[hivaids-twg] Today's News (2009.11.12ex)

Thu Nov 12 12:35:40 GMT 2009

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

UNAIDS

1. JAIDS - Increasing Civil Society Participation in the National HIV Response: The Role of UNGASS Reporting

2. JAIDS - Human Rights in the Global Response to HIV: Findings From the 2008 United Nations General Assembly Special Session Reports 

3. JAIDS - Is There a Gender Gap in the HIV Response? Evaluating National HIV Responses From the United Nations General Assembly Special Session on HIV/AIDS Country Reports 

4. JAIDS - Financing the Response to HIV in Low-Income and Middle-Income Countries 

5. Examiner.com - UNAIDS discuss human rights on the Hill 

AFRICA AND MIDDLE EAST    

1. Daily Monitor, Uganda - Community-based HIV testing is the way to go

2. Fraternité Matin, Côte d’Ivoire - Sida en milieu scolaire : 3152 ENSEIGNANTS VIVENT AVEC LE VIRUS

3. Ghana News Agency - Gomoa West prepares AIDS workplace policy 

4. IRIN/PlusNews - Africa: Older People Need Help to Raise the Next Generation 

ASIA AND PACIFIC

1. Manila Bulletin - Women unable to avail of health care – WHO

2. Daily Express, Malaysia - Over 500 Sabahans have HIV 

EUROPE

1. The Guardian, UK - HIV awareness ads to run during Premier League matches on African TV 

2. AFP - Recorded AIDS deaths in Iran top 3,400: report

3. Le Monde - L'autorisation d'adopter pour une homosexuelle ravive le débat politique 

4. El Mundo, Spain - El cambio físico, el principal temor de las mujeres con VIH 

LATIN AMERICA AND CARIBBEAN

1. Crónica de Hoy, Mexico - Buscan mayor presupuesto para enfermos de VIH/Sida 

2. Agência Senado, Brazil - Doação para Moçambique fabricar remédio contra aids passa na CAE 

NORTH AMERICA

1. Washington Post - HUD threatens to cut off D.C. AIDS funding next year

2. New York Times - After Setbacks, Small Successes for Gene Therapy

3. Chicago Tribune - Bill Clinton: Health care reform vital to HIV/AIDS patients 

UNAIDS WEB.SITE

1. UNAIDS - New report calls for policy changes on HIV and disability

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

UNAIDS

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

Increasing Civil Society Participation in the National HIV Response: The Role of UNGASS Reporting
JAIDS Journal of Acquired Immune Deficiency Syndromes

12/2009

Volume 52 - Issue - pp S97-S103

doi: 10.1097/QAI.0b013e3181baee06

Supplement Article

Peersman, Greet PhD; Ferguson, Laura MSc; Torres, Mary Ann JD; Smith, Sally MSc; Gruskin, Sofia JD

Abstract

Background: The 2001 Declaration of Commitment on HIV/AIDS provided impetus for strengthening collaboration between government and civil society partners in the HIV response. The biennial UNGASS reporting process is an opportunity for civil society to engage in a review of the implementation of commitments.

Methods: Descriptive analyses of the National Composite Policy Index from 135 countries; a debriefing on UNGASS reporting with civil society in 40 countries; and 3 country case studies on the UNGASS process.

Findings: In the latest UNGASS reporting round, engagement of civil society occurred in the vast majority of countries. The utility of UNGASS reporting seemed to be better understood by both government and civil society, compared with previous reporting rounds. Civil society participation was strongest when civil society groupings took the initiative and organized themselves. An important barrier was their lack of experience with national level processes. Civil society involvement in national HIV planning and strategic processes was perceived to be good, but better access to funding and technical support is needed. Instances remain where there are fundamental differences between government and civil society perceptions of the HIV policy and program environment. How or whether differences were resolved is not always clear, but both government and civil society seemed to appreciate the opportunity for discussion.

Cited Here... Collaborative reporting by government and civil society on UNGASS indicators is a small but potentially valuable step in what should be an ongoing and fully institutionalized process of collaborative planning, implementation, monitoring, assessment and correction of HIV responses. The momentum achieved through the UNGASS process should be maintained with follow-up actions to address data gaps, formalize partnerships and enhance active and meaningful engagement

Author Information

From the *Payson Center for International Development and Technology Transfer, Law School, Tulane University, New Orleans, LA; †Program on International Health and Human Rights, Harvard School of Public Health, Boston, MA; ‡International Council of AIDS Service Organizations, Toronto, Canada; and §Civil Society Partnerships Unit, Evidence, Monitoring and Policy Department, UNAIDS, Geneva, Switzerland.

The authors of this paper declare no conflicts of interest.

Correspondence to: Greet Peersman, PhD, Payson Center for International Development and Technology Transfer, Tulane University, 300 Hebert Hall, 6823 St. Charles Avenue, New Orleans 70118, LA (e-mail: greet_peersman at yahoo.com).

Full article: http://journals.lww.com/jaids/Fulltext/2009/12012/Increasing_Civil_Society_Participation_in_the.4.aspx

4

Human Rights in the Global Response to HIV: Findings From the 2008 United Nations General Assembly Special Session Reports  
JAIDS Journal of Acquired Immune Deficiency Syndromes

12/2009

Volume 52 - Issue - pp S104-S110

doi: 10.1097/QAI.0b013e3181baeeac

Supplement Article

Gruskin, Sofia JD; Ferguson, Laura MSc; Peersman, Greet PhD; Rugg, Deborah PhD

Abstract

Background: Every country in the world has made human rights-related commitments in relation to HIV, yet assessment of the extent to which HIV-related rights are indeed respected, protected and fulfilled remains relatively new. Civil society has, in some places, highlighted the strengths and shortcomings of government action, but attention to governments' own reports of their performance vis-à-vis their HIV-related human rights obligations offers an important and inadequately explored data source.

Methods: We reviewed National Composite Policy Index data from 133 United Nations General Assembly Special Session Country Progress Reports and examined their narrative reports for text relating to human rights.

Findings: 2008 National Composite Policy Index data show an increase in the number of countries reporting on human rights issues since 2006. These reports offer important information, even when they are internally inconsistent. Almost all reporting countries (94%) note that their national HIV policies explicitly mention the promotion and protection of human rights, yet only 22% of these countries report performance indicators to assess human rights compliance. In addition, 71% of countries report protective laws or regulations for vulnerable subpopulations, yet 63% of those same countries report the existence of laws or policies that hinder access to HIV services for vulnerable subpopulations.

Interpretation: Because they include data that have been provided or approved by governments, the United Nations General Assembly Special Session Country Reports provide critical information to support national legal and policy reform and implementation of a human rights-based approach to HIV. By identifying shortcomings in the fulfillment of human rights, a refocusing of efforts is possible, which can aid both governments and civil society in achieving an effective and appropriate response to HIV through advocacy for and implementation of laws, policies and programs that support human rights.

Author Information

From the *Program on International Health and Human Rights, Department of Global Health and Population, Harvard School of Public Health, Boston, MA; †Payson Center for International Development, Tulane University, New Orleans, LA; and ‡Monitoring and Evaluation Division, UNAIDS, Geneva, Switzerland.

The authors of this paper declare no conflicts of interest.

Correspondence to: Sofia Gruskin, Program on International Health and Human Rights, Department of Global Health and Population, Harvard School of Public Health, 665 Huntington Avenue, 1-1202, Boston, MA 02115 (e-mail: sgruskin at hsph.harvard.edu).

Full article: 

http://journals.lww.com/jaids/Fulltext/2009/12012/Human_Rights_in_the_Global_Response_to_HIV_.5.aspx

5

Is There a Gender Gap in the HIV Response? Evaluating National HIV Responses From the United Nations General Assembly Special Session on HIV/AIDS Country Reports 

JAIDS Journal of Acquired Immune Deficiency Syndromes 

12/2009

Volume 52 - Issue - pp S111-S118

doi: 10.1097/QAI.0b013e3181baeec2

Supplement Article

Carael, Michel PhD; Marais, Hein MA; Polsky, Judith MA; Mendoza, Aurorita MA

Abstract

Background: The Declaration of Commitment of the United Nations General Assembly Special Session on HIV/AIDS (UNGASS), in 2001, sets out several policy and programmatic commitments that pertain to women and the gender aspects of the HIV epidemic. Some of them are general, whereas others are more specific and include time-bounded targets. This article summarizes data on policies and strategies affecting women and men equity in access to antiretroviral treatment and other HIV services, as reported by countries but do not address other issues of gender, such as men having sex with men.

Methods: The analysis includes data from the National Composite Policy Index as reported by 130 countries in response to 14 questions relating to progress in creating an enabling policy environment for women. Additional data on gender equity in knowledge of HIV and access to HIV testing and antiretroviral treatment is obtained with other core UNGASS indicators. The review aggregates countries according to regions.

Results: A total of 147 countries provided national reports in which 78% of relevant UNGASS indicators were either completely or partially disaggregated by sex. However, 16% of countries did not report any HIV indicators by sex (with a range of 0%-29% across regions). A total of 82% (108 of 130) of countries report having policies in place to ensure that women have equal access to HIV-related services, but 14% of reporting countries also had laws and policies in place that hinder their ability to deliver effective HIV programs for women. About 80% of countries report having included women as a specific sector in their multisectoral AIDS strategies or action frameworks. However, only slightly more than half (53%) of those countries report having a budget attached to programs addressing women issues. As of the end of 2007, antiretroviral therapy reached 33% of people in need, and women represent a slight majority of those on treatment. The gender gap on HIV knowledge has narrowed, but overall levels of knowledge on how to prevent HIV remains at low levels, with only about 40% of young men (aged 15-24 years) and 36% of young women with correct comprehensive knowledge about HIV prevention.

Conclusions: Since 2001, a large majority of countries have integrated women-related issues into their national HIV policies and strategic plans. However, countries and regions with low-level or concentrated HIV epidemics lag behind countries with generalized epidemics in integrating women-focused policies into national frameworks. The lack of budget support for women-focused programs in half of the countries indicates that those policies have not been sufficiently translated into multisectoral activities. The engagement of development ministries in women's social and economic empowerment is largely still lacking, which raises the concern that strategies to reduce gender inequality may also be lacking in broader development plans. The apparent attainment of gender equity in HIV testing and the delivery of antiretroviral treatment is an important achievement. There has also been a significant increase in countries' abilities to collect and report data disaggregated by sex and age. The monitoring of women's progress in HIV responses via the UNGASS reporting system provides important insights but should be complemented with data that strengthen understandings of the actual implementation of strategies, as well.

Author Information

From the *Faculty of social sciences, Free University Brussels, Brussels, Belgium; †Independent writer, PO Box 1363, Gallo Manor, Johannesburg 2052, South Africa; and ‡UNAIDS, Global Coalition on Women and AIDS, Geneva, Switzerland.

The authors of this paper declare no conflicts of interest.

Correspondence to: Dr. Michel Carael, Royal River Park, House 102/2, 102 Nakhonchaisi Rd, DUSIT, Bangkok 103000, Thailand (e-mail: caraelm at yahoo.fr).

Full article: http://journals.lww.com/jaids/Fulltext/2009/12012/Is_There_a_Gender_Gap_in_the_HIV_Response_.6.aspx

6

Financing the Response to HIV in Low-Income and Middle-Income Countries  
JAIDS Journal of Acquired Immune Deficiency Syndromes 

12/2009

Volume 52 - Issue - pp S119-S126

doi: 10.1097/QAI.0b013e3181baeeda

Supplement Article

Antonio Izazola-Licea, José MD, PhD; Wiegelmann, Jan MA; Arán, Christian BA; Guthrie, Teresa MSc, MPH; Lay, Paul De MD, MPH; Avila-Figueroa, Carlos MPH

Abstract

Objectives: To describe levels of national HIV spending and examine programmatic allocations according to the type of epidemic and country income.

Methods: Cross-sectional analysis of HIV expenditures from 50 low-income and middle-income countries. Sources of information included country reports of domestic spending by programmatic activity and HIV services. These HIV spending categories were cross tabulated by source of financing, stratified by type of HIV epidemic and income level of the country and reported in international dollars (I$).

Results: Fifty low-income and middle-income countries spent US $ 2.6 billion (I$ 5.8 billion) on HIV in 2006; 87% of the funding among the 17 low-income countries came from international donors. Average per capita spending was I$ 2.1 and positively correlated with Gross National Income. Per capita spending was I$ 1.5 in 9 countries with low-level HIV epidemics, I$ 1.6 in 27 countries with concentrated HIV epidemics and I$ 9.5 in 14 countries with generalized HIV epidemics. On average, spending on care and treatment represented 50% of AIDS spending across all countries. The treatment-to-prevention spending ratio was 1.5:1, 3:1, and 2:1 in countries with low-level, concentrated and generalized epidemics, respectively. Spending on prevention represented 21% of total AIDS spending. However, expenditures addressing most-at-risk populations represented less than 1% in countries with generalized epidemics and 7% in those with low-level or concentrated epidemics.

Conclusions: The most striking finding is the mismatch between the types of HIV epidemics and the allocation of resources. The current global economic recession will force countries to rethink national strategies, especially in low-income countries with high aid dependency. Mapping HIV expenditures provides crucial guidance for reallocation of resources and supports evidence-based decisions. Now more than ever, countries need to know and act on their epidemics and give priority to the most effective programmatic services.

Author Information

From the *AIDS Financing and Economics Division, Joint United Nations Program on AIDS (UNAIDS), Geneva, Switzerland; and †Centre for Economic Governance and AIDS in Africa (CEGAA), Cape Town, South Africa.

The work was done independently of influence from funding.

We declare that none of the competing interests found at http://www.icmje.org/index.html# are relevant and therefore have nothing to declare.

The authors of this paper declare no conflicts of interest.

Correspondence to: Carlos Avila, MPH, Financing and Economics Division, Joint United Nations Program on AIDS (UNAIDS); 20 Avenue Appia, Geneva, Switzerland (e-mail: avilac at unaids.org <mailto:avilac at unaids.org> ).

Full article: http://journals.lww.com/jaids/Fulltext/2009/12012/Financing_the_Response_to_HIV_in_Low_Income_and.7.aspx

7

UNAIDS discuss human rights on the Hill
Examiner.com

11/11/2009

DC Charity Examiner Felicia Montgomery

The UNAIDS Washington Office, an organization that works with policymakers and the US Congress and Administration to ensure effective engagement in the global response to AIDS, is continuing their fall series of events with a briefing on Capitol Hill titled, “HIV, Human Rights and People who inject drugs”.

In cooperation with Congresswoman Sheila Jackson-Lee (D-TX), the panel plans to feature Paola Barahona of Physicians for Human Rights, Matthew Kavanagh of Health GAP, Christian Kroll of UNODC, Karina Kran Rapposelli of Department of State, Robert Tolbert of Voices of Community Advocates and Leaders, and Rev. Mpho A. Tutu of the Tutu Institute for Prayer and Pilgrimage . Dr. Pauline Muchina, senior partnership adviser of UNAIDS, comments that the series of events have focused on marginalized populations affected by HIV/AIDS like men who have sex with men (MSM), sex workers, injecting drug users, and those living in extreme poverty.

She hopes members of congress, NGOs who work on HIV/AIDS issues attend especially. “An HIV/AIDS services group might think they have a successful program, but may be ignoring marginalized groups” notes Muchina. This panel and other initiatives of the UNAIDS Washington Office seeks to shed light on the human rights of overlooked populations.

Muchina is aware of the staggering HIV infection rates in the DC area, in particular among African Americans and Latinos. She commends some of the local organizations addressing HIV/AIDS in a “comprehensive” way, like the Women’s Collective, Metro TeenAIDS, Whitman-Walker Clinic, and Miriam House. 

The panel is open to the public. 

Event Details:

UNAIDS in cooperation with Congresswoman Sheila Jackson-Lee (D-TX) hosts panel on “HIV, Human Rights and People who inject drugs”

Thursday, November 12, 2009

12:30 - 2:30 pm 

Capitol Visitor Center 215-House Side

For more information: 202-223-7613

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

AFRICA AND MIDDLE EAST

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

Community-based HIV testing is the way to go
Daily Monitor, Uganda

12/11/2009

Arthur Namara Araali

Twenty seven years in the fight against HIV, only 15 per cent of the estimated 1.1 million people living with HIV/Aids in Uganda know their HIV Sero-status. The current HIV prevalence in Uganda is estimated to be 6.4 per cent among adults according to the Uganda HIV/Aids Sero-Behavioural Survey of 2004 – 05.

It is feared that the above trend is once again on the rise, with a total of 130,000 new infections being recorded yearly according to Uganda Aids Commission. This translates to about 357 Ugandans being infected every day!

The above figure is very disturbing and contradicts the targets under Millennium Development Goal number six – to halt and reverse the spread of HIV by 2015. And yet, Uganda is often regarded a model for Africa in the fight against HIV/Aids, having been able to bring down the prevalence rate from18 per cent in the late 80s and early 90s to five per cent by 2000. An estimated 21 per cent of women and 23 per cent of men perceive themselves to be at high risk of contracting HIV according to STI/Aids Control Programme records.

Many Ugandans wait for the signs and symptoms to strike before they go to the health centres. This attitude has affected behaviour change. Several members of the community we have tested under Health Nest Uganda, Community Based VCT Programme, have confessed that they all along thought they were infected with HIV. A member of a Marwa joint in Lunyo, Entebbe took long to accept his Sero-negative HIV results in one of our outreaches thinking it was a hoax.

Many people lack the courage to go to health centres for a HIV test, others are busy, others feel uncomfortable lining up openly for the test in the health centres. That is partly why the routine counselling and testing introduced by the Ministry of Health has not changed the trends of those seeking counselling and testing, which is a vital entry point to care and support.

As a way forward, we must give priority and roll out massive community-based HIV VCT campaigns/service. This strategy should target men who rarely go to clinics, couples (where 43 per cent of all the new infections occurred in 2008) and the fishing community and discordant couples who are 10 times more vulnerable to contracting HIV than the general population.

At Bugonga Landing site, 121 people volunteered for an HIV test after less that a week of mobilisation while 54 members of Group IV in Entebbe volunteered to test after an evening health talk on the importance of knowing one’s sero-status. Let us all unite and fight the epidemic while taking care of those who are already infected. Together we can make a difference.

Mr Namara is the principal director of Health Nest Uganda

arthurnamara at yahoo.com <mailto:arthurnamara at yahoo.com> 

2

Sida en milieu scolaire : 3152 ENSEIGNANTS VIVENT AVEC LE VIRUS
Fraternité Matin, Côte d’Ivoire

12/11/2009

Par Cissé Mamadou

La fondation Pétroci procède, depuis hier, aux Lycées modernes d’Abobo I et II, en partenariat avec le ministère de l’Education nationale, au lancement d’une caravane de sensibilisation aux fléaux du moment tels que le Sida, la prostitution, la pédophilie, l’alcoolisme, la drogue. M. Gbo Yaéo, Directeur de l’informatique, de la planification, de l’évaluation et des statistiques, représentant le ministre de l’Education nationale, a relevé que 3.152 personnes (enseignants et élèves) vivent avec le Vih/Sida en milieu scolaire. 1.151 cas de grossesse d’élèves ont été dénombrés. Quant à l’usage des excitants, il a relevé que cela est devenu de plus en plus courant,  sans toutefois donner des chiffres. Le tout, couronné par les cas d’indiscipline généralisée qui plongent l’environnement scolaire dans un état de déliquescence avancé.

D’où,  selon lui, les mauvais résultats aux examens de fin d’année en 2009. Il a conclu que ce constat interpellant tous les partenaires de l’éducation et la tutelle au premier chef, ils ont décidé d’instaurer une campagne dans des établissements des dix communes d’Abidjan. M. Koua Wognin Théophile,  parlant au nom des proviseurs des deux lycées, après avoir  souhaité la bienvenue à ses hôtes,  a saisi l'occasion pour poser des revendications. Il s'agit de la couverture  d'un caniveau à ciel ouvert qui fait affluer toutes les eaux usées de la commune vers leur établissement.

Conséquence, la pratique de l'épreuve physique et sportive dans la cour est impossible.

Le proviseur a aussi demandé la construction, dans de brefs délais, de nouvelles toilettes pour les élèves et la réalisation d'une salle polyvalente pouvant en accueillir au moins 1000. Avant de saluer les partenaires  pour avoir débuté la caravane par leur établissement.

Selon M. Sangaré Issiaka, directeur des ressources humaines de la Pétroci, l’objectif poursuivi par leur fondation est de  promouvoir ou financer l’équipement d’établissements scolaires en milieu urbain et rural pour les plus démunis. Tout en oeuvrant au plein épanouissement de l’Ivoirien, à la redistribution la plus large et équitable des fruits de l’exploitation des ressources naturelles hydrocarbures. La caravane prend fin dans 10 jours

3

Gomoa West prepares AIDS workplace policy
Ghana News Agency

11/11/2009

Apam, Nov. 11, GNA - The Gomoa West District AIDS committee, in collaboration with heads of departments, have drawn up an AIDS workplace policy to guide departments to sensitize their workers and people they often com into contact with.

Mr. Eric Akobeng, District HIV and AIDS Focal Person, said 90 HIV cases recorded in the district during the last quarter of this year should be a concern for all in the district to step up the sensitization programme.

He said fighting the pandemic must not be seen as a responsibility of the AIDS Committee alone and urged everybody to show concern.

Mr. Akobeng said the pandemic had a toll on every sector of the economy and called for efforts to tackle it through a multi-sector approach.

He urged researchers to research into the effect of the pandemic on the sectors to make people know what actually the nation loses through HIV and AIDS.

That, he said, would make the authorities to step up their programmes for the formal sector of the economy.

Mr. Akobeng, who is also the District Budget analyst, said stigmatization and discrimination were making people having the virus to hide their status and some of them infect more people.

He urged employers to protect the confidentiality of their employees who had the virus.

A lady with the virus advised her colleagues who are on anti retroviral drugs against taking any other drug without the permission of their doctors.

The lady, who said she was infected by her husband about four years ago, said they had two children who are also HIV positive and are expecting their third child in about a month's time.

She said they live happily as a family and did whatever married couples do.

She advised people with the virus to reveal their status for them to get support from the Ghana AIDS Commission and other donor agencies.

The lady said those who hid their status often died earlier and in deplorable conditions.

GNA

5

Africa: Older People Need Help to Raise the Next Generation
IRIN/PlusNews

11/11/2009

Nairobi — When the working members of a household die from HIV-related illnesses in northern Tanzania, older dependants have to work longer hours to cope financially, according to recently published World Bank study.

"Adult death is associated with increased farm hours ... Older women who suffer the loss of a co-resident member among their baseline household are working five hours more each week," the study found.

More than 1,000 men and women older than 50 were surveyed over a 13-year period between 1991 and 2004 in the Kagera region.

Older adults who had relied on remittances and other in-kind support from their adult children were left with the burden of caring not only for themselves but also their orphaned grandchildren.

"Grandparents who should be in retirement are forced to start working and parenting again, often when they are not in the best physical condition," said Wamuyu Manyara, portfolio manager at the Africa Regional Development Centre of HelpAge International. "An older woman with thinning bones should really not be forced to return to the field and farm."

The study noted that the shocks caused by the death of adult children were primarily felt by older people living with the children when they died. Women had less secure access to land and assets than men, but shouldered most of the labour after their children died, and also felt the shocks more than men. Owning more assets, such as land and animals, could act as a buffer.

"Policies which help ensure complete markets for livestock and other forms of assets, provide asset accumulation, and preserve women's rights to property may help mitigate the long-run negative impact of prime-age [15-50 years] deaths," the report said.

Little support

The elderly were often marginalised by state welfare programmes. "Older people are not organised enough to advocate for their needs, and they wind up being grouped in government departments with either children or people with disabilities - both these groups have powerful lobbies that drown out the needs of older people," said HelpAge's Manyara.

"In Kenya we are currently in the process of identifying community spokespeople to give them a public voice, but because many of them can't speak English or are illiterate, they are not always willing to take on the challenge."

Several African governments were doing more to include older people in social welfare programmes, particularly older carers. "There is now an appreciation of the magnitude of the problem, and there are some programmes catering for older people's economic needs," Manyara noted.

"Old-age pensions and child-care grants provided to older South Africans, and cash transfer programmes for older Kenyans, are practical examples of the types of programmes that need to be rolled out across the region ... [but the need] is still much higher than the numbers being catered for."

Research by the UN Children's Fund, UNICEF, in five African countries found that between 40 percent and 60 percent of all orphans in Kenya, Namibia, Tanzania, Uganda and Zimbabwe were being cared for by grandparents, particularly grandmothers.

Need for targeted programming

"Some of these older people can still work - they have energy and should be supported in their work with income-generating projects," Manyara suggested. "The conditions for accessing microfinance are usually so rigid that older people do not qualify; something should be done to encourage older people still able to work to access these funds."

Kavutha Mutuvi, HelpAge International's regional advocacy coordinator, said older people needed secure incomes. "There should be social pensions ... especially for those who are caring for households in their old age," she said.

Yet the bureaucratic hurdles in accessing support were considerable. "When a grandmother wants to claim a foster care grant, she may be asked for death certificates for her children or birth certificates of the grandchildren," Mutuvi pointed out.

"She may not have or have access to this documentation, but the fact that she is their grandmother can easily be verified by consulting community leaders - there should be a way to do away with much of the red tape they go through to claim support."

Older people also needed psychosocial assistance when their children died and they were left to raise the grandchildren. "We have tried to form support groups, which are more successful among women than men, but when it comes to helping grandparents with parenting skills, there is a definite need ... because they do come to us with questions when kids, for instance, want to know about sexuality," Mutuvi said.

The role of older people should be acknowledged when drawing up national home-based care policies and programmes, she said, by providing meaningful support such as physical help from community workers.

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

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

ASIA AND PACIFIC

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

Women unable to avail of health care – WHO
Manila Bulletin

11/11/2009

By JENNY F. MANONGDO

Women all over the world are still unable to avail themselves of important health care needs despite vast developments in societies, a report by the World Health Organization (WHO) revealed.

The WHO report, launched at WHO headquarters in Geneva, Switzerland the other day, entitled “Today’s Evidence Tomorrow’s Agenda,” pictured the lack of health services for women and adolescent girls in many countries.

WHO Director-General Dr. Margaret Chan said it is about time that governments come up with more programs for women and adolescent girls from birth to older age.

“If women are denied a chance to develop their full human potential, including their potential to lead healthier and at least somewhat happier lives, is society as a whole really healthy? What does this say about the state of social progress in the 21st century? asked Chan.

Despite providing the bulk of health care in the home, community, or in the health system, Chan lamented that women’s specific health needs and challenges are still unmet throughout their lives.

The global health body leader cited that up to 80 percent of all health care and 90 percent of care for HIV/AIDS-related illness are provided in the home-almost always by women. “Yet more often than not, they go unsupported, unrecognized, and unremunerated in this essential role,” she said.

“When it comes to meeting women’s health care needs, some services such as care during pregnancy, are more likely to be in place than those covering issues such as mental health, sexual violence and screening and treatment for cervical cancer,” she added.

Chan said that in many countries sexual and reproductive health services are mostly targeted to married women ignoring the needs of unmarried women and adolescents.

Chan said governments must come up with services that cater to ‘marginalized groups’ of women such as sex workers, intravenous drug users, ethnic minorities, and rural women

2

Over 500 Sabahans have HIV
Daily Express, Malaysia

12/11/2009

Kota Marudu: Cumulative figures as at June this year indicate that 1,067 people living in Sabah have contracted HIV while another 343 persons are suffering from AIDS with 146 deaths so far. 

Tandek Assemblywoman Anita Baranting said Wednesday, of the figure (1.067), some 240 are non-Malaysians, 278 are West Malaysians (that is, 216 Chinese, 54 Malays and eight Indians) and seven are Sarawakians. 

"Indeed, it is saddening to note that 542 Sabahans are HIV-positive. 

What is more worrying is that the age of HIV/AIDS patients is too young, within the 20-29 age range," she said at the opening of a seminar on Preventing and Stopping the Spread of HIV/AIDS. 

The text of her speech was read by the People's Development Leader (PKR) for Tandek, Encik Hendrus Anding. Baranting said the seminar was in line with the National Strategic Plan (2006-2010) with six components: 

Strengthening leadership and advocacy; Training and Capacity Enhancement; Reducing HIV vulnerability among intravenous drug users (IDUs) and their partners; Reducing HIV vulnerability among women, young people and children; Reducing HIV vulnerability among marginalised and vulnerable groups; and Improving access to prevention, treatment, care and support. 

The seminar was organised by the Sabah Women's Advisory Council (MPWS) Health Committee with the co-operation of the Kota Marudu District Office and funded by the Department of Women Development under the Ministry of Women, Family and Community Development. 

It was targeted at village chiefs, village security & development committee (JKKK) chairmen, men and women aged between 20 and 50, youth in the 13-19 age range and saloon, night club, hotel and pub workers. 

Among several hundred participants were students from SMK Kota Marudu, SMK Kota Marudu Dua, SMA Goshen, SMK Langkon, SK Khoi Ming and Giatmara Malaysia, Kota Marudu. 

Earlier, MPWS Chairperson Datuk Asnimar Hj Sukardi said the seminar was proposed by the Council's Health Sub-Committee in view of the increase in the number of HIV cases in the district. 

"The aim is to raise awareness on the danger of HIV/AIDS among the local community so that they will take necessary precautions against infection," she said. 

The seminar was held in conjunction with the State-level Women's Day celebration and also to mark World AIDS Day which falls on December 1. 

The text of her speech was read by MPWS Health Sub-Committee Chairperson, Dr Maria Suleiman who is also the State Health Department's Principal Assistant Director (Non-Communicable & Communicable Diseases). 

Free blood tests and voluntary HIV screening were provided by the Tandek Health Clinic, Kota Marudu. On hand to assist were Community Nurse Lianah James and Laboratory Technologist Siti Noorrazmah Abdul Razak. 

Dr Maria later told reporters that Kota Marudu had one new HIV case in August this year. "Going by the statistics, the rate of incidence in the district is 1.2 per 100,000 population," she said. 

Cumulatively, as at the end of 2008, there were 84,639 HIV-infected persons, 14,576 AIDS patients and 12,589 deaths in the country. Malaysia's first AIDS case was detected in 1986. 

Papers were presented by Kudat Area Health Officer, Dr Muhammad Jikal (HIV/AIDS Situation in Malaysia and Sabah) and Family Health Physician, Dr Mohd Nazri Mohd Daud of Keningau Area Health Office (Introduction and Management of HIV/AIDS). 

In his presentation, Dr Muhammad said the most common methods of transmission of HIV are unprotected sex with an infected partner and sharing needles with an infected person. 

Dispelling misconceptions among the public, he clarified that AIDS will not spread through sharing of public amenities (for example, transport), and neither will it spread through food and drinks. 

"Likewise, interaction at school and in the workplace will not cause the disease to spread." 

Also present were Kota Marudu District Officer Luvita Koisun, Kota Marudu's Officer in-charge of Station (OCS) Sergeant-Major Yahya Hj Osman and Federal and State Government officers.

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

EUROPE

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

HIV awareness ads to run during Premier League matches on African TV
The Guardian, UK

12/11/2009

Mark Sweney

Advertising breaks in TV coverage of the English Premier League matches broadcast across Africa will be used to run Comic Relief-funded messages featuring football stars raising awareness of issues including HIV, condom use and education in the run-up to next year's football World Cup in South Africa.

Comic Relief, which has focused extensively on Africa in its charity fund raising activities, has struck a deal to run a series of "key lifestyle and health" public service messages delivered by Premier League players.

The charity organisation has struck the deal with Optima Sports Management International, which broadcasts Barclays Premier League matches and highlights free-to-air in 49 countries across Africa, to run the messages from January up to the start of the world cup in South Africa next summer.

London ad agency Mother is creating a string of public service announcements, with the first promoting the use of a mosquito net to protect families from illnesses such as malaria. Subsequent messages will focus on using a condom, getting HIV tests and education.

Mark Waites, creative partner at Mother, said that the strategy was to send "messaging disguised as entertainment".

"As the enormous popularity of football generally in Africa and the Barclays Premier League in particular grows apace, there is an unrivalled opportunity to deliver an inspiring educational campaign across the continent to give guidance to the entire population on sensible lifestyle and healthcare choices," added Kevin Cahill, the chief executive of Comic Relief.

It is intended that after the World Cup, the Comic Relief-funded messages will continue in coverage during the 2010 Premier League season as the campaign becomes embedded in popular African culture

3

Recorded AIDS deaths in Iran top 3,400: report
AFP

12/11/2009

TEHRAN, Nov 12, 2009 (AFP) - Iran has recorded at least 3,409 deaths from AIDS, while another 2,097 people have been diagnosed as having the disease, according to health ministry figures reported by the ILNA news agency on Thursday.

The news agency said a total of 20,130 people had tested positive for HIV. It did not specify whether that figure included those who had gone on to develop AIDS.

The report said men accounted for a full 93 percent of recorded HIV infections.

With testing facilities limited and HIV-infected people or those living with AIDS often unwilling to come forward, the health ministry has previously estimated that total HIV infections are four times higher than the recorded figure.

The ministry says that intravenous drug use is the most common way HIV is transmitted in Iran.

It has not made clear when it started compiling its figures.

sgh-jds/kir

© Copyright AFP 2009.

4

L'autorisation d'adopter pour une homosexuelle ravive le débat politique
Le Monde

11/11/2009

LEMONDE.FR avec AFP et Reuters

Au lendemain de la décision rendue par le tribunal administratif de Besançon, qui ordonne au conseil général du Jura de délivrer à une enseignante homosexuelle un agrément d'adoption dans les quinze jours, tour d'horizon des réactions des responsables politiques.

Bien que la décision du tribunal n'accorde pas d'agrément au couple mais bien à la seule demandeuse, ce qui n'est pas une première, le débat se place sur le terrain de l'adoption par les couples homosexuels. "Le jugement rendu n'est pas une reconnaissance du droit à l'adoption pour les couples homosexuels, mais le simple rappel qu'en droit français, un célibataire peut obtenir un agrément en vue de l'adoption, a souligné Michèle Tabarot, présidente du Conseil supérieur de l'adoption et députée UMP des Alpes-Maritimes. Dans l'affaire en question, il n'y aura qu'une mère adoptive et sa compagne restera un tiers vis-à-vis de l'enfant", a-t-elle insisté.

À DROITE

Le président du Nouveau Centre et ministre de la défense, Hervé Morin, est "favorable" à l'adoption d'enfants par des couples homosexuels. "L'amour d'un couple, c'est beaucoup mieux que les services de la DDASS." "Ce qui compte, d'abord et avant tout, c'est l'amour que peut avoir un enfant, quelle que soit la configuration du couple", insiste-t-il.

La secrétaire d'Etat chargée de la famille, Nadine Morano, a déclaré qu'"il n'y a pas de projet pour réformer l'adoption en faveur des couples homosexuels. C'est un engagement du président de la République", tout en ajoutant qu'"il faudra ouvrir le débat, pourquoi pas lors de la prochaine élection présidentielle en 2012" et "sortir de l'hypocrisie qui existe en France".

Le porte-parole du gouvernement et ministre de l'éducation, Luc Chatel, a rappelé "que le gouvernement a eu l'occasion de dire à plusieurs reprises – le président de la République lui-même s'est exprimé sur le sujet – que nous n'étions pas favorables à l'adoption d'enfants par les couples homosexuels".

Dans un communiqué, Christian Vanneste, de l'UMP, a condamné "la malheureuse décision" du tribunal qui "fait l'objet de l'habituel rouleau compresseur médiatique du groupe de pression homosexuel".

"Dès qu'il y a un enfant, il faut un papa et une maman", a déclaré le député UMP Eric Raoult à l'Assemblée.

Dans un communiqué, Marine Le Pen, vice-présidente du FN, écrit : "Ainsi donc, sans que les Français ni leurs représentants élus n'en aient décidé, sur simple décision d'une instance européenne et de la Halde, structure technocratique sans légitimité démocratique, on assiste à un bouleversement du droit de la famille." "Comme dans l'affaire [Frédéric] Mitterrand, cette décision consacre la disparition d'une certaine morale d'Etat et le triomphe d'une société hédoniste où les volontés de certains adultes priment sur les droits légitimes des enfants."

À GAUCHE

Le député socialiste Patrick Bloche, affirme que "la société est prête à accepter que des couples homosexuels adoptent des enfants. La loi doit être modifiée". M. Bloche parle d'une "jurisprudence qui oblige le législateur à prendre ses responsabilités". "Quand le législateur le veut, il peut être en phase avec la société. Le pacs en est l'exemple fort", a ajouté celui qui fut rapporteur de la loi sur le pacs il y a exactement dix ans.

Le député-maire Noël Mamère (Verts) qui, en 2004, avait symboliquement célébré un mariage entre deux hommes dans sa mairie de Bègles en Gironde, salue "une grande victoire. C'est le rêve que le droit est en train de rejoindre la société. Le combat mené par des avocats et un certain nombre d'entre nous est maintenant une réalité reconnue par le droit". "C'est un pas très important qui vient d'être franchi. Nous espérons surtout que ce symbole deviendra réalité pour les couples homosexuels qui demandent la reconnaissance de leur droit de parent", ajoute-t-il.

Le Parti communiste français "espère que cette décision fera jurisprudence en France et dans tous les pays de l'Union européenne". "L'adoption par des célibataires est autorisée en France, et il n'est fait nulle part mention de l'orientation sexuelle de l'adoptant dans les textes réglementaires. Le rejet par l'administration française des demandes répétées de cette femme, institutrice, n'était donc motivé que par des préjugés homophobes", selon le PCF.

DU CÔTÉ DES ASSOCIATIONS

Sous le titre "Adoption par un couple d'homosexuelles : 11 ans de procédures judiciaires contre la discrimination homophobe !", SOS homophobie se réjouit dans un communiqué "de cette victoire contre l'homophobie".

L'association militante Homosexualités et socialisme "se réjouit, et rappelle que les citoyens interrogés cette année dans le cadre des états généraux de la bioéthique se sont exprimés, à l'unanimité, en faveur de l'ouverture de l'adoption aux couples de même sexe."

Pour la Confédération nationale des associations familiales catholiques (CNAFC), "l'éducation d'un enfant et en particulier le processus progressif de la découverte et de l'affirmation de son identité sexuelle, exigent plus que de simples 'référents' de deux sexes, mais bien la présence d'un homme et d'une femme qui entretiennent une relation stable d'amour. Pour la CNAFC, cette décision de justice démontre la nécessité que le législateur clarifie ce qu'est l'intérêt de l'enfant. La CNAFC demande au législateur de prononcer sans équivoque le droit de l'enfant à avoir un père et une mère et de rappeler formellement que ce droit est premier, il prévaut sur tout 'droit à l'enfant'".

GayLib, mouvement proche de l'UMP, "regrette qu'il ait été nécessaire d'en arriver à une décision de justice pour faire reconnaître la capacité des homosexuels à adopter. Puisque cette capacité est reconnue, nous demandons à ce que l'agrément en vue d'une adoption puisse être accordé également aux partenaires d'un pacs. Dans le cadre de l'intérêt de l'enfant, ce qui est valable pour un seul futur parent doit devenir possible pour un couple. Dès lors, de même, rien ne s'oppose à l'adoption par le second parent (parent social homosexuel) pour les enfants, ne disposant aujourd'hui que d'une seule filiation". 

Le Collectif contre l'homophobie "se réjouit de la décision de justice rendue ce jour par le tribunal administratif de Besançon. Elle sonne comme un nouveau camouflet pour Jean Raquin, le président du conseil général du Jura. Forts de ces décisions judiciaires et de la jurisprudence désormais établie, nous veillerons à la stricte application du droit par tous les départements français, en effet ceux-ci ne peuvent pas prétexter de l'homosexualité d'un-e célibataire pour refuser un agrément d'adoption lorsque les conditions requises sont remplies". 

Le porte-parole de l'interassociative Inter-LGBT, Philippe Castel, salue la décision du tribunal de Besançon et du conseil général du Jura qui s'est engagé à appliquer le jugement, en déclarant : "Il était temps, une autre décision aurait couvert le conseil général de ridicule". "A un moment, il faut arrêter l'hypocrisie, même si ce sont des célibataires qui produisent la demande d'agrément, la réalité est que ces célibataires vivent souvent en couple, et parfois en couple homosexuel", dit-il. "Si un couple homosexuel offre des garanties pour l'accueil d'un enfant, je crois qu'il est temps pour le gouvernement ou les parlementaires d'autoriser par la loi le couple homosexuel adoptant", conclut M. Castel.

5

El cambio físico, el principal temor de las mujeres con VIH 

El Mundo, Spain

11/11/2009

ISABEL F. LANTIGUA

MADRID.- Un día a día entre engaños, enmascarando una realidad que las atormenta, de la que se sienten culpables. Las mujeres con VIH en España fingen -y sueñan- a diario que no pasa nada, que todo marcha bien, que el virus de la inmunodeficiencia humana (VIH) nunca se apoderó de sus organismos. Se mienten a sí mismas y a los demás para evitar el rechazo social, una de las cosas que más temen. Así lo han confesado un centenar de mujeres seropositivas de todo el país que se han dado cita en Benidorm, en el II Foro Nacional para Mujeres con VIH, respaldado por CESIDA, la coordinadora estatal de VIH-Sida.

Reconocen que viven con miedo a la discriminación social, laboral, familiar, sexual e, incluso, médica. En el trabajo, muchas de ellas se han visto obligadas a mentir para evitar ser discriminadas por sus compañeros o para no ser despedidas. Pero el estigma que rodea a la enfermedad no se limita al ámbito laboral. La mayoría de las seropositivas también percibe el trato médico como deficiente, ya que sienten el temor de los doctores ante la posibilidad de que les transmitan la infección.

Uno de los factores que incrementa el riesgo de ser estigmatizadas es el cambio físico que experimentan por culpa de la medicación y que lleva a algunas de ellas a abandonar los fármacos con tal de no aparentar que están enfermas. La temida lipodistrofia (una distribución anormal de la grasa corporal) es un efecto secundario de los antirretrovirales que afecta al 65,6% de las pacientes seropositivas.

Este trastorno "es el dedo acusador de las mujeres con VIH que temen revelarlo, de ahí su angustia por padecerlo y la drástica decisión de abandonar el tratamiento", señala Begoña Bautista, de JURISIDA, una organización que da consejo legal a las personas con VIH.

La terapia antirretroviral de alta eficacia, que apareció en 1996, cambió la historia de esta epidemia. "De aprender a morir (ya que antes del tratamiento el sida era una condena a muerte) se tuvo que aprender a vivir", indica Bautista. Pero si las mujeres abandonan la medicación tendrán consecuencias graves, señala la doctora Piedad Arazo, de la unidad de enfermedades infecciosas del Hospital Miguel Servet. Por eso, los expertos reunidos en el Foro se plantean el reto de buscar el tratamiento más adecuado para ellas y apoyarlas para que se sientan bien consigo mismas.

Sentimiento de culpa

Las pacientes que han participado en el Foro, el único de estas características que se celebra en España, consideran que además de la discriminación que sufren por su condición de seropositivas tienen un elemento más para ser rechazadas: su género.

A todas estas dificultades y sensaciones se añade un sentimiento de culpa, que aflora constantemente y es producto de la reacción negativa de la sociedad. Para María José Fuster, miembro de la Asociación Amigos y responsable de investigación de SEISIDA, "estas emociones son fruto de la interiorización de la visión negativa que tiene la población y que ellas expresan en términos de culpa o vergüenza. Estos sentimientos producen temor a mantener relaciones sexuales y afectivas o a mirarse en el espejo".

Temas como la maternidad o la menopausia, que otras mujeres afrontan con ilusión, las seropositivas los convierten en dudas y miedos. Según las cifras como las de ONUSIDA, de los 33 millones de personas con VIH que hay en el mundo, casi la mitad son mujeres.

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

LATIN AMERICA AND CARIBBEAN

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

Buscan mayor presupuesto para enfermos de VIH/Sida
Crónica de Hoy, Mexico

10/11/2009

El secretario de Salud del gobierno capitalino, Armando Ahued, anunció que solicitará a la Cámara de Diputados mayores recursos financieros para dar mejor atención a los enfermos de VIH/Sida.

Refirió que en el Distrito Federal existen más de 14 mil afectados por el Virus de Inmunodeficiencia Humana y "no se tiene un centavo" para construir una nueva clínica en la delegación Iztapalapa, con el fin de atender a casi siete mil personas que padecen ese mal y la mayor parte de ellos vive en esa zona.

"Ya se tienen el terreno y el proyecto médico-arquitectónico, lo único que hace falta son 152 millones de pesos para llevar a cabo esa obra", agregó.

Al participar en inauguración del Módulo de Orientación en Derechos Humanos para Pacientes con VIH de la Clínica Condesa, Ahued Ortega comentó que la ciudad de México es la entidad con mayor número de casos acumulados de VIH y Sida del país.

A la fecha, dijo, se tienen registrados 14 mil 644 personas con VIH y el Síndrome de Inmunodeficiencia Adquirida (Sida), la mayoría de ellas entre 23 y 47 años de edad y no cuentan con seguridad social.

Recordó que en su informe del año pasado la Comisión de Derechos Humanos del Distrito Federal (CDHDF) planteó modificar algunos procedimientos e incluir programas y servicios en materia de prevención, atención y apoyo, así como mejorar las capacidades de la dependencia.

Dio a conocer que la Clínica Condesa es un centro especializado en VIH con mayor cobertura de población en el continente americano y el mejoramiento de la calidad en los servicios que ofrece es un compromiso del gobierno capitalino.

Los avances de este año, destacó, son el mejoramiento de la oportunidad en exámenes de laboratorio especializado, imprescindible para el monitoreo de los tratamientos y la detección del VIH y otras infecciones de transmisión sexual.

Además se incrementó la plantilla médica especializada y colaboración con los institutos nacionales de salud y hospitales federales de referencia.

Por otra parte, Armando Ahued refirió que en la reunión del jefe de gobierno capitalino, Marcelo Ebrard, con diputados federales se planteó la necesidad de construir un fondo sanitario de 600 millones de pesos para atender cualquier contingencia sanitaria.

Observó que en este año el Programa Conjunto de las Naciones Unidas sobre el VIH/Sida eligió como lema para la conmemoración del Día Mundial de Lucha contra el Sida "El acceso universal y derechos humanos".

Apuntó que las personas que viven con esta enfermedad tienen derecho al tratamiento antirretroviral, que cuando es administrado adecuadamente y con oportunidad mejora significativamente su esperanza y calidad de vida.

A su vez, la coordinadora del Programa de VIH/Sida del Gobierno del Distrito Federal, Andrea González, expuso que 70 por ciento de los afectados no tienen seguridad social pues carecen de empleo o son trabajadores migrantes

4

Doação para Moçambique fabricar remédio contra aids passa na CAE  
Agência Senado, Brazil

11/11/2009

A Comissão de Assuntos Econômicos (CAE) aprovou, nesta terça-feira (10), autorização para o governo brasileiro doar a Moçambique recursos da ordem de R$ 13,6 milhões para a primeira fase de instalação de fábrica de antirretrovirais - medicamentos utilizados para tratamento de pessoas portadoras do vírus da AIDS. A proposta (PLC 193/09) já havia sido aprovada pela Comissão de Constituição, Justiça e Cidadania (CCJ) na semana passada e ainda terá que ser examinada pela Comissão de Relações Exteriores (CRE), onde receberá decisão terminativa.

De acordo com o relator, senador Marcelo Crivella (PRB-RJ), trata-se de uma doação de caráter humanitário que poderá beneficiar pelo menos 400 mil pessoas infectadas com o vírus da AIDS. Segundo explicou, serão fabricados 20 dos 25 componentes do coquetel ANTIRETROVIRAL na fábrica a ser instalada pela Fiocruz. Ainda segundo Crivella, cerca de cinco mil famílias de brasileiros vivem naquele país, trabalhando nas minas de carvão do Rio Mambese, da Companhia Vale do Rio Doce.

Crivella lembrou que 40% do Produto Interno Bruto (PIB) de Moçambique decorrem de doação. Informou ainda que 80% da força de trabalho naquele país estão na informalidade e que a maioria da população é empregada do governo. Os recursos para doação, segundo explicou, já estão no exterior especificamente para esse objetivo. 

Segundo informações do Ministério da Saúde, a instalação da fábrica permitirá o controle de epidemias e reduzirá o número de óbitos não apenas em Moçambique, mas também em outras nações para onde a produção poderá ser exportada.

O senador Eduardo Suplicy (PT-SP) destacou o trabalho do governo brasileiro em prol da instalação da fábrica da Fiocruz em Moçambique. O senador Inácio Arruda (PCdoB-CE) elogiou o papel de Crivella pela aprovação da matéria, que poderá beneficiar milhões de famílias, como já acontece no Brasil, onde há o tratamento com o coquetel antirretroviral. O senador Roberto Cavalcanti (PRB-PB) observou não se tratar de despesa de caráter continuado e ressaltou o gesto positivo do Brasil ao socorrer um país irmão.

Críticas

Mesmo reconhecendo o sentido humanitário da doação, o senador Papaléo Paes (PSDB-AP) afirmou tratar-se de um contrassenso doar recursos para instalar fábrica de antirretrovirais em Moçambique, enquanto em Pernambuco um hospital que tem o propósito de distribuir esses medicamentos está sem condições de atuar por falta de recursos. Ele também criticou a escassez de verbas para tratamento de usuários de drogas. 

Do mesmo modo, o senador Cícero Lucena (PSDB-PB) destacou a situação precária da saúde no país, em especial no Nordeste. Segundo o senador, o governo não libera os recursos destinados ao setor. 

Crivella respondeu que, embora haja pessoas com AIDS no Brasil, não existe o quadro dramático observado em Moçambique, onde morrem sete mil pessoas por dia, vitimadas pela doença. 

O senador Efraim Morais (DEM-PB) também questionou a doação. Para ele, é incoerente "praticar solidariedade e ser bonzinho enquanto se esquece de fazer o dever de casa". Ao lembrar o avanço do consumo do crack no Rio de Janeiro, Efraim disse que o governo federal não tem liberado recursos para enfrentamento desse e de outros problemas do país. Crivella reconheceu a legitimidade do alerta da oposição com relação à saúde e se comprometeu a verificar os repasses de recursos para o setor

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

NORTH AMERICA

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

HUD threatens to cut off D.C. AIDS funding next year 
Washington Post

12/11/2009

By Debbie Cenziper

Washington Post Staff Writer 

The U.S. Department of Housing and Urban Development, worried about widespread lapses in oversight of the District's AIDS program, is threatening to cut off $12.2 million in federal funding next year if the problems are not fixed. 

Assistant Secretary Mercedes M. Márquez said HUD will send a letter to the city this week stipulating that no new AIDS housing money will be awarded unless the D.C. Department of Health's HIV/AIDS Administration improves its tracking of services and spending. 

Márquez also wrote last week to D.C. Mayor Adrian M. Fenty (D), saying she was "deeply concerned" about a recent Washington Post series that found the HIV/AIDS Administration had paid more than $25 million to nonprofit groups that delivered substandard care or failed to account for their work. 

Many were housing groups funded with HUD money, including one that received more than $400,000 for a promised job-training center that never opened. Márquez, head of community planning and development, said the city possibly violated more than 60 HUD requirements. 

"It is absolutely unacceptable that any single person suffers as a result of the District not being able to manage taxpayer dollars," Márquez said this week. "This is where they pushed it to: No new money until you fix this." 

Mafara Hobson, spokeswoman for the mayor's office, said the city will work closely with HUD to ensure continued funding. 

HUD officials said this is the first time in the AIDS housing program's 18-year history that money would be withheld from a city based on poor performance.

Márquez said the agency decided to take the step, first reported Wednesday on washingtonpost.com, because the District's AIDS program has consistently been among the most troubled in the nation. 

Since at least 2003, HUD's monitoring reports have repeatedly found that the city, which has the highest rate of AIDS cases in the country, has failed to keep tabs on nonprofit groups that promised to provide housing for the sick. In some cases, the District did not provide financial records and other documents from HUD monitors. 

Last year, the city had to return more than $600,000 in AIDS housing money for failing to fix problems chronicled by HUD monitors in 2003 and 2006. HUD has provided training to the city and has noted improvements in client care and housing standards, but accountability lags. 

This year, as HUD prepared to do its 2009 monitoring, the agency sent two letters to HIV/AIDS Administration Director Shannon L. Hader. The letters urged the city to release records and arrange for a meeting between HUD and the city's financial management team. 

"They were making it almost impossible to do the monitoring. . . . It's really like pulling teeth with the District," Márquez said. 

When the 2009 report was complete, HUD again found the city had failed to ensure that nonprofit groups submitted basic documentation to account for their spending, such as payroll reports, time cards, consulting contracts, and invoices for supplies and other expenses. 

In a September letter, HUD asked the HIV/AIDS Administration to provide the records and overhaul its practices. The city provided a partial response, which is under review, but HUD is waiting for more documentation. HUD officials said they expect the District to comply, which will enable the money to be released. 

Until the issues are resolved, however, HUD intends to freeze next year's housing grant, worth $12.2 million, Márquez said. Much of the Washington region would be affected because the HIV/AIDS Administration shares the money with programs in parts of Maryland, Virginia and West Virginia, including Prince George's, Loudoun, Fairfax and Arlington counties. Combined, the region receives the third-largest grant from HUD's Housing Opportunities for Persons with AIDS program. 

The HIV/AIDS Administration receives money from other federal agencies for medical care, drugs and HIV prevention. Along with money from city government, the agency oversees about $100 million a year. Much of the money goes to large medical clinics, but the District also funds a network of smaller nonprofit groups -- about 90 since 2004 -- that promise services from counseling to case management. 

The Post identified a number of deficiencies among those groups. Some failed to file tax returns or secure a business license with the city. Others submitted employee résumés and consulting contracts with false information or had spent hundreds of thousands of dollars on travel and executive pay. 

Fenty and D.C. Attorney General Peter Nickles announced an investigation in recent weeks, giving priority to groups receiving AIDS money. Two Republican congressmen are also pushing for an investigation. 

An advisory group that helps oversee federal AIDS money in the District also stepped in, urging the city late last month to start providing more details about site inspections and grievances filed against local nonprofit groups. Hader has agreed to do so. 

The advisory group continues to push the city to produce records to account for the spending of AIDS consultant Robin Beale, whose company drew more than $2 million in recent years. Beale, hired to provide logistical support for the advisory group, billed the city for unnamed employees and subcontractors, rent for a high-end office that was rarely used, and start-up costs for furniture and equipment that city officials later deemed improper, The Post found. 

Wallace Corbett, who heads the advisory group, said the HIV/AIDS Administration has not provided the records. 

"I think it's all about the money," Corbett said. "They don't know where it went." 

2

After Setbacks, Small Successes for Gene Therapy
New York Times

06/11/2009

By GINA KOLATA

Not long ago, gene therapy seemed troubled by insurmountable difficulties. After decades of hype and dashed hopes, many who once embraced the idea of correcting genetic disorders by giving people new genes all but gave up the idea.

But scientists say gene therapy may be on the edge of a resurgence. There were three recent, though small, successes — one involving children with a fatal brain disease, one with an eye disease that causes blindness and one with children who have a disease that destroys the immune system. 

“We are ready to move,” said Dr. Luigi Naldini of the Institute for Gene Therapy at Vita-Salute San Raffaele University in Milan.

Dr. Kenneth Cornetta, a gene therapy researcher at Indiana University and president of the American Society of Gene and Cell Therapy, added: “It’s exciting. The science gets better every year.”

But given the history of gene therapy, some, like Dr. Mark Kay, a gene therapy researcher at Stanford, were careful to avoid promising too much. 

The field was dealt a blow when the first gene therapy success, reported six years ago, turned out to have a problem. Eighteen of 20 children with a rare genetic disease were cured, but then three of the children developed leukemia and one died of it. Researchers and gene therapy companies became skittish. 

“I like to be really cautious,” Dr. Kay said. But now, he added, “there is a lot of reasonably cautious optimism.”

The latest encouraging news arises from a paper published Friday in the journal Science. An international team of researchers is reporting the successful treatment of two children with adrenoleukodystrophy, or ALD, in which the fatty insulation of nerve cells degenerates. A result is progressive brain damage and death two to five years after diagnosis. The disease was the focus of the movie “Lorenzo’s Oil.”

Scientists say they believe they avoided the cancer problem by using a different method to get genes into the children’s DNA. Two years have gone by, and the children are doing well.

The children were not cured, but their disease was arrested. And gene therapy was as good as the standard treatment, a bone marrow transplant. In this case, the children could not have a transplant because they did not have marrow donors who were genetic matches.

In addition, a paper last month in the journal Lancet reported that a different method of gene therapy, which did not involve inserting a new gene into DNA, partly restored the sight of five children and seven adults with a rare congenital eye disease, Leber’s congenital amaurosis. People with the disease have a mutated gene that prevents them from making a retina protein. 

While not in the DNA, the added gene remains in the body of the cells, directing the production of the missing protein and helping correct the disorder. The patients had no standard treatment, and gene therapy offered them a chance to see again, although their sight was far from perfect. But the gene is not copied when cells divide, as it would be if it were part of the cells’ DNA, so the method applies only to cells, like those of the retina, that divide rarely. 

And a paper in The New England Journal of Medicine a year ago reported that 8 out of 10 patients with a rare immunological disorder were cured with gene therapy. The method was the same as the one that led to leukemia, and Dr. Cornetta said scientists were still studying why it did not cause cancer in those children.

The paper in Science was accompanied by an editorial by Dr. Naldini titled, “A Comeback for Gene Therapy.” In a telephone interview, he added that the result was “pushing a lot of people to move forward,” including him. 

The story of gene therapy for ALD began when Amber Salzman of Merion Station, Pa., learned that her nephew had the disease. Since it is a genetic disorder, the entire family was tested. A second nephew had the gene, and, Ms. Salzman learned, so did her 1-year-old son.

Ms. Salzman and her sisters got to work, forming the Stop ALD Foundation and pushing scientists and doctors to meet and plan a study of gene therapy. 

It turned out that several groups of researchers had been developing a new way to get genes into a cell’s DNA. The original method used a modified mouse leukemia virus to insert genes. That method was used in the study in France that led to leukemia in some children. 

And the virus was unsuitable anyway for most diseases because it corrected gene defects in only 0.1 percent of cells. That, many said, was a worse problem than the leukemia.

Researchers were stymied, said the lead investigator of the ALD study, Dr. Patrick Aubourg of Inserm, an institute for health and medical research in France. 

The new approach involved using H.I.V., the virus that causes AIDS, to insert genes, modifying the virus first so it could not cause disease.

“We were scared, of course,” said Dr. Naldini, who was working on the virus in the laboratory of Dr. Inder M. Verma at the Salk Institute. But he reasoned that if he could remove enough H.I.V. genes to make it safe, the modified virus could work. 

It solved the efficiency problem — the modified AIDS virus added genes to 15 percent of cells. And researchers believe it solved the cancer problem. The virus had less chance of turning on genes that could lead to cancer.

Ms. Salzman and Ms. Lapin found out about the work and contacted Dr. Verma. In the end, the company Cell Genesys made the virus, and Dr. Aubourg treated two boys from Spain. 

Ms. Salzman’s son had a bone marrow transplant. Her sister’s older boy died of ALD, and her younger son underwent a bone marrow transplant but had complications from the procedure and now, successfully treated for ALD, is in a wheelchair from side effects of the transplant.

Dr. Aubourg has also treated a third boy with ALD, and he is doing well, but it is too soon to know if his disease has been arrested.

“We have to be cautious — very, very cautious,” Dr. Aubourg said. “But this is the first time that a very serious disease of the brain, a lethal disease of the brain, has been treated with success by gene therapy.”

3

Bill Clinton: Health care reform vital to HIV/AIDS patients
Chicago Tribune

12/11/2009

By Angie Leventis Lourgos Tribune reporter

Former President Bill Clinton said homeless HIV/AIDS patients are in dire need of health care reform in a speech at a benefit Wednesday for the Chicago House & Social Service Agency, a nonprofit providing housing and support for people with HIV and AIDS.

"There's still an increasing number of homeless people with HIV/AIDS, and a lot of that is because of the health care crisis," he told an audience of about 1,000 donors at the downtown Palmer House Hilton Hotel.

The event raised an estimated $400,000 for the charity, which helps 1,160 Chicagoans with HIV/AIDS and their family members find housing, medical care and emotional and spiritual support.

The homeless are three to nine times more likely to have HIV or AIDS than people with stable housing, according to a 2004 study by the Centers for Disease Control and Prevention and the Department of Housing and Urban Development. In his speech, Clinton attributed this fact to the high cost of medications and treatments and said public health care could curb homelessness for those with the virus.

Health care reform is not only morally right, but because reform would encourage preventive care, it would save money in the long run, Clinton said.

"The government will have to provide a health care program not just to be as healthy (as other countries) but also to be economically competitive," he said.

The Rev. Stan Sloan, CEO of Chicago House, said the former president was his first choice to speak at the benefit because he started the Clinton HIV/AIDS Initiative, which helps developing countries provide treatment and prevention. Clinton's work overseas mirrors Chicago House's work here, Sloan said.

"We hope you leave here inspired," Sloan said.

Clinton closed his talk with a story about a 15-year-old HIV-positive boy in Rwanda whose parents already had died of AIDS. The Clinton HIV/AIDS Initiative built him and his sister a new home. Clinton knelt down to talk to the boy, who had only made it to the third grade because of his illness.

"I said: 'I hope you're not discouraged to go to school,' " he said.

The boy earnestly replied "no," that he planned to study hard, go to medical school and become a doctor to help other sick children.

"We've got to create a world of positive interdependence," Clinton said. "We're in this together."

eleventis at tribune.com 

Copyright © 2009, Chicago Tribune

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

UNAIDS WEB.SITE

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

New report calls for policy changes on HIV and disability

UNAIDS

11/11/2009

A new report by Health Canada’s International Affairs Directorate has called for a greater focus on rights of people with disabilities in HIV policy. The report makes recommendations for policy change and follows an International Policy Dialogue held between UNAIDS, Health Canada and the Public Health Agency of Canada in Ottawa in March 2009. 

Titled “HIV/AIDS and Disability: Final Report of the 4th International Policy Dialogue”, it calls for the United Nations' Convention on the Rights of Persons with Disabilities (CRPD) to become a catalyst for change by shifting the disability discourse from charity-based or medical-based approaches to a rights-based approach. This approach views people with disabilities as active participants in society, ensuring their wellbeing rather than treating them as passive recipients of charitable goodwill. 

The report recommends the involvement of stakeholders in helping CRPD become a tool for change. These stakeholders include WHO, UNICEF, UNAIDS, national governments and ministries and civil society organizations working in the areas of disability and HIV. 

There is a double stigma experienced by people living with both HIV and disability. Much effort is required to overcome this, beginning with raising awareness and open communication. For example, in South Africa youth with disabilities are trained to provide HIV prevention and treatment information to their peers; in Kenya HIV screening information is provided to the deaf by the deaf; and Uganda has established mental health clinics for people living with HIV. The report suggests taking a lead from these programmes.

It calls for service providers in the AIDS response to be sensitised on how to interact with people with disabilities and to establish mobile voluntary counselling and treatment services to increase access to people living with disabilities who are unable to reach them on their own. 

The HIV and Disability report recognises the need for more education and awareness for children, youth and adults living with developmental disabilities, and also suggests working on providing information on sexual and mental to people with disabilities. 

The report discusses challenges related to sustaining pilot projects, securing funds, sharing the results and benefits of HIV, AIDS and disability projects, and educating donor countries, governments and NGOs in the value of investing in this area. 

UNAIDS, along with WHO and the United Nations Office of the High Commissioner for Human Rights, has collaborated on a policy brief exploring the links between HIV and disability and that also makes recommendations for policy change.

Apart from discussing the actions needed to increase the participation of persons with disabilities in the HIV response and to ensure they have access to HIV services, it also recommends for governments to incorporate persons with disabilities into their national HIV policies. 

It also urges civil society to ensure campaigns to combat stigma and discrimination of people living with HIV are also accessible to persons with disabilities and advocates for the latter to be included in planning, implementation and evaluation of HIV programmes. 

People with disability 

Around 650 million people, or 10% of the world’s population, have a disability. Although people with disabilities are found within the populations at higher risk of exposure to HIV, not much attention has been paid in the past to the relationship between HIV and disability

People with disabilities and people living with HIV shared their personal experiences during the International Policy Dialogue in March to give voice to both the challenges they face and the abilities they hold. 

Persons with disabilities experience all of the risk factors associated with HIV, and are often at increased risk because of poverty, severely limited access to education and health care, lack of information and resources, lack of legal protection, increased risk of violence and rape, vulnerability to substance abuse, and stigma.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20091112/b72f4766/attachment-0009.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: 2009.11.12ex.doc
Type: application/msword
Size: 270336 bytes
Desc: 2009.11.12ex.doc
Url : http://ngocentre.org.vn/pipermail/hivaids-twg/attachments/20091112/b72f4766/attachment-0009.doc 