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Archive for December 17th, 2008


Posted by African Press International on December 17, 2008

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To the Chief Editor: The last possibility of truth being revealed has collapsed.

Posted by African Press International on December 17, 2008

I am very disappointed that you want to respect the feelings of obama
and would agree to keep secret the material that you have. Youcertainly will be in good company but while it’s understandable formedia in the US to do so because they want to curry favor andguarantee access, there is no reason for you to do this unless you tooare trying to climb to the top of the heap with a media empire andobama has promised you help.

It is the way he does business so come tothink of it that is entirely possible. It is very unlikely I will beonline at the time you meet to discuss with readers, but I hope youaddress this issue: has obama made promises to you regarding yourmedia plans for the future? If you really are a journalist then yourmission is to report the story to the public without regard for thefeelings on one man and his sponsors. The funny thing is all theattacks by mountain sage and the rest were completely unnecessary. Allthat was needed was a bit of flattery from the president elect and yougave in. I didn’t realize how much I was hoping you really would comethrough until I read your posting the other evening and realized thatthe last possibility of truth being revealed has collapsed.

What doesthe imam who brought the documents out of Kenya think about that? Aslong as that secret is kept he will remain in some danger though the
more time passes, the less impact it would have if revealed. Theywill simply make an exception to the constitution by act of congress.That imam, though, must have thought it was important to do what hedid. Is he disappointed with this turn of events? I hope you will postsomething about his reaction to your cooperation with obama’s requestto make the story go away.

By Teresa Kao

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“I studied in Bangui. I messed about [had sexual relations] a lot with boys too. At college there were information campaigns about AIDS and I started to wonder: ‘maybe I’ve already got HIV’?

Posted by African Press International on December 17, 2008

CENTRAL AFRICAN REPUBLIC: Mabelle Kpawilina, “AIDS in Sam Ouandja is worse than in Bangui”

Photo: UNICEF/CAR/2008/Pierre Holtz
“But there’s nothing here – there isn’t even an organisation [for people living with HIV”

SAM OUANDJA, 11 December 2008 (PlusNews) – Mabelle Kpawilina, 22, is the only HIV-positive patient known to be taking antiretroviral (ARV) medication in Sam Ouandja, a mining town in the northeast of the Central African Republic, where the prevalence rate is 7.4 percent. She told her story to IRIN/PlusNews.

“I was born in Bangui [the capital] and lived there throughout my childhood, firstly with my parents, then alone with my father, who was in the military, after my mother died in 2001.

“I studied in Bangui. I messed about [had sexual relations] a lot with boys too. At college there were information campaigns about AIDS and I started to wonder: ‘maybe I’ve already got HIV’?

“Thanks to the advice given in these campaigns, in 2006 I found the courage to go and get tested. I was positive. I was really sad and I thought about it all the time.

“I was in my second [year] when my dad died [in 2007]. I was all alone in Bangui, with no family and no support, and I couldn’t continue with my studies. The only family I had left was my grandmother in Sam Ouandja.

“I’d heard that the IMC [the International Medical Corps, the organisation that runs the hospital] was giving free care there [in Sam Ouandja], so in January 2008 I decided to go and join my grandmother.

“When I arrived, I went to the hospital and explained my situation. There are lots of HIV cases in the region, but there is no [HIV/AIDS] service in Sam Ouandja – no testing and no treatment – but IMC helped me get medication from Bangui. Thanks to them, I have been taking ARVs here for a few months.

“In Bangui there are lots of organisations working with AIDS. There are awareness campaigns everywhere: in colleges, on the road, in bars, at the market. But there’s nothing here – there isn’t even an organisation [for people living with HIV].

“At least if there were an organisation for young people, we could talk about AIDS. I’ve tried to start talking about it in conversation with people around me, but some say that AIDS doesn’t exist.

“But people are dying, and when they get sick, people say that they were poisoned by their neighbours. I want to raise awareness; I can talk to boys just as easily as girls.

“In Bangui people are starting to change their behaviour, but in Sam Ouandja AIDS is worse than in Bangui – here the problem is money [from the diamond mines].

“People want lots of money, and those that have it, pay to get it [unprotected sexual relations]. There are more men than women because of the mines; there are also armed men [military and ex-rebels] who look for girls in the town – it’s a risk.

“For the moment, I’m selling peanuts near the market. [The head of the town’s Health Management Committee] is supporting me; he helped me to get this small business going. Sometimes I also help my grandfather in the fields.

“But I’m not doing anything else – I’m not even doing any awareness raising. I’d prefer to go back to Bangui and start my studies again. [ARVs] can help me for a few years, but there isn’t anything here. I cannot stay.

“I haven’t told my grandmother that I’m HIV-positive yet. She is old, and if people in the neighbourhood find out she will be humiliated. As I’ve got high blood pressure, I’ve told that is why I take medication.

“But I want to start talking about it and hold meetings to speak to people about HIV, which is why I am talking openly about it today.”


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HIV infection on the rise in Uganda

Posted by African Press International on December 17, 2008

UGANDA: Rising infections demand new prevention approach

Photo: PSI
A message from a 2007 campaign against cross-generational sex

KAMPALA, 15 December 2008 (PlusNews) – Nearly two decades after Uganda managed, with meagre resources, to drastically reduce its HIV prevalence, the rate of new infections is rising again, despite significant amounts being spent on prevention.

Prevalence of over 20 percent in the early 1990s declined to about six percent in 2000, and since then has gone down slightly to the current UNAIDS estimate of 5.4 percent.

An update on the global epidemic, published by UNAIDS in July 2008, pointed to signs in Uganda of “a possible resurgence in sexual risk-taking that could cause the epidemic to grow again.”

First Lady Janet Museveni, who has been active in Uganda’s AIDS efforts, commented that the country’s previous success in reducing its HIV rate was achieved through “concerted and focused effort from all sections of society … the ‘do or die’ push of a desperate people”.

She blamed the current situation of “regression amidst plenty” partly on poorly conceived prevention campaigns. Billboards discouraging “cross-generational” sex, for example, could be read as telling young people that sex was safe as long as it was with someone their own age.

“The programme activities being funded may not be helping to prevent AIDS but may actually be fuelling the rate of infection,” said Museveni.

According to the most recent data, HIV incidence [new infection] rates are highest among couples in long-term relationships when one or both partners also have other sexual relationships at the same time.

Some have blamed the recent resurgence in HIV infections on complacency, arguing that since life-prolonging antiretroviral (ARV) drugs became freely available, Ugandans think of HIV/AIDS as just another chronic but manageable disease.

''The programme activities being funded may not be helping to prevent AIDS but may actually be fuelling the rate of infection''

Dr Chris Baryomunsi, vice-chairperson of the parliamentary committee on HIV/AIDS, said business was booming at lodges where couples conducted illicit affairs; such establishments used to stock their rooms with condoms, but no longer. “People are relaxed, [they’re] not taking precautions,” he said.

The considerable resources available for the fight against HIV/AIDS may have contributed to the complacency, said Thomas Munghono, an HIV consultant at the HIV/AIDS Alliance in Uganda, a global partnership of nationally based organisations working to support community action on AIDS in developing countries.

“The donors believe in us because we did right the first time. The question is – are we still doing it right?” he said.

Baryomunsi said too many HIV/AIDS programmes were continuing as usual, despite mounting evidence that they were ineffective, while others appeared to have run out of steam.

Uganda recently launched a five-year strategic plan with an estimated price tag of US$2 billion, which aims to decrease the rate of new infections by 40 percent, but Baryomunsi said prevention messages would have to take into account new research about what was driving the country’s evolving epidemic.

“Previously, the messages were for young people, but the risk is much higher among married people now. It is important that we review our work,” he told IRIN/PlusNews.

There is general consensus that reinvigorating HIV prevention in Uganda will mean tailoring programmes to address behaviour driving the epidemic, such as multiple partnerships, lack of HIV testing, and unprotected sex between discordant partners (where one is HIV-positive and the other negative).

Recent studies have also identified certain population groups with HIV prevalence rates way above that of the general population. In fishing communities around Lake Victoria, for example, up to six out of 10 people are HIV-positive, according to a report released earlier in 2008 by the Lake Victoria Fisheries Organisation.

The high local infection rate is fuelled by fishermen with disposable income to spend on alcohol and sex workers. Many of the sites where fishermen land their catches also lack access to HIV/AIDS information and services.

In its five-year national strategic plan, the Uganda AIDS Commission said it planned to reduce new infections by continuing to use the ABC (Abstain from Sex, Be faithful and use a Condom) approach but would also implement strategies to prevent infections in key high-risk groups.


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Senegal: Senegal’s Diop said the government had responded to bottlenecks by integrating ARV distribution into its national, and later regional, distribution systems for essential medication.

Posted by African Press International on December 17, 2008

WEST AFRICA: Unplugging bottlenecks in ARV distribution

Photo: Casey Johnson/IRIN
Supply chain hiccups stop ARVs from reaching those who need them

DAKAR, 10 December 2008 (PlusNews) – In West and Central Africa, large amounts of money are spent on buying antiretroviral (ARV) drugs but weak distribution systems mean many HIV-positive patients never get them, said speakers at the 15th International Conference on AIDS and STIs in Africa (ICASA) in Dakar, Senegal, last week.

Approximately half of all international funding invested in the fight against AIDS is used to buy “inputs”, including ARVs, HIV tests, and medication for opportunistic infections.

This is the figure noted in a study carried out jointly by the UN children’s fund, UNICEF, the World Health Organisation, and the French organisation, ESTHER (Ensemble pour une solidarit thrapeutique en rseau/Network for Therapeutic Solidarity in Hospitals), which works to improve access to quality treatment for people living with HIV and AIDS in developing countries.

Presenting the study findings at ICASA, Eric Mercier, UNICEF’s regional HIV/AIDS advisor, said part of the reason these items did not always make it to patients was that national systems for purchasing and managing stocks were unable to keep up with constantly increasing demand: between 2001 and 2005 the number of patients on ARVs in sub-Saharan Africa increased sixteen-fold.

Karim Diop, from the STI/HIV division of the Senegalese Ministry of Health, noted that aside from the vital medical importance of ARVs, they also had “a strong emotional significance” to patients, and should be available at all times.

Numerous actors

Mercier said the problems in supply-chain and distribution systems in West and Central Africa were similar in many countries, but “what varies is the intensity of the issues.”

One of the major glitches was a lack of coordination between people at various stages of the chain, some of whom were working outside a country’s regulatory framework. The Democratic Republic of Congo’s Minister of Health, Mwami Auguste Mopipi, said this could destabilise distribution.

“We have various actors showing a great keenness to help, but this also poses problems for us, as we do not manage their orders or what they are bringing into the country,” he said. “We have a set distribution chain, we try to coordinate and standardise, but the problem is we don’t know if partners are ready to agree to State control.”

Poorly identified needs

Another common obstacle was the lack of reliable data on the required quantity of ARVs and other AIDS-related medicines, which meant stocks could run out, or expire and have to be destroyed. A lack of flexibility in supply procedures often meant emergency orders could not be placed, so unexpected shortages took a long time to be resolved.

Caroline Damour, an ESTHER pharmacist who worked on the study, said it was hard for countries to help each other in emergency situations, partly because it would arouse suspicion amongst donors, but also because no forms of credit had been set up for this purpose.

Although the responsibility of partners was important, this should not overshadow the country’s responsibility. “The country needs to be aware if it is facing a break in supplies, because it is often very hard to make [emergency deliveries]; sometimes it takes three weeks for the problem to be flagged, and then it takes more time to go through the [formalities],” she said.

Various solutions

The study emphasised that these issues can and should be resolved to increase access to HIV/AIDS treatment. UNICEF’s Mercier pointed out that “Managing ARVs is a complex issue, and the problem of breaks in supplies was anticipated. However, it is possible to take measures to prevent this.”

Senegal’s Diop said the government had responded to bottlenecks by integrating ARV distribution into its national, and later regional, distribution systems for essential medication. This standardisation of stock management had greatly reduced breaks in supplies.

There were still hurdles to overcome, Diop acknowledged, such as how information was communicated, and providing more training for managers and pharmacists, but the system was working.

Nigeria, which faces considerable geographical and demographic obstacles, decided to outsource various parts of its distribution chain to partners – public, private, national and international – selected for their skills in the areas of product selection, supplying, stocking and distribution.

Not everyone has approved, with some arguing that existing national systems should be strengthened, rather than implementing parallel systems. But Collins Ndukwe, supply and logistics officer at the Nigerian National Agency to Combat AIDS (NACA), said ARV distribution to 120 treatment centres around the country had improved.

“We lost our grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria [in 2006], because we couldn’t get the medication to the right place at the right time. We had to make sure this didn’t happen again and now with the system we have in place, we have [a very good reputation] with the Global Fund,” he said.

Mercier said the challenges of distributing ARVs had highlighted similar problems with other medicines, and that the solutions could be applied to entire systems. “Thanks to [funding by] the Global Fund and others, HIV brings about an opportunity to resolve not just HIV issues, but other systemic issues.”


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The Tamil’s want to respect the convention: Stopping using child soldiers

Posted by African Press International on December 17, 2008

SRI LANKA: Breakaway Tamil Tiger faction to stop child recruitment

Photo: Government of Sri Lanka
TMVP leader Vinyagamurthi Muralitharan (right) with Sri Lankan President Mahinda Rajapakse

COLOMBO, 16 December 2008 (IRIN) – A breakaway faction of the Tamil Tigers is to stop underage recruitments completely, the group’s leader told IRIN.

Vinayagamurthi Muralitharan, leader of the Tamil Makkal Viduthalai Pulikal (TMVP), which broke away from the Tamil Tigers in 2004, said it signed the action plan with the government and UN Children’s Fund (UNICEF) on 1 December, with a three-month deadline for ensuring that all underage recruits in the TMVP are demobilised.

“I do not want children to carry arms and get into the armed culture. We, the TMVP, signed an agreement with UNICEF to show our commitment to protecting the rights of children,” Muralitharan, better known as Karuna, told IRIN. “My wish is to provide children with the basic facilities for their education and also for their development in life.”

Muralitharan, who joined the Liberation Tigers of Tamil Eelam (LTTE) in 1983 as a 17-year-old, broke away in April 2004 and formed the TMVP. He was appointed a member of parliament with the ruling People’s Freedom Alliance on 7 October 2008.

“The Action Plan must now be translated into concrete actions [by the TMVP] on the ground,” Philippe Duamelle, UNICEF’s representative in Sri Lanka, said.

UNICEF said the three-month plan set out a clear timeframe: by 1 January 2009, the TMVP must release all children from its ranks; by 1 February, the TMVP is to spell out its stance on underage recruitment and issue directives to members; and by 1 March it should have trained key TMVP personnel on recruitment and child protection.

Photo: Amantha Perera/IRIN
A young TMVP supporter in front of the party office in Batticaloa

Access to camps

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UNICEF’s spokesman James Elder told IRIN the TMVP would also give UNICEF and the Sri Lankan government access to its camps and offices to verify the status of children associated with the party. UNICEF had complained that efforts to gain access to TMVP camps had been unsuccessful, despite pledges from high-ranked officials.

“The Action Plan states that the TMVP will carry out checks in all their camps and offices to identify the number and whereabouts of all children in their ranks,” Elder said. “They will provide the government and UNICEF with a list of all children, their locations and areas of origin. UNICEF will then work with the government to make contact with the children’s parents and begin the preparations for [their] return home.”

Once home, their status will be assessed by Save the Children and the Probation and National Child Protection Authority, the government body overseeing the protection of children. The two agencies will also assist in the rehabilitation and reintegration of the children, Elder said.

“UNICEF’s preferred strategy is that all children, wherever possible, return to their families and communities. However, there will be cases where some children upon release need to go into alternative care,” said Elder. “Ideally these children should be accommodated in areas where they can maintain their links with their community, culture and family. But if there are security threats to the children, it would be in their best interests to move outside their district until it is safe for them to return.”

According to UNICEF statistics, there were 133 outstanding cases of underage recruitment by the TMVP as of 31 October. Of that number, 62 were younger than 18, while 71, who had been recruited while under 18, had passed that age.

Muralitharan told IRIN his organisation was not recruiting children into armed combat but that most of the underage members had sought protection.

When it entered elected politics in the Batticaloa District in eastern Sri Lanka, its home base, by contesting two regional elections in March and May this year, the TMVP also released more underage recruits from its ranks. In April, it released 39 children just before the elections for the Eastern Provincial Council.


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