on STD, HIV/AIDS 23-25 September 2010 Tbilisi, Georgia To: "[health-vn discussion group]" *From: *tmsstd at anet.net.th *Date: *18 June 2010 10:56:18 PM PDT *To: *undisclosed-recipients:; *Subject: **25th IUSTI European Conference on STD, HIV/AIDS 23-25 September 2010 Tbilisi, Georgia* Dear Colleague, On behalf of Executive Committee of IUSTI (International Union Against Sexually Transmitted Infection) I am very please to invite you to join the 25th IUSTI Europe Conference on STIs & HIV/AIDS which will be held on September 23-25, 2010 in Tbilisi, Georgia The main scientific programme topics are: - STI public health interventions of the 21st Century - Biological driver of HIV - New diagnostics and rapid tests - Sexual health associate such as sexuality education, sexually risk Behavior, sexual health need for minority populations, condom promotion - Vaccines for HPV and HIV - Challenges to effective syndromic management - Selected STI updates - Male circumcision - Prevention of mother-child HIV transmission - ARV treatment and monitoring - Microbicides - Sexual health and infections - Sex worker and trafficking - Basic Science - Epidemiology of STI - STI Prevention Policy - STI in gynecology and urology In this Congress you will gain more update knowledge and share your experiences with a lot of scientists who have come to join. For more information please visit our website www.iusti2010-tbilisi.ge Or through Email secretariat at iusti2010-tbilisi.ge I am looking forward to see you at the conference. Yours sincerely, Chavalit Mangkalaviraj M.D.,M.P.H. IUSTI Executive Committee Senior Consultant in Preventive Medicine Bangrak Hospital Department of Disease Prevention and Control Ministry of Public Health 9 (formerly 189) Sathorn Road Sathorn District Bangkok 10120 Thailand -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/830f9724/attachment-0011.html From hivtwg.moderator at gmail.com Mon Jul 12 03:42:23 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:42:23 +0700 Subject: [hivaids-twg] Social Determinants of Health: Prevention-control: HIV/AIDS, Viral Hepatitis, Sexually Transmitted Infections, Tuberculosis In-Reply-To: <0A0D6D5A-F077-404F-8691-1CD387858D77@gmail.com> References: <28939CE16D9179459E89EF2C4E8E405015D131@hq-exch-is05.wdc.paho.org> <0A0D6D5A-F077-404F-8691-1CD387858D77@gmail.com> Message-ID: *From: *"Ruggiero, Mrs. Ana Lucia (WDC)" *Date: *17 June 2010 3:37:37 PM PDT *To: *EQUIDAD at LISTSERV.PAHO.ORG *Subject: **[EQ] Social Determinants of Health: Prevention-control: HIV/AIDS, Viral Hepatitis, Sexually Transmitted Infections, Tuberculosis* *Reply-To: *"Equity, Health & Human Development" *Addressing Social Determinants of Health in the Prevention and Control of HIV/AIDS, Viral Hepatitis, Sexually Transmitted Infections, and Tuberculosis * *Public Health Reports / 2010 Supplement 4 / Volume 125* Public Health Reports (PHR) is the official journal of the U.S. Public Health Service. Published by the Association of Schools of Public Health (ASPH). Available online at: http://bit.ly/clFnzM ????..A special supplement focusing on the *Social Determinants of Health*in the on-going battle to prevent and control HIV/AIDS, Viral Hepatitis, sexually transmitted infections, and Tuberculosis. This supplement covers the constant barriers society faces when fighting and attempting to rectify diseases that have plagued our society for centuries. >From economic to cultural to racial obstacles, Public Health Reports examines the ?*cause and effect*? relationships that continue to be the main hindrance to decreasing the spread of these diseases. This special supplement of Public Health Reports presents innovations, advances, and insights regarding the role of social determinants in the spread of HIV, viral hepatitis, sexually transmitted infections and tuberculosis. Research and commentary are presented on community and societal characteristics, such as the effects of incarceration and the differences in HIV transmission among foreign-born and native-born people; income and/or social status, including registered and non-registered female sex workers; stigma; and education; among other areas. The supplement includes an editorial by guest editors, Drs. Hazel Dean and Kevin Fenton of the US Centers for Disease Control and Prevention (CDC) and also includes commentary and a viewpoint penned by former CDC Directors and WHO Commission on Social Determinants of Health members Drs. David Satcher and William Foege???..? . *Content:* * Article Title * *G**uest Editorial: * *A**ddressing social determinants of health in the prevention and control of hiv/aids, viral hepatitis, sexually transmitted infections, and tuberculosis * *Kevin A. Fenton* / *Hazel D. Dean, ScD* / Hazel D. Dean, Deputy Director and Kevin A. Fenton, Director, of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention (CDC), in Atlanta, Georgia ???.This special issue of Public Health Reports (PHR) focuses on innovations and advances in incorporating a socialdeterminants- of-health (SDH) framework for addressing the interrelated epidemics of human immunodeficiency virus (HIV), viral hepatitis, sexually transmitted infections (STIs), and tuberculosis (TB) in the United States and globally. This focus is particularly timely given the evidence of increasing burden and worsening health disparities for these conditions, the evolution in our understanding of the social and structural influences on disease epidemiology, and the far-reaching implications of the global economic downturn. The global trends and adverse health impact of HIV, viral hepatitis, STIs, and TB remain among the major and urgent public health challenges of our time.1 These conditions account for substantial morbidity and mortality, with devastating fiscal and emotional costs to individuals, families, and societies. Despite decades of investment and support, the U.S. still experiences a disproportionate burden of these conditions compared with other Western industrialized nations, with substantial health disparities being observed across population subgroups and geographic regions.2 The reasons for these inequities are multifaceted and complex. It is true that individual-level determinants, including high-risk behaviors such as unsafe sexual and drug-injecting practices, are major drivers of disease transmission and acquisition risk. However, it is also clear that the patterns and distribution of these infectious diseases in the population are further influenced by a dynamic interplay among the prevalence of the infectious agent, the effectiveness of preventive and control interventions, and a range of social and structural environmental factors.3,4 Many of these conditions arise because of the circumstances in which people grow, live, work, socialize, and form relationships, and because of the systems put in place to deal with illness, all of which are, in turn, shaped by political, social, and economic forces??..? *Include a Social Determinants of Health Approach to Reduce Health Inequities* *David S. Satcher, MD, PhD* *Social Determinants of Health and Health-Care Solutions*[Feature Article] *William H. Foege, MD* *Summary of CDC Consultation to Address Social Determinants of Health for Prevention of Disparities in HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis* *Tanya Sharpe, PhD* / *Kathleen McDavid, PhD, MPH* / *Hazel D. Dean, ScD* *The Social Determinants of HIV Serostatus in Sub-Saharan Africa: An Inverse Relationship Between Poverty and HIV?* *Ashley Fox, PhD* *Prisons as Social Determinants of Hepatitis C Virus and Tuberculosis Infections* *Niyi Awofeso, MBChB* *Tuberculosis and Stigmatization: Pathways and Interventions* *Andrew Courtwright, MD* / *Abigail N. Turner, PhD* *Risk Factors for HIV Disease Progression in a Rural Southwest American Indian Population* *Jonathan Iralu, MD* / *Bonnie Duran, DrPH* / *Cynthia Pearson, PhD* / *Yizhou Jiang**, MS* / *Kevin Foley, PhD* / *Melvin Harrison, BA* / *Sexually Transmitted Diseases Among American Indians in Arizona: An Important Public Health Disparity* *Michelle Winscott, MD* *Epidemiologic Differences Between Native-Born and Foreign-Born Black People Diagnosed with HIV Infection in 33 U.S. States, 2001?2007* *Anna Satcher Johnson, MPH* / *Xiaohong Hu* / *Hazel D. Dean, ScD* *Associations of Sex Ratios and Male Incarceration Rates with Multiple Opposite-Sex Partners: Potential Social Determinants of HIV/STI Transmission * *Enrique R. Pouget, Phd* / *Trace S. Kershaw, PhD* / *Jeannette R. Ickovics, PhD* / *Kim M. Blankenship, PhD* *The Context of Economic Insecurity and Its Relation to Violence and Risk Factors for HIV Among Female Sex Workers in Andhra Pradesh, India* *Elizabeth Reed, MPH* / *Jhumka Gupta* / *Monica Biradavolu, PhD* / *Kim M. Blankenship, PhD* / *Vasavi Devireddy, BS* *Economically Motivated Relationships and Transactional Sex Among Unmarried African American and White Women: Results from a U.S. National Telephone Survey* *Kristin L. Dunkle, PhD* / *Gina M. Wingood, ScD* / *Christina Camp, PhD* / *Ralph DiClemente* *A Comparison of Registered and Unregistered Female Sex Workers in Tijuana, Mexico* *Nicole Sirotin, MD* / *Steffanie A. Strathdee, PhD* / *Remedios Lozada, MD*/ *Lucie Nguyen, MS* / *Manuel Gallardo, MD* / *Alicia Vera, MPH* / *Thomas L. Patterson, PhD* *Does Education Matter? Examining Racial Differences in the Association Between Education and STI Diagnosis Among Black and White Young Adult Females in the U.S.* *Lucy Annang, PhD* / *Katrina M. Walsemann, PhD* / *Debeshi Maitra, MHA* / *Jelani C. Kerr, PhD* * * * This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics; Information Technology - Virtual libraries; Research & Science issues. [DD/ KMC Area] ?Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings and interpretations included in the Materials are those of the authors and not necessarily of The Pan American Health Organization PAHO/WHO or its country members?. ------------------------------------------------------------------------------------ PAHO/WHO Website *Equity List - Archives - Join/remove*: http://listserv.paho.org/Archives/equidad.html *Twitter http://twitter.com/eqpaho * IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please dispose of and delete this transmission. Thank you. -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/a9c79151/attachment-0011.html From hivtwg.moderator at gmail.com Mon Jul 12 03:44:16 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:44:16 +0700 Subject: [hivaids-twg] Comment period ends soon for input on draft Business Case! In-Reply-To: <01b401cb2133$4c2912c0$e47b3840$@org> References: <01b401cb2133$4c2912c0$e47b3840$@org> Message-ID: From: Jack Beck Date: Mon, Jul 12, 2010 at 2:57 AM Subject: [msm-asia] Comment period ends soon for input on draft Business Case! To: Jack Beck *Comment period ends soon for input on draft Business Case!* 11 July 2010 Dear all, Thank you so much for your comments so far on the draft Business Case we blasted last week! If you have not yet commented, please do so now! This is an important opportunity to have your voice heard and ideas known. For more background on the Business Case (including links to the English, French and Spanish versions), read below! Thank you very much! The MSMGF *** The UNAIDS outcome framework 2009-2011 declares that one of UNAIDS? top priorities is the health and rights of men who have sex with men (MSM), sex workers, and transgender people, stating that people in these key populations can and should be empowered to protect themselves from HIV infection, achieve full health, and realise their human rights. To advance UNAIDS strategic thinking and implementation of this priority, an inter-agency ?Priority Area Working Group?, involving the UNAIDS Secretariat, UNDP, UNESCO, UNFPA, and WHO, has drafted a Business Case which articulates a proposed goal and three intended bold results for UNAIDS. The intention of this Business Case is to represent the agreed priority goal, bold results, and intended actions of all ten UNAIDS Cosponsors. Along with the UNAIDS Outcome Framework and the UNAIDS 2011-2015 strategic plan, this UNAIDS Business Case is being developed to: ? inform UNAIDS? programmatic objectives, ? guide future UNAIDS investments and action, ? identify country-level and population-level indicators to which the UNAIDS Secretariat and the Cosponsors should be accountable, and ? affirm the ways in which the UNAIDS Secretariat and ten Cosponsors leverage their respective organizational mandates and resources to work collectively to deliver results. You can find the draft Business Case below: - In English, here: http://www.msmgf.org/documents/OPP_INT_bizcaseEN.pdf - En fran?ais, ici: http://www.msmgf.org/documents/OPP_INT_bizcaseFR.pdf - En espa?ol, aqu?: http://www.msmgf.org/documents/OPP_INT_bizcaseES.pdf Please take a few minutes to provide comments and feedback on this new draft Business Case. Any input you have should be sent in an email to input at msmgf.org by 31 July 2010. Please circulate this call among your contacts and networks! *Jack Beck *|* *Communications Associate *The Global Forum on MSM & HIV (MSMGF) *436 14th Street, Suite 1500 Oakland, CA 94612 P: 510.271.1956 E: jbeck at msmgf.org www.msmgf.org -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/6870cb08/attachment-0011.html From hivtwg.moderator at gmail.com Mon Jul 12 03:45:41 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:45:41 +0700 Subject: [hivaids-twg] Skills-Building Announcement: E-Health and Social Media for Clinical HIV Management In-Reply-To: <659420.51516.qm@web37302.mail.mud.yahoo.com> References: <659420.51516.qm@web37302.mail.mud.yahoo.com> Message-ID: From: Ishdeep Kohli Date: Thu, Jul 8, 2010 at 11:55 PM Subject: [AIDS ASIA] Skills-Building Announcement: E-Health and Social Media for Clinical HIV Management To: AIDS_ASIA Announcement: Professional Development Workshop - Distance Based Learning Technologies E-Health and Social Media for Clinical HIV Management Swasthya India, Jodhpur School of Public Health, HIV Atlas and I-TECH India, announce the Professional Development Workshop, ?Distance Based Learning Technologies E-Health and Social Media for Clinical HIV Management? at the XVIII International AIDS Conference, to be held in Vienna, Austria, 18-23 July 2010. Session date: July 19, 2010 Session time: 14:30-18:00 The advent of Information and Communication Technology is seen as a vital factor in enhancing development and healthcare efforts. Countries with high incidence of HIV are benefiting from the Internet, E-Networking and Social Media to improve the efficiency of information exchange. Addressing need for cutting-edge information about HIV/AIDS in resource-limited settings the HIV/AIDS Clinical Seminar Series presentation will increase knowledge and skills of health care workers related to care, treatment, diagnosis, and comprehensive management of HIV/AIDS patients. Effective clinical training is often limited by the non-availability of appropriate cases and the challenges associated with bed side case discussions. OI videos will assist clinicians in correctly diagnosing opportunistic infections associated with HIV and build capacity of health care workers. E-Health challenges and opportunities for HIV Physicians will be presented and how Social Media can be harnessed effectively by HIV physicians. Participants will understand to utilize web-based Voice-over-Internet-Protocol (VoIP) technology to provide interactive, case-based instructional sessions on the clinical management of HIV/AIDS. The Adobe CPL platform will be explained that allows participants to see a PowerPoint presentation and hear the lecture in real time and demonstrations provide on how global HIV/AIDS experts present a variety of topics like advanced care, comprehensive management, and treatment via synchronous live sessions. An understanding of online communities and their impact on HIV clinical management and Social Media as a tool for HIV physicians will be provided. Adaptation of ICT in HIV patient care has been relatively slow and many physicians are not ready to use this opportunity. E-health provides opportunities and challenges. This session will present a detailed analysis of both. Target Audience: Physicians, Nurses, Community Health Workers, Pharmacists, Psychologists, Counselors, Social workers, Traditional or Complementary Therapy Practitioners, Lab Technicians, Trainers, Clinical Mentors, Academicians and others working in Clinical Science, Prevention Science, Epidemiology. Participants wishing to attend can confirm their participation to Ishdeep Kohli at ishdeepkohli at hotmail.com Ishdeep Kohli Director Programs and Partnerships Swasthya India Mumbai , India e-mail:> __._,_.___ -- HIV TWG Listserv Address to post message: hivaids-twg at ngocentre.org.vn Subscribe to the listserv: http://mailman.ngocentre.org.vn/cgi-bin/mailman/listinfo/hivaids-twg -------------- next part -------------- An HTML attachment was scrubbed... URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20100712/f91a2d4a/attachment-0011.html From hivtwg.moderator at gmail.com Mon Jul 12 03:46:31 2010 From: hivtwg.moderator at gmail.com (HIV-TWG Moderator) Date: Mon, 12 Jul 2010 09:46:31 +0700 Subject: [hivaids-twg] Fwd: Today's News (2010.07.09ex)-HCM City receives US$6.8 mln foreign aid Message-ID: From: Diaz, Clara Date: Fri, Jul 9, 2010 at 6:07 PM Subject: Today's News (2010.07.09ex) To: Please find attached the following AIDS-related articles compiled by UNAIDS *UNAIDS* 1. Voice of America News - *Namibia** Lifts HIV Travel Ban* 2. Botswana Gazette - *Prof Tlou appointed UNAIDS Regional Support Team Director* 3. UN News Service -* **UN lauds Namibia?s lifting of travel ban for people living with HIV/AIDS* 4. Eurasia Review - *AIDS On The Rise In Middle East, North Africa* 5. New Kerala, India - *Namibia** lifts travel ban for HIV/AIDS people * *AFRICA** AND MIDDLE EAST* 1. New Vision, Uganda - *HIV Bill should accomodate all voices * 2. The Citizen, Tanzania - *Why blame a certain gender for a disease * 3. Cameroon Tribune - *VIH - Renforcer la protection pour les enfants * 4. Le Matin, Morocco - *Le Maroc engag? ? renforcer son action * *ASIA** AND PACIFIC* 1. The Hindu, India - *Powerful HIV antibodies found for vaccine * 2. VOV News, Viet Nam - *HCM** City** receives US$6.8 mln foreign aid * *EUROPE*** 1. International Herald Tribune - *Where is the H.I.V. vaccine? (Op-Ed) * 2. Reuters - *Antibody finding could lead to AIDS vaccine* 3. Reuters - *World Bank names Zimbabwean to head AIDS program* 4. The Lancet, UK - *Innovation and education improve health in Rio's favelas* *LATIN AMERICA AND CARIBBEAN* 1. La Naci?n, Argentina - *Nuevo avance en la vacuna contra el sida * 2. Ag?ncia de Not?cias da Aids, Brazil - *Governo distribui novo medicamento contra a aids para crian?as * *NORTH AMERICA* 1. New York Times - *U.S.** to Provide $25 Million to Help Buy AIDS Drugs* 2. IPS Terra Viva - *Making 2010 a Turning Point for Women's Health * 3. TMCNet - *Major Technology Providers to Sponsor 2010 mHealth Summit Conference* 4. IPS Terra Viva - *HIV Vaccine Advances Made Ahead of Global Conference * 5. UN Dispatch - *An Argument Against the Obama Global Health Initiative * 6. Wall Street Journal - *Advance in Quest for HIV Vaccine * *UNAIDS WEB.SITE* 1. UNAIDS - UNICEF and partners help make the World Cup a win for children =========================== *UNAIDS* =========================== *Namibia Lifts HIV Travel Ban** **Voice of America News* 08/07/2010 Joe DeCapua Namibia has lifted its long-standing travel ban for people living with HIV. Namibian officials say even though there?s no record of enforcement of the ban, it did not reflect Namibia?s commitment to democracy and human rights. UNAIDS praises the decision, saying the country is now in line with international public health standards. ?The fact that visitors coming to Namibia have to fill in a visa form where they are asked whether they suffer from a contagious disease, including HIV and AIDS, which is legally done as a basis to refuse them entry into the country, is a difficult issue to face,? says Henk Van Renterghem, UNAIDS country coordinator for Namibia. What?s more, he adds, ?It?s discrimination against people suffering from a disease.? The right thing to do Van Renterghem says besides being ?the right thing to do? in bolstering human rights, lifting the ban supports the country?s public health policy. ?There is no evidence whatsoever that limiting mobility or travel of people living with HIV has any effect on the epidemic. And in this sense, people who live with the disease?get the wrong impression they should be somehow contained in their mobility and in their rights to move around freely,? he says. The United States and China recently lifted their long-standing HIV travel restrictions. But UNAIDS reports there are ?51 countries, territories and areas that continue to impose some form of restriction on the entry, stay and residence of people living with HIV based on their HIV status.? It goes on to say that five countries deny visas for even short-term stays, while 22 countries ?deport individuals once their HIV status is discovered.? Relic of the past? ?Most of these regulations and laws were put in place in the early days of the epidemic,? says Van Renterghem. ?It gives a very wrong impression of how we treat people living with HIV. We know that stigma and discrimination against people living with HIV?reduce to a large extent?the capacity to access services.? He says lifting such bans sends a message to HIV-positive people that ?we care about you. You?re equal to all other citizens and we everything to put in place a framework that allows us to provide the best possible services.? UNAIDS Executive Director Michel Sidibe has designated 2010 the year of lifting of HIV travel restrictions. ?That?s why it?s important that countries (such) as the U.S., China and Namibia actually effectively lift these regulations,? Van Renterghem says. Rights here, right now The 18th International AIDS Conference, AIDS 2010, will be held in Vienna from July 18th through the 23rd. The theme of the conference is Rights Here, Right Now. Van Renterghem says a number of news conferences and sessions are planned on the travel ban issue. UNAIDS says, ?There is no evidence that such restrictions prevent HIV transmission or protect public health. Furthermore, HIV-related travel restrictions have no economic justification, as people living with HIV can lead long and productive working lives.? *2** * *Prof Tlou appointed UNAIDS Regional Support Team Director** **Botswana Gazette*** 08/07/2010 The Joint UN Programme on HIV/AIDS (UNAIDS) has announced the appointment of Professor Dinotshe Shiela Tlou as the new Regional Support Team Director for East and Southern Africa. She will take over the role from the Acting Director, Dr. Mbulawa Mugabe, in September 2010. Shiela Tlou, a Botswana National, is currently a Professor of Nursing at the University of Botswana.Prior to that she was the Minister of Health for the Government of Botswana from 2004 to 2009, where she spearheaded the countries highly effective AIDS programme.She was a Professor of Nursing at the University of Botswana from 1999 to 2004. Sheila has held the positions of Director, WHO Collaborating Centers and Professor with the University of Botswana, Gaborone, Botswana, from 1994 to 1999. Prof. Tlou has a Doctorate of Nursing Science, majoring in Public Health Nursing and Research. She has a Master of Education, majoring in Curriculum and Instruction in the Health Sciences, from Columbia University as well as a Master of Science, majoring in Public Health Nursing and Psychology, from The Catholic University of America, Washington D.C. Sheila is a strong and committed advocate for an effective AIDS response and has demonstrated superb leadership throughout the region over many years. Upon accepting the offer of appointment, Professor Tlou noted, ?I am delighted and honored to accept the role of UNAIDS Regional Director for Eastern and Southern Africa, an organization that leads global advocacy on HIV and AIDS. I look forward to bringing my combined background of research, teaching, policy and management to the School, and to working with staff to improve HIV and AIDS responses in the region." The UNAIDS Executive Director, Mr. Michel Sidibe, comments that he is confident that she will provide excellent leadership within UNAIDS team and within the region as we continue to build and strengthen the AIDS response with countries. *4* *UN lauds Namibia?s lifting of travel ban for people living with HIV/AIDS** **UN News Service* 08/07/2010 8 July 2010 ? The Joint United Nations Programme on HIV/AIDS (UNAIDS) today welcomed Namibia?s decision to remove travel restrictions for people living with the virus, a move that aligns the country?s laws with international public health standards. The new legislation lifting restrictions for people living with HIV/AIDS and other contagious diseases took effect in Namibia on 1 July. Restrictions that limit movement based on HIV-positive status only are discriminatory and violate human rights, according to UNAIDS. There is no evidence that such restrictions prevent HIV transmission or protect public health, the agency said, adding that HIV-related travel restrictions have no economic justification, as people living with HIV can lead long and productive working lives. ?I am heartened by this announcement in Namibia,? said Michel Sidib?, UNAIDS Executive Director. ?HIV-related travel restrictions serve no purpose and hamper the global AIDS response,? he added. UNAIDS advocates for an individual?s right to freedom of movement, regardless of HIV status. There are now 51 countries, territories, and areas that continue to impose some form of restriction on the entry, stay and residence of people living with HIV based on their HIV status. Five countries deny visas even for short-term stays, while 22 countries deport individuals once their HIV-positive status is discovered. The United States and China removed long-standing HIV-related travel restrictions earlier this year. Several other countries, including Ukraine, have pledged to take steps to remove such restrictions. *5* *AIDS On The Rise In Middle East, North Africa** **Eurasia Review* 09/07/2010 By Cecily Hilleary For years, the lack of reliable data on HIV/AIDS in the Middle East and North Africa led regional governments to believe they had somehow managed to escape the epidemic. But a new United Nations report shows that numbers are on the rise: more than 400,000 people are currently living with HIV across the Middle East and North Africa region, or MENA. Of those, 68,000 need anti-retroviral treatment, but only 14 percent are actually getting it. The rest may not even know they are infected. Hind Khatib is a regional director of the U.N. Joint Programme on HIV/AIDS or UNAIDS. She has just returned from a two-day conference in Dubai, where regional leaders gathered to discuss the issue. Khatib:It's still low prevalence, but you know we've just put out the synthesis report, which was an epidemiological study of HIV and its evolution in the region, and the report says that probably, at least for the near future, we'll never have an epidemic of HIV in the region. But still, there is evidence that HIV is growing among key populations. The key populations as defined by the study are the people who are mainly drug injectors, men who have sex with men, and sex workers. So we thought that it's timely, especially that this year, there was a great effort by UNAIDS invested in the region to ensure that all the countries will actually report and live up to their commitments made to the 2001 Declaration in the U.N. General Assembly Special Session on HIV. The national reports clearly, from 20 countries out of the 21 countries in the region, Iraq was the only country that could not report, for understandable reasons - all 20 countries have shown that they have weak programs, weak surveillance, and that the coverage is very, very poor. So yes, while we have national AIDS programs, while countries are attempting to draw up their national strategies, coverage, in terms of treatment, voluntary counseling and testing and even prevention, is very, very poor. So we thought this was the time to actually convene policy makers together with civil society with small communities of people living with HIV, to get together under one roof and start talking [about] what's next. Hilleary:What's the biggest obstacle to people getting tested and treated for HIV/AIDS in the MENA region? Khatib:It's stigma. Stigma and discrimination. People are afraid. I mean, I think that knowing how HIV basically gets transmitted is something that people are afraid, that people know that they have had extra-marital sex-the whole concept of men who have sex with other men--it's a big taboo, and the region does not want to admit that we have these groups. They don't want to admit to a lot of extra-marital activities. So I think it's very much cultural and related also to religion and Islam, and people, you know, like to believe that we don't have such conducts here. But I think slowly, slowly, people here are that HIV is very much home-grown. Up until now, it has been the perception, 'Oh, we got it from outside.' I think that with a lot of advocacy and, as you know now there is a good amount of popular faces, popular stars that also engage in HIV, whether it's through UNICEF, and recently UNAIDS has appointed its first regional Goodwill Ambassador [Egyptian actor Amr Waked was recently named the first UNAIDS Goodwill Ambassador for the Middle East and North Africa region by the Joint United Nations Program on HIV/AIDS], and we are very happy that he's coming out loud, speaking about stigma and discrimination, speaking about the rights of our key populations, speaking about the time to act, speaking about the right policies, targeted action. But I think there is a lot the region still needs to do to reduce fear. Hilleary:What does the U.N. plan to do with the data it has gathered now? Khatib:First, I think we are working with countries on improving the national strategies. So it's much more targeted and it doesn't address HIV as if it's a generalized epidemic. What's next is actually to have concerted efforts to bring up awareness, because if you don't bring awareness to all different targeted groups, including the health workers. Even if you do confidential testing, you will need the people who run those services to bring awareness and educate people. It's just educating. *6* *Namibia lifts travel ban for HIV/AIDS people ** **New Kerala, India* 08/07/2010 New York, Jul 8 : The Joint United Nations Programme on HIV/AIDS (UNAIDS) on Thursday welcomed Namibia's decision to remove travel restrictions for people living with the virus, a move that aligns the country's laws with international public health standards. The new legislation lifting restrictions for people living with HIV/AIDS and other contagious diseases took effect in Namibia on 1 July. Restrictions that limit movement based on HIV-positive status only are discriminatory and violate human rights, according to UNAIDS. There is no evidence that such restrictions prevent HIV transmission or protect public health, the agency said, adding that HIV-related travel restrictions have no economic justification, as people living with HIV can lead long and productive working lives. "I am heartened by this announcement in Namibia," said Michel Sidibe, UNAIDS Executive Director. "HIV-related travel restrictions serve no purpose and hamper the global AIDS response," he added. UNAIDS advocates for an individual's right to freedom of movement, regardless of HIV status. There are now 51 countries, territories, and areas that continue to impose some form of restriction on the entry, stay and residence of people living with HIV based on their HIV status. Five countries deny visas even for short-term stays, while 22 countries deport individuals once their HIV-positive status is discovered. The United States and China removed long-standing HIV-related travel restrictions earlier this year. Several other countries, including Ukraine, have pledged to take steps to remove such restrictions. =========================== *AFRICA** AND MIDDLE EAST* =========================== *HIV Bill should accomodate all voices ** **New Vision, Uganda* 08/07/2010 On Tuesday, May 18, the HIV Prevention and Control Bill was tabled in Parliament for the first reading. This is a milestone in Uganda?s efforts to manage the HIV epidemic as it portrays the Government?s commitment in the fight against HIV/AIDS. However, in its current form, the Bill undermines the public health of Ugandans as it does not depict a comprehensive approach towards the HIV problem. The Bill promotes mandatory disclosure of the HIV status, it promotes mandatory testing for HIV and it criminalises intentional transmission of HIV/AIDS. If the Bill is to achieve a holistic response to HIV/AIDS in Uganda, its intentions would not only be limited to preventing and controlling the spread of the epidemic, but also to promote and protect the rights of people living with HIV (PHAs). The Government is obliged to respect, promote and protect the rights of all its citizens without discrimination, but the Bill does not address this. This undermines the HIV/AIDS prevention efforts. People will choose not to know their HIV status, as they will feel legally safer not to test. Otherwise, they would be proved guilty hence ?ignorance of the status becomes a defence?. An appropriate intervention would be looking at reducing barriers to voluntary testing and increasing the use of the service. The Bill also makes a woman more vulnerable to abuse yet they are already marginalised. Mothers will choose not to access antenatal services and for those who will be conditioned to test, they will keep silent about their HIV-positive status, and not access mother-to-child preventive services. In the end, they will infect their newly born babies because if they dare to disclose their HIV status, they will be hacked. Consequently, it is like shooting ourselves in the foot because we will witness an increase in the number of people living with HIV/AIDS, child and maternal mortality and morbidity. Parliament should, therefore, function objectively, not on emotions and listen to other voices, especially the civil society. This group has expressed their views about the Bill in its current form. Mandatory testing, involuntary disclosure and criminalisation ought to be removed from the HIV Bill if we have to observe public health. *The writer is a Makerere University School of Public Health-CDC HIV/AIDS fellow* *2* *Why blame a certain gender for a disease ** **The Citizen, Tanzania* 09/07/2010 By Fatima Hussenali Just over a week ago, I boarded a taxi to town, the driver happened to be a young man in his twenties. Although I listen to similar conversations often this one left me spellbound, I learnt a few things which just confirmed how ignorant our people are, regarding HIV/ Aids. The young man was telling one of the passengers in the car how difficult it is to find a 'decent' young woman these days. Being a young woman myself, I felt offended but decided not to say anything just to allow the conversation reach its logical conclusion. The 'dude' preached on how in the 'good old days', women took pride in who they were and how one would not find decent women in bars or nightclubs. "Were there shanty bars in the good old days," I asked myself or at least that's what my grandmother told me. But I continued to listen to the young man rant as he spoke of how he would not want to get involved with just any woman these days especially the ones who hang out at clubs. According to him, clubs are places where women go to hunt for men who will meet their needs even if the relationship is guaranteed to last only 24 hours or less and as a result HIV is most likely to be transmitted. "Even the innocent girls we grew up with cannot be trusted," the taxi driver rumbled on. Reacting the negative words he spoke about women and how they encourage the spread of HIV, I concluded that the brother had no respect for women. But what can I say. Everyone is entitled to their opinion. I wasn't brave enough to share my opinion with the taxi driver that day even when I felt I was clearly offended by such ill informed idle talk. Regarding by this brothers conversation a bar or a club is an evil place which makes me think that even men should not hang out there. This is not meant to attack anyone but just to point out some of the misleading issues. Often times we find men (even married ones) promising the moon and the stars to young girls, who in many cases are school dropouts in clubs and other places, while their children and wives do not even have anything to eat at home. And then you find the same men who are just never satisfied with one partner, apparently diversity is good... and the cases are endless. The issue at hand is, an epidemic such as HIV cannot be blamed on an individual or a particular gender. Time should rather be spent looking for solutions that will help everybody, for example, what can be done about young women spending their times at nightclubs with sugar daddies. How best can the HIVmessages be transmitted? Is the current education/information regarding HIV really efficient and transmitted in the right channels? Can we successfully fight the HIV pandemic? I'd say yes we can but only if each individual takes their position in this fight. And as the saying goes, It begins with you, and therefore, let?s be the change we want to see. People have to be willing to change and they have to realise that HIV/Aids is real and most of all people will have to let go of the stigma that is often caused by ignorance. People have to love themselves and their fellow humans enough not to engage in reckless behaviour. It is certain that if you are not infected with HIV you are affected. *You can reach the writer of this article on: husenalif at gmail.com * *3* *VIH - Renforcer la protection pour les enfants** **Cameroon Tribune* 07/07/2010 Eric Elouga Un atelier organis? depuis lundi par le Circb pour am?liorer la pr?vention et la recherche m?dicale Le probl?me de la mortalit? m?re-enfant en Afrique ?tait il y a quelques semaines encore, sur la table du G8 qui a tir? la sonnette d'alarme, devant le constat de pi?tinement enregistr? dans la r?alisation de cet objectif du Mill?naire pour le D?veloppement. Il n'en fallait pas plus pour que le Centre international de r?f?rence Chantal Biya pour la recherche, mette un accent particulier sur les questions de transmission ? l'enfant, dans son programme de pr?vention et de lutte contre le Vih sida. Depuis hier ? Yaound? se tient, en effet, un atelier international sur le th?me de la recherche clinique sur les enfants infect?s par le vih. Objectif de ces travaux, faire le point sur la situation g?n?rale du continent en mati?re de prise en charge clinique des patients infect?s, avec un focus particulier sur les cas des enfants. C'est ainsi qu'autour de la table, les ?minents scientifiques et chercheurs associ?s au Circb vont ainsi plancher jusqu'? demain, sur les strat?gies de pr?vention et traitement des infections de la m?re ? l'enfant De mani?re sp?cifique, l'atelier de Yaound? s'articule autour de six modules. L'importance du choix des th?rapies ? adopter face aux r?sistances du virus ? certains anti-r?troviraux, les moyens de pr?vention et de traitement des transmissions de la m?re ? l'enfant, la question des effets collat?raux des anti-r?troviraux sur les jeunes patients, le r?le de la recherche m?dicale, les applications g?n?tiques dans cette recherche et le point sur les avanc?es en mati?re de traitements et de vaccin, sont ainsi les principaux axes autour desquels tourneront les expos?s et les d?bats. De mani?re plus globale, il sera surtout question, nous a laiss? entendre un intervenant, de mettre en rapport les progr?s faits en rapport avec cette probl?matique de la recherche sur les enfants infect?s au niveau international, avec le contexte plus sp?cifique de l'Afrique. *5* *Le Maroc engag? ? renforcer son action** **Le Matin, Morocco* 08/07/2010 Le Maroc est engag? ? renforcer son action dans le cadre du plan strat?gique national de lutte contre le sida 2007-2011 pour atteindre les objectifs mondiaux, ? savoir z?ro nouveaux cas d'infection et une prise en charge totale des personnes atteintes, a assur? jeudi la ministre de la Sant?, Yasmina Baddou. Intervenant ? l'ouverture de ?l'atelier de revue ? mi-parcours du plan strat?gique national de lutte contre le Sida?, la ministre a indiqu? que ce plan vise ? assurer un acc?s global ? la pr?vention et aux soins, saluant ? cet ?gard l'implication de l'ensemble des partenaires pour la r?alisation des objectifs fix?s pour 2011. Ces objectifs, a-t-elle expliqu?, consistent ? couvrir un million de personnes appartenant aux populations cl?s les plus expos?es aux risques d'infection, accroitre et diversifier les opportunit?s de conseil et de d?pistage du Vih, assurer des soins de qualit? et une prise en charge psychosociale incluant l'acc?s aux antir?troviraux ? 4.500 personnes atteintes outre le renforcement du leadership pour une gestion et une coordination efficaces de la r?ponse multisectorielle au Vih/Sida. Mme Baddou a ?galement fait remarquer que le nombre de personnes test?es a connu ?un essor important?, ajoutant que les centres de conseil et test Vih sont pass?s de 24 en 2006 ? plus de 60 cette ann?e. A son tour, le nombre des personnes diagnostiqu?es cette ann?e s'est ?lev? ? 90.000 contre un peu plus de 57.000 en 2006, a-t-elle poursuivi, pr?cisant que parmi les personnes test?es, une proportion importante appartient aux cat?gories ? risque. De m?me, a poursuivi la ministre, le nombre des personnes sous traitement antir?troviraux a doubl? entre 2006 et 2009, passant actuellement ? pr?s de 3.000 cas. Evoquant la strat?gie de r?duction des risques chez les usagers de drogues injectables, Mme Baddou a indiqu? que celle-ci s'articule autour de quatre principaux axes: la r?duction de la demande, la r?duction des risques li?s ? ces drogues, le traitement et la prise en charge des usagers de drogues et le suivi et l'?valuation. Dans ce cadre elle a rappel? que le traitement de substitution ? la m?thadone avait ?t? lanc? en juin dernier ? titre pilote dans trois sites, faisant ainsi du Maroc le 2e pays ? introduire la m?thadone dans la r?gion d'Afrique du Nord et du Moyen-Orient (Mena). De son c?t?, le repr?sentant de l'OMS au Maroc, Said Salah Youssef, a indiqu? qu'? la faveur de son engagement politique et du Plan strat?gique de lutte contre le sida, le Maroc a enregistr? un progr?s consid?rable en la mati?re, ce qui en fait l'un des pays pionniers dans la r?gion Mena. Il a, ?galement, salu? les efforts consentis par le minist?re de la Sant?, les organisations non gouvernementales et les secteurs concern?s en vue de mettre en application le Plan strat?gique national 2007-2011, se f?licitant de la dynamique de la soci?t? civile marocaine et de la parfaire coordination des diff?rents partenaires avec les agences des Nations unies. Au programme de cet atelier, qui s'?tale sur deux jours, figurent trois axes principaux : la situation ?pid?miologique au Maroc, les obstacles et les opportunit?s, et l'analyse des plans nationaux de lutte contre le sida. *=======================* * * *ASIA** AND PACIFIC* * * *=======================*** *Powerful HIV antibodies found for vaccine** **The Hindu, India* 09/07/2010 DPA - U.S. scientists have discovered the most effective HIV antibodies to date, which could be used to find a vaccine for the virus, according to a study published in Science Thursday. A team of researchers coordinated by the National Institutes of Health (NIH) found the two proteins that can neutralize more than 90 per cent of known global strains of HIV. The VRC01 and VRC02 antibodies neutralize more strains with greater strength than any other previously known antibody, the study said. After finding out how the antibodies work and where they attach to the virus, the scientists have started developing a potential vaccine. They also said that their work could be used in HIV treatment. ?In addition, the technique the teams used to find the new antibodies represents a novel strategy that could be applied to vaccine design for many other infectious diseases,? said Anthony Fauci, director of the NIH?s National Institute of Allergy and Infectious Diseases. An AIDS vaccine, which will prevent HIV infection as effectively as vaccines prevent polio and other viral infections, is still several years away. Vaccine development is expensive and daunting because HIV is like a moving target, mutating readily. Finding individual antibodies that can neutralize HIV strains is difficult because the virus is constantly changing its surface proteins to evade recognition by the immune system - resulting in a very large number of HIV variants worldwide. But the newly found antibodies ?attach to a virtually unchanging part of the virus, and this explains why they can neutralize such an extraordinary range of HIV strains,? said John Mascola, who led one of the study teams. The findings were published shortly before a large international AIDS conference that brings together scientists, international bodies and non-governmental advocates in Vienna from July 18. *2* *HCM City receives US$6.8 mln foreign aid** **VOV News, Viet Nam* 09/07/2010 Ho Chi Minh City received a total of US$6.8 million in grants from foreign non-governmental organisations, companies and individuals in the first half of the year. Of the funding, 75 percent went to the city?s Health Department and HIV/AIDS prevention committee. The city?s achievements in social welfare, education, health, poverty reduction and job generation has encouraged the contributions of NGOs and international organizations, said Nguyen Thi My Tien, General Secretary of the Ho Chi Minh City Union of Friendship Organisations at a gathering on July 8. During the meeting with representatives of NGOs operating in the city, Tien promised that the union will work with relevant agencies to streamline the current procedures concerning NGOs? operations. The city is calling for US$713,000 aid for more than 20 projects, including legal advice and consultancy for people living with HIV and affected by HIV/AIDS; scholarships, teaching tools and equipment for poor students, students who are hearing-impaired or mentally retarded; protection and support for migrant children, street children and ethnic minority children. VOVNews/VNA *========================* *EUROPE*** *========================* *Where is the H.I.V. vaccine?(Op-Ed)** **The International Herald Tribune* 08/07/2010 Seth Berkley and Alan Bernstein On the eve of the XVIII International AIDS Conference in Vienna, it is time to face some difficult realities about the global response to H.I.V. and AIDS. More than 2.7 million people worldwide are newly infected with H.I.V. every year. Current H.I.V. drugs are not cures. Every person infected with H.I.V. will require expensive and often complex antiretroviral treatment for life. The U.S. government, the Clinton Foundation, the Global Fund to Fight H.I.V., Tuberculosis and Malaria and others are leading efforts to provide treatment to the ever-increasing millions of people in need. These efforts save lives and strengthen developing-world health systems, and they deserve strong and continued support. The 5 million people now receiving H.I.V. drugs in developing countries, however, are still just one-third of the number in need. For each person who receives treatment, 2.5 more are infected. Simply put, we cannot treat ourselves out of this pandemic. This pandemic needs a vaccine. Multiple approaches to stopping H.I.V., including condoms, circumcision and widespread promotion of monogamy and safer sex, along with new approaches in development, are all important to slowing this epidemic. Historically, however, vaccines are the best tool to limit or stop the spread of a virus. Smallpox and polio are examples of global killers that have been completely or nearly eliminated with a vaccine. So why don't we have an H.I.V. vaccine yet, and what can we do to get one? The development of an H.I.V. vaccine is slowed by the complexity of the challenge - H.I.V. is the most elusive virus ever targeted for a vaccine - but also by inadequate support for research. Consider that the global economic impact of AIDS is estimated between $20 and $50 billion every year. The cost of providing treatment to even the one-third of people who need it today is more than $10 billion per year. But the amount spent on the entire global effort to develop and test H.I.V. vaccines was only about $800 million last year - 10 percent less than 2007 funding. That's not enough to get the job done. Only four major trials of H.I.V. vaccine candidates have been conducted in 27 years of research - not nearly enough to gather critical scientific information. We are poised to take major steps forward in H.I.V. vaccine research if the effort receives the support it needs. Recently, a vaccine trial in Thailand reduced H.I.V. infection risk by 31 percent - a major advance and the first demonstration that a vaccine can prevent H.I.V. infection. While 31 percent protection is too low for a useable vaccine, it shows that a vaccine is possible. In other advances, scientists have discovered a number of antibodies that neutralize different variations of H.I.V. found around the world. Combining two or more of these antibodies in the laboratory provides protection against most strains of H.I.V. Other innovative vaccine strategies aimed at controlling H.I.V. infection have tested well in animals. Work to translate these discoveries into vaccine candidates needs support. Stepping up the H.I.V. vaccine research effort requires more funding. It may sound unrealistic to advocate for more spending on AIDS vaccines in the midst of a global economic crisis - but insufficiently funding this effort makes no sense from either a humanitarian or economic standpoint. The amounts needed to support a new era in AIDS vaccine research are small when compared to the enormous potential benefit - real and lasting control of this global epidemic. One way to increase support is to make the search for an H.I.V. vaccine a truly global effort. Today, a handful of funders led by the U.S. government pay for the bulk of global H.I.V. vaccine research. But H.I.V./AIDS is a global problem, and it demands a global solution. Current funders must continue their strong support, but other countries must also come to the table. This will help encourage the private sector - whose expertise and resources are needed to make an H.I.V. vaccine a reality, but which now plays only a minor role in H.I.V. vaccine research - to recommit itself to this essential global health goal. It's time to focus again on what seemed so clear at the beginning of this pandemic - ending H.I.V./AIDS urgently requires a vaccine. The evidence that a safe and effective H.I.V. vaccine can be developed is stronger than ever. Without a truly global effort to act on that promise, however, we may find ourselves asking the same question after 25 more years of this pandemic: Where is the H.I.V. vaccine? *2* *Antibody finding could lead to AIDS vaccine** **Reuters* 08/07/2010 *Story carried by Globe and Mail (Canada)* Maggie Fox Washington - Researchers have discovered antibodies that can protect against a wide range of AIDS viruses and said they may be able to use them to design a vaccine against the fatal and incurable virus. The bodies of some people make these immune system proteins after they are infected with the AIDS virus, when it is too late for them to do much good. But a properly designed vaccine might help the body make them much sooner, the researchers reported in Friday?s issue of the journal Science. ?I am more optimistic about an AIDS vaccine at this point in time than I have been probably in the last 10 years,? Gary Nabel of the National Institute of Allergy and Infectious Diseases, who led the study, said in a telephone interview. Two of the antibodies can attach to and neutralize 90 percent of the various mutations of the human immunodeficiency virus that causes AIDS, Dr. Nabel said. ?This is an antibody that evolved after the fact. That is part of the problem we have in dealing with HIV -- once a person becomes infected, the virus always gets ahead of the immune system,? Dr. Nabel said. ?What we are trying to do with a vaccine is get ahead of the virus.? AIDS infects about 33 million people globally, according to the United Nations AIDS agency UNAIDS. It has killed 25 million people since the pandemic began in the early 1980s and there is no vaccine or cure, although drugs can help control it. The virus is difficult to fight in part because it attacks immune system cells and in part because it mutates constantly, making it a moving target for drugs or the immune system. It has been almost impossible to make a vaccine that will affect the virus. Last September, researchers reported their biggest success yet with a vaccine that appeared to slow the rate of infection by about 30 percent in Thai volunteers but the trial raised many questions. MOVING TARGETS Researchers have been looking for parts of the virus that do not mutate so they can design vaccines that will protect against these constantly changing versions. Dr. Nabel?s team found two of the antibodies in the blood of a patient infected with HIV who had not become ill despite the infection. Such people are called non-progressors and researchers study their immune systems to find out why they control the virus better than most patients. They then found the immune system cells called B-cells that made these particular antibodies, using a new molecular device that they invented. In yet another experiment, they managed to freeze one of the antibodies in the process of attaching to and neutralizing the virus, getting an atomic-level image in a process called x-ray crystallography. Being able to ?see? what the structure looks like could enable researchers to design a vaccine using a process called rational vaccine design, akin to an established technique for making drugs called rational drug design, Dr. Nabel said. It may also be possible to design gene therapy to help patients make these antibodies themselves, or use an older technique that transfuses the antibodies directly. One of the antibodies, called VRC01, partially mimics the way an immune cell called a CD4 T-cell attaches to a piece of the AIDS virus called gp120, the researchers said. ?The antibodies attach to a virtually unchanging part of the virus, and this explains why they can neutralize such an extraordinary range of HIV strains,? Dr. John Mascola, who worked on the study, said in a statement. ?The discovery of these exceptionally broadly neutralizing antibodies to HIV and the structural analysis that explains how they work are exciting advances that will accelerate our efforts to find a preventive HIV vaccine for global use,? NIAID director Dr. Anthony Fauci added in a statement. ?In addition, the technique the teams used to find the new antibodies represents a novel strategy that could be applied to vaccine design for many other infectious diseases.? *3* *World Bank names Zimbabwean to head AIDS program** **Reuters* 08/07/2010 WASHINGTON July 8 (Reuters) - The World Bank on Thursday named David Wilson, a Zimbabwean national who has written extensively about AIDS in the developing world, to head the poverty-fighting institution's global HIV/AIDS program. Wilson, who joined the Bank in 2003, has advised governments in South Africa, Nigeria, Lebanon, Vietnam, China and Papua New Guinea. Wilson said one of the Bank's key tasks was "providing countries with evidence to better understand where and how new HIV infections are occurring, and to use proven approaches to tackle these infections." "With better evidence we can make prevention services succeed and make AIDS treatment more sustainable," he said in a statement. With more HIV/AIDS funding going to organizations such as the Geneva-based Global Fund to fight AIDS, Tuberculosis and Malaria, the World Bank has slowly shifted its focus from financing HIV/AIDS projects to advising countries on how best to manage AIDS funding and improve HIV prevention programs. Wilson will lead the Bank's delegation to the International AIDS Conference in Vienna this month, the Bank said. (Writing by Lesley Wroughton; Editing by David Storey) *4* *Innovation and education improve health in Rio's favelas** **The Lancet, UK* 10/07/2010 Sharmila Devi Access to health care in Brazil's favelas is poor, but several innovative projects in Rio de Janeiro are starting to improve the situation. Sharmila Devi reports. Nanko van Buuren rushed back to the head office of the Brazilian Institute for Innovations in Social Healthcare, the non-profit group he started in 1989 that is best known by its Portuguese acronym of Ibiss. But his waiting colleagues are long-used to the erratic time-keeping of this tall Dutchman, whom the street children of Rio de Janeiro's favelas or slums call Paitrao, which combines the Portuguese words for father and boss. On this warm afternoon in mid-April, he was delayed because he had been touring some Ibiss projects with a delegation from Success for Kids, an educational charity backed by Madonna, the latest high-profile celebrity who wanted to tackle the entrenched poverty in the favelas. ?Madonna called me personally last week to talk about how they can adapt Success for Kids to our own situation?, said van Burren. ?They will have to adapt it because a lot of kids here are running around with guns because of organised crime and the drugs trade.? Ibiss has grown into one of Rio de Janeiro's best-known non-governmental organisations through its many projects aimed at helping the city's most economically and socially excluded people. Since the beginning, its model has been to go into the favelas and ask the residents themselves not just what they need, but how they would organise it. If the programme is successful, Ibiss then lobbies the government to adopt it on a wider scale. Successful initiatives include leprosy-awareness programmes, helping children to leave or to avoid the drug gangs using football and music, and training favela residents to become community health-care workers. Ibiss has grown from just van Buuren and a handful of Brazilian staff to some 600 employees, mostly locally trained Brazilians, who work on about 62 projects. Brazil will host the soccer World Cup in 2014 and the Olympic Games in 2016 and the government has promised to spend billions of dollars on infrastructure and security to ensure safety and enjoyment for the influx of international visitors. In Rio de Janeiro, a city of about 6 million people, the 1 million residents of some 1000 favelas hope they will benefit from the largesse too. Long neglected by government agencies, they have relied on their own efforts and the help of groups such as Ibiss to ensure access to basic health care and other services, such as electricity or waste collection. The death toll from gun battles in the favelas between drug gangs, security forces and unofficial police militias is huge considering there is no actual insurgency or civil war. The UN has estimated the police murder three people a day on average in Rio de Janeiro, making them responsible for one in five killings in the city. Populated mostly by economic migrants from the north-east of Brazil, and caught between the drug gangs and the police, the favelas lack systematic access to the health-care system. There are high rates of tuberculosis and maternal and child mortality. Children are particularly vulnerable to diseases that spread in unsanitary conditions. Meanwhile, many Brazilian doctors and nurses are lured by higher salaries to the private sector. Brazil accounts for about 17% of worldwide cases of leprosy, second only to India, which has about 54% of cases. The spread of leprosy is for the most part a consequence of migration to the favelas, since patients from rural areas often interrupt their 12?18 month course of treatment when they move to Rio's favelas, said Nancy Torres, an Ibiss health worker who helps to organise self-treatment groups. Ibiss also worked with the producers of a popular telenovela, or TV soap opera, to introduce a character with leprosy to help erode its social stigma. Brazil does have one of the developing world's best programmes to combat HIV/AIDS, thanks in part to legislation guaranteeing universal access to antiretroviral treatments and the government's authorisation to local companies to produce the drugs without the consent of the patent-holder. But Joseph Amon, director of health and human rights at Human Rights Watch, said issues such as the treatment of drug dependency and the deinstitutionalisation of psychiatric care are still in need of urgent reform. Brazil is one of at least 115 countries that recognises a constitutional right to health. ?We're just starting to see the start of advocacy efforts by the government, which needs to give meaning to the constitutional right to healthcare?, he said. Some favelas have achieved progress in basic sanitation, education and roads. But many others are no-go areas for outsiders, including health workers and local journalists. Heavily armed police making a raid on drug gangs are often the only visitors. Even the more developed favelas provide a stark contrast to rich areas of Rio de Janeiro, such as Ipanema and Copacabana. The wealthiest 10% in Brazil are thought to control about 50% of the country's wealth. van Buuren, a former WHO psychiatrist, first ventured into the favelas more than 20 years ago, building up trust with the heavily armed drug lords who rule by fear. ?It's now very easy for us to do our work because we are very well-known in the slums, especially by the bosses of organised crime,? he said. ?It took years of building up confidence. One of the main reasons is that I can't look at people as just criminals or murderers. I ask how are the kids and the man thinks not as a drugs boss but as the father of his children and he's proud to explain. If you are afraid when you talk to the boss, he smells that you're afraid and you're treated in that way.? van Buuren now speaks better Portuguese than English, having fallen in love with Brazil and its people. Before moving to Brazil, he developed programmes to deliver psychiatric care to the homeless, immigrants, and other hard-to-reach populations in his native Netherlands. For WHO, he helped to train health professionals to cope with disaster and conflict situations. He said Brazilians thought he was crazy when he started Ibiss, with its ethos of enlisting people in the favelas to help to formulate solutions to their problems. ?What is funny about Brazil is that people are very open. They looked at us and said you're crazy but go ahead if you want to do it?, he said. ?In Holland, they've already created so many obstacles that you can't even start to experiment.? Ibiss ran into strong opposition when it began distributing condoms, including among street children, but condom distribution is now routine in Brazil. ?The church and other groups wanted to think that children had no sexuality and I don't know how they combined that thinking with young girls getting pregnant?, he said. One of Ibiss's biggest successes is its community health-care training programme, which has since been adopted by the Brazilian Government following strong advocacy by Ibiss. There are now more than 3000 health posts all over Brazil. ?In the early 1990s, we saw how the public health system didn't enter the slums?, he said. ?So we took people, mostly women, from the slums and gave them training, one-and-a-half days a week for nine months, in the early detection of diseases, how to seek treatment and how to get a prescription.? He said the women felt greatly empowered. ?Many would ask after they had referred someone to a medical post about the final diagnosis and they would feel incredibly proud when they found out they were right in their initial diagnosis.? Brazil is also a source country for the international trafficking of people. The government is being urged, like that of South Africa before it hosted this summer's soccer World Cup, to adopt stricter measures so that offenders are brought to justice. According to the UN, over 75 000 Brazilian women are being sexually exploited in Europe. Rio de Janeiro is seen as one of the principal points of departure for these women to leave the country. Ibiss works on the streets with male and female prostitutes and transvestites and tries to map where and how people are gathered in the better-known areas of prostitution in Rio de Janeiro. Security remains of paramount concern. The Brazilian Government has now embarked on a pacification programme in which police enter and stay in a favela to enforce law and order. Seven favelas have been occupied so far and dozens more occupations are planned in the run-up to the World Cup and Olympics. Van Buuren fears the programme could become a victim of its own success, with favela residents selling their homes for a quick profit but unable to survive for long in new shantytowns further out of town. ?Pacification has to include incentives for companies to settle in these areas and create jobs or else poor people will lose out.? *========================* * * *LATIN AMERICA AND CARIBBEAN* * * *========================* *Nuevo avance en la vacuna contra el sida ** **La Naci?n, Argentina* 09/07/2010 Sebasti?n A. R?os El descubrimiento de dos anticuerpos capaces de bloquear la infecci?n por el virus del sida (VIH) ha reavivado las esperanzas de encontrar una vacuna. En los ?ltimos a?os, esta b?squeda hab?a concluido en sucesivos fracasos, con experimentos que no fueron efectivos o generaron una protecci?n m?nima. El desarrollo de un m?todo diferente para detectar anticuerpos propios del ser humano posibilit? hallar dos (el VRC01 y el VRC02) que bloquean la infecci?n del 90% de las cepas del virus del sida conocidas. Ese nuevo procedimiento, precisamente, abre un camino de investigaci?n que renueva las esperanzas de poder contar, probablemente en el mediano plazo (en no menos de 5 a 10 a?os), con una vacuna eficaz contra el VIH. "Los descubrimientos que hemos hecho podr?an superar las limitaciones que durante mucho tiempo han bloqueado el desarrollo de vacunas contra el VIH basadas en anticuerpos", declar? ayer el doctor Peter Kwong, del Centro de Investigaci?n en Vacunas, del Instituto Nacional de Alergia y Enfermedades Infecciosas de los Estados Unidos, y autor de uno de los estudios publicados en Science donde se comunicaron los descubrimientos. Lo que los investigadores liderados por Kwong y sus colegas John Mascola y Gary Nabel lograron en primer lugar fue desarrollar un nuevo m?todo de biolog?a molecular que permite aislar los anticuerpos de los que se vale el sistema inmunol?gico para combatir los agentes infecciosos o impedir que ?stos infecten las c?lulas del organismo. El nuevo m?todo se basa en una prote?na del VIH modificada que s?lo reacciona ante los anticuerpos que impiden que el virus del sida se aferre a las c?lulas humanas antes de invadirlas. Al aplicar este m?todo a muestras de sangre de un paciente infectado los investigadores dieron con los anticuerpos VCR01 y VCR02, que han demostrado tener un poder para neutralizar el virus mucho m?s grande que todos los anticuerpos conocidos contra el VIH. Pero los investigadores fueron un paso m?s all?: determinaron la estructura at?mica de uno de esos anticuerpos en el exacto momento en que se pega al VIH impidiendo la infecci?n de la c?lula humana. "Con ese conocimiento -inform? un comunicado del instituto donde se realiz? la investigaci?n- se han comenzado a dise?ar los componentes de un candidato de vacuna que podr?a ense?ar al sistema inmune humano a producir anticuerpos similares al VRC01 que podr?an prevenir la infecci?n causada por la vasta mayor?a de las cepas de VIH de todo el mundo." Aun as?, moder? el doctor Pedro Cahn, jefe de infectolog?a del hospital Fern?ndez, "si bien se trata de un estudio auspicioso y prometedor, debe quedar en claro que es una investigaci?n b?sica e inicial, que no tiene ninguna implicancia en el corto plazo". "Muchas otras veces se logr? aislar anticuerpos neutralizantes de amplio espectro, como los que han sido descubiertos ahora, pero que despu?s no lograron cumplir su funci?n cuando fueron probados en estudios cl?nicos en seres humanos", agreg? la doctora Andrea Mangone, investigadora del Conicet en el Laboratorio de Retrovirus del hospital Garrahan. Sorteando obst?culos Pero m?s all? del descubrimiento de los mencionados anticuerpos, lo m?s interesante del trabajo es la posibilidad de contar con un nuevo m?todo -cuya efectividad a?n debe ser corroborada por otros grupos de investigaci?n- para aislar anticuerpos que puedan ser empleados para el desarrollo de vacunas o de tratamientos en VIH/sida. Es m?s, agreg? Mangone, "si esta herramienta demuestra ser tan efectiva como dicen sus creadores, incluso podr?a servir para buscar anticuerpos para otras enfermedades infecciosas". Pero volviendo al terreno del VIH/sida, lo que los expertos del Centro de Investigaci?n en Vacunas parecen haber logrado es superar dos de los obst?culos que hasta ahora han impedido el desarrollo de una vacuna eficaz. Uno de ellos es la alta capacidad del virus para mutar las prote?nas de su superficie, impidiendo que sea reconocido por el sistema inmunol?gico. "Han sido identificadas unas pocas ?reas en la superficie del virus que permanecen constantes en casi todas sus variantes -se?al? el citado comunicado-. Una de ellas es el sitio de uni?n CD4. El VRC01 y el VRC02 bloquean la infecci?n al pegarse al sitio de uni?n CD4, impidiendo que el virus se aferre a las c?lulas." "Los anticuerpos se adhieren a una parte virtualmente invariable del virus, y eso explica por qu? pueden neutralizar un rango tan extraordinario de cepas de VIH", declar? el doctor Mascola. Otro de los obst?culos para el desarrollo de vacunas contra el VIH ha sido lograr que ?stas permitan la maduraci?n completa de los anticuerpos que genera la vacuna, coment? Mangano. En los estudios publicados en Science , los investigadores proponen formas de sortear ese obst?culo. El tiempo y futuras investigaciones dir?n si est?n en lo cierto. *4* *Governo distribui novo medicamento contra a aids para crian?as ** **Ag?ncia de Not?cias da Aids, Brazil* 07/07/2010 Combina??o de dois ANTIRRETROVIRAIS em um comprimido facilita a ades?o ao tratamento, afirma infectologista Marinella Della Negra Para o HIV se tornar infeccioso dentro do corpo ? essencial que as prote?nas do v?rus sejam cortadas e estruturadas corretamente. Os inibidores da protease bloqueiam o local onde o corte deve ocorrer, impedindo os novos v?rus de amadurecer e de infectar outras c?lulas. A infectologista Marinella Della Negra, do Hospital Em?lio Ribas em S?o Paulo, defende h? v?rios anos a cria??o de melhores solu??es medicamentosas para o tratamento da AIDS em crian?as. "Os ANTIRRETROVIRAIS s?o lan?ados sempre primeiro para os adultos e levam alguns anos at? serem adaptados ? forma pedi?trica. Aquelas que est?o com falha terap?utica, por exemplo, muitas vezes ficam sem op??o de tratamento", comentou. Segundo Marinella, o comprimido do Kaletra em menor tamanho se torna mais f?cil para o tratamento pedi?trico. Ela explica que a nova f?rmula do medicamento, tamb?m chamada de baby dose, ? composta por 100mg de lopinavir e 25mg de ritonavir, enquanto que a concentra??o do comprimido original, de uso adulto, ? de 200mg de lopinavir e 50mg de ritonavir. "Damos o rem?dio conforme o metro corporal do paciente. Quando usamos o medicamento de adultos para crian?as, temos que quebrar para chegar na dose certa", comenta. De 1996 a 2009, foram registrados cerca de 11 mil casos de AIDS em menores de cinco anos no Brasil, o que representa aproximadamente 2,0% do total de notifica??es da doen?a no pa?s. De acordo com o DEPARTAMENTO DE DST, AIDS e Hepatites Virais do Minist?rio da Sa?de, 90 crian?as est?o usando a vers?o do Kaletra para crian?as. Aqueles que se adaptam ? formula??o adulta desse rem?dio somam 1600. O ?rg?o informa que a tend?ncia ? mudar aos poucos o tratamento das crian?as que usam rem?dios para adultos para a baby dose. O valor pago pelo Governo brasileiro ao laborat?rio Abbott na primeira aquisi??o do Kaletra para crian?as foi de aproximadamente 66 centavos de real por cada comprimido. Kaletra e patentes Em 2005, o ex-ministro da Sa?de Humberto Costa fez um "quase-an?ncio" de licen?a compuls?ria do Kaletra para adultos. O motivo foi a recusa da Abbott em negociar a patente do medicamento. Quatro meses depois, quando Saraiva Felipe assumiu o Minist?rio, o governo federal conseguiu uma diminui??o no pre?o do medicamento, mas desagradou a vontade de muitas das organiza??es n?o governamentais que pediam a licen?a compuls?ria do rem?dio. Uma das principais cr?ticas da sociedade civil organizada foi de que o acordo fixou o pre?o do rem?dio, com redu??es graduais, por um per?odo muito longo - at? 2011 - e n?o previu a transfer?ncia de tecnologia. Os termos do acordo tamb?m foram considerados abusivos porque garantiram o monop?lio da patente do Kaletra. Desde ent?o, o Minist?rio negocia sucess?veis quedas no pre?o do medicamento. Hoje, cerca de 200 mil pessoas est?o em tratamento antirretroviral no Brasil, sendo que 52 mil fazem uso da vers?o adulta do Kaletra. Na ?ltima compra nacional desse medicamento, o governo gastou R$ 119,7 milh?es, o que representa quase 15% do total investido para a compra de ANTIRRETROVIRAIS no pa?s. Lucas Bonanno *========================* *NORTH AMERICA* *========================* *U.S. to Provide $25 Million to Help Buy AIDS Drugs** **New York Times* 08/07/2010 By ROBERT PEAR WASHINGTON ? Kathleen Sebelius, the secretary of health and human services, said Thursday that she would provide $25 million more to help states buy life-saving medications for people with H.I.V. or AIDS. Advocates for patients said the money was not nearly enough to eliminate waiting lists, which have surged to record levels as people have lost health insurance, along with their jobs, and states have cut their budgets. Ms. Sebelius said she was ?reallocating and transferring $25 million in existing resources? to provide medicines for people on waiting lists. Dr. Howard K. Koh, the assistant secretary of health and human services in charge of the program, said the action ?reflects the administration?s commitment to H.I.V. treatment and care.? In an interview, Dr. Koh repeatedly refused to say where the money had come from. Ms. Sebelius said she was confident that the $25 million would meet the existing and projected need until the end of the fiscal year on Sept. 30. As of July 1, about 2,100 people were on waiting lists for the AIDS Drug Assistance Program in 11 states: Florida, Hawaii, Idaho, Iowa, Kentucky, Louisiana, Montana, North Carolina, South Carolina, South Dakota and Utah. Other states have narrowed eligibility, limited enrollment or restricted the drugs for which they will pay. These measures affect thousands of people. Carl Schmid, deputy executive director of the AIDS Institute, an advocacy group for patients, said: ?The $25 million will help. It?s a start. But it?s definitely not enough.? Ann Lefert, a policy analyst at the National Alliance of State and Territorial AIDS Directors, said, ?We appreciate the action taken by the Obama administration, but we are not sure it will be sufficient.? Advocacy groups and state officials had urged the administration to provide $126 million in emergency assistance for the current fiscal year, on top of the $835 million that Congress had already appropriated. The administration?s action follows expressions of deep concern by members of Congress from both parties. Three Republican senators ? Richard M. Burr of North Carolina, Tom Coburn of Oklahoma and Michael B. Enzi of Wyoming ? had implored Ms. Sebelius to address what they described as a public health crisis. John Hart, a spokesman for Mr. Coburn, said, ?The secretary is taking a step in the right direction, but it?s not enough to serve the more than 2,000 patients who are on waiting lists.? Many people with H.I.V. have been able to live long lives, with the use of antiretroviral treatments. But the drugs cost an average of $12,000 a year a person, and many people cannot afford them without public assistance. ?Once patients start taking these drugs, they must continue taking them every day for the rest of their lives,? Mr. Schmid said. The AIDS Drug Assistance Program serves mainly low-income, uninsured people, many of whom are members of minority groups. More than 168,000 people received medications through the program last year. About 45 percent of them had incomes below the poverty level ($10,830 for an individual), and all but 2 percent had incomes less than four times the poverty level ($43,320). *A version of this article appeared in print on July 9, 2010, on page A15 of the New York edition.* *2* *Making 2010 a Turning Point for Women's Health** **IPS Terra Viva* 09/07/2010 Thalif Deen UNITED NATIONS, Jul 8 (IPS) - As the international community readies to commemorate World Population Day Sunday, the United Nations is reviewing the state of the world's women - and how they stack up against the risks of maternal mortality and the lack of universal access to reproductive health. U.N. Secretary-General Ban Ki-moon wants 2010 to be "a turning point for women's and children's health". Hundreds of thousands of women - 99 percent of them in the developing world - die annually as a result of pregnancy or childbirth, he said, adding, "We know how to save their lives. We can do it with quality health systems, qualified medical staff, information and tools for preventing and treating diseases such as malaria and HIV/AIDS." A U.N. report on the status of the eight Millennium Development Goals (MDGs), including drastic reductions in hunger and poverty, says there has been slow progress in expanding the use of contraceptives by women primarily for two reasons: poverty and lack of education. "The use of contraception is lowest among the poorest women, and those with no education," it says. The study points out that "the unmet need for family planning remains moderate to high in most regions, particularly sub-Saharan Africa". At least one in four women aged 15 to 49, who are married or in a relationship, have expressed the desire to use contraceptives but do not have access to them. Still, progress has been recorded by many countries on maternal mortality. "We welcome the MDG reports indication of progress, with some nations significantly reducing maternal death ratios," Thoraya Ahmed Obaid, executive director of the U.N. Population Fund (UNFPA), told IPS. However, as the report notes, the reductions fall far below the rates required to meet the MDG target of 5.5 percent annual reduction. "Therefore, to speed up progress, we must invest more in reproductive health for women and girls," said Obaid. "If every woman received reproductive health care, maternal death and disability would cease to be the devastatingly common tragedy it is today," she added. Obaid said that evidence from research and from the progress made so far prove that investing in women is not only the right thing to do, it is also smart economics. "When women are healthy and survive, they provide enormous social and economic benefits for their families, communities and nations," she added. In a report released last year, Population Action International (PAI) said the number of African women who died from pregnancy and childbirth in 2008 was much higher than the number of casualties from all the major conflicts in Africa combined. "Maternal mortality continues to be the major cause of death among women of reproductive age (15-49) in sub-Saharan Africa," it said. Most of these women die from complications that can often be effectively treated in a health system with adequate skilled personnel, and a functioning referral system that can respond to obstetric emergencies when they occur, the report pointed out. Kathy Calvin, chief executive officer of the United Nations Foundation, told IPS, "If world leaders put women and children at the top of the global agenda, we can make real progress toward meeting the Millennium Development Goals." She said hundreds of thousands of women die needlessly during pregnancy and childbirth every year. Every death is one too many. As the U.N. secretary-general has made clear in his Joint Action Plan, everyone has a role to play in ensuring the health of the world's women, she added. "Women around the world are counting on the global community to insist on universal access to family planning and to satisfy the unmet need for contraceptives," said Calvin. Obaid said UNFPA asserts the right of everyone to be counted, especially women, girls, the poor and marginalised. Population dynamics including growth rates, age structure, fertility and mortality, migration, and more influence every aspect of human, social and economic development. "With quality data we can better track and make greater progress to achieve the Millennium Development Goals, and promote and protect the dignity and human rights of all people," she said. Obaid stressed that data can reveal striking situations in countries. "Girls may be delaying marriage, an indigenous population may be drastically underserved, and higher rates of contraceptive use and skilled birth attendance may show progress towards improving maternal health," she said. The MDGs include a 50 percent reduction in poverty and hunger; universal primary education; reduction of child mortality by two-thirds; cutbacks in maternal mortality by three-quarters; promotion of gender equality; environmental sustainability; reversal of the spread of HIV/AIDS, malaria and other diseases; and a global partnership for development between the rich and the poor. *3* *Major Technology Providers to Sponsor 2010 mHealth Summit Conference** **TMCNet* 08/07/2010 By Rajani Baburajan, TMCnet Contributor The conference organizers of the 2010 mHealth Summit announced that the wireless health research and technology providers, Abbott, Microsoft Research, Pfizer, Qualcomm, Robert Wood Johnson Foundation, Skype (News - Alert) and Verizon Wireless, have joined the 2010 mHealth Summit as sponsors. The 2010 mHealth Summit is a partnership of the Foundation for the National Institutes of Health, the Nat