INVITATION  AIDS_ASIA e FORUM.

Hi,

If you are already a member of this FOURM please forward this message to your
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[AIDS_ASIA e FORUM] is an experimental occasional electronic newsletter. 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 4,000 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/

Futures Group is a management, marketing, research, and strategic
planning organization that help clients make well-informed decisions
in  the presence of future uncertainty. Since its founding in 1971, the
Futures Group has worked in more than 60 developing countries to
build  local capacity to design and implement effective strategies to
address critical development issues. We have earned a reputation as a global
leader in public health and social concerns, including population,
family planning, reproductive health, HIV/AIDS and sexually
transmitted infections, safe motherhood, poverty alleviation, education, and the
environment.

Purpose: The Project Director (PD) will have overall responsibility
for directing the Futures Group Avahan Advocacy Program in HIV/AIDS.

Overall Program Description: The Avahan Advocacy Program (AAP)
utilizes a capacity building model to help galvanize the leadership around
HIV/AIDS and foster a supportive environment for HIV prevention, care
and treatment efforts. There is a special emphasis on reducing
HIV-related stigma and discrimination by increasing leadership
involvement at all levels. As a result, partners and stakeholders
will be better placed to understand the impact of the HIV epidemic and
take effective advocacy, policy and program measures to address it. The
program will be operational in Tamil Nadu, Karnataka, Andhra Pradesh,
Maharashtra, Manipur, Nagaland, and Delhi.

Responsibilities:

The Project Director is responsible for the technical, program,
personnel, operations, and financial management of the AAP in all six
locations. This includes overall responsibility for assessing state
policy and advocacy conditions, designing state programs, and
ensuring state and national programmes are carried out and monitored
successfully. Additionally, the PD is responsible for working in
partnership and coordinating with other members of the Avahan team to
support the overall objectives of the Gates Avahan Initiative in
India.

Specific responsibilities include:

1. Reports to the Futures Group Managing Director.
2. Provide management leadership and overall technical direction of
project activities to all staff.
3. Work closely with the Managing Director to assure that project
objectives are met in a timely and effective manner.
4. Provide technical and management guidance to the 5 State
Coordinators
in policy areas including advocacy, policy dialogue, multisectoral
approaches, planning and finance, and capacity development.
5. Identify training needs of State Coordinators, other AAP staff and
partners and create opportunities to build local capacity.
6. Coordinate interaction and experience sharing amongst AAP staff
and partners
7. Provide specific guidance to state programs on subcontracting,
grants, systems, and operating procedures. Review and approve project
and state-level work plans and budgets. Approve travel, consultant
agreements, subcontracts and grants.
8. Develop and implement monitoring and evaluation activities
implemented by country programs.
9. Responsible for annual program and financial reports as well as
other ad hoc reports as required.
10. Initiate and participate in liaison activities with Avahan
partners, other agencies and organizations to ensure information sharing,
coordination, and collaboration.
11. Interact with Gates Foundation project managers and facilitate
communication in both directions.

Qualifications: Senior level position requiring 10 yrs minimum,
demonstrated experience, successfully managing HIV/AIDS or similar
health activities. Knowledge and experience with standard
contracting, management systems, operational procedures, budgeting and financial
reporting required. Documented experience leading policy and advocacy activities
in the field. Technical expertise in HIV/AIDS working with
vulnerable populations, treatment access, or policy issues essential.

Excellent oral and written skills required in English. Knowledge of
Telugu, Tamil, Kannada and Marathi besides Hindi is an added
advantage. Experience working with teams of diverse cultural and professional
backgrounds required. This position will be based in Hyderabad.
People with HIV are encouraged to apply.

To apply visit the job board found on our website
www.futuresgroup.com.

Press release: HIV INTERVENTIONS MUST BE PART OF TSUNAMI RELIEF
EFFORTS, SAYS UNAIDS

Bangkok, 28 January 2005 – As the tsunami relief efforts in
devastated areas across the Indian Ocean shift towards long-term
strategies, it is essential to sustain HIV prevention and
care efforts, said Mr Prasada Rao, Director of the Regional Support
Team of the Joint United Nations Programme on HIV/AIDS (UNAIDS) in
Asia today.

The earthquake and subsequent tsunamis have created post-disaster
conditions that could increase the risk of HIV transmission in
affected regions. In any emergency situation, basic services
essential to preventing sexually transmitted infections and HIV
break down. Across the tsunami-devastated areas, health care systems
have been destroyed, condoms are not readily available and existing
HIV prevention and care programmes have been disrupted.

"Refugees or internally displaced persons, especially women and
children, are often highly vulnerable to HIV infection during an
emergency situation," said Dr Ulf Kristoffersson,

Director of the UNAIDS Office on AIDS, Security and Humanitarian
Response. "This tsunami disaster has displaced over 1 million
people, many of whom have been separated from or lost their
families, spouses or partners. These people have been exposed to
unique pressures, working constraints, living conditions and
possible gender-based sexual violence, exploitation and abuse, all
factors which may put them at increased risk of HIV."

Dr. Kristoffersson also stressed the importance of briefing and
training uniformed services in the region about the risks of HIV
infection in emergency situations. "In all affected countries,
large numbers of troops and police have been deployed to carry out
the relief work,'" he said.

While the majority of tsunami relief efforts have focused on
lifesaving measures, such as provision of health care, water, food
and shelter, UNAIDS has been working to ensure that HIV prevention
and care needs do not go unmet and continue in parallel with the
emergency response in the affected countries.

"UNAIDS has recognized the need for a coordinated and multisectoral
response to integrating HIV activities into all areas of
assistance," said Mr. Rao. "At both regional and country levels,
UNAIDS has been coordinating efforts around HIV and AIDS through the
work of our ten Cosponsoring agencies, and widely disseminating
guidelines for HIV interventions in emergency settings."

The guidelines have been developed by UN agencies and NGOs, to
ensure that HIV prevention and care efforts are included in any
emergency action plans carried out by international humanitarian
organizations and governments.
____________________________________________________________________
For further information, contact: Ms. Nana Taona Kuo, South East
Asia & Pacific Focal Point for UNAIDS Office on AIDS Security and
Humanitarian Response, Bangkok, (+ 66) (0) 2 288 1216 kuot@...,
or Dominique De Santis, UNAIDS, Geneva, (+41) 22 791 4509,
desantisd@.... See web site :
http://www.aidsandemergencies.org

Dear Friends,

As 2005 gets underway, POZ is planning a very special feature: our
first-ever POZ 100. We want to honor and celebrate 100 individuals
(or, in some cases, groups) around the world in shaping the future
treatment and prevention of HIV. And we need your input to get us
started.

Please take a moment to list those folks who you believe are doing
critical, cutting-edge, even unheralded work in the 5 categories
listed below.

Who are the pioneering figures here and abroad, in the labs, the
clinics, the halls of power, the streets and the arts? Who have
you've met, read or heard about in your own labors working to end
the  epidemic , whether it's forging immune/vaccine discoveries,
designing  new therapies, facilitating treatment and care in poor nations,
holding leaders to account, fighting for scare funds, speaking truth
to power or putting a public face on the epidemic? They may be
household names or unsung heroes-or maybe even YOU!

All we ask is that you apply an earnest 5 minutes of your thought to
the challenge-and, of course, a word or two of explanation if
needed, and a contact if you have one. Here are the categories:

TREATMENT & RESEARCH:

POLICY & GOVERNMENT:

ACTIVISM & ADVOCACY:

FUNDRAISING & PHILANTHROPY:

MEDIA, ARTS & ENTERTAINMENT:

Thanks for helping us spotlight who to watch-and to root for-in the
years ahead!

Best,

The Editors
POZ
www.poz.com

--
Walter Armstrong
Editor in Chief, POZ magazine
Editorial Director, Smart + Strong
500 Fifth Avenue, Suite 320
New York, NY 10110
phone 212-242-2163 x 203
fax 212-675-8505
cell 646-734-2739
E-mail: <waltera@...>

Dear all,

This is to seek your opinion and comments on the "Governance of
International Conference on HIV/AIDS in Asia Pacific (ICAAP)

Observations were made by many independent commentators on HIV and
AIDS related issues in Asia Pacific about the need for an informed
debate on the current state of affairs of the "Governance of HIV and
AIDS Knowledge in Asia Pacific'and the role of ICAAP

The overall objective of this discussion is to review the state of
governance of HIV and AIDS related knowledge in Asia Pacific region
with a particular emphasis on the governance of International
conference on HIV &AIDS in Asia and Pacific (ICAAP). As the major
institution for the articulation, expression and management of HIV and
AIDS related knowledge in this region the governance of ICAAP has
major implications.

`Knowledge' is defined as  (a)  "the fact or condition of knowing
something with familiarity gained through experience or association
(b): acquaintance with or understanding of a science, art, or
technique , (c): the fact or condition of being aware of something
(d): the range of one's information or understanding (e): the
circumstance or condition of apprehending truth or fact through
reasoning" . In the context of HIV/AIDS our ability to use `the
knowledge' to develop appropriate policy and programs is critical for
a successful HIV and AIDS response this region.

Traditionally the biannual gathering of ICAAP provided a space for
presenting HIV and AIDS knowledge and to explore the policy and
program implications of such knowledge in Asia Pacific region. So far
no critical analysis was ever made to understand the linkages between
HIV and AIDS knowledge and it's governance.

"HIV/AIDS Governance refers to the exercise of power and resource
allocation in the broader context of relationship among and between
the stakeholders and of civil society, corporate and state contexts.
HIV/AIDS governance refers to the rules, regulations and processes of
key stake holders that affect the way in which powers are exercised
and resources are allocated to address the determinants and
consequences of HIV infection".

The ramifications of inadequate governance can be great. If an
organization fails to carry out this role effectively, it stands to
lose credibility with its members and the public at large, damage its
ability to carry out policies or deliver services, and ultimately fail
at its primary mission or objectives.  Poor governance and poor
management lead to organizational crisis and failure. Failed
governance is often deemed a betrayal of public trust. A Governance
failure of ICAAP will lead to an erosion of public confidence in
regional HIVAIDS institutions, and to calls for greater transparency
and public accountability.

But, good governance is about more than getting the job done.
Especially in the context of governing HIV and AIDS knowledge
management in the Asia Pacific region. ICAAP is one of the key
institutional space for articulating HIV and AIDS knowledge in the
region.  Values and norms typically play an important role in
determining both organizational purpose and style of operation,
process is as important as product. Good governance of ICAAP becomes
more than only a means to organizational effectiveness and becomes an
end in itself.

Good governance of ICAAP is about both achieving desired results and
achieving them in the right way.  Since the "right way" is largely
shaped by the shared cultural norms and values of the ICAAP
organization and it's stake holders and there can be no universal
template for good governance. Each organization must tailor their own
definition of good governance to suit their needs and values. It
appears that in order to reach a wider consensus on the concept of
good governance of ICAAP a much more intense and transparent debate
and discussion is essential.

And you are invited to share your thoughts about  "good governance of
ICAAP".

Your participation in this discussion is voluntary. All contributions
will be gratefully acknowledged if the permission is given to do so.
All other contributions will be treated as `strictly confidential'.
There are no institutional affiliations for this discussion, the
opinions and comments will be of the authors alone.  The out come of
this discussion may be compiled and it may be circulated in
appropriate forums for further discussion and debate.

Please answer to the following questions in few sentences:

(Introduce yourself briefly, if you are willing to do so)

A) Relevance of ICAAP as the key custodian of HIV & AIDS Knowledge in
Asia Pacific

B) Who are the stake holders of HIV and AIDS knowledge in Asia-pacific?


C) Please comment of the following aspects of the governance of ICAAP

1. Transparency
2. Accountability
3. Participation/ Partnership
4. Ownership
5. Process of agenda setting
6. Capacity building
7. Resource management
8. Knowledge management
9. Use of information technology

D) Success and Failures of the Governance of ICAAP


E) Suggestions about making ICAAP more relevant and meaningful

Please e-mail your response to <joe_thomas123@...> or
<aids_asia@yahoogroups.com>

Thank you for your attention

Joe Thomas
Convenor
Asia Pacific People's Alliance to Combat HIV & AIDS (APPACHA)
E-mail: joe_thomas123@...

MMWR Recommendations and Reports: Antiretroviral Postexposure
Prophylaxis After Sexual, Injection-Drug Use, or Other
Nonoccupational Exposure to HIV in the United States

An HIV-related recommendation was published in the most recent issue
of the Morbidity and Mortality Weekly Report, Recommendations and
Reports, January 21, 2005:

Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug
Use, or Other Nonoccupational Exposure to HIV in the United States,
located at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5402a1.htm.

This document is also available in the Adobe Acrobat (PDF) file
format at http://www.cdc.gov/mmwr/PDF/rr/rr5402.pdf. The PDF file
contains graphics and figures and is a true representations of the
hard copy of the MMWR. The Adobe Acrobat format requires the free
Adobe Acrobat Reader.

http://www.cdc.gov/hiv/dhap.htm.

The New York Times, January 18, 2005
*EDITORIAL*

India's Choice

  For an AIDS patient in a poor country lucky enough to get antiretroviral
  treatment, chances are that the pills that stave off death come from
  India. Generic knockoffs of AIDS drugs made by Indian manufacturers -
  now treating patients in 200 countries - have brought the price of
  antiretroviral therapy down to $140 a year from $12,000.

  That luck may soon run out. India has become the world's supplier of
  cheap AIDS drugs because it has the necessary raw materials and a
  thriving and sophisticated copycat drug industry made possible by laws
  that grant patents to the process of making medicines, rather than to
  the drugs themselves. But when India signed the World Trade
  Organization's agreement on intellectual property in 1994, it was
  required to institute patents on products by Jan. 1, 2005. These rules
  have little to do with free trade and more to do with the lobbying power
  of the American and European pharmaceutical industries.

  India's government has issued rules that will effectively end the
  copycat industry for newer drugs. For the world's poor, this will be a
  double hit - cutting off the supply of affordable medicines and removing
  the generic competition that drives down the cost of brand-name drugs.

  But there is still a chance to fix the flaws in these rules, because
  they are contained in a decree that must be approved by Parliament.
  Heavily influenced by multinational and Indian drug makers eager to sell
  patented medicines to India's huge middle class, the decree is so tilted
  toward the pharmaceutical industry that it does not even take advantage
  of rights countries enjoy under the W.T.O. to protect public health.

  In November 2001, members of the World Trade Organization agreed that
  countries can issue compulsory licenses to permit generic production of
  patented drugs without the patent holder's agreement in order to protect
  public health, at home or abroad. But under the Indian decree, getting a
  compulsory license would be slow and difficult; each application would
  face a fight from multinational drug firms and the governments that do
  their bidding. India should adopt laws that expedite compulsory
  licenses, including allowing challenges to proceed after production
  begins instead of holding it up. In addition, India must close an
  important loophole affecting the sick overseas: under the current rules,
  Malawi, for example, could not import from India an inexpensive version
  of a medicine that is not under patent in Malawi. This needs to be changed.

  Industry lobbyists managed to insert two noxious provisions in the
  decree that go well beyond the W.T.O. rules. The decree would limit
  efforts to challenge patents before they take effect. Also, it is
  uncomfortably vague about whether companies could engage in
  "evergreening" - extending their patents by switching from a capsule to
  tablet, for example, or finding a new use for the product. This
  practice, a problem in America and elsewhere, extends monopolies and
  discourages innovation.

  While some drugs - those that existed before 1995 - will always be off
  patent in India, some widely used drugs are at risk. So are new
  generations of much more expensive AIDS drugs that will soon be needed
  worldwide as resistance builds to current medicines. If the decree is
  not changed before Parliament approves it, it will be very difficult for
  India to supply them. India's parliamentarians must keep in mind that
  this arcane dispute is actually a crucial battleground for the health of
  hundreds of millions of people in India and worldwide.

http://www.nytimes.com/2005/01/18/opinion/18tues2.html

AIDS bodies abandoned in PNG

13 JANUARY 2005 PORT MORESBY (Pacnews) - The stigma surrounding
HIV/AIDS in Papua New Guinea has left the capital, Port Moresby's
main morgue clogged with unclaimed bodies and forced it to send out
dozens of unclaimed bodies for mass burial in paupers' graves.
Packed in plywood coffins, 84 bodies are being buried this week in
unmarked graves at Nine Mile Cemetery on the city' outskirts, among
them 16 stillborn babies.

Many of the bodies are those of HIV/AIDS sufferers whose relatives
have shunned contact because of the social shame associated with the
disease in PNG. Some are unidentified while others were left
unclaimed for up to 18 months because relatives did not know of the
death or could not afford the expense of funerals and burial.
The Port Moresby General Hospital morgue is in need of repair and is
designed to accommodate only 64 bodies, but has been holding more
than 200, some of which had begun decomposing after being stacked in
a corner.

St John's Voluntary Service superintendent Fred Bukoya and his team
of volunteers have been contracted to box and carry the bodies to
the cemetery. Once there, cords are slung beneath the coffins and
without ceremony they are lowered into the ground.

Nearby are the graves of a dozen unclaimed children who died with
HIV/AIDS and were interred in November, their graves marked only
with bougainvilleas donated by the city's international school. Mr
Bukoya said people in PNG, which has the highest reported rate of
HIV infection in the Pacific, needed to be educated about HIV/AIDS
to remove the stigma.

"It's dealing with the unknown. They are very fearful of it. We have
just come out of an age of sorcery and witchcraft. So anything like
this can still strike fear in normal Papua New Guineans," he said.
Hospital chairman Brian Bell said families of HIV/AIDS sufferers
wanted nothing to do with the victims.

"A lot of people wouldn't even attend a funeral when bodies were
being interred. People here still think you can contract HIV/AIDS
just sitting on a seat used by somebody else," Mr Bell said.

Another major reason for unclaimed bodies was that many people who
died in Port Moresby only had relatives in the bush who had no way
of knowing they were dead, Bell said. Burying someone is also
expensive in PNG.

"By the time you've bought a coffin, sealed it and put it on an
aircraft and flown it to somewhere out in the bush, it's cost you up
to 2,500 kina (USD$795) and that can take some people a lot of time
to get together," he said...PNS (ENDS)

http://news.ninemsn.com.au/article.aspx?id=28148

New Delhi, Jan. 13: The concerted efforts of groups of People Living
with HIV/AIDS (PLWHA) and other stakeholders during the last few
years have led to the emergence of an impressive PLWHA movement in
the Asia Pacific region, but their inclusion in the responses to the
epidemic is still far from satisfactory.

Though the principle of GIPA (Greater Involvement of People Living
with HIV/AIDS) has gained currency across the region, its practice
is still feeble, and, in many instances, tokenistic.

A new publication from UNDP Regional HIV and Development Programme,
which documents the results of  its Asia Pacific Initiative for the
Empowerment of PLWHA during the last three years, points to the need
for a "third generation response" to ensure the centrality of HIV
positive people to the responses. The well-being, empowerment and
meaningful participation of PLWHA are indispensable ingredients for
such a rights and gender sensitive response, the publication says.
It also calls for enhanced human, technical and financial resources
and vigorous attention on issues such as stigma and discrimination,
access to treatment, enabling legal and ethical environment and
avenues for sustainable livelihoods.

The publication, titled "From Involvement to Empowerment" notes that
without empowerment, the participation of PLWHA will not be complete
and GIPA will never be meaningful. It features some concrete
initiatives by 23 PLWHA groups across the Asia Pacific region in
association with APN+ (Asia Pacific Network for People Living with
HIV/AIDS), INP+ (Indian Network for People Living with HIV/AIDS) and
UNDP in areas of networking, capacity building and leadership
development.

"Years of engagement with the epidemic have brought home the
fundamental realization that active participation and support of
PLWHA are critical for an effective, human response to HIV. But it
is yet to gain momentum in Asia Pacific," said Ms. Sonam Yangchen
Rana, head of the UNDP Regional HIV and Development Programme in
Asia Pacific. "On the one hand decision makers do not seem to fully
appreciate the potential demonstrated by PLWHA, while on the other
there are limitations which need to be addressed," she added.

The publication (56 pages, ISBN 81-902585-1-6) can be downloaded
from www.youandaids.org, the HIV/AIDS Portal for Asia Pacific.

Pan Pacific Regional HIV/AIDS Conference 2005

TE WHANAU O TE MOANA-NUI-A-KIWA, ME TE MATE PAREKORE –

FAMILY OF THE PACIFIC AND HIV/AIDS CONFERENCE
- Pan Pacific Regional HIV/AIDS Conference 2005 -

INVITATION TO ATTEND

We invite you to Auckland, Aotearoa/New Zealand for the Te Whanau o
te Moana-nui-a-Kiwa, me te Mate Parekore - Family of the Pacific and
HIV/AIDS Conference, to be held from 25-28 October 2005.

This conference will focus on the following streams:
• Improving Care – Clinical research, treatment and care
• Engaging Communities – Health promotion, intervention and
community action
• Building Knowledge – Basic science, epidemiology and social
research
• Stregthening Leadership- Policy, leadership and human rights

Further information on the abstract submission, accommodation,
exhibiting, invited speakers, program, sponsorship, social program,
and travel will be available from mid-January.

important dates

• Thursday 16 June 2005 - Abstract submission deadline
• Thursday 16 June 2005 - - Scholarship application deadline
• Thursday 28 July 2005 - Earlybird registration deadline
• Friday 23 September 2005 - Accommodation Booking deadline
• Thursday 13 October 2005 - Registration deadline
• Tuesday 25 October 2005 - Conference commences

e-mail: contact@...

http://www.panpacific-hivaids05.net.nz/

AIDS agencies response to Tsunami disaster !

The World AIDS Campaign web site is carrying a poll on International
HIV/AIDS agencies effort to mainstream HIV programmes into Tsnami
response.

View Poll Results: Satisfied with the HIV/AIDS agencies in
mainstreaming HIV into Tsunmi response?

http://www.worldaidscampaign.net/community/showthread.php?p=16#post16

" I for one, have seen no mention of AIDS as regards the Tsunami
disaster; not in the mainstream media anyway. Out of curiosity, I also
just checked about six major organisation sites, organisations
involved in the disaster directly, and none have any mention
whatsoever of an AIDS component. And, not that they should, but just
checked five major AIDS sites (major orgs) and no mention of the Bay
of Bengal there either". Giray

http://worldaidscampaign.net/community/

British Medical Journal (BMJ) rapid response article.

http://bmj.bmjjournals.com/cgi/eletters/330/7482/59#92036

Mainstream HIV prevention into `Tsunami' response
10 January 2005

Dr.Joe Thomas, Convenor, APPACHA ,
Dr.Mridula Bandyopadhyay, The University of Melbourne, Victoria 3010

The direct and indirect impact of the `Asian Tsunami' is staggering.
The latest estimates of deaths are over 146 000 (anticipated to rise
over 185 000), with over 525 000 injured, over 20 000 missing, close
to 1.6 million displaced, and over 1 million estimated homeless
(Moszynski, 2005).

The initial governmental and community response to this terrible
disaster was to organise an immediate relief operation consisting of
food, shelter and medical attention. The global response was
extraordinary. Even, aid recipient country such as India, declined
bilateral aid, so that aid could go to other needy countries and
deployed 32 warships, over 80 aircrafts, unmanned aerial vehicles and
17,500 members of the army to locate and aid the survivors and victims
and pledged US$25 million aid to the Tsunami affected neighbouring
countries.

As we are gradually moving into the next phase (the long term) of the
Tsunami disaster response, it is imperative to mainstream HIV/AIDS
prevention and care programs as part of a long term re-reconstruction
of the affected communities and individuals.

Though natural calamities do not transmit HIV, however, some of the
post disaster situations may provide a fertile environment which would
enhance vulnerability of individuals to HIV. Although, a systematic
analysis has yet to be undertaken on how natural disasters could
enhance vulnerability to HIV, based on our understandings about the
social context of HIV vulnerability, we could safely predict that the
post Tsunami situation could lead to insecure conditions, exacerbating
the spread of HIV/AIDS. The Tsunami disaster could contribute to
inadequate safe blood, shortage of clean injecting equipments for
injecting drug users, an insufficient supply of condoms and health
care; and the vulnerability of displaced people, especially women and
children to sexual abuse and violence. In addition, during the periods
of population displacement, HIV/AIDS prevention and care is often
disrupted.

The HIV epidemic presents key challenges to both humanitarian and
development assistance, and to the interface between them. The
challenges raised by the HIV pandemic in the Asia Pacific are only
beginning to be fully realised now, and HIV is clearly a massive
crisis in all the Tsunami affected areas and can be described as an
emergency.

HIV/AIDS has profound humanitarian consequences, both by directly
causing illness and death, and in terms of the wider impact it has on
societies. These consequences will develop over decades. The existing
models of humanitarian response to natural calamities may not be
appropriate in understanding and integrating an effective HIV
response. Equally, existing models of development assistance are
likely to prove inadequate in developing an HIV response.

There is ample evidence to advocate for mainstreaming an effective HIV
response to the Tsunami Disaster response. Elsey and Kutengule (2002)
defined mainstreaming HIV/AIDS into disaster relief as the process of
analysing how HIV/AIDS impacts on post disaster situations and
developing appropriate responses, including the impact of the disaster
on people who are already living with HIV/AIDS and survived the disaster.

Mainstreaming HIV programming into humanitarian responses is to
determine how each sector should respond based on its comparative
advantage. In this context the specific organisational response may
include: putting in place policies and practices that protect staff
from vulnerability to infection and support staff who are living with
HIV/AIDS, whilst also ensuring that training and recruitment takes
into consideration future staff depletion rates, and future planning
takes into consideration the disruption caused by increased morbidity
and mortality. Humanitarian organisations must ensure those infected
and affected by the pandemic are included and are able to benefit from
their activities. Agencies must also ensure that their activities do
not increase the vulnerability of the communities to HIV/STIs, or
undermine their options for coping with the affects of the pandemic.

The "Tsunami response" is now moving from the immediate humanitarian
response to developmental phase. The UNAIDS Working Definition of
Mainstreaming AIDS (2004) into development work is more illuminating
"Mainstreaming AIDS is a process that enables development actors to
address the causes and effects of AIDS in an effective and sustained
manner, both through their usual work and within their workplace".

`Development actors' are all the people and institutions involved in
development, including all sectors and levels of government, the
business sector, civil society, and international agencies. Whilst
`usual work' is the work that development actors are supposed to do as
set forth by their mandate, mission or business interests.

Based on current experiences aimed at mainstreaming HIV/AIDS at
different levels, five simple principles have emerged that attempts to
provide a comprehensive framework to analyse where and when to
introduce and implement HIV/AIDS mainstreaming (UNADS/GTZ 2002).

Principle 1 underscores the importance of developing a clearly defined
and focused entry point or theme for mainstreaming HIV/AIDS in order
to maintain the critical focus necessary to make an impact.

Principle 2 maintains that, at the country level, mainstreaming does
not take place outside of the existing national context. Thus National
Policies or Strategic Frameworks for HIV/AIDS should be used as the
frame of reference. Mainstreaming efforts should be located within
existing institutional structures.

Principle 3 necessitates advocacy, sensitisation and capacity building
in order to place people in a better position to undertake
mainstreaming. Mainstreaming cannot be expected to develop of its own
accord.

Principle 4 asserts the need to maintain a distinction between two
domains in mainstreaming: the internal domain or workplace, where
staff risks and vulnerabilities are addressed; and the external
domain, where the institution undertakes HIV/AIDS interventions based
on its mandate and capacities in support of local or national
strategic efforts.

Principle 5 highlights the importance of developing strategic
partnerships based upon comparative advantage, cost effectiveness and
collaboration.

Tsunami response presents an opportunity to use the community links
established through disaster relief programs to ensure that men, women
and children are aware of their rights to aid which is not conditional
on accepting sexual exploitation. The long term disaster relief staff
should have access to HIV/AIDS awareness, and to train them to
opportunities to carry out HIV education as part of the overall
disaster response.

The United Nations Inter-Agency Standing Committee Task Force on
HIV/AIDS in Emergency Settings has produced a detailed guideline for
HIV/AIDS interventions in emergency settings. The purpose of this
guideline is to enable governments and cooperating agencies, including
UN Agencies and NGOs, to deliver the minimum required multi-sectoral
response to HIV/AIDS during the early phase of any emergency situation.

These guidelines, focusing on the early phase of an emergency, should
not prevent organizations from integrating such activities in their
preparedness planning. As a general rule, this response should be
integrated into existing plans and the use of local resources should
be encouraged. A close and positive relationship with local
authorities is fundamental to the success of the response and will
allow for strengthening of the local capacity in the future

Paul Harvey (2004) analysed the relationship between livelihood and
HIV/AIDS in the context of humanitarian programming. Livelihood
insecurity due to Tsunami could increase HIV vulnerability as local
social security networks have been severely disturbed by the disaster.

Based on Harvey's and UNADS/GTZ observations the following points in
relation to humanitarian programming in the context of an HIV/AIDS
epidemic should be taken into consideration:

1. Early-warning systems and assessments need to incorporate analyses
of HIV/AIDS and its impact on livelihoods.

2. The emergence of new types and areas of vulnerability due to
HIV/AIDS should be considered in assessment. Groups such as widows,
the elderly and orphans may be particularly vulnerable, and urban and
peri- urban areas may need to be assessed.

3. Targeting and the delivery of aid must be sensitive to the
possibility of AIDS-related stigma and discrimination.

4. The HIV/AIDS epidemic reinforces the existing need for humanitarian
programmes to be gender-sensitive.

5. Emergency interventions must aim to ensure that they do not
increase people's susceptibility to infection with HIV/AIDS.

6. Food aid in the context of HIV/AIDS should review ration sizes and
types of food and assess delivery and distribution mechanisms in light
of HIV/AIDS related vulnerabilities, such as illness, reduced labour
and increased caring burdens.

7. Labour-intensive public works programmes should consider the needs
of labour-constrained households, the elderly and the chronically ill.

8. HIV/AIDS reinforces the need for health issues to be considered as
a part of any humanitarian response.

9. Support to agricultural production (including seed distribution)
and pisciculture support should recognise adaptations that people are
making in response to HIV/AIDS.

10. Micro economic impact on people living with HIV in the disaster
affected areas to be considered.

11. As part of the Tsunami disaster challenge, all the agencies must
be encouraged to explore the possibility of mainstreaming HIV
prevention into their work.

12. All long term responses must explore the possibility of
distribution of condoms, where appropriate, in line with the UNAIDS
minimum package for HIV prevention in emergencies.

13. Mainstreaming HIV response into disaster relief starts with the
concerns of the community; policy makers and institutions need to
understand these issues.

14. There is an urgent need to document the evaluation and monitoring
of mainstreaming work into Tsunami response.

15. Tsunami response must also have an enabling environment which
would provide space for sharing HIV and AIDS concerns and to propose
solutions.

16. HIV prevention and care needs to be integrated into the Tsunami
disaster needs assessment

17. Long term Tsunami response must take into account HIV prevention
and care needs of the community

18. Tsunami affected national governments must ask their national HIV
programs to assess the impact of the disaster on their HIV programs
and to respond adequately.

19. Donor agencies and humanitarian agencies must allocate line item
specific funding for integrating HIV programs into the current
humanitarian responses.

20. UNAIDS along with other key stake holders may take leadership to
establish a regional mechanism to monitor the progress of
mainstreaming HIV into humanitarian responses and for rapid diffusion
of lessons learned from each setting.

References:

Peter Moszynski (2005) Disease threatens millions in wake of Tsunami
BMJ, 330:59 (8January), doi:10.1136/bmj.330.7482.59

IASC TF (Not dated) Guidelines for HIV/AIDS interventions in emergency
settings. The Inter-Agency Standing Committee Task Force on HIV/AIDS
in Emergency Settings

UNAIDS/GTZ (2002) Mainstreaming HIV/AIDS: A conceptual framework and
implementing principles. June 2002

Elsey, Helen & Kutengule, Priscilla (2003): HIV/AIDS Mainstreaming: A
Definition, Some Experiences and Strategies. Liverpool School of
Tropical Medicine, HEARD, DFID Ghana.

UNAIDS (2004) Support to Mainstreaming AIDS in Development
Oxfam (2001) Lessons Learnt in Mainstreaming HIV/AIDS: Oxfam, Malawi.

Harvey, P., (2004) HIV/AIDS and humanitarian action. Humanitarian
Policy Group, Overseas Development Institute. UK. April 2004

Murphy. L., (2004) HIV/AIDS and humanitarian action: Insights from US
and Kenya-based agencies. Humanitarian Policy Group, Overseas
Development Institute. UK April 2004

Harvey, P., (2003) HIV/AIDS: What are the Implications for
Humanitarian Action? A Literature Review. Overseas Development
Institute, July 2003 (draft), http://www.odi.org.uk/Food-Security-
Forum/docs/Harvey.pdf


Competing interests: Dr Thomas is the convenor of Asia Pacific
people's alliance to combat HIV and AIDS (APPACHA)

APPACHA calls for free and universal access to antiretroviral
treatment for people living with HIV and AIDS in Asia Pacific region.

1) Asian People's Alliance to Combat HIV and AIDS (APPACHA) joins the
call for Free and universal access to anti retroviral therapies (ART)
for all those who need it.

2) APPACHA, a multi-sectoral Asia Pacific regional HIV and AIDS
alliance of people infected and affected by HIV/AIDS, trade unions,
student movements, health activists and development workers is
endorsing the call for Free and universal access to antiretroviral
treatment for all those who needs it. APPACHA is particularly
concerned about the un-met, treatment needs of  people living with HIV
and AIDS in Asia Pacific region.

3) Free and universal access to ART is important to people living with
HIV and AIDS in Asia Pacific As well. In Asia, some 8.2 million people
are estimated to be living with HIV, including 1.2 million people
newly infected in the past year. The number of women living with HIV
has increased by 56% since 2002, bringing the total number of women
currently living with the virus to around 2.3 million. AIDS claimed
some 540 000 lives in Asia in 2004.

4) The nature and quantity of unmet ARV treatment needs of people
living with HIV and AIDS varies from country to country.  While some
Asia pacific countries urgently need to scale up ARV treatment.
(Cambodia, Myanmar, India and Thailand), others are only now starting
to experience rapidly expanding epidemics and need to mount swift,
effective treatment strategies (Indonesia, Nepal, Viet Nam, and
several provinces in China).

5) Free and universal access to anti retroviral therapies (ART) for
all those who needs it should be one of the key objectives of the
National HIV and AIDS response in countries which are still seeing
extremely low levels of HIV prevalence, even among people at high risk
of infection, and have golden opportunities to pre-empt serious
outbreaks. These countries include Bangladesh, East Timor, Laos,
Pakistan, and the Philippines.  The HIV prevention benefit of a free
and universal access to anti retroviral therapies (ART) i n these
countries is enormous.

6) "We challenge all governments and leading agencies concerned to
take on the "free by 5 initiative". It is the state's responsibility
to provide the basic social needs of its people, including affordable,
accessible and acceptable health care. While billions of dollars is
spent yearly on the wars of aggression, there is the reality that
something must be done in the reality that there is the upsurge of the
HIV and AIDS epidemic and the rise of number of women and children
being affected by the modern day plague."  Said, Dr. Geneve Rivera of
the Community Medicine Development Foundation- a key member of the
People's Health Movement in the Philippines and the APPACHA regional
coordination committee member.

7) "The HIV and AIDS commitment of the national governments,
International agencies including, various UN agencies and bilateral
HIV and AIDS support programs should be measured against those
agencies commitment to enhance access to ARV treatment" said Dr. Joe
Thomas, one of the regional co-ordinator of APPACHA.

8) As a policy, provision for a free and universal ART treatment- line
item should be integral to all the national HIV and AIDS budgets.

9) John Rock of  Asia Pacific Net work of People living with HIV/AIDS
(APN+) says that "it is essential that ARV's be provided free of
charge for all people in the developing world who need them, just as
those people like me fortunate enough to live in the developed world
have access to them. Anything less is morally unacceptable."

10) UN Theme groups, WHO country representatives and the UNAIDS in
country staff need to develop proactive strategies to ensure technical
assistance are offered to the National HIV and AIDS programs.
Monitoring such initiatives will be an integral part of APPACHA
regional access to treatment monitoring initiative

11) The "Free by 5" declaration, originally  initiated by the Health
Economics and
HIV/AIDS Research Division (HEARD) of the University of KwaZulu-Natal
is rapidly gathering  support from key actors and organisations all
over the world.  The declaration urges international donors to
actively promote the implementation of free treatment and to pledge
additional resources to make this a reality. It also presses WHO and
UNAIDS to formally adopt clear guidelines on the necessity of free
ARV-treatment. You can find the full text of the declaration, as well
as the list of signatories, on http://www.nu.ac.za/heard/free/freeby5.asp


FOR FURTHER DETAILS PLEASE CONTACT APPACHA REGIONAL TEAM
<appacha@...>

Ms.Rosanna Barbero:  (Cambodia) (rosanna@...)
Mr.  Nimit Tien Udom:  (Thailand) (nimit@...)
  Dr. Joe Thomas:  (Australia):  (joe_thomas123@...)
Mr. John Rock: (Australia): (smruti@...)
  Mr.Rajendra Bahadur Raut:  (Nepal) :  (udecont@...)
Dr. John Forhan:  (Afghanistan):  (smruti@...)
Mr. Abraham. K. K: (Chennai, India):  kkabraham@...)
Dr.  Geneve E Rivera: (Manila- Philippines): (genevemd@...)
Ms.Aanasuya.M  (Bangalore- India)  (milana_bgl@...)
Mr.Mukul Sharma' (New Delhi) (mukul@...)
Dr. Unnikrishnan (Bangalore)  (unni@...)
Dr. Ekbal  (Kerala,India) (ekbal@...)

Do you have a communicable disease – Toronto 2006

Are we as the international community of advocates, activists and
especially the conference co-sponsors becoming blasé in hosting these
International AIDS Conferences?

I get a ting of excitement when I remember so clearly the passion and
activism that was involved in moving the International AIDS
Conference from the USA to Amsterdam in 1992…the reasons were clear, the passion
and activism was intense and it produced results…the Amsterdam
conference was held with a sense of achievement, not only because the
Dutch organizers managed to pull it off, but we the international
community had demonstrated our power!

Let me also say from the outset that this is certainly NOT the most
important battle that we have to fight or address in our struggle
against HIV/AIDS, but it does beg the question of how serious a
violation has to be, to make people become passionate, angry, make
their voices heard and make a difference.

In July 2000, Canada changed its immigration policies to
inhibit/restrict/control/coordinate (whatever the word is) the
immigration of people living with HIV if they were/are found to be
considered "excessive burden" on the health care system(I am not
quite sure of the exact wording, and am sure that the Canadian HIV/AIDS
legal network can assist in this matter).

However, Canada now also has that dreaded question on their ordinary
tourist visa application forms (same as the USA) "Do you have a
communicable disease?", and then a long list of other questions. If
you answer "yes" to any of these questions then you have to provide the
details.

I had the experience of having to travel to Canada at the end of
November (2004) to attend a meeting with ICASO and UNAIDS. I answered
yes to this question (partly because they have my history on file,
and partly because I do not want to be charged and accused of applying
for a visa fraudulently, as was the case when I answered no to the question
with a US visa application – as was the international advocacy
strategy in the late 80's and early 90'2.)

The Embassy then contacted me and asked me to provide a letter from
my doctor that stated what my CD4 count was, my viral load and my
general state of health. This was then going to be sent off to the Canadian
High Commissioner's Medical Officer for Africa (who is situated in Kenya),
for a final decision. I eventually got my tourist visa in time, in
part also due to the internal work of ICASO colleagues in Toronto with the
various ministries), but this for now is a side issue.

There are a number of meetings that happen prior to the conference
actually taking place, and most of the representatives of the
cosponsors of the international AIDS Conference (ICASO, ICW, GNP+, UNAIDS, IAS)
are "fortunate enough" that they are able to travel with passports that
do not require them having to apply for visas, and I guess the case is
also somewhat different for colleagues traveling from the US and some
European countries. For participants traveling from "developing
countries" the case is somewhat different, and I do think that it is
important that not only raise a number of questions, but that we also
attempt to discuss, debate and answer them?

1.What is going to happen to the information on the visa
application forms? Will it be kept in a central database, and the
person will always be identified as being HIV positive, and therefore having
potential repercussions for future visa applications. The pressure to
provide quick and politically correct answers will no longer be there
once the conference has gone.

2. What happens to people who are HIV positive, and decide to
answer NO to this question?

3. How do we guarantee (almost impossible) the confidentiality
of people applying for visas, when in some consulates or embassies
around the world there are local people employed in the visa section?

4. What is going to happen to people who do answer yes to the
question and then have to provide blood tests results and state of
health letters? What is this going to do to visa application times?
(This may not be standard policy – as was explained to me in the
situation described above, but how do we guarantee that all Embassies
and Consulates around the world apply the same policies and
procedures?

5. During the Vancouver AIDS Conference, the cosponsors and
hosts managed to secure health insurance for all participants attending the
International AIDS conference – is Toronto going to be doing the
same.

These are just some of the questions that spring to mind, and I do
know that there are colleagues and friends in Toronto at the Local
Organising Committee and ICASO who are trying to deal with these issues and get
answers. I also hope that they understand where my concern is coming
from, as I would not want us to have empty promises by politicians in
the run up to the conference, and then endless problems and
discrimination for people who are labeled within the system after the
conference.

I am certainly not advocating for a boycott, because as we know there
are now more and more countries that have introduced discriminatory
laws against people with HIV/AIDS (yes I know that there are other
exclusions as well, but this one impacts on so many of us), and this could then
mean that the countries that could host the international AIDS
Conference would be very limited…BUT,

I do seriously think that the International AIDS Society, the
conference cosponsors and we as an international community have to seriously
look at how host countries/cities are chosen, what is the purpose of these
conferences (an ongoing debate and discussion I know) and remind
ourselves of the passion, activism and reasoning that has prevented
conferences from going to the US.

So either we stop the façade of saying we cannot host a conference in
the US because of their travel restrictions, or we apply the same
policies and criteria across the board.

I am also equally sure, that we are going to receive many pc answers,
many answers that are not going to satisfy us, and many of us will
still go through the humiliation and stress of applying for a visa,
providing letters and answering sensitive questions through a glass window in a
public waiting room, fly endless hours to get to Toronto, experience
hassles at immigration because we happen to be from a developing
country, register for the conference, get our scholarships, reconnect
with old friends and listen to badly presented papers and then get
excited about the host city of the next conference…which is supposed
to be in a developing country again….oh the passion!

Shaun Mellors
HIV/AIDS Consultant and Trainer
Postal Address:
PostNet Suite 132
Private Bag X4
Gordons Bay, 7151
Republic of South Africa
T: 27(0)21 856 0318
F: 27(0)21 856 0318
C: 27 (0) 84 416 5912
E: s-mellors@...

Dear Friends,

With this letter we would like to inform you about the 'Umrah' Project for
HIVpositive Muslims organised by ABIM and Pelangi Community Foundation.

UMRAH with HOMELESS HIV POSITIVE MUSLIMS: May 2005
Organized by
Muslim Youth Movement of Malaysia (ABIM) Pelangi Community Foundation
With the cooperation of, Positive Muslim (PCF), Prokim, Positive Living (PTF)

Introduction

Months ago ABIM and Pelangi Community Foundation developed the idea to organize
Umrah for homeless HIV positive Muslims. Actually we toke up the wish of some of
our clients to make the pilgrimage as long as they are healthy enough to do so.

It would be the first time in history that HIV positive Muslims are going as a
group for Umrah. We invited another NGO’s who are involved in HIV projects and
work with recovering Drug Users. We wanted as much different input as possible.

Umrah can be defined as visit. It is a visit to Holy Places to seek guidance and
mercy from Allah.

Objective

As all humans HIV positive people need physical, mental and spiritual strength.
After living for years as outcast of the society, the Umrah   would be the place
where they will be reunited with Allah and receive his blessings and will return
to Islam as a way of life. They wish to purify and seek repentance. They want to
get closer to Allah and seek guidance for the life ahead.

Theme
Oh ye God, we are thirsty of your guidance and your mercifulness.

Costs
The cost for the Umbra will be RM 3500 excluding pocket money. The travel agent
provides a Malay Muslim as guide in Mecca and Medina. The duration will be 12
days and 10 nights.

Appeal for Donation

As all our clients are homeless and have no income we humbly as you to donate to
our UMRAH FUND. Please make your donation payable to:
Pelangi Community Foundation, 5, Jalan SG 8/11, Taman Sri Gombak, 68100 Batu
Caves. Malaysia. http://www.pelangifoundation.org

Wishing you all an happy New Year 2005.
Best regards.

Rainer
E-mail: <rainersg@...>

Myanmar: Update on HIV/AIDS Policy
Asia Briefing: 16 December 2004

OVERVIEW

Myanmar's military government has acknowledged its serious HIV/AIDS
problem in the two years since Crisis Group published a briefing
paper.[1] This has permitted health professionals, international
organisations and donors to begin a coordinated response. The
international community has boosted funding and shown more willingness
to find ways to help victims and counter the pandemic. Some government
obstacles have been removed although the regime's closed nature is
unaltered. The opposition National League for Democracy (NLD), which has
generally opposed aid involving contact with the junta, has supported
many HIV/AIDS steps because of the humanitarian imperative. The urgent
need now is to boost the local staff capabilities and make more
effective use of the money flowing into the country. In the process
civil society and small NGOs and other local organisations can be
fostered that can eventually help prepare a democratic transition.

Significant problems remain. About 1.3 per cent of Myanmar's[2] adults
are believed to be infected with the virus, one of the highest rates in
Asia. Government spending on health and education is perilously low, and
the economy has been grossly mismanaged by the military. HIV continues
to present serious risks to the population, to security and to Myanmar's
neighbours.[3]

Critics of assistance to Myanmar have said the government would
misappropriate any funds. This has not been the case so far. Increased
international contact with the government on this issue has pushed it
towards more pragmatic positions and opened up program possibilities
that were not available in 2002. HIV prevention and treatment suffered
then from a lack of resources and knowledge. Now the main constraint is
the implementation capacity of groups involved in HIV prevention and
AIDS care. The critical steps that need to be taken include:

* expansion of assistance through all available channels to border
areas where the HIV problem is particularly intense;

* expansion of national capacity to deal with HIV, including more
technical aid and training;

* expansion of support for local and community-based organisations to
strengthen their capacity and enable them to be larger providers of
grassroots education, counselling and treatment;

* more effective outreach to minority and ethnic communities with
HIV/AIDS prevention education as well as counselling and treatment;

* streamlining of disbursement, evaluation and monitoring procedures
for funding; and

* expansion of harm reduction programs.

The political situation in Myanmar is extremely uncertain. Former Prime
Minister Khin Nyunt is now under arrest on suspicion of corruption. He
had chaired a key government committee on health issues and had
supported greater involvement of international NGOs in fighting HIV. It
is now very unclear whether further steps forward will be possible.

Yangon/Brussels, 16 December 2004
*************************************************************
[1] See Crisis Group Asia Briefing, Myanmar: The HIV/AIDS Crisis, 2
April 2002.
[2] A note on terminology. This report uses the official English name
for the country, as applied by the UN, the national government, and most
countries outside the U.S. and Europe. This should not be perceived as a
political statement, or a judgment on the right of the military regime
to change the name. In Burma/Myanmar, "Bamah" and "Myanma" have both
been used for centuries, being respectively the colloquial and the more
formal names for the country in the Burmese language.
[3] See Crisis Group Issues Report N°1, HIV/AIDS as a Security Issue, 19
June 2001.

Read the full Crisis Group briefing on our website: http://www.icg
http://www.icg.org/home/index.cfm?l=1&id=3174

INVITATION  AIDS_ASIA e FORUM.

Hi,

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

[AIDS_ASIA e FORUM] is an experimental occasional electronic newsletter. 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 4,000 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/

OPEC and UNESCO create AIDS project for twelve countries in Asia and
the Arab world

UNESCO and OPEC FUND have concluded an agreement to create a two-
year Project on Reducing the Impact of the HIV/AIDS Crisis in and
through Education. It aims to help curb the rate of new HIV
infections among young people in and out of school in 12 countries:
three Arab states, three in Central Asia and six in southeast Asia
(1). The OPEC Fund has undertaken to provide US$ 2,250,000 for the
Project, which will focus on information and education, assistance
to ministries, teaching programmes and curriculum enhancement.

To be implemented by UNESCO's International Institute for
Educational Planning, in cooperation with National Commissions for
UNESCO and education ministries, the new Project will complement the
UNESCO-led Global Initiative on HIV/AIDS and Education that aims to
strengthen education ministries' ability to meet the teaching,
learning and management needs generated by the pandemic.

Working with UNAIDS partners, ministries and civil society
organizations, the Project, covering the period of January 2005
through 2006 will:

1. Consolidate knowledge on what works and develop evidence-based
advocacy materials for ministries, schools and other actors in
education systems;
2. Strengthen national and local capacity of key actors in the
education sector, including strategic planning, curriculum
development, teacher-training, monitoring and evaluation;
3. Expand prevention education against HIV/AIDS through the media;
4. Strengthen tools for international monitoring and response to the
impact of HIV/AIDS on education in cooperation with UNAIDS;
5. Scale up HIV/AIDS prevention education in schools.

The joint Project will also build on and expand some on-going grass
roots activities such as peer education programmes for youth leaders
in Uzbekistan, or for men who have sex with men in Viet Nam,
advocacy by famous Cambodian sports personalities to promote testing
for HIV, and popular music concerts against HIV/AIDS held and
broadcast for hill tribe people in Thailand, Lao People's Democratic
Republic and southern China.

The OPEC Fund's HIV/AIDS Special Account was established in June
2001 to pursue cooperative arrangements with international
institutions that have lead roles in the global campaign against the
HIV/AIDS pandemic.

****
(1)Afghanistan, Bangladesh, Cambodia, China, Jordan, Kazakhstan, Lao
PDR, Lebanon, Syrian Arab Republic, Thailand, Uzbekistan, and Viet
Nam.
(2)The Initiative focuses on four specific areas: improving
analytical tools; training; assistance in accessing funding; and
technical assistance in the early implementation.

http://portal.unesco.org/en/ev.php-
URL_ID=24324&URL_DO=DO_TOPIC&URL_SECTION=201.html

Dear friends,

Indian Institute of Health Management Research, Jaipur- Rajasthan, India is 
conducting a six-day short training programme on "Operations and Evaluation
Research in Health Programmes" during January 31 - February 5, 2005 at IIHMR,
Jaipur, India. The programme aims to raise the participant's skills and
knowledge to design and conduct operations research with the application of
appropriate techniques of data collection and analysis. The details of the
program is given below.

DHIRENDRA KUMAR, Ph.D.
Associate Professor
Indian Institute of Health Management Research,
Jaipur - 302 011 Rajasthan,
E-mail: dhir@... & dk_sakhi@...
**************************************************************************
Management Development Program (Short Training Programme)
Operations and Evaluation Research in Health Programs
(January 31 - February 5, 2005)

Background

Operations Research (OR) is a research technique that uses systematic data
gathering to support decision-making for improving the coverage, quality and
sustainability of services and programmes. Primarily, the application of
operations research was most popular in the family planning programme to
improve the efficiency, quality, effectiveness and availability of services.
The use of this technique has grown over time; it is being widely applied in
reproductive health by health managers.

The health of children, women and men in India and most of the South-Asian
countries is the poorest in the world. The level of infant and maternal
mortality is still very high. Reproductive tract infections and sexually
transmitted diseases are widespread among men and women and this has been
the leading cause of HIV infections. In spite of huge investments in the
infrastructure, technology and manpower development in health services, the
accessibility and availability of services has been a perpetual problem to
the health manager. Health managers struggle to redirect and restructure
programmes to increase access to their services, improve quality of care,
use available resources efficiently and raise funds. Operations research
helps them in these endeavours. It applies systematic research techniques
to evaluate programmes in a variety of settings, with a focus on factors
under managerial control. Keeping these factors in view the Indian
Institute of Health Management research (IIHMR), Jaipur offers a one-week
management development programme for mid-career professionals who are
working for the improvement of the health of people in their country.

Objectives
The programme is specifically designed to enhance the participants' skills
in conducting operations research and evaluation studies in health
programmes. The programme will be participatory in nature, based on
experimental learning.

The specific objectives of the programme are:
· To provide an overview of the health situation and
scope of operations research.
· To discuss the concept, definition and techniques of
operations research and evaluation.
· To develop skills among the participants to design
outlines for conducting operations research and evaluation studies, which
include problem identification and diagnosis, strategy selection, strategy
testing and evaluation, information dissemination, and utilization. The
principles of research methodology will be discussed to explain sampling
procedures and sample size, formulation of questionnaires and tools, data
quality control, data analysis and interpretation
· To prepare strategic interventions based on the
findings of operations research.

Contents
· Operations research: scope and utility
· Evaluation studies: concept, type, methods and design
· Linkages: information technology and evaluation
· Survey design: type, issues and sampling techniques
· Basics of questionnaire design
· Planning of data analysis and dummy tables
· Field procedures and controlling: uniform instructions, manuals and
protocols
· Communicating research findings: barriers in using research results,
strategy and action plan for presenting health findings

Pedagogy
The programme is an interactive one, providing a blend of lectures,
participatory exercises, individual and group presentations, and group
discussion focusing especially on the issues of reproductive and general
health.

Participants
The programme is aimed at middle and senior level health mangers, planners,
researchers and officials involved in health care in both government and
non-government sectors in developing countries. A working knowledge of
English is essential for this course.

Certification
A certificate of participation will be awarded on successful completion of
the course.

Programme Fee
Residential Rs. 12,000/ ($600 for overseas participants)

The course fee includes tuition fee, charges for course material, and board
and lodging facilities on the Institute's campus for the total duration of
the course.

Arrival/Departure
Participants are advised to reach Jaipur by the evening of January 30, 2005
and plan their departure on the evening of February 5, 2005. IIHMR is
located at a distance of 2.5 km from Jaipur Airport and 20 km from Jaipur
Railway Station/Bus Stand. Participants will be met at the Airport / Railway
Station / Bus Stand, if informed in advance about the airline / flight
number / train number and date and time of arrival.

Programme Director
Dhirendra Kumar, M.Phil., Ph.D. (IIPS, Mumbai)
Associate Professor, IIHMR

Nominations
Please fill in the enclosed nomination form and send it with a demand draft
for Rs 12000 in favour of Indian Institute of Health Management Research
latest by January 5, 2005 to:

THE DEAN (TRAINING) or Prof. Dhirendra Kumar
INDIAN INSTITUTE OF HEALTH MANAGEMENT RESEARCH
1, Prabhu Dayal Marg
Sanganer Air Port, Jaipur - 302011
Phones : 91-141-2791431/32/33/34
Fax : 91-141-2792138
E mail : iihmr@...
URL : http:/www.iihmr.org

**********************************************************************
INDIAN INSTITUTE OF HEALTH MANAGEMENT RESEARCH, JAIPUR

NOMINATION FORM
1.Programme Title: Operations and Evaluation Research in Health Programmes
2.Duration : January 31 - February 5, 2005
3. Name and address of the sponsoring organization........
............................................................
Phone ...............................................
Fax....................................................
4. Personal details of the nominee(s)

Name
Designation
Age

...............................
.............................
.............................

To The Dean (Training)

Please register my/our nomination(s) for the above mentioned programme as
per above details. Enclosed is Draft
No.......................................................................
Dated....................................of
Bank...................................................... for Rs./US
$........... .................. towards the nomination fee, drawn in favour
of Indian Institute of Health Management Research, Jaipur, India.

Name of the sponsoring authority
...............................................................

Designation of the sponsoring authority
................................................................


Date
...........................

Signature
..........................

PLEASE SEND THIS FORM WITH NOMINATION FEE TO

The Dean (Training)
INDIAN INSTITUTE OF HEALTH MANAGEMENT RESEARCH
1, Prabhu Dayal Marg, Sanganer Airport, Jaipur - 302 011, INDIA
Phone: 91-141-2791431/32/33/34 Fax:91-141-2792138
E-mail: iihmr@... OR dhir@...
Internet : http://www.iihmr.org

Integrated HIV & Development Programme for SEA & South Asia Region

Dear Friends,

This message is a follow up to the Dec 14 message posted by Lee Nah
Hsu

First of all on behalf of the UNDP Regional HIV and Development
Programme I would like to thank Dr. Lee Nah Hsu for the leadership
she has provided to the UNDP SEAHIV project. Considerable headway
has been made in the areas of governance, mobility and HIV, which
will be maintained and strengthened under the new integrated UNDP
HIV and Development Programme.

As a result of the internal reorganization within UNDP, the two
existing sub-regional HIV and Development programmes (SEAHIV for
East Asia and REACH, for South and North East Asia) are in the
process of being merged. The integrated Programme will work across
23 countries in Asia on issues of HIV and mobility (including
trafficking and migration), PLWHA empowerment and advocacy and
capacity development. It will be located in the Regional Centre in
Colombo, Sri Lanka and will be supported through a sub-office in
Bangkok, Thailand.

Continuity will be maintained of the processes, projects and
activities initiated by both SEAHIV and REACH in partnership with
Governments, civil society, bi-lateral/ multi-lateral agencies as
well as private sector. Existing partnerships will be strengthened
by the integrated Regional Programme and newer partnerships will be
forged based on need, demand and merit. The integration expands
opportunities and platforms for cross learning and experience
sharing.

For all future correspondence with regards to UNDP SEA HIV and UNDP
REACH, please contact me at sonam.yangchen.rana@...  or
hivproj.in@... .

With best wishes,

Sonam
E-mail: <sonam.yangchen.rana@...>

[7th ICAAP] Deadline Approaching !!

Seventh International Congress on AIDS in Asia and the Pacific
Kobe, JAPAN July 1-5, 2005

Web-site: http://www.icaap7.jp

++++++++ 7th ICAAP ++++++++

Abstract/Proposal submission deadline:
Wendnesday, January 5, 2005 (Submission on Paper),
Wendnesday, January 12, 2005 (Submission on via Website)
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

Dear Sir or Madame,

Thank you for your attention to the 7th International Congress on
AIDS
in Asia and the Pacific (7th ICAAP) to be held in Kobe, Japan from
July 1 to 5, 2005.

We look forward to receiving abstract/proposal submissions!
Please help make the congress interesting by sharing your
experiences/observations/projects with participants from all over
the world.

The more presenters we have, the better chance we have to meet the
participants' requirements for a session!

Your active participation would be grateful, could you please
encourage your colleagues to participate as well?

Also we would appreciate it if you would forward this announcement
to anyone who might be interested in attending this congress.

We're looking forward to seeing you at the 7th ICAAP Kobe 2005.

*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*
  How to submit Abstracts/Proposals
*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*

1. All participants of the 7th ICAAP must register first from the
top page    (http://www.icaap7.jp/).  Upon registering, you input
your preferred Password    and you will be provided with your
Registration ID automatically.

2. Using your Registration ID and Password, you may login to the
User's Page    (from "Registered User Login" of the top page)
where you can submit abstracts and proposals.

There are four types of Abstracts/Proposals;

1. Abstracts for Oral Sessions and Poster Sessions (A): suitable for
scientific research
2. Abstracts for Oral Sessions and Poster Sessions (B): suitable for
experience
3. Proposals for Skills Building Workshops
4. Proposals for Cultural Programs

*One or two abstracts/proposals can be submitted.
*All applicants for scholarship are requested to submit
abstract/proposal

In the same way, you can submit visa questionnaire for an official
letter of invitation.

You are able to check the current status of each of your submissions
on this page.

http://www.icaap7.jp/

Abstract/Proposal submission deadline:
Wendnesday, January 5, 2005 (Submission on Paper),
Wendnesday, January 12, 2005 (Submission on via Website)

All application data including abstracts/proposals and scholarship
received by the Secretariat before the postponement was cleared, and
the  former Registration ID is also invalid.

Please apply again for registration, abstracts/proposals and
scholarship.

*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*
Exhibition(Deadline: 5th January, 2005)
*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*
Those who wish to apply for exhibition at the 7th ICAAP are
requested to complete and send an application form to the
Secretariat. Detailed information and an application form are
downloadable from our official website; http://www.icaap7.jp/

All application data received by the Secretariat before the
postponement was cleared.
*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*

Please do not hesitate to contact us if you have any questions
about  the Congress. We're looking forward to seeing you at the 7th
ICAAP Kobe 2005.

Sincerely yours,

Tadamitsu Kishimoto
Chair, the 7th ICAAP Organizing Committee

_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/
Correspondence Address
7th ICAAP Secretariat
c/o Convention Linkage, Inc.
PIAS TOWER 11F, 3-19-3 Toyosaki, Kita-ku,
Osaka 531-0072, Japan
Tel: +81-6-6377-2188 Fax: +81-6-6377-2075
E-mail: info_icaap7@...
URL: http://www.icaap7.jp/
_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/_/

The Nation, 15 December 2004

RX Files: What to do if the condom breaks

Every infectious disease specialist in Bangkok has received calls, usually in
the middle of the night or early morning, from emergency-room residents at
private hospitals who are confronted by an anxious patient who had just realised
that he had unprotected sex and may have been HIV-infected.

The usual story is that “My condom broke” or “I was too drunk to think first”.
The partner usually comes from a bar or massage parlour. High risk behaviour,
for sure! What to do?

Recommendations from public-health authorities are often unclear, but always
there is a full month of anti-HIV drugs if there is real risk of infection.

Differences lie in how to determine the real risk in such situations. The
decision to treat or not is an emergency, since the drugs must be started as
soon as possible, and no later than 72 hours after exposure.

Is such treatment really effective and worth the cost and discomfort, since all
of these drugs have adverse side effects?

Obviously, credible animal experiments are near impossible to do since Aids is a
human disease and animal studies may not be applicable. However, studies of HIV
post-exposure prophylaxis (PEP) have been performed in hospitals where doctors
or nurses obtained nicks or cuts by possibly infected tissue or
fluid-contaminated instruments.

Most of these have been promising, but it was never certain that the recipients
had actually been infected.

A few years ago, a child in Europe received an emergency blood transfusion,
which within hours was known to have come from an HIV-infected donor. PEP was
immediately applied and the child remained free of HIV.

One problem for the physician to evaluate is the extent (risk) of actual
infection and how to balance this against the cost and adverse side effects of
the drugs.

Most patients tend to minimise the exposure, partly as self-deception and partly
being unwilling to admit that they’d been stupid. Here’s where the broken-condom
story comes in.

How many condoms actually break? The quality ones undergo rigid pressure and
friction tests.

The involved sex worker almost always tells the customer that she or he had
regular HIV tests, which were negative, and that condoms are used in all
encounters.

Hard to rely on, so what should be done?

Most patients know where they met their partner and can be told to go back
there, find that person and pay them whatever it takes to have an HIV test.
These are available at all local hospitals and results should be back in
minutes.

If the partner’s test is negative, the risk is significantly reduced. The sex
partner may still be in the “window period” of HIV, where infection has just
taken place, and the test is still negative because antibodies have not yet
formed.

This is a time when a person can be infectious but has a negative antibody test
to HIV.

Doing a viral load test (PCR) might be a theoretical solution, but this test is
not 100-per-cent reliable and not readily available and takes several days – too
long, since starting PEP is not effective after 72 hours post-exposure.

The patient should be informed of this smaller risk and given the choice of
deciding whether he wants PEP, even though the partner’s HIV antibody test was
negative.

Failure to get an HIV test from the partner, and the exposure being deemed
significant, mandates PEP. A pre-treatment HIV and syphilis test is then done
and the patient evaluated for other diseases and treated for any suspected STDs.

He or she is then given a prescription for anti-HIV drugs. The usual drugs
prescribed in Thailand are Combid (Lamivudine and AZT) with a third drug Stocrin
(Efavirenz).

Combid is a fixed combination drug that should not be used if the patient’s
weight is less than 50 kilograms. A one-month supply would cost approximately
Bt16,000 from a Bangkok private hospital pharmacy.

GPO-VIR (a combination of three drugs) should not be used for PEP because it
contains Nevirapine and is designed for long-term treatment.

There is still controversy whether two or three different drugs should be
prescribed. The UN stocks an HIV-PEP kit that contains only two drugs to be
taken for five days as well as contraceptive pills.

This makes little sense unless the patient consults a competent doctor before he
runs out of medication or is able to determine that there was no risk of
infection.

All of the anti-HIV drugs have adverse side effects, consisting of dizziness,
numbness, depressions of the white blood-cell count and gastrointestinal
reactions, as well as occasional drug rashes. However, most patients tolerate
them.

HIV and syphilis tests should also be carried out and repeated after completion
of PEP. The patient must be given a letter for his personal doctor detailing the
nature of PEP and reasons for starting it.

It’s obviously far better to avoid being in such a situation.

________________
Dr Wilde is attached to the Queen Saovabha Memorial Institute, Thai Red Cross
Society.

Cross posting from HIV-News-AsiaPacific@...
[hiv-news-asiapacific] No 416 – China, Singapore and Thailand (17 December
2004). Thailand

Free by 5 declaration:  AIDS treatment must be free for all patients
in developing world

Health experts, economists and policy makers join in appeal to donors:
AIDS TREATMENT MUST BE FREE FOR ALL PATIENTS IN DEVELOPING WORLD

Starting from Tuesday, 14th December 2004, an alliance of renowned
experts, institutions and non-governmental organisations launched
the `Free by 5' declaration and present it to the World Bank, aid
donors, the World Health Organisation (WHO), UNAIDS and many other
parties.

While the WHO aims to have three million HIV-positive people
on Anti-Retroviral (ARV) treatment in the course of next year, the
declaration points out that ARVs and associated care need to be
provided free of charge to all patients in developing countries.

Stephen Lewis, UN Special Envoy for HIV/AIDS in Africa and signatory
of the declaration states:  'The push for access to Anti-Retroviral
treatment has greater momentum than ever before. For many it will mean
the difference, literally, between life and death. However, if it is
not free then the poor…will not benefit. This declaration clearly sets
out why treatment should be available free. It is deserving of our
support.'

Of the 5.5 million HIV-positive people in need of treatment globally
only 440,000 are receiving it. In Africa, not more than 4% of people
living with HIV/AIDS are on ARV treatment.  Despite decreasing market
prices of the drugs, many people who have AIDS in developing countries
are dying because they cannot afford the user fees asked for
treatment. The declaration gives evidence that the payment required
(patient fees) excludes many patients, heightens people's
vulnerability to HIV/AIDS, as well as decreases treatment adherence,
which may lead to drug-resistance. From a medical, a public health, an
economic and a human rights perspective providing universal free
treatment to AIDS patients is a necessary and rational course of action.

Professor Alan Whiteside, Director of HEARD, summarises: "Levels of
poverty in most resource-poor settings are such that, unless treatment
is provided completely for free, people will be excluded. I believe
that it makes economic sense for public health services to offer free
HIV/AIDS treatment."

The "Free by 5" declaration, initiated by the Health Economics and
HIV/AIDS Research Division (HEARD) of the University of KwaZulu-Natal,
rapidly gathered support from key actors and organisations all over
the world. To date nearly 600 people have signed in support. Among
them are many esteemed public health experts, economists and policy
makers including Stephen Lewis (UN Special Envoy on HIV/AIDS), Hélène
Rossert-Blavier  (Director-General of AIDES, France and Vice President
of the Global Fund to fight AIDS, Tuberculosis and Malaria), and Gorik
Ooms (Executive Director of Médecins Sans Frontières in Belgium).

Gorik Ooms of Médecins Sans Frontières: `Patient fees often make it
impossible to reach those who need treatment most. The families that
are most affected by AIDS in many cases lose their income from labour
and can simply not afford to pay for treatment. Where AIDS care is
provided in clinics that are sponsored by international donors but
require patients to pay part of the cost, patients that can no longer
afford tests or drugs, will drop out.'

The declaration urges international donors to actively promote the
implementation of free treatment and to pledge additional resources to
make this a reality. It also presses WHO and UNAIDS to formally adopt
clear guidelines on the necessity of free ARV-treatment.

You can find the full text of the declaration, as well as the list of
signatories, on www.heard.org.za

Please contact Sabrina Lee at HEARD on +27 (0)31 260 2483 E-mail:
<freeby5@...>  for further information.
_______________________
Sabrina Lee
"Free by 5"
<freeby5@...>

The Nation, 11 December 2004

BETWEEN THE LINES: Ethical practices must be held foremost in drug trials

By MUKDAWAN SAKBOON

The planned trials of the anti-Aids drug Tenofovir, for which recruitment of
study subjects is due to commence early next year, should be treated with great
care. Researchers should ensure that all processes are transparent and all
ethical considerations respected.

The drug, produced by California-based Gilead Sciences, was the subject of
controversial debates recently, not because of the nature of the drug itself but
because of the procedures drawn up for the trials. Recently the Cambodian
government rejected trials of the drug among commercial sex workers.

During the 15th World Aids Conference in Bangkok in July, activists protested at
the planned Cambodian Tenofovir study. The issue of unethical practices was
raised as activists complained that sex workers who participated in the trial
would not be advised to be aware of their risk of infection and thus were
unlikely to tell their clients to use condoms.

In Thailand, the planned "Study of the safety and efficacy of daily Tenofovir to
prevent HIV infection among injecting drug-users in Bangkok," (the Bangkok
Tenofovir Study) will be sponsored by the United States Centre for Disease
Control and Prevention, in partnership with the Ministry of Public Health and
with pharmaceutical support from Gilead Sciences.

Pending approval from three ethical review boards, the study aims to enrol 1,600
drug-users to test the efficacy of the drug in preventing the spread of HIV
through intravenous drug use.

Like studies before it, the trial has prompted concern among anti-Aids advocates
and human-rights activists because the subjects of study, injecting drug-users,
are often marginalised in Thai society. For researchers, this group is an easy
target for any kind of drug study. Indeed, researchers know full well the power
they have over drug-users, who might feel compelled to enrol if they are to
receive services. Drug-users are also vulnerable to studies that pay scant
attention to ethical considerations, not to mention the negative attitudes held
against them by officials and researchers, as has been witnessed before trails
of anti-Aids vaccines carried out by the Bangkok Metropolitan Administration.

HIV-positive injecting drug-users may be pressured to quit drugs in order to be
eligible for healthcare services, including anti-retroviral therapy. Activists
call this a form of discrimination in the healthcare setting. While there is no
evidence-based policy to maintain methadone, which is primarily provided for
detoxification programmes, poor outreach has been severely compromised by the
dangerous legal and political environment, according to rights activists.

In addition, they say, drug-treatment programmes, which primarily promote
abstinence, eschewing scientific- and therapeutic-based approaches, have put
injecting drug-users at increased risk of HIV infection in pre-trial detention
and prison.

The concerns raised by non-governmental organisations, including the Thai
Drug-Users' Network, the Thai Aids Treatment Action Group (TTAG), the Thai NGO
Coalition on Aids (TNCA), MSF-Belgium/Thailand and the Centre for Aids Rights,
about possible unethical or substandard measures in testing should therefore be
taken into consideration.

The fact that the study will involve a placebo is an area of concern. Activists
have pointed to the provision in the international convention, the Declaration
of Helsinki, which emphasises the importance of care in studies involving a
placebo-controlled trial. Indeed in many industrialised countries, including the
US, the use of placebos is prohibited if proven prophylactic, diagnostic and
therapeutic methods exist.

Whether injecting drug-users who participate in the trial will receive
information about the most effective prevention tools remains unclear.

Tenofovir is being tested in multiple sites around the world, including the US.
Participants will be offered prevention package including condoms. However,
injecting drug-users should also be equipped with other tools that have been
proved to be effective in the reduction of infections , clean needles and
syringes.

Indeed, to match the government's pledge to support harm reduction and the
active involvement of drug-users, researchers should embrace a comprehensive
harm-reduction approach in this kind of study and in the standards of care for
injecting drug-users.

Researchers on the Tenofovir study need to ensure that the quality of referrals,
support, treatment and care that the trial participants will receive through the
public healthcare system are guaranteed.

Another issue of concern is how the participants in the trial will gain access
to the drug after the trial. This issue must be clearly identified in the study
protocol. Who should have access to the drug is another vital issue to consider,
as well as the negotiated price of the drug that Thailand, as a host country,
should benefit from.

Community involvement meanwhile should be treated as an essential element of the
study. Representatives of drug-users, NGOs and activists should be involved from
the outset on any official committee and not just as part of a community
advisory board normally set up after all protocols have been accepted.

______________________
A cross posting from HIV-News-AsiaPacific@...
[hiv-news-asiapacific] No 415 – China, Thailand and Vietnam (14 December 2004)

Dear Friends,

I am writing to inform you that the UNDP South East Asia HIV and
Development Programme (UNDP-SEAHIV) will be closing down on 31 December
2004 following an internal restructuring of the UNDP.

It has been my privilege for the past six years to assist the countries
in South East Asia to become better aware of the inter-relations between
HIV and development processes and to assist in the formulation of
policies and programmes that would address this inter-relationship
through development processes and factors.

Through our joint efforts and collaboration, we have achieved in
building a knowledge base to inform decision-making and action under the
principles of governance. The pillars of the Programme have been
developing Early Warning Rapid Response Systems (EWRRS), mapping
techniques and community empowerment (e.g. Farmers' Life Schools). We
have also been able to identify mobility systems and have facilitated
the cooperation between various development sectors such as transport,
construction and agriculture. This has led, for example, to the signing
of the first Memorandum of Understanding (MOU) which has now just been
expanded and signed for another five years (2004 -2009); the Regional
Task Force on Mobility and HIV Vulnerability Reduction, and over 50
publications and other materials in English that have also been
translated into Bahasa, Burmese, Chinese, Khmer, Laotian, Thai, Tagalo
and Vietnamese. Most of these materials can be found on the SEAHIV
website at: www.hiv-development.org <http://www.hiv-development.org/> .

Through these efforts, I have had the opportunity to work with many
committed and innovative government officials from AIDS programmes,
development sectors, donor and NGO representatives, researchers and
experts, colleagues from various organizations within the United Nations
system and the dedicated members of my team. All these partners of the
Programme came from a wide range of backgrounds in agriculture and rural
development, construction, land transport, maritime industry, planning
and poverty reduction, among others. The success of the Programme is
largely due to their continuing cooperation and support. Thus, I hope to
have contributed my share in preventing and mitigating the impacts of
HIV/AIDS epidemics, which continue to grow in the region. I appreciate
UNDP in providing me with such a unique opportunity to serve the people
in this region.

For future contacts, I can be reached at zeehsu@...

Lee-Nah Hsu
Manager
UNDP South East Asia HIV and Development Programme
Convenor
United Nations Regional Task Force on Mobility and HIV Vulnerability
Reduction

Call to Mainstream Fight Against HIV/AIDS

Fri Dec 10, 7:19 AM ET, World - OneWorld.net

Rajiv Tikoo

NEW DELHI, Dec 10 (OWSA) - Militarization and globalization have been
identified as the key challenges in the fight against HIV (news - web
sites)/AIDS (news - web sites) at a recent conference in Indian
capital New Delhi.

The Asia Pacific Conference on HIV/AIDS and Governance on December 2-
3 sought to establish linkages between HIV/AIDS and governance and
discuss an action strategy to bring in governance approach to action
at the grassroots level.

Organized by the Asia Pacific Peoples Alliance to Combat HIV/AIDS
(APPACHA) and ActionAid International, the conference had 70
participants from 15 countries like Australia, Bangladesh, Cambodia,
India, Nepal, Thailand, Viet Nam, and The Philippines.

They shared their country experiences. Saying that the existing
government structures are not sufficient to tackle the threat of
HIV/AIDS, Chitralekha Yadav, deputy speaker of the Royal Nepalese
Government, added, But I am hopeful. HIV/AIDS is getting high on
priority in Nepal with the Prime Minister taking a personal interest
in it.

Participants deliberated on the impact of HIV/AIDS on democracy, the
need for multi-sectoral alliances, formulation of accountability
frameworks, advantages of community-based approach to monitoring and
evaluating budgeting, role of civil society and social capital,
inseparability of community and human rights and governance of the
creation and the use of domain knowledge.

More importantly the conference sought to bond a wider section of
stakeholders including people living with HIV/AIDS, trade unions
workers, health and human rights activists, law makers, medical
professionals, politicians and international agencies.

Admitting that there wasnt sufficient representation from the
government, Convener of Peoples Health Movement-India, B Ekbal added:
Its time to do introspection for all of us - not just for the
government, but for all of us. Added T S Rajakumari from FXB Society,
Vishakhapatanam, India, Its imperative for NGOs, citizens and the
governments to work together.

And this is what APPACHA is trying to do. It is acting as a platform
to forge alliances between people living with HIV/AIDS, trade union
activists, students, youth groups, healthcare workers and others in
the fight against HIV/AIDS. Said Unnikrishnan PV, Asia advisor,
International Emergencies Team, ActionAid International, HIV/AIDS is
a hostage in the hands of international NGOs and corporates. APPACHA
is an effort to reach out to unusual suspects in the HIV/AIDS
discourse.

Added John Samuel, international director, ActionAid International,
The idea is to make HIV/AIDS a mainstream political issue than a
sectoral concern of the government. We need political movements
similar to the ones in Uganda and Thailand.

http://news.yahoo.com/news?
tmpl=story&u=/oneworld/20041210/wl_oneworld/4591993771102684793

Dear moderator/Forum members,

Ref: Singapore  for pre-marital HIV test, Is there any follow up guidance, if
one of the couple found to be HIV (+)?

This is an important issue for us in confronting the Human Right issue.

Please let us know.

Dr.Suharto (NAC Indonesia).
E-mil: <doc_suharto@...>

News: Singapore may test couples for HIV before marriage
05 Dec 2004
***********

SINGAPORE (Reuters) -- Couples in Singapore may face mandatory HIV tests before
marrying, Singapore media reported on Sunday, a week after the government said
all pregnant women would be screened for HIV/AIDS to stem a rise in new
infections.

Health Minister Khaw Boon Wan said Singapore planned to seek public feedback on
the pre-marital HIV tests in the wealthy, tightly controlled city-state, where
the number of new HIV infections reached a record high this year.

"If you ask me as a parent, I think there is no harm. I have three girls and you
do not know what their boyfriends will be like," Khaw was quoted by The Straits
Times as telling local reporters on Saturday.

"I think we are more likely to succeed if we treat this as a purely public
health problem, so let's take away the morality and religion from all this," he
said.

Although the Southeast Asian island has one of Asia's lowest levels of HIV
infection, it is tightening defences after data from health workers showed women
and girls in Asia increasingly at risk of becoming infected with the deadly
disease.

Khaw said Singapore was at the beginning of a second wave in the development of
HIV, where more women are becoming infected. Singapore media reports have
recently focused on the problem of men visiting prostitutes while travelling in
Asia.

The number of new infections are already at a record high this year with 257
cases reported in the first 10 months of 2004, topping the 242 new cases
reported for all of 2003.

Health officials say Singapore, a tiny island of 4.2 million people, could face
1,000 new cases a year by 2010 according to current trends. To date, Singapore
has recorded a total of 2,332 HIV infections, of whom 874 have died.

Activists say AIDS awareness efforts are undermined in Singapore by antiquated
laws that make gay sex illegal between men.

Online at: http://www.alertnet.org/thenews/newsdesk/SIN247521.htm

Cross posted from: SEA-AIDS
by : A. SANKAR
Executive Director
EMPOWER

Two factors in the Asia Pacific region look more overwhelming than
ever before: the rapidly rising rate of HIV infection and the
increasing feminisation of the epidemic.

With 8.2 million people infected, Asia Pacific has more people
living with HIV/AIDS than any other region in the world except Sub
Saharan Africa. More than half a million people died due to AIDS-
related illnesses in 2004 and twice as many people were newly
infected during the same period - a disturbing epidemic momentum,
particularly in view of the fact that until the late 1980s no
country in the region had a major HIV epidemic.

What causes graver concern is the uneven rise of infection among
women. About one third of people living with HIV/AIDS in the region
now are women compared to about 20 per cent a decade ago. In fact,
the number of women living with HIV grew by 13 per cent between 2001
and 2003.

Women and HIV: the multiple jeopardy

Surveillance systems tell us how the epidemic is spreading. But what
they often fail to tell us is that the spread of HIV is closely
linked to relationships and power dynamics between individuals and
within communities that are grossly unfavourable to women. The low
economic and social status of women; the endemic abuse and violence
against them; lack of recourse measures, and limited legal and
social protection increase their vulnerability to HIV. For many
women in the region, sexual intercourse is not a question of choice,
but rather a question of survival and duty. A woman's fertility and
her relationship to her husband is often the source of her social
identity. As the UN Secretary General, Mr. Kofi Annan says, social
inequalities put them at risk - unjust, unconscionable and
untenable.

Dominant social constructs in the region dictate that a married
woman has little or no power to negotiate the nature of her sexual
relationship with her husband. We also know that increased income
alone does not lead to empowerment and autonomy of women in the
absence of legal, ethical and social environment that will allow
them to gain better control of their lives.

More than half the new infections in the world are among people of
15-24 years of age. Among them, women face the highest risk. In
addition, younger girls are increasingly being forced into sexual
relations and prostitution in an attempt by men to avoid infection
and also from a mistaken belief that intercourse with a virgin can
cure them of the virus.

Another strong determinant in women's vulnerability to HIV in Asia
Pacific is the oppressive violence against them, which range from
homes to workplaces. Violence and HIV are mutually reinforcing, both
directly through rape and sexual coercion, but also indirectly by
predisposing women to risky behaviour later in life. There is also
growing evidence that HIV can be a precursor to violence as women
face retribution for disclosing their HIV status.

In Asia Pacific, the vulnerability of women also arises from unsafe
mobility and trafficking. In several parts of the region, women are
compelled to move within their countries and across national borders
in unsafe conditions and without adequate preparedness. Such
situations in many cases, lead to their being trafficked. Studies on
trafficking and HIV linkages show that one out of three trafficked
survivors are HIV positive.

What is apparent, but unseen, is that unless the interaction between
HIV infection, cultural values and the rights and needs of women are
recognised, the fundamental changes required to stem the epidemic
will be unattainable. Where women are denied dignity and respect,
HIV/AIDS spreads.

HIV and the Human Development Linkages

One of Asia's major challenges in containing the epidemic is also
that a large part of its population live on the margins of society
and their vulnerabilities are not recognised: mobile workers and
their families, rural families clustered in urban slums, sex
workers, men having sex with men, injecting drug users and women and
children living and working under hazardous or exploitative
conditions.

HIV is not random in its spread and impact. Bulk of the epidemic
burden is on the poor, the marginalised (sex workers, injecting drug
users, men having sex with men, migrant labourers and their families
and trafficked persons), the youth and women. This is because social
inequalities facilitate the spread of the virus and the virus in
turn reflects and reinforces these inequalities.

The learning from the last two decades show that HIV is not just
a "disease", but a manifestation of poor human development and deep-
rooted socio-economic and cultural factors that we have failed to
address over the years. There are many more disconcerting factors
that call for urgent responses. Key among them are the intense
stigma and discrimination and violation of rights faced by people
living with HIV/AIDS, lack of access to treatment, inadequate
leadership, lack of integrated responses and shortage of resources.

For instance a study by the Asia Pacific Network for People Living
with HIV/AIDS (APN+) showed that 80 per cent of the respondents have
experienced discriminatory practices. The rights violations have
been from moderate to repressive: from denial of treatment and
eviction from jobs to fatal assaults. On the treatment front, as the
latest UNAIDS report shows, fewer than 6 per cent of people who
require antiretroviral treatment are receiving it.

On the resource front, a recent ADB study says that in 2001, the
countries in the region required more than US $ 1.5 billion to
finance a comprehensive response, but had only 200 million. From
2007, as much as US $ 5.1 billion will be required each year. The
brighter side of the coin, however, is the fact that it is only 0.2
per cent of the regional gross income.

HIV/AIDS is indeed a daunting challenge, but it also offers
opportunities. (There are success stories such as Thailand,
Cambodia, Uganda and Brazil.) It is not the first epidemic in human
history. Neither will it be the last. What sustains such epidemics
is poor human development. Needless to say, the answer is good human
development practice.

The Millennium Development Goals (MDGs), that have become a
framework for development practice, recognises the impact of HIV on
human development by listing reversal of the epidemic as a key goal.
There is absolute consensus among sociologists, economists and
development practitioners that without achieving the MDG on HIV,
attainment of all the other MDG is in jeopardy.

That definitely does not augur well for global humanity and we are
left with only one choice: the choice of multi-sectoral action that
respects the rights of women, marginalised communities and HIV
positive people.


By Sonam Yangchen Rana

The author is a senior UNDP official and heads the UNDP Regional HIV
and Development Programme in Asia Pacific.

To access the column online please click on the link
http://www.youandaids.org/Guest Column/SYR/index.asp

ASIA  PACIFIC  ALLIANCE  TO  COMBAT  HIV & AIDS
  &
ACTIONAID  INTERNATIONAL

Press Release:  New Delhi, 2nd December 2004:

"MILITARISATION  AND  WTO  ARE  KEY  CHALLENGES
IN  THE  FIGHT  AGAINST  HIV/ AIDS  AND  POVERTY".

"Militarisation and WTO (World Trade Organization) are key
challenges in the fight against HIV/ AIDS and poverty" said Rep.
Satur C Ocampo, Senator and President of Bayan Muna (People First),
Philippines. He was addressing Asia Pacific Conference on HIV/ AIDS
and Governance. "Place poverty in the top of the agenda in the
fight
against HIV/ AIDS" he said.

The fight against HIV/ AIDS in Asia Pacific region received a boost
today as People Living with HIV/ AIDS, trade unionists, health and
human rights activists, law makers, medical professionals,
politicians and international agencies came together for this two
days conference.

The conference that began today is jointly being organized by Asia
Pacific People's Alliance to Combat HIV/ AIDS (APPACHA) and
ActionAid International- (AAI).

APPACHA is a new initiative that brings people from various walks of
life together (like People living with HIV/ AIDS, trade unions,
student and youth groups, health activists and others) in the fight
against HIV/ AIDS. AAI works in over 40, countries, some of
them `flash points' of the HIV/ AIDS epidemic.

"Solidarity, synergy and participation are crucial in addressing
HIV/ AIDS and its governance issues" said Mr. K.K. Abraham,
President of INP + during the inaugural session. "Getting care
and
treatment is a challenge" he said.

"Epidemic is far from control" said Ms. Chitralekha Yadav,
Deputy
Speaker of the Royal Nepalese Government. "The existing
governance
structures are not competent enough to tackle the crisis" she
said.

Consider the facts:

• Every 24 hours over 8,000 people die worldwide from HIV/
AIDS. Majority of them are poor.
• Last year, the epidemic killed over 3 million people – most
of them from Africa.
• 39.4 million people are living with HIV/ AIDS worldwide.
This is a big jump from the situation in 2002 when over 36.6 million
were affected.
• Women are badly hit. The number of women living with HIV has
increased across the world. UN agencies report that close to half of
37.2 million positive adults (aged 15 to 49 years) are women.
"The
steepest increase is in Asia. In East Asia, there was a 56 %
increase in the past 2 years. Eastern Europe and Central Asia comes
next with 48 %" said a recent report by UNAIDS.
• In Sub Saharan Africa, the worst AIDS affected region in the
world, nearly 60 % adults living with HIV/ AIDS are women– that
is
13.3 million, nearly the population of India's capital city, New
Delhi.

"Go beyond the numbers and statistics" said John Samuel,
International Director, ActionAid International. "Put people
first
to make the system accountable" he said. The conference is
expected
to raise hard questions about the lack of accountability and
transparency.

"Time to do a soul searching- not just for the government, but
also
for other civil society  actors" said Prof. B. Ekbal, former Vice
Chancellor of University of Kerala and convener of People's
Health
Movement- India. "Epidemic and its politics are too complex to be
left to any single entity" he said.

"Absence of choices is making people more vulnerable" said
Ms. Sonam
Yangchen Rana, Senior Advisor, Regional HIV and Development
Programme, UNDP, New Delhi. "Integrated responses are
necessary" she
said.

"Media needs to fight the fatigue of reporting HIV/ AIDS"
said Ms.
Nupur Basu from India, a journalist associated with New Delhi
Television. "We are yet to unleash the power of the media"
she said.

"Patents shouldn't come in the way of accessing essential
medicines"
said Vivek Divan of Lawyer's Collective, India. The changes in
the
patent laws, under the directions of WTO, will increase the drug
prices several times and thus making it unaffordable for the poor
people.

Impact of the HIV/ AIDS epidemic on workers and labour force was
reiterated by most of the speakers on this opening day of the
conference.

The conference is expected to amplify the voices of People Living
with HIV/ AIDS and communities they live in. A regional action plan
for better governance, strengthening of the primary health care
system and access to treatment and care for people living with HIV/
AIDS is an expected outcome.

For media enquiries: +91-(0)98450 91319 (Dr. Unnikrishnan PV) +91-98180 65092
(Ms.Kiran Shaheen)

ActionAid International- India; C 88; South Extention Part 2; New
Delhi 110 049