News (Updated November 21, 2009)

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AIDS, malaria eclipse the biggest child-killers

By MARGIE MASON, AP Medical Writer Margie Mason, Ap Medical Writer Nov 19, 2009

HANOI , Vietnam – Diarrhea doesn't make headlines. Nor does pneumonia. AIDS and malaria tend to get most of the attention.

Yet even though cheap tools could prevent and cure both diseases, they kill an estimated 3.5 million kids under 5 each a year globally — more than HIV and malaria combined.

"They have been neglected, because donor or partnership mechanisms shifted their emphasis to HIV and AIDS and other issues," said Dr. Tesfaye Shiferaw, a UNICEF official in Africa . "These age-old traditional killers remain with us. The ones dying are the children of the poor."

Global spending on maternal, newborn and child health was about $3.5 billion in 2006, according to a report by the Bill & Melinda Gates Foundation. That same year, nearly $9 billion was devoted to HIV and AIDS, according to UNAIDS.

Pneumonia is the biggest killer of children under 5, claiming more then 2 million lives annually or about 20 percent of all child deaths. AIDS, in contrast, accounts for about 2 percent.

If identified early, pneumonia can be treated with inexpensive antibiotics. Yet UNICEF and the World Health Organization estimate less than 20 percent of those sickened receive the drugs.

A vaccine has been available since 2000 but has not yet reached many children in developing countries. The GAVI Alliance, a global partnership, hopes to introduce it to 42 countries by 2015.

Diarrheal diseases, such as cholera and rotavirus, kill 1.5 million kids each year, most under 2 years old. The children die from dehydration, weakened immune systems and malnutrition. Often they get sick from drinking dirty water.

The worst cholera outbreak to hit Africa in 15 years killed more than 4,000 people in Zimbabwe last year. The country recently reported new cases of the waterborne disease, and more are expected as the rainy season peaks and sewers overflow.

Rotavirus, a highly contagious disease spread through contaminated hands and surfaces, is the top cause of severe diarrhea, accounting for more than a half million child deaths a year.

A vaccine routinely given to children in the U.S. and Europe is expected to reach 44 poorer countries by 2015 through the GAVI Alliance.

"Every child in the United States gets it, even though they have access to clean water and hygiene," said John Wecker, of the Program for Appropriate Technology in Health, a Seattle-based nonprofit that is part of the vaccine alliance. "The only effective way to prevent these deaths is through vaccination."

Diarrheal diseases received more attention in the 1980s and 1990s, he said, but interest has waned or been diverted elsewhere, allowing them to creep back.

"How did the leading killers end up at the bottom of the global health agenda? I don't know," Wecker said at a recent GAVI meeting in Hanoi . "We've got the tools. We're not looking for the next technological breakthrough. It's here now and it's not being used."

Death can often be prevented by giving children fluid replacement, a simple recipe of salt and sugar mixed with clean water to help ward off dehydration. Yet 60 percent of children with diarrhea never receive the concoction, according to a WHO and UNICEF report released last month.

"It is so preventable," said Dr. Richard Cash, a Harvard University expert who helped develop the oral rehydration therapy 40 years ago. "Preventing the deaths is at the very least what we should be striving for."

AIDS activists to Obama: Send funds to the South

Nov 16, 2009

JACKSON , Miss. – People with AIDS, activists and health care professionals want the Obama administration to provide more money to combat the disease's toll in the rural South.

That will be the message Monday in Jackson , when a top White House aide holds a community discussion to gather input on a national strategy to combat the disease.

Patrick Packer of the Southern AIDS Coalition says the South leads the nation in percentage of new HIV cases, yet it receives the less federal funding than any other region in the U.S.

Packer says that medication assistance programs in some states have waiting lists, and that care for patients is lacking despite changes to steer more money to rural areas.

US AIDS program undaunted by recession, head says

By DONNA BRYSON, Associated Press Writer Donna Bryson, Associated Press Writer  Nov 18, 2009

PRETORIA , South Africa – The global recession is not dampening America 's international drive to stop AIDS, the head of the campaign said Wednesday.

Eric Goosby also described a new era of cooperation with South Africa , the nation that bears the greatest AIDS burden and where officials are turning around policies once led by a president and a health minister who denied HIV causes AIDS.

International aid groups have expressed fears that the international economic downturn threatens AIDS funding. Goosby, who heads the President's Emergency Plan for AIDS Relief, known as PEPFAR, acknowledged the economy was a concern and that other U.S. government departments were cutting back.

But Goosby said President Barack Obama and Secretary of State Hillary Rodham Clinton have assured him his program remains among "the highest priorities."

"It's a clear commitment," Goosby said in a telephone interview from Washington . "I'm grateful that the president and the secretary have prioritized this."

In South Africa , PEPFAR's budget was to grow from $550 million in the current budget year to $560 million for 2010-11, said Mary Fanning, head of health programs at the U.S. Embassy in Pretoria .

South Africa , a nation of about 50 million, 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. The country is the largest recipient of PEPFAR funds.

For nearly a decade, AIDS policy in South Africa was set by former President Thabo Mbeki, who denied the link between HIV and AIDS, and his health minister Manto Tshabalala-Msimang, who promoted beets and garlic as AIDS treatments.

A Harvard study has concluded that more than 300,000 premature deaths in South Africa could have been prevented had officials here acted sooner to provide drug treatments to AIDS patients and to prevent pregnant women with HIV from passing the virus to their children.

President Jacob Zuma, who took office after elections earlier this year, and his health minister, Dr. Aaron Motsoaledi, have said bluntly that past policies were wrong. Motsoaledi has set a target of getting 80 percent of those who need AIDS drugs on them by 2011.

Fanning, the U.S. Embassy health chief, said the U.S. was gearing up to help Motsoaledi reach his goals. In an unprecedented move, it had left 5 percent of next year's budget free to be used as the South African government saw fit.

"We are very gratified to be able to partner with the Zuma administration in a much more robust manner," Goosby said.

Former President George W. Bush launched PEPFAR in 2003, and the program earned him fans in Africa . During the Bush years, it helped to treat more than 2 million Africans, and supported 10 million more.

AIDS activists have been closely watching for signs of how PEPFAR will fare under Obama. Medecins Sans Frontieres has expressed concern about funding, saying PEPFAR-supported programs in Africa have been told to turn away new patients. Goosby and Fanning, though, said PEPFAR's budget was secure.

The international charity World Vision made a point in a recent statement to urge the U.S. Congress to keep funding AIDS and other health programs.

  Buenos Aires grants first marriage license to gays

By VANESSA HAND ORELLANA, Associated Press Writer Vanessa Hand Orellana, Associated Press Writer Mon Nov 16, 2009

BUENOS AIRES, Argentina – Two men were granted a marriage license in Argentina's capital on Monday, breaking ground in a country and region where laws ban gay marriage.

Jose Maria Di Bello and his partner Alex Freyre won the right to get married when a judge ruled last week that a ban on gay marriage violates Argentina 's constitution.

"On December 1st we will become man and man," said Di Bello, welling up in tears as a city clerk gave him the paperwork.

Buenos Aires Mayor Mauricio Macri said the city will not appeal — in effect inviting other same-sex couples to pursue their rights in court as well.

"We have to live with and accept this reality: the world is moving in this direction," Macri said Friday, adding that it is important officials "safeguard the right of each person to freely choose with whom they want to form a couple and be happy."

Freyre, 39, executive director of the Buenos Aires AIDS Foundation, and Di Bello, 41, an executive with the Argentine Red Cross, sued after being denied a license in April.

Their request was granted by Judge Gabriela Seijas, who said laws limiting marriage to "a man and a woman" violate constitutional rights of equality.

Argentina 's Congress is considering changing dozens of articles in the civil code to enable same-sex marriage. The proposal has support among ruling party lawmakers but President Cristina Fernandez has yet to take a stand. The Roman Catholic Church and other Christian groups are opposed.

Currently no country in Latin America allows gay marriage, though some jurisdictions allow gay partners to form civil unions with many of the same rights.

Seijas' ruling sets no precedent beyond this case, but other gays and lesbians can cite it and hope for positive results in court if their requests for marriage licenses are denied.

"Ideally we want the bill to pass so that couples won't have to resort to this type of action," said Maria Rachid, president of the Gay, Lesbian, Bisexual and Transsexual Federation of Argentina.

Buenos Aires in 2002 became the first city in Latin America to allow same-sex civil unions, and Mexico City followed in 2007. Uruguay has legalized civil unions nationwide. Spain went further, legalizing same-sex marriage in 2005.

The men — both HIV positive — plan to marry on World AIDS Day at the same civil registry in the capital's Palermo neighborhood. They told The Associated Press that marriage — and not just a civil union — is important to them because they want a shared health insurance policy and inheritance rights, among other things married couples now enjoy.

Puerto Rico gay slaying investigated as hate crime

By MIKE MELIA, Associated Press Writer Mike Melia, Associated Press Writer Nov 18, 2009

SAN JUAN , Puerto Rico – The slaying of a gay teenager whose decapitated, partially burned body was found along a road in Puerto Rico last week is under investigation as a possible hate crime, a police official said Wednesday.

Activists say it would be the first case in this U.S. territory to invoke a law covering crimes based on sexual orientation.

The dismembered body of 19-year-old college student Jorge Steven Lopez Mercado was discovered Friday in the interior town of Cayey . Lopez was widely known as a volunteer for organizations advocating HIV prevention and gay rights, and activists are planning remembrance vigils for him in cities including San Juan , New York and Chicago .

A suspect was arrested earlier this week, and a prosecutor who interrogated him concluded the killing was a hate crime, police Col. Hector Agosto said. No charges had been filed in the case as of Wednesday afternoon.

The prosecutor, Jose Bermudez Santos, said the suspect met Lopez while looking for women Thursday night in an area known for prostitution. Bermudez said the suspect confessed to stabbing Lopez, who was dressed as a woman, after discovering he was a man.

"He has a deep-seated rage," Bermudez said in remarks reported by the newspaper El Nuevo Dia.

A suspect convicted of a hate crime offense as part of another crime automatically faces the maximum penalty for the underlying crime. For a murder charge, that would be life in prison.

A 2002 hate crime law in Puerto Rico has not been applied to cases involving sexual orientation or gender identity despite calls to use it more aggressively, said Pedro Julio Serrano, a Puerto Rico native who is a spokesman for the National Gay and Lesbian Task Force.

Serrano said he has identified at least 10 slayings on the island over the last seven years that should have been investigated as hate crimes, including some in which the victims were sex workers.

Two U.S. Congress members from New York , who are of Puerto Rican origin, have suggested prosecuting the case under new federal hate crimes legislation that extended coverage to sexual orientation. President Barack Obama signed it last month.

The FBI is monitoring the investigation, and Lymarie Llovet Ayala, a spokeswoman for the U.S. attorney's office in San Juan , said Wednesday that federal prosecutors are considering whether to take on the case.

Puerto Rico has some history of violence against gays. In the 1980s, the island was terrorized by serial killer Angel Colon Maldonado, known as "The Angel of the Bachelors," who was linked to the murders of 27 homosexual people and is serving life in prison.

But the island also is known as a welcoming place for gays, particularly in comparison with more socially conservative Caribbean islands where homosexuals often live in hiding.

"The people of Puerto Rico are very inclusive and accepting of differences," said Serrano. "I think these kinds of crimes show the ugly side of homophobia, but it's a minority of people that are willing to be so violent in expressing their prejudice,"

Serrano said a protest against homophobia was planned for Thursday outside Puerto Rico 's Capitol.

UGANDA : AIDS Commission takes new direction in prevention

Source: IRIN

KAMPALA , 16 November 2009 - The Uganda AIDS Commission (UAC) is revamping its national HIV information campaign after HIV prevention messages were less successful than hoped.

"We shall use basic facts in the messages to communicate effectively because we have realized that the level of knowledge about basic facts on HIV information is quite limited," said Saul Onyango, senior health educationist with the UAC.

The term high-risk sex - previously defined as sex with an irregular partner - is to be redefined as sex with anyone whose HIV status is not known. As such, the term "most at-risk populations" will no longer refer to specific groups such as sex workers, fishing communities and men who have sex with men, but to all members of the population engaging in risky sex.

Campaigns aimed at ending cross-generational sex will be abandoned in favour of generic warnings about engaging in risky sex because of fears that young people may believe that sex within their own generation is risk-free. Officials have also said factors such as alcohol abuse, which predispose people to risky sexual behaviour, must be tackled alongside HIV prevention.

The commission has assembled a team of medical and communication experts to develop the new messages, and will work with English and local language media to disseminate them.

"We have to change the destiny of this country, even if it means putting back the drums of the 1980s that used to frighten people," said UAC director-general, David Kihumuro Apuuli.

An ominous drumbeat, followed by a booming voice warning that "AIDS kills", was the centre of a radio HIV prevention campaign when Uganda first began its fight against HIV in the late 1980s. Several senior officials - including Jesse Kagimba, senior presidential adviser on HIV/AIDS - have called for the return of fear-driven campaigns, which they say were instrumental in Uganda 's initial success in lowering prevalence.

However, detractors of this method say the key to success in prevention is education, not fear. Some studies http://www.popline.org/docs/1323/147687.html show that scare tactics alone do not lead to behaviour change, but rather encourage denialism and fatalism. Experts also say that such campaigns promote stigma and discrimination, and that in the age of widely available life-prolonging antiretroviral medication, they could prove ineffective.

After successfully bringing prevalence down from more than 20 percent in the 1980s to about 6 percent by 2000, Uganda 's HIV levels have stagnated, showing a marginal increase in prevalence over the past few years.

Tailored response

The new messages will attempt to bring the HIV response in line with the drivers of the epidemic. According to a recent study http://www.unaidsrstesa.org/files/u1/Uganda_MoT_Country_Synthesis_Report_7April09_0.pdf, 37 percent of new Ugandan HIV infections are attributable to multiple partnerships, 35 percent occur within discordant monogamous couples, 18 percent are due to mother-to-child transmission, and 9 percent occur through commercial sex networks.

"We need to change the mentality and behaviour of men; they have multiple sexual partnerships now called side dishes, which is creating a web," Kihumuro said. "Before we know it the whole of Kampala [the capital] will be entangled into one web."

According to the UAC, there are 110,000 new HIV infections annually and 63,000 deaths from HIV-related illnesses.

The study found that although Uganda had made good progress in rolling out key HIV prevention services, the campaigns had not reached all sections of the population.

"Over three-quarters of all adults, including many people living with HIV, do not know their HIV sero-status; services for PMTCT currently reach less than half of pregnant women," it found. "Although condom use has increased, its coverage has not yet reached the critical levels necessary for it to impact on population level HIV transmission."

Kihumuro noted that there was an urgent need for the government to commit more resources to the fight against HIV/AIDS. At present, the government funds about 6 percent of the national HIV response.

"A lot of the money coming in is from donors; we cannot sustain this," he added.

NY protesters target Uganda anti-gay law

Nov 19, 2009

NEW YORK (AFP) – Demonstrators targeted Uganda 's UN mission in New York on Thursday to protest a proposed law that would punish homosexuality with life in prison in the eastern African country.

About 40 people picketed the UN mission at Uganda House in Manhattan , chanting: "Gay rights are human rights. Dismiss the law now!"

Uganda has come under international criticism for the draft law that would punish "touch(ing) another person with the intention of committing the act of homosexuality" with life behind bars, according to the International Gay and Lesbian Human Rights Commission, which organized the protest.

The law would impose the death penalty for "aggravated homosexuality," including by those who are HIV positive.

"It's unimaginable. You're talking about the death penalty and prison for an entire class of human beings," said protestor Brendan Fay, 50, a filmmaker.

"It's incredible that in 2009 a nation's parliament is considering this," he added.

Mark de Solla Price, 49, came to the demonstration with his male partner Vinny Allegrini and said Uganda was "on the wrong side."

He waved a placard that read "love should be legal everywhere" on one side and "shame on Uganda " on the other.

France and the United States have condemned the bill.

One of the bill's supporters, Ugandan lawmaker David Bahati, responded earlier this month by saying that "homosexuality is not a human right".

"The fact that the moral fabric of America and Europe has been put under siege by the supporters of this creeping evil of homosexuality should not suggest that we follow suit."

Prostitutes fear S.Africa's World Cup clean-up

Nov 20, 2009

JOHANNESBURG (AFP) - Jabulisile works the streets in Hillbrow, a rough area normally avoided by tourists, but just a stone's throw from one of the World Cup stadiums that she hopes will bring in visitors looking for sex.

"The World Cup will be good for business," said the 48-year-old, who said she turned to prostitution to feed her two children.

Every day, her work brings the risk of arrest -- for her and her clients.

She hopes the authorities will let her work in peace during the World Cup, which runs June 11 to July 11, when she dreams of earning enough to build a little nest egg that would let her leave prostitution.

"I am going to quit after the World Cup. I won't be a sex worker until 65," she said.

But Jabulisile could be disappointed. Despite calls to decriminalise prostitution, South Africa could instead try to crack down.

In September, Cape Town set up a vice squad tasked with "cleaning up" the city's brothels and prostitutes -- a move applauded by religious and family groups.

"There is quite a sense of religious and sexual moralism on the subject that does not help in term of public health and human rights," said Marlise Richter, a researcher who collaborates with sex worker advocacy groups.

"Making sex work more invisible makes it harder for sex workers to negotiate safer sex, and it will have greater influence on HIV prevalence."

South Africa already has the world's biggest HIV caseload, with 5.7 million of its 48 million people infected. An estimated 45 percent of prostitutes have the disease, according to a 1998 study.

Branding their work as a crime also leaves prostitutes vulnerable to abuse from their clients, pimps, and the police, Richter added.

"The police are harassing us, they ask for money," Jabulisile said. "We give the money, and if we don't, they sleep with us. You sleep with them because you are scared that they will put you in jail."

South Africa in 1997 revised its sex crimes laws, inherited from the racist and puritanical apartheid government.

Parliament decriminalised homosexuality, and toughened penalties for rape and paedophilia. Early next year, lawmakers are due to consider a human trafficking law.

But criminal penalties for adult prostitution remain unchanged. The Law Reform Commission, which is due to release a report on the subject in 2011, voluntarily excluded prostitution from the initial reforms.

"We did not include adult prostitution (in this review) because it is quite contentious on its own and we did not want to hamper the process," said Dellene Clark, an official at the commission.

Without new legislation in place before the World Cup, prostitutes are seeking a moratorium on enforcement during the competition. For the moment, the government isn't taking a decision.

Sibani Mngadi, spokesman at the ministry for women, said government had taken "no position at this stage".

"There are ongoing discussions involving various groups to look at what should be the appropriate situation in South Africa , what would be in the best interests of women," he said.

The government won't wade into the issue soon, said Chandre Gould, a researcher at the Institute for Security Studies, who authored a study on prostitution.

"It is such a difficult matter, and the chances are that it will generate so much controversy, that I don't think anybody in the ruling party is going to be pushing for this issue to be debated by parliament before the World Cup," Gould said.

"We know that South Africa has put a lot of energy in tidying up and making South Africa look much more pretty and tourist-friendly," Richter said.

"If you follow the signs from Cape Town , our fear is that these vice squads will be rolled out in other big areas as well."

Woman guilty of having HIV sex

By KEVIN CONNOR, SUN MEDIA

21st November 2009

A woman with HIV was sentenced to two years house arrest for having sex with a man and not disclosing her positive status.

Robin St. Clair, 28, who pleaded guilty to two counts of sexual assault, cried in court yesterday when she was told she would be registered as a sex offender for life and would be made to provide a DNA sample.

Prior to going into the Finch Ave. courtroom, St. Clair was all giggles and was ogling a picture of shirtless men in the Toronto Sun.

She didn't speak in court, and at times looked bored and picked her teeth.

Justice Paul Taylor said the victim "won't find favour with my decision."

"No sentence could restore (his) confidence in fellow human beings."

The man -- who can't be named because of a publication ban -- met St. Clair in March, 2007, at a Toronto house and asked St. Clair for oral sex.

St. Clair said no but agreed to have intercourse with a condom.

The man had intercourse with St. Clair twice and on the second occasion the condom ripped.

That was when St. Clair told the man she was HIV-positive, even though in 2004 she was issued with a so-called "Section-22" from public health officials that details her responsibility to disclose her status.

"Criminal law has a role to play when people with HIV put the lives of others at risk. No one would voluntarily get the disease," Taylor said.

"(The man) was exposed to a risk he shouldn't have been exposed to. If he was told of her status he would have rejected her, which was his decision to make."

Court heard the man had a one in 2,000 chance of contracting the HIV virus. He remains disease-free.

Taylor said St. Clair's actions weren't calculating so he decided to let her serve he time under house arrest.

"She wasn't seeking out men to expose them to the disease," Taylor said.

"But she is not blessed with all the intellectual gifts."

St. Clair is only allowed to leave the house on Saturdays between noon and 4 p.m. for shopping and is not allowed to communicate with the man she could have infected.

She will also be on probation for three years after the house arrest.

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