Switzerland: The fight against malaria, HIV/AIDS and tuberculosis

Switzerland steps up its commitment to the fight against malaria, HIV/AIDS and tuberculosis

 

BERN, Switzerland, December 13, 2013/African Press Organization (APO)/ –The Federal Council has approved a contribution of CHF 60 million for the 2014-2016 period for the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM). Switzerland was one of the founders of the Geneva-based fund in 2002 and has been one of its key partners since the beginning. Malaria, HIV/AIDS and tuberculosis remain the leading causes of death in sub-Saharan Africa. These three diseases are among the most important factors hampering development.

 

Three diseases – malaria, HIV/AIDS and tuberculosis – are among the most frequent causes of death worldwide, and especially in Africa. Malaria remains the leading parasitic disease worldwide. In 99 countries, approximately 219 million new cases are registered every year. About half of the world’s population lives in areas affected by malaria. The WHO estimates that in countries in Africa with endemic malaria the disease lowers economic growth by 1.3 percentage points per year.

 

Some 2.5 million people are still becoming newly infected with HIV every year and more than 1.7 million people die of AIDS-related illnesses every year worldwide. In the case of tuberculosis, the estimated number of annual deaths is 1.4 million. HIV/AIDS and tuberculosis frequently occur in combination, making them very difficult to treat in developing countries.

 

Nevertheless, considerable progress has been made in the fight against these three diseases over the past ten years. For example, new HIV infections declined by 33% worldwide, and by more than 50% among children in medium-income countries. Some 8 million people in Africa are currently receiving antiretroviral therapy – a twenty-fold increase from 2003. Significant progress has also been made in the fight against tuberculosis: the TB mortality rate has fallen by approximately 41% since 1990. The UN’s millennium development goal of stopping the spread of HIV/AIDS, malaria and other major diseases by 2015 and gradually reversing their incidence is thus within reach.

 

The fight against malaria, HIV/AIDS and tuberculosis is a high priority for international development cooperation as well as for Switzerland. The significant progress achieved so far can no doubt be attributed amongst others to the efforts of GFATM, which is the biggest backer in the fight against these three diseases.

 

SOURCE

Switzerland – Ministry of Foreign Affairs

 

A high-level political meeting on increased domestic funding for AIDS, tuberculosis and malaria, in Addis Ababa from November 11-12, 2013

 

ADDIS ABABA, Ethiopia, November 8, 2013/African Press Organization (APO)/ – The African Union Commission (AUC) in collaboration with the Global Fund to Fight AIDS, TB and Malaria and the African Development Bank (AfDB) will convene a high-level political meeting on increased domestic funding for AIDS, tuberculosis and malaria, in Addis Ababa from November 11-12, 2013.

The meeting will advocate for increased innovative domestic resource mobilization following renewed commitments in Abuja by Heads of State and Government this year in July and pledges to support the Global Fund’s fourth replenishment.

The response to AIDS, tuberculosis and malaria over the last three decades has mobilized unprecedented resources, commitment and action at the national, regional and global levels. However the results achieved and the progress made over the years in responding to these epidemics is not sustainable. African countries have relied heavily on external financing, leaving them vulnerable to the unpredictability of donor funds and often considerably weakening national ownership. Sub-Saharan Africa’s dependency on international funding has been especially stark, with over 60 per cent of investment coming from external sources. More innovative domestic resource mobilization is vital in effectively implementing the African Union Roadmap for Shared Responsibility and Global Solidarity on AIDS, TB and malaria (2012-2015) and related continental commitments.

The commitment of implementing countries to the fight against the diseases in the form of investing increasing amounts of domestic resources in their national health and disease programs is crucial for demonstrating country ownership and for the long-term sustainability of programs. It also demonstrates accountability and sends a strong message to donors that implementing countries are taking action to address their countries health and development challenges.

Pledges from African Union Member States can provide an opportunity to help secure a fully funded Global Fund, which in turn is a guarantee for implementing countries to receive sufficient and predictable funding in order to reach the Millennium Development Goals and win the fight against the three pandemics.

These commitments are all the more crucial as we stand at a key historic moment: it is now within our grasp to turn the three epidemics into low-level epidemics, virtually control them, and remove them as threats to public health if we intensify our efforts. The global community has secured the science, acquired the requisite experience and understands the high impact interventions that will sustain the results.

The African Union spearheads Africa’s development and integration in close collaboration with African Union Member States, the Regional Economic Communities and African citizens. AU Vision: An integrated, prosperous and peaceful Africa, driven by its own citizens and representing a dynamic force in global arena. 

The Global Fund is a unique global public/private partnership dedicated to attracting and disbursing additional resources to prevent and treat AIDS, tuberculosis and malaria. This partnership between governments, civil society, the private sector and affected communities represents a new approach to international health financing. The Global Fund works in close collaboration with other bilateral and multilateral organisations to supplement existing efforts in dealing with the three diseases.

The African Development Bank (AfDB) spurs sustainable economic development and social progress in its 54 regional member countries (RMCs), thus contributing to poverty reduction through mobilizing and allocating resources for investment in RMCs; and providing policy advice and technical assistance to support development efforts. The AfDB’s Human Development Department supports RMCs in areas of Education, Science, Technology and Innovation, Health, Social Protection and Youth Employment and Entrepreneurship. The AfDB recently approved a new Strategy for 2013-2022.

SOURCE

African Development Bank (AfDB)

 

NGO denounces the suspension of antiretroviral (ARV) drug treatments

BRAZZAVILLE,  – A human rights NGO based in the Congolese capital Brazzzaville has denounced the suspension of antiretroviral (ARV) drug treatments for thousan ds of HIV/AIDS patients in Congo.

“As we speak, Congo is totally lacking ARVs. We’ve been to enquire at the Outpatient Treatment Centre [which supports patients]: It has no Atripla, Efavirenz or Nevirapine,” Pan African Association Thomas Sankara (APTS) chairman Germain Cephas Ewangui told IRIN.

“The situation could cause a rise in the number of deaths, the development of resistance [to ARVs administered later] and the recurrence and development of opportunistic infections. The situation is serious: we are facing very serious violations of human rights and particularly the right to life,” said Ewangui.

“It is indeed a form of irresponsibility that we equate to an organized crime, requiring not only administrative sanctions, but also… prosecution because the situation is serious, intolerable and unacceptable,” Ewangui added.

According to the Ministry of Health and Population, some 16,310 patients in Congo were receiving ARVs, while 38,500 are waiting to get them.

The ministry acknowledged that ARV treatment had stopped. “There was a malfunction. There was a break in the supply and distribution chain, but the situation is being corrected,” said Executive Secretary of the National Council for the Fight against AIDS (CNLS) Marie-Francke Puruehnce.

“The situation should not lead to declarations and denunciations,” said Puruehnce.

A consultant from the Ministry of Health, who requested anonymity, told IRIN: “Such failures sometimes happen once or twice a year. But they do not last long.”

Officially Congo spends 2-5 billion CFA francs (US$4-10 million) a year on providing free treatment to HIV/AIDS patients.

According to the ministry, HIV prevalence fell from 4.2 percent in 2003 to 3.2 percent in 2011. The prevalence of pregnant women with HIV/AIDS fell from 3.4 percent in 2009 to 2.8 percent in 2012.

Congo, where per capita income in 2011 was estimated at $4,600, committed in 2001 to allocate 15 percent of the state budget to health, but it is currently earmarking only about 9 percent, according to the World Bank.

Interruption of ARV therapy risks patients developing resistance to the drugs and can hasten progress to AIDS and death.

lmm/cb  source http://www.irinnews.org

Kenya’s First Lady calls for unity to combat the AIDS scourge during her visit to China

She said co-operation in fighting AIDS and other infectious diseases will further reduce the HIV/AIDS pain and suffering, particularly of children infected or orphaned by AIDS.

She spoke at Beijing Ditan Hospital Capital Medical University during a tour of the premier medical facility.

“The world has a lot to learn from Beijing Ditan Hospital which combines use of Traditional Chinese Medicine and Western Medicine in combating the devastation caused by AIDS and other infectious diseases,” she said.

The Hospital’s President, Zhang Yong Li, said Traditional Chinese Medicine was affordable and effective in the management and treatment of AIDS and other infectious diseases compared to western medicine.

He added that at Ditan, they had managed to reduce the rate of mother-to-child infections from 30% to 2% among the 2000 patients that have been diagnosed with AIDS since 1989.

Earlier, First Lady Margaret Kenyatta urged Kenya and China to take concrete steps to protect women and children’s interests.

She called on organizations championing the rights of women and children in China and Kenya to start exchange programmes to enable women to gain from diverse experiences.

She was speaking at the iconic Great Hall of the People in Beijing, when she paid a courtesy call on the President of All-China Women’s Federation (ACWF), Mrs. Shen Yue Yue, a leading figure in the Chinese political establishment.

“Women leaders must focus on issues that affect their members at the grassroots so that they can help them build a prosperous society,” the First Lady said.

The First Lady is accompanying President Kenyatta who is on his first State visit to China.

End

source.Statehousewebsite

HIV still on the – not yet inside the comfort zone

Photo: Brendan Brady/IRIN

Sound science, but no thank you

KATHMANDU,  – Despite years of scientific advances in HIV treatment and prevention, more than two million people are newly diagnosed with HIV annually, demonstrating how community-driven approaches to prevention are still needed to curb the epidemic, experts say.

For years evidence has mounted that anti-retroviral therapy (ART) – virus-suppressing drug combinations that are the primary treatment for HIV – can also be used effectively in prevention.

However due to the complications associated with ART procurement, distribution, uptake, adherence, and potential behaviour change in patients (some studies have linked increased risk-taking behaviours in HIV patients post-treatment), a fresh local approach to implementing ART-based prevention programmes is needed, new research argues.

“Research in HIV prevention needs to get out beyond its comfort zone and meet with the people who have very different ideas about what HIV means,” Jim Pickett, the project director for Mapping Pathways, an international research and advocacy project, told IRIN.

Despite international research and policy developments that have boosted awareness and popularity of
what is known as “treatment as prevention”, local-level implementation of it remains murky and piecemeal.

“We talk a lot about the results of science and figuring out how to `make it make sense’ in local contexts. But science is itself a process that should involve communities from the very beginning,” Pickett said.

From efficacy to effectiveness

According to Mapping Pathways, the ideal approach to implementing treatment as prevention should consider not only the clinical goal of efficacy (works in a lab), but also effectiveness (how to apply the solution in a community).

“I know that if you get anti-retroviral drugs into someone’s blood, they suppress the virus. We have amazing proof of that – it’s a major scientific breakthrough in the history of humankind,” said Linda-Gail Bekker, chief operating officer of the Desmond Tutu HIV Foundation, based in South Africa.

“But now we have to put this together so it works, which means engaging with a wide range of human beings who live very different lives than those of us who run these programmes might imagine,” she said.

Effectiveness requires behaviour change and, therefore, varies across cultures, governments, and communities based on “the firms that produce the drugs, the healthcare clinics that deliver the drugs, the community centres that provide education, and the partnerships developed,” according to Mapping Pathways.

“Human beings will behave like human beings. What does that mean? Well, social sciences have been trying to figure that out for centuries and don’t have one single theory, so why should our HIV programmes?” asked Bekker.

“The notion that in HIV programmes `one size fits all’ has backfired on us and it has been a humbling moment for those of us who work in this field.”

“Local” science

According to Molly Morgan Jones, a researcher at the international public policy think tank Rand Corporation and lead author of Mapping Pathways’srecent report, the varied applications of science must be taken into account when designing programmes: “Uptake of new ideas or products is contingent on a lot of factors that might have nothing to do with what’s created in a lab or recommended by policy experts…

“ART has been around for a while, the innovation at this point is how we are going to use the drugs – a new way of thinking about how communities access, understand, and employ this technology,” she explained.

Development of the Mapping Pathways model relied on research carried out with partners in the US, UK, South Africa and India.

In each of the locations, local stakeholders – including clinicians, researchers, policymakers, the medical industry, patient advocates and coalition groups – interpreted scientific evidence differently, which had “profound” effects on how HIV prevention and care was carried out, the researchers noted.

“Here’s all this science – now what?” said Pickett, referring to the conventional top-down approach to HIV interventions, which often assumes that scientific proof a drug works will be enough to convince patients to use it.

“We need these processes to be local from inception,” he said, echoing arguments from the UN special rapporteur on the right to health that the participation of affected populations in decision-making is key to successful interventions.

However promising, concerns about putting this theory into practice remain.

The World Health Organization recently published recommendations that call for the number of people enrolled on ART to be increased by up to 25 million worldwide (up from the current 9.7 million). Financing the scale-up while also boosting local buy-in will be a challenge, say analysts.

But, the effort must be made, argued Pickett: “Just because something adds complexity to a methodology or a protocol doesn’t mean it shouldn’t be done – go there, to the places where the results of the scientific endeavour are meant to be utilized, and have a conversation with the people about what it can do, and most importantly, what they need it to do.”

kk/pt/cb  source http://www.irinnews.org

 

The HIV/AIDS experience – Africa

NAIROBI,  – Twelve years after African governments pledged in the Abuja Declaration to alloc ate at least 15 percent of their annual budgets to healthcare by 2015, just six countries have met this goal.

Liberia, Madagascar, Malawi, Rwanda, Togo and Zambia have met the target, and five other countries are spending at least 13 percent of their annual budgets on health, according to data compiled by the UN World Health Organization (WHO).While on aggregate spending on health has increased – up to 10.6 percent from 8.8 – about a quarter of African Union (AU) member-states have regressed and are now spending less on health than they were in 2001, adds the WHO data.

Recently, the AU held another special summit on HIV/AIDS, tuberculosis (TB) and malaria in Abuja, Nigeria, dubbed Abuja +12, which provided an opportunity for African governments and other stakeholders to review progress made and to discuss what should be done to ensure health funding targets are met before 2015.

The HIV/AIDS experience

“A renewed and bold commitment here in Abuja is essential as, drawing from experiences in the AIDS response, we know that smart investments will save lives, create jobs, reinvigorate communities and further boost economic growth in Africa,” said Michel Sidibé, the executive director of UNAIDS, in a press statement.

At present, funding for healthcare remains short of requirements and is very unevenly spread across countries. According to UNAIDS, an additional US$31 billion per year will be needed to meet the continent’s 15 percent health funding targets.

As of 2011, at least 69 percent of the world’s 34 million people estimated to be living with HIV/AIDS were in sub-Saharan Africa.

But there are encouraging signs. The number of new HIV infections fell to 25 percent in 2011 compared to a decade earlier.

“The main challenge in the fight against HIV and AIDS globally is how to ensure universal access to prevention, treatment, care and support, and… ensuring zero transmission of new HIV infections in children,” wrote Ghanaian President John Dramani Mahama in a blog article in May.

Among 21 priority countries in Africa, the number of children newly infected with HIV has fallen by 38 percent since 2009, according to a joint AU-UNAIDS report launched at Abuja +12.

Malaria and TB burden

Africa is also lagging behind in reducing cases of – and deaths from – TB and malaria.

Globally, Africa is the only region not on track towards halving TB deaths by 2015, and it accounts for almost a quarter of the global caseload, according to WHO.

Inadequate TB detection and drug-resistant strains of the disease, which can be 100 times more expensive to treat, pose significant challenges in Africa. About 40 percent of TB cases in Africa go undetected, adds WHO.

Malaria is also a serious health problem. Eighty percent of the world’s cases and 90 percent of malaria-related deaths occur in Africa.

“We are at a turning point for making historical gains in Liberia’s health sector – where no child dies of malaria and every mother living with HIV can give birth to HIV-negative children while living healthy lives themselves,” wrote Liberian President Ellen Johnson-Sirleaf, in a statement to the Global Fund.

Liberia allocates 18.9 percent of its annual budget to healthcare, the second highest proportion in Africa; Rwanda spends 23.7 percent.

Health for development

According to the AU/UNAIDS Abuja +12 report, there is an economic case to be made for further investment in healthcare: For every year that life expectancy rises across the continent, it argues, GDP will increase by 4 percent. The average life expectancy in Africa is 54.4 years, the lowest globally.

“A sick population cannot generate the productivity needed to maintain the acceleration of our economy,” said Ghana’s President Mahama.

More funding for health could also mean more jobs within the health sector. In 2012 for example, the AU approved a business plan to increase the output of the local pharmaceutical industry.

“Focusing on three things that Africa needs to do urgently – decrease dependency by growing African investments, deliver quality-assured drugs sooner to the people who need them, and leadership – the blueprint will help African countries to build long-term and sustainable solutions,” stated Mustapha Sidiki Kaloko, the AU Commissioner of Social Affairs, in a statement, ahead of the Abuja +12 summit. “Africa’s health and our prosperity are inextricably linked.”

aps/aw/rz source http://www.irinnews.org

 

Danger of ignoring to know: Less than 1 percent of people in the Philippines have tested for HIV.

Photo: UN Photo/Louise Gubb

Less than 1 percent of people in the Philippines have tested for HIV

MANILA, – Consistent increases in HIV infections in the Philippines cannot be reversed without appropriate interventions, say health experts, following the recent release of the country’s highest monthly infection rate recorded thus far.

In May 2013 415 new HIV cases were recorded, with 55 percent of cases being among those aged 20-29.

Since 2007, the Department of Health’s National Epidemiology Centre (DOH-NEC) has noted a steady increase in HIV cases. In 2000, there was one case registered every three days; in 2011, this number grew to one case every three hours.

“The nature of the HIV epidemic has changed. Transmission is still primarily through unprotected sex, but infections are now mostly through same sex transmission whereas previously, it was heterosexual,” said Teresita Bagasiao, the Joint UN Programme on HIV/AIDS (UNAIDS) country coordinator in the
Philippines.

Concentrated epidemic

Part of the problem is that current interventions have not kept pace with change.

“Most interventions are still focused on heterosexual transmission. There is an opportunity for focused interventions [on men having sex with men and injecting drug users] to reach the recommended 60-80 percent of key affected populations,” said Bagasiao.

But even with these interventions, any drop in HIV infections would not occur for another 3-5 years, she added.

Though Philippines is a low-prevalence country with less than 1 percent of the nearly 95 million population infected, Bagasiao said the epidemic is “concentrated” with an average 4-5 percent rate of infection among what donors call “key” populations, including sex workers, men who have sex with men and injecting drug users.

Since 1987 when HIV was first discovered in the Philippines, DOH-NEC has registered 13,594 infections.

“Tip of the iceberg”

But others say this official number is just the “tip of the iceberg”. Stigma continues to surround HIV and with less than 1 percent of the general population getting tested for HIV, officially recorded cases most likely do not accurately reflect the epidemic.

“We project that the number of infected will reach 39,000-50,000 by 2015,” said Jonas Bagas, executive director of The Library Foundation Sexuality, Health and Rights Educators Collective, Inc (TLF-Share), an NGO member of the Philippine National AIDS Council (PNAC), the country’s central advisory body on HIV/AIDS.

“HIV is still considered a gay disease and equated to a death sentence. Prevention messages are mostly scare tactics making people afraid of getting tested. They’d rather not know their status, especially the young people,” said Bagas.

Barriers discouraging testing among youths include a provision in the 1998 Philippine AIDS Prevention and Control Act that requires parental consent for anyone under 18 to be tested for HIV.

Advocates are fighting to amend the requirement.

Rather, added Bagas, an appropriate response to halt the spread of HIV is to give youths sex education that focuses on prevention strategies such as delaying first sexual encounters, as well as a nationwide publicity campaign on HIV information and services.

“We have yet to have a nationwide campaign on HIV on the scale that we have for other diseases like dengue,” Bagas said. As of early June there have been at least 42,000 dengue infections reported in 2013 nationwide, with nearly 200 deaths.

Concerted effort needed

But budgets for such an HIV prevention campaign are hard to secure.

Though government agencies such as DOH and the Department of Social Welfare and Development have increased spending in recent years for HIV prevention, funds from international agencies for HIV have shrunk dramatically.

In 2009, international donors funded almost 73 percent of the country’s budget for HIV prevention and control; in 2010, the contribution barely reached 40 percent.

The 2008 Commission on AIDS Report recommended US$1 per capita annual spending for HIV prevention and control – nearly $95 million based on the current estimated population.

According to the Philippines National AIDS Council 2012 report, $37 million was spent on HIV from 2009-2011, or an average of about $12.4 million per year.

“We need the help of the LGUs [local government units, the country’s smallest unit of government] in appropriating funds in their local budgets for HIV and STI [sexually transmitted disease] prevention and information. The DOH cannot do it alone,” said Genesis Samonte, the department’s chief epidemiologist for HIV.

“We are at a tipping point. We have a choice [to determine] how big this problem will be, but we cannot go back any more. It is our response to HIV that will now dictate its magnitude,” Samonte concluded.

as/pt/cb source http://www.irinnews.org

 

HIV test kits – shortage in Uganda because demand outpaces supply

Photo: John Nyaga/IRIN

Demand outpaces supply (file photo)

KAMPALA, – Uganda has run out of most antiretroviral drugs (ARVs), HIV testing kits, drugs to treat opportunistic infections and several crucial diagnostic tools for HIV care, according to a recent Ministry of Health stock status report.

The report, posted by the ministry on 27 May, listed the status of medical supplies as of 1 May. It reported that central stocks of a number of first- and second-line ARVs, paediatric ARV formulations and HIV test kits were either out or below the minimum stock levels in country’s three government warehouses – National Medical Stores (NMS), Joint Medical Stores (JMS) and Medical Access Uganda Limited (MAUL).

The report noted that the antifungal drug Fluconazole, used to fight opportunistic infections in people living with HIV, was out of stock at all three warehouses, while laboratory commodities for haematology, clinical chemistry and assessing CD4 counts – a measure of immune strength – were also running dangerously low. In addition, stocks of “nearly all first-line TB [tuberculosis] drugs” were low.

The ministry noted that a number for of requests had been sent to partners – including the US President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to fight AIDS, Tuberculosis and Malaria, and pharmaceutical giant Pfizer – to boost stocks.

Ruth Aceng, the director general of health services at the Ministry of Health, told IRIN the countrywide ARV shortage was result of government’s move to increase the number of ARV-accredited sites, on national, district and county level, to improve access to HIV treatment. The government has recently expanded its prevention of mother-to-child HIV transmission programme, and it is also running a voluntary medical male circumcision programme and a provider-initiated HIV testing programme, all of which have contributed to increases in the demand for tests and treatment.

Demand outpacing supply

As of 2012, some 62 percent of those needing HIV treatment in Uganda were on ARVs, up from 50 percent in 2010; that figure is expected to rise again in 2013.

“It’s true we have an ARV shortage in the country. We made a deliberate effort to get everybody who was eligible for ARVs to be enrolled. The deliberate, ambitious expansion and the scale-up has brought the current stock-outs we are experiencing,” Aceng, told IRIN. “Instead of enrolling 100,000 people annually, we decided to put all 190,000 who were eligible for treatment this year. This was a little ambitious plan for us.”

“We are working around the clock with our partners to normalize the situation. We expect the drugs to arrive in the country in the next two weeks or so,” she added.

Civil Society Organizations (CSOs) working to increase access to ARVs, TB drugs and other essential medicines said in an 11 June statement that 24 districts had reported stock-outs of HIV test kits. Health officials now fear the stock-outs will lead to drug resistance, illness and death.

“We call upon the members of the country coordinating mechanism to help expedite the process of procurement of the testing kits and other essential commodities through the Global Fund HIV Grant,” the CSOs said. “We also urgently call upon the Ministry of Health, NMS, relevant offices in the local governments and [officials] in charge of the affected health facilities to ensure that clients obtain drugs and testing services.”

“A big number of patients in the district have been affected [by] the current ARVs stock-outs. The patients can’t refill their monthly stock because the drugs are not there. This is going to cause adherence issue[s] and create drug resistance, which is very dangerous,” Janet Oola, health officer for northern Uganda’s Nwoya District, told IRIN.

Persistent supply-chain issues

John Anguzu, health officer for the northeastern district of Nakapiripirit, said he had been forced to borrow drugs from neighbouring Moroto District to fill his patients’ ARV prescriptions.

“This crisis is particularly concerning given Uganda’s rising rates of HIV incidence, unique among East and Southern African countries,” said the CSOs’ statement.

Uganda’s HIV prevalence rose from 6.4 percent in 2005 to 7.3 percent in 2012, a sign that the country’s once-successful HIV prevention programme is faltering.

The current shortage is only the latest in a list of supply-chain problems that have caused similar stock-outs of drugs and condoms in the past. Activists say continued mismanagement of the distribution chain is harming the country’s HIV response.

“The Ministry of Health exactly knows the number of people on ARVs. I wonder what is difficult with them to focus and make the right quantifications of the drugs,” Oola said. “The ministry should also have buffer stock for emergencies.”

“We are tired of this preventable crisis. It’s time for [the] government to guarantee that stock-outs will be a thing of the past,” said Margaret Happy, the advocacy manager for the National Forum of People Living with HIV/AIDS Networks in Uganda (NAFOPHANU).

so/kr/rz  source http://www.irinnews.org

 

“The world won’t end AIDS without PEPFAR”

Photo: Eva-Lotta Jansson/IRIN

“The world won’t end AIDS without PEPFAR”

ADDIS ABABA,  – Ten years ago, a shipping container was converted into Ethiopia’s first HIV treatment centre, in Addis Ababa, the capital. Created in response to a dramatic rise in new HIV infections and AIDS -related deaths, the centre offered the only hope for HIV-positive Ethiopians, who had to pay to access the life-prolonging antiretroviral therapy (ART).

When US Global AIDS Coordinator Ambassador Eric Goosby joined other US and Ethiopian officials at the centre on a recent trip, they found a state-of-the-art facility, where thousands of clients receive free, comprehensive HIV treatment. The centre, a wing at the Empress Zewditu Memorial Hospital, has just added an outpatient annex.

“At least 350 clients will be seen daily in this new facility, some of whom have not been able to receive the services they need and deserve elsewhere. I particularly applaud Zewditu for its tremendous effort to build the first site in Ethiopia that offers counselling and testing services for the deaf and blind,” Goosby said at the inauguration ceremony.

The centre is now one of 900 sites across the country where over 290,000 people are receiving ART. The new centre, like thousands across Africa, was funded by the US government-run President’s Emergency Plan for AIDS Relief (PEPFAR).

Established in 2003, PEPFAR was the product of a rare bipartisan deal between former US president George W. Bush and lawmakers spearheaded by the Congressional Black Caucus. It was first a commitment of US$15 billion in funding to fight the global HIV/AIDS pandemic; at the launch of the plan, only 50,000 Africans were accessing ART, according to Eric Goosby who heads PEPFAR.

In 2012, an estimated 8 million people were receiving treatment in low- and middle-income countries – of which PEPFAR directly supported 5.1 million. This was a 20-fold increase in treatment coverage since PEPFAR was created in 2003. In 2012 alone, the emergency plan helped carry out 46 million HIV tests, preventing 230,000 babies from being born HIV-positive, Goosby said in an interview with IRIN.

Funding cuts versus AIDS-free generation

But experts are concerned that consistent budget cuts in PEPFAR funding could make reaching the goal of an HIV-free generation difficult, if not impossible.

Chris Collins, a vice president and director of public policy at the Foundation for AIDS Research (amfAR), argues that despite impressive gains made in the AIDS response now is not the time for funding cuts.

“Funding for PEPFAR has fallen 12 percent since 2010 in the State Department HIV bilateral budget line. Last week, the White House proposed an additional $50 million cut for 2014. When the mandated sequestration cut is taken into account, the programme is now at its lowest funding level since 2007,” Collins noted in an April editorial.

“The honest truth is that the world won’t end AIDS without PEPFAR. Some will say: judge PEPFAR on its outcomes, not its funding. But when PEPFAR’s own Blueprint calls for rapid scale-up of effective services in order to show tangible gains, it’s hard to understand why now is the time to cut back,” Collins argued.

But Goosby explained the cuts are being made for three reasons. The first is because they are “getting better and smarter” in service delivery, such as procuring and shipping commodities like condoms and test kits at cheaper costs and favouring less expensive generic drugs over pricey brands.

“We also started a dialogue (this… was an attempt to try to make these services sustainable, not just dependent on one funder) with governments around what their contribution was now to these services and what they could be. And governments all heard this and [began] to pour… their own money into the service pot,” he told IRIN. “So, again, it would be additives, so we can build on what we have already started… with a donor-start but it is a government finish.”

The US is also looking to more cooperation with the Global Fund to Fight AIDS, Tuberculosis and Malaria to raise funds to pay for the HIV prevention and treatment programmes, according to Goosby, who says the US donates a third of the money that goes to the Global Fund.

“So we think of it as a shared responsibility… We see our ethical obligation to the patients that are using these services… We will not renege on that. But we also feel that in order to make sure these services continue, we need to diversify the fund portfolio so others are contributing.”

Chipping in

But whether poorer countries in the region will be able to take over the ongoing programmes is a concern for many.

According to the African Union commission, a number of countries have begun to implement innovative AIDS financing measures intended to reduce dependence on external funders such as PEPFAR.

“Zimbabwe and Kenya now earmark a portion of domestic tax revenues for an AIDS Trust Fund, while countries such as Benin, Congo, Madagascar, Mali, Mauritius, Niger, Rwanda and Uganda have established special HIV levies on mobile phone usage or airfares,” said the commission in a statement issued on May 26. “Taking a different approach, South Africa reduced its spending on antiretroviral medications by 53 percent by reforming its tender process to increase competition among suppliers.”

“Our continent is demonstrating strong political commitment and action by embracing transformative reforms to address AIDS, TB [tuberculosis] and malaria,” said the commission’s chairperson, Nkosazana Dlamini Zuma.

PEPFAR’s Goosby agrees it is not yet time to scale back the fight against HIV/AIDS. “If we pull back on what we are doing for HIV, it will come right back, without any doubt. We see that in just about every infectious disease, but HIV is notorious for this. So keeping this going becomes the challenge. That’s why we want to emphasize the shared responsibility.”

kta/kn/rz  source http://www.irinnews.org

 

There is a seven billion dollar gap in global HIV funding

Photo: VladKol/Shutterstock

There is a seven billion dollar gap in global HIV funding

NAIROBI,  (PlusNews) – Private philanthropists in the European Union and the US spent some US$644 million on global HIV/AIDS programmes in 2011, a 5 percent increase from 2010, largely driven by funding from a small number of large donors, a new report has revealed.
In their annual report, two groups – the US-based Funders Concerned About AIDS (FCAA) and the European HIV/AIDS Funders Group (EFG) – reported that US funders spent $491 million in 2011 while EU funders spent $170 million. Although the amount of money donated by private funders grew, the growth could be attributed to a few large donors; several other donors had, in fact, reduced their funding.
“We look at it as level growth; we’ve identified a few new funders, but the growth is mild,” Sarah Hamilton, of the FCAA, told IRIN/PlusNews. “The Bill and Melinda Gates Foundation and a few others are the main donors driving the growth. If you take them out, there was actually an overall decrease in private philanthropy for HIV. The donor field is concentrated at the top; the top ten donors in the US contribute about 80 percent of total funds, while in the EU they contribute about 82 percent.”
“The decrease could be a result of the economy, but we’ve also seen donors become more focused on other areas, some related to HIV, such as maternal health, health systems and reproductive health,” she added.

• Where has the money gone?

An estimated 44 percent of US funding was targeted at programmes with a global aim. East and Southern Africa received $69 million – the most of any region outside the US – followed by South Asia and the Pacific, which received $40 million, and East and Southeast Asia, which got $22 million.
About half of all EU funding in 2011 was targeted at projects in countries and regions outside western and central Europe, while one-third went to programmes with a global aim. Twelve percent of EU funding was spent in western and central Europe.
Much of the funding was directed towards research; the top target populations for US funding were medical research teams and projects focusing on women, men who have sex with men, and youth. The EU funders mainly targeted orphans and vulnerable children, youth, and women.
“Private philanthropy has the advantage of being better able to support programmes that may not receive adequate government funding or support. Some of the areas with gaps in funding are, in the US, men who have sex with men, and worldwide, prevention of mother-to-child transmission,” Hamilton said.
She noted that trends towards “non-restricted” and “multi-year” funding indicate donors have confidence in the accountability and impact of the programmes they support.

• Shared responsibility

The report’s authors note that 2012 funding is forecasted to remain level. Experts are calling for greater funding, not only from the private funders but also from western governments and beneficiary nations.
Low- and middle-income countries are increasing their contributions to the HIV response, investing  some $8.6 billion in 2011, an increase of 11 percent compared to 2010, according to a UNAIDS reportreleased in July.

The donor field is concentrated at the top; the top ten donors on the US contribute about 80 percent of total funds, while in the EU they contribute about 82 percent

The international community contributed $8.2 billion.
“We are in an era where shared responsibility for the AIDS response is vitally important. Countries are stepping up their domestic investments for HIV, but there is still a $7 billion gap between what is needed and what is available,”

Paul De Lay, deputy executive director for programmes at UNAIDS, said in a statement. “Philanthropic investments for AIDS are extremely important, particularly in supporting civil society-led engagement, which can often be missing from larger-scale donor-funding plans.”
Hamilton said the FCAA and the EFG were working to identify new funders, both in the west and around the world.
“Regardless of the numbers, we are proud of and excited by the funders’ support, especially in these economic times,” she said. “As the report notes, there has been a decline in funding – we need to build on the political and financial commitment to HIV.”

 
kr/rz

source http://www.irinnews.org

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IMF recommends land reforms

Photo: James Hall/IRIN

Cattle grazing on Swazi Nation Land

JOHANNESBURG, – Land reform has been recommended by the International Monetary Fund (IMF) as part of the solution to deepening economic decline in Swaziland, a country where more than two-thirds of the population lives in poverty.
Following a two-week visit by a delegation, the IMF announced, in a 7 November statement, that one of the key challenges facing Swaziland – in addition to high unemployment, rising inequality and the world’s highest HIV/AIDS prevalence – is “improving access to modern financing by an appropriate land tenure reform.”
Dimpho Motsamai, a researcher from the Africa Conflict Prevention Program at the Pretoria-based think tank Institute for Security Studies (ISS), told IRIN, “It is refreshing land [in Swaziland] is being highlighted as part of the solution to poverty” by international institutions.
Swazi Nation Land Swaziland has dual system of land ownership, in which some people have title deeds while the majority live on Swazi Nation Land (SNL). SNL is often referred to as communal land, although communal land practices apply only to non-arable and livestock pastures. Land used for crop production is individually held and allocated by chiefs, who also act as arbiters in land disputes.

SNL is held in trust by King Mswati III, sub-Sahara’s last absolute monarch, forming the bedrock of his power base. The king imposes his authority through a chieftain system in rural areas, which comprise about 60 percent of the country’s land mass.
Those residing on SNL have no title deeds and can be evicted by the chiefs without recourse. Without title deeds, subsistence farmers have no collateral to raise the funds needed to undertake basic improvements, such as irrigation systems, that would increase their yields. As a result, many farming practices are rudimentary, and many people are vulnerable to food insecurity.
Mandla Mduli, a trade unionist and member of the Swaziland Solidarity Network, an umbrella organization of pro-democracy groups, told IRIN, “Land reform as recommended by the IMF will not be done because the system keeps the royal family in power. Seventy percent of Swazis live on these lands that are, in effect, owned by the royal family and run by chiefs appointed by the king. Anyone who joins a [opposition] political party is exiled [from SNL].”
Declining maize production
The preliminary results of the World Food Programme’s (WFP) vulnerability assessment estimated that this year’s harvest of the staple maize was 76,000 tons – over 8,000 tons lower than the previous season.
“About 116,000 people, or 11 percent of the population, will experience food shortages in the lean season before the next harvest in May 2013,” the assessment said.
Swaziland’s maize production has been declining since 2000; previously the country produced about 100,000 tons of maize annually. WFP attributed the slump to “erratic weather, high fuel and input costs, the devastating impact of HIV and AIDS, and a decline in the use of improved agricultural practices and inputs.”
A national land policy was drafted in 2000, outlining a national development strategy for land and rural development, but the policy was never implemented. An agricultural academic at the University of Swaziland, who declined to be identified, told IRIN, “The policy was never adopted, as it would have taken power [over land matters] away from the chiefs, and the chiefs enjoy their power.”
The academic said there is “absolute disorder when it comes to land” in Swaziland. There is widespread corruption, SNL is being sold off without any official documentation by chiefs and “people pretending to be chiefs”, and land allocation is used as an instrument of political patronage.
Problem worsening
A 2010 report published by the University of the Western Cape’s Institute for Poverty, Land and Agrarian Studies(PLAAS) said, “Swazi citizens are increasingly losing their hold over the land as the population increases and the demand for land intensifies. The continuance of poor land administration in the face of the continuing challenges of population growth has already had massively harmful social and economic consequences, which will only worsen until the nettle of land reform is grasped.”

It’s land reform of land owned by one guy essentially

ISS researcher Motsamai said land reform is “very controversial” within the country, as it is not a question of land redistribution “from colonizer to colonized,” but of taking power from the “entitlement of a royal household”.
“It’s [proposed] land reform of land owned by one guy essentially,” she said.
As those living on SNL cannot afford to purchase or lease the land, one consideration could be to nationalize it, but in that scenario, the state would take ownership of the land when the “king is the state,” she said.

 
go/rz

source http://www.irinnews.org

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Media still need training on HIV

NAIROBI, 1 November 2012 (PlusNews) – Scourge. Plague. Killer disease. All are terms still routinely used by Kenya’s media to describe the HIV epidemic more than thirty years after it was first identified. Experts say the media needs to step up to promote a better understanding of the illness.

“The use of words like ‘scourge’ or ‘sufferer’ in the media to refer to HIV/AIDS or to people living with it… shows the disease is such a bad thing, yet there are people living with it, and examples are countless, who are doing normal things and leading normal lives,” Allan Maleche, a human rights lawyer and head of the Kenya Legal and Ethical Issues Network on HIV and AIDS, told IRIN/PlusNews. “Stigma has been one of the issues that helped HIV to spread, and there is need to train the media on how to report HIV in less stigmatizing ways.” Media outlets often concentrate on the more salacious or scandalous details of stories involving HIV rather than the more informative, educational aspects. One woman interviewed by a Kenyan TV station earlier this year told IRIN/PlusNews of her disappointment when the story was broadcast. “The journalists dwelt mainly on how I got infected instead of how I protected my unborn child from infection, which was my main aim of calling the journalist,” she said.

• Difficult to cover

Journalists IRIN/PlusNews spoke to said stories about HIV were more difficult to cover than other news stories, involving in-depth research, a strong understanding of scientific subjects and tough interviews dealing with very personal issues. “Covering HIV and AIDS is… a sensitive area and… you have to look at issues from the [position] of the interviewee… People living with HIV are often misjudged, blamed for ‘getting it’, which in turn leads to their being stigmatized and shunned,” Waweru Mugo, a freelance Kenyan journalist who has written extensively on HIV, told IRIN/PlusNews. “This therefore requires a journalist to be careful with the language [so] that [it] does not discriminate and stigmatize further.”

“I suggest that journalists are trained and retrained in the use of language, for it requires ethical and professional handling,” he added. Jane Thuo, chief executive officer of the Association of Media Women in Kenya, noted that there is a need to ensure HIV continues to receive press coverage amid newer, equally serious

health issues such as cancer and other non-communicable diseases.

• Training

In 2002, the Coalition of Media Health Professionals produced a guide to reporting on HIV for Kenyan journalists in an effort to boost journalists’ sensitivity on the subject. But experts say there is a need for specific training for journalists who write about HIV. One such  training, sponsored by the International Planned Parenthood Federation (IPPF), was recently held in the Kenyan capital Nairobi. Tom Japanni, a senior BBC producer and trainer for the two-day workshop, noted that journalists were well placed to simplify the medical terminologies and disseminate them to the society.

“We are advantaged to be able to interpret health-related research findings, parliamentary bills and other related instruments, even in our local languages,” he said. “That is all the more reason journalists should be well equipped to deliver the correct information to the society. You must be informed for you to inform others.” “There are people in Kenya who still do not understand HIV beyond transmission, prevention and treatment,” Helen Barsosio, a Kenyan-based reproductive health researcher and the technical advisor on HIV programs for the NGO HOPE worldwide, told IRIN/PlusNews. “This kind of training is ideal for journalists to enable them to understand the correct language to use while reporting and to identify the stories within the HIV main story.”

• Having an effect

“We train the journalist on the art of interview, among other areas,” said Anne Mikia, a radio specialist and trainer at Internews, which supports local media around the world. “Interviewing a person living with HIV needs a lot of skill, lest you offend the interviewee.” Although Mikia says it is difficult to measure the impact of their trainings, she noted that stigmatizing language and pictures were on the decline in most major media houses. “The trainings… go for only one week, and that is not sufficient for a journalist to acquire absolute effective skills on HIV reporting,” she added, noting that journalists need to use their own initiative to develop the skills to report on HIV. A local network of HIV-positive journalists is also playing a role in improving reporting on HIV in the media. “We realized that journalists rarely speak about themselves but report only what others have said or done.

As journalists living with HIV, we can easily address HIV issues because we relate with them,” said Elvis Bassudde, chairman of the East Africa chapter of Journalists Living with HIV/AIDS. “A journalist living with HIV and who sits in an editorial committee can [more] easily campaign for a space for an HIV story than one who is not.” lm/kr/rz source www.irinnews.org