INVITATION  AIDS ASIA e FORUM.

Hi,

If you are already a member of this FOURM please forward this message to your
colleagues who may find this FORUM useful.

[AIDS ASIA eFORUM] is an e- forum committed to the development of an Asian
perspective on AIDS prevention and care issues. HIV/AIDS does not recognize
national boundaries. As Asia- pacific countries are increasingly interconnected
through migration and trade, it is imperative to generate a regional perspective
on HIV/AIDS related issues.

A forum for critical analysis of issues, events and programs, which has
implications on, our ability to address HIV/AIDS prevention and care issues
across the region. More than 7,600 subscribers are using this FORUM.

Strategic HIV information and communication support to promote the capacity of
Asian leaders, activists and people living with HIV/AIDS, to facilitate their
engagement and networking, to highlight their experiences and the solutions they
are offering to address HIV/AIDS issues in this region.

A cross cultural discourse on issues and concerns of Asia- Pacific countries
(regions): Afghanistan, Australia, Bangladesh, Bhutan, Brunei, Cambodia, China,
East Timor, Fiji, India, Indonesia, Japan, Kiribati, Laos, Malaysia, Marshall
Islands, Micronesia, Mongolia, Myanmar, Nepal, New Zealand, North Korea,
Pakistan, Palau, Papua New Guinea, Philippines, Samoa, Singapore, Solomon
Islands, South Korea, Sri Lanka, Taiwan, Thailand, Tonga, Tuvalu, Vanuatu and
Viet Nam will be presented and promoted on this forum.

Please review the archived messages on the following url

http://health.groups.yahoo.com/group/AIDS_ASIA/

Dr. Joe Thomas
Editor
AIDS ASIA e FORUM
http://health.groups.yahoo.com/group/AIDS_ASIA/

Dear all,

As you may know, The Global Forum on Men Who Have Sex with Men and HIV
(MSMGF) recently launched its new website, www.msmandhiv.org

In addition to the latest news and reports on MSM and HIV all over the world,
one of the most exciting features of the new website is our Directory

<http://www.msmandhiv.org/MSMGFdirectory/index.htm>  of organizations
that work on issues concerning MSM and HIV.

Organized by type and region, this directory allows the user to browse a library
of potential funders and collaborators working in the field of MSM and HIV with
the ultimate goal of catalyzing new partnerships and facilitating the creation
of new projects.

We would like to invite you to register your organization with our
Directory.  Whether you are a non-government organization or a
government agency, a funder or a research institution, if your work
involves MSM we want to hear from you!

All it requires is filling out one form that can be submitted electronically- it
will take about five minutes to complete.

To add your organization, click here!
<http://www.msmandhiv.org/MSMGFdirectory/directorysignup.htm>


Thank you very much!

Jack

Jack Beck

The Global Forum on MSM and HIV
AIDS Project Los Angeles, Secretariat
The David Geffen Center
611 S. Kingsley Dr.
Los Angeles, CA 90010
P: 213.201.1362, F: 213.201.1598
E: jbeck@...
www.msmandhiv.org

Hi, all.

I want to thank David Gordon for his comments and offer encouragement for the
work he and his organization is doing in Papua, and for the poster of the
original article.
 
I found the original article written by Julia Medew extremely offensive,
however, so much so that I can barely contain myself.

I'm an American, and obviously, we have our own prejudices and blind-spots (more
than anyone in the world, I'll freely admit), but still, I find much Australian
reportage about HIV and AIDS-related issues in Papua New Guinea as extremely
offensive and short-sighted and, as in this piece, remarkably misogynous
(although I grant that others are more so).

Reading between the lines, the sub-text behind this article, the Miranda Tobias
report and others of its ilk is that of a "black" creeping viral and moral
threat to "white" safety and goodness.

I mean, the poor, poor Aussie businessmen (and diplomats and federal police) who
are "at-risk" from the Port Moresby "bar girls" and "prostitutes" and "sex
workers"!  Protected?

Who needs protection, here? This neglects to mention the significance of
male-male sex across borders as well as  Aussie women and PNG men's sexual
networking and much of the history of the introduction of STDs into these
regions.

There's no excuse for such shoddy reporting that reproduces inequalities of
class and race and gender and colonization, among other things. How many of the
Aussie federal police, missionaries, businessmen, athletes, diplomats,
politicians, etc., are infected with this or that STD or with HIV?

Instead of once again "targeting" sex-workers, how about funding programs that
teach Aussie males (and American and German and British ones) not to be drunken
sot horn dogs when they travel?

Mr. Gordon, I totally take your points about needing to address the links
between alcohol, sexual risk, and sexual violence (among the many more problems
raised by alcohol and other drugs in PNG), although I don't at all agree that
the Papuan and the Papua New Guinean HIV and AIDS epidemics are even remotely
similar (excepting the superficial similarity of "the numbers." I deal with this
at length in my upcoming book).

I also agree with your definition of "risky behaviour" (i.e., condomless sex),
but I worry still about any kind of model or program that pretends to
individualizing explanations of infection and prevention there of, instead of
grappling more forthrightly with structure-structure and political-economy of
colonization, militarism, missionization, capital flows, resource extraction and
the like.
 
I'd like to learn more about your organization, Mr. Gordon, and I wish you and
your colleagues well in your work.
 
Sincerely yours,

Lawrence Hammar
Dayton, Ohio, U.S.A.
e-mail: <gorokadubu@...>

Dear AIDS ASIA e FORUM,

http://health.groups.yahoo.com/group/AIDS_ASIA/message/1377

Thank you for your report.
 
What Julia Medew reports about the HIV/AIDS epidemic in Papua New Guinea is the
same we find in Papua. The amount of HIV/AIDS is already staggering [some 3.4
percent in Papua] and rapidly increasing throughout the region. Currently the
virus continues to increase without control.

What I want to address is the statement Julia gave -by Dr. Gardiner, who said;
"one way to help Control PNG's epidemic would be by teaching sex workers to act
as "front-line protection workers".

We need skilled professional sex workers who can say no to drunk middle-aged
Australian men, and have the back-ups necessary to do that without violence
following."
 
"drunk".... Many people/organizations / religious community -have said over the
years "drugs are not a problem in Papua or PNG!".

While drugs such as heroin and methamphetamine, agreed,are still not [yet] a
major issue or threat in the region- but 'alcohol' is. And alcohol is one of the
main driving forces of the HIV/AIDS epidemic in both PNG and Papua.

This year Cordaid & Yakita opened a Recovery & Treatment Center in Jayapura
-directly dealing with alcohol abuse and alcoholism and HIV/AIDS.

The Center is now fully operational, and there are participants, and
participants with HIV. Many, many people /organizations have known about
problems relating to alcohol and alcohol abuse for many years, but no Centers /
Organizations had been opened to confront and treat those having drink-problems.
Or confronted the alcohol and co-related HIV/AIDS issue.

Also the current crisis in Jayapura [as across Papua] with HIV/AIDS has been
directly fueled by alcohol abuse /alcoholism, which greatly adds to 'risk
behavior'

Meaning simply 'sex with no condoms'. The same holds true in PNG.

I too believe sex workers need much assistance, and should be more organized,
and be able to assert greater voice and have more say in their lives.
Absolutely. This is an area of concern many of us should concentrate on.
 
I also know 'we' need to address the problem with alcohol and alcoholism, and
how drink affects behavior. This, education, needs to be done, begun, with young
people.

Education on alcohol & drugs / reproductive health / sex and sexuality in Junior
High, High School, and Universities.

Both PNG and Papua are 'sensitive'in both culture and religion - and
education in these areas must also take this into consideration

Still education on HIV/AIDS and alcohol / drugs in PNG & Papua is today a
primary issue & concern and must be undertaken.
 
David Gordon

Joyce & David Djaelani Gordon
YAKITA - Addiction Recovery Center
Villa Pandawa, Jl. Ciasin No. 21,
Desa Bendungan,
PO Box 126, Bogor - Bogor, Jawa Barat, Indonesia
Management Office: yakita@...
{62} {251} 243 005
www.yakita.or.id

Nearly one in five intravenous drug users may have HIV: estimate

PARIS (AFP) — Around 16 million people around the world inject
illegal drugs, and nearly one in five of them may have the AIDS
virus, according to an estimate published online Wednesday by The
Lancet.

The global tally of intravenous drug users (IDUs) is put at 15.9
million, around three million of whom could have the human
immunodeficiency virus (HIV), it says.

China has largest number of IDUs, with a mid-range estimate of 2.35
million people. The HIV infection rate among them is calculated at
12.3 percent.

The United States has the second highest total, with around 1.85
million IDUs and an estimated infection rate among them of between
15.6 percent.

The report also warned of high HIV numbers among IDUs in Ukraine and
Russia, which could be 42 percent and 37 percent respectively.

The assessment is led by Bradley Mathers of the National Drug and
Alcohol Research Centre at the University of New South Wales in
Sydney, Australia.

It is based on official national figures and estimates published in
peer-reviewed journals.

The review covers 148 countries, but admits that many blanks remain
where the data are sketchy or absent and the range estimates are
broad.

"Areas of particular concern are countries in Southeast Asia,
Eastern Europe and Latin America, where the prevalence of HIV among
some sub-populations of people who inject drugs has been reported to
be over 40 percent," the paper says.

Injecting drug use is one of the major drivers for the global AIDS
pandemic.

HIV is spread by infected IDUs who share syringes or turn to
prostitution, which thus helps the virus to enter the main
population.

AIDS campaigners say the problem has to be tackled by a panoply of
methods, including programmes to exchange used needles for sterile
ones and the use of methadone, an opiate substitute, to wean IDUs
off heroin.

http://afp.google.com/article/ALeqM5jVF1jHGnraGyelaqFY8Z0RCRZ6XA

Warning on AIDS in Asia-Pacific
Julia Medew,

September 18, 2008
AUSTRALIA must act to prevent HIV epidemics in the Asia-Pacific
region, particularly in Papua New Guinea, from worsening and
creeping onto its shores, the head of the Red Cross global HIV
program says.

Dr Bernard Gardiner, an Australian based in the Red Cross' Geneva
headquarters, said a recent cluster of infections among heterosexual
Australian men who had visited PNG, reinforced why Australia could
not be complacent about neighbouring epidemics.

"Australia cannot sit back and wait for this to become a big
problem," he said.

"It's a really dangerous notion for Australia to treat itself as
though it is somehow wrapped in cotton wool and protected from the
reality of the global HIV epidemic. It isn't. As a rich country, we
need to play our part."

Dr Gardiner's warning came as the Federal Government's chief HIV
adviser, former health minister Michael Wooldridge, said the cluster
of infections should be assessed and the implications for Australia
considered.

"It's obviously something to look at in the context of the next
strategy," Dr Wooldridge, chairman of the ministerial advisory
committee on AIDS, sexual health and hepatitis, said.

"At the moment we're reviewing the existing strategy, and that
review will form the basis of the next one, which should be
completed by the middle of next year."

This week, a sexual health conference in Perth heard that six
Queensland businessmen had contracted HIV after having unprotected
sex in PNG in the past 10 months. There had also been a 68% increase
in HIV infections acquired overseas by heterosexual West Australian
men between 2002-04 and 2005-07.

PNG has the highest incidence of HIV in the Pacific region — about
64,000 people, or 2% of the adult population — and experts have
warned that epidemics in South-East Asia, including in Thailand and
Vietnam, are raging unchecked.

In June, Murray Proctor, Australia's ambassador for HIV/AIDS, said
HIV infections in the Asia-Pacific region were "outpacing the
response".

By next year, Australia is likely to have spent $700 million on its
regional response to HIV since 2000. Mr Proctor told a UN meeting on
HIV in New York that this was no time for half measures.

Dr Gardiner, who visited PNG last month, said one way to help
control PNG's epidemic would be by teaching sex workers to act
as "front-line protection workers". "We need skilled professional
sex workers who can say no to drunk middle-aged Australian men, and
have the back-ups necessary to do that without violence following,"
he said.

Australian Federation of AIDS Organisations director Don Baxter has
called on Australia to dramatically upgrade its response to regional
epidemics, particularly those emerging among gay men.

http://www.theage.com.au/national/warning-on-aids-in-asiapacific-20080917-4ip4.h\
tml

Dear  Colleagues

My comments on the Asian AIDS Commission report follows.

Re: http://health.groups.yahoo.com/group/AIDS_ASIA/message/1360

The report is mainly focused on three key population for HIV
transition in Asia, i-e, FSW, MSM, IDU. One group is newly focused,
wives of the most-at-risk men. But it left the entire migrant
populations & truckers.

They have categorized three HRGs & explained vividly that from where
they get infection & what are the best methods of prevention of HIV
for each HRG.

HIV behind Prison Walls: Prisoners have grater chance of being HIV
infected. They become infected by using non-serialize injection
during taking of drugs. Basically it is found that disposable
syringes are not easily available in jails.  In Thailand, India,
China etc different studies have been conducted among prison
inmates. The report shows that in Chennai (India), they were more
than twice as likely to be infected compared with those who had
never been to jail. After that if they have unprotected sex with
other inmates who are not injectors they are much more likely to
transmit HIV.

The report has highlighted on the general population that gradually
the pregnant mothers become victimized by HIV. That is why it is
called `generalized epidemic'. But they lack the detailed estimates.

Solid data & analysis is required to understand & respond to the
epidemic.

The report lucidly explained why did Current Surveillance Systems
Overestimating HIV in Asia?

In economic report it has explained vividly that how HIV affects the
house hold income of the people, how it affects the entire national
income structure & makes lose of productivity?

The report has focused upon the women in some context but the
details relationship between women & HIV is absent.

Report has not highlighted issues related to orphan and other
children made vulnerable by HIV .

It has given much attention on how to create enabling environment,
which makes an impact on effective prevention of HIV. It has also
made the sex workers more confident & helps them to empower.

The report has focused little on the effectiveness of peer outreach
workers & no statistical data has mentioned regarding them.

Widely covered the matter that how HIV can be prevented in best way

It does not focus on the tribal population regarding HIV issues.

The report says the efficacy of using Global Fund & World Bank money
in HIV & AIDS issues but it didn't include the overall outcomes of
projects.

In some cases the report has pointed out the role of Govt. agencies
but it lacks in details analysis of the role of Government sector.

Report gave a good overview on the need for meaningful community
engagement on HIV issue. It says that community participation is
essential for reaching people involved in risky behavior with
information & services they are likely to trust. Along with it
participation from national bodies like National AIDS Commissions or
Country Coordinating Mechanisms should involve as a process in which
communities nominate their representatives.

Community involvement can open space for discussion about
controversial issues. The report has given an excellent example of
Sonagachi project in Kolkata on this issue.

Policy Recommendation:

Interventions:

The report should incorporate that the Government has to provide
nutritional support to the PLHIV community.

Community Involvement:

In the report it is clear that in case of community involvement in
policy making, programme designing, implementation, monitoring &
evaluation, the CBOs, Government bodies, regional inter-governmental
organizations like ASEAN & SAARC or UN Organization are actively
involved or their roles are very clear for developing & supporting
of all strategies.

Strategies & programme implementation:

Prevention:

Life skill education training for HIV affected, effected &
vulnerable people have not mentioned any where.

Different types of prevention programs for different high risk
groups such as FSW, MSM, IDU & wives of the most-at-risk men have
clearly explained. In this context the role of Government sectors
have vividly mentioned.

In case of making strategies for prevention of HIV, the report just
asked for the introduction of female condom or encourages the sex
workers for using of female condoms as an empowering measure for
women. But it doesn't give any facts & figures or any feed back or
demand regarding the usages of female condom by female sex workers.

All the prevention programs are available for different high risk
groups like FSW, MSM, IDU, the client of the sex workers or even the
general populations like the wives of men who buy sex, IDU or MSM
etc. But there is no provision or program is mentioned for truckers,
migrant workers or tribal community.

Arpita Majumdar
e-mail: arpitamaj@...

GNP+ RECEIVES BILL & MELINDA GATES FOUNDATION GRANT TO SUPPORT
PREVENTION PROGRAMMES DRIVEN BY PEOPLE LIVING WITH HIV

AMSTERDAM - The Global Network of People living with HIV (GNP+) is
proud to announce the start of a new programme to stimulate the
leadership of people living with HIV in prevention strategies.

GNP+ has received a $998,000 grant from the Bill & Melinda Gates
Foundation to support a two-year programme to build a stronger global
response to the HIV epidemic by helping organizations and networks of
people living with HIV worldwide to design and monitor prevention
strategies.

Attention to the role of people living with HIV in prevention has
grown in recent years, as antiretroviral therapies have enabled people
with HIV to live longer, fuller lives. People who are HIV-positive
need prevention programmes to help them stay healthy and avoid
sexually transmitted and opportunistic infections. They also need
support for their efforts to protect their sex partners, or those they
inject drugs with, from HIV infection.

As people living with HIV live longer, their hopes and dreams of
leading normal lives are becoming a reality. HIV-positive people have
the same aspirations as others to plan and have families and to remain
productive within their communities.

Wide-reaching and well-designed prevention programmes that capitalise
on the leadership of people living with HIV have the potential to save
the health and lives of millions. To be effective, prevention
strategies must be responsive to and compatible with the practical
realities people living with HIV contend with in trying to protect
themselves and others, while optimising their quality of life and that
of their family members.

This GNP+ programme is rooted in the belief that the active engagement
of people living with HIV is critical to the success and uptake of HIV
prevention programmes. Through its regional partners, GNP+ will
encourage and gather input from people living with HIV around the
world. In addition, GNP+ and its partners will promote research
designed to fill evidence gaps related to effective prevention efforts
focused on the needs of people living with HIV.

The programme will include a focus on supporting the development of
new preventive technologies, such as microbicides, pre- and
post-exposure prophylaxis, and other antiretroviral-based prevention
strategies, as well as male circumcision. In these areas, GNP+ will
work to ensure and promote the involvement of people living with HIV
in clinical trial protocol development and monitoring, and in
integrating proven technologies into comprehensive approaches to HIV.

Martin Stolk
Communications Coordinator,
Global Network of People living with HIV/AIDS (GNP+)
Te: +31-20-423 4114
e-mail: mstolk@...

HIV rates climbing: new figures

September 17, 2008, 12:59 am

HIV, chlamydia and syphilis are cutting a swathe across Australia,
according to new national statistics which have disease experts
calling for more testing and reinvigorated public health campaigns.
The report by the National Centre in HIV Epidemiology and Clinical
Research in Sydney shows a nine per cent increase in the nation's
most common sexually transmitted disease, chlamydia, between 2006 and
2007.

HIV infections increased by five per cent in the same period, from
998 new notifications in 2006 to 1,051 new diagnoses in 2007.
New infections have finally stabilised in Victoria, and they remain
static in NSW, but they continue to climb in Queensland where they
increased from 3.3 to 4.6 infections in every 100,000 people.
The rate of infectious syphilis more than doubled from 3.1 in every
100,000 people in 2004 to 6.6 in 2007, with increases mostly among
gay men.

Basil Donovan, a professor in sexual health at the centre, said the
ongoing rise in all three conditions was a significant cause for
concern, and required individual targeted response in each case.

"These are three very different infections and the situation is not
good in any case," Prof Donovan said.

The 51,867 cases of chlamydia diagnosed in 2007 represented only one
in five Australians with the infection.

"We know testing is incredibly low, with only 10 per cent of young
people accessing the free tests available online," he said.

"What we need is an effective national plan that gets testing to
everyone."

Plans are afoot to introduce a radical plan to control syphilis by
mass treating the highest-risk gay men regardless of whether they
have contracted the infection.

"We think that's the best chance we have of taking the wind out of
the outbreak," Prof Donovan said.

With HIV, a localised approach was necessary, with stronger, targeted
messages needed in Brisbane, along with more health workers to boost
the campaign, he said.

Australian Federation of AIDS Organisations executive director Don
Baxter called for renewed government funding commitments, saying the
relentless increase proved current investments in HIV programs were
not sufficient to reverse the upward trend.

He said he was also concerned by a new trend of HIV infections
arising among heterosexual businessmen and miners from WA, Queensland
and the Northern Territory who travel to Papua New Guinea for work.

"Gay tourists also need to be more vigilant than ever as it has
recently become very clear that in most Asian cities HIV epidemics
among gay and bisexual men are now raging virtually unchecked," Mr
Baxter said.

http://au.news.yahoo.com/a/-/latest/5020345/hiv-rates-climbing-new-
figures/

Second Independent Evaluation  of UNAIDS

Dear Sir/Madam,

The Oversight Committee (OC) of the Second Independent Evaluation
(SIE) is undertaking broad consultations on the draft Inception
Report (IR) prepared by the Evaluation Team (ET) consortium
ITAD/HLSP.  The draft IR will provide the final terms of reference
for the Evaluation, setting  out the design, methodology, work plan,
and approach for the SIE according to purpose and terms of reference
set by the UNAIDS Programme Coordinating Board (PCB).

The objectives of the consultations are to:

i) solicit suggestions from stakeholders for strengthening the
methodology of the design and process of the Evaluation to ensure it
achieves its purpose; and
ii) strengthen stakeholder involvement and understanding of material
that will be presented in the Final Report.


Written comments, submitted by 26 September 2008, will be taken into
account in finalizing the Inception Report.  Comments received prior
to 15 September 2008 will be made available to participants in a
Stakeholder Workshop to be held in Geneva on 15-16 September, a
complementary event in the broad consultation.

All comments are welcome, but the Evaluation Team is particularly
interested in stakeholder perceptions on any or all of following
issues and questions in order to inform the ET in finalizing the
Inception Report and the OC in approving it:

1. Stakeholder perceptions on How UNAIDS is responding to the
changing context:

1. Health systems
a. How UNAIDS has strengthened health systems.
b. How other initiatives to strengthen health systems have supported
the achievement of UNAIDS objectives.

2. Working relationships between UNAIDS and other global players such
as Global Fund, PEPFAR, private sector etc.

3. Implications of donor focus on aid effectiveness and current
pilots of UN reform (Delivering as One) for a dedicated joint
programme on HIV/AIDS.

2. Stakeholder perceptions on How UNAIDS works

1. What are the strengths and weaknesses in the governance of UNAIDS?
2. Where should the ET concentrate its enquiries to add value to
previous reviews?
3. Has the UBW been an effective tool for influencing the Cosponsor
programmes?
4. Where are there clear examples of Cosponsor programmes being
changed to respond to the division of labour?

3. Stakeholder perceptions on How UNAIDS is fulfilling its ECOSOC
mandate – success and lessons learned:

1. To what extent has UNAIDS incorporated gender and human rights
issues into its own policies and programmes and supported efforts by
countries to address these issues?

2. Has UNAIDS succeeded in supporting the active and meaningful
engagement of civil society and PLHIV in the response to HIV and AIDS
at global and national levels (e.g. policy making, implementation,
monitoring and evaluation)?

3. How can the ET best find evidence about how UNAIDS has improved
the coordination and provision of appropriate and timely technical
support to national AIDS responses?

N. B. Comments on cross-cutting social themes relating to vulnerable
groups (e.g. women, children, PLHIV, aged, drug users) on any aspect
of the questions will also be taken into account.

Your comments can be sent by email or fax to the

Oversight Committee Secretariat (OCS):
Email:  IndependentEval2@...
Tel: (+41) 22 791 5528/4555
Fax: (+41) 22 791 4187 or (+41 22) 791 4891

We look forward to hearing your views.  Any questions or further
information can be addressed to the OC Secretariat:


Yours sincerely,

Catherine Hodgkin
Chair, Oversight Committee

To contact the Oversight Committee:

Room V25
c/o UNAIDS
20, avenue Appia
CH-1211, Geneva 27
Switzerland Telephone:  (+41) 22 791 5528
(+41) 22 791 4555
Facsimile:  (+41) 22 791 4187
Email:  IndependentEval2@...

http://www.unaids.org/en/AboutUNAIDS/IndependantEvaluation/

Cambodia faces new HIV threat as 'condom campaign at risk'

PHNOM PENH (AFP) - Threats to a successful Cambodian condom campaign
has raised fears the country could experience a second epidemic of
the disease, health officials said Wednesday.

Tia Phalla, of Cambodia's National AIDS Authority, said the country's
so-called 100 percent condom use programme, which provides sex
education and distributes condoms to sex workers, "is facing
difficulties" because of a new anti-sex trafficking law and lack of
financial support.

Police began a crackdown on brothels after the new law was passed in
February, which has reportedly forced prostitutes to leave condoms
behind as they move from place to place.

"Enforcement of the anti-trafficking law harms the 100 percent condom
use in brothels," Tia Phalla told a three-day national AIDS
conference in Phnom Penh.

The percentage of sex workers who consistently used condoms with
clients had already begun to drop to 94 percent in 2007 from 96
percent in 2003, according to AIDS authority data.

Additionally, only six of the country's 24 provinces and cities
currently have funds to carry out the programme, Tia Phalla said.

"The main risk of a second wave of HIV infections occuring in
Cambodia is from female sex workers, their clients and sweethearts,"
said a statement by the AIDS authority.

Before the 100 percent condom use programme began, Cambodia's overall
HIV rate was the worst in the region, peaking at 3.7 percent of the
population in 1997. Rates among prostitutes were estimated at 40
percent.

The aggressive condom and sex education campaign is believed to have
helped drop Cambodia's overall HIV prevalence to 0.9 percent.

http://news.yahoo.com/s/afp/20080910/hl_afp/healthaidscambodiacondom

Born Into a Brothel, Studying at NYU

[AIDS ASIA e FORUM subscribers are invited to send their views of the Asian AIDS
Commission Report.

The  e_Consultation on Asian AIDS Commission Report: "Redefining AIDS in Asia –
Crafting an effective response", (2008, June 30th to September 30th). On behalf
of the UNAIDS Regional Support Team for Asia and the Pacific, AIDS ASIA eFORUM
is hosting an e_Consultation on Asian AIDS Commission Report: "Redefining AIDS
in Asia – Crafting an effective response".

http://health.groups.yahoo.com/group/AIDS_ASIA/message/1292
_____________________

Redefining the Epidemic in Asia: Decriminalization

Dear all,

The Commission on AIDS in Asia is calling all the countries to decriminalize
PLHIV and people who are most-at-risk. The big question is: How effective is
this call? Will the countries answer to this call?

I would agree to the recommendation and I personally think that the
recommendation create an opportunity for community and other stakeholders.

One of the recommendations is calling the country to remove and correct any
policy that decriminalize PLHIV and people who are most-at-risk for HIV
transmission. However, we¹ve been talking about decriminalization for some time
now.

And some efforts has been strongly made by the community groups
and limited actions has also been taken by some of the governments. In
Singapore and Philippine success has been also shown by regulating licensed sex
worker.

However, violence & harassment against drug users, sex workers and transgender
has been repeatedly reported for most of the Asian countries as well; and just
like the report stated: only 5 Asian countries that does not criminalize MSM.

But, still, the question remains: How possible is this idea of
decriminalization in the Asian region? Especially looking at the low
political commitments in the region and at the country level. And what is the
level of priority it deserves?

I am also hoping that some countries would be able to share their stories, both
success and failure in terms of decriminalization, and most significantly if
there is any country that have seen impact of
decriminalization or from criminalization.

Cheers,

Rico Gustav
E-MAIL: <rico.gustav@...>

Dear ALL,


We now have 106 endorsements (65 organizations and 41 individuals) for  the
sign-on letter re the Anti-Counterfeiting treaty, which may threaten access to
generic meds globally. The list is below the intro note and  draft letter,
below. If you would like to endorse the letter, please send me a note by Monday
September 8, 2008 (or even very early Tuesday morning, EST)! We accept
organizational and individual endorsements.

Note: we really need more Japanese and European endorsements, as well as some
Mexican endorsements (these are 3 of the negotiating countries/regions not well
represented so far)!!!

Sarah
--

Dear Friends,

The United States, the European Union, Japan, South Korea, Canada,
Mexico, Australia and New Zealand are now negotiating a new treaty known  as the
Anti-Counterfeiting Trade Agreement (ACTA).

The text of what they are negotiating remains secret, but there's a lot  to be
worried about. An over-reaching treaty in this field could
undermine access to low-cost generic medicines, require Internet Service
Providers (ISPs) to monitor all consumers' Internet communications, and
interfere with fair use of copyrighted materials, among many other dangers.

Does the proposed ACTA contain provisions that would result in these
harmful effects?

There's no way to know, because the treaty text remains secret. There is no
legitimate rationale for such secrecy, which denies people around the world an
opportunity to comment on and influence the negotiations.

We are asking organizations and individuals from around the world to
sign on to a letter to ACTA negotiators, asking that they immediately
make public the draft text of the treaty. The text of the letter, with initial
signatories, is below.

If you would like to sign the letter, please send your name, affiliation (if
any), city/country and email address to Sarah Rimmington of Essential Action at:
<srimmington@...>.

Please specify if you are signing in your individual capacity or on behalf of an
organization.

**Pleaase note: Our deadline for accepting signatures
is Monday August 8, 2008.**

For open and accountable government,

Robert Weissman and Sarah Rimmington,
Essential Action
E-MAIL:  <srimmington@...>
---

For more on ACTA, see:

<http://www.keionline.org/index.php?option=com_content&task=view&id=187>

<http://www.publicknowledge.org/issues/acta>

<https://secure.eff.org/site/Advocacy?JServSessionIdr009=m5722xgyi2.app2a&cmd=di\
splay&page=UserAction&id=383>

<http://ipjustice.org/wp/campaigns/acta/>

<http://www.michaelgeist.ca/tags/acta>

---

LETTER TO ANTI-COUNTERFEITING TRADE AGREEMENT NEGOTIATORS

Dear [Negotiator],

We are writing to urge the negotiators of the Anti-Counterfeiting Trade
Agreement to agree to publish immediately the draft text of the
agreement, as well as pre-draft discussion papers (especially for
portions for which no draft text yet exists), before continuing further
discussions over the treaty. We ask also that you publish the agenda for
negotiating sessions and treaty-related meetings in advance of such meetings,
and publish a list of participants in the negotiations.

There is no legitimate rationale to keep the treaty text secret, and
manifold reasons for immediate publication.

The trade in products intended to deceive consumers as to who made them poses
important but complicated public policy issues. An overbroad or poorly drafted
international instrument on counterfeiting could have very harmful consequences.
Based on news reports and published material from various business associations,
we are deeply concerned about matters such as whether the treaty will:

* Require Internet Service Providers to monitor all consumers' Internet 
communications, terminate their customers' Internet connections based on rights
holders' repeat allegation of copyright infringement, and divulge the identity
of alleged copyright infringers possibly without judicial process, threatening
Internet users' due process and privacy rights; and potentially make ISPs liable
for their end users' alleged infringing
activity;

* Interfere with fair use of copyrighted materials;

* Criminalize peer-to-peer file sharing;

* Interfere with legitimate parallel trade in goods, including the
resale of brand-name pharmaceutical products;

* Impose liability on manufacturers of active pharmaceutical ingredients (APIs),
if those APIs are used to make counterfeits -- a liability system that may make
API manufacturers reluctant to sell to legal generic drug makers, and thereby
significantly damage the functioning of the legal generic pharmaceutical
industry;

* Improperly criminalize acts not done for commercial purpose and with no public
health consequences; and

* Improperly divert public resources into enforcement of private rights.

Because the text of the treaty and relevant discussion documents remain secret,
the public has no way of assessing whether and to what extent these and related
concerns are merited.

Equally, because the treaty text and relevant discussion documents
remain secret, treaty negotiators are denied the insights and
perspectives that public interest organizations and individuals could
offer. Public review of the texts and a meaningful ability to comment
would, among other benefits, help prevent unanticipated pernicious
problems arising from the treaty. Such unforeseen outcomes are not
unlikely, given the complexity of the issues involved.

The lack of transparency in negotiations of an agreement that will
affect the fundamental rights of citizens of the world is fundamentally
undemocratic. It is made worse by the public perception that lobbyists from the
music, film, software, video games, luxury goods and pharmaceutical industries
have had ready access to the ACTA text and pre-text discussion documents through
long-standing communication channels.

The G8's recent Declaration on the World Economy implored negotiators to include
ACTA negotiations this year. The speed of the negotiations makes it imperative
that relevant text and documents be made available to the citizens of the world
immediately.

We look forward to your response, and to working with you toward
resolution of our concerns.

Sincerely,

[List in Formation]

**Organizations**

Act Up East Bay
Oakland, CA, USA

Act Up Paris
Paris, France

African Underprivileged Children's Foundation (AUCF)
Lagos, Nigeria

AIDS Access Foundation
Thailand

American Medical Student Association
Reston, VA, USA

ASEED Europe
Amsterdam, The Netherlands

Australian Digital Alliance
Kingston, Australia

Australian National University
Canberra, Australia

Australian Privacy Foundation
Sydney, Australia

Bharatiya Krishakn Samaj
New Delhi, India

The Canadian HIV/AIDS Legal Network
Toronto, Canada

The Canadian Internet Policy & Public Interest
Clinic (CIPPIC)
University of Ottawa, Faculty of Law

The Canadian Library Association
Ottawa, Canada

Center for Democracy and Technology
Washington, DC

Center for Digital Democracy
Washington, DC

The Center for Women's Culture & Theory
Korea

Christian Media Network
Korea

CHOICE (Australian Consumers Association)
Marrickville, Australia

Consumentenbond
The Hague, Netherlands

Consumer Action
San Francisco, CA, USA

Consumer Federation of America
Washington, DC, USA

Consumers Union. Publisher of Consumer Reports
Yonkers, NY, USA

Consumers Union of Japan (ihon Shohisha Renmei)
Tokyo, Japan

La Corporacion Opcion por el Derecho a Ser y el Deber de Hacer, NIT
Bogotá, Colombia

Corporate Europe Observatory
Amsterdam, The Netherlands

Cultural Action
Korea

Electronic Frontier Foundation
San Francisco, CA, USA

Electronic Frontiers Australia
Adelaide, Australia

The Electronic Privacy Information Center (EPIC)
Washington, DC, USA

Essential Action
Washington, DC, USA

European AIDS Treatment Group (EATG)
Brussels, Belgium

Foreign Policy in Focus
Institute for Policy Studies
Washington, DC

Foundation For Consumers (FFC)
Thailand

Foundation for Media Alternatives
Philippines

Free Press
Washington, DC, USA

Global Trade Watch
Washington, DC USA

Gram Bharati Samiti Society for Rural Development
Amber, India

Gyeonggi NGO Network
Korea

Health Action International (HAI) – Asia Pacific
Colombo, Sri Lanka

Health Action International (HAI) – Europe
Amsterdam, The Netherlands

Health Action International (HAI) – Global
Amsterdam, The Netherlands

Health Action International – Latin America & Caribbean
Lima, Perú

Health GAP (Global Access Project)
Philadelphia, PA, USA

Information & Culture Nuri for the Disabled
Korea

International Federation of Library Associations and Institutions (IFLA)
The Hague, Netherlands

IP Justice
San Francisco, CA, USA

IPLeft
Seoul, Korea

Knowledge Ecology International (KEI)
Washington, DC, USA

Korean Progressive Network Jinbonet
Seoul, Korea

Labour, Health and Human Rights Development Centre
Lagos, Nigeria

Lawyers Collective HIV/AIDS Unit
India

Media Access Project
Washington, DC, USA

La Mesa de ONGs Con Trabajo en VIH/SIDA
Bogotá, Colombia

National Consumer Council (NCC)
London, UK

People's Coalition for Media Reform
Seoul, Korea

Positive Malaysian Treatment Access & Advocacy Group (MTAAG+).
Malaysia

Privacy Activism
USA

Privacy Rights Clearinghouse
San Diego, CA, USA

Public Knowledge
Washington, DC, USA

Social movement to combat private media ownership and enhance public media
Korea

Swisslinux.org
Mayens-de-Chamoson, Switzerland

The Transparency and Accountability Network
New York, NY, USA

Third World Network
Malaysia

Universities Allied for Essential Medicines (UAEM)
Berkeley, CA, USA

U.S. Public Interest Research Group (PIRG)
Washington, DC, USA


**Individuals**

Jamie Acosta
Miami, FL, USA

Jennifer Bruenger
Reference Librarian & Education Program Coordinator
Linda Hall Library of Science, Engineering & Technology
Mission, KS, USA

Sae-Rom Chae
University of Illinois at Chicago College of Medicine
Chicago, IL, USA

Sylvia Caras
Santa Cruz, CA, USA

Jeff Chester
Executive Director
Center for Digital Democracy
Washington, DC USA

Don Christie
President
New Zealand Open Source Society

Mark R. Costa
Clay, NY, USA

Chris Curry
MD/PhD Candidate
Loyola University Chicago
Forest Park, IL, USA

Anke Dahrendorf (LL.M.)
Junior Researcher, International and European Law
University of Maastricht
Maastricht, The Netherlands

Professor Peter Evans
Department of Sociology
University of California, Berkeley, USA

John Dillon
Program Coordinator
KAIROS: Canadian Ecumenical Justice Initiatives
Toronto, Canada

Thomas Alured Faunce
Assoc. Professor, College of Law
Assoc. Professor, Medical School, College of Medicine and Health Sciences
Australian National University
Canberra, Australia

Professor Brian Fitzgerald
Professor of Intellectual Property and Innovation
Law Faculty
Queensland University of Technology
Brisbane, Australia

Sean Flynn,
Associate Director
Program on Information Justice and Intellectual Property
American University Washington College of Law
Washington DC, USA

Maurice J. Freedman
Past President, American Library Association
Mount Kisco, Ny, USA

Michael Geist
Canada Research Chair in Internet and e-commerce Law
University of Ottawa
Ottawa, Canada

Jonathan Walter Giehl
Ocala, Florida, USA

Mark W. Heffington, M.D.
Cashiers, NC, USA

Matthew Herder
Visiting Professor of Law
Loyola University Chicago
Chicago,IL,  USA

Ellen ‘t Hoen , LLM
Campaign for Essential Medicines
Medecins sans Frontières (Doctors without Borders)
Geneva, Switzerland

Dr. KR John
Dept. of Community Health
Christian Medical College
Vellore, India

Alison Katz
Member
People’s Health Movement and Centre Europe Tiers Monde
Geneva, Switzerland

Adam M Kost
Student
University of Illinois at Chicago College of Medicine
Chicago, IL, USA

Nicholas J. Lusiani
International Network for Economic, Social and Cultural Rights
ESCR-Net / Red-DESC / Réseau-DESC
New York, NY, USA

Hamish MacEwan
Open ICT Consultant
Wellington, New Zealand

Eduardo Mayorga
ALAFAR
Quito, Ecuador

Ibraheem Naeem
Medical student
Lahore, Pakistan

Dr. Pat Neuwelt
Public Health Physician and Professor
Mt Albert, Auckland, New Zealand

Ahti Otala
Espoo, Finland

Frank Ottey
Media, PA, USA

Kevin Outterson
Associate Professor of Law & Director of the Health Law Program
Boston University School of Law

A. Sankar
Executive Director
EMPOWER
Tuticorin, India

Dr Canan Sargin, MD
UNICEF
Ankara, Turkey

Professor Susan K. Sell
George Washington University
Washington, DC USA

Aaron Shaw
Berkman Center for Internet and Society
Harvard University
Cambridge, Massachusetts, USA

Dr. Mira Shiva, M.D.
People's Health Initiative, India

Dr. Vandana Shiva
Navdanya, India

Wilma Teran
Pharmaceutical Biochemist, Public Health
Platform on Access to Medicines and Intellectual Property
La Paz, Bolivia

Mike Waghorne
Esquibien, France

Professor Kimberlee Weatherall
TC Beirne School of Law
The University of Queensland
Brisbane, Australia

Patricia Whelehan, Ph.D
Professor, Anthropology
State University of New York-Potsdam
Potsdam, NY, USA



---

(Attachment to Sign-on Letter):

OPENNESS IN TRADE AND OTHER MULTILATERAL NEGOTIATIONS

Negotiating texts are commonly made public in multilateral trade
negotiation, although some trade negotiations are characterized by secrecy.

Examples of negotiations where texts are or were made public include:

* The current Doha Round negotiations at the World Trade Organization;

http://www.wto.org/english/tratop_e/dda_e/dda_e.htm

* The Free Trade Area of the Americas;

http://www.ftaa-alca.org/FTAADraft03/Index_e.asp

* The Multilateral Agreement on Investment (although initial texts were not made
public)

http://www.oecd.org/document/35/0,3343,en_2649_33783766_1894819_1_1_1_1,00.html

* Draft text at the World Health Organization, where resolutions are
published in advance of consideration and treaty or treaty-like
negotiations are handled openly, including this example of follow-on
negotiations for the Framework Convention on Tobacco Control:

http://www.who.int/gb/fctc/

* The World Intellectual Property Organization, including this example of a
draft Treaty on the Protection of Broadcasting Organizations:

http://www.wipo.int/meetings/en/doc_details.jsp?doc_id=57213




--
Sarah Rimmington
Attorney
Essential Action, Access to Medicines Project
Washington, DC
Tel: (202) 387-8030
Cell: (202) 422-2687
www.essentialaction.org/access/
E-MAIL: <srimmington@...>

Editors note: This article should be read in concurrence with the earlier
posting Shocking" rates of "Circumcision Problems Impair HIV Prevention -Study"

Re: http://health.groups.yahoo.com/group/AIDS_ASIA/message/1366
____________________

Adolescent boys: who cares?

George P Schmid a, Bruce Dick b

Editorial:  Bulletin of the World Health Organization | September
2008, 86 (9)

The paper by Bailey et al.1 in this issue of the Bulletin is the
first to systematically investigate adverse events following
traditional male circumcision. It highlights the frequency of
lingering and permanent sequelae, including sequelae that likely
impair sexual functioning. In one of the few other studies that has
explored this issue, between 2001 and 2005, the Eastern Cape province
of South Africa recorded 1748 hospital admissions, 177 deaths and 107
genital mutilations/amputations following circumcision.2

Despite this significant morbidity among adolescents and young men,
it is surprising that so little attention has been paid to the
complications of traditional male circumcision by most organizations..

Globally, 30¨C34% of men are circumcised.3 Most of these circumcisions are
performed for cultural or religious reasons during adolescence, outside formal
health-care settings, without anaesthesia and in challenging traditional
settings. Within sub-Saharan Africa, this is a particularly important issue
within the context of current efforts to scale-up male circumcision services for
HIV prevention.4

There, depending on the country, 15% to 80% of men are circumcised.5

These circumcisions, when done in adolescence, as in Bungoma, Kenya, are
typically practiced as part of ¡°rites of passage¡± ceremonies, as the
adolescent moves from childhood to manhood. The ceremonies, variable from
society to society, often last for weeks and are held under secretive
circumstances. They may include instructions on how to behave as men and
responsible community members and deliberately test the adolescents¡¯ ability
¡°to be men¡± ¨C their tolerance to pain ¨C but factors sometimes associated
with the circumcision, such as cold, hunger or dehydration, are also
challenging. Circumcision is
performed without anaesthesia, often using a single cutting instrument (of
unknown sharpness and sterility) for multiple boys,
without the use of sutures to prevent haemorrhage.

The populations affected seem very aware of the consequences.6,7 Of
initiates in South Africa, 70% expected complications to occur,8 and
pain is particularly feared.7 Although not wanting to lose the
traditional activities that surround circumcision, parents are also
aware of the high likelihood of significant complications occurring
and many would prefer that their sons be circumcised in the formal
health-care system.6,7,9

Male circumcision provides partial protection for men against
acquiring HIV infection through heterosexual sex, about 60%
effectiveness at two years of follow-up,3 with one study now showing
protection over 42 months of 64%.10 Countries in sub-Saharan Africa
are developing strategies to make male circumcision part of a
comprehensive strategy for HIV prevention. The critical question is
how to increase young men¡¯s access to and use of safe male
circumcision services.

Bailey et al. show that the focus of these efforts should not only be
on traditional circumcising communities but also on the formal health-
care setting, the focus for interventions in countries and
communities where there is high HIV prevalence and low male
circumcision prevalence. Here, too often, there is currently
insufficient training, supervision, hygiene, equipment and supplies.

That the adverse event rate of 35.2% in traditional settings was
twice the rate of 17.7% in medical settings is scarcely comforting.1

WHO and UNAIDS recognize that services must be safe and have
developed a variety of guidance documents and training tools
(available at: www.who.int/hiv/topics/malecircumcision/en/index.html)
while international partners are addressing additional needs,
including ways of working with the private sector and supplying
appropriate surgical commodities.

In those communities where the tradition of male circumcision occurs,
it likely makes an important contribution to HIV prevention. However,
working with traditional circumcisers to improve the safety of male
circumcision remains a challenge. We must, therefore, explore ways to
increase the provision of safe and humane male circumcision services
to those who want to be circumcised in these settings. Several
examples were discussed during a meeting of faith-based
organizations, convened by the Catholic Medical Mission Board, in
collaboration with WHO and other UNAIDS cosponsors in 2007.9

This meeting indicated that many parents and adolescent boys want a
clinical option in the formal health-care setting as well as
traditional activities. By providing male circumcision in a clinical
facility and at the same time supporting traditional activities
surrounding the circumcision, it is possible to contribute to
adolescent boys¡¯ sexual and reproductive health via counselling and
education programmes that are currently lacking or which could be
enhanced.

In addition to improving adolescent boys¡¯ access to safe male
circumcision services when these are provided within a traditional
context, when developing male circumcision programmes in the formal
health-care system, we must carefully regulate the providers to
ensure that they are adequately trained and have the equipment and
supplies to perform male circumcision safely and effectively.

The paper by Bailey et al. is timely, with important messages. By
recognizing the need for safe services for adolescent boys, wherever
delivered, male circumcision can provide an entry point for promoting
safer sex practices, improving sexual and reproductive health and
contributing to positive gender attitudes and behaviours.

References
1. Bailey RC, Egesah O, Rosenberg S. Male circumcision for HIV
prevention: Complications in clinical and traditional settings in
Bungoma, Kenya. Bull World Health Organ 2008; 86: 669-78.
2. Weiss HA, Halperin D, Bailey RC, Hayes RJ, Schmid G, Hankins
CA. Male circumcision for HIV prevention: From evidence to action?
AIDS 2008; 22: 567-74 pmid: 18316997.
3. WHO and UNAIDS announce recommendations from expert meeting
on male circumcision for HIV prevention. Geneva: UNAIDS & WHO; 2007.
Available from:
http://www.who.int/hiv/pub/meetingreports/mc_montreux_march07/en/
[accessed on 12 August 2008].
4. Male circumcision. Global trends and determinants of
prevalence, safety and acceptability. WHO and Joint United Nations
Programme on HIV/AIDS; 2007. Available from:
http://www.who.int/hiv/topics/malecircumcision/MC_Glob_Trends_Dets_Fin
al.pdf [accessed on 12 August 2008].
5. Meissner O, Buso DI. Traditional male circumcision in the
Eastern Cape ¨C scourge or blessing? S Afr Med J 2007; 97: 371-3 pmid: 
17599221.
6. Rain-Taljaard RC, Lagarde E, Taljaard DJ, Campbell C,
MacPhail C, Williams B, et al., et al. Potential for an intervention
based on male circumcision in a South African town with high levels
of HIV infection. AIDS Care 2003; 15: 315-27 doi:
10.1080/0954012031000105379 pmid: 12828151.
7. Westercamp N, Bailey RC. Acceptability of male circumcision
for prevention of HIV/AIDS in sub-Saharan Africa: A review. AIDS
Behav 2007; 11: 341-55 doi: 10.1007/s10461-006-9169-4 pmid: 17053855.
8. Peltzer K, Nqeketo A, Petros G, Kanta X. Traditional
circumcision during manhood initiation rituals in the Eastern Cape,
South Africa: A pre-post intervention evaluation. BMC Public Health
2008; 8: 64- doi: 10.1186/1471-2458-8-64 pmid: 18284673.
9. Male adolescent circumcision for HIV prevention and as an
entry point for sexual and reproductive health the role of faith
based organizations [Meeting Report]. Limuru, Kenya: September, 2007.
10. Bailey RC, Moses S, Parker CB, Agot K, Maclean I, Krieger JN,
et al. The protective effect of male circumcision is sustained for at
least 42 months: results from the Kisumu, Kenya trial [Abstract
THAC05.]. XVII International AIDS Conference, 3-8 August 2008.

Affiliations

a. Department of HIV/AIDS, World Health Organization, 20 avenue
Appia, 1211 Geneva 27, Switzerland.
b. Department of Child and Adolescent Health and Development,
World Health Organization, Geneva, Switzerland.

http://www.who.int/bulletin/volumes/86/9/08-057752.pdf

Re: http://health.groups.yahoo.com/group/AIDS_ASIA/message/1292


Dear all,

Warm greetings from Bangkok.

As may all of you have known that since my involvement in the ad-hoc Commission
on AIDS in Asia as the PLHIV and Community's representative. I have been
updating the mailisters on what's going on/process of the report.

Here, since the launch of the report last March 2008 in New York and the report
was handed to the Secretary General, Ban Ki-Moon. There were several launches
done in Asia, there were done in Cambodia, India, Vietnam. This report was also
being discussed in various events like Mexico IAC and the latest was in Manila
Low Prevalence countries conference, last August 2008.

It is clear that Commission on AIDS in Asia’s report is only the beginning to
endorse the betterment of AIDS response in Asia. The report, titled “Redefining
AIDS in Asia: Crafting an Effective Response”, is one of the few documents that
tried to get a picture of the AIDS epidemic in Asia through a broader & wider
socio-economic-epidemiological perspectives. A set of recommendations also being
proposed by this report and present an opportunities for countries and
stakeholders to adopt these recommendations as a part of their effort to
increase the effectiveness of the AIDS response.

It is also believed that the report could be one of the advocacy tools that can
be used by the stakeholders, in particular the community organizations, in
advocating the issues that are close to the community who are at the frontline
of AIDS response. As the Commission report stated, the community play a
significant role in the AIDS response and it strong participation should be
consider as crucial in achieving Universal Access targets.

There were a lot of individuals and community organizations participated and
feed their opinions and thoughts into the report (up to 600 people from 25
countries in Asia, through the on-line survey)... why these efforts have not
been carried on?

Which I think we should, and as what we have been doing, advocating to the
policy makers.

These facts leads to the importance of taking the next steps in following-up the
Commission’s report. Efforts should have been done to translate the report into
series of actions towards strengthening AIDS response in Asia.

Therefore, a project has been planned to follow-up and monitor the impact of
Commission’s report, in particular the impact to the community & civil society
groups in enhancing their participation in the AIDS response.

Consultations & partnerships with the community has been and always be the part
of how the Commissions work. And though the Commission has been dissolved,
community should and will be part of the follow up.

Various meaningful consultations with the community have also fed some 
important information to the report and it will only be reasonable to have a
community follow-up and monitoring as the next steps after the report, as the
community could significantly brought the recommendations of this report to the
next level.

A team has been set up in overseeing this follow up project, I'll be part of the
team. And Rico Gustav, will be helping me on this as well.

We are willing to see what are the components that can be used as the advocacy
key messages and how Community can play a better role on this and use the
messages as we need, in a way in pursuing actors in AIDS field to be counted
accountable.

There are 2 main objectives of this project:

- For the community to monitor progresses the country made in terms of achieving
UA & UNGASS targets, using CAA's recommendations as a road map to Universal
Access

- To also follow-up the CAA recommendation on increasing in community capacity
in terms of organizational & network management, service delivery and
participation at the policy and overall decision-making level

The project would include 6 Asian countries. The countries will be identified
based on most urgent needs for Civil Society Strengthening and possibility of
achievable results.

A regional consultation will be made in October 2008, after the advocacy
champions in each participating countries identified. The advocacy champions
would then play a significant role in carrying forward in stimulating
discussions, approaching stakeholders and establishing platforms at the country
level. At the same time, regional level discussion will be also be sustained.

As of now, if you have any inputs or feedbacks and interested in this
discussions (how to do the follow up of the report, or on how to use the
recommendations of the report as our advocacy messages, please do not hesitate
to bring this issues up, we still need your feedbacks and thoughts)

-You may also send an individual emails to: rico.gustav@... or to
frikachia@...

Hope to hear from some of you :-)

Cheers,
Frika
e-mail: frikachia@...

Shocking" rates of   "Circumcision Problems Impair HIV Prevention -
Study"

  "Circumcision Problems Impair HIV Prevention - Study"
Reuters     (09.01.08):: Laura MacInnis

A World Health Organization (WHO) study released Monday raises doubts
about the rapid implementation of male circumcision as a strategy to
fight HIV/AIDS in Africa, where researchers found "shocking" rates of
complications from the procedure. Studies have shown that male
circumcision reduces the risk of female-to-male HIV infection by up
to 70 percent.

The WHO study authors, Kenyan Omar Egesah and Robert Bailey and
Stephanie Rosenberg of the United States, found that as many as 35
percent of males circumcised by traditional practitioners in Kenya's
Bungoma district had complications, including bleeding, infection,
excessive pain, and erectile dysfunction. "Other common adverse
effects reported were pain upon urination, incomplete circumcision
requiring recircumcision, and laceration," said the authors,
estimating that 6 percent of patients had life-long problems as a
result.

The researchers physically examined 298 of the 1,007 participants in
the study; they intervened when they observed complications.

While male circumcision is universally practiced in Bungoma, the
study indicated that many clinicians there lacked sharp and sterile
instruments and few were formally trained. Even public clinics had a
complication rate of 18 percent.

The study's findings "should serve as an alarm to ministries of
health and the international health community that focus cannot only
be on areas where circumcision prevalence is low," said the
authors. "Extensive training and resources will be necessary to build
the capacity of health facilities in sub-Saharan Africa before safe
circumcision services can be aggressively promoted for HIV
prevention," they wrote.

The study, "Male Circumcision for HIV Prevention: A Prospective Study
of Complications in Clinical and Traditional Settings in Bungoma,
Kenya," was published in the Bulletin of the World Health
Organization (2008;86(9):657-736).
________________________________
Abstract and link to the original paper

Male circumcision for HIV prevention: a prospective study of
complications in clinical and traditional settings in Bungoma, Kenya

Robert C Bailey,a Omar Egesahb & Stephanie Rosenbergc

Objective Male circumcision reduces the risk of HIV acquisition by
approximately 60%. Male circumcision services are now being
introduced in selected populations in sub-Saharan Africa and further
interventions are being planned. A serious concern is whether male
circumcision can be provided safely to large numbers of adult males
in developing countries.

Methods This prospective study was conducted in the Bungoma district,
Kenya, where male circumcision is universally practised. Young males
intending to undergo traditional or clinical circumcision were
identified by a two-stage cluster sampling method. During the July–
August 2004 circumcision season, 1007 males were interviewed 30–89
days post- circumcision. Twenty-four men were directly observed
during and 3, 8, 30 and 90 days post-circumcision, and 298 men
underwent clinical exams 45–89 days post-procedure. Twenty-one
traditional and 20 clinical practitioners were interviewed to assess
their experience and training. Inventories of health facilities were
taken to assess the condition of instruments and supplies necessary
for performing safe circumcisions.

Findings Of 443 males circumcised traditionally, 156 (35.2%)
experienced an adverse event compared with 99 of 559 (17.7%)
circumcised clinically (odds ratio: 2.53; 95% confidence interval:
1.89–3.38). Bleeding and infection were the most common adverse
effects, with excessive pain, lacerations, torsion and erectile
dysfunction also observed. Participants were aged 5 to 21 years and
half were sexually active before circumcision. Practitioners lacked
knowledge and training. Proper instruments and supplies were lacking
at most health facilities.

Conclusion Extensive training and resources will be necessary in sub-
Saharan Africa before male circumcision can be aggressively promoted
for HIV prevention. Two-thirds of African men are circumcised, most
by traditional or unqualified practitioners in informal settings.
Safety of circumcision in communities where it is already widely
practised must not be ignored.

Bulletin of the World Health Organization 2008;86:669–677.

http://www.who.int/bulletin/volumes/86/9/08-051482.pdf

UNAIDS Poster Competition for World AIDS Day

We at UNAIDS are back with this exciting effort at mainstreaming the
issues of sexual minorities in our country. We now announce the
highly popular poster competition for World AIDS Day (WAD) this year.

This is what you can do if you are a MSM, transgender or
lesbian/bisexual women's group of any sexual orientation (except
heterosexual) or any gender identity. This year you will notice that
we are bringing in the lesbian/bisexual women into the ambit of this
poster competition in an effort to visibilising their issues in
mainstream society.

How you go about winning this competition

You get together as a group, sit down and thrash out what are your
main issues in dealing with everyday life as you live it. Then, as a
group, you make a poster based on those ideas. Try to make the poster
as polished and ready-to-go as you can; we might send it to Geneva
for international audiences.

You then take it to a college, preferably a school or college
teaching fine arts like painting, crafts or design. You talk to the
Principal of the Institution and show this announcement to him/her
and ask him/her to allot you a particular senior class to talk to
about your issues. Get a letter from the Principal that he/she has
heard you out and agrees or disagrees with what you had to say
regarding your issues..

Use your poster as an educational tool discussing your issues with
the class. The class then gets to do a poster based on your
discussion and their talents at drawings/ painting. It also must also
give you a letter signed by a class-representative saying they heard
you out and that their poster explains how much they understood and
appreciated or otherwise did not appreciate your issues.

Put both posters into a poster-holder/tube and send it to the address
given below to reach us before November 1st, 2008. The first three
poster-pairs will win prizes of Rs. 20,000, Rs. 15,000 and Rs. 10,000
respectively. There will be another fourth prize for the "best
effort" poster-pair. All selected and short-listed poster-pairs will
be displayed at an exhibition UNAIDS arranges every year in Delhi and
the prize winners will get trophies that are really worth exhibiting
in your offices. If we have the money we will get you to Delhi to
accept the award from our UN Country Coordinator (UCC)

Last year, the posters were so well appreciated that somebody stole
all the prize winning posters from the Alliance Franscaise outdoor
gallery despite tight security. That's how much they were
appreciated. Rest assured they will surface after a decade and be
sold for millions of rupees….

So get going and try your hand at this important poster competition.
And remember the last date – November 1st, 2008.

So Queer Folk, don't just march, make a poster too and show them what
material you are made of…..There are prizes to be won and fame and
name to be grabbed too.

Who qualifies to enter this competition?

• You must be a group based in India and a majority of your
group should be Indian citizens.
• You must be a MSM, transgender (hijra) or lesbian/bisexual
women's CBO, self-help group or even an e-list (the world then gets
to know about your amazing e-list and the support it gives to sexual
minorities).
• You must have a letter from the Principal of the
College/Institute which you went to with your poster saying the issue
was discussed with him/her
• You must have a letter from the class representative to the
effect that you did your best in explaining the issue to them.
• You as a group should send us a letter about yourself and
what you are doing (support system for your members, counseling,
health services, just gup-chup, whatever)
• A letter from any person in your area – a Nagar Sevak, a
Municipal Corporator, an MLA, MP or even a Minister (!!) that you
approached for help sometime about the problems you face.(not
essential but would be nice for future advocacy).
• Each self-help group, NGO, CBO, Network must register with
the UNAIDS NGO-Gateway as a measure of their legitimacy and effort to
mainstream their issues.
• All NGOs, CBOs and self-help groups (SHGs) must show they
have become members of the AIDS community e-list at
http://www.solutionexchange-un.net.in/subscribe/index.php?comm=AIDS

The posters will be judged by a three-member panel that includes one
MSM/TG/Lesbian or Bisexual rep, one art aficionado and one art
collector.

No employee or consultant of any UN agency shall sit on the panel

The decisions of this panel shall be final. The final authority of
the competition will be the UCC, India.

Address to courier the posters

Ashok Row Kavi

MSM/TG Consultant
UNAIDS
A2/35 Safdarjung Enclave
New Delhi 110,029
e-mail: <asha47@...>

International fashion designer joins hands with HIV positive women in
Cambodia

Phnom Penh, Sept 3:  An internationally-renowned fashion designer
Bibi Russell, UNDP, and Modern Dress Sewing Factory (MDSF), an all-
women business subsidiary of the network of people living with HIV in
Cambodia today jointly launched a new international designer label
titled "Bibi for WE".

Under this brand, MDSF will produce and market a range of bags
designed by Bibi Russell, who had been synonymous with leading
international designer-labels and fashion-houses in the 1970s and
1980s. The products will be contemporary in style and utility while
representing the rich cultural heritage of Cambodia, said Bibi,
addressing a press conference here today.

"If you join hands with women living with HIV with affection and
confidence, they can create magic with their fingers," said Bibi, who
is also a UNAIDS goodwill ambassador and founder of "Fashion for
Development," a global movement seeking to help weavers and women
across the globe. The products under the "Bibi for WE" label will
initially comprise designer bags meant for a global market.  The
design will use local materials such as Cambodian silk and will be
rich in local cultural motifs. Bibi has trained HIV positive women in
the selection of materials, design, finishing and quality control.

First part of the training is currently underway.

"We don't want sympathy, but support to live a life of respect and
dignity," said Pham Srim, Business Manager, MDSF. "Severe poverty,
and stigma and discrimination make our lives impossible. We have
recurrent health problems and have to fend for our treatment, food
and shelter; but the most crushing is the discrimination by society"
she said. "This project helps us to stand on our feet, earn a living
and stay unfazed by the stigma and discrimination staring on our
face," she added. "With HIV, one can lead a normal and productive
life - that is the message of WE," she said.  Since MDSF began its
operations in 2006, there has been a marked improvement in the
attitude of people towards women living with HIV and their
families. "Our earnings also keep us alive".

"WE is a symbol of resilience and resolve by women in the face of ill-
health, poverty and discrimination," said Mr. Douglas Broderick,
Resident Representative of UNDP in Cambodia. He said the label
represents a new hope and empowerment for all the women living with
HIV in Cambodia.  He urged the private sector and general public to
generously support the initiative.

Ms. Caitlin Wiesen, Practice Team Leader and Regional Programme
Coordinator, Regional HIV and Development Programme, said "Bibi for
WE" is a milestone in the evolution of the "Women and Wealth"
project. "Women and Wealth and the WE brand arose out of the acute
necessity of positive women to cope socially and economically with
the impact of the epidemic on their lives." In Asia and the Pacific,
the household level burdens of HIV is disproportionately borne  by
women, and their socio-economic empowerment is a crucial step to
enable them to provide for themselves and their children, to reduce
the stigma they face and build a future with dignity," she said.  "At
present, the Women and Wealth initiative is in operation in Cambodia
and India and we hope to expand it to other countries in the region."

Ms. Wiesen said. Innovation and sustainability are the essential
features of the Women and Wealth project.

About the Women and Wealth Project: (www.wwp-we.org)

Background
Women, who currently account for 29% of adults living with HIV in
Asia , are disproportionately impacted by the epidemic, both
economically and socially.

When their HIV positive husband becomes severely, women often single-
handedly provide constant care and even reduce their own food or
other consumptions to pay for medical expenses and make ends meet. In
many places throughout the region, women may also falsely be accused
of infecting her husband and may be chased away from the household.

When the husband dies, the wife in some cases may be chased away from
her marital home and denied her right to inheritance and property of
her late husband and even to children's custody. Finally she is
double-stigmatized and discriminated against as a widow living with
HIV or associated with an HIV-positive family member. She is denied
her right to employment, housing, and life with dignity and hope.

As a consequence, women become highly vulnerable to rapid
impoverishment, transactional sex for survival, unsafe migration and
human trafficking, which could also increase their risk to HIV
infection, if they are not already infected. The HIV-related plight
of women has been underexposed and underappreciated in Asia due to
strong stigma and discrimination against them.

Stigmatized, discriminated against and rejected from their families
and communities, these women often have nowhere to seek support
except for groups/networks of women living with HIV. Such self-
support groups, their last resort, are slowly emerging in the region
to offer care and support designed specifically for the women.

However, these groups are struggling to survive due to perpetual lack
of funding and low capacity of members, often caused by deep-rooted
gender inequalities and prevailing disempowerment of women in the
region.

When women's lives are affected by HIV and associated stigma and
discrimination, entire communities become dysfunctional and prospects
for social and economic prosperity are reduced. There is an urgent
need to mobilize forces and resources and to create partnerships to
support initiatives which aim to reach tangible results in the
creation of livelihood strategies for women living with HIV.

The Women and Wealth Project (WWP)
In response to emerging social and economic issues affecting the
lives of HIV- positive women, the UNDP Regional HIV and Development
Programme for Asia and the Pacific initiated the Women and Wealth
Project (WWP) in late 2006, in partnership with a Thai NGO,
Population and Community Development Association (PDA) and UNDP
country offices. WWP is currently being implemented with groups of
women living with HIV in Cambodia and India.

As a regional pilot initiative, WWP pursues the socioeconomic
empowerment of women living with and affected by HIV through the
development of small-scale social enterprises. The Modern Dress
Sewing Factory, a garment factory, was created in Cambodia, and the
Social Light Communications developed in India with a focus on
communication design and print production.

WWP takes a two-phased approach. The first phase is the development
of sustainable social enterprises to provide employment and a
sustainable flow of financial resource for the positive women's
groups and also to finance the second phase. The second phase is the
implementation of a unique micro-credit programme specifically
designed for people living with HIV called "the Positive Partnership
Programme (PPP)," which is devised by PDA (PPP has been selected by
UNAIDS for its 2007 Best Practice Collection).

Strengths of WWP include the following:

• Economic empowerment both individually and collectively by
creating livelihood opportunities and generating revenue for groups,
respectively
• Social empowerment by reducing stigma and discrimination
against positive women through business interactions, by making them
income earners and "business owners" and by nurturing self-confidence
and hope
• Providing a safe working environment for the women with no
stigma and discrimination and with an understanding on unique needs
of women living with HIV
• PPP (micro-credit) provides opportunities to distribute the
benefits of the project to a greater number of the women across the
country
• Involvement of the business sector for capacity development
of the groups
• South-South cooperation through facilitating capacity
transfer from Thailand (PDA) and interactions among the groups from
Cambodia and India
• All products produced by these positive women's groups are
collectively marketed under the "WE" brand, which stands for "Women
Empowered" and "Together, WE can".

Major achievements include:

• The establishment of basic business infrastructures and the
development of minimum internal capacity by all groups participating
in the project to manage their small social enterprises with
accountability and transparency
• The social enterprise in Cambodia was visited by the UNDP
Goodwill Ambassador and an established Japanese actress Misako Konno
in 2007 as a best practice in response to growing needs of women
living with HIV in Cambodia.
• A common brand for all the products by these groups "WE"
(Women Empowered) was launched at the 8th International Congress on
AIDS in Asia and the Pacific (ICAAP) in Sri Lanka.
• Women participating in the project have expressed increased
confidence, dignity, and hope and reduced stigma and discrimination
against them.

Modern Dress Sewing Factory (MDSF) (www.wwp-we.org/mdsf)

The Modern Dress Sewing Factory (MDSF) started its operations in
January 2007. The factory employs 17 women living with HIV, including
three women who form the management team.

Successes:

• MDSF have provided employment opportunities for 17 women
living with HIV.
• The factory has provided support for all the women, where
they can share concerns in a confidential and safe working
environment.
• MDSF has put in place policies, which focus on the healthcare
management of their workers – each worker is entitled to one day off
a month for hospital visits. The business has also allowed the women
to take ARV treatments together as a group. Everyday, a management
team keeps a checklist to ensure the women have taken their HIV
medication, contributing to healthy work force and prevention of drug
resistence.
• MDSF has established a large support network covering
government organizations, non-government organizations, international
agencies, and the private sector.
• MDSF have drawn strong interests from the media – locally and
internationally. In August 2007, MDSF was visited by a UNDP Goodwill
Ambassador.
• MDSF has produced quality products for consumers and
organizations across the globe.
• The factory has fostered a strong sense of commitment,
entrepreneurship, and teamwork among the workers.
• The management team is regularly taking English lessons.

Current needs:

• Promoting products in the national and international markets
• Expansion of a regular customer base for sustainable orders
• Training in basic business knowledge and skills, including
English proficiency.
• Regular skill-building training among workers
• Technical support to strengthen quality control and assurance
• Technical support for new product development for
international markets
• Raising more financial resources for capital investments such
as a back-up generator and special sewing machines

For more information:

For more information please visit www.wwp-we.org  or write to
kazuyuki.uji@... in Colombo.

China steps up random blood tests of travellers to check HIV

Economic Times, India 26 August 2008

BEIJING: China has stepped up random checking of blood of travellers
entering the country as part of the efforts to prevent the spread of
HIV.

Under the new exercise, 312 travellers were found to be HIV positive
in the first seven months of this year, up 19 per cent year-on-year,
a report said.

They were among 756,000 travellers on whom random blood checks
conducted at border crossings, according to the report compiled by
the General Administration of Quality Supervision, Inspection and
Quarantine, the quality watchdog.

The increase in HIV positive cases was mainly due to the rise in the
number of people who underwent the checks, Xia Wenjun, a press
officer with the administration, said.

Only 65,900 travellers were subjected to such random checks in the
same period last year.

Xia said such checks were usually conducted among high-risk groups,
or those who appeared to have the symptoms. However, she did not
elaborate, a national newspaper reported.

The report did not say how many of the HIV positive travellers were
foreigners.

Under current Chinese laws, foreigners with HIV/AIDS are generally
banned from entering the country, while the Chinese are referred to
local disease control and prevention agencies.

The HIV/AIDS ban is expected to be lifted next year on foreigners
entering China, the Ministry of Health had said earlier.

<http://economictimes.indiatimes.com/News/PoliticsNation/China_steps_up_random_b\
lood_tests_of_travellers_to_check_HIV/articleshow/3410992.cms>

JOB ADVERTISEMENT

Project Director, Technical Support Facility - South Asia

ActionAid International (AAI) is a unique partnership of people working in over
50 countries in Asia, Africa, Australia, the Americas and Europe, committed to a
mission of working "with poor and excluded people to eradicate poverty and
injustice". HIV/AIDS is one of ActionAid's core six themes to achieve its
overall mission goals.

The Technical Support Facility (TSF) is a two year multi country project to
support effective technical capacity development on HIV/AIDS in South Asia. It
is supported by UNAIDS and will be managed by ActionAid and its partners, TATA
Institute of Social Sciences (TISS) India and The International Centre for
Diarrhoeal Disease Research, Bangladesh (ICDDRB). The project will cover seven
countries in the sub region (Bangladesh, Bhutan, India, Maldives, Nepal,Pakistan
and Sri Lanka).

The Project Director will provide strategic leadership and effectively manage
the implementation of the project through advocating, harmonizing and enlarging
the existing HIV services provided by partners and addressing coordination and
implementation capacity constraints at the country level including those of
national AIDS councils in the sub region.

The desired candidate will have an advanced degree in social sciences, medical
or other relevant disciplines; five year senior management experience including
multi country project management and familiarity with working with international
donors and governments. She/He will bring an in-depth understanding of the HIV
epidemic in South Asia, its current discourses and be well connected with
HIV/AIDS networks and alliances in the sub region and globally. With  excellent
leadership, communication and facilitation skills our desired candidate will be
well aligned to the values of ActionAid and UNAIDS. Excellent knowledge of
English is a requirement whilst familiarity of the local languages in the sub
region is an asset.

This is a senior post based in Kathmandu, Nepal with frequent travel within the
sub region and internationally. The position is offered under AAI`s
international terms and conditions for a two year contract initially with
possibility of one year extension.

An application letter along with an updated CV including two referees should be
sent to job.asia@... by 10th September 2008. We will be able to
respond only to the shortlisted candidates for the selection processes.

For the detailed, job description as well as for more information on ActionAid
International visit: www.actionaid.org

Whilst all applicants will be assessed strictly on their individual merits,
qualified women are especially encouraged to apply.


ActionAid
e-mail: job.asia@...

Dear  Colleagues

This is a gentle reminder to our earlier communication on your
possible contribution - comments on the Asian AIDS Commission report.
It will be appreciated if you could send your contribution at your
earliest convenience..

This is to invite you to take part in the e_Consultation on Asian
AIDS Commission Report: "Redefining AIDS in Asia – Crafting an
effective response".

How can one take this finding forward in  your country?

On behalf of the UNAIDS Regional Support Team for Asia and the
Pacific, AIDS ASIA eFORUM is hosting an e_Consultation on Asian AIDS
Commission Report: "Redefining AIDS in Asia – Crafting an effective
response".

http://health.groups.yahoo.com/group/AIDS_ASIA/

As a key HIV/AIDS Stake holder in Asia Pacific region, you are
invited to take part in this e_Consultation.

An independent Commission on AIDS in Asia was established in June
2006 with support from UNAIDS to review the HIV situation in Asia
from a wide socioeconomic perspective reaching beyond the public
health context. The commission was Chaired by  Dr. Chakravarthi
Rangarajan,  who is the Chairman of the Economic Advisory Council to
the Prime Minister of India

According to the Commission report, to address concentrated epidemics
requires leadership to overcome the social drivers behind the
epidemic. These include structural and social factors, such as
criminalization and marginalization of certain groups, human rights
violations and discrimination. Failing to address these constitutes a
major barrier to an effective national response.  Many of the
recommendations of the commission have far reaching implications. For
instance the commission recommends the need for civil society
adopting the NGO code of conduct and a AIDS Watch is being created in
each countries by the civil society.

Broader themes for discussion.

The following broader themes will be presented for discussion. Sub
themes under the broader themes will be developed in consultation
with a selected group "resource persons".


1) Redefining the epidemic, and why Asia HIV epidemic is unique. The
Report argues that the "standard classification of `low-
level', `concentrated' or `generalised' based on the HIV prevalence
in pregnant women does not capture the actual nature and dynamics of
Asia's epidemics." The Commission on AIDS in Asia instead proposes
four epidemic scenarios for Asia : latent, expanding, mature, and
declining (pages 53-54, table 2.1; pages 65-70) and links a proposed
package of prevention interventions with the most impact for each
scenario.

How can one take this finding forward in  your country and how might
one advocate for how government should invest their resources?

2) Decriminalization. How best can we review, remove or relax
legislation which harass sex workers, drug users, MSM and the service
providers who assist them? What do you think of the suggestion from
page are some lessons learnt from the region?

3) Accountability. How can we promote accountability by government,
donors/international community and the NGOs/community organizations?
Suggest practical AIDS watch mechanisms which can ensure follow-up to
internationally or regionally agreed frameworks for scaling up access
to prevention and treatment?

4) Increasing domestic funding. The Report stated that "as available
resources for funding HIV programmes have increased, the percentage
of total HIV expenditure funded out of national budgets has decreased
in the 14 surveyed countries – from 60 percent in 1996 to 40 percent
in 2004 (page 136). How does one make the case for increasing
domestic resources for AIDS in the Asia region?

5) Country and regional follow up. Discuss follow up country and
regional level needed to take forward the recommendations of the
Commission on AIDS in Asia . Country advocates could share their
plans and describe support needed.

A free electronic version of the report is available form the
following url

http://data.unaids.org/pub/Report/2008/20080326_report_commission_aids
_en.pdf

The consultation will be open from June 30th  to September 30th. At
the end of the consultation a detailed report of the out come of the
consultation with the list of participants will be submitted to the
UNAIDS regional office.

PLEASE SEND YOUR COMMENTS TO <joe_thomas123@...> or post
directly on the FORUM by visiting the following url

http://health.groups.yahoo.com/group/AIDS_ASIA/

For further details of this consultation please contact the
facilitator of the consultation Dr. Joe Thomas by  e-mail:
joe_thomas123@...  or by Skype  <joethomas123>


Thank you for your attention

Joe Thomas

AIDS ASIA e FORUM
http://health.groups.yahoo.com/group/AIDS_ASIA/

INVITATION  AIDS ASIA e FORUM.

Hi,

If you are already a member of this FOURM please forward this message to your
colleagues who may find this FORUM useful.

[AIDS ASIA eFORUM] is an e- forum committed to the development of an Asian
perspective on AIDS prevention and care issues. HIV/AIDS does not recognize
national boundaries. As Asia- pacific countries are increasingly interconnected
through migration and trade, it is imperative to generate a regional perspective
on HIV/AIDS related issues.

A forum for critical analysis of issues, events and programs, which has
implications on, our ability to address HIV/AIDS prevention and care issues
across the region. More than 7,600 subscribers are using this FORUM.

Strategic HIV information and communication support to promote the capacity of
Asian leaders, activists and people living with HIV/AIDS, to facilitate their
engagement and networking, to highlight their experiences and the solutions they
are offering to address HIV/AIDS issues in this region.

A cross cultural discourse on issues and concerns of Asia- Pacific countries
(regions): Afghanistan, Australia, Bangladesh, Bhutan, Brunei, Cambodia, China,
East Timor, Fiji, India, Indonesia, Japan, Kiribati, Laos, Malaysia, Marshall
Islands, Micronesia, Mongolia, Myanmar, Nepal, New Zealand, North Korea,
Pakistan, Palau, Papua New Guinea, Philippines, Samoa, Singapore, Solomon
Islands, South Korea, Sri Lanka, Taiwan, Thailand, Tonga, Tuvalu, Vanuatu and
Viet Nam will be presented and promoted on this forum.

Please review the archived messages on the following url

http://health.groups.yahoo.com/group/AIDS_ASIA/

Dr. Joe Thomas
Editor
AIDS ASIA e FORUM
http://health.groups.yahoo.com/group/AIDS_ASIA/

Dear FORUM,

We can indeed trust the pharmaceutical industry--to do anything and
everything to make bigger profits.

If babies die in the process, well, you can't make money without
breaking a few eggs, eh? (Or maybe you can but gosh it probably won't be nearly
as much.)

George M. Carter
E-MAIL: <fiar@...>
___________________

Children Die in an Outsourcing Boom

Tuesday 26 August 2008: by: J. Sri Raman, truthout | Perspective

Stories of children's deaths do not shock India too much. Over
2.1 million kids die every year in the country before they reach the
ripe age of five, according to a count by the United Nations
Children's Fund (UNICEF) in its State of the World's Children 2008
report. The fate of 49 babies, however, fell in a different category.

They died during clinical trials at New Delhi's All-India
Institute of Medical Sciences (AIIMS), which it is obligatory for the  nation's
media to describe as either "premier" or "prestigious,"
during the last two and a half years. The institute parted with this
news in response to a query from a non-profit organization that
sought it under a recently enacted law investing the citizen with a
"right to information."

The AIIMS pediatrics department conducted 42 sets of trials on
4,142 babies - 2,728 of them below the age of one - since January 1,
2006. As if to soften the impact of the information, the institute
added that the deaths amounted to a 1.18 percent mortality rate.

The belated announcement of the unmourned baby deaths has
brought to light a major issue that sections of the media and the
middle class - busy hailing India's "economic boom" - have preferred
to ignore. Can they continue to evade the issue of the outsourcing of  clinical
trials of drugs and therapies by the US and other Western  pharma giants and the
outrageous health and human costs of such  operations?

The man who has made it a public issue minces no words about the
meaning of the cradle deaths - the guinea-pig role reserved for the
country's poor in the scheme of things of the elite set on making
India a glittering "economic power." Rahul Verma, founder of New
Delhi-based Uday Foundation for Congenital Defects and Rare Blood
Groups, reiterates that he and his foundation were mainly concerned
about the "socioeconomic conditions" of the strata that provided the
tender subjects of the clinical trials.

The AIIMS did not answer his question on this count, but Verma
points out that the poor of India alone could be tempted by the
trials as they could not afford private medical care, while public
heath care was in a pathetic state. The institute provided no
information about the reasons for the babies' deaths, their ages or
their gender, since he had not specifically asked for it.

Talking on the telephone to Truthout, Verma confided that he had
named his foundation after his son Uday, suffering from congenital
defects and undergoing surgical treatment since his birth just two an  a half
years ago. "You can watch your father die, but not your child die," said Verma.
He cannot watch the children of the poor die,  either, only to save research and
development costs for some of the  world's richest merchants in medicare.

Verma finds particularly "scary" the fact that such a big
proportion of the babies were under one year old. It troubles many
medical practitioners that the trials of at least two of the drugs
involved should be conducted on even the age group of one to 16
years.

The drugs - olmesartan and valsartan, meant for reducing blood  pressure - have
never been tried on patients below age 18, according
to Chandra M. Gulhati, editor of the Monthly Index of Medical
Specialties.

In a media interview, he asks: "Is hypertension in this age
group a problem in India? If yes, what is the incidence and
prevalence? If it is not a major problem, why conduct a trial in
India and put children at risk without any benefit?"

The AIIMS tragedy has also raised questions afresh about the
official moves afoot to make such clinical trials even easier and
more common than ever - all as a part, of course, of an Indian
economic miracle in the making. Powerful lobbies for local industry
have long pleaded for steps to liberalize the trials, arguing that
the country's earnings from them could increase tenfold if annoying
obstacles were out of the way. The plea has not gone unheeded.

The plea is for revising present regulations of the trials,
conducted in three phases. Phase I trials test a drug's safety on
healthy volunteers. Phase II and III trials test larger numbers for
the drug's efficacy, besides collecting information on its safety and  effective
doses. Phase IV trials are conducted once the drug is
marketed to monitor for its safety in larger populations.

According to Schedule Y of India's Drugs and Cosmetics Act,
permission is given for international clinical trials in India one
phase behind the rest of the world. If a drug is going through Phase
III trials elsewhere, for example, it can be tried only in Phase II
trials here. Phase I trials of new drug substances discovered in
other countries can be conducted in India if data of the Phase I
trials in other countries are already available.

All this will change if the regulations undergo the planned
revision. Trials may then be conducted in the same phase as
elsewhere. According to the interim report of the expert government
committee: "Comprehensive revision of Schedule Y, that prescribes
requirements of clinical trials, has been undertaken in order to
harness (the) country's potential to participate in global multi-
centric clinical trials."

Concurrent-phase trials will open up the scope for multi-centric
trials at all phases, currently not possible here. They, however,
will also expose Indians to greater risks since Phase I trials will
be permitted - and since the people have much less access to proper
health care.

According to one report, meanwhile, the Confederation of Indian
Industries is pushing for "automatic approvals" of all applications
with the Drug Controller-General of India if not cleared within a
stipulated time frame. The health of the poor is too petty a
consideration for corporates in a hurry.

The first reaction of the government in New Delhi to disclosure
of the babies' deaths was predictable: Health Minister Anbumani
Ramadoss announced the setting up of a committee to investigate the
entire affair and submit a report soon. Only two days later, however,  he told a
newspaper: "The AIIMS is a renowned research institution.

The children must have died because they were already very ill."

At a public function around the same time, while promising a
review of the clinical trial process, the minister added: "We can
have a broad discussion on the subject in the country, but at the
same time, I would say that India has become the hub of a lot of
research activities, which is the need of the hour."

How proud should a patriotic Indian wax in this case that is so
very different from outsourcing in software or other areas? The
pharma firms make no secret of what lures them to India. Sandhya
Srinivasan, of the Indian Journal of Medical Ethics, cited an
eloquent example in an article four years ago. Wrote she: "A huge
population with a diversity of diseases that are untreated - yes,
that is the 'India Advantage' identified by iGate Clinical Research
International, commenting that India represents a largely untapped
resource for clinical trials." That the ill in India are largely
"drug naive" (meaning "untreated") is an added attraction.

iGate (with US headquarters in Pittsburgh, Pennsylvania) notes
that India has "40 million asthmatic patients, about 34 million
diabetic patients, eight to ten million people HIV positive, eight
million epileptic patients, three million cancer patients" among
other categories. What a mouth-watering prospect for pharma majors,
especially considering the poverty of this pool! Add to that the
bonus of illiteracy and semi-literacy of the subjects of the trials
that make it so easy to obtain "informed consent."

Just a few figures suffice to explain the glee among the global
pharma players and their local partners over the clinical-trial
cooperation. The average cost of bringing a new drug to market is
estimated at $1 billion. Human clinical trials are the most expensive  phase of
drug development. As much as 60 percent of the costs can be cut by holding the
trials in a country such as India.

On the other side, Global consultancy McKinsey and Company
estimates that, by 2010, global pharma majors will spend around $1
billion to $1.5 billion just for drug trials in India. As many as 139  new
trials were outsourced to India last year, putting it well ahead of China, which
had 98. The market value for clinical trials
outsourced to India is estimated to stand at $300 million, having
increased by 65 percent over last year.

What does India - as distinct from some of its industries,
institutions and individuals in important positions - gain? The World  Medical
Association Declaration of Helsinki Ethical Principles for  Medical Research
Involving Human Subjects lays down: "Medical
research is only justified if there is a reasonable likelihood that
the populations in which the research is carried out stand to benefit
from the results of the research."

Doctors in India, who have tried  to translate this into practice, say that they
got only verbal  assurances from the multinationals in this regard and very
little  beyond. The prohibitively priced drugs under trial, in any case, are
beyond the reach of the poor Indians.

The harm that can be done by the trials, however, is far from
hypothetical. In 2002, a trial in India, along with 31 other
countries, of Novo Nordisk's diabetes drug ragaglitazar had to be
suspended after a pre-clinical trial in mice revealed that the
compound caused urinary bladder tumors.

In 2003, it was reported that  researchers from India-based Sun Pharmaceuticals
had given the  anticancer drug letrozole to 430 young women to see if it would 
induce ovulation, despite the fact that the drug is known to be toxic to
embryos.

The deaths in the AIIMS are just the latest in a long series of
cases worldwide that raise serious questions over outsourcing in
clinical trials. We can only watch with concern whether the fate of
the child victims will make the rulers of a "rising India" (as they
advertise it) act like responsible adults.

http://www.truthout.org/article/children-die-outsourcing-boom

Papua New Guinea (PNG) AIDS groups criticises Australian workers
scheme

August 31, 2008: Australia's seasonal worker pilot program that will
offer 2500 temporary jobs to Pacific Islanders next year has been
criticised by HIV AIDS support groups in Papua New Guinea.

PNG Correspondent Steve Marshall reports the PNG government says
those who tests positive for HIV AIDS will not be allowed to take up
seasonal work in Australia and that's angered HIV supporters like
Floreance Memo from IGAT Hope.

"If Papua New Guinea says that we can't get because they're HIV
positive then it's a total discrimination we're talking about."

PNG Foreign Minister Sam Abal has defended the decision to introduce
compulsory testing for the seasonal worker visa.

"This will be a requirement and part of that I think also helps us
get people tested anyway."

The seasonal worker program is expected to start next year.

http://www.radioaustralia.net.au/news/stories/200808/s2351097.htm

Dear FORUM,

Southevy, a 70 year old TG sex worker activist from Cambodia is lodging an civil
party complaint with the  Extraordinary Cambers of the Courts of Cambodia (Khmer
Rouge Tribunal) for the investigation of crimes against transgenders during the
Khmer Rouge regime.

We have been working closely with her for 18 months now, and this will be the
first time that an international criminal court has accepted to investigate
crimes against sexual minorities as potential crimes against humanity.

It would be great if organisations or individuals can help get this information
out to the press and other interested parties and relevant lists so it gets the
sort of coverage that it should.

APNSW will be putting out a second press release on Monday. I have pasted the
official ECCC press release below.

A video done by Dale from APNSW about her escape from a death camp during the
Khmer Rouge can be seen here:

http://www.sexworkerspresent.blip.tv/#774424

At her press conference Southevy will be using the space to highlight issues of
discrimination against TG's and the situation for sex workers under the new
anti-trafficking law in Cambodia.

As she says  "How does the government think it's new law and locking
people up in rehabilitation centres can stop sex work? The Khmer Rouge could not
stop prostitution when they turned the whole country into a prison- I should
know as I was arrested for selling sex by the Khmer Rouge"

Anyone who wants copies of the press release or other materials please email me
and I can send them to you.
_______________________________
PRESS STATEMENT: BY CIVIL PARTIES LAWYER SILKE STUZINSKY

First Civil Party Application before the Extraordinary Chambers in the Courts of
Cambodia (ECCC) on Gender-Based Violence under the Khmer Rouge Regime

On 3 September 2008 the first application to be recognised as a Civil Party
before the ECCC for gender-based crimes will be submitted to the Court's Victims
Unit.

S. is a transgendered person (male to female) who was imprisoned several times
in re-education camps as well as in prisons , and suffered numerous rapes during
the Khmer Rouge Regime by Khmer Rouge soldiers and cadres. She was punished for
having committed “moral offences” and for behaving as a woman. She was forced to
cut her long hair and to wear men’s clothing (as was the custom under the Khmer
Rouge). Furthermore , she was threatened with death if she refused to marry a
woman , and the Khmer Rouge ordered the performance of sexual intercourse as
part of the marital obligation. These acts must be considered within the crime
of rape , as they were committed without
the consent of the concerned person , and were conducted following orders
because of threats and the general coercive nature of the circumstances.

Now S. is searching for justice before the ECCC , to hold senior leaders of the
Khmer Rouge responsible for the crimes she suffered.

This is the first complaint before the ECCC concerning sexual violence under the
Khmer Rouge regime. To date, a widespread silence and/or confusion has covered
up crimes of sexual violence. According to common perception, sexual violence
occurred during the regime, but has not been as formally documented as have
other atrocities. But
failure to punish the perpetrators obviously leads to a climate of general
impunity for such crimes.

The senior leaders of the Khmer Rouge Regime bear responsibility for those acts
of sexual violence committed by their soldiers and cadres , because they were
conducted in the framework of a general policy on sexual behaviour, with
predictable consequences. Due to a lack of effective supervision of their
subordinates they bear criminal responsibility for those acts of sexual
violence.

To date , the investigations at the ECCC have not included acts of sexual
violence for the reason that there is a lack of sufficient evidence. However ,
investigations in this regard were never conducted.

Therefore , the aforementioned complaint requests the opening of further
investigations into gender-based violence. This step would encourage other
victims of such crimes to come forward and demand acknowledgment and justice for
their suffering , which has largely been ignored until now.

Interested victims can receive more information from the Court's Victims Unit as
well as various local NGOs. Moreover , applicants can be provided with numerous
protective measures to grant them the appropriate circumstances to speak and to
break the long lasting
silence.
----------------------------------
Herewith , we invite all interested media and individuals
to a press conference to be held on

3 September 2008 at 2.30 pm

Sunway Hotel , #1 , St. 92 , Sangkat Wat Phnom , Phnom
Penh .

For further information please contact:

Co-Lawyer -- Silke Studzinsky (012 657 014)

ECCC Press Officer -- Reach Sambath (012 488 156)

ECCC Chief of Public Affairs -- Helen Jarvis (012 488 134)

Supporting organisations

Medica Mondiale
Network Men Women Development Cambodia
Women’s Network for Unity
Womyns Agenda for Change
Asia Pacific Network of Sex Workers


Andrew Hunter
apnsw.org
E-MAIL <ahunter@...>

Inequities are killing people on a "grand scale" reports WHO's
Commission

28 August 2008 | GENEVA -- A child born in a Glasgow, Scotland suburb
can expect a life 28 years shorter than another living only 13
kilometres away. A girl in Lesotho is likely to live 42 years less
than another in Japan. In Sweden, the risk of a woman dying during
pregnancy and childbirth is 1 in 17 400; in Afghanistan, the odds are
1 in 8. Biology does not explain any of this. Instead, the
differences between - and within - countries result from the social
environment where people are born, live, grow, work and age.

These "social determinants of health" have been the focus of a three-
year investigation by an eminent group of policy makers, academics,
former heads of state and former ministers of health. Together, they
comprise the World Health Organization's Commission on the Social
Determinants of Health. Today, the Commission presents its findings
to the WHO Director-General Dr Margaret Chan.

"(The) toxic combination of bad policies, economics, and politics is,
in large measure responsible for the fact that a majority of people
in the world do not enjoy the good health that is biologically
possible," the Commissioners write in Closing the Gap in a
Generation: Health Equity through Action on the Social Determinants
of Health. "Social injustice is killing people on a grand scale."

"Health inequity really is a matter of life and death," said Dr Chan
today while welcoming the Report and congratulating the
Commission. "But health systems will not naturally gravitate towards
equity. Unprecedented leadership is needed that compels all actors,
including those beyond the health sector, to examine their impact on
health. Primary health care, which integrates health in all of
government's policies, is the best framework for doing so."

Sir Michael Marmot, Commission Chair said: "Central to the
Commission's recommendations is creating the conditions for people to
be empowered, to have freedom to lead flourishing lives. Nowhere is
lack of empowerment more obvious than in the plight of women in many
parts of the world. Health suffers as a result. Following our
recommendations would dramatically improve the health and life
chances of billions of people."

Inequities within countries

Health inequities – unfair, unjust and avoidable causes of ill
health – have long been measured between countries but the Commission
documents "health gradients" within countries as well. For example:

• Life expectancy for Indigenous Australian males is shorter by 17
years than all other Australian males.

• Maternal mortality is 3–4 times higher among the poor compared to
the rich in Indonesia. The difference in adult mortality between
least and most deprived neighbourhoods in the UK is more than 2.5
times.

• Child mortality in the slums of Nairobi is 2.5 times higher than in
other parts of the city. A baby born to a Bolivian mother with no
education has 10% chance of dying, while one born to a woman with at
least secondary education has a 0.4% chance.

• In the United States, 886 202 deaths would have been averted
between 1991 and 2000 if mortality rates between white and African
Americans were equalized. (This contrasts to 176 633 lives saved in
the US by medical advances in the same period.)

• In Uganda the death rate of children under 5 years in the richest
fifth of households is 106 per 1000 live births but in the poorest
fifth of households in Uganda it is even worse – 192 deaths per 1000
live births – that is nearly a fifth of all babies born alive to the
poorest households destined to die before they reach their fifth
birthday. Set this against an average death rate for under fives in
high income countries of 7 deaths per 1000.

The Commission found evidence that demonstrates in general the poor
are worse off than those less deprived, but they also found that the
less deprived are in turn worse than those with average incomes, and
so on. This slope linking income and health is the social gradient,
and is seen everywhere – not just in developing countries, but all
countries, including the richest. The slope may be more or less steep
in different countries, but the phenomenon is universal.

Wealth is not necessarily a determinant

Economic growth is raising incomes in many countries but increasing
national wealth alone does not necessarily increase national health.

Without equitable distribution of benefits, national growth can even
exacerbate inequities.

While there has been enormous increase in global wealth, technology
and living standards in recent years, the key question is how it is
used for fair distribution of services and institution-building
especially in low-income countries. In 1980, the richest countries
with 10% of the population had a gross national income 60 times that
of the poorest countries with 10% of the world's population. After 25
years of globalization, this difference increased to 122, reports the
Commission. Worse, in the last 15 years, the poorest quintile in many
low-income countries have shown a declining share in national
consumption.

Wealth alone does not have to determine the health of a nation's
population. Some low-income countries such as Cuba, Costa Rica,
China, state of Kerala in India and Sri Lanka have achieved levels of
good health despite relatively low national incomes. But, the
Commission points out, wealth can be wisely used. Nordic countries,
for example, have followed policies that encouraged equality of
benefits and services, full employment, gender equity and low levels
of social exclusion. This, said the Commission, is an outstanding
example of what needs to be done everywhere.

Solutions from beyond the health sector

Much of the work to redress health inequities lies beyond the health
sector. According to the Commission's report, "Water-borne diseases
are not caused by a lack of antibiotics but by dirty water, and by
the political, social, and economic forces that fail to make clean
water available to all; heart disease is caused not by a lack of
coronary care units but by lives people lead, which are shaped by the
environments in which they live; obesity is not caused by moral
failure on the part of individuals but by the excess availability of
high-fat and high-sugar foods." Consequently, the health sector –
globally and nationally – needs to focus attention on addressing the
root causes of inequities in health.

"We rely too much on medical interventions as a way of increasing
life expectancy" explained Sir Michael. "A more effective way of
increasing life expectancy and improving health would be for every
government policy and programme to be assessed for its impact on
health and health equity; to make health and health equity a marker
for government performance."

Recommendations

Based on this compelling evidence, the Commission makes three
overarching recommendations to tackle the "corrosive effects of
inequality of life chances":

1. Improve daily living conditions, including the circumstances in
which people are born, grow, live, work and age.

2. Tackle the inequitable distribution of power, money and resources –
the structural drivers of those conditions – globally, nationally and
locally.

3. Measure and understand the problem and assess the impact of
action.

Recommendations for daily living

Improving daily living conditions begins at the start of life. The
Commission recommends that countries set up an interagency mechanism
to ensure effective collaboration and coherent policy between all
sectors for early childhood development, and aim to provide early
childhood services to all of their young citizens. Investing in early
childhood development provides one of the best ways to reduce health
inequities. Evidence shows that investment in the education of women
pays for itself many times over.

Billions of people live without adequate shelter and clean water. The
Commission's report pays particular attention to the increasing
numbers of people who live in urban slums, and the impact of urban
governance on health. The Commission joins other voices in calling
for a renewed effort to ensure water, sanitation and electricity for
all, as well as better urban planning to address the epidemic of
chronic disease.

Health systems also have an important role to play. While the
Commission report shows how the health sector can not reduce health
inequities on its own, providing universal coverage and ensuring a
focus on equity throughout health systems are important steps.

The report also highlights how over 100 million people are
impoverished due to paying for health care – a key contributor to
health inequity. The Commission thus calls for health systems to be
based on principles of equity, disease prevention and health
promotion with universal coverage, based on primary health care.
Distribution of resources

Enacting the recommendations of the Commission to improve daily
living conditions will also require tackling the inequitable
distribution of resources. This requires far-reaching and systematic
action.

The report foregrounds a range of recommendations aimed at ensuring
fair financing, corporate social responsibility, gender equity and
better governance. These include using health equity as an indicator
of government performance and overall social development, the
widespread use of health equity impact assessments, ensuring that
rich countries honour their commitment to provide 0.7% of their GNP
as aid, strengthening legislation to prohibit discrimination by
gender and improving the capacity for all groups in society to
participate in policy-making with space for civil society to work
unencumbered to promote and protect political and social rights. At
the global level, the Commission recommends that health equity should
be a core development goal and that a social determinants of health
framework should be used to monitor progress.

The Commission also highlights how implementing any of the above
recommendations requires measurement of the existing problem of
health inequity (where in many countries adequate data does not
exist) and then monitoring the impact on health equity of the
proposed interventions. To do this will require firstly investing in
basic vital registration systems which have seen limited progress in
the last thirty years. There is also a great need for training of
policy-makers, health workers and workers in other sectors to
understand the need for and how to act on the social determinants of
health.

While more research is needed, enough is known for policy makers to
initiate action. The feasibility of action is indicated in the change
that is already occurring. Egypt has shown a remarkable drop in child
mortality from 235 to 33 per 1000 in 30 years. Greece and Portugal
reduced their child mortality from 50 per 1000 births to levels
nearly as low as Japan, Sweden, and Iceland. Cuba achieved more than
99% coverage of its child development services in 2000. But trends
showing improved health are not foreordained. In fact, without
attention health can decline rapidly.

Is this feasible?

The Commission has already inspired and supported action in many
parts of the world. Brazil, Canada, Chile, Iran, Kenya, Mozambique,
Sri Lanka, Sweden, and the UK have become 'country partners' on the
basis of their commitment to make progress on the social determinants
of health equity and are already developing policies across
governments to tackle them. These examples show that change is
possible through political will. There is a long way to go, but the
direction is set, say the Commissioners, the path clear.

WHO will now make the report available to Member States which will
determine how the health agency is to respond.

Comments from the Commissioners

Fran Baum, Head of Department and Professor of Public Health at
Flinders University, Foundation Director of the South Australian
Community Health Research Unit and Co-Chair of the Global
Coordinating Council of the People's Health Movement: "It is
wonderful to have global endorsement of the Australian Closing the
Gap campaign from the CSDH established by the WHO. The CSDH sets
Closing the Gap as a goal for the whole world and produces the
evidence on how health inequities are a reflection of the way we
organize society and distribute power and resources. The good news
from the CSDH for Australia is that it provides plenty of ideas on
how to set an agenda that will tackle the underlying determinants of
health and create a healthier Australia for all of us"

Monique Begin, Professor at the School of Management, University of
Ottawa, Canada, twice-appointed Minister of National Health and
Welfare and the first woman from Quebec elected to the House of
Commons: "Canada likes to brag that for seven years in a row the
United Nations voted us "the best country in the world in which to
live". Do all Canadians share equally in that great quality of life?
No they don't. The truth is that our country is so wealthy that it
manages to mask the reality of food banks in our cities, of
unacceptable housing (1 in 5), of young Inuit adults very high
suicide rates. This report is a wake up call for action towards truly
living up to our reputation."

Giovanni Berlinguer, Member of the European Parliament, member of the
International Bioethics Committee of UNESCO (2001–2007) and
rapporteur of the project Universal Declaration on Bioethics: "A
fairer world will be a healthier world. A health service and medical
interventions are just one of the factors that influence population
health. The growth of inequalities and the phenomena of increased
injustice in health is present in low and middle income countries as
well as across Europe. It would be a crime not to take every action
possible to reduce them."

Mirai Chatterjee, Coordinator of Social Security for India's Self-
Employed Women's Association, a trade union of over 900 000 self-
employed women and recently appointed to the National Advisory
Council and the National Commission for the Unorganised Sector: "The
report suggests avenues for action from the local to national and
global levels. It has been eagerly awaited by policy-makers, health
officials, grassroot activists and their community-based
organizations. Much of the research and evidence is of particular
relevance to the South-East Asian region, where too many people
struggle daily for justice and equity in health. The report will
inspire the region to act and develop new policies and programmes."

Yan Guo, Professor of Public Health and Vice-President of the Peking
University Health Science Centre, Vice-Chairman of the Chinese Rural
Health Association and Vice-Director of the China Academy of Health
Policy: "A man should not be concerned with whether he has enough
possessions but whether possessions have been equally distributed",
this is a time-honored teaching in China. Constructing a harmonious
society is our shared aspiration, and equity, including health
equity, composes the prerequisite for a harmonious development.

Eliminating determinants that are adverse to health under the efforts
from all of the society, promoting social justice, and advancing
human health are our shared goals. Let's join our hands in this grand
course!"

Kiyoshi Kurokawa, Professor at the National Graduate Institute for
Policy Studies, Tokyo, Member of the Science and Technology Policy
Committee of the Cabinet Office, formerly President of the Science
Council of Japan and the Pacific Science Association: "The WHO
Commission addresses one of the major issues of our global world -
health inequity. The report's recommendations will be perceived,
utilized and implemented as a major policy agenda at national and
global levels. The issue will increase in importance as the general
public become more engaged via civil society movements and multi-
stakeholder involvement."

Alireza Marandi, Professor of Pediatrics at Shaheed Beheshti
University, Islamic Republic of Iran, former two-term Minister of
Health and Medical Education, former Deputy Minister and Advisor to
the Minister and recently elected to be a member of the Iranian
Parliament: "According to the Islamic ideology, social justice became
a priority, when the Islamic revolution materialized in Iran.

Establishing a solid Primary Health Care network in our country, not
only improved our health statistics, but it was an excellent vehicle
to move towards health equity. Now through the final report of the
CSDH and implementing its recommendations we need to move much faster
in our own country toward health equity."

Pascoal Mocumbi, High Representative of the European and Developing
Countries Clinical Trials Partnership, former Prime Minister of the
Republic of Mozambique, former head of the Ministry of Foreign
Affairs and the Ministry of Health: "The Commission on Social
Determinants of Health report will help African leaders adapt their
national development strategies to address the challenges to health.
These are derived from the current systemic changes taking place in
the global economy that affects heavily on the poorest segments of
Africa's population."

Amartya Sen, Lamont University Professor and Professor of Economics
and Philosophy at Harvard University, awarded the Nobel Prize in
Economics in 1998: "The primary object of development - for any
country and for the world as a whole - is the elimination
of 'unfreedoms' that reduce and impoverish the lives of people.
Central to human deprivation is the failure of the capability to live
long and healthy lives. This is much more than a medical problem. It
relates to handicaps that have deep social roots. Under Michael
Marmot's leadership, this WHO Commission has concentrated on the
badly neglected causal linkages that have to be adequately understood
and remedied. A fuller understanding is also a call for action."

David Satcher, Director of the Center of Excellence on Health
Disparities and the Satcher Health Leadership Institute Initiative,
formerly the United States Surgeon General and Assistant Secretary
for Health and also Director of the Centers for Disease Control and
Prevention: "The United States of America spends more on health care
than any other country in the world, yet it ranks 41st in terms of
life expectancy. New Orleans and its experience with Hurricane
Katrina illustrate why we need to target social determinants of
health (SDH) — including housing, education, working and learning
conditions, and whether people are exposed to toxins—better than any
place I can think of right now. By targeting the SDH, we can rapidly
move towards closing the gap that unfairly and avoidably separates
the health status of groups of different socio-economic status,
social exclusion experience, and educational background."

Anna Tibaijuka, Executive Director of UN-HABITAT and founding
Chairperson of the independent Tanzanian National Women's
Council: "Health delivery is not possible for people living in
squalor, in dehumanizing pathetic conditions prevailing in the ever
growing slum settlements of cities and towns in developing countries.

Investment in basic services such as water and education will always
remain constrained if not wasted unless accompanied by requisite
investment in decent housing with basic sanitation."

Denny Vågerö, Professor of Medical Sociology, Director of CHESS
(Centre for Health Equity Studies) in Sweden, member of the Royal
Swedish Academy of Sciences and of its Standing Committee on
Health: "Countries of the world are presently growing apart in health
terms. This is very worrying. In many countries in the world social
differences in health are also growing, and this is true in Europe.
We have been one-sidedly focused on economic growth, disregarding
negative consequences for health and climate. We need to think
differently about development."

Gail Wilensky, Senior Fellow at Project HOPE, an international health
education foundation. Previously she directed the Medicare and
Medicaid programmes in the United States and also chaired two
commissions that advise the United States Congress on Medicare: "What
this report makes clear is that improving health and health outcomes
and reducing avoidable health differences—goals of all countries--
involves far more than just improving the health care system. Basic
living conditions, employment, early childhood education, treatment
of women and poverty all impact on health outcomes and incorporating
their effects on health outcomes needs to become an important part of
public policymaking. This is as true for wealthy countries like the
United States as it is for many of the emerging countries of the
world, where large numbers of people live on less than $2 per day."


A copy of the report is available on the following url
http://whqlibdoc.who.int/publications/2008/9789241563703_eng.pdf

Sex slave convictions upheld

August 28, 2008, 6:04 pm: The federal government needs to do more to
eliminate sexual slavery in Australia, a lawyer said, after the High
Court upheld the conviction of a former Melbourne brothel owner.
Wei Tang was sentenced to 10 years jail for enslaving five Thai women
at her inner- Melbourne brothel, Club 417, and forcing them to serve
900 clients to work off debts of $45,000 each.

In June last year, Tang successfully appealed her convictions in the
Victorian Court of Appeal.

But the High Court on Thursday overturned the Court of Appeal order
for a new trial and held that the prosecution made out the required
elements of the offences and did not need to prove she knew or
believed the women were slaves.

David Manne, director of the Refugee and Immigration Legal Centre in
Melbourne which represented the five women, said sexual slavery still
existed in Australia.

"This is a very important victory," Mr Manne told AAP.

"This is also a wake-up call for the government and law enforcers.
More needs to be done. Australia is not immune to sexual slavery, it
hasn't stopped.

"The sad tragedy of this is we are still acting for women. This
situation is going on on a daily basis in Australia. It's behind
closed doors and run by very well organised international crime
syndicates.

"There needs to be substantial improvements in the protection of
these women."

Tang was the first person to be found guilty by a jury under federal
anti-slavery laws introduced in 1999.

She was convicted in 2006 of five counts of possessing a slave and
five counts of exercising a power of ownership over a slave.

Her convictions were quashed and a fresh trial was ordered after the
Court of Appeal ruled directions given to the jury were inadequate.

The Commonwealth Director of Public Prosecutions appealed the
decision to the High Court.

The case came to light following a 2003 raid of Club 417, in
Brunswick Street, Fitzroy.

According to the evidence, the five Thai women worked six days a week
to serve 900 customers so they could earn enough to pay their $45,000
debt.

The women's debt was reduced by $50 per customer.

If they worked a seventh day, they could keep the $50 per customer.
The women were not under lock and key but had little money, limited
English, worked long hours and feared they would be found by
immigration authorities.

Their visas had been obtained illegally and their passports were
withheld by Tang.

Two of the women paid off their debts in six months and restrictions
on them were lifted, their passports were returned, they were paid
and they could choose their hours of work.

"They were taken advantage of in an horrific way, they were literally
turned into slaves, all of them had their basic freedoms taken away
and then were subjected to brutal abuse on a daily basis," Mr Manne
said.

He said the women were still in Australia and were rebuilding their
lives.

Tang was ordered to serve six years jail before being eligible for
parole.

http://au.news.yahoo.com/a/-/mp/4970964/sex-slave-convictions-upheld

AIDS cases seen on the rise in Philippines

By Tess Thompson. MANILA (Reuters) - The Philippines has a lower
incidence of HIV than most of its neighbors despite sharing many of
the risks, but health officials warned on Thursday that many new
cases were now coming to light.

A spate of new HIV cases suggests that the Philippines' situation
might be more accurately described as "hidden and growing," said
Mario Villaverde, an undersecretary in the Department of Health.

"More recent statistics have already indicted a more or less abrupt
change in the number of people afflicted," he said, on the sidelines
of a conference on HIV/AIDS in nine Asian countries deemed to have
low prevalence of the disease.

Villaverde said more infected people could be making their status
known because treatments were now cheaper, although this was being
verified by the health department.

"In the past two years, anti-retroviral drugs have become available
for free, meaning some HIV positive people previously unknown to the
authorities are now being reported," he said.

The number of Filipinos living with HIV was estimated by the United
Nations at 7,000 cases in 2007, out of a total population of about 91
million.

The Philippines Department of Health however put the number of HIV
patients at about 3,360 as of July, but says over 300 new cases have
surfaced this year alone.

LOW PREVALENCE
Nevertheless, the status of HIV infection in the Philippines has been
classified as low prevalence, meaning that less than 0.1 percent of
the population and less than 5.0 percent of people in high-risk
groups were infected.

This was despite the low usage of condoms in the Catholic-majority
country, where the powerful church frowns on artificial methods of
contraception.

According to a 2005 study, only 13.5 percent of heterosexual Filipino
males in the 15-24 age group used condoms.

India, China and Thailand all have higher incidence of HIV/AIDS than
the Philippines.

Other Asian countries deemed to have low prevalence of HIV/AIDS
include Bangladesh, Bhutan, Indonesia, North Korea, Fiji, Laos,
Malaysia, Mongolia and Sri Lanka.

"In the Philippines, the low partner exchange, the frequency or the
number of male clients (of prostitutes) frequenting other partners,
the contributory factor of circumcision, those are some of the
conditions that have somehow kept the HIV prevalence low," said Bai
Bagaso, UNAIDS representative for the country.

"But what we're saying is it does mask the threat because it might
not reveal the changes in the way HIV is spreading."

(Editing by Raju Gopalakrishnan and David Fox)

http://news.yahoo.com/s/nm/20080828/hl_nm/aids_philippines_dc_1

312 travelers found HIV positive

By Zhu Zhe/ China Daily

2008-08-27 06:58 Three hundred and twelve travelers were found to be HIV
positive in the first seven months of this year, up 19 percent year-on-year, a
report released Tuesday showed.

They were among 756,000 travelers who received random blood checks at border
crossings, according to the report compiled by the General Administration of
Quality Supervision, Inspection and Quarantine (AQSIQ).

The increase in positive cases was mainly due to the growth in the number of
people who underwent the checks, Xia Wenjun, a press officer with the
administration, said.

Such random checks were conducted on only 65,900 travelers in the same period
last year.

Xia said such checks were usually conducted among high-risk groups, or those who
appeared to have the symptoms. She would not elaborate.

The report failed to say how many of the HIV positive travelers were foreigners.

Under current laws and regulations of China, foreigners with HIV/AIDS are
generally banned from entering the country, while the Chinese are referred to
local disease control and prevention agencies.

The HIV/AIDS ban is expected to be lifted next year on foreigners entering
China, the Ministry of Health said earlier.

The report also said border quality and quarantine officers checked 9.6 million
batches of products from January to July this year, and found 59,720 of them to
be substandard. The rate is about the same as the corresponding period last
year.

http://www.chinadaily.com.cn/china/2008-08/27/content_6972922.htm