IRIN PlusNews Weekly Issue 190, 16 July 2004
Saturday 21 August 2004
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IRIN PlusNews Weekly Issue 190, 16 July 2004


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


NEWS:

AFRICA: Keep orphans in school, UN envoy urges
AFRICA: Spending bottlenecks hamper anti-AIDS initiatives
SWAZILAND: Bishops find lack of governance and human rights
SOUTHERN AFRICA: Households burdened by increasing number of AIDS orphans
AFRICA: Simplified, high-quality public health initiatives needed
AFRICA: Focus on funding at global AIDS conference
SOUTH AFRICA: Medicines Control Council phases out Nevirapine monotherapy
UGANDA: UN Agency calls for better access to services for war-affected children
AFRICA: Global workforce could be devastated by AIDS
AFRICA: WHO issues guidelines on Nevirapine
AFRICA: New strategies needed for HIV prevention in youth
AFRICA: MSF calls for greater focus on paediatric ARVs

LINKS:

1. CCIH Recommended Resources for HIV/AIDS Work
2. MSF Briefing Document for the XV International AIDS Conference
3. Nelson Mandela 15th International AIDS Conference Video Webcast

CONFERENCES/ EVENTS/ RESEARCH/ RESOURCES:

JOB OPPORTUNITIES:



AFRICA: Keep orphans in school, UN Envoy urges

In communities grappling with the devastating effects of AIDS, women are quietly bearing the brunt, absorbing orphans into their existing families, caring for the ill and running their households.

"It really amounts to conscripted labour, but that's a truth that the world has never been willing to admit," UN Special Envoy for HIV/AIDS in Africa Stephen Lewis told a press conference at the International AIDS Conference in Bangkok.

This coping mechanism will soon be incentivised in the tiny Kingdom of Swaziland, where by 2010, an estimated 10 to 15 percent of the total population will be children orphaned, mostly by AIDS.

"To face the accelerating catastrophe, Swaziland has decided to mobilise ten thousand women to take on the task of helping to care for thousands upon thousands of orphans, over and above all the other work these women already do in their own communities: looking after their own children, absorbing children who are orphans as part of the extended family, looking after the sick and the dying, while running their own households," said Lewis.

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AFRICA: Spending bottlenecks hamper anti-AIDS initiatives

The limited capacity of African countries to implement large-scale HIV/AIDS programmes should not be an excuse for donors to put the brakes on funding, activists said on Monday at the 15th International AIDS Conference in Bangkok, Thailand.

Total global spending on AIDS increased from US $1.2 billion in 2000 to an estimated $6 billion this year, according to UNAIDS. However, to finance a "comprehensive response to the epidemic", $12 billion would be needed in 2005 and $20 billion in 2007.

There has been recognition that even when money is available, "in many heavily affected countries it is clear there are serious bottlenecks to spending it effectively," UNAIDS said in its 2004 report on the pandemic, released last week.

These blockages include a lack of human and institutional capacity, "shortfalls in political commitment, slow transfer of funds from national to local and community levels, inadequate accounting and auditing mechanisms, and inconsistent bureaucratic funding processes of the global donor community", UNAIDS said.

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SWAZILAND: Bishops find lack of governance and human rights

A high-powered delegation of Anglican bishops from five nations completed a two-day fact-finding tour of Swaziland at the weekend, examining issues such as constitutional reform and the high HIV/AIDS rate.

The Archbishop of the Anglican Church in Southern Africa, Njongonkulu Ndungane, led a delegation that included Bishop David Beetge of the Highveld (South Africa), John Chane, Episcopal Bishop of Washington DC, Brian Smith, Bishop of Edinburgh in Scotland and representative of the Archbishop of Canterbury, Rev. John Peterson, Secretary General of the Worldwide Anglican Communion, and the Rev. James Rosenthal of the US.

Commenting on his country's controversial palace-driven constitutional reform process, Swaziland's Anglican Bishop Meshack Mabuza said: "It is not the content of the constitution that bothers us, it is the process of the constitution - it will only be legitimate if the people have a hand in the process."

King Mswati III has forbidden political opposition and human rights groups from making submissions to the Constitution Drafting Committee headed by his brother, Prince David Dlamini.

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SOUTHERN AFRICA: Households burdened by increasing number of AIDS orphans

By 2010 more than one in five children in Botswana, Lesotho, Swaziland and Zimbabwe will be orphaned by AIDS, a joint UN and US report warned on Tuesday.

"Children on the Brink 2004" is the fourth edition of this biennial report, based on surveys conducted by the UN Children's Fund (UNICEF), UNAIDS and the US Agency for International Development (USAID).

Alarmingly, the studies found that 20 percent of households with children in Southern Africa were taking care of one or more AIDS orphans.

About 78 percent of Zimbabwe's orphans and 77 percent of Botswana's had lost their parents to AIDS. Botswana, with 20 percent of its children orphaned, has the highest rate of orphaning in sub-Saharan Africa, followed closely by Zimbabwe with 19 percent.

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AFRICA: Simplified, high-quality public health initiatives needed

Innovative community-based public health initiatives are needed to enable the rapid rollout of HIV/AIDS treatment in Africa, the World Health Organisation (WHO) director of HIV/AIDS, Jim Yong Kim, told PlusNews on Tuesday.

To reach WHO's '3 by 5' goal (three million people on treatment by 2005) "simplified, high-quality public health initiatives are needed", Kim said at the 15th International AIDS Conference in Bangkok, Thailand. "There needs to be an attitude of learning by doing."

The 3 by 5 initiative, launched by WHO in 2003, was a strategy to "energise" what has been a painfully slow rollout of antiretroviral (ARV) treatment, said Kim. Over 4 million people are in need of life-prolonging drugs in Africa, but less than 5 percent are receiving them, in a continent further handicapped by grinding poverty, weak public health systems and, in some cases, limited political commitment.

"Treatment scale-up has been theoretical - people have been paying lip service to it, but are not into it. The focus of efforts has been funding and price cuts, but that's all press releases [rather than action]," said Kim. "We are trying to change the nature of the discourse."

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AFRICA: Focus on funding at global AIDS conference

United States government officials in general, and Ambassador Randal Tobias in particular, have acted as a magnet for placard-waving activists this week at the 15th International AIDS Conference in Bangkok, Thailand.

Tobias heads the US administration's global AIDS policy, whose centrepiece is the US $15 billion President's Emergency Plan for AIDS Relief (PEPFAR), which aims to treat two million HIV-positive people and prevent seven million new infections over a five-year period, mainly in the 15 worst-affected countries. The US government allocated $2.4 billion in 2004 towards those laudable goals.

But critics argue that the bilateral initiative diverts urgently needed financing away from the Global Fund to Fight AIDS Tuberculosis and Malaria, and accuse President George Bush of acting in the interests of the pharmaceutical industry.

PEPFAR has also been condemned for allegedly pushing an ideological message of abstinence - when that is not an option for many women - and for spending too much on US service providers at the expense of local expertise and capacity.

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SOUTH AFRICA: Medicines Control Council phases out Nevirapine monotherapy

South African activists are up in arms after an announcement by the Medicines Control Council (MCC) that the only drug used to prevent transmission of HIV from mother to child be phased out or used only in conjunction with other drugs.

Nevirapine has been used in the South African public health sector since 2001 when the MCC approved the drug as a monotherapy for prevention of mother-to-child transmission, conditional upon monitoring resistance and its impact on efficacy.

Studies have shown that a dose of Nevirapine given to infected pregnant women during labour, followed by a dose given to the newborn baby, can reduce transmission of HIV by up to 50 percent.

According to the MCC, Nevirapine is increasingly ineffective on its own, but is acceptable if used in combination with other antiretroviral drugs like Zidovudine (AZT).

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UGANDA: UN Agency calls for better access to services for war-affected children

The United Nations Children's Fund (UNICEF) on Wednesday called for universal access to basic services for children affected by HIV/AIDS in war-torn northern and eastern Uganda. It said this would help them exercise their right to a more caring environment.

"The recent move to expand the access to anti-retroviral drugs [ARVs] in Uganda is encouraging, but we still need a stronger and forward-looking response, especially in the war-affected regions in northern Uganda where, because of the displacement, infrastructure and health facilities are inadequate," Chulho Hyun, UNICEF's communications officer in the capital, Kampala, told IRIN.

Chulho Hyun was speaking in the context of a UNICEF statement suggesting that in conflict-affected districts, children living with HIV/AIDS were still excluded from programmes designed to mitigate the effects of the AIDS pandemic. The statement called for more far-reaching assistance to ensure that children "realise their rights to access basic services and to live in a caring environment".

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AFRICA: Global workforce could be devastated by AIDS

HIV/AIDS is holding back economic growth and putting a massive strain on workers in some of the world's poorest nations, the International Labour Organisation (ILO) has said.

The first global analysis of the impact of HIV/AIDS on the workplace by the UN's labour agency estimates the disease could claim the lives of some 28 million working people by the end of 2005.

By 2015 the number of AIDS-related deaths will have reached 74 million world wide, and sub-Saharan Africa will have lost 12 percent of its workforce.

"HIV/AIDS is not only a human crisis, it is a threat to sustainable global social and economic development," ILO director-general Juan Somavia said in a statement.

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AFRICA: WHO issues guidelines on Nevirapine

Amid concerns that South Africa would phase out an anti-AIDS drug preventing the transmission of HIV from seropositive mothers to their children, the World Health Organisation (WHO) has released new guidelines on the use of antiretroviral (ARV) treatment for pregnant women.

The UN health agency on Wednesday said the guidelines, 'Antiretroviral Drugs for Treating Pregnant Women and Preventing HIV Infection in Infants', "took into account the most recent information on the safety and effectiveness of different drug regimens, as well as concerns over resistance to some of the drugs, including Nevirapine".

In a controversial move South Africa's Medicines Control Council had announced that the use of Nevirapine as a monotherapy would be phased out and the drug would be used only in combination, as HIV-positive mothers could be developing a resistance to the drug.

But WHO said concerns about resistance needed to be balanced with the "simplicity and practicality" of delivering single-dose Nevirapine, compared with other regimens. Studies have shown that a dose of Nevirapine given to infected pregnant women during labour, followed by a dose given to the newborn baby, can reduce transmission of HIV by up to 50 percent.

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AFRICA: New strategies needed for HIV prevention in youth

Prevention of HIV infection among the youth is seen as key to the fight against AIDS. But, analysts say, there is no clear consensus on the content of the message, how it should be transmitted, and the profile of the audience it intends to reach.

"Strategies that are developed to address youth as a homogeneous group are inefficient. They do not take into account differences in gender, culture, norms, values and sexuality," youth leader Raoul Fransen said at the International AIDS Conference in Thailand this week. "The AIDS vulnerability of an impoverished young woman living in a rural village in Africa is different to the AIDS vulnerability of an emerging gay youth in the favelas of Rio."

Sophie Dilmitis of Zimbabwe's Choose Life Trust said orthodox AIDS messages portrayed HIV as a consequence of promiscuity. But she didn't feel she was "sleeping around", and therefore not at risk when she contracted HIV. "Sex education is currently not youth-friendly, or realistic, or addressing our needs," she told the conference.

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AFRICA: MSF calls for greater focus on paediatric ARVs

Medecins Sans Frontieres (MSF) called on the international pharmaceutical industry this week to develop AIDS drugs suitable for children.

"Children are not just small adults," Dr David Wilson, MSF coordinator in Thailand, told a press conference at the 15th International AIDS Conference in Bangkok. "There are specific issues in terms of treatment."

Because preventing mother-to-child transmission of HIV had been successful in Western countries, fewer children were being born with the virus. "The resulting lack of a profitable market means that paediatric formulations are in short supply, despite the growing need for them in developing countries," MSF said in a press statement.

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LINKS:

1. CCIH Recommended Resources for HIV/AIDS Work

A comprehensive resource guide to videos and books that would be of huge value to anyone looking for ideas on how to tackle the HIV/AIDS pandemic.

The table listing the resources makes it quick and easy to understand the merit of each tool. Search by keywords or country and region.

Use the links to get to the source's website or simply email.

2. MSF Briefing Document for the XV International AIDS Conference

"MSF AIDS Treatment Experience: Rapid Expansion, Emerging Challenges" is available online and provides insights into their wealth of experience in expanding access.

3. Nelson Mandela 15th International AIDS Conference Video Webcast

Former South African President Nelson Mandela officially retired from public life on June 1 to complete his autobiography, but decided to make the trip to Bangkok to address the delegates at the 15th International AIDS Conference.

His address follows the recent screening of "46664: The Message," a film based on the concert held in Cape Town in November 2003 to raise HIV/AIDS awareness and funds.

A video webcast of Mandela's address and other coverage of the 15th International AIDS Conference will be available online at: www.kaisernetwork.org

[ENDS]


Recent AFRICA Reports
IRIN PlusNews Weekly Issue 195, 20 August 2004, 20/Aug/04
HIV-positive women speak out, 17/Aug/04
Sexual Offences bill raises many concerns, 13/Aug/04
IRIN PlusNews Weekly Issue 194, 13 August 2004, 13/Aug/04
Removal of generic drugs from WHO list a wake-up call, 6/Aug/04
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PlusNews is produced under the banner of RHAIN, the Southern African Regional HIV/AIDS Information Network. RHAIN's members currently include:

  • UNAIDS
  • IRIN
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