News (Updated August 28, 2011)

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Global Fund lifts China grant freeze

By GILLIAN WONG, Associated Press – 23 August, 2011

BEIJING (AP) — A high-profile global health fund that has come under pressure to clean up corruption has ended its dispute with China and will resume hundreds of millions of dollars in funding for programs to fight AIDS and other diseases, thereby removing a source of embarrassment for Beijing.

The Global Fund to Fight AIDS, Tuberculosis and Malaria froze disbursements of its AIDS grant to China in November and then all other grants in May over suspected misuse of the money and the government's reluctance to involve community groups. The move was seen as a rebuke to the authoritarian government over its customary suspicion of independent groups.

The Geneva-based Global Fund said Tuesday it is lifting the freeze on funding to China to ensure AIDS work in the country continues while it works with government officials, representatives from United Nations' agencies and private groups to resolve the dispute.

"During these discussions, the parties agreed to resume funding flows to ensure that the Chinese AIDS program would not be impeded by the ongoing efforts to strengthen fiduciary controls and to ensure sufficient civil society engagement in The Global Fund-supported programs," Global Fund spokesman Jon Liden emailed in response to an Associated Press query.

" China and The Global Fund will continue to work closely together to tighten fiduciary controls and ensure that programs are as effective as possible in combatting the three diseases," Liden said. He said the lifting was effective immediately.

The Global Fund froze payments of a $283 million AIDS grant in November after finding that Chinese government agencies had breached an agreement by channeling too small a share of the funds to grass-roots groups. Then in May, it stopped payments of all other grants in China after concerns about how the money was being used by the thousands of counties that receive grant payments.

Earlier this year, the $22 billion Global Fund faced a backlash among major donors over reports of corruption. It has said it will make public more detailed information about money it has lost to fraud and mismanagement.

Resolving the China dispute could mean China will continue to receive payments of $300 million in funding over the next several years for programs to prevent and treat HIV and AIDS in prostitutes, injecting drug users and others and for malaria and tuberculosis — unless the recent talks resulted in a reduction of the funding.

Beijing already funds the majority of its efforts to fight AIDS, TB and malaria, the fund added in its statement.

The dispute comes amid a larger debate among international aid donors and groups about whether China should continue to receive foreign aid, considering its relative prosperity resulting from decades of high economic growth. Critics point to the government's ability to fund a manned space program and extravaganzas like the 2008 Beijing Olympics, while proponents say China still has hundreds of millions of poor and needs international know-how.

Critics have said that by competing with poorer developing countries for Global Fund grants, China is effectively robbing the poor. Since 2003, the Global Fund has disbursed $570 million in grants to China .

The Global Fund did not provide details about what the Chinese government has done to meet the demands of the fund before the decision to lift the freeze was made.

But in the months since the freeze, China 's Health Ministry has issued statements acknowledging the contributions of China 's independent health groups. Health Minister Chen Zhu attended a meeting with community AIDS groups in late June in the southwestern city of Kunming and pledged that his ministry would try to help facilitate the work of private groups.

The government has also agreed to allocate 25 percent of the Global Fund budget to community organizations, and to set up a separate entity to manage all funding that is allocated to civil society groups, according to a public tender notice issued late last month by the Chinese Center for Disease Control and Prevention, or China CDC, the Global Fund's main recipient in China.

The China CDC's moves were welcomed by the leader of a network of more than 130 groups working to help people with HIV across in China .

"To community groups, this is a really good thing, because it has pushed the government to change its attitude toward us," said Wang Long, who heads the China National Network of AIDS Community-Based Organizations. "It has made the government value the contribution of civil society groups."

Follow Gillian Wong on Twitter at http://twitter.com/gillianwong

Copyright © 2011 The Associated Press.

 

Fall in Asia-Pacific HIV infections ‘fragile’ - UNAIDS chief

26 Aug 2011

By Thin Lei Win

wpe6.jpg (9035 bytes)BANGKOK (AlertNet) – The decline in new HIV infections across Asia Pacific is “very fragile” as most states rely on shrinking donor funds and prevention programmes fail to reach those most in need, the head of the U.N. agency for HIV/AIDS said in an interview.

“This is a moment of truth in Asia,” Michel Sidibe, executive director of UNAIDS, told AlertNet ahead of the 10th International Congress on AIDS in Asia and the Pacific in Busan, South Korea .

According to a report launched at the meeting , an estimated 4.9 million people in Asia and the Pacific were living with HIV in 2009, a figure that has remained relatively stable since 2005.

“This report is coming at a moment at a time when we are seeing a decline in new infections, but at the same time we are seeing a potential risk because that progress is very fragile,” Sidibe said.

Despite a 20 percent decrease in new infections since 2001, and a three-fold increase in access to lifesaving antiretroviral therapy (ART) since 2006, more than three out of five people who need treatment still cannot access it, the report said.

Asia Pacific could provide universal access to ART, Sidibe said. “It’s just (a case of) prioritisation and certainly, political will,” he added.

FUNDING SHORTFALL

One problem is that funding for HIV/AIDS responses in the region - both from domestic and international sources – remains inadequate. Apart from China , Malaysia , Pakistan , Samoa and Thailand , countries rely largely on international assistance - for up to 95 percent of their HIV budgets in some cases.  

In 2009, an estimated $1.1 billion was spent in 30 countries across the region, approximately a third of the funding needed to achieve universal access to HIV services, according to the Commission on AIDS in Asia .

Funding cutbacks led to a decline in international support for AIDS programmes globally for the first time in 2010. That threatens the sustainability of ART, which is almost entirely funded by donors in many countries, Sidibe told AlertNet from Busan.

Governments need to start looking at paying for their own programmes, he said. Middle-income countries that spend less than 0.5 percent of gross national income on HIV/AIDS could help close the funding gap, he added.

“It is possible, it’s a matter of redefining where our priorities are,” the U.N. official said. “If we don’t invest today we will continue to pay forever.”

SEX WORKERS’ CLIENTS MISSED OUT

Another obstacle is that existing HIV programmes do not target the groups who need them most, and tend to be aimed rather at the general population.

As a result, they have minimal impact on reducing the rising number of HIV infections in the highest-risk groups - people who inject drugs, men who have sex with men and transgender people, and people who buy and sell sex - despite consuming the bulk of resources, Sidibe said.

Most HIV prevention programmes do not reach the male clients of sex workers, according to the report. They number an estimated 75 million across Asia Pacific, and are “the largest single population to transmit HIV to their regular intimate partners”.

Sidibe also pointed to the Philippines  , where after 20 years of a low-level epidemic, infection is spreading rapidly among vulnerable groups. Prevention programmes reach less than 40 percent of their members, according to the latest Philippines ’ country report.

As a result, HIV prevalence among people who inject drugs in the city of Cebu jumped from 0.6 percent in 2009 to 53 percent in 2011, fuelling concerns the virus could start spreading faster among the general population.

“The major challenge is the tendency to feel that those people are living in isolation, but they are interacting with the rest of the population and then the risk is their partners also become infected,” Sidibe said.

“This shows that… if we don’t pay attention to specific communities where prevalence can grow quickly, we could miss the boat in dealing with this epidemic.”

 

S.Africa's HIV infections fall to 5.4 million: government

(AFP) – 26 August, 2011

JOHANNESBURG — The number of people living with HIV in South Africa has dropped slightly to 5.38 million, and the number of AIDS deaths is finally starting to fall, Deputy President Kgalema Motlanthe said Thursday.

South Africa has more HIV infections than any country in the world, previously estimated at 5.6 million by the United Nations in its global report on HIV in 2009, released late last year.

" South Africa has invested a large amount of resources into its HIV response," Motlanthe said in a written reply to a question from parliament, where lawmakers had asked for an update on the success of the anti-AIDS fight.

"The number of deaths due to HIV-related causes is beginning to show a decline due to the intensification of anti-retroviral treatment."

He said government statistics place South Africa 's HIV infection rate at 10.6 percent of the overall population of 50 million people, with 16.6 percent of 15- to 29-year-olds infected.

Among pregnant women, the infection rate stands at just below 30 percent, Motlanthe said. But he added that transmission of the infection from expecting mothers to their babies has fallen from 10 percent to 3.5 percent in the last three years.

Motlanthe said the government is still struggling to reduce the number of new infections.

"The rate of new infections continues to outpace our prevention efforts, and thus prevention programmes will be prioritised in the new national strategic plan which is being developed for the term 2012 to 2016," he said.

Motlanthe's response came several weeks after the end of a massive testing campaign that reached nearly 14 million people, two million of whom tested positive.

It also came on the heels of an announcement by the government that it will provide potentially life-saving anti-retroviral (ARV) drugs to all HIV patients whose CD4 count, a measure of white blood cells, falls below 350 cells per microlitre.

Previously the drugs were only handed out when the count hit 200 cells per microlitre, but studies have found earlier treatment can save people's lives.

South Africa has the largest ARV drug programme in the world, with some 1.3 million people receiving treatment.

Copyright © 2011 AFP. All rights reserved.

 

KENYA : Weak HIV-positive people struggle to access food aid

23 Aug 2011

NAIROBI, 23 August 2011 - Every morning, Julia Aukot walks 17km to eastern Kenya's Isiolo town in search of work so she can feed her six children and ailing husband; the journey is punishing, but as her family's sole breadwinner, she has no choice.

"Here in the village, there is [absolutely] nothing you can do to make money to buy food. So every morning at six, I go to Isiolo town to do menial jobs for people and... buy food for my children and my husband," the 39-year-old told IRIN/PlusNews.

When she cannot find work, Aukot begs on Isiolo's streets - which she finds deeply humiliating - or visits a nearby slaughter house to scrape what little meat is left on the carcasses.

"After they have taken the good meat from the slaughtered animals, I follow them with a knife and cut meat from the remaining skins," she added. "When I gather enough, I take it home and we eat; my children and husband have now gotten used to eating the meat without any ugali [maize meal, a Kenyan staple]. I can't afford maize flour."

A 90kg bag of maize, which in April 2011 cost about KSh2,500 (US$27.10), now costs as much as KSh4,800 ($52).

Aukot's husband used to help out, but the poor diet the family has subsisted on recently has left him very weak. He is on antiretroviral medication, and insufficient food increases the side-effects [ http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0010340 ] of the drugs, leaving him unable to contribute to the family income.

"He is sick, it's not his fault; if he doesn't eat, the medicine can't help him," said Aukot. "I can't sit back and watch him just waste away... he is so weak - for me, there is no difference between him and the children."

Partly because of a prolonged dry spell, some 3.6 million Kenyans need emergency food assistance. While Aukot and her family qualify for aid, poor roads mean the food does not reach her village. Most villagers walk to Isiolo town to access food aid, but the weakest often do not have the energy to walk that far.

"We have food meant for the hungry people but some areas are just too hard to reach," an aid worker in Isiolo told IRIN/PlusNews. "By the time the food [aid] gets to them, many have already gone without anything to eat for days."

Lillian Naseo, a community social worker in Isiolo, asks local well-wishers to donate food, which she then shares with people living with HIV and those infected with tuberculosis.

Too weak to walk

"They can't walk to look for food, not just for themselves but also their families, so I beg for them... I walk into restaurants and when they give me leftovers, I take them to these people," she said. "But this is not enough because I don't know all those living with HIV in Isiolo District."

According to local health officials, Isiolo's HIV prevalence rate is more than 4 percent.

Junnius Mutegi, the district nutrition officer for Garba Tulla District, in upper Eastern Kenya , says: "Life is hard for everybody, but when food aid is not getting to people in the rural areas early enough, many of those suffering from HIV find it extremely difficult to survive, because they can't make the journeys to trading centres to look for food. It is either you get it to them or they die of hunger."

On a dusty street corner in Garba Tulla, Hawa*, 41 and HIV-positive, begs passers-by for money and food. She is too weak to work and without a strong support network, she says her options are to beg or die.

"I need to eat but I can't work and I rely on relief food, but it doesn't come every day, so I moved to town to beg," she told IRIN/PlusNews. "In the village you can't beg, because everybody is just like me... they need food just like me."

According to Mutegi, the situation calls for new ways to ensure the most vulnerable have access to food assistance.

"I think the situation now calls for some innovativeness, so that even if the roads are bad, we can use camels or donkeys to ensure food reaches those who need it in good time," he said. "People living with HIV and taking antiretrovirals seriously need food... Otherwise we are faced with a situation where people will start to default on their drugs, and it is bad if we get there."

*not her real name

ko/kr/am/mw

 

AIDS stalks gay and transgender Indians

By Ammu Kannampilly (AFP) – 24 August, 2011

NEW DELHI India 's success in slashing HIV/AIDS infection rates by 50 percent in the last decade masks a high rate of infection among homosexual and transgender people, experts say.

This anomaly was highlighted last month by the country's Health Minister Ghulam Nabi Azad in a now notorious speech at an AIDS conference that will be remembered for other reasons.

Azad went on to call homosexuality "a disease which has come from other countries" and "unnatural", in comments widely condemned by gay rights activists and AIDS workers.

At the Pahal Foundation in the northern state of Haryana, which provides free HIV tests, condoms and counselling services to gay and transgender people, project manager Maksoom Ali says he faces a constant battle against ignorance. Most gay men, fearing homophobia, are forced to hide their sexual activity, and others have no idea about the dangers of unprotected intercourse, he said.

"Many people think that men having sex with men cannot get HIV and that's one reason why (homosexual and transgender) people have a lot of unsafe sex," Ali told AFP.

The country's National AIDS Control Organisation (NACO) estimates that 7.3 percent of India 's homosexual population lives with HIV, compared with 0.31 percent of the total adult population.

The UN AIDS agency estimated that around a third of men who have sex with men in India fail to access services like HIV testing, sex education and free condom supplies.

Many of the people who use Pahal's services are low-paid factory workers, labourers, or sex workers like 25-year-old Sanam who first came to the centre three years ago.

Sanam, a transgender whose original name was Sushil Kumar Pandey, told AFP she knew nothing about sexually transmitted diseases when she entered the sex trade.

"I never used to take it seriously, we used to do it without condoms," she said.

She learnt about HIV/AIDS only after visiting the Pahal premises.

"They first conducted a blood test on me, then they told me about HIV, what it is, how it spreads. Because of that I always use condoms," she said.

Although the Indian government has committed funds to HIV-fighting organisations that work with the gay and transgender community, many NGOs say that financing falls short.

The Pahal Foundation says it treats 50 percent more people than it has budgeted for.

Gay rights activist and UNAIDS technical officer for sexual minorities, Ashok Row Kavi, said that authorities lack a true awareness of the problem in the gay community.

"We don't have a proper denominator for the number of MSM (men having sex with men), and that number is much higher than what we are willing to accept," he told AFP.

"It's very worrying because hardly four percent of the (government) money for fighting HIV is coming to MSM groups," he added.

Attitudes to homosexuality are slowly changing in India , although it is still often viewed as a mental illness or something shameful to be ignored, particularly in rural areas.

Two years ago, a landmark Delhi High Court ruling decriminalised homosexuality, which was illegal under a 150-year-old British colonial law that banned "carnal intercourse against the order of nature".

Conviction carried a fine and maximum 10-year jail sentence.

But many gay and transgender sex workers who spoke to AFP said they continue to face verbal and physical abuse on a regular basis.

Rupali, a 24-year-old transgender sex worker whose original name was Lalit Sharma, said she feared for her safety nearly every day.

"There are people who turn up drunk, local goons, we have to convince them that there is such a frightening disease going around, there can be a problem like this, so use a condom," she told AFP.

But sometimes, she said, customers used force to pressure her and other sex workers to have unprotected sex.

Most of all she feared the police. "They force us to have sex, they take our money and then they beat us up," she said.

Copyright © 2011 AFP. All rights reserved.

 

More HIV cases in Devon and Cornwall , figures show

wpeB.jpg (10424 bytes)Health professionals took part in Cornwall 's Gay Pride event to raise HIV awareness

The number of people in Devon and Cornwall who are HIV positive has risen, according to the Health Protection Agency (HPA).

The figures for 2009 show 2,804 people living with the disease and accessing NHS care in the South West - 315 more than the previous year.

It is one of the fastest growing conditions in the UK and if left untreated, can lead to Aids.

Health specialists want to encourage more routine testing.

Al Green, project lead for Healthy Gay Cornwall from the Primary Care Trust, said it was important to reduce people's fear of accessing sexual health service as early detection was "crucial".

"Late detection, as we are seeing, means not only that other people are at risk of contracting the infection, it also means that when people are diagnosed they are incredibly ill," he said.

"HIV can affect any one regardless of race, gender and sexual orientation.

"Sexual health check ups should be as routine as getting an eye test or a dental check up."

Health professionals were in Truro on Saturday for Cornwall 's annual Gay Pride event, to raise awareness of the issue.

 

Studies show a spread in HIV among an unexpected Pakistani demographic

By PPI

Published: August 26, 2011

KARACHI

Researchers believe that HIV has spread from the usual ‘at-risk’ groups in Pakistan and has leaked into the bloodstreams of women and children.

wpe12.jpg (30512 bytes)An international team of researchers, including scientists from Aga Khan University and Dow Medical University and from the University of Florida (UF), crunched the numbers to show that Pakistan ’s general population is in danger of contracting the AIDS-causing Human Immunodeficiency Virus (HIV). The team’s epidemiological findings were published in July in the open-access journal, PLoS One.

The researchers are concerned that the transmission of the virus into the general population may serve as an indication that the virus could be spreading into populations within neighbouring Afghanistan also. One way to prove this would be to understand how the virus is spreading and to determine its strain.

“Are the strains in Pakistan and Afghanistan of two different epidemic origins, or are they the same? It’s an important question,” said paper author Marco Salemi of the University of Florida College of Medicine and Emerging Pathogens Institute. “Genetic evidence can be used to test how different populations are intersecting. As you can imagine, behavioural data is difficult to get in some countries and this is why molecular tools are important.”

The team explained that the technique used to understand how this particular virus spreads could also help healthcare professionals understand and intervene in other deadly disease outbreaks wherever they occur.

Salemi analysed the DNA sequences from blood taken from three HIV-positive groups – intravenous drug users, men who have intercourse with men, and women who have become infected by their spouses. Understandably, the spread is exacerbated when two of these groups intersect. Scientists say that, by examining the evolutionary make-up of HIV strains, one of the strongest factors of the disease’s spread is through men who have intercourse with male intravenous drug users.

The study was led by scientists from AKU and DUHS, both in Karachi , and the team is part of a larger worldwide, consortium of researchers. They are documenting the spread of the virus in predominantly Muslim countries and say that they will continue epidemiological work in Afghanistan .

Molecular studies are also essential to complement information derived from in-person interviews that may not necessarily be accurate, or true. “These questions are very sensitive and most of the behaviour we deal with, even in countries outside the Middle East , is illegal,” said Willi McFarland, director of the HIV Epidemiology Section at the San Francisco Department of Public Health.

McFarland is the author of a PLoS One paper that also appeared this summer. That research was led by scientists from the Qatar branch of Weill Cornell Medical College who had conducted smaller studies in Middle East and North Africa by examining men who hid their sexuality out of fear of prosecution.

Despite certain social and legal limitations that may make conducting similar studies in some parts of the world difficult, McFarland believes that the trust and confidentiality established between physicians and their patients has proven crucial in acquiring demographic information needed to conduct international such studies.

“Despite the legal consequences, doctor patient-relationships do seem to be respected,” he said.

Published in The Express Tribune, August 26th,  2011.


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