News (Updated July 18, 2009)

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Global Fund grants Togo $108 mln to fight AIDS

Friday, July 17 07:42 pm

The Global Fund to Fight AIDS, Tuberculosis and Malaria has granted Togo 108 million dollars (77 million euros), the health ministry said on Friday.

The grant will support antiretroviral (ARV) treatments for those afflicted by AIDS as well as organisations fighting the pandemic, it said.

Togo 's prevalence rate is estimated at 3.2 percent and access to ARV treatment was made free last November.

Around 9,100 of 26,232 HIV-AIDS patients are on ARV treatments, according to the national programme to fight HIV.

From storm-tossed Ala. clinic to top doctor post

wpe2.jpg (9647 bytes)By DESIREE HUNTER, Associated Press Writer Desiree Hunter, Associated Press Writer Tue Jul 14, 3:17 am ET

BAYOU LA BATRE, Ala. – Battered and flooded by Hurricane Katrina, this coastal Alabama fishing village was in wreckage four years ago when Dr. Regina Benjamin began assessing her patients' needs. Trouble was, her little health clinic had been flooded and they couldn't come to see her.

So she went to them.

She could be seen "going door-to-door in all that mud and sewer, just a mess from her head to her toes with boots on," Stan Wright, one of her patients, said Monday, hours after Benjamin was nominated by President Barack Obama to be U.S. surgeon general.

"It'd be way before we'd open the roads up for traffic and I was concerned she was going to run into a big washout hole or something, but she'd put on her rain coat and boots and get her little doctor's bag and say, 'I'm going to go check on my patients'," said Wright, the town's mayor.

People across the bayou voiced pride that Obama had reached into a rural, economically struggling area for a physician to become the nation's top doctor.

"I'm shocked. It's good news. Nothing that good ever happens in the bayou," said Jason Ngam ( NAM '), 20, who is not a patient at the clinic but like many others is familiar with it.

After Katrina ruined the nonprofit clinic — as another hurricane had done several years before — Benjamin laid out medical charts to dry in the post-storm sun and pointed out the need for electronic records that would be invulnerable to hurricanes.

Rebuilt by volunteers, the clinic burned down just as it was about to reopen after Katrina. Awarded a $500,000 MacArthur Foundation "genius grant" last fall, Benjamin promised to use the money to help finish the job.

Today, the temporary clinic is a small brick building next to City Hall with a wooden ramp leading to its door. Behind it stands another building three times its size that will be the new clinic, which is to be completed when more money comes in.

On Monday, the 52-year-old Benjamin pledged to take her fight from the rural, impoverished outpost to the top tier of American medicine so that "no one falls through the cracks."

Her focus has long been on preventable disease and she will continue in that line. It's a cause she knows personally and three times over. Her father died with diabetes and high blood pressure, her mother died of lung cancer after years of smoking and she lost her only brother to HIV.

"I cannot change my family's past. I can be a voice in the movement to improve our nation's health care and our nation's health," Benjamin said. "I want to be sure that no one falls through the cracks as we improve our health care system."

Speaking from the White House Rose Garden, Obama noted the obstacles Benjamin has overcome and said she "represents what's best about health care in America , doctors and nurses who give and care and sacrifice for the sake of their patients."

The diverse patient mix of Bayou La Batre — white, black and, increasingly, immigrants from Vietnam , Cambodia and Laos — was evident Monday as a steady rotation of people visited the clinic.

Waiting patients were treated to a nearly constant chorus of rings from the practice's two telephone lines as people called to offer congratulations and support.

If confirmed by the Senate, Benjamin would assume a job as the people's health advocate, a bully pulpit position that can be tremendously effective when paired with an effective personality.

Benjamin won't have any problem combining the powerful position with her personality to produce results for the country, said Elorise Bradley, who has been a patient of Benjamin's for the past three years.

"She has a personality that I've never really seen in a person that is a doctor. She's just sweet and she's funny sometimes but very, very stern," she said. "Whatever she says, she means it. She's gotten on me a couple of times about medication when I don't do it right or take it on time — she'll get you."

Benjamin, a Daphne native, became the first black woman and the first doctor under age 40 elected to the American Medical Association's board of trustees, and in 2002 became the first black woman to head a state medical society.

She served as a National Health Service Corps scholar with Mostellar Medical Center in nearby Irvington in the 1980s, which helped her pay off student loans from medical school and later went to Tulane where she earned a master's degree in business administration.

But despite all her accomplishments, she hasn't lost her down-to-earth ways, said Ruth Marchand, a resident of nearby Grand Bay .

Her son Al went to fix the clinic's air conditioner once and went in to see a woman mopping the floor where the cooling unit had fallen to the ground.

"He told the lady he was there to see the doctor and she said 'I'm the doctor,'" Marchand said, adding that her son had told the story as an example of the doctor's humility. "That impressed Al to think that she wasn't too good to mop the floor."

 

US AIDS chief lays out priorities  

Published online 8 July 2009 | Nature 460, 162 (2009) | doi:10.1038/460162a

Focus to shift from US priorities to those of countries receiving aid.

Erika Check Hayden

The new head of the US President's Emergency Plan for AIDS Relief (PEPFAR) takes the reins of the sometimes controversial programme just as the global economic slump has made the job more difficult than ever.

The Senate confirmed physician Eric Goosby as US global AIDS coordinator on 19 June. Goosby was deputy director of the White House Office of National AIDS Policy during the Clinton administration, and then chief executive officer of the non-profit Pangaea Global AIDS Foundation in San Francisco , California .

“Goosby has got an enormous challenge ahead of him.”

Doctors and advocates hope that Goosby will expand PEPFAR's success in delivering AIDS treatment and services while ditching less favoured parts of the programme, such as its focus on prevention by the ABC strategy — abstain, be faithful, use condoms.

"He is incredibly well-grounded in the prevention and treatment issues facing the developing world," says Christine Lubinski, vice-president for global health at the Infectious Diseases Society of America in Arlington , Virginia . "But he has got an enormous challenge ahead of him."

In May, advocates called President Barack Obama's global health request of $63 billion over six years "meager", saying it broke his campaign pledge to provide $1 billion a year in new spending for PEPFAR. The plan spent $18.8 billion between 2003 and 2008, making it the largest aid programme for one disease.

The recession has forced some aid recipients to scale back. In February, Botswana — which has received more than $300 million from PEPFAR — said that after 2016 it might stop enrolling patients in its programme to provide free medications. And in May, Tanzania , a recipient of $828 million from PEPFAR, said it would shrink its AIDS programmes by 25%.

"The sustainability issue is of high concern for us," Goosby acknowledges. He hopes to shift PEPFAR's focus away from US non-governmental organizations and towards helping aid-recipient governments set their priorities.

His other main priority is prevention. PEPFAR has been criticized for focusing on ABC because it fails to help many groups at risk in developing nations, such as married women. Goosby says PEPFAR's prevention efforts must be more sustained and aggressive, should target high-risk groups and should broaden their focus — by, for instance, making condoms and reproductive-health services more widely available.

These priorities are encouraging to doctors and advocates such as Paul Volberding, vice-chair of medicine at the University of California , San Francisco . "I think that there will be some big changes," he says.

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Feds: HIV doesn't block barber, masseuse licenses

On Thursday July 16, 2009

WASHINGTON (AP) -- Aspiring barbers, masseuses, and home health care aides cannot be denied professional licenses because they have AIDS or HIV, federal authorities said Thursday.

The Justice Department is advising state authorities that it is a violation of the Americans with Disabilities Act to stop someone with the HIV virus from getting such licenses or not admitting them to occupational training schools.

For instance, some states require cosmetologists be free from contagious, communicable or infections diseases. The government says that type of regulation is outdated and was not intended to bar people with HIV.

The original goal of such a rule was to prevent the spread of tuberculosis and other diseases, not prevent people with the HIV virus from working in certain fields. Because HIV is not spread through casual contact, barring people with the virus from such professions is discriminatory, officials said.

"People with HIV or AIDS should not be denied access to their chosen profession because of outdated laws or unfounded stereotypes and fears," said Loretta King, the acting head of the Justice Department's Civil Rights Division.

The Supreme Court has found people with AIDS or HIV are covered under the law barring discrimination against people with disabilities.

 

UK health booklet's message: Teen sex can be fun

By GREGORY KATZ, Associated Press Writer Gregory Katz, Associated Press Writer Tue Jul 14, 2009

LONDON Britain 's National Health Service has a message for teens: Sex can be fun. Health officials are trying to change the tone of sex education by urging teachers to emphasize that sexual relations can be healthy and pleasurable instead of simply explaining the mechanics of sex and warning about diseases.

The new pamphlet, called "Pleasure," has sparked some opposition from those who believe it encourages promiscuity among teens in a country that already has high rates of teenage pregnancy and sexually transmitted diseases.

The National Health Service in the city of Sheffield produced the booklet, which has a section called "an orgasm a day" that encourages educators to tell teens about the positive physical and emotional effects of sex and masturbation, which is described as an easy way for people to explore their bodies and feel good. Like more traditional sex education guides, it encourages demonstrations about how to use condoms and other contraceptives.

Some professionals have hailed the new approach as a welcome antidote to traditional sex education, which they say can be long on biological facts but short on information about the complexity of human relationships.

The booklet suggests ways in which teachers can encourage sexual awareness and responsibility while teaching young people that sex is something that is meant to be enjoyed.

Steve Slack, who helped produce the leaflet as Director of the Center for HIV & Sexual Health in Sheffield , said one goal is to help young people learn to resist peer pressure and delay having sex until they are emotionally ready.

"Far from promoting teenage sex, it is designed to encourage young people to delay losing their virginity until they are sure they will enjoy the experience," he said.

Slack said some of the ideas in the booklet came from the Netherlands , which is well known in Europe for its liberal attitude toward sexual behavior.

But the pamphlet is condemned by some educators who believe it will lead to more casual sex among teens.

"Some of it is good sense, but I think it's wrong is to suggest that 16-year-olds should wantonly enter into having sexual intercourse for pleasure," said Anthony Seldon, headmaster of Wellington College , a school for teens. "I think this is medically wrong and emotionally wrong and will increase teenage pregnancy and impact negatively on the formation of a long-term loving relationship."

He said teens should be taught about the value of a long-term commitment, not simply about the pleasures of sexual intercourse.

Ruth Smith, news editor of Children & Young People Now magazine, said one goal of the new booklet is to help young people become more comfortable with their sexuality and to let them know they can speak out if they are abused or forced into a situation they don't like.

"Research shows young people feel pressured to have sex before they're ready," she said."This booklet is intended to give them the skills to discuss it. It's not a license to go out and have sex, it's saying if you do, do it, wait until you're ready and enjoy it. It makes them more confident and more able to say no."

She said the instruction guide will not be given to students but is intended to suggest ways in which teachers can start a conversation about sex.

"It's trying to find what works with young people," she said.

 

Allies' stance cited in US gays-in-military debate

By DAVID CRARY, AP National Writer David Crary, Ap National Writer Mon Jul 13, 3:53 am ET

wpe5.jpg (10075 bytes)NEW YORK – When it comes to dealing with gay personnel in the ranks, the contrasts are stark among some of the world's proudest, toughest militaries — and these differing approaches are invoked by both sides as Americans renew debate over the Pentagon's "don't ask, don't tell" policy.

In the United States , more than 12,000 service members — including dozens of highly trained Arabic linguists — have been dismissed since 1994 because it became known they were gay. Current targets for discharge include a West Point graduate and Iraq war veteran, Army National Guard Lt. Dan Choi, and a veteran of combat missions over Iraq and Afghanistan, Air Force Lt. Col. Victor Fehrenbach.

In Britain , on the other hand, gay and lesbian service members marched in crisp uniforms in the annual Pride London parade July 4. Gay Australian soldiers and sailors had their own float in Sydney 's Gay Mardi Gras parade. In Israel , the army magazine earlier this year featured two male soldiers on the cover, hugging one another.

America 's "don't ask, don't tell" policy — which prohibits gays from serving openly in the armed forces — is the target of intensifying opposition, and President Barack Obama says he favors lifting the ban. But he wants to win over skeptics in Congress and the Pentagon, and a fierce debate lies ahead that will inevitably touch on the experiences of allied nations that have no bans.

U.S. Rep. Patrick Murphy, the first Iraq war veteran elected to Congress, has just launched a campaign for a bill to repeal "don't ask, don't tell." He observed British troops in Iraq operating smoothly with a serve-openly policy and bristles at the contention that America's armed forces would suffer morale and recruiting problems if they followed suit.

"I take it as a personal affront to our warriors," said the Pennsylvania Democrat. "To say that other countries' soldiers are professional enough to handle this and American soldiers aren't is really a slap in the face."

Those seeking to preserve the U.S. ban question whether the allies' experiences have been as smooth as advertised and depict America 's military as so unique that lessons from overseas should be ignored anyway.

"We are the military leaders in the world — everybody wants to be like us," said Brian Jones, a retired sergeant major who served in the Army Rangers. "Why in the world would we try to adjust our military model to be like them?"

With such polarized views as a backdrop, Associated Press reporters took an in-depth look at how the militaries of Israel , Britain and Australia have managed with serve-openly policies, and interviewed partisans on both sides of the debate in the United States about the relevance of those experiences.

 

SOUTH AFRICA : Sexual abuse behind bars

13 Jul 2009 16:41:04 GMT

Source: IRIN

Reuters and AlertNet are not responsible for the content of this article or for any external internet sites. The views expressed are the author's alone.

JOHANNESBURG , 13 July 2009 (IRIN) - Sexual abuse is widespread in South Africa 's prisons, but the provision of health services to this vulnerable population remains problematic.

A rights group, Just Detention International (JDI), alleges that overcrowding, staff shortages and a culture of violence in correctional facilities are fuelling sexual abuse and rape - crimes against which there is little or no protection.

JDI Programme Director Cynthia Totten said a recent study at South Africa 's Pollsmoor Maximum Security Prison, 25km outside Cape Town , found that inmates at high risk of HIV infection had inadequate access to condoms, lubricant and medical services.

In some cases, forced or coerced sex in prison may be part of being initiated into one of South Africa 's notorious "Numbers gangs", like the infamous 27s and 28s, said Sasha Gear, a researcher at the South Africa-based Centre for the Study of Violence and Reconciliation.

In other cases it may be about manipulation, like being tricked into accumulating a debt in the form of drugs, food or protection that will have to be repaid with sex, she told IRIN/PlusNews.

"I met a 15-year-old boy in prison who said he would look after me ... he invited me to sleep with him [in the same bunk] for protection, and in the middle of the night he sodomised me," one inmate told Totten. "I was angry and demoralized ... this wasn't supposed to happen to me."

As of March 2008, most of South Africa 's prisons were housing 50 percent more prisoners than they were designed to accommodate, according to comments submitted to parliament by then Correctional Services Minister Ngconde Balfour.

Big court cases, little change

Despite a ground-breaking ruling in 2006 that guaranteed access to treatment for prisoners, Totten said there had been little change, and the quality of HIV-related health services varied from prison to prison.

"All inmates are supposed to have access to condoms, but it's so problematic in prisons that once the dispenser runs out of condoms it could be months or weeks before it's refilled," she said. "And where condoms are distributed, there's no lubricant, so you find inmates using substitutes for lubricant that could comprise the condoms' integrity."

Data on HIV prevalence among inmates are hard to come by, but a 2006 survey by the Department of Correctional Services in its Westville prison, outside the east-coast port of Durban , indicated an infection rate of 22 percent.

 


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