News (Updated November 8, 2009)

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China 's Economy Powering Syphilis Spread

By Laura MacInnis

Reuters

GENEVA

China is experiencing an epidemic of syphilis, a sexually transmitted disease that the country virtually wiped out in the 1960s, a senior public health official was quoted as saying on Tuesday.

In the WHO Bulletin, a journal produced by the World Health Organization, Xiang-Sheng Chen of China 's Center for Disease Control and Prevention said mass migration of rural workers to Chinese cities has been a major factor in the viral spread.

While China nearly eradicated syphilis "through a powerful campaign of propaganda, mass screening, closing brothels and providing free treatment for sex workers," the expert said "the epidemic has re-emerged since the economic boom of the 1980s."

"The areas with higher syphilis prevalence are usually places where the economy is booming but where there is also greater economic inequality, such as the south-eastern coastal areas," Chen said.

The Chinese CDC's deputy director for sexually transmitted disease control said there were 278,215 officially reported syphilis infections in 2008, triple the number from 2004 and a tenfold increase over the past decade.

"On average, syphilis cases are increasing by 30 percent a year across the nation," he said.

MIGRANT WORKERS

Much of the rise has come from unsafe practices of migrant workers, including men who left their wives back in their home villages and solicit sex from prostitutes who do not use condoms, Chen said.

Fears of stigma and a lack of privacy have also kept many patients from going to seek treatment for syphilis and other sexual infections which can make people more likely to catch and spread HIV/AIDS, according to the Chinese expert.

There are no national statistics on how many people in China have both HIV and syphilis.

Globally, the WHO estimates that there are at least 340 million new cases of curable sexually transmitted infections -- such as syphilis, gonorrhea, chlamydia and trichomoniasis -- every year among people aged 15 to 49.

Infection with sexually transmitted infections can cause acute symptoms, chronic infections and delayed consequences including infertility, ectopic pregnancy and cervical cancer.

Michel Sidibe, the head of the U.N. program UNAIDS, and his colleague Kent Buse appealed in a separate WHO Bulletin article on Tuesday for more collaboration between work on HIV/AIDS and sexually transmitted infection worldwide.

Pregnant women and their partners should be offered HIV screening as well as services to prevent sexual infections as part of their regular treatment, they recommended, saying: "The moment is right to take the AIDS response out of isolation."

Copyright 2009 Reuters News Service. All rights reserved.

Medical aid group raises alarm about AIDS funding

By DONNA BRYSON, Associated Press Writer Donna Bryson, Associated Press Writer Thu Nov 5, 2009

In this photo taken Tuesday April 14, 2009 a pedestrian passes ...JOHANNESBURG – The global recession and pressure to divert funds to other health crises are hurting the fight against AIDS, a medical group warned Thursday, with one health worker saying he feared a return to the days when the AIDS virus was a death sentence in Africa .

Medecins Sans Frontieres campaigners said at a news conference in South Africa that clinics funded by international donors in Uganda were being told not to take on new patients. MSF, also known as Doctors Without Borders, said they feared a major global distributor of AIDS money was considering cutting back worldwide.

HIV, the virus that causes AIDS, is a major concern in sub-Saharan Africa . South Africa has the world's largest number of HIV cases, with some 5.7 million people infected with the virus, according to the United Nations' AIDS agency.

"We think we are at a very dangerous turning point," said Dr. Tido von Schoen-Angerer, director of the aid group's campaign to provide essential medicines. "The donors are getting cold feet about commitment to longterm, chronic disease."

He said he has been told that donors wanted to spend on "cheap and easy" illnesses rather than AIDS, which can mean a lifelong commitment to providing expensive drugs.

A spokesman for the Global Fund to Fight AIDS, Tuberculosis and Malaria said despite the "challenging" financial times, "there is no interruption in any funding whatsoever."

The fund provides a quarter of all international financing for AIDS, two-thirds for tuberculosis and three-quarters for malaria, and MSF raised concerns Thursday about its ability to take on new projects.

Fund spokesman Andrew Hurst said its directors would meet next week to discuss a new three-year round of funding — the current round ends next year — and meetings with donors would follow.

MSF also said a top U.S. AIDS initiative was faltering. The President's Emergency Plan for AIDS Relief, or PEPFAR as the project started by former President George W. Bush is known, plans to keep funding at current levels for the next two years, even though needs are growing, MSF said.

PEPFAR officials did not immediately respond to requests for comment.

Shrinking funds means spending will have to be smarter, said Helen Epstein, who has written about managing AIDS programs in Africa and advised the U.N.

Philip Stevens, a public health specialist at the International Policy Network in London , said the emphasis might be on preventing rather than treating AIDS in the poorest countries. And even when funding for treatment was needed, middle income countries should not rely on "the largesse of" wealthy industrialized nations, he said.

MSF officials said other models, such as a levy on international money transfers to fund health care, should be considered. And while they disagree that it should be a choice between treatment and prevention, they said there were areas where savings could be made, such as on the cost of drugs.

Olesi Ellemani Pasulani, an MSF worker at a hospital in rural Malawi , made a passionate plea.

He said that when the group started working in the Thyolo area in 1997, there was only enough funding for AIDS education and counseling, and many died of AIDS. The clinic began providing AIDS treatment drugs with Global Fund money in 2003, and by 2007 was getting them to everyone who needed them in Thyolo — some 18,000 patients, he said.

"We have seen patients who were bedridden going back to their lives," Pasulani said. "Let us be there for them, now and forever."

Copyright © 2009 Yahoo! Inc. All rights reserved.

Bill Threatens Progress on HIV/AIDS

06 Nov 2009 21:57:00 GMT

Source: Human Rights Watch

( Kampala ) - A proposed Ugandan law on HIV/AIDS promotes dangerous and discredited approaches to the AIDS epidemic and would violate human rights, a group of more than 50 Ugandan and international organizations and individuals said in a report released today. The HIV and AIDS Prevention and Control Bill could be taken up by Uganda 's parliament shortly.

The report, a 10-page analysis of the bill, was released in Kampala , Uganda , and Geneva , Switzerland at a meeting on HIV treatment sponsored by the World Health Organization. The report criticizes repressive provisions in the legislation as contrary to the goal of universal access to HIV prevention, care, and treatment. The proposed law includes mandatory testing for HIV and forced disclosure of HIV status. It also criminalizes the willful transmission of HIV, the failure to "observe instructions on prevention and treatment," and misleading statements on preventing or controlling HIV.

"We know what works and what doesn't in fighting HIV," said Beatrice Were of the Uganda Network on Law, Ethics & HIV/AIDS. "This bill, unfortunately, is full of ineffective approaches that violate human rights and will set us back in our efforts to fight the AIDS epidemic and expand HIV programs nationwide."

The report cites Uganda 's success during the 1990's in addressing HIV. Rather than adopt punitive approaches, the government engaged civil society in prevention efforts and worked to reduce the stigma of the disease. Citing international standards and "best practices," the report says that mandatory testing and criminal penalties can be counterproductive, driving people away from testing and treatment.

The report also highlighted how laws that criminalize HIV transmission can result in disproportionate prosecution of women because more women are tested as part of pre- or ante-natal medical care and therefore know their HIV status. Women's inability to safely negotiate condom use or disclosure to partners who might have been the source of their infection is not recognized in the bill as defenses against criminal penalties. Women who transmit HIV to their infants after birth via breast milk would also be subject to criminal prosecution, the report says.

"Women and girls have been disproportionately affected by HIV/AIDS," said Joseph Amon, health and human rights director at Human Rights Watch. "My fear is that mandatory testing and disclosure will lead to prosecution and violence instead of treatment and care."

The bill also criminalizes a wide and ill-defined range of conduct, such as discrimination against people living with HIV/AIDS and breach of confidentiality. According to the report, many of these acts are better dealt with through civil liability. Criminalizing such a wide range of actions opens the door for the government to prosecute people in selective or abusive ways while adding to the huge backlog in Uganda 's courts.

The report highlights other areas in which the bill lacks specificity or appropriate guidance, including provisions that waive consent to testing when it is "unreasonably withheld." The report also found that the bill contains insufficient protections relating to the testing of children and their subsequent treatment, care, and support.

Further, the bill would mandate compulsory testing for drug users and sex workers, two already marginalized and criminalized groups. The report expresses concern that the proposed law, combined with other legislative efforts strengthening penalties related to homosexuality, is adding to a body of repressive criminal law in Uganda . These laws make it more difficult for civil society and non-governmental organizations to conduct effective programs with stigmatized communities.

"It's important to have a law that protects the rights of people with regard to the HIV/AIDS epidemic," Amon said. "But the bill as drafted would only make it harder to prevent and treat HIV and would put Uganda 's HIV policies and response far outside of global norms."

In early November, a slightly updated version of the bill was made available for public comment. The most troubling aspects, including the lack of consent in testing, third party disclosure by medical practitioners, and criminalization of transmission have not changed. The modifications to the bill are in some instances harmful, in others beneficial.

The bill introduces additional, troubling provisions:

Attempted transmission of HIV is now criminalized. This further opens the door for abusive prosecutions.

Government responsibility to take steps necessary to ensure access to essential medicines at affordable prices by persons with HIV/AIDS has been deleted.

Some changes to the bill improve the potential for human rights protections, such as:

Failure to inform one's sexual partners of HIV status is no longer criminalized, and discriminatory acts are now subject to civil, rather than criminal, liability.

Failure to take reasonable steps and precautions to protect oneself from HIV transmission is no longer criminalized.

Children born to HIV-positive women are guaranteed immediate appropriate treatment, care, support, and routine medication.

 

Africa the worst hit by AIDS, by far

Thursday, November 5 05:46 pm

An estimated 33 million people around the world are HIV positive, the bulk of cases emanating from the developing world which relies on donor aid to reduce infections and treat carriers of the disease.

Here are some facts about AIDS.

* Sub-Saharan Africa remains the region most heavily affected by HIV, accounting for two thirds of all infections and 75 percent of AIDS deaths in 2007.

* Global deaths from AIDS reached an estimated 2 million in 2007, down from 2.1 million deaths in 2006. Since the AIDS pandemic started in the early 1980s, more than 25 million people have died from the virus.

* The annual number of new HIV infections declined to 2.7 million in 2007 from 3.0 million in 2001.

* Some 33 million people had human immunodeficiency virus infections in 2007, most of them in Africa , according to the 2008 United Nations report on the AIDS epidemic.

* An estimated 1.9 million people were newly infected with HIV in sub-Saharan Africa in 2007, bringing to 22 million the number of Africans living with HIV.

* More than half of the 9.5 million people who need AIDS drugs cannot get them, a United Nations report said at the end of September.

* In South Africa , an estimated 5.7 million people are living with HIV. About 350,000 have died from AIDS.

Sources:Reuters/UNAIDS

 

In Brief: HIV-positive cases jump to 556 in Afghanistan

Source: IRIN

KABUL, 5 November 2009  -  Over 50 people have been diagnosed as HIV-positive in Afghanistan over the past nine months, bringing the number of registered cases to 556, according to the National HIV/AIDS Control Programme.

"Most of them have got the virus through intravenous drug use," Malika Popal, the Programme's advocacy and communications adviser, told IRIN, adding that three HIV/AIDS patients had died so far this year.

The Health Ministry estimates 2,000-3,000 people are living with HIV/AIDS in Afghanistan . The virus prevalence rate of about 0.5 percent is considered among the lowest in the world.

Armed conflict, lack of awareness of HIV/AIDS, lack of access to basic social services such as education and health, rising intravenous drug addiction, and the poor social status of women are among the factors which, experts say, could lead to a rapid spread of HIV/AIDS.

 

Cambodia aims to raise AIDS/HIV awareness among drivers


By Wang Eng Eng, Channel NewsAsia | Posted: 06 November 2009

PHNOM PENH : Cambodia 's battle against AIDS and HIV infection has hit the road.

From this year, new drivers will have to learn more than just how to handle a vehicle; they will also be quizzed on their knowledge of AIDS/HIV infection.

"Every year, we have more than 20,000 people who want to get a driver's licence. So during the examination, we'll put 12 questions on HIV prevention," said Lim Sidenine, director of Planning and Admin General Department, Ministry of Public Works & Transport, Cambodia .

Questions include how AIDS/HIV infection is transmitted and how to protect oneself against the disease.

The Ministry of Public Works & Transport is also taking the lead in educating truck and lorry drivers, as this group is considered at greater risk of AIDS/HIV infection.

Truck and lorry drivers play a key role in Cambodia 's infrastructure growth as they transport building materials across the country.

However, most of the infrastructure and road improvement projects are concentrated in towns with a high prevalence of AIDS/HIV infection such as Poipet, which is at the Thai-Cambodia border.

Cambodia 's HIV infection rate has fallen in recent years from 0.9 per cent in 2006 to 0.7 per cent in 2008 - mostly due to government efforts to promote condom use in brothels. - CNA /ls


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