World News Archives 

Fall 2009

"Group: HIV/AIDS Among Top 10 Crises of the Year"
Associated Press , (12.21.2009) Michael Astor
While this decade saw millions of HIV/AIDS patients in developing nations gain access to treatment, an estimated 10 million patients still go without, Doctors Without Borders reported Monday. DWB’s top-ten list of humanitarian crises includes AIDS treatment access, because many of the G8 nations that pledged support for universal treatment access in 2005 have announced plans to scale back or limit funding. The G8 sought universal treatment access by 2010.

“When there are concerning signs of retreat for access to treatment, it’s important to state that HIV/AIDS is an emergency,” said Sophie Delaunay, executive director of DWB-United States. “In some countries doctors are turning patients away, advised to wait until other patients die,” said Delaunay. “What’s going to happen is that patients are going to show up at the door of our clinics and there is a high possibility of us getting overwhelmed.”

DWB has issued an annual list of crises since 1998, spurred on by a famine in southern Sudan largely ignored in the US media. The crises are not ranked in order of importance. This year, DWB cited governments in Sri Lanka, Pakistan, and Sudan for blocking lifesaving assistance. In the Democratic Republic of Congo, government forces attacked civilians who had gathered for a DWB childhood vaccination campaign, the group said.

DWB also flagged Chagas, visceral leishmaniasis, sleeping sickness, and other diseases of the poor as neglected by the international community. To access the list, visit http://www.doctorswithoutborders.org/publications/topten/2009/ .
 

GLOBAL:"Patent Pool to Boost AIDS Drug Access"
Agence France Presse , (12.15.2009) CDC NPIN Summary
In a move it hopes will slash the cost of generic medicines in the developing world, the international drug-buying consortium UNITAID on Monday announced the formation of a global patent pool for AIDS medicines.

The plan, which organizers hope to have in operation by mid-2010, represents “an enormous step for humanity,” said Philippe Douste-Blazy, UNITAID’s chief. The pool won the approval of UNITAID’s board at a meeting in Geneva.Start-up funds - $4 million - will be supplied by UNITAID, which is already in talks with US drug-makers Gilead, Johnson & Johnson, Merck, and Sequoia.

Under the plan, generic pharmaceutical companies would be able to combine newer, more effective drugs from different suppliers into fixed-dose combinations, an approach presently complicated by patent restrictions. By encouraging competition among drug labs, UNITAID believes the pool will cut billions of dollars from the cost of AIDS drugs in developing nations.

The drugs produced would be distributed only in the developing world, where viral resistance to existing treatments is spurring the need for newer medicines still under patent. UNITAID so far has identified 19 drugs from nine firms for potential inclusion in the patent pool. A further advantage, Douste-Blazy said, is that the pool would facilitate the production of HIV/AIDS medicines in special doses for children, who now account for 10 percent of demand.

Doctors Without Borders hailed the advancement but warned its success will depend upon the cooperation of patent holders. “This needs to happen fast, as the clock is ticking for millions of patients,” said Michelle Childs, DWB’s director of policy and advocacy.
 

UGANDA:"Anti-Gay Bill May Cost Uganda Research Institution"
Agence France Presse , (12.14.2009)  CDC NPIN Summary
UN and Ugandan officials announced on Monday that the base of the African AIDS Vaccine Program will be shifted from Geneva to Entebbe - a move designed to raise Africa’s role in AIDS vaccine research. However, a UN official also said the decision could be imperiled if Uganda’s parliament passes a strict anti-homosexual measure now under consideration. The issues were discussed at AAVP’s conference in Kampala.

Under the proposed bill, individuals who “promote” homosexuality could be jailed for one year. People in positions of authority would be required to inform police of any known homosexual activity, and the death penalty would be imposed under certain circumstances.

“Criminalizing adult consensual sex is not only a human rights issue, it goes against a good HIV strategy,” said Catherine Hankins, the head scientific advisor for UNAIDS, which backs AAVP with the help of the World Health Organization. “If the bill passes, UNAIDS and WHO would have to decide what happens and to see whether this is an appropriate place.”

Homosexual transmission accounted for less than 1 percent of new HIV infections in 2008, Kihumuro Apuuli, Uganda’s AIDS Commission, said recently. “You go back to France and tell them that in Uganda we have limited resources and have to allocate resources to areas of need,” he told Agence France Presse.

Provisions relating to the death penalty will be reviewed in parliament, say senior government officials.
 

"Obama Is Criticized on AIDS Program"
New York Times , (12.09.2009) Donald G. McNeil Jr.   CDC NPIN Summary
Some AIDS advocates accuse the Obama administration of turning its back on global HIV treatment in its attempt to focus more on HIV prevention and on the less costly treatment of other diseases in poor countries.

On Dec. 7, the administration released more information about its five-year strategy for the President’s Emergency Plan for AIDS Relief (PEPFAR), including treatment objectives. From 2010 to 2014, the goal is to increase the number of patients receiving antiretroviral (ARV) therapy in target countries to 4 million. The 2010-14 plan for 320,000 new patients on treatment per year is slower than PEPFAR’s previous pace of almost 500,000 per year since 2004.

PEPFAR’s head, Dr. Eric Goosby, denied the administration is backtracking on its promise to fight AIDS overseas. “We’re honoring our commitment,” said Goosby, noting that more people will receive antiretroviral therapy each year.

Some global health advocates expressed sympathy but said the administration is being pragmatic in shifting funds for cheaper interventions that save even more lives. It is an approach advocated in a November 2008 paper in the Journal of the American Medical Association by Dr. Ezekiel J. Emanuel, a bioethicist at the National Institutes of Health, an Office of Management and Budget advisor and brother of the president’s chief of staff, Rahm Emanuel.

Fighting “simple but more deadly diseases, such as respiratory and diarrheal illnesses, the US government could save more lives - especially young lives - at substantially lower cost,” Dr. Emanuel wrote. Since then, he has denied having an influence on the administration’s management of PEPFAR. “This is the president’s policy and the way he wants to approach it, and no individual counselor stands in his way,” he said.

Fearing PEPFAR cutbacks, a number of presidents and deans of schools of medicine and public health submitted an open letter on Nov. 18 urging Obama to continue expanding ARV access.
 

Kaiser Hosts Town Hall Forum With Ambassador Eric Goosby, U.S. Global AIDS Coordinator
The Foundation held a town hall-style session with Ambassador Eric Goosby, the U.S. Global AIDS Coordinator, to explore the new five-year strategy for the President's Emergency Plan for AIDS Relief (PEPFAR), announced by the Obama Administration earlier this week. Ambassador Goosby discussed the strategy, including how it fits into the larger U.S. Global Health Initiative, and fielded questions from the in-person audience and from viewers of the live webcast. The session was moderated by Jen Kates, Kaiser Vice President and Director of HIV Policy at the Foundation. An archived version of the webcast is now available at http://www.kff.org/globalhealth/gh120409video.cfm.

"Vancouver Olympic Athletes Provided with 100,000 Free Condoms"
Xinhua News Agency , (12.04.2009)
Canadian media reported Thursday that “50,000 to 100,000” condoms have been ordered for distribution to the 6,850 athletes and officials expected to take part in the 2010 Winter Games. Welcome packets will inform participants of where they can access the condoms at the two Olympic villages in the co-host cities of Vancouver and Whistler. Condoms have been distributed to Olympic athletes at least since the 1992 Summer Games in Barcelona. Supported jointly by UNAIDS and the International Olympic Committee, the condom program “is a really good opportunity to use the profile of the Olympics to put positive health promotion messages out there,” said Reka Gustafson, medical health officer for the Vancouver Coastal Health Authority.
 

"US Unveils Five-Year Plan to Fight AIDS Worldwide"
Agence France Presse , (12.01.2009)  CDC NPIN Summary
On World AIDS Day, US officials announced a new five-year plan that will refocus the nation’s overseas AIDS-fighting efforts. This new direction will shift the program’s emphasis toward achieving long-term, sustainable improvements in prevention, treatment, and care.

“We’re going to begin transitioning from an emergency response to a sustainable one through greater engagement with and capacity-building of governments,” said Dr. Eric Goosby, the global AIDS coordinator who oversees the President’s Emergency Plan for AIDS Relief (PEPFAR). For instance, the Obama administration will encourage partner governments’ ministries of health, education and finance to take over management of PEPFAR efforts and increase financial support for them, Goosby said.

“We’re going to scale-up highly effective prevention interventions like male circumcision [and] prevention of mother-to-child transmission,” Goosby said. “We’re going to work with countries to determine not just how many people are infected, but where the new infections are occurring.”

“With treatment, we will continue a strategic scale-up of services to more than 4 million people,” said Goosby. “In 2009 alone, PEPFAR has supported life-saving antiretroviral therapy for more than 2.4 million people, essential care to nearly 11 million people, and counseling and testing for nearly 29 million people.”

PEPFAR’s interventions have prevented 100,000 mother-to-child HIV infections during the past year and nearly 240,000 such infections during the past five years, Goosby said. PEPFAR’s five-year goal is to double the number of mother-to-child HIV transmissions prevented.

For more information about the five-year plan, visit http://www.pepfar.gov/documents/organization/133035.pdf .

 

Kaiser Brief Analyzes the U.S. Budget for the Obama Administration’s Global Health Initiative

A new policy brief and chartpack, http://www.kff.org/globalhealth/8009.cfm , from the Kaiser Family Foundation provide a detailed breakdown of the U.S. budget for the global health programs in President Obama’s new Global Health Initiative, announced in May 2009.

The Global Health Initiative, a new six-year, $63 billion proposed effort, would for the first time develop a comprehensive, U.S. government-wide strategy for global health focused on the health challenges and needs of those in low-and middle-income countries. The initiative builds on the Bush Administration’s efforts to address HIV, TB, and malaria through the President’s Emergency Plan for AIDS Relief (PEPFAR) and President’s Malaria Initiative but also broadens and augments the focus on other global health challenges, particularly maternal and child health, family planning and reproductive health, and neglected tropical diseases. The effort currently encompasses most, but not all, of the federal government’s investment in global health.

The brief provides an overview of the projected budget for the Global Health Initiative, including the $8.6 billion proposed by the Administration in its pending fiscal year 2010 request and the $8.4 billion approved in fiscal year 2009. It examines the different U.S. programs that would fall under the Global Health Initiative over time, tracking data back to fiscal year 2001. The supplemental chartpack includes additional breakouts and budget trends over time.

The policy brief is part of the Foundation’s growing collection of resources focused on the U.S. government’s role in global health, including original policy research and polling, daily news summaries, a policy tracker monitoring key actions by the Administration and Congress, and videos and transcripts of Kaiser’s global health policy briefings and webcasts. These resources and more are available through the Foundation’s Global Health Gateway at http://globalhealth.kff.org/ .

Upcoming Event:

On Friday, Kaiser hosts a DC event, http://www.kff.org/newsroom/upload/mediaadvisory_PEPFAR_120409.htm , and live webcast, http://www.kff.org/globalhealth/gh120409video.cfm , of a town hall-style discussion with Ambassador Eric Goosby, the U.S. Global AIDS Coordinator.

 

International AIDS Conference Returns to U.S. in 2012
The XIX International AIDS Conference (AIDS 2012) will be held July 2012 in Washington, DC. As the custodian of the conference, the International AIDS Society (IAS) made the decision because the United States is repealing its HIV travel ban, effective January 4, 2010. The last time the conference was held in the United States was 1990 in San Francisco.
http://www.poz.com/articles/aids2012_washington_dc_1_17635.shtml

Report: PEPFAR, Other Global AIDS Initiatives Ease Pandemic
The President’s Emergency Plan for AIDS Relief (PEPFAR) and other global AIDS initiatives have contributed to significant declines in AIDS-related mortality, according to a report by amfAR, The Foundation for AIDS Research, and the Center for Global Health Policy.
http://www.poz.com/articles/report_amfar_pepfar_1_17636.shtml
 

"AIDS Deaths Top 25 Million but Infections Slow"
Agence France Presse , (11.24.2009) D’Arcy Doran  CDC NPIN Summary
The number of people living with HIV grew by 2.7 million new infections in 2008, but that represented a 17 percent decline from eight years earlier, the UN reported Tuesday.

Since 2001, HIV incidence has plummeted by 25 percent in East Africa, by 15 percent in sub-Saharan Africa, and by 10 percent in South and Southeast Asia, according to the UN’s “2009 AIDS Epidemic Update.” Compared to the global epidemic’s 1996 high point of about 3.5 million new infections, global incidence in 2008 was 30 percent lower.

The number of low- and middle-income HIV/AIDS patients receiving antiretroviral therapy has grown 10-fold in the past five years, said Michel Sidibe, executive director of UNAIDS. With improved access to ARVs, HIV-related deaths have been cut, standing at an estimated 2 million last year - a 10 percent reduction since the 2004 peak of 2.2 million deaths. To date, an estimated 60 million people have acquired HIV, and 25 million people have died from AIDS.

“The good news is that we have evidence that the declines we are seeing are due, at least in part, to HIV prevention,” Sidibe said. He added, “If we do a better job of getting resources and programs to where they will make the most impact, quicker progress can be made and more lives saved.”

Treatment access is still being outpaced by some 7,400 new HIV infections a day, said Sidibe. “Any time we are putting two people on treatment, five people are becoming infected,” making effective prevention strategies imperative, he said.

“International and national investment in HIV treatment scale-up has yielded concrete and measurable results,” said Margaret Chan, head of the World Health Organization. “We cannot let this momentum wane.”

To view the report, visit http://data.unaids.org/pub/Report/2009/2009_epidemic_update_en.pdf .



"Over 33 Million Infected with AIDS Virus: UN"
Reuters , (11.24.2009) CDC NPIN Summary
Global advances in HIV treatment and prevention continue to be lopsided, UN officials said during the release of the organization’s “2009 AIDS Epidemic Update.” Antiretroviral drugs (ARVs) have extended the lives of millions of patients, yet more than half of patients in low- and middle-income countries who need treatment are not getting it. Expanding access to ARVs is one of several priorities the UN details in the report.

“The major problem we are facing today is inequity,” said Michel Sidibe, executive director of UNAIDS. “It is very important we don’t continue to have 400,000 babies born with HIV in Africa every year. That is something we can deliver. That is why we are calling for virtual elimination of transmission from mother to child by 2015.”

In 2008, more than 4 million people living with the virus were receiving ARVs, up from 3 million in 2007, said Teguest Guerma, acting director of the World Health Organization’s HIV/AIDS department. Even so, more than 5 million people need treatment and are not receiving it, he said.

Second-line drugs are “still very expensive,” Guerma said. “If [patients] fail in the first-line regime, they need to switch to the second. One reason it is not being done is because it is not available and it costs too much. Countries are not purchasing it.”

The HIV/AIDS epidemic appears to be stabilizing in most regions of the world, said Paul De Lay, deputy executive director of UNAIDS. “The data we are seeing confirm this,” De Lay said. “It is a combination of decreasing deaths, more people therefore living, adding to the total number of infected and decreasing new infections.”

Sidibe called for countries to end discriminatory laws that fuel HIV’s spread by driving underground such high-risk groups as men who have sex with men. Other UN priorities include ending violence against females and protecting drug users from HIV.

 

World facing multiple and evolving HIV epidemics, says UNAIDS
A UNAIDS/WHO report has shown there are multiple and evolving HIV epidemics around the world. Read More at aidsmap

Global epidemic report shows HIV treatment preventing deaths; infections fall by 17%
Increasing access to antiretroviral therapy is starting to have a major impact on the global AIDS epidemic, according to a report released by UNAIDS and WHO. Prevention is also having an impact on new infections, although some of the decline in new infections is due to the natural course of the epidemic. Read More at aidsmap

Global Fund Extension of HIV Prevention Programmes for People at High Risk for HIV in Russia Will Save Thousands of Young Lives

13 November 2009 (Geneva, Switzerland) - The International AIDS Society (IAS) and the International Harm Reduction Association (IHRA) today welcomed the announcement by the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) to extend by two years its funding of HIV prevention programmes (known as the GLOBUS grant) in the Russian Federation at a cost of US$24 million.

"This two-year extension will save thousands of lives," said Robin Gorna, IAS Executive Director. "While this decision is very welcome, it is nevertheless a band-aid measure, not a long-term solution. External funding cannot prop up Russia's HIV response forever. The onus is still on the Russian Government to listen to the science and 20 years of proven practice and put in place long-term harm reduction prevention programmes that will save tens of thousands of young Russian lives."

GLOBUS addresses the needs of specific groups including prevention programmes specifically targeted at people who inject drugs, sex workers and men who have sex with men. Funding for GLOBUS ended on 31 August 2009, potentially leaving projects in ten regions subject to staff layoffs and closures, despite the fact that they have averted an estimated 37,000 HIV infections.1

An estimated one million people are living with HIV in Russia, 80 percent of whom are under the age of 30. An estimated 1.85 million Russians, two percent of the adult population, inject drugs, one of the highest rates in the world. In 2007, 64.5 percent of new HIV infections in Russia were the result of injecting drug use. International AIDS Society and International Harm Reduction Association Press Release (11.13.09)
 

GSK and Pfizer launch joint HIV venture, ViiV Healthcare
The pharmaceutical companies GlaxoSmithKline and Pfizer announced today that the joint venture created by the merger of their HIV divisions is called ViiV Healthcare. The deal was first announced in April, and aims to improve the two companies’ position in the HIV market by cutting costs, sharing research and combining sales operations. Read More at aidsmap

Experts Warn That AIDS Will Remain a Global Crisis in 2031
Unless there is a more comprehensive response to HIV/AIDS, the epidemic will remain out of control on its 50th anniversary in 2031, according to a panel of experts reported on in The New York Times. Read more at POZ http://www.poz.com/articles/aids_global_crisis_2031_1_17515.shtml
 

International AIDS Society urges New Focus on ART as Prevention
4 November 2009 (Geneva, Switzerland) - The International AIDS Society (IAS) today saluted the World Health Organization (WHO) for its focus on scaling up antiretroviral therapy (ART) as prevention as well as for treatment. The WHO consultation that concluded today has reaffirmed the urgent need for universal access to ART for the treatment of people living with HIV, emphasizing the clinical benefit of early treatment for individuals, as well as the prevention impact of increased access to ART in reducing HIV transmission and tuberculosis (TB) incidence. The IAS's statement came at the end of a three-day consultation on ART for HIV Prevention convened by WHO.
 

"Non-Governmental Organizations Praise End to HIV Travel Ban"
Inter Press Service , (10.30.2009) Jim Lobe CDC NPIN Summary
Domestically and abroad, health advocates are applauding the Obama administration’s repeal of the policy banning non-nationals with HIV from visiting or immigrating to the United States. On Friday, Obama announced that the final rule ending the 22-year-old restriction would be published on Monday, and that it would go into effect “just after the New Year.”

“We lead the world when it comes to helping stem the AIDS pandemic, yet we are one of only a dozen countries that still bar people with HIV from entering our own country,” Obama noted at the White House.

“The US travel ban was stigmatizing to people living with HIV/AIDS, and many countries around the world modeled their own stigmatizing travel bans on the US law,” said Paul Zeitz, head of the Global AIDS Alliance. “So this will help lift the stigma that many HIV-positive people experience around the world.”

Describing the ban as “scientifically baseless” and “contemptible,” Asia Russell, director of the Health Global Access Project, added, “We call on the remaining countries with travel bans to join the US in eliminating those restrictions.”

“This long-overdue move brings the US in line with current scientific and international standards of public health and will lessen the painful stigma and discrimination suffered by HIV-positive people,” said Arlene Bardeguez, who is stepping down as director of the Infectious Diseases Society of America.

“The HIV travel ban made the United States a pariah in human rights circles, and harmed our reputation as a world leader of HIV/AIDS prevention, treatment and care,” said Frank Donaghue, head of Boston-based Physicians for Human Rights. “Starting in 2010, people living with HIV will no longer be prevented from entering this country, no longer turned away at customs, no longer forced to hide their condition and interrupt medical treatment, and no longer be treated by our government with contempt.”

 

"Experts Warn of Drastic AIDS Funding Shortfall"
Agence France Presse , (11.03.2009) CDC NPIN Summary
When the global AIDS pandemic hits its 50th year, annual spending needed to fight the disease in developing countries could reach $35 billion, three times the current level, according to a new study. At the same time, more than 1 million people could be newly infected each year, estimated researchers for the AIDS 2031 project. The study is one of a series of articles about HIV/AIDS in the November/December issue of Health Affairs.

“The cost of fighting the epidemic for treatment and prevention is rising very rapidly around the world, especially in southeastern Africa,” said study co-author Robert Hecht, managing director of the Washington-based Results for Development Institute. In the current global financial crunch, funding resources are becoming scarcer and other priorities more competitive, he said.

This is “a moment of opportunity, because it’s a chance for government officials and external funders to take a hard look at what they have been doing and to find ways to spend the money that is available in a more efficient way to cut down on waste,” said Hecht. Economizing strategies “need to be addressed as soon as possible if we are going to see a successful fight against AIDS over the next 10 to 20 years,” he said.

One example of shifting to high-impact strategies would be to rely on nurses rather than doctors for treatment in some cases, said Hecht. For high-impact prevention, male circumcision has been shown to be very effective in reducing female-to-male HIV risk. Most young adult males are not circumcised in southeastern Africa, and infection rates there remain high, he said. In addition, antiretroviral drugs very effectively reduce mother-to-child HIV transmission risk, he noted.

The full report, “Critical Choices in Financing the Response to the Global HIV/AIDS Pandemic,” was published in Health Affairs (2009;28(6):1591-1605).

 

"UN Urges Nations to Follow Obama’s Lead, Lift HIV Travel Ban"
Agence France Presse , (11.01.2009)  CDC NPIN Summary
President Barack Obama’s announcement that he would overturn the 22-year-old policy banning non-nationals with HIV from entering the United States drew high praise from the leader of the UN. In a statement released by UNAIDS, Secretary-General Ban Ki-moon congratulated Obama on his decision and added, “I urge all other countries with such restrictions to take steps to remove them at the earliest. Such restrictions, strongly opposed by UNAIDS, are discriminatory and do not protect public health.” UNAIDS reports that China and Ukraine, which also have such policies, are among countries considering following the US example, while South Korea, Ban’s home nation, is “in the last stages of removing travel restrictions” for people with HIV.

 

"Sex, Alcohol, Fat Among World’s Big Killers"
Reuters , (10.28.2009) Kate Kelland  CDC NPIN Summary
About a quarter of the 60 million premature deaths globally each year are due to unsafe sex, poor childhood nutrition, alcohol, inadequate sanitation and hygiene, and high blood pressure, according to a new World Health Organization report. Global life expectancy could gain almost five years if these five problems were tackled, said WHO’s “Global Health Risks” report.

HIV/AIDS is the world’s sixth biggest killer. In 2004, unsafe sex was responsible for more than 99 percent of HIV infections in Africa, the only region where more women than men have HIV/AIDS, noted the report. Elsewhere, the proportion of HIV deaths due to risky sexual behaviors ranged from about 50 percent in low- and middle-income countries of WHO’s Western Pacific Region to 90 percent in countries of the Americas with similar resources.

Sexually acquired human papillomavirus (HPV) infection is responsible for virtually all cervical cancer, which represents 11 percent of global mortality due to unsafe sex, stated the report. It is the leading cause of cancer deaths in WHO’s African Region. “Almost three-quarters of the global burden of unsafe sex occur in sub-Saharan Africa, and another 15 percent in India and other countries of the Southeast Asia Region,” it said.

“As health improves, gains can multiply,” the report said. “Reducing the burden of disease in the poor may raise income levels, which in turn will further help to reduce health inequalities.”

“The poorest countries still face a high and concentrated burden from poverty, under-nutrition, unsafe sex, unsafe water and sanitation,” WHO said. “At the same time, dietary risk factors for high blood pressure, cholesterol, and obesity, coupled with insufficient physical activity, are responsible for an increasing proportion of the total disease burden.”

The report can be found at http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf .

UGANDA:
"France Joins US in Slamming Uganda’s Draft Anti-Gay Law"
Agence France Presse , (11.02.2009)  CDC NPIN Summary
US opponents of a draft law that strengthens Uganda’s anti-gay legal code are attempting to enlist Secretary of State Hillary Clinton to their cause.

“The egregious bill represents one of the most extreme anti-equality measures ever proposed in any country,” Rep. Ileana Ros-Lehtinen (D-Florida) and three other members of the House of Representatives wrote in a letter to Clinton.

The lawmakers said Uganda’s stance on homosexuality threatened the effectiveness of US funding for HIV prevention and care. The approximately $300 million spent in Uganda by the US President’s Emergency Plan for AIDS Relief (PEPFAR) in 2008 amounted to 2.6 percent of the nation’s entire economy.

“We believe the ‘Anti-Homosexuality Bill’ would undermine the substantial US contribution to Uganda through PEPFAR and raise serious questions about the effectiveness of this global health investment,” the letter said.

France recently registered its “deep concern” about the proposed Ugandan legislation. “France reiterates its commitment to the decriminalization of homosexuality and the fight against discrimination based on sexual orientation and gender identity,” said a letter from the French foreign ministry.

Denunciations from the United States and France seemed to have little effect on the authors of the legislation.

“The fact that the moral fabric of America and Europe has been put under siege by the supporters of this creeping evil of homosexuality should not suggest that we follow suit,” bill author David Bahati wrote in an article in Uganda’s Observer.

 

GLOBAL: Bill Gates Urges More Spending on Global Health
Jennifer C. Kerr
Associated Press (10.27.09) - Wednesday, October 28, 2009
In Washington on Tuesday, Microsoft founder Bill Gates and his wife Melinda introduced their new "Living Proof Project" touting the huge returns that result from investments in global health initiatives. "Global health money improves lives more effectively than any other spending," Bill Gates said. The pair's new project will seek to publicize the success stories of such health- improvement efforts. Among programs cited as effective:
*The US President's Emergency Plan for AIDS Relief, which has helped 1.2 million people access HIV prevention and treatment;
*The GAVI Alliance, whose efforts to immunize children are credited with preventing 3.4 million deaths in less than a decade; and
*The Gateses' own Bill & Melinda Gates Foundation, which spent $1.8 billion on global health last year.

The two plan to ask lawmakers and administration officials to commit to cutting preventable childhood deaths from 9 million a year at present to 5 million a year by 2025. CDC HIV/Hepatitis/STD/TB Prevention News Update For Wednesday, October 28, 2009

 

RUSSIA: Russia Rejects Methadone to Stem HIV Epidemic
Agence France Presse (10.28.09) - Wednesday, October 28, 2009
More than 60 percent of people with HIV in Eastern Europe and Central Asia acquired the virus through injection drug use, Russia's chief medical official said Wednesday. However, Russia will not be embracing methadone maintenance treatment for injection drug users (IDUs), Gennady Onishchenko told the Eastern Europe and Central Asia AIDS Conference in Moscow. More than 500,000 people are officially listed as HIV-positive in Russia.

"The danger is that the epidemic will cross over from a concentrated one to a general one," Onishchenko said. Russia offers IDUs effective programs other than methadone maintenance, he said. "Russia speaks out categorically against this component in prevention programs," he said, noting that the synthetic drug is illegal in the country. "We aren't simply denying this problem, we are proposing our solution," he added.

At the conference, international speakers criticized Russia's policy against methadone, which is given to IDUs to help them cease drug injection. The International AIDS Society and the Eurasian Harm Reduction Network released a statement urging Russia to support methadone programs.

Such interventions are "an essential element of universal access to HIV prevention," said Michel Sidibe, executive director of UNAIDS. "I fear that in this region the legal barrier to harm-reduction programs also makes [IDUs] a target for harassment, driving the people most affected by this epidemic underground," he said. "I urge each country in this region to define within its own legislation the harm-reduction program it needs, just like China has done with great success." CDC HIV/Hepatitis/STD/TB Prevention News Update For Wednesday, October 28, 2009

UGANDA: Uganda Member of Parliament Urges Death for Gay Sex
BBC (10.16.09) - Wednesday, October 28, 2009
A lawmaker from Uganda's ruling party has proposed a bill to create new capital offences for homosexuality, which is already illegal in the country. Under Member of Parliament (MP) David Bahati's measure, HIV-positive gays who have sex would be guilty of "aggravated homosexuality," which would be punishable by death. In addition, the bill widens the definition of homosexual acts and levies fines or potentially seven years imprisonment for promoting homosexuality.

The "Anti-Homosexuality Bill's" chance of passing is high, as senior figures in the ruling National Resistance Movement will probably back it, according to Joshua Mmali, a BBC correspondent in Kampala. It has a "99 percent chance" of passing, said John Otekat Emile, an independent MP. That assessment was shared by Emmanuel Dombo, a ruling party MP.

Activist groups such as Human Rights Watch (HRW) and the International Gay and Lesbian Human Rights Commission are condemning the bill, saying it violates several international agreements and Uganda's own constitution.

The bill would "put major barriers in the path of effective HIV/AIDS prevention efforts," said HRW. "Discrimination and punitive laws like this aimed at marginalized groups and at those among the most affected by HIV drive people underground and do nothing to help slow down the AIDS epidemic," said Daniel Molokele, Africa program officer at the World AIDS Campaign.

Researchers, Public Health Experts Urge Russia to Expand HIV Prevention Programmes for People Who Inject Drugs As Regional AIDS Conference Opens in Moscow
Evidence-based Programmes in Ukraine and Kyrgyzstan and Russian Scale-up of HIV Treatment Highlight Potential for Action
28 October 2009 (Moscow, Russian Federation) – As Moscow prepares to host the 3rd Eastern Europe and Central Asia AIDS Conference (EECAAC) on 28–30 October, the Eurasian Harm Reduction Network, the International AIDS Society and the International Harm Reduction Association issued a joint call to the Russian Government to dramatically expand access to HIV prevention programmes for people who inject drugs.
An estimated one million people are living with HIV in Russia, 80 percent of whom are under 30. An estimated1.85 million Russians, two percent of the adult population, inject drugs, one of the highest rates in the world. In 2007, 64.5 percent of new HIV infections in Russia were the result of injecting drug use.

Study rates Luxembourg as having the best HIV prevention and care in Europe
A study assessing 29 European countries’ HIV policies and services has highlighted best practice and areas for improvement, with widespread differences between European countries. Overall, the countries rated as having the best response to HIV were Luxembourg, Malta, Switzerland, Finland and the Netherlands, while the United Kingdom came in ninth. Read More at aidsmap >>

Ugandan bill proposes death penalty for sexually active HIV-positive gay men
A Ugandan MP has introduced a bill which would impose the death penalty on HIV-positive gay men in Uganda if they have sex with another man. Read More  at aidsmap>>

GLOBAL:
"Don’t Flag on Support, AIDS Chiefs Say at Vaccine Conference "
Agence France Presse , (10.19.2009) Richard Ingham CDC NPIN Summary
The financial crisis is constraining aid spending among donor countries, but scaling back international AIDS efforts now would be penny-wise and pound-foolish, experts say.

“The financial crisis is of course affecting, and clearly affecting, the capacity of donors to fund international programs on AIDS,” said Michel Kazatchkine, executive director of the Global Fund to Fight AIDS, TB and Malaria. He and Peter Piot, head of the Institute for Global Health in London, spoke to journalists on Monday at the start of the AIDS Vaccine 2009 conference in Paris.

Kazatchkine said he is concerned especially for next year, when a three-year round of fundraising ends. “2010 will be a key year when it comes to funding global health and funding AIDS prevention, treatment and AIDS science,” he said. “The risk is… that we lose momentum, that we lose the trust and that we lose the hope that we have generated in an unprecedented movement in global health in the last eight years.”

“It is very ironic, [in] that it comes at a time when we have real results - 4 million people on antiretroviral therapy in lower- and middle-income countries [and] achievement in HIV prevention,” said Peter Piot, the former UNAIDS chief. “Now is not the time to decrease efforts, because the bill is then going to get higher and higher. It’s a matter of ‘pay now or pay later.’ We know that there is money…. The bailout of banks has shown that there is money, there is mega-money when it is needed.”

Phase II results of a Swedish AIDS vaccine study, conducted among 60 healthy Tanzanian policemen, are expected to be presented at the conference on Wednesday. “We hope that our vaccine could increase protection to 50 percent,” said Britta Wahren, a professor emeritus at Sweden’s Karolinska Institute.

 

ASIA-PACIFIC:
"Conference Urges Sexual Health Service for Asia-Pacific Youth"
Xinhua News Agency , (10.18.2009) CDC NPIN Summary
The Fifth Asia Pacific Conference on Reproductive and Sexual Health and Rights, now underway in Beijing, has issued a call for better sexual health services for young people. “Few young people receive adequate preparation for their sexual lives. This leaves them potentially vulnerable to coercion, abuse and exploitation, unintended pregnancies and sexually transmitted infections, including HIV,” said the Youth Declaration, which was announced Sunday. The risks of HIV transmission are exacerbated by poverty and malnutrition in the region, said the statement, which challenged national governments and civil societies to better target prevention services to young people, particularly those in marginalized groups. The conference — co-sponsored by the National Population and Family Planning Commission of China, the UN Population Fund and the International Planned Parenthood Federation — concludes Tuesday. For more information, visit http://www.5apcrshr.org/.

 

CANADA:
"Ban on Gay Blood Donors Is Unconstitutional, Man Argues in Counter-Suit"
Canadian Press , (10.05.2009) Ottawa Sun
A man who lied about having sex with men so he could donate his blood had syphilis, an attorney representing the Canadian Blood Services told an Ontario Superior Court judge Monday. CBS is suing Kyle Freeman for lying during the donor screening process and donating blood 18 times.

Freeman is counter-suing CBS, saying the lifetime ban on blood donation by any male prospective donor who has ever had sex with a man since 1977 is unconstitutional. Freeman is asking Justice Catherine Aitken to strike down the agency’s lifetime ban in favor of a behavioral risk assessment that would not disqualify all gay men.

“When Mr. Freeman donated blood in June of 2002, that blood tested positive for syphilis,” CBS lawyer Sally Gomery told the court. “Mr. Freeman was tested a month before, he didn’t think he had syphilis but he did.”

Though no one was hurt by Freeman’s actions, “self-screening” is dangerous, Gomery said. “It’s effectively the approach that the Canadian Red Cross Society used in the early days of the HIV outbreak. This approach resulted in thousands of Canadian blood recipients being infected with HIV and hepatitis C.”

“Scientifically, it doesn’t make any sense,” Freeman said of the syphilis test result. “I was tested before I donated and there was no sexual contact.”
“This case is not about eliminating safety for inclusivity,” said Patricia LeFebour, Freeman’s attorney. “The issue is whether the CBS blood donor questionnaire should screen risk behaviors rather than targeting a group protected by the Charter.”

Tim Morgan of the Canadian Hemophilia Society testified that the court should view the decision through the eyes of blood recipients. Blood donors do not have any risk, in contrast to recipients, he noted. “It is their lives that will be impacted if anything goes wrong,” Morgan said.

 

GLOBAL:
"HIV/AIDS Treatment for Poor Grows Tenfold in Five Years:
Agence France Presse , (09.30.2009) CDC NPIN summary
By 2008, the number of HIV/AIDS patients in low- and middle-income countries who were receiving antiretroviral therapy (ARVs) had grown by 10-fold over five years, according to a UN report issued today. The largest increase, 39 percent, was in sub-Saharan Africa.

In 2008, 4.03 million poor patients these countries were receiving ARVs, up from 2.97 million patients the previous year, the report said. However, just 42 percent of the 9.5 million African HIV/AIDS patients needing ARVs were receiving them. Some 7 million people are expected to be receiving ARVs by next year, a 3 million increase in two years, said Michel Sidibe, executive director of UNAIDS.

“One of the major factors which contributed to create a wider availability of treatment is reduction of price of the most frequently used [ARVs],” said Teguest Guerma, head of the HIV/AIDS program at the World Health Organization (WHO). The prices of cheaper first-line ARVs fell by 10-40 percent between 2006 and 2008, a key reason for improved treatment access, she noted.

“This report shows tremendous progress in the global HIV/AIDS response,” said Margaret Chan, WHO’s director-general. “But we need to do more. At least 5 million people living with HIV still do not have access to life-prolonging treatment and care.”

The number of new HIV infections is also increasing at a faster rate than the number of people on ARVs, according to WHO. “All indications point to the number of people needing treatment rising dramatically over the next few years,” Sidibe said.



JAMAICA:
"How AIDS Became a Caribbean Crisis"
The Atlantic , (09.22.2009) Micah Fink CDC NPIN summary
The Caribbean has the highest rate of new HIV infections after sub-Saharan Africa, and AIDS is now its leading cause of death among adults. Part of the region’s susceptibility to HIV/AIDS is pervasive homophobia, which drives the epidemic underground, helping to spread infections and make education and outreach more difficult, experts say.

Jamaica, where gay men have a 32 percent HIV infection rate, is a case study in how widespread homophobia amplifies the impact of HIV/AIDS. The “abominable act of buggery,” as anal sex is termed in Jamaican law, is punishable by up to 10 years hard labor. Popular dance music celebrates the murder of gay men, inciting and reflecting widespread acts of violence against gays. A religious context of homosexuality as a mortal sin compounds the contempt that checks any concern for gays.

“The reality in Jamaica is that men who have sex with men, for fear of being prosecuted and being found guilty under the sodomy law, pretend that they’re not gay,” said Miriam Maluwa, UNAIDS representative for Jamaica. “[Gay men] marry fairly rapidly, they have children fairly rapidly to regularize themselves, and that is really a ticking time bomb. So we are really talking about this targeted group, having quite high levels of infections, which is interacting sexually with the general population.”

Though the growing consensus among experts suggests targeted prevention programs for gay men, rather than general public health messages, the social and political climate makes that virtually impossible.

“If it were AIDS that were killing us, I would use a condom,” said a 20-year-old man in Kingston whose boyfriend was stabbed to death on the street for being gay. Another close friend was locked inside his parents’ house by a crowd and burned alive. “But it’s people, not AIDS, that is killing us. AIDS has nothing to do with it.”



KENYA:
"Anti-AIDS Campaigners Now Turn to Positive Advertising"
Business Daily Africa (Nairobi) , (09.23.2009) Victor Juma CDC NPIN summary
Informed by social marketing research, anti-AIDS campaigners in Kenya are turning away from fear-based ads in favor of more positive approaches.

One well-known ad, once featured prominently in medical settings, used monsters to represent the AIDS virus. Another presented images of a man and woman, tracking them from the time of HIV infection as they wasted away and eventually died.

“The skeleton images, apart from scaring the public, did little to create awareness of AIDS,” said Dr. Christine Ombaka of the community group Ulumbi Youth AIDS. “The messages did not offer hope; death was shown as the immediate consequence of infection.” Further, she said, “The fear tactics employed ended up stigmatizing those already infected. They withdrew and were not encouraged to seek support or care from health institutions.”

Instead, newer ads accept the reality of sexual relationships and ask partners to protect each other. One displays condoms prominently while showing a young couple in a romantic setting.

“Fear appeal will get people’s attention for a while, but often the threat soon diminishes and they revert back to risky behavior,” said David Onuong’a, who teaches psychology of communication at Maseno University.

Social psychologists cite the theory of cognitive dissonance to explain how people react to fear-based messages. Confronted by a frightening message, experts say, a person engaged in high-risk sex may seek to resolve the conflict by downplaying the message’s importance; adding interpretations consonant with his/her behavior; or modifying the risky behavior. While the third outcome is the one desired by campaign designers, experts say the audience is more likely to discredit the message and engage in “biased optimism.”


Remarks at Swearing-In Ceremony for Dr. Eric Goosby Global AIDS Coordinator and Ambassador-at-Large
Hillary Rodham Clinton,Secretary of State; Eric Goosby, M.D.,Global AIDS Coordinator
September 17, 2009
 

GLOBAL:
"HIV/AIDS Presents New and Different Security Threats, Says Report"
Voice of America News , (09.22.2009) Joe DeCapua
Nine years ago, the UN Security Council made HIV/AIDS a top priority, as the disease was beginning to be taken seriously as an international security risk.

“The alarmism of a decade ago has dissipated,” said Alex de Waal, program director at the Social Science Research Council in New York. “Armies are not imploding. States are not collapsing. But there is a host of issues that we still need to be concerned about,” said de Waal, principal investigator of a report that offers recommendations for dealing with the security risks of HIV/AIDS.

Such threats include violence against women in conflict situations. “Any woman who is exposed to acts of sexual violence is at greater risk of receiving HIV,” de Waal said. And the men who perpetrate sexual violence are themselves at high risk of being HIV-infected, he added.

As countries transition from war to peace, “You may see a lot of investment going into certain towns,” de Waal noted. “They may become boom towns. They may attract sex workers. They may attract impoverished young women who get drawn into sex work.”

“In most countries of the world, we see that the epidemic is concentrated amongst groups that are on the margins of the law or beyond those margins: people like injecting drug users, like sex workers, like gay men in countries where homosexuality is illegal,” de Waal said. “They rarely have interactions with the authorities that are straightforward and open,” he said, making it difficult to access them, gain their confidence, and provide treatment and care.

“The most effective methods for controlling HIV and AIDS in armies and uniform services is when responsibility is vested not so much in the medical services, but in the command of those institutions,” said de Waal.

The report, “HIV/AIDS, Security and Conflict,” is a joint project of the council and Clingendael Institute for International Relations in The Hague.


CHINA:
"High HIV Prevalence Detected in 2006 and 2007 Among Men Who Have Sex with Men in China’s Largest Municipality: An Alarming Epidemic in Chongqing, China"
JAIDS , (09..2009) Vol. 52; No. 1: P. 79-85::Liangui Feng, MD, MS; and others
In many large cities in China, HIV prevalence data among men who have sex with men (MSM) show striking increases in recent years. To help target HIV prevention in this population, the current study surveyed Chongqing MSM at community venues and cruising areas in three districts in 2006-07 and sought to determine HIV prevalence and associated factors.

HIV prevalence increased from 10.4 percent in 2006 to 12.5 percent in 2007. Among participants recruited at bathhouses and saunas, HIV prevalence was 19.7 percent in 2006 and 26.5 percent in 2007, more than twice the prevalence among participants recruited from other venues. Among MSM over age 40, HIV prevalence was more than 20 percent, much higher than among younger MSM. Among married MSM, prevalence was 15.9 percent in 2006 and 20.9 percent in 2007, in comparison with non-married MSM rates of 7.6 percent in 2006 and 9.2 percent in 2007.

“Urgent attention for prevention services is required to address the overall high HIV prevalence among MSM in the city, with special focus on subgroups as older, married MSM, and those recruited from bathhouses and saunas,” concluded the study authors.



GLOBAL:
"Call to Eradicate Cervical Cancer"
Press Association (United Kingdom) , (09.24.2009)
An expert from the Cancer Research UK Center for Epidemiology in London believes that the combination of vaccination and continued screenings could wipe out cervical cancer in five decades. Professor Jack Cuzick raised this hope in his address to the recent joint 15th Congress of the European Cancer Organization and 34th Congress of the European Society for Medical Oncology in Berlin. Current vaccines offer protection against two cancer-causing strains of human papillomavirus (HPV) and have the potential to prevent three-quarters of cervical cancer cases, Cuzick said. It is hoped that new vaccines under development will be effective against nine HPV strains, and, “If they are successful, there should be no need to screen women that have been vaccinated at all,” he said. “That’s the long-term future: vaccination and no screening. After about 50 years, we could see cervical cancer disappearing.” He added, however, “Women vaccinated above the age of 16 will need to be regularly screened for the rest of their life, because the vaccine is not effective in women who have already been exposed to the virus. Even for girls vaccinated before this age with the current vaccine, there will be need to for some screening to protect from cancers caused by HPV types not in the vaccine, so screening is here to stay for the foreseeable future.”



VIETNAM:
"Vietnam Birth Trend May Fuel Sex Work, Trafficking: UN"
Reuters , (09.09.2009) John Ruwitch
The growing number of male babies born in Vietnam in recent years could lead to an increase in sex work and human trafficking, according to a report from the UN Population Fund. In 2000, 106.2 boys were born in Vietnam for every 100 girls; however, by 2008, the ratio had risen to 112.1 boys per 100 girls. If these trends continue, adult males could outnumber females by 10 percent or more by 2035, UNPF said. “Scarcity of women would increase pressure for them to marry at a younger age; there may be a rising demand for sex work, and trafficking networks may also expand in response to this imbalance,” the report said. Sons are strongly preferred over daughters in Vietnam, whose economy has long been based on agriculture. UNPF said parents’ increasing access to sex-selection technology “has allowed couples to pursue their desire for one or more sons.”

 

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