News (Updated
August 30, 2009)
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Mon Aug 24, 9:13 PM
"Although
The journal published a
series of articles highlighting the challenges facing
But the country faces a
collision of epidemics including AIDS and tuberculosis, as well as a high level
of deadly violence and poor services for mothers and children, the articles
said.
Health Minister Aaron
Motsoaledi described the country's the health system as in trouble.
"Both the private and
public sectors are in trouble. As government we take responsibility of the
mistakes especially with regards to HIV/AIDS where wrong policies were
adopted," he said at a press conference.
"However, some of the
problems we have inherited from apartheid and colonialism," he added.
Motsoaledi met Monday with
a team of international experts, including the articles' authors, in
"Failures in
leadership and stewardship and weak management have led to inadequate
implementation of what are often good policies," South African researchers
said in one article.
Former president Thabo
Mbeki for years denied the threat posed by AIDS, questioning whether HIV causes
the illness and delaying the rollout of life-prolonging drugs.
Lancet editor Richard
Horten said the election of President Jacob Zuma earlier this year offered an
opportunity to redress the mistakes of the past.
"The catastrophic
failure of previous leadership to address certain health issues has broken the
trust of the
The articles highlighted
gaping differences in health care among
In the
Poor mother and child
services mean
AIDS remains the biggest
challenge to
But many people with HIV
also suffer from tuberculosis, while ailments like obesity, heart disease,
substance abuse and anxiety and depression are also on the rise, the articles
said.
The violent death rate in
"Violence is
profoundly gendered, with young men (aged 15-29 years) disproportionately
engaged in violence both as victims and perpetrators," the researchers
said.
"Half the female
victims of homicide are killed by their intimate male partners and the country
has an especially high rate of rape of women and girls."
28 Aug 2009 15:41:04 GMT
Source: IRIN
"For me, cricket has
always been a passion and today, after winning this match, I feel good. It is my
bid [to be] accepted in society," said Abdul Latif, the team captain.
HIV-positive people still
find it hard to live openly in
Latif was working as a
professional cook in
The First Positive Cricket
Club team will be competing with other cricket teams at city and district level.
Their first match in
The stands were not as
full as they are for some of the major matches, but the estimated 200 supporters
cheered loudly for the rookie team. However, no family members came to watch, as
some of the players had not disclosed their status, while others have been
shunned by their relatives.
The club was formed under
the aegis of the Pakistan Society [http://www.pakistansociety.org], an NGO
working for the rights of people living with the virus and injecting drug users
in
"Cricket is what
unifies all Pakistanis, and we wanted to get our message across in the best
possible manner. The rationale behind the formation of the HIV-positive cricket
team and cricket club is to give the general population an idea that being HIV
positive is not a reason why some should be treated like an outcast," the
head of the Pakistan Society, Dr Saleem Azam, told IRIN/PlusNews.
The team practiced every
day after work for their first match. "We had all been playing it in our
youth and continued watching it. However, after getting HIV, we started becoming
withdrawn and even energy levels went down," said Saqib Khan (not his real
name).
"Yet whenever a
cricket match was on, we felt like watching it and would even ask our employer
if we could stay at the office and watch it together. For us, it's about being
together and playing together."
After a nail-biting
innings, the team won handsomely, leaving their opponents and the fans amazed
that HIV-positive players could be so active - one of the team members was asked
whether antiretroviral medication was also a form of performance-enhancing
drugs.
"We are thankful that
the authorities were so cooperative with us, and provided us with the space that
was needed for the match without any discriminatory attitude. Rather, their
attitude was positive and encouraging," said Azhar Hussain Magsi, a manager
at the Pakistan Society.
"More matches are
scheduled to take place all over Pakistan in the coming weeks ... We are also
having talks with other NGOs in India, and look forward to having an
international HIV-positive cricket match."
Now, a combination of
three ARVs - zidovudine (AZT), nevirapine and lamivudine (3TC) - will be used
for mother and baby, rather than the single dose of nevirapine administered
previously, which led to some women and children developing resistance to the
drug.
"With these
guidelines we intend to move into more efficacious regimens," Dr Martin
Sirengo, the PMTCT programme manger at the National AIDS and STD Control
Programme (NASCOP), told IRIN/PlusNews.
Although the government
intended phasing out single-dose nevirapine in PMTCT altogether, the new drug
regimen will take some time to implement as it involves additional costs and
training for health workers.
The guidelines, issued in
the capital,
The strategy is also aimed
at men. "Male involvement is key to our success in rolling out an effective
programme for prevention of mother-to-child transmission of HIV," said Beth
Mugo,
According to the Ministry
of Health, 90 percent of women attending antenatal clinics agree to be tested
for HIV, but only 10 percent of their male partners accompany them and are also
tested. Couples counselling and incentives like delivery vouchers for those who
attend together are being implemented to encourage male participation.
NASCOP's Sirengo noted
that female-specific HIV-prevention activities were crucial to reducing the
number of infants born with the virus - three out of every five HIV-positive
Kenyans are women.
"Because a majority
of infants get infected through the mother, it is important to reduce the HIV
burden among women if we are to succeed in eradicating paediatric HIV and
preventing new infections involving children," he said.
Every year more than
114,000 babies are exposed to HIV, and at least 45,640 are born HIV-positive.
These are the findings of
several leading local researchers and epidemiologists, who chronicle the history
of the HIV and TB epidemics in "Health in South Africa", a new series
published in the UK-based medical journal, The Lancet.
The evolution of
Since then the level of
new HIV infections has remained high, but prevalence has stabilized or even
declined in some age groups, largely as a result of HIV-related mortality.
Despite the belated
roll-out of an antiretroviral (ARV) treatment programme, which started in 2004
and is now the largest in the world, average life expectancy has declined to
48.4 years for men and 51.6 years for women.
Starting in the late
1990s, the HIV epidemic has fuelled a sharp rise in TB incidence: 50 percent of
new TB cases occur in patients co-infected with HIV, making TB the most common
natural cause of death in the country.
The poor performance of TB
control programmes and many years of low cure rates have seen the emergence of
drug-resistant strains of the disease that are more difficult and costly to
diagnose and treat - the caseload of drug-resistant TB now puts
Strong leadership needed
These are grim statistics,
yet The Lancet authors describe the government's response to the two epidemics
in the past decade as marked by "denialism, ineptitude, obtuseness and
deliberate efforts to undermine scientific evidence as the basis for
action."
Important achievements,
such as a vastly increased distribution of male condoms, the scale up of the ARV
programme, and the development of well-formulated national strategic plans for
HIV/AIDS and TB have not been enough to overcome a lack of high-level political
commitment to controlling the health crises.
An international HIV/AIDS
scorecard various elements in country-level programmes found
The authors note that the
change of administration in 2008 has provided a potential "window of
opportunity" to tackle HIV and TB, and suggest a number of priority
actions. In the area of TB control, they recommend improving case detection and
cure rates, and integrating HIV and TB services.
The first step in
strengthening HIV prevention efforts should be using all available data to
generate a clearer picture of the demographic features and key drivers of the
epidemic, followed by scaling up prevention of mother-to-child transmission,
targeted behaviour-change programmes, and making male circumcision widely
available.
HIV treatment efforts
could be boosted by routinely offering testing at all health care facilities,
and raising the threshold for starting ARV treatment to a CD4 cell count of 350.
Treatment programmes play
an important part in prevention: studies show that patients who start ARV
treatment early are less likely to transmit the virus, and more likely to access
sexual and reproductive health services.
However, the authors note
that successful implementation of these approaches will require "strong
leadership, political will, social mobilisation, adequate human and financial
resources, and sustainable development of health care services."
25 Aug 2009 17:36:04 GMT
Source: Reuters
*
Aboriginal share of AIDS cases doubles in 4 years
* Drug use bigger cause of
infection than unsafe sex
By Rod Nickel
WINNIPEG, Manitoba, Aug 25
(Reuters) - AIDS is spreading faster among Canada's aboriginal people than in
the general population, and a strong cultural stigma and links to rising drug
use make the problem difficult to solve.
One health official
compared it last week to the AIDS epidemic in Africa and warned that up to 30
percent of the aboriginal population in the western
Many aboriginals, a broad
term that includes Indians, Inuit and Metis, live in poverty and suffer poorer
health than most other Canadians. They make up about 3.3 percent of the
population, living mainly in western cities, the North and on rural reserves.
Despite their relatively
small population, aboriginals accounted for almost one-quarter of
Intravenous drug use,
especially among women, is the cause of more than half the infections with the
human immunodeficiency virus (HIV), which leads to AIDS. Canadian non-aboriginal
infections are mostly linked to unsafe sex.
Aboriginals with HIV
infections also tend to be younger than other infected Canadians and more often
women.
"(It's) partly
because of the vulnerabilities of that group -- (especially) if they're addicted
and dependent on the sex trade for their income," said Dr. Moira McKinnon,
chief medical health officer for
INFECTION RATE ON RISE
The rate of HIV infection
in
An estimated 73,000
Canadians were infected with HIV as of 2007, according to the United Nations
AIDS agency. Worldwide, 33 million people had the HIV virus as of 2007, with
almost one-third in southern
The spread of the AIDS
virus in
Rates of diabetes and
tuberculosis are also higher among aboriginals than in the general population,
causing HIV infection to become fatal more quickly, Clement said.
Some aboriginals, once
infected, are reluctant to use HIV drugs. "It's scary and a real
concern," Clement said. "HIV becomes another layer of their
disease."
A strong stigma about AIDS
within aboriginal circles can also discourage testing and treatment, said Art
Zoccole, a gay aboriginal man who is infected with HIV.
"Once you get outside
the urban centers, I find the stigma still exists," said Zoccole, 57, who
lives in
It all adds up to a
problem without a one-size-fits-all solution, said Phat Ha, public health policy
analyst for the Assembly of First Nations (AFN). Most government attempts to
control the spread of AIDS center on safe sex, he said .
"There's a large
portion (of the population) that's not being addressed, in particular the
injection junkies," Ha said.
"I'm optimistic that
within a couple of years, we'll see those figures go down," she said.
(Editing by Rob Wilson)
Tue Aug 25, 2009 8:36am
EDT
WASHINGTON
(Reuters) - AIDS expert Dr. Helene Gayle, president and chief executive of the
charity CARE
Gayle, former head of AIDS
research at the U.S. Centers for Disease Control and Prevention, will advise
President Barack Obama on fighting the virus, which has infected an estimated 1
million Americans and 33 million people globally.
"As we organize
numerous ways to engage the American people in confronting the HIV epidemic in
our country, the Presidential Advisory Council on HIV/AIDS will play a critical
role in developing and implementing a national HIV/AIDS strategy," Obama
said in a statement.
Gayle has also headed AIDS
efforts at the Bill & Melinda Gates Foundation.
Kristi Heim
Dr. Stefano Bertozzi is
joining the Bill & Melinda Gates Foundation next week as its new HIV
director in the global health program.
An expert in health
economics, he will manage grants in HIV vaccine development, biomedical
prevention research, diagnostics, development and resistance monitoring, and
strategies for introduction and scaling-up of interventions, the foundation
said.
HIV is one of the biggest
programs at the foundation, which has spent nearly $12 billion on global health
since 1994.
For the past 11 years
Bertozzi has worked in the National Institute of Public Health (INSP) in
He also chairs the
Steering Committee of aids2031, an international consortium of people from
diverse backgrounds looking for new ideas for the global response against
HIV/AIDS. I found this video of him in which he talked about the need for a new
approach to HIV that is longer term, and building more efficient management
systems.
"We've been so caught
up in the urgency of people dying that we haven't thought about how to win this
fight over the long term," he said.... "It's foolish for us to take an
emergency response to prevention."
Bertozzi co-authored this
paper that discusses the spread of HIV from sex workers whose clients are
willing to pay more not to have to use a condom.
"His intimate
knowledge of the medicine, science, economics and policy of HIV will help make
this important portfolio have the most impact," said Tachi Yamada,
president of the Gates Foundation's global health program. Bertozzi worked with
the foundation in his previous roles at UNAIDS, the World Health Organization
(WHO) and the World Bank.
Bob Roberts Reporting
WBBM Newsradio 780
CHICAGO
(WBBM) - Cook County Board President Todd Stroger met Tuesday with a group of
irate AIDS activists, who said he jumped the gun by trying to arrange the
clinical testing of a vaccine to treat the deadly disease.
Stroger assured the activists he meant well.
"I thought this was something that would help people," he said.
"It's not about me. It's about other people."
The GeoVax vaccine in question is reported to be testing well in preventive
tests in 13 locations, in which the participants are uninfected. The
activists said this test would be different, in that it would be used in
therapeutic testing, which is being done nowhere else, and would require 10
HIV-positive patients to go off their current medications.
Papers signed by Stroger, by the Cook County Health and Hospital System, and by
the CORE Foundation that administers county health services June 15 did not
commit the county to the therapeutic test, but only gave the county's Ruth M.
Rothstein CORE Center the ability to determine if it wanted to participate.
On June 24, the CORE Foundation board, headed by County Commissioner John Daley,
wrote GeoVax that CORE administrators elected not to go forward.
With a solitary exception, those who spoke at the 90-minute meeting backed
While others talked in abstract about their misgivings, one man was blunt.
"When I'm taken off my medications, I become ill," he said.
"I have diarrhea. I have fever. I have fainting spells and my body
shuts down. In other words, I could die."
Several physicians affiliated with
"This is a safety trial to see if it is safe...for 10 patients. That
is what we got -- a single-site, 10-patient study," said
Dr. Adeyeni suggested that GeoVax instead recruit patients at one of the 13
sites in which preventive testing is being done.
Not everyone who attended was in agreement.
"There will be a therapeutic trial," one man said. "Do you
want to be the one to say you did not allow that chance to happen? It's
doesn't make sense to me the risk of not finding out if this vaccine could
work."
Others complained that the man did not realize the dangers that could result
from the testing to participants.
Stroger communications director Eugene Mullins acknowledged speaking for two
hours with
Even Stroger himself admitted he could have benefitted from a more in-depth
briefing before taking a stand.